Molecular advances in cardiac and cardiovascular disease.

Recent advances in the field of molecular biology have led to a better understanding of the pathological mechanisms of cardiovascular disease. The impact of these findings will shape the future of treatment modalities for cardiovascular disorders. Postulated targets and biological rationale of new techniques are being developed in a race towards molecular therapies for vascular diseases. Whether it is modulation of transmembrane cell receptors or phenotypic changes via vectors that mediate gene transfer, there is no doubt that molecular strategies will be an integral part of the future. Here we examine past and recent perspectives, describe directions and challenges in cardiac and cardiovascular areas of research, and discuss relevance to the field of cardiovascular perfusion.

Lipoproteins and coagulation.

A broad range of molecular and cellular interactions contribute to various pathophysiological alterations in haemostasis. Recent studies have shown strong links between lipoproteins and coagulation factors. Findings suggest that lipoproteins play an important role in the fibrinolytic and thrombogenic mechanisms that influence the risks of patients in acute coronary syndromes. We will examine specific aspects of lipoproteins with reference to the effects of hyperlipidaemia on endothelial dysfunction and haemostasis, and its relevance in the patient presenting for revascularization.

Lipoproteins in heart disease.

Most lipids are carried in the circulation by lipoproteins. Lipoproteins and their associated proteins, called apolipoproteins, are currently being studied in an effort to further our understanding of atherosclerotic cardiovascular disease. Lipoprotein assembly, secretion, transportation, modification and clearance are essential elements of healthy lipid metabolism. When one or more of these key steps becomes altered, various disease states are induced. Current data suggest that lipoprotein(a), a low density lipoprotein (LDL)-like particle, is an acute phase reactant that plays a critical role in the modulation of fibrinolysis. Several aspects of lipoproteins and lipoprotein metabolism will be examined. Emphasis will be placed on the proatherogenic and thrombogenic effects of oxidized LDL.

Monoclonal antibodies specific for the binding site on the LH receptor alter progesterone production in cultured granulosa cells.

Monoclonal antibodies (mAbs) specific for the LH receptor (LHR) were generated through a modified auto-anti-idiotypic approach in which human chorionic gonadotropin (hCG) was used as the immunogen followed by cyclophosphamide to induce anti-idiotypic antibodies. The purpose of this study was to investigate the effectiveness of these antibodies to alter progesterone production in porcine granulosa cells in vitro. Anti-LHR mAbs were incubated with granulosa cells in the presence or absence of a stimulatory dose of hCG. Progesterone output by treated cells was measured using a RIA procedure. Most of the mAb could inhibit stimulated progesterone production by cultured granulosa cells. It was speculated that two possible mechanisms may cause the inhibition effect observed. Several of the antibodies appeared to block hCG binding thus removing the stimulatory effects of hCG. However, the most potent inhibiting mAbs for progesterone production had little or no effect on hCG binding, suggesting that some other mechanism was responsible for the observed inhibition. In addition, several of the antibodies were found to have a stimulatory effect on progesterone production by granulosa cells even in the absence of a stimulating dose of hCG. It is proposed that these antibodies were able to mimic hCG.

Receptor-mediated uptake of lipoproteins by cultured porcine granulosa cells.

Receptor-mediated uptake of low density lipoprotein (LDL) has been shown to provide a major source of cholesterol for a variety of cell types, particularly steroidogenic cells. In this study, the functional significance of lipoproteins in porcine ovarian granulosa cells and their mechanism of uptake by the cell was examined. Porcine LDL and high density lipoprotein (HDL) were isolated using a KBr density gradient, and the purity of both lipoproteins was confirmed by single corresponding bands on agarose gel stained for lipid and protein. Purified LDL and HDL were radioiodinated and labelled with colloidal gold for binding and tracer studies respectively. Both lipoproteins bind to cell surface and are internalized within 30 min at 37 degrees C. The cultured granulosa cells possess more HDL binding sites than LDL binding sites and are more responsive in progesterone production when supplemented with HDL. These results suggest that granulosa cells may preferentially utilize HDL over LDL as a source of cholesterol for steroidogenesis.

Change in gonadotropin-binding sites in intracellular organelles and plasma membranes during luteal growth, development and regression.

