desmosine and Cardiovascular-Diseases

Chronic obstructive pulmonary disease (COPD) can no longer be considered as a disease affecting only the lungs. Increasing evidence supports the presence of a systemic inflammatory component which is thought to provide the link between COPD and the co-morbidities commonly associated with this disease. These include cardiovascular disorders, skeletal muscle dysfunction, diabetes, and osteoporosis. The majority of current therapies for COPD have been developed to improve airway obstruction or to target airway inflammation, leaving an unmet medical need with respect to the systemic inflammatory component of COPD and its extra-pulmonary manifestations. This review describes systemic biomarkers in COPD and their relationship with both the local lung and systemic manifestations of the disease. A summary is provided of the most promising biomarkers that have been investigated in COPD and its co-morbidities. Such biomarkers may be used to assess and manage the systemic effects of COPD, and may guide future development of novel therapeutic interventions to provide a more holistic approach to treating this multi-faceted disease.

Topics: Adiponectin; Aging; Airway Remodeling; Biomarkers; C-Reactive Protein; Cachexia; Cardiovascular Diseases; CD40 Ligand; Chemokines, CC; Cytokines; Desmosine; Fibrinogen; Humans; Inflammation; Intercellular Adhesion Molecule-1; Isodesmosine; Lung Neoplasms; Matrix Metalloproteinases; Natriuretic Peptide, Brain; Osteoprotegerin; Pulmonary Disease, Chronic Obstructive; Pulmonary Surfactant-Associated Protein D; Serum Amyloid A Protein; Severity of Illness Index; Telomere; Uteroglobin

Topics: Aged; Biomarkers; Bronchiectasis; Cardiovascular Diseases; Cause of Death; Desmosine; Female; Humans; Male; Middle Aged

Elastin degradation is a key feature of emphysema and may have a role in the pathogenesis of atherosclerosis associated with chronic obstructive pulmonary disease (COPD). Circulating desmosine is a specific biomarker of elastin degradation. We investigated the association between plasma desmosine (pDES) and emphysema severity/progression, coronary artery calcium score (CACS) and mortality.pDES was measured in 1177 COPD patients and 110 healthy control subjects from two independent cohorts. Emphysema was assessed on chest computed tomography scans. Aortic arterial stiffness was measured as the aortic-femoral pulse wave velocity.pDES was elevated in patients with cardiovascular disease (p<0.005) and correlated with age (rho=0.39, p<0.0005), CACS (rho=0.19, p<0.0005) modified Medical Research Council dyspnoea score (rho=0.15, p<0.0005), 6-min walking distance (rho=-0.17, p<0.0005) and body mass index, airflow obstruction, dyspnoea, exercise capacity index (rho=0.10, p<0.01), but not with emphysema, emphysema progression or forced expiratory volume in 1 s decline. pDES predicted all-cause mortality independently of several confounding factors (p<0.005). In an independent cohort of 186 patients with COPD and 110 control subjects, pDES levels were higher in COPD patients with cardiovascular disease and correlated with arterial stiffness (p<0.05).In COPD, excess elastin degradation relates to cardiovascular comorbidities, atherosclerosis, arterial stiffness, systemic inflammation and mortality, but not to emphysema or emphysema progression. pDES is a good biomarker of cardiovascular risk and mortality in COPD.

Topics: Adult; Aged; Biomarkers; Body Composition; Bronchodilator Agents; Calcinosis; Cardiovascular Diseases; Case-Control Studies; Coronary Vessels; Desmosine; Disease Progression; Elastin; Emphysema; Female; Forced Expiratory Volume; Humans; Inflammation; Male; Middle Aged; Pulmonary Disease, Chronic Obstructive; Pulmonary Emphysema; Pulse Wave Analysis; Respiratory Function Tests; Risk Factors; Smoking; Vascular Stiffness

