Cyclisches Adenosinmonophosphat ist ein ubiquitärer zweiter Botenstoff zahlreicher Signalwege im menschlichen Körper. Auf eine Vielzahl verschiedenster extrazellulärer Signale folgt jedoch eine Erhöhung desselben intrazellulären Botenstoffs - cAMP. Nichtsdestotrotz schafft es die Zelle, Signalspezifität aufrecht zu erhalten. Ein anerkanntes, wenn auch bisher unverstandenes Modell, um dieses zu ermöglichen, ist das Prinzip der Kompartimentierung. Die Zelle besitzt demnach Areale verschieden hoher cAMP-Konzentrationen, welche lokal begrenzt einzelne Signalkaskaden beeinflussen und somit eine differenzierte Signalübertragung ermöglichen. Eine mögliche Ursache für die Ausbildung solcher Bereiche geringerer cAMP- Konzentrationen (hier als Domänen bezeichnet), ist die hydrolytische Aktivität von Phosphodiesterasen (PDEs), welche als einzige Enzyme die Fähigkeiten besitzen, cAMP zu degradieren. In dieser Arbeit wird der Einfluss der cAMP-Hydrolyse verschiedener PDEs auf die Größe dieser Domänen evaluiert und mit denen der PDE4A1 verglichen, welche bereits durch unsere Arbeitsgruppe aufgrund ihrer Größe als Nanodomänen definiert wurden. Der Fokus wird dabei auf den Einfluss von kinetischen Eigenschaften der Phosphodiesterasen gelegt. So werden eine PDE mit hoher Umsatzgeschwindigkeit (PDE2A3) und eine PDE mit hoher Substrataffinität (PDE8A1) verglichen. Mithilfe sogenannter Linker, Abstandshaltern definierter Länge, werden zusätzlich die Nanodomänen ausgemessen, um einen direkten Zusammenhang zwischen Größe und kinetischer Eigenschaft anzugeben. Die Zusammenschau der Ergebnisse zeigt, dass die maximale Umsatzgeschwindigkeit der Phosphodiesterasen direkt mit der Größe der Nanodomänen korreliert. Durch den unmittelbaren Vergleich der gesamten PDE mit ihrer katalytischen Domäne wird zusätzlich der Einfluss von regulatorischen Domänen evaluiert. Es wird gezeigt, dass diese cAMP-Gradienten modulieren können. Bei der PDE2A3 geschieht die Modulation u.a. durch Stimulation mit cGMP, welche höchstwahrscheinlich dosisabhängig ist und somit graduell verläuft. Hiermit präsentieren sich die Domänen als dynamische Bereiche, d.h. sie können in ihrer Ausprägung reguliert werden. In dieser Arbeit wird die Hypothese bestätigt, dass Phosphodiesterasen eine wichtige Rolle in der Kompartimentierung von cAMP spielen, die Gruppe jedoch inhomogener ist, als bislang angenommen. Die Gradienten-Bildung lässt sich nicht bei jeder Phosphodiesterase darstellen (PDE8A1). Einige Phosphodiesterasen (PDE2A3) jedoch bilden Kompartimente, die durch externe Stimuli in ihrer Größe reguliert werden können. Die Arbeit legt den Grundstein zur breiteren Charakterisierung des spezifischen Einflusses weiterer PDEs auf cAMP-Kompartimentierung, welches nicht nur das Verständnis der Kompartimentierungs-Strategien voranbringt, sondern auch essentiell für das Verständnis der Pathophysiologie zahlreicher Krankheitsbilder, aber auch für das Verständnis bereits angewandter aber auch potentiell neuer Medikamente ist. / Cyclic AMP is a ubiquitous second messenger, which is involved in a huge variety of signaling pathways. Nevertheless, thinking about signaling specificity, it is unclear how numerous diverse signals are all translated via the same second messenger. However, to ensure downstream specificity there is one accepted model - the compartmentalization of cAMP. Different levels of cAMP therefore lead to signaling islets or areas, which ensure a more diverse downstream signaling. One example, which guarantees areas with lower cAMP concentration, is the local hydrolysis of cAMP due to phosphodiesterases’ hydrolytic activity. In this thesis the ability of different phosphodiesterases to build cAMP gradients is compared to the ability of the PDE4 to build cAMP domains in the scale of nanometers, which was already shown by our group. To discriminate influence factors of the formation of those nanodomains, the focus was set on distinct PDEs’ kinetic properties. Therefore, a PDE with a high velocity (PDE2A3) for cAMP hydrolysis is compared to the PDE with the highest known affinity (PDE8A1) to cAMP. Furthermore, with the tools provided by our group, linkers, which are “nanorulers” of distinct size, were used to directly measure the radius of those domains. It is revealed, that the size of the nanodomains directly correlates with the hydrolysis velocity. Furthermore, by comparison of full length PDE with its catalytic domain, it is shown, that their regulatory domains can modulate the ability of phosphodiesterases to create cAMP gradients. In PDE2A3, modulation of cAMP gradients was observed upon cGMP stimulation, which probably occurs in a concentration-dependent matter. Thus, cAMP domains seem to be dynamic areas, i.e. they can be regulated in their size. It is postulated, that phosphodiesterases are one important force for creating compartments, but the family of PDEs itself is inhomogeneous. Not every PDE can build detectable compartments (PDE8A1), but others can build compartments, which are regulated through external stimuli (PDE2A3). The thesis builds the foundation for additional characterization of the other PDE families, which would provide further insight in strategies of cAMP compartmentalization. Moreover, the knowledge of distinct functions of PDEs on cAMP compartments is crucial for the understanding of the pathophysiology of several diseases and the understanding of present and future pharmacological therapies.

