Aubdool Aisah A, Thakore Pratish, Argunhan Fulye, Smillie Sarah-Jane, Schnelle Moritz, Srivastava Salil, Alawi Khadija M, Wilde Elena, Mitchell Jennifer, Farrell-Dillon Keith, Richards Daniel A, Maltese Giuseppe, Siow Richard C, Nandi Manasi, Clark James E, Shah Ajay M, Sams Anette, Brain Susan D
From Cardiovascular Division, BHF Centre of Research Excellence and Centre of Integrative Biomedicine, King's College London, United Kingdom (A.A.A., F.A., S.-J.S., S.S., K.M.A., E.W., J.M., K.F.-D., G.M., R.C.S., S.D.B.); Institute of Pharmaceutical Sciences, King's College London, United Kingdom (P.T., M.N.); Cardiovascular Division, BHF Centre of Research Excellence, James Black Centre, King's College London, United Kingdom (M.S., D.A.R., A.M.S.); Department of Cardiology and Pneumology, Medical Center Goettingen, Germany (M.S.); Cardiovascular Division, BHF Centre of Research Excellence, Rayne Institute, St Thomas' Hospital, King's College London, United Kingdom (J.E.C.); Novo Nordisk A/S, Diabetic Complications Biology, Novo Nordisk Park, Maaloev, Denmark (A.S.); and Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet, Denmark (A.S.).
Circulation. 2017 Jul 25;136(4):367-383. doi: 10.1161/CIRCULATIONAHA.117.028388. Epub 2017 Apr 26.
Research into the therapeutic potential of α-calcitonin gene-related peptide (α-CGRP) has been limited because of its peptide nature and short half-life. Here, we evaluate whether a novel potent and long-lasting ( ≥7 hours) acylated α-CGRP analogue (αAnalogue) could alleviate and reverse cardiovascular disease in 2 distinct murine models of hypertension and heart failure in vivo.
The ability of the αAnalogue to act selectively via the CGRP pathway was shown in skin by using a CGRP receptor antagonist. The effect of the αAnalogue on angiotensin II-induced hypertension was investigated over 14 days. Blood pressure was measured by radiotelemetry. The ability of the αAnalogue to modulate heart failure was studied in an abdominal aortic constriction model of murine cardiac hypertrophy and heart failure over 5 weeks. Extensive ex vivo analysis was performed via RNA analysis, Western blot, and histology.
The angiotensin II-induced hypertension was attenuated by cotreatment with the αAnalogue (50 nmol·kg·d, SC, at a dose selected for lack of long-term hypotensive effects at baseline). The αAnalogue protected against vascular, renal, and cardiac dysfunction, characterized by reduced hypertrophy and biomarkers of fibrosis, remodeling, inflammation, and oxidative stress. In a separate study, the αAnalogue reversed angiotensin II-induced hypertension and associated vascular and cardiac damage. The αAnalogue was effective over 5 weeks in a murine model of cardiac hypertrophy and heart failure. It preserved heart function, assessed by echocardiography, while protecting against adverse cardiac remodeling and apoptosis. Moreover, treatment with the αAnalogue was well tolerated with neither signs of desensitization nor behavioral changes.
These findings, in 2 distinct models, provide the first evidence for the therapeutic potential of a stabilized αAnalogue, by mediating (1) antihypertensive effects, (2) attenuating cardiac remodeling, and (3) increasing angiogenesis and cell survival to protect against and limit damage associated with the progression of cardiovascular diseases. This indicates the therapeutic potential of the CGRP pathway and the possibility that this injectable CGRP analogue may be effective in cardiac disease.
由于α-降钙素基因相关肽(α-CGRP)的肽性质和短半衰期,对其治疗潜力的研究一直有限。在此,我们评估一种新型强效且长效(≥7小时)的酰化α-CGRP类似物(α类似物)是否能在两种不同的高血压和心力衰竭小鼠体内模型中减轻和逆转心血管疾病。
通过使用CGRP受体拮抗剂在皮肤中证明了α类似物通过CGRP途径选择性发挥作用的能力。在14天内研究了α类似物对血管紧张素II诱导的高血压的影响。通过放射遥测法测量血压。在小鼠心脏肥大和心力衰竭的腹主动脉缩窄模型中,在5周内研究了α类似物调节心力衰竭的能力。通过RNA分析、蛋白质印迹和组织学进行了广泛的体外分析。
与α类似物(50 nmol·kg·d,皮下注射,该剂量在基线时未产生长期降压作用)联合治疗可减轻血管紧张素II诱导的高血压。α类似物可预防血管、肾脏和心脏功能障碍,其特征为肥大减轻以及纤维化、重塑、炎症和氧化应激的生物标志物减少。在另一项研究中,α类似物逆转了血管紧张素II诱导的高血压以及相关的血管和心脏损伤。α类似物在小鼠心脏肥大和心力衰竭模型中5周内均有效。通过超声心动图评估,它可保留心脏功能,同时预防不良心脏重塑和细胞凋亡。此外,用α类似物治疗耐受性良好,既没有脱敏迹象也没有行为变化。
在两种不同模型中的这些发现首次证明了稳定的α类似物的治疗潜力,其通过介导(1)降压作用、(2)减轻心脏重塑以及(3)增加血管生成和细胞存活来预防和限制与心血管疾病进展相关的损伤。这表明CGRP途径的治疗潜力以及这种可注射的CGRP类似物可能对心脏病有效的可能性。