Thromb Haemost 2015; 113(02): 350-362
DOI: 10.1160/TH14-06-0549
Cellular Signalling and Proteolysis
Schattauer GmbH

Levosimendan exerts anti-inflammatory effects on cardiac myocytes and endothelial cells in vitro

Konstantin A. Krychtiuk
1   Department of Internal Medicine II, Medical University of Vienna, Austria
2   Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
,
Lukas Watzke
1   Department of Internal Medicine II, Medical University of Vienna, Austria
,
Christoph Kaun
1   Department of Internal Medicine II, Medical University of Vienna, Austria
,
Elisabeth Buchberger
3   Department of Surgery, Medical University of Vienna, Austria
,
Renate Hofer-Warbinek
4   Department of Vascular Biology and Thrombosis Research, Medical University of Vienna, Austria
,
Svitlana Demyanets
1   Department of Internal Medicine II, Medical University of Vienna, Austria
,
Julia Pisoni
1   Department of Internal Medicine II, Medical University of Vienna, Austria
2   Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
,
Stefan P. Kastl
1   Department of Internal Medicine II, Medical University of Vienna, Austria
,
Sabine Rauscher
5   Skin and Endothelium Research Division (SERD), Department of Dermatology, Medical University of Vienna
6   Core Facilities, Medical University of Vienna, Austria
,
Marion Gröger
5   Skin and Endothelium Research Division (SERD), Department of Dermatology, Medical University of Vienna
6   Core Facilities, Medical University of Vienna, Austria
,
Arezu Aliabadi
3   Department of Surgery, Medical University of Vienna, Austria
,
Andreas Zuckermann
3   Department of Surgery, Medical University of Vienna, Austria
,
Gerald Maurer
1   Department of Internal Medicine II, Medical University of Vienna, Austria
,
Rainer de Martin
4   Department of Vascular Biology and Thrombosis Research, Medical University of Vienna, Austria
,
Kurt Huber
2   Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
7   3rd Medical Department for Cardiology and Emergency Medicine, Wilhelminenhospital, Vienna, Austria
,
Johann Wojta
1   Department of Internal Medicine II, Medical University of Vienna, Austria
2   Ludwig Boltzmann Cluster for Cardiovascular Research, Vienna, Austria
6   Core Facilities, Medical University of Vienna, Austria
,
Walter S. Speidl
1   Department of Internal Medicine II, Medical University of Vienna, Austria
6   Core Facilities, Medical University of Vienna, Austria
› Author Affiliations
Further Information

Publication History

Received: 23 June 2014

Accepted after major revision: 25 August 2014

Publication Date:
27 November 2017 (online)

Summary

Levosimendan is a positive inotropic drug for the treatment of acute decompensated heart failure (HF). Clinical trials showed that levosimendan was particularly effective in HF due to myocardial infarction. Myocardial necrosis induces a strong inflammatory response, involving chemoattractants guiding polymorphonuclear neutrophils (PMN) into the infarcted myocardial tissue. Our aim was to examine whether levosimendan exhibits anti-inflammatory effects on human adult cardiac myocytes (HACM) and human heart microvascular endothelial cells (HHMEC). Cardiac myocytes and endothelial cells were stimulated with interleukin-1β (IL)-1β (200 U/ml) and treated with levosimendan (0.1–10 μM) for 2–48 hours. IL-1β strongly induced expression of IL-6 and IL-8 in HACM and E-selectin and intercellular adhesion molecule-1 (ICAM-1) in HHMEC and human umbilical vein endothelial cells (HUVEC). Treatment with levosimendan strongly attenuated IL-1β-induced expression of IL-6 and IL-8 in HACM as well as E-selectin and ICAM-1 in ECs. Levosimendan treatment further reduced adhesion of PMN to activated endothelial cells under both static and flow conditions by approximately 50 %. Incubation with 5-hydroxydecanoic acid, a selective blocker of mitochondrial ATP-dependent potassium channels, partly abolished the above seen anti-inflammatory effects. Additionally, levosimendan strongly diminished IL-1β-induced reactive oxygen species and nuclear factor-κB (NF-κB) activity through inhibition of S536 phosphorylation. In conclusion, levosimendan exhibits anti-inflammatory effects on cardiac myocytes and endothelial cells in vitro. These findings could explain, at least in part, the beneficial effects of levosimendan after myocardial infarction.