We assessed the effects of D-penicillamine (D-PA) on cross-linkages in elastin and vaso-regulatory function in rats. After administration of D-PA at a dose of 100 mg/kg/day for 7 weeks to adult and young rats, the thoracic aortas were isolated. The elastic lamellae in the aorta were disrupted histopathologically in all the treated groups. The content of cross-linkages in elastin, i.e. desmosine and isodesmosine, which gives elasticity to the aortic wall, was significantly reduced in the D-PA treated groups versus the control groups. On the other hand, the content of pyridinoline as a marker of insoluble collagen was significantly reduced in the D-PA treated groups, even though the total collagen content was not changed. In addition, after 7 weeks of treatment with D-PA, the change between systolic blood pressure before and after sympathetic stimulation (Δ-SBP) by L-epinephrine was about 2.5-fold larger than that in the control group. Similar results were obtained using angiotensin II or ouabain instead of L-epinephrine. These findings demonstrated that D-PA disrupted elastic lamellae of the rat aorta by reduction of the cross-linkages in elastin and collagen, which caused dysfunction of vaso-regulation. Also, they suggested the possibility that long-term treatment with D-PA in patients could cause a decrease in vaso-regulatory function and could increase the risk of cardiovascular events.

Topics: Administration, Oral; Age Factors; Amino Acids; Animals; Aorta; Arterial Pressure; Cardiovascular Diseases; Chelating Agents; Desmosine; Elastic Tissue; Elasticity; Elastin; Humans; Injections, Subcutaneous; Isodesmosine; Male; Penicillamine; Rats; Rats, Sprague-Dawley

We assessed the effects of rofecoxib on cross-linkage formation in elastin and vaso-regulatory function in rats. After administration of rofecoxib at a dose of 10 mg/kg for 7 weeks to young rats and for 7 and 10 weeks to adult rats, thoracic aortas were isolated. The elastic lamellae in the aortas were disrupted histopathologically in all the treated groups. However, the content of cross-linkages in elastin, i.e. desmosine and isodesmosine, which give elasticity to the aortic wall, was not significantly different between the rofecoxib treated and control groups. On the other hand, although the baseline blood pressure was not changed during the treatment period in both young and adult rats, after several weeks of treatment with rofecoxib the change between systolic blood pressure before and after sympathetic stimulation by L-epinephrine was 2 to 3-fold larger than that in the control group. Similar results were obtained using angiotensin II instead of L-epinephrine. The exposure to rofecoxib (area under the plasma concentration-time curve) of rats after single administration was a few times higher than that of humans in clinical use. These findings indicate that rofecoxib did not directly inhibit formation of cross-linkages in elastin of the aorta in rats. However, the treatment with rofecoxib for several weeks disrupted elastic lamellae and caused depression of vaso-regulatory function in rats, which could bring on an increased risk of cardiovascular events in human.

Topics: Administration, Oral; Age Factors; Amino Acids; Animals; Aorta; Arterial Pressure; Cardiovascular Diseases; Cyclooxygenase 2 Inhibitors; Desmosine; Elastic Tissue; Elasticity; Elastin; Humans; Injections, Subcutaneous; Isodesmosine; Lactones; Male; Rats; Rats, Sprague-Dawley; Sulfones

The development of atherosclerotic lesions and abdominal aortic aneurysms involves degradation and loss of extracellular matrix components, such as collagen and elastin. Releases of the elastin cross-links desmosine (DES) and isodesmosine (IDE) may reflect elastin degradation in cardiovascular diseases. This study investigated the production of soluble elastin cross-linking structures by proteinases implicated in arterial diseases. Recombinant MMP-12 and neutrophil elastase liberated DES and IDE as amino acids from insoluble elastin. DES and IDE were also released from insoluble elastin exposed to monocyte/macrophage cell lines or human primary macrophages derived from peripheral blood monocytes. Elastin oxidized by reactive oxygen species (ROS) liberated more unconjugated DES and IDE than did non-oxidized elastin when incubated with MMP-12 or neutrophil elastase. These results support the exploration of free DES and IDE as biomarkers of elastin degradation.

Topics: Animals; Biomarkers; Cardiovascular Diseases; Cell Line; Desmosine; Elastin; Humans; Isodesmosine; Leukocyte Elastase; Matrix Metalloproteinase 12; Mice; Reactive Oxygen Species; Recombinant Proteins