@article{BrandAmannMandeletal.2014, author = {Brand, Susanne and Amann, Kerstin and Mandel, Philipp and Zimnol, Anna and Schupp, Nicole}, title = {Oxidative DNA Damage in Kidneys and Heart of Hypertensive Mice Is Prevented by Blocking Angiotensin II and Aldosterone Receptors}, series = {PLOS ONE}, volume = {9}, journal = {PLOS ONE}, number = {12}, issn = {1932-6203}, doi = {10.1371/journal.pone.0115715}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-118011}, pages = {e115715}, year = {2014}, abstract = {INTRODUCTION: Recently, we could show that angiotensin II, the reactive peptide of the blood pressure-regulating renin-angiotensin-aldosterone-system, causes the formation of reactive oxygen species and DNA damage in kidneys and hearts of hypertensive mice. To further investigate on the one hand the mechanism of DNA damage caused by angiotensin II, and on the other hand possible intervention strategies against end-organ damage, the effects of substances interfering with the renin-angiotensin-aldosterone-system on angiotensin II-induced genomic damage were studied. METHODS: In C57BL/6-mice, hypertension was induced by infusion of 600 ng/kg • min angiotensin II. The animals were additionally treated with the angiotensin II type 1 receptor blocker candesartan, the mineralocorticoid receptor blocker eplerenone and the antioxidant tempol. DNA damage and the activation of transcription factors were studied by immunohistochemistry and protein expression analysis. RESULTS: Administration of angiotensin II led to a significant increase of blood pressure, decreased only by candesartan. In kidneys and hearts of angiotensin II-treated animals, significant oxidative stress could be detected (1.5-fold over control). The redox-sensitive transcription factors Nrf2 and NF-κB were activated in the kidney by angiotensin II-treatment (4- and 3-fold over control, respectively) and reduced by all interventions. In kidneys and hearts an increase of DNA damage (3- and 2-fold over control, respectively) and of DNA repair (3-fold over control) was found. These effects were ameliorated by all interventions in both organs. Consistently, candesartan and tempol were more effective than eplerenone. CONCLUSION: Angiotensin II-induced DNA damage is caused by angiotensin II type 1 receptor-mediated formation of oxidative stress in vivo. The angiotensin II-mediated physiological increase of aldosterone adds to the DNA-damaging effects. Blocking angiotensin II and mineralocorticoid receptors therefore has beneficial effects on end-organ damage independent of blood pressure normalization.}, language = {en} } @article{DrechslerRitzTomaschitzetal.2013, author = {Drechsler, Christiane and Ritz, Eberhard and Tomaschitz, Andreas and Pilz, Stefan and Sch{\"o}nfeld, Stephan and Blouin, Katja and Bidlingmaier, Martin and Hammer, Fabian and Krane, Vera and M{\"a}rz, Winfried and Allolio, Bruno and Fassnacht, Martin and Wanner, Christoph}, title = {Aldosterone and cortisol affect the risk of sudden cardiac death in haemodialysis patients}, series = {European Heart Journal}, volume = {34}, journal = {European Heart Journal}, doi = {10.1093/eurheartj/ehs361}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-132562}, pages = {578-585}, year = {2013}, abstract = {Background: Sudden cardiac death is common and accounts largely for the excess mortality of patients on maintenance dialysis. It is unknown whether aldosterone and cortisol increase the incidence of sudden cardiac death in dialysis patients. Methods and results: We analysed data from 1255 diabetic haemodialysis patients participating in the German Diabetes and Dialysis Study (4D Study). Categories of aldosterone and cortisol were determined at baseline and patients were followed for a median of 4 years. By Cox regression analyses, hazard ratios (HRs) were determined for the effect of aldosterone, cortisol, and their combination on sudden death and other adjudicated cardiovascular outcomes. The mean age of the patients was 66 ± 8 years (54\% male). Median aldosterone was <15 pg/mL (detection limit) and cortisol 16.8 µg/dL. Patients with aldosterone levels >200 pg/mL had a significantly higher risk of sudden death (HR: 1.69; 95\% CI: 1.06-2.69) compared with those with an aldosterone <15 pg/mL. The combined presence of high aldosterone (>200 pg/mL) and high cortisol (>21.1 µg/dL) levels increased the risk of sudden death in striking contrast to patients with low aldosterone (<15 pg/mL) and low cortisol (<13.2 µg/dL) levels (HR: 2.86, 95\% CI: 1.32-6.21). Furthermore, all-cause mortality was significantly increased in the patients with high levels of both hormones (HR: 1.62, 95\% CI: 1.01-2.62). Conclusions: The joint presence of high aldosterone and high cortisol levels is strongly associated with sudden cardiac death as well as all-cause mortality in haemodialysed type 2 diabetic patients. Whether a blockade of the mineralocorticoid receptor decreases the risk of sudden death in these patients must be examined in future trials.