 
  • References

  • 1 Papp Z, Edes I, Fruhwald S. et al. Levosimendan: Molecular mechanisms and clinical implications: consensus of experts on the mechanisms of action of levosimendan. Int J Cardiol 2012; 159: 82-87.
  • 2 Follath F, Cleland JG, Just H. et al. Efficacy and safety of intravenous levosimendan compared with dobutamine in severe low-output heart failure (the LIDO study): a randomised double-blind trial. Lancet 2002; 360: 196-202.
  • 3 Packer M, Colucci W, Fisher L. et al. Effect of Levosimendan on the Short-Term Clinical Course of Patients With Acutely Decompensated Heart Failure. JACC: Heart Failure 2013; 01: 103-111.
  • 4 Mebazaa A, Nieminen MS, Packer M. et al. Levosimendan vs dobutamine for patients with acute decompensated heart failure: the SURVIVE Randomized Trial. J Am Med Assov 2007; 297: 1883-1891.
  • 5 Moiseyev VS, Poder P, Andrejevs N. et al. Safety and efficacy of a novel calcium sensitizer, levosimendan, in patients with left ventricular failure due to an acute myocardial infarction. A randomized, placebo-controlled, double-blind study (RUSSLAN). Eur Heart J 2002; 23: 1422-1432.
  • 6 Husebye T, Eritsland J, Muller C. et al. Levosimendan in acute heart failure following primary percutaneous coronary intervention-treated acute ST-elevation myocardial infarction. Results from the LEAF trial: a randomized, placebo-controlled study. Eur J Heart Fail 2013; 15: 565-572.
  • 7 Maharaj R, Metaxa V. Levosimendan and mortality after coronary revasculari-sation: a meta-analysis of randomised controlled trials. Crit Care 2011; 15: R140.
  • 8 Du Toit EF, Muller CA, McCarthy J. et al. Levosimendan: effects of a calcium sensitizer on function and arrhythmias and cyclic nucleotide levels during is-chaemia/reperfusion in the Langendorff-perfused guinea pig heart. J Pharmacol Exp Ther 1999; 290: 505-514.
  • 9 Kersten JR, Montgomery MW, Pagel PS. et al. Levosimendan, a new positive inotropic drug, decreases myocardial infarct size via activation of K(ATP) channels. Anesth Analg 2000; 90: 5-11.
  • 10 Lepran I, Pollesello P, Vaj da S et al.. Preconditioning effects of levosimendan in a rabbit cardiac ischaemia-reperfusion model. J Cardiovasc Pharmacol 2006; 48: 148-152.
  • 11 Pollesello P, Papp Z. The cardioprotective effects of levosimendan: preclinical and clinical evidence. J Cardiovasc Pharmacol 2007; 50: 257-263.
  • 12 Kopustinskiene DM, Pollesello P, Saris NE. Levosimendan is a mitochondrial K(ATP) channel opener. Eur J Pharmacol 2001; 428: 311-314.
  • 13 Oldenburg O, Cohen MV, Yellon DM. et al. Mitochondrial K(ATP) channels: role in cardioprotection. Cardiovasc Res 2002; 55: 429-437.
  • 14 Uberti F, Caimmi PP, Molinari C. et al. Levosimendan modulates programmed forms of cell death through K(ATP) channels and nitric oxide. J Cardiovasc Pharmacol 2011; 57: 246-258.
  • 15 Grossini E, Molinari C, Caimmi PP. et al. Levosimendan induces NO production through p38 MAPK, ERK and Akt in porcine coronary endothelial cells: role for mitochondrial K(ATP) channel. Br J Pharmacol 2009; 156: 250-261.
  • 16 Hasslacher J, Bijuklic K, Bertocchi C. et al. Levosimendan inhibits release of reactive oxygen species in polymorphonuclear leukocytes in vitro and in patients with acute heart failure and septic shock: a prospective observational study. Crit Care 2011; 15: R166.
  • 17 Frohlich GM, Meier P, White SK. et al. Myocardial reperfusion injury: looking beyond primary PCI. Eur Heart J. 2013 Epub ahead of print.
  • 18 Gwechenberger M, Mendoza LH, Youker KA. et al. Cardiac myocytes produce interleukin-6 in culture and in viable border zone of reperfused infarctions. Circulation 1999; 99: 546-551.
  • 19 Kyrzopoulos S, Adamopoulos S, Parissis JT. et al. Levosimendan reduces plasma B-type natriuretic peptide and interleukin 6, and improves central haemody-namics in severe heart failure patients. Int J Cardiol 2005; 99: 409-413.
  • 20 Sareila O, Korhonen R, Auvinen H. et al. Effects of levo- and dextrosimendan on NF-kappaB-mediated transcription, iNOS expression