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Signaling Pathways and Novel Therapies in Heart Disease

A special issue of International Journal of Molecular Sciences (ISSN 1422-0067). This special issue belongs to the section "Molecular Pathology, Diagnostics, and Therapeutics".

Deadline for manuscript submissions: 20 July 2025 | Viewed by 4039

Special Issue Editor

Department of Internal Medicine, Virginia Commonwealth University, 1101 East Marshall Street, Sanger Hall, Rm # 7020B, Richmond, VA 23298, USA
Interests: cardioprotection against myocardial ischemia/reperfusion injury with pharmacological agents, including mTOR inhibitor and phosphodiesterase-5 inhibitor; myocardial pre- and post-conditioning; cardioprotective mechanism in diabetic heart; myocardial infarction; cardiac hypertrophy; heart failure; developing a novel pharmacotherapy against doxorubicin-induced or other anti-cancer drug-induced cardiotoxicity; role of nitric oxide, protein kinase G, mTOR signaling, STAT3 signaling, specific long-non-coding RNA, and microRNA in cardioprotection; inflammation; necrosis; apoptosis; autophagy
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Heart disease continues to be a leading cause of morbidity and mortality worldwide, necessitating ongoing research efforts to identify novel therapeutic approaches. This Special Issue will explore the intricate signaling pathways involved in cardiac pathogenesis and showcase innovative therapies, including gene therapy and pharmacotherapy. By delving into the molecular mechanisms underlying cardiac dysfunction and highlighting promising treatment modalities, this Special Issue will advance the collective understanding and management of heart disease.

Topics of interest include, but are not limited to, the following:

  • Identification and characterization of signaling pathways implicated in heart disease;
  • Role of signaling pathways (e.g., MAPK, PI3K/Akt, Wnt/β-catenin, mTOR) in heart disease;
  • Molecular mechanisms underlying cardiac hypertrophy, fibrosis, and remodeling;
  • Role of inflammation and immune signaling in cardiovascular disorders;
  • Novel therapeutic targets for heart failure, arrhythmias, and ischemic heart disease;
  • Precision medicine approaches in the treatment of cardiac arrhythmias;
  • Therapeutic modulation of autophagy and apoptosis in ischemic heart disease;
  • Emerging gene- and cell-based therapies for myocardial regeneration;
  • Application of nanomedicine and drug delivery systems in cardiac therapeutics;
  • Clinical trials and translational research in cardiovascular pharmacotherapy;
  • Challenges and opportunities in drug discovery and the development of advanced treatment strategies for heart disease;
  • Advances in gene therapy for inherited cardiac disorders and acquired heart diseases;
  • Pharmacological interventions targeting key signaling molecules and pathways in heart disease;
  • Development of targeted therapies and precision medicine approaches for the personalized treatment of heart disease.

We invite researchers, clinicians, and scientists from diverse disciplines to contribute original research articles, reviews, and perspectives discussing the signaling pathways and therapeutic strategies shaping the future of cardiovascular medicine. Together, we can translate cutting-edge research into effective treatments that improve outcomes for patients with heart disease.

Dr. Anindita Das
Guest Editor

Manuscript Submission Information

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Keywords

  • heart failure
  • arrhythmias
  • ischemic heart disease
  • myocardial regeneration
  • inflammation
  • gene- or cell-based therapy
  • precision medicine

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Published Papers (2 papers)

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Research

Jump to: Review

17 pages, 3613 KiB  
Article
Urolithin A Protects against Hypoxia-Induced Pulmonary Hypertension by Inhibiting Pulmonary Arterial Smooth Muscle Cell Pyroptosis via AMPK/NF-κB/NLRP3 Signaling
by Xinjie He, Zhinan Wu, Jinyao Jiang, Wenyi Xu, Ancai Yuan, Fei Liao, Song Ding and Jun Pu
Int. J. Mol. Sci. 2024, 25(15), 8246; https://doi.org/10.3390/ijms25158246 - 28 Jul 2024
Cited by 3 | Viewed by 1640
Abstract
Recent studies confirmed that pyroptosis is involved in the progression of pulmonary hypertension (PH), which could promote pulmonary artery remodeling. Urolithin A (UA), an intestinal flora metabolite of ellagitannins (ETs) and ellagic acid (EA), has been proven to possess inhibitory effects on pyroptosis [...] Read more.
Recent studies confirmed that pyroptosis is involved in the progression of pulmonary hypertension (PH), which could promote pulmonary artery remodeling. Urolithin A (UA), an intestinal flora metabolite of ellagitannins (ETs) and ellagic acid (EA), has been proven to possess inhibitory effects on pyroptosis under various pathological conditions. However, its role on PH remained undetermined. To investigate the potential of UA in mitigating PH, mice were exposed to hypoxia (10% oxygen, 4 weeks) to induce PH, with or without UA treatment. Moreover, in vitro experiments were carried out to further uncover the underlying mechanisms. The in vivo treatment of UA suppressed the progression of PH via alleviating pulmonary remodeling. Pyroptosis-related genes were markedly upregulated in mice models of PH and reversed after the administration of UA. In accordance with that, UA treatment significantly inhibited hypoxia-induced pulmonary arterial smooth muscle cell (PASMC) pyroptosis via the AMPK/NF-κB/NLRP3 pathway. Our results revealed that UA treatment effectively mitigated PH progression through inhibiting PASMC pyroptosis, which represents an innovative therapeutic approach for PH. Full article
(This article belongs to the Special Issue Signaling Pathways and Novel Therapies in Heart Disease)
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Figure 1