Nitric oxide is released from the endothelium and causes relaxation of vascular smooth muscle by stimulating guanylate cyclase to produce guanosine 3’,5’-cyclic monophosphate (cGMP) which, in turn, is degraded by phosphodiesterase type 5 (PDE5). Inhibition of PDE5, with drugs like sildenafil citrate, promotes NOstimulated relaxation of vascular smooth muscle. The overall aim of the work contained within this thesis was to further characterise the systemic vascular effects of PDE5 inhibition. Four clinical studies were performed. The aims of the first study were to investigate in healthy men the effect of smoking on endothelium-dependent vasomotor function measured as the change in peripheral arterial wave reflection with inhaled salbutamol, and the effect of acute sildenafil 100 mg on this response. Smokers (n=12) exhibited a reduced response to inhaled salbutamol compared to non-smokers (n=11) [mean(standard deviation) area under the curve of the change in central augmentation index following salbutamol 400 μg: -29(143) AU in smokers vs -159(124) AU in non-smokers, P=0.03]. In the smokers, there was a trend to an improvement in the response to salbutamol following sildenafil [-96(266) AU vs -29(143) AU with matched placebo; P=0.2]. The co-administration of glyceryl trinitrate (GTN) and sildenafil is absolutely contraindicated because of the potential for profound hypotension. The aim of the second study was to characterise the time course of this interaction. Twenty men with stable angina, maintained on their usual medicines, were administered sublingual GTN 400 μg 1, 4, 6 and 8 hours after sildenafil 100 mg or matched placebo. Compared to the combination of GTN and placebo, the combination of GTN and sildenafil resulted in greater mean maximum reductions from baseline in sitting systolic blood pressure (BP) at 1, 4 and 8 hours, and in sitting diastolic BP at all time points (all P<0.05). Compared to placebo, sildenafil alone reduced systolic BP at 1, 4, 6 and 8 hours (P<0.01 at 1 hour and P<0.05 at 4, 6, and 8 hours) and diastolic BP at 4, 6, and 8 hours (all P<0.01). Analysis of the change in BP from the measures taken before each GTN challenge suggested that the interaction on BP might be synergistic at 1 hour after sildenafil, but no more than additive at 6 and 8 hours after sildenafil. Symptoms consistent with hypotension occurred following GTN in 6 subjects at 1 hour and 3 subjects at 4 hours after sildenafil, but in no subjects at 6 and 8 hours after sildenafil or at any time after placebo. In the third study, 25 otherwise untreated hypertensives were given sildenafil 50 mg or matched placebo three times daily for 16 days and the effects on ambulatory BP, clinic BP, arterial wave reflection, carotid-femoral pulse wave velocity and brachial artery flow-mediated dilatation were measured. Three subjects were withdrawn because of side effects and the data from the remaining 22 subjects were analysed. Sildenafil reduced ambulatory BP [change from baseline in average daytime BP: systolic -8(9) mmHg vs 2(9) mmHg with placebo, P<0.01; diastolic -6(5) mmHg vs 0(6) mmHg, P<0.01] and clinic BP [change from baseline to 1 hour after drug administration on day 16: systolic -5(11) mmHg vs 4(10) mmHg, P<0.01; diastolic -5(5) mmHg vs 2(7) mmHg, P<0.01]. Sildenafil, but not placebo, reduced arterial wave reflection [central augmentation index from 32(9)% at baseline to 30(10)% at 1 hour after administration on day 16, P<0.05; radial augmentation index from 88(13)% to 84(13)%, P<0.01], but the change in arterial wave reflection was not statistically significant compared to the change with placebo. Sildenafil did not affect pulse wave velocity or flow-mediated dilatation. The fourth study investigated the potential of combined PDE5 inhibition and organic nitrate for the management of treatment-resistant hypertension (TRH). In 6 patients with TRH, maintained on their usual antihypertensives sildenafil 50 mg alone, isosorbide mononitrate (ISMN) 10 mg alone and co-administered sildenafil and ISMN all acutely reduced systolic BP and diastolic BP compared to placebo (quantified as the area under the curve of the change from baseline to 4 hours after drug administration; all P≤0.01). The combination produced a greater reduction in systolic BP than did either sildenafil alone (P=0.03) or ISMN alone (P=0.01) and a greater reduction in diastolic BP than did sildenafil alone (P=0.02). Compared to placebo, from 1 to 3 hours after drug administration BP was on average 13/10 mmHg lower with sildenafil alone, 18/14 mmHg lower with ISMN alone and 26/18 mmHg lower with the combination. The following conclusions were made. (1) Smokers exhibit impaired vascular responsiveness to inhaled salbutamol, indicating systemic endothelial dysfunction, which may be improved by sildenafil. (2) In men with stable angina there is an interaction on BP reduction between sildenafil 100 mg and sublingual GTN 400 μg for at least 8 hours after sildenafil administration, but this interaction is no more than additive from 6 hours after sildenafil administration. (3) Regular sildenafil monotherapy reduces BP in hypertension. (4) In patients with TRH maintained on their usual antihypertensives sildenafil alone and ISMN alone both acutely reduce BP and there is additional BP reduction when these drugs are given in combination.