Changes in the gonadotropin-binding sites in plasma membranes and several intracellular organelles of bovine corpora lutea of days 3, 13 and 19 of the cycle were investigated. These three times represent periods of rapid luteal growth (early luteal phase), maturity (mid luteal phase) and the onset of regression (late luteal phase), respectively. The 5'-nucleotidase activity was highest in the fraction possessing a predominance of plasma membranes. It was undetectable in nuclear fractions and detectable to a varying extent in fractions enriched with mitochondria-lysosomes, rough endoplasmic reticulum and Golgi. The gonadotropin-binding sites, as measured by 125I-human choriogonadotropin (hCG) specific binding, were found in all the subcellular organelles. Whereas the affinities remained about the same, the total number of available gonadotropin-binding sites in all the organelles increased from day 3 to 13 and then declined by day 19 of the cycle. Occupancy of binding sites by endogenous luteinizing hormone was not detectable and therefore was unlikely to be responsible for the changes in total number of available binding sites. Thus, binding site changes observed in all the organelles of early, mid and late luteal phase corpora lutea probably reflect actual changes in the steady-state turnover of binding sites. Morphometrically determined relative membrane counts of various subcellular organelles varied with the luteal phase. The relative total gonadotropin-binding sites, calculated from the relative membrane counts and the total number of available binding sites, increased in all the organelles from early to mid and then declined by late luteal phase. Plasma membranes of all three luteal phases contained greater relative total gonadotropin-binding sites than any other single intracellular organelle. However, all the intracellular organelles combined contained 59% of the total luteal cell gonadotropin-binding sites in early luteal phase which decreased to 43 and 28% by mid and late luteal phases respectively.

Secretory granules and progesterone secretion by ovine corpora lutea in vitro.

To study the relationship between formation and release of Golgi-derived secretory granules and progesterone secretion, slices of ovine luteal tissue were incubated in the presence of LH and/or calcium ionophore A23187. Increases in progesterone secretion in response to LH and/or ionophore were accompanied by a concomitant release of secretory granules. In contrast, in the presence of colchicine, LH-stimulated progesterone secretion was significantly reduced (P less than 0.01), granule formation appeared to be blocked, and there was little evidence of exocytosis. In addition, unusual pleomorphic membrane-bounded saccules containing an electron-dense material were abundant throughout the centrospheric region of cells treated with colchicine. Because of the close parallelism between formation and release of Golgi-derived secretory granules and progesterone secretion, it appears that progesterone secretion may be coupled to exocytosis of secretory granules. Although the exact content and function of the secretory granules described remains to be elucidated, the data obtained are compatible with the notion that they may contain a progesterone carrier protein.

Adrenergic control of hypothalamic function during osmotic stress in the mallard duck (Anas platyrhynchos).

The role of the paraventricular nucleus (PVN) and biogenic amines (BA) in regulating the level of corticoids in the serum of osmotically stressed mallard ducks (Anas platyrhynchos) was analyzed employing three experimental approaches: 1) pharmacologic alteration of central BA levels, 2) microscopic evaluation of BA distribution, and 3) placement of electrolytic lesions into the PVN. Reserpine and alpha-methyl-p-tyrosine (alphampt), agents that decrease the amount of BA's in the central nervous system, produced a fivefold increase in the concentration of serum corticoids. Conversely, pargyline and amphetamine, agents that increase the functional pool of BA's, prevented the rise in serum corticoid concentration normally observed in birds challenged with an intraperitoneal injection of hypertonic saline. When the topographic distribution of BA's was analyzed in the brains of osmotically stressed and nonstressed ducks distinct changes in the intensity of catecholamine (CA) fluorescence were observed in only bone location, the PVN of the hypothalamus. Additionally, electrolytic lesions stereotaxically placed in the PVN blocked the osmotic stress-induced rise in serum corticoid concentration. These data therefore indicate that the PVN in the mallard duck plays some role in regulating the observed stress-induced rise in serum corticoid concentration, and that this regulatory function is probably inhibited by catecholamines.

Neurosecretory pathways in the mallard duck (Anas platyrhynchos) brain: localization by aldehyde fuchsin and immunoperoxidase techniques for neurophysin (NP) and gonadotrophin releasing hormone (Gn-RH).