Figure 1
<p>Urolithin A attenuates the progression of hypoxia-induced PH. (<b>a</b>) Protocol for administration of UA (HX + UA) or vehicle (HX) to mice subjected to hypoxia or normoxia (NOR). (<b>b</b>) RVSP, mPAP, RVHI (RVHI = RV/LV + S), and body weight in mice exposed to normoxia (NOR) or hypoxia with UA (HX + UA) or vehicle (HX) treatment (<span class="html-italic">n</span> = 6–8 per group). (<b>c</b>) Representative photomicrographs of hematoxylin and eosin (H&amp;E) staining and elastin–van Gieson (EVG) staining of lung tissue from mice exposed to normoxia (NOR) or hypoxia with UA (HX + UA) or vehicle (HX) treatment (<span class="html-italic">n</span> = 6 per group). Scale bars: 50 μm. (<b>d</b>) Qualification of pulmonary vascular remodeling by percentage of vascular medial thickness to total vessel size for mice exposed to normoxia (NOR) or hypoxia with UA (HX + UA) or vehicle (HX) treatment (<span class="html-italic">n</span> = 6 per group). (<b>e</b>) Representative immunofluorescence staining of lung tissue for α-SMA (green, smooth muscle cells), vWF (red, endothelial cells) and DAPI (blue, nuclei) from mice exposed to normoxia (NOR) or hypoxia with UA (HX + UA) or vehicle (HX) treatment (<span class="html-italic">n</span> = 6 per group). Scale bars: 50 μm. (<b>f</b>) Qualification analysis of the α-SMA<sup>+</sup> or vWF<sup>+</sup> areas. ** <span class="html-italic">p</span> &lt; 0.01 compared to the NOR group, *** <span class="html-italic">p</span> &lt; 0.001 compared to the NOR group, # <span class="html-italic">p</span> &lt; 0.05 compared to the HX group, ## <span class="html-italic">p</span> &lt; 0.01 compared to the HX group.</p>
Full article ">Figure 2
<p>Urolithin A inhibited NLRP3-mediated pyroptosis pathway in hypoxia-induced PH mice lungs. (<b>a</b>,<b>b</b>) Western blotting analysis for the protein expression of NLRP3, GSDMD, N-GSDMD, IL-1β, and cleaved-Caspase-1 relative to β-actin from lungs of mice exposed to normoxia (NOR) or hypoxia with UA (HX + UA) or vehicle (HX) treatment (<span class="html-italic">n</span> = 6 per group). (<b>c</b>) Representative immunofluorescence staining of lung tissue for α-SMA (greens), Caspase-1 (red) and DAPI (blue) from mice exposed to hypoxia with UA or vehicle treatment (<span class="html-italic">n</span> = 6 per group). Scale bars: 50 μm. (<b>d</b>) Quantification of the α-SMA<sup>+</sup> Caspase-1<sup>+</sup> areas. (<b>e</b>) Representative TEM images of pulmonary arterial smooth muscle cells of mice exposed to normoxia (NOR) or hypoxia with UA (HX + UA) or vehicle (HX) treatment (<span class="html-italic">n</span> = 4 per group). Red arrows indicate the membrane oligomeric pores. Scale bars: 2 μm. * <span class="html-italic">p</span> &lt; 0.05 compared to the NOR group, ** <span class="html-italic">p</span> &lt; 0.01 compared to the NOR group, *** <span class="html-italic">p</span> &lt; 0.001 compared to the NOR group, # <span class="html-italic">p</span> &lt; 0.05 compared to the HX group, ## <span class="html-italic">p</span> &lt; 0.01 compared to the HX group.</p>
Full article ">Figure 3
<p>UA alleviated the proliferation and migration of hPASMCs. (<b>a</b>) Cell viability of hPASMCs exposed to hypoxia for varying durations (<span class="html-italic">n</span> = 6 per group). * <span class="html-italic">p</span> &lt; 0.05 compared to the 0 h group, ** <span class="html-italic">p</span> &lt; 0.01 compared to the 0 h group, *** <span class="html-italic">p</span> &lt; 0.001 compared to the 0 h group. (<b>b</b>) Cell viability of hPASMCs exposed to hypoxia for 48 h with different concentrations of UA (<span class="html-italic">n</span> = 6 per group). * <span class="html-italic">p</span> &lt; 0.05 compared to the 0 μM UA group, ** <span class="html-italic">p</span> &lt; 0.01 compared to the 0 μM UA group. (<b>c</b>) Representative images and (<b>d</b>) qualification analysis of wound confluency of hPASMCs (<span class="html-italic">n</span> = 3 per group). ** <span class="html-italic">p</span> &lt; 0.01 compared to the control group, *** <span class="html-italic">p</span> &lt; 0.001 compared to the control group, # <span class="html-italic">p</span> &lt; 0.05 compared to the hypoxia group, ### <span class="html-italic">p</span> &lt; 0.001 compared to the hypoxia group. (<b>e</b>) Representative images and (<b>f</b>) qualification analysis of cell counts of hPASMCs using Transwell assay (<span class="html-italic">n</span> = 3 per group). Scale bars: 100 μm. ** <span class="html-italic">p</span> &lt; 0.01 compared to the control group, # <span class="html-italic">p</span> &lt; 0.05 compared to the hypoxia group.</p>
Full article ">Figure 4