Blood vessel growth is mediated by angiogenesis, which is defined as the formation of new blood vessel out of existing vessels, as well as vasculogenesis, a process that circulating progenitor cells contributes to adult neovascularization. Cilostazol, a commercially available drug holding antiplatelet and vasodilating effects, increases intracellular cyclic adenosine monophosphate (cAMP) levels through inhibiting the activity of phosphodiesterase 3. Interestingly, this chemical compound has a lot of cellular effects. In current work, we demonstrated that cilostazol promoted proliferation and migration of human umbilical cord vein endothelial cells (HUVECs), enhanced in-vitro vascular tube formation, and increased releasing of cAMP and NO from them. Furthermore, cilostazol activated eNOS and PI3-K/Akt signaling pathways. We also examined the angiogenic and vasculogenic effects of cilostazol in a murine hindlimb ischemia model. Our data showed that cilostazol enhanced angiogenesis and vasculogenesis with resultant flow recovery after murine hindlimb ischemia partly mediated by promoting mobilization of bone marrow-derived stem cells into circulation and increasing in situ expression of some proteins involved in angiogenesis. In addition, cilostazol significant increased colony forming unit of human endothelial progenitor cells. These results are unique and clinically significant with potential in translational therapy. According to our report, further preclinical and clinical studies of cilostazol on the other ischemic situations such as myocardial infarction will be justified.

Thesis (Ph. D.)--University of Washington, 2003. / Vita. Includes bibliographical references (leaves 101-113).

Phosphodiesterases (PDEs) are the enzymes responsible for the hydrolysis of cyclic nucleotides including cAMP and cGMP. We recently discovered that natriuretic peptides elicit effects in the atrial myocardium via a PDE dependant pathway; however, the role(s) of specific PDE subtypes in atrial myocytes are not clear. Thus, I studied the effects of PDE selective blockers on mouse atrial action potentials (APs) and L-type Ca2+ currents (ICa,L). AP duration (APD) was significantly increased in the presence of IBMX (inhibits all PDEs) as well as EHNA (PDE2 inhibitor) and rolipram (PDE4 inhibitor). The PDE 3 inhibitor milrinone had no effect on APD. Applying milrinone and rolipram (PDE3/PDE4 inhibition) or EHNA, milrinone, and rolipram (PDE2/ PDE3/PDE4 inhibition) in combination prolonged APD as effectively as IBMX. A similar pattern of results was obtained for atrial ICa,L. These data provide novel insight into the unique effects of PDE inhibitors in atrial myocytes