}, language = {en} } @phdthesis{Queisser2010, author = {Queisser, Nina}, title = {Oxidative and nitrosative stress induced by the mineralocorticoid aldosterone - Mechanism of induction and role of signal transduction pathways and transcription factors}, url = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-53566}, school = {Universit{\"a}t W{\"u}rzburg}, year = {2010}, abstract = {Several epidemiological studies found that hypertensive patients have an increased risk to develop kidney cancer. Hyperaldosteronism frequently results in arterial hypertension and contributes to the development and progression of kidney injury, with reactive oxygen species (ROS) playing an important role. ROS are thought to be associated with many pathological conditions such as cancer and other disorders, like cardiovascular complications , which often go along with hypertension. The aim of the present work was to investigate whether the effects of elevated aldosterone concentrations might be involved in the increased cancer incidence of hypertensive individuals. First, the potential capacity of aldosterone to induce oxidative stress and DNA damage was investigated in vitro and in vivo. In LLC-PK1 porcine kidney cells and MDCK canine kidney cells the significant formation of ROS, and especially of superoxide (O2˙ˉ) was assessed. With two genotoxicity tests, the comet assay and the micronucleus frequency test, the DNA damaging potential of aldosterone was quantified. In both genotoxicity tests a dose-dependent increase in aldosterone-induced structural DNA damage was observed. Oxidative stress and DNA damage were prevented by antioxidants, suggesting ROS as a major cause of DNA damage. Furthermore, the oxidatively modified DNA lesion 8-oxo-7,8-dihydro-2´-deoxyguanosine (8-oxodG), was found to be significantly elevated. In kidneys of rats with desoxycorticosterone acetate (DOCA)/salt-induced hypertension, which is a model of severe mineralocorticoid-dependent hypertension, elevated levels of ROS and superoxide were found, compared to kidneys of sham rats. Also DNA strand breaks, measured with the comet assay and double strand breaks, visualized with antibodies against the double strand break-marker gamma-H2AX were significantly elevated in kidneys of DOCA/salt-treated rats. In addition, significantly increased amounts of 8-oxodG were detected. Proliferation of kidney cells was found to be increased, which theoretically enables the DNA damage to manifest itself as mutations, since the cells divide. Second, the effects of aldosterone on the activation of transcription factors and signaling pathways were investigated. A significant activation of the potentially protective transcription factor Nrf2 was observed in LLC-PK1 cells. This activation was triggered by an increase of ROS or reactive nitrogen species (RNS). In response to oxidative stress, glutathione synthesis and detoxifying enzymes, such as the subunits of the glutathione-cysteine-ligase or heme oxygenase 1 were rapidly induced after 4 h. Nevertheless, after 24 h a decrease of glutathione levels was observed. Since ROS levels were still high after 24 h, but Nrf2 activation decreased, this adaptive survival response seems to be transient and quickly saturated and overwhelmed by ROS/RNS. Furthermore, Nrf2 activation was not sufficient to protect cells against oxidative DNA damage, because the amounts of double strand breaks and 8-oxodG lesions steadily rose up to 48 h of aldosterone treatment. The second transcription factor that was time- and dose-dependently activated by aldosterone in LLC-PK1 and MDCK cells was NF-kappaB. Furthermore, a significant cytosolic and nuclear activation of ERK was detected. Aldosterone induced the phosphorylation of the transcription factors CREB, STAT1 and STAT3 through ERK. Third, the underlying mechanisms of oxidant production, DNA damage and activation of transcription factors and signaling pathways were studied. Aldosterone exclusively acted via the MR, which was proven by the MR antagonists eplerenone, spironolactone and BR-4628, whereas the glucocorticoid receptor (GR) antagonist mifepristone did not show any effect. Furthermore, aldosterone needed cytosolic calcium to exert its negative effects. Calcium from intracellular stores and the influx of calcium across the plasma membrane was involved in aldosterone signaling. The calcium signal activated on the one hand, the prooxidant enzyme complex NAD(P)H oxidase through PKC, which subsequently caused the generation of O2˙ˉ. On the other hand, nitric oxide synthase (NOS) was activated, which in turn produced NO. NO and O2˙ˉ can react to the highly reactive species ONOO- that can damage the DNA more severely than the less reactive O2˙ˉ. In the short term, the activation of transcription factors and signaling pathways could be a protective response against aldosterone-induced oxidative stress and DNA damage. However, a long-term NF-B and ERK/CREB/STAT activation by persistently high aldosterone levels could unfold the prosurvival activity of NF-kappaB and ERK/CREB/STAT in aldosterone-exposed cells. DNA damage caused by increased ROS might become persistent and could be inherited to daughter cells, probably initiating carcinogenesis. If these events also occur in patients with hyperaldosteronism, these results suggest that aldosterone could be involved in the increased cancer incidence of hypertensive individuals.}, subject = {Aldosteron}, language = {en} }