<p>UA attenuated hypoxia-induced pyroptosis in hPASMCs. (<b>a</b>,<b>b</b>) Western blotting analysis for the protein expression of NLRP3, GSDMD, N-GSDMD, IL-1β, and Caspase-1 relative to β-actin in hPASMCs exposed to hypoxia with or without UA treatment (<span class="html-italic">n</span> = 6 per group). (<b>c</b>) Representative immunofluorescence staining for α-SMA (greens), Caspase-1 (red) and DAPI (blue) in hPASMCs exposed to hypoxia with or without UA treatment (<span class="html-italic">n</span> = 3 per group). Scale bars: 50 μm. (<b>d</b>) Qualification analysis of the NLRP3<sup>+</sup> or Caspase-1<sup>+</sup> areas. ** <span class="html-italic">p</span> &lt; 0.01 compared to the control group, *** <span class="html-italic">p</span> &lt; 0.001 compared to the control group, # <span class="html-italic">p</span> &lt; 0.05 compared to the hypoxia group, ## <span class="html-italic">p</span> &lt; 0.01 compared to the hypoxia group.</p>
Full article ">Figure 5
<p>UA attenuated PASMC pyroptosis through inhibiting the NF-κB/NLRP3 signaling pathway. (<b>a</b>,<b>b</b>) Western blotting analysis for the protein expression of p-P65 relative to P65 and p-IκB-α relative to IκB-α in hPASMCs exposed to hypoxia with or without UA treatment (<span class="html-italic">n</span> = 6 per group). ** <span class="html-italic">p</span> &lt; 0.01 compared to the control group, # <span class="html-italic">p</span> &lt; 0.05 compared to the hypoxia group, ## <span class="html-italic">p</span> &lt; 0.01 compared to the hypoxia group. (<b>c</b>,<b>d</b>) Western blotting analysis for the protein expression of p-P65 relative to P65 and p-IκB-α relative to IκB-α from lungs of mice exposed to normoxia (NOR) or hypoxia with UA (HX + UA) or vehicle (HX) treatment (<span class="html-italic">n</span> = 6 per group). ** <span class="html-italic">p</span> &lt; 0.01 compared to the NOR group, # <span class="html-italic">p</span> &lt; 0.05 compared to the HX group.</p>
Full article ">Figure 6
<p>UA inhibited NF-κB/NLRP3 pathway via activating AMPK. (<b>a</b>) Molecular structure of UA. (<b>b</b>,<b>c</b>) The molecular docking models of UA with (<b>b</b>) AMPK-α1 and (<b>c</b>) AMPK-α2, respectively. The solid blue lines represent hydrogen bonds, the gray dotted lines represent hydrophobic effect, and the green dotted lines represent π-π stacking interaction. (<b>d</b>,<b>e</b>) Western blotting analysis for the protein expression of p-AMPK relative to β-actin in hPASMCs exposed to hypoxia with or without UA treatment (<span class="html-italic">n</span> = 6 per group). ** <span class="html-italic">p</span> &lt; 0.01 compared to the control group, # <span class="html-italic">p</span> &lt; 0.05 compared to the hypoxia group. (<b>f</b>,<b>g</b>) Western blotting analysis for the protein expression of p-AMPK relative to β-actin from lungs of mice exposed to normoxia (NOR) or hypoxia with UA (HX + UA) or vehicle (HX) treatment (<span class="html-italic">n</span> = 6 per group). ** <span class="html-italic">p</span> &lt; 0.01 compared to the NOR group, # <span class="html-italic">p</span> &lt; 0.05 compared to the HX group.</p>
Full article ">Figure 7
<p>The AMPK selective inhibitor Compound C hindered the protective effect of UA on hPASMCs. (<b>a</b>,<b>b</b>) Western blotting analysis for the protein expression of p-AMPK relative to β-actin in hPASMCs administered with different concentrations of Compound C (<span class="html-italic">n</span> = 3 per group). * <span class="html-italic">p</span> &lt; 0.05 compared to the 0μM Compound C group, *** <span class="html-italic">p</span> &lt; 0.001 compared to the 0 μM Compound C group, ns means nonsignificant. (<b>c</b>,<b>d</b>) Western blotting analysis for the protein expression of p-IκB-α relative to IκB-α and p-P65 relative to P65 in hPASMCs exposed to hypoxia with or without UA or Compound C treatment (<span class="html-italic">n</span> = 6 per group).(<b>e</b>,<b>f</b>) Western blotting analysis for the protein expression of NLRP3, N-GSDMD, IL-1β, and Caspase-1 relative to β-actin in hPASMCs exposed to hypoxia with or without UA or Compound C treatment (<span class="html-italic">n</span> = 6 per group). ** <span class="html-italic">p</span> &lt; 0.01 compared to the control group, *** <span class="html-italic">p</span> &lt; 0.001 compared to the control group, # <span class="html-italic">p</span> &lt; 0.05 compared to the hypoxia group, ## <span class="html-italic">p</span> &lt; 0.01 compared to the hypoxia group, ^ <span class="html-italic">p</span> &lt; 0.05 compared to the hypoxia + UA group, ^^ <span class="html-italic">p</span> &lt; 0.01 compared to the hypoxia + UA group.</p>
Full article ">Figure 8
<p>Urolithin A protects against hypoxia-induced pulmonary hypertension by inhibiting NF-κB/NLRP3-mediated PASMC pyroptosis via regulating AMPK signaling (created with BioRender.com). PASMC, pulmonary arterial smooth muscle cell; IL-1β, interleukin-1β; GSDMD, gasdermin D; NLRP3, NOD-like receptor (NLR) family pyrin domain-containing 3; AMPK, AMP-activated protein kinase.</p>
Full article ">