Localization studies of the hypothalamohypophysial and tuberoinfundibular neurosecretory systems were performed in the adult male mallard duck with an immunoperoxidase techinque for the demonstration of neurophysin (NP) and gonado-tropin-releasing hormone (Gn-RH) and with aldehyde fuchsin for the staining of neuosecretory material (NSM). A comparison was made between the distribution of NSM stained with aldehyde fuchsin and NP seen by immunocytochemistry. The magnocellular perikarya of the supraoptic (SON) and paraventricular (PVN) nuclei, the zona externa of the anterior median eminence (ME), the fiber layer of both the anterior and posterior ME, and small neurons in the tractus quintofrontalis were stained by both the immunoperoxidase method for NP and by the aldehyde fuchsin stain. In contrast, the parvocellular neurons of the PVN, extra-hypothalamic neurosecretory fibers dorsal to the anterior commissure in the septal region and tanycytes lining the ventral 1/3 of the third ventricle at the level of the anterior ME, were stained only by the immunocytochemical procedure for NP. These observations indicate that immunocytochemistry is more sensitive than aldehyde fuchsin staining for detecting low concentrations of NP in cells and tissues, but the two techniques produce comparable results where the concentration of the NP is relatively high. Two populations of beaded axons containing Gn-RH were distributed throughout the zone externa of both the anterior and posterior ME. One group of fibers paralleled the hypothalamo-hypophysial neurosecretory tract whereas the other was distributed in the contact zone of the ME. Immunoreactive Gn-RH was found in the cytoplasm of a sparse population of cell bodies in the dorsolateral portion of the arcuate nucleus as well as in the axons that project from this nucleus ventrally towards the ME.

Relationship between membrane potential and progesterone release in ovine corpora lutea.

When slices of ovine luteal tissue were perfused with medium containing luteinizing hormone (LH), the output of progesterone was increased significantly (P less than 0.01) in eleven of twelve experiments. However, addition of LH to the medium did not influence the luteal cell membrane potential. The addition of 47 mM potassium to the medium resulted in increased progesterone output (P less than 0.01) and depolarization of the luteal cell membrane within 2 min. Progesterone output decreased to approximate pretreatment levels within 2 min of the return to normal potassium levels in the perfusion medium. High levels of potassium further increased the output of progesterone from tissue stimulated with LH. Perfusion of the slices with sodium-free medium also resulted in increased (P less than 0.01) progesterone output within 2 min, which returned to pretreatment levels within 2 min after normal sodium levels were restored to the medium. Perfusion of the slices with sodium-free medium did not influence the membrane potential. Perfusion of the tissue with LH, 47 mM potassium, or sodium-free medium had no effect on progesterone output if the medium was calcium-free and/or contained 2 mM EGTA. These data suggested that the calcium ion plays an important role in mediating the steroidogenic response of ovine luteal tissue to LH. A second series of experiments was designed to ascertain if luteal cells were coupled electrically. Sixty-six pairs of luteal cells separated by 150-300 mum were penetrated with electrodes and the membrane potential of both cells was studied. One cell of each pair was hyperpolarized by passage of 0.4 nA current into the cell, but in no case was there an effect on the membrane potential of the other penetrated cell. Likewise, when five cells were injected iontophoretically with Procion Yellow there was no evidence of diffusion of the dye to adjacent cells. There was no evidence obtained in this study which suggested that ovine luteal cells were coupled electrically.

Luteinizing hormone, progesterone and the morphological development of normal and superovulated corpora lutea in sheep.

The development of granulosa-lutein cells was studied in 27 normal and 32 superovulated ewes between days 0-4(day 0 began with the preovulatory LH peak in normal animals and the HCG injection in superovulated ewes). The pattern of differentiation was similar in both groups. Following initial hormonal stimulation (0-12 hours after LH or HCG), granulosa cells were approximately 100 mu2 and contained small, pleomorphic nuclei with large amounts of clumped chromatin. Elongate cells lining the basement membrane possessed large, heterogeneous dense bodies, and a well-developed Golgi apparatus. Mitotic figures were observed up to 6 hours prior to ovulation. Sixteen to 20 hours following the LH surge or HCG injection, hypertrophy of granulosa cells was evident. Nuclei contained definitive nucleoli. Blood vessels in the theca interna were abundant and highly dilated. Ovulation occurred approximately 24 hours after the LH peak or HCG injection. Visible signs of luteinization were evident 6-12 hours after ovulation. A slight increase in serum progesterone levels was detected. The second post-ovulatory day was characterized by continuing hypertrophy of granulosa cells and extensive proliferation of smooth endoplasmic reticulum and mitochondria. Nuclei of granulosa cells were larger and possessed extremely large nucleoli. Numerous mitotic figures were apparent within the corpus luteum. Serum progesterone concentrations began increasing at 60-72 hours after hormone stimulation. By the end of the third post-ovulatory day, the corpus luteum consisted of large, pleomorphic, parenchymal cells, interspersed between capillaries and connective tissue elements. Only an occasional mitotic figure was apparent within the corpus luteum at 100 hours. Light microscopic autoradiography of 5, 10, and 15 day corpora lutea taken from ewes pulsed with 3H thymidine at specific times before and after ovulation revealed that granulosa cells did not undergo secondary mitoses following ovulation. In contrast, thecal, mesenchymal and endothelial cells did mitose on day 3.

