EPICARDIAL ADIPOSE TISSUE, OBESITY AND INFLAMMATION IN ATHEROSCLEROSIS

动脉粥样硬化中的心外膜脂肪组织、肥胖和炎症

• 批准号: 8600755
• 负责人: Devendra K. Agrawal
• 金额: $ 67.61万
• 依托单位: CREIGHTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-23 至 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8600755
• 关键词: Acetylcholine; Address; Adenosine; Adipocytes; Adipose tissue; Angiography; Angioplasty; Anterior; Anti-Inflammatory Agents; Anti-inflammatory; Area; Arterial Fatty Streak; Arteries; Atherosclerosis; Balloon Angioplasty; Biochemical; Blood Vessels; CCL2 gene; Caliber; Cardiac; Cardiovascular system; Cell Nucleus; Cell Proliferation; Cholesterol; Chronic; Clinical Research; Coronary; Coronary Arteriosclerosis; Coronary artery; Deposition; Development; Diet; Disease; Endocrine Glands; Endothelium; Event; Exposure to; Extracellular Matrix; Family suidae; Fatty acid glycerol esters; Fructose; Functional disorder; Genetic Transcription; Health; Heart; Histologic; Hormones; Housing; Human; Hyperplasia; IL2RA gene; ITGAX gene; Immune response; Impairment; Importins; Inflammation; Inflammation Mediators; Inflammatory; Inflammatory Response; Insulin Resistance; Interferons; Interleukin-10; Interleukin-17; Interleukin-6; Intervention; Investigation; Left; Leptin; Lighting; Lymphocyte; Measurement; Measures; Mediating; Metabolic; Modeling; Molecular; Myocardium; Nerve Tissue; Obesity; Optical Coherence Tomography; Outcome; Pathogenesis; Patients; Phenotype; Population; Positioning Attribute; Prevalence; Regulatory T-Lymphocyte; Stenosis; Stents; Sunlight; Supplementation; Surface; T-Lymphocyte Subsets; TNF gene; Testing; Thick; Tissues; Torsion; Translating; Translations; Tunica Adventitia; Ulcer; Vasodilation; Vitamin D; Vitamin D Deficiency; X-Ray Computed Tomography; adipokines; adiponectin; animal facility; arginase; chemokine; cytokine; dietary supplements; feeding; intima media; mRNA Expression; macrophage; p65; prohibitin; protein expression; public health relevance; resistin; response to injury; restenosis; subcutaneous; vascular inflammation

DESCRIPTION (provided by applicant): Epicardial adipose tissue (EAT) is present in close proximity to the adventitia of the coronary arteries and the underlying myocardium, and functions as both endocrine organ and inflammatory tissue, secreting hormones, cytokines and chemokines. Since atherosclerotic lesions result from inflammation and extracellular matrix formation that are exaggerated by obesity, there is a poor outcome in obese atherosclerotic patients following contrary intervention. We hypothesize that obesity-induced inflammatory phenotype of epicardial fat is exacerbated by vitamin D deficiency leading to endothelial dysfunction and enhanced intimal hyperplasia following coronary intervention. Aim 1: Our hypothesis predicts that high fructose and high fat diet will increase thickness and the inflammatory phenotype of EAT accompanied with impairment of coronary vasodilatation and increased reoccurrence of cardiovascular events following coronary artery intervention. Aim 2: Our hypothesis predicts that vitamin D deficiency will exacerbate and vitamin D supplementation will decrease thickness and the inflammatory phenotype of EAT and restore coronary vasodilatation and this will correlate with decreased reoccurrence of cardiovascular events following coronary artery intervention. Aim 3: Our hypothesis predicts that enhanced inflammatory phenotype of EAT in obese and atherosclerotic swine is due to increased translocation of NF-?B to the nucleus via increased transcription and translation of importin-¿3 and decreased prohibitin and SOCS3, and vitamin D suppresses pro-inflammatory responses in EAT. Hypercholesterolemic swine on high fructose diet will undergo balloon angioplasty and stenting. Effect of vitamin D will be examined in vitamin D-deficient, -sufficient and supplemented swine fed with high cholesterol and high fructose diet. Epicardial fat thickness will be measured by cardiac CT. Angiogram and Optical Coherence Tomography will be done to assess cardiac function and quantify in-segment minimal luminal diameter and intimal hyperplasia. Endothelium-dependent and -independent coronary vasodilatation will be measured by intracoronary administration of adenosine and acetylcholine. Biochemical parameters in epicardial fat will include the changes in adipocyte size, M1/M2 macrophage polarity, T-lymphocyte subsets, levels of pro- and anti-inflammatory mediators and cytokines. Histologically, intimal thickness and intimal hyperplasia, lumen area, intima-media ratio, plaque development, and re-occlusion will be examined. The proposed studies will provide conceptual support of our hypothesis and position us to translate our investigation into a clinical study in obese patients with coronary artery disease.

描述（由申请方提供）：心外膜脂肪组织（EAT）存在于冠状动脉外膜和下层心肌附近，具有内分泌器官和炎症组织的功能，分泌激素、细胞因子和趋化因子。由于动脉粥样硬化病变是由炎症和细胞外基质形成引起的，而肥胖又加剧了这些病变，因此，肥胖动脉粥样硬化患者在相反的干预后结局较差。我们假设，肥胖诱导的心外膜脂肪的炎症表型是由维生素D缺乏导致内皮功能障碍和增强内膜增生后冠状动脉介入治疗加剧。目标1：我们的假设预测高果糖和高脂肪饮食将增加EAT的厚度和炎症表型，伴随着冠状动脉血管舒张功能受损和冠状动脉介入治疗后心血管事件复发率增加。目标二：我们的假设预测，维生素D缺乏将加剧和维生素D补充将减少厚度和炎症表型EAT和恢复冠状动脉血管舒张，这将与减少冠状动脉介入治疗后的心血管事件复发。目标3：我们的假设预测，增强炎症表型EAT在肥胖和动脉粥样硬化猪是由于增加易位的NF-？B通过增加importin-3的转录和翻译以及减少prohibitin和SOCS 3而进入细胞核，维生素D抑制EAT中的促炎反应。高胆固醇血症猪高果糖饮食将接受球囊血管成形术和支架。将在用高胆固醇和高果糖饮食喂养的维生素D缺乏、充足和补充的猪中检查维生素D的作用。将通过心脏CT测量心外膜脂肪厚度。将进行血管造影和光学相干断层扫描，以评估心脏功能并量化节段内最小管腔直径和内膜增生。将通过冠状动脉内给予腺苷和乙酰胆碱来测量内皮依赖性和非依赖性冠状动脉血管舒张。心外膜脂肪中的生化参数将包括脂肪细胞大小、M1/M2巨噬细胞极性、T淋巴细胞亚群、促炎和抗炎介质和细胞因子水平的变化。将在组织学上检查内膜厚度和内膜增生、管腔面积、内膜-中膜比、斑块形成和再闭塞。 拟议的研究将为我们的假设提供概念上的支持，并使我们能够将我们的调查转化为对肥胖冠心病患者的临床研究。