Review

Jump to: Research

12 pages, 971 KiB  
Review
Current Understanding of Cardiovascular Calcification in Patients with Chronic Kidney Disease
by Sijie Chen, Rining Tang and Bicheng Liu
Int. J. Mol. Sci. 2024, 25(18), 10225; https://doi.org/10.3390/ijms251810225 - 23 Sep 2024
Viewed by 1528
Abstract
The burden of chronic kidney disease (CKD) is increasing, posing a serious threat to human health. Cardiovascular calcification (CVC) is one of the most common manifestations of CKD, which significantly influences the morbidity and mortality of patients. The manifestation of CVC is an [...] Read more.
The burden of chronic kidney disease (CKD) is increasing, posing a serious threat to human health. Cardiovascular calcification (CVC) is one of the most common manifestations of CKD, which significantly influences the morbidity and mortality of patients. The manifestation of CVC is an unusual accumulation of mineral substances containing calcium and phosphate. The main component is hydroxyapatite. Many cells are involved in this process, such as smooth muscle cells (SMCs) and endothelial cells. CVC is an osteogenic process initiated by complex mechanisms such as metabolic disorders of calcium and phosphorus minerals, inflammation, extracellular vesicles, autophagy, and micro-RNAs with a variety of signaling pathways like Notch, STAT, and JAK. Although drug therapy and dialysis technology continue to advance, the survival time and quality of life of CVC patients still face challenges. Therefore, early diagnosis and prevention of CKD-related CVC, reducing its mortality rate, and improving patients’ quality of life have become urgent issues in the field of public health. In this review, we try to summarize the state-of-the-art understanding of the progression of CVC and hope that it will help in the prevention and treatment of CVC in CKD. Full article
(This article belongs to the Special Issue Signaling Pathways and Novel Therapies in Heart Disease)
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Figure 1

Figure 1
<p>The mechanism diagram of CVC. P: phosphorus, PTH: parathyroidhormone, IS: Indoxylsulfate, VSMCs: vascular smooth muscle cells, miRNAs: micro-RNAs, EVs: extracellular vesicles, Runx2: runt-related transcription factor 2, BMP2: bone morphogenetic protein, TNF: tumor necrosis factor, IL: interleukin, ROS: reactive oxygen species, EndMT: endothelial-to-mesenchymal transition, STAT: transcriptional activation factor, NICD: Notch intracellular domain.</p>
Full article ">
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