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Biomedical subjects

Costanza Emanueli

Publications and source records attributed to Costanza Emanueli.

24 records · Page 2Linked to original sources

Targeting kinin B(1) receptor for therapeutic neovascularization.

BACKGROUND: Kinins are modulators of cardiovascular function. After ischemic injury, enhanced kinin generation may contribute in processes responsible for tissue healing. METHODS AND RESULTS: Using pharmacological and genetic approaches, we investigated the role of kinin B(1) receptor in reparative angiogenesis in a murine model of limb ischemia. The effect of B(1) pharmacological manipulation on human endothelial cell proliferation and apoptosis was also studied in vitro. Abrogation of B(1) signaling dramatically inhibited the native angiogenic response to ischemia, severely compromising blood perfusion recovery. Outcome was especially impaired in B(1) knockouts that showed a very high incidence of limb necrosis, eventually leading to spontaneous auto-amputation. Conversely, local delivery of a long-acting B(1) receptor agonist enhanced collateral vascular growth in ischemic skeletal muscle, accelerated the rate of perfusion recovery, and improved limb salvage. In vitro, B(1) activation stimulated endothelial cell proliferation and survival, whereas B(1) antagonism induced apoptosis. CONCLUSIONS: Our results indicate that the B(1) plays an essential role in the host defense response to ischemic injury. B(1) signaling potentiation might be envisaged as a utilitarian target for the treatment of ischemic vascular disease.

Animals↗

Reversal of angiogenic growth factor upregulation by revascularization of lower limb ischemia.

BACKGROUND: Tissue kallikrein (tK) and vascular endothelial growth factor (VEGF) are potent angiogenic agents. Upregulation of tK or VEGF was documented in animal models of acute ischemia, yet it remains unknown whether these endothelial cell mitogens are overexpressed in chronic peripheral vascular insufficiency. METHODS AND RESULTS: Circulating tK and VEGF were measured in 36 patients with symptomatic peripheral vascular disease before and after surgical revascularization. In 6 patients without symptoms at rest, tK was assayed after exercise stress test. VEGF levels fell within the normal range in all patients (96+/-11 versus 109+/-13 pg/mL in healthy control subjects, P=NS) and remained unchanged after revascularization. In contrast, tK expression was upregulated in 34 of 36 patients (1107+/-203 versus 85+/-10 pg/mL in control subjects, P<0.05), with no further increase after exercise. Tissue kallikrein levels in the venous effluent of ischemic limbs were found to be positively correlated with the number of angiographically recognizable collateral vessels (P<0.001). Follow-up studies documented reversal of tK upregulation after revascularization (P<0.01), whereas no change was observed in venous samples from untouched legs. CONCLUSIONS: Induction of tK could represent a compensatory response to chronic arterial insufficiency, attempting to maintain an adequate tissue perfusion. Heterogeneous statement of growth factors may have important implications in reparative and therapeutic angiogenesis.

Adult↗

Ramipril improves hemodynamic recovery but not microvascular response to ischemia in spontaneously hypertensive rats.

BACKGROUND: Angiotensin converting enzyme (ACE) inhibition exerts positive effects on the microvasculature of normotensive animals, although this concept is not universally accepted. Recently, ACE inhibitors have been suggested to be useful for rescue in peripheral ischemia. METHODS: We investigated whether chronic treatment with the ACE inhibitor ramipril may have a positive impact on the defective healing response to ischemia that is typical of spontaneously hypertensive rats (SHR). Unilateral limb ischemia was induced in 20-week-old SHR by surgically removing the left femoral artery. Rats were allowed to regain consciousness and then were randomly allocated to treatment with ramipril (1 mg/kg body weight in drinking water) or vehicle for 28 days. RESULTS: The SHR failed to develop reparative angiogenesis in response to ischemia, thus having inadequate perfusion recovery. Ramipril reduced both tail-cuff systolic blood pressure (180 +/- 7 v 207 +/- 2 mm Hg in the vehicle group at 28 days, P < .05) and intra-arterial mean blood pressure (115 +/- 6 v 135 +/- 5 mm Hg in the vehicle group, P < .05). These effects were associated with increased responsiveness to endothelium-dependent vasodilatation by acetylcholine. Treatment with ramipril did not influence muscular capillary and arteriole density but accelerated the rate of perfusion recovery, leading to complete healing within 28 days after surgery. CONCLUSIONS: These results indicate that ACE inhibition by ramipril may be useful for the treatment of peripheral vascular complications in hypertension.

Angiotensin-Converting Enzyme Inhibitors↗

Angiotensin AT(1) receptor signalling modulates reparative angiogenesis induced by limb ischaemia.

1. The concept that angiotensin II exerts pro-angiogenic activity is not universally accepted. We evaluated whether inhibition of the renin-angiotensin system (RAS) would influence reparative angiogenesis in a murine model of limb ischaemia. 2. Perfusion recovery following surgical removal of the left femoral artery was analysed by laser Doppler flowmetry in mice given the ACE inhibitor ramipril (1 mg kg(-1) per day), the AT(1) antagonist losartan (15 mg kg(-1) per day), or vehicle. Muscular capillarity was examined at necroscopy. Ramipril-induced effects were also studied under combined blockade of kinin B(1) and B(2) receptors. Furthermore, the effects of ischaemia on AT(1) gene expression and ACE activity were determined. 3. In untreated mice, muscular AT(1a) gene expression was transiently decreased early after induction of limb ischaemia, whereas AT(1b) mRNA was up-regulated. ACE activity was reduced in ischaemic muscles at 1 and 3 days. Gene expression of AT(1) isoforms as well as ACE activity returned to basal values by day 14. Spontaneous neovascularization allowed for complete perfusion recovery of the ischaemic limb after 21 days. 4. Reparative angiogenesis was negatively influenced by either ramipril (P<0.02) or losartan (P<0.01), leading to delayed and impaired post-ischaemic recovery (50 - 70% less compared with controls). Ramipril-induced effects remained unaltered under kinin receptor blockade. 5. The present study indicates that (a) expression of angiotensin II AT(1) receptors and ACE activity are modulated by ischaemia, (b) ACE-inhibition or AT(1) antagonism impairs reparative angiogenesis, and (c) intact AT(1) receptor signalling is essential for post-ischaemic recovery. These results provide new insights into the role of the RAS in vascular biology and suggest cautionary use of ACE inhibitors and AT(1) antagonists in patients at risk for developing peripheral ischaemia.

Angiotensin II↗

Levels of human tissue kallikrein in the vitreous fluid of patients with severe proliferative diabetic retinopathy.

The aim of this study was to determine the levels of human tissue kallikrein in the vitreous fluid of patients with severe proliferative diabetic retinopathy (PDR). Tissue kallikrein levels were measured using a specific ELISA (range: 0.4-25 ng/ml) in 7 vitreous fluids from eyes with severe PDR. Seven vitreous samples from eyes which underwent vitrectomy because of rhegmatogenous retinal detachment served as non-PDR controls. Enzymatic activity was also tested by an amidolytic assay using a chromogenic substrate. In the PDR patients, vitreous tissue kallikrein was <0.4 ng/ml (5 eyes) or very low (0.52 and 0.58 ng/ml). Vitreous tissue kallikrein was <0.4 ng/ml in all non-PDR controls. These results were confirmed by the amidolytic test. Results suggest that vitreous tissue kallikrein probably plays either a secondary or no role in the pathogenesis of PDR.

Adult↗