Vascular endothelial cells (VECs) maintain vascular integrity by regulating the passage of solutes, macromolecules, and cells between the vascular and perivascular space and are critical in a wide number of physiological processes, such as the delivery of nutrients and oxygen to surrounding tissues, leukocyte trafficking, angiogenesis, and tissue repair. VEC permeability is regulated, at least in part, by VE-cadherin-based adherens junctions that coordinate inter-VEC contacts and communicate the strength of these interactions to the cell via the actin cytoskeleton. Although the ubiquitous second messenger, cyclic adenosine 3'€™, 5'€™-monophosphate (cAMP), has been shown to reduce VEC permeability, the molecular basis of this effect is currently unclear. Herein, we report that cAMP and its two effectors, cAMP-dependent protein kinase A-II (PKA-II) and exchange protein activated by cAMP-1 (EPAC1), improve barrier function and differentially coordinate this effect through both VE-cadherin and actin cytoskeletal structures. We have also identified cyclic nucleotide phosphodiesterase (PDE) 4 as the major PDE regulating VEC barrier function. Through the use of cAMP-elevating agents and RNAi-mediated knockdown of PKA-Cα, EPAC1 and PDE4D, we have identified a dominant role for EPAC1 in VEC permeability as well as recognized PDE4D as a potential adaptor protein VE-cadherin-based complexes. Our results are consistent with previous reports of a role for both PKA and EPAC1 in controlling VE-cadherin mediated barrier function and additionally provide novel insight into the differential roles that PKA, EPAC1 and PDE4D play in stabilizing VEC barrier function. / Thesis (Master, Pathology & Molecular Medicine) -- Queen's University, 2009-09-18 16:09:59.12

Thesis (Ph.D.) -- Virginia Commonwealth University, 2005. / Title from title-page of electronic thesis. Prepared for: Dept. of Physiology. Bibliography: p. 81-91.

Aims: To assess the diagnostic accuracy of four undiagnosed Type 2 diabetes mellitus risk scores accounting for erectile dysfunction status. Methods: This was a population-based cross-sectional study. Type 2 diabetes was defined according to a oral glucose tolerance test and self-reported physician diagnosis. Erectile dysfunction was defined according to the answer to the question, ‘Have you had difficulties obtaining an erection in the last 6 months?’ (yes/no). The risk scores used were the FINDRISC, LA-FINDRISC, American Diabetes Association score and the Peruvian Risk Score. A Poisson regression model was fitted to assess the association between Type 2 diabetes and erectile dysfunction. The area under the receiver-operating characteristic curve was estimated overall and by erectile dysfunction status. Results: A total of 799 men with a mean (sd) age of 48.6 (10.7) years were included in the study. The overall prevalence of Type 2 diabetes was 9.3%. Compared with healthy men, men with Type 2 diabetes had 2.71 (95% CI 1.57–4.66) higher chances of having erectile dysfunction. Having excluded men aware of Type 2 diabetes status (N=38), the area under the receiver-operating characteristic curve of three of the risk scores (not the American Diabetes Association score) improved among those who had erectile dysfunction in comparison with those who did not; for example, the area under the receiver-operating characteristic curve of the LA-FINDRISC score was 89.6 (95% CI 78.7–99.9) in men with erectile dysfunction and 76.5 (95% CI 68.5–84.4) overall. Conclusions: In a population-based study, erectile dysfunction was more common in men with Type 2 diabetes than in the otherwise healthy men. Screening for erectile dysfunction before screening for Type 2 diabetes seems to improve the accuracy of well-known risk scores for undiagnosed Type 2 diabetes. / Antonio Bernabe-Ortiz is a Research Training Fellow in Public Health and Tropical Medicine (103994/Z/14/Z), funded by the Wellcome Trust. / Revisión por pares

Indiana University-Purdue University Indianapolis (IUPUI) / Methamphetamine (METH) is a psychostimulant with high abuse potential. Currently there are no pharmacological treatments specific for relapse to METH use disorder. Chronic METH abuse has been associated with changes to the dopamine and glutamate neurotransmitter systems, as well as inflammation. Phosphodiesterase-4 inhibitors are known to affect cAMP involved in dopaminergic and glutamatergic neurotransmission, as well as having anti-inflammatory action. In pre-clinical models, phosphodiesterase inhibitors can reduce behaviors associated with the self-administration of drugs of abuse if given directly before tests of relapse-like behavior. However, they have not been examined in the more clinically relevant context as a treatment for use during abstinence from drugs of abuse. To address this gap, a METH self-administration model in the rat was used in which roflumilast, a phosphodiesterase 4 inhibitor, was administered during the abstinence period before a relapse test. The overarching hypothesis was that roflumilast inhibited inflammation associated with METH self-administration abstinence to reduce subsequent relapse-like behaviors. A detailed behavioral analysis showed that the chronic treatment with roflumilast during 7 days of forced abstinence reduced relapse-like behavior to METH seeking and METH taking. Roflumilast treatment during 7 days of forced abstinence did not affect subsequent sucrose seeking and sucrose taking behaviors. Biochemical analyses of proteins related to dopamine and glutamate neurotransmission did not reveal changes in these neurotransmitter systems, nor was there evidence of overt inflammation. These data suggest that roflumilast may be a treatment for METH use disorder that is effective when taken during abstinence, but further studies related to the mechanism of action of roflumilast are needed.

Thesis (Ph. D.)--University of Washington, 2007. / Vita. Includes bibliographical references (leaves 102-118).