Corticoid uptake by the paraventricular nucleus in the hypothalamus of the duck, Anas platyrhynchos.

3H-corticoids were localized by autoradiography in small neurons in the area of the magnocellular paraventricular nucleus of mallard ducks. Correlative data show that: (1) the label is principally unmetabolized steroid, (2) the hypothalamus competitively binds corticosterone, (3) the paraventricular nucleus contains immunoreactive neurophysin, is richly innervated by boutons of monoaminergic nerves and is involved in the adaptive response to osmotic stress.

Correlations between brain catecholamines, neurosecretion, and serum corticoid levels in osmotically stressed mallard ducks (Anas platyrhynchos).

The effects of depleting brain catecholamines with a combined treatment of reserpine and alpha-methyl-p-tyrosine on serum corticosterone levels and release of immunoreactive neurophysin from the median eminence, in osmotically stressed and unstressed mallard ducks, were studied. Corticoid levels in salt loaded birds were more than three times that of unstressed birds. The combined treatment of reserpine and alpha-methyl-p-tyrosine significantly decreased the concentration of brain monoamines in all experimental groups and raised serum corticoid levels in non-stressed birds to the same level found in the osmotically stressed animals. Immunoreactive neurophysin in the zona externa of the median eminence was depleted in all birds subjected to either osmotic stress and/or reserpine treatment but not in unstressed control birds. These preliminary data indicate that catecholamines may exert an inhibitory influence on both ACTH release from the anterior pituitary and neurophysin from the median eminence and that these two events may in some way be interrelated in the duck.

Ultrastructural analysis of the granulosa--luteal cell transition in the ovary of the dog.

The transition from ovarian granulosa to lutein cell during the estrus cycle of 60 pregnant and non-pregnant beagle bitches was analyzed by light and electron microscopy (both 100 and 1000 KV). Early proestrus was characterized by a gradual rise in serum estrogen levels, hyperplasia of the granulosa cells, the accumulation of follicular fluid, and the development of tortuous intercellular channels. During the second half of proestrus, serum estrogen levels continued to rise, but growth, division, and differentiation of the granulosa cells was minimal. Estrus was marked by the first acceptance of the male and a well-defined LH peak In the subsequent 24 hour period, the granulosa-lutein cells hypertrophy rapidly and develop a large Golgi apparatus, small profiles of granular endoplasmic reticulum, numerous microfilaments, and large gap junctions between the cells. Mitochondria also proliferate, enlarge, and elongate, but retain lamelliform cristae. Luteinization of the cells and progesterone secretion begin just after ovulation which in turn occurs about 24 hours after the LH peak. On the third and fourth day of estrus, numerous small vesicles of agranular endoplasmic reticulum fill the extoplasm and the mitochondria swell up and round off. The vesicles rapidly fuse into whorled and flattened cisternae or anastomosing tubules of agranular endoplasmic reticulum, while the mitochondria develop tubulovesicular cristae. These structures gradually become organized with respect to the basal lamina. The Golgi apparatus is centered over the pole of the nucleus that faces the pericapillary space. Stacked and whorled cisternae of agranular ER develop in the lateral margins and avascular end of the cell while mitochondria and tubular elements of agranular ER predominate in the central medial and most basal portions of the cytoplasm. Microfilaments are ubiquitous and appear to be instrumental in this orientation process. The cell surface develops three distinct regional specializations that coincide with the underlying cellular compartments: interconnecting pleomorphic folds fill the pericapillary space; long tenous microvilli project from the lateral cell surface and form tortuous intercellular channels and canaliculi; and large gap junctions form along the margins of the cell furthest removed from the basal lamina. By the sixth day of estrus, the granulosa-luteal cell transition is nearly complete and serum progesterone levels are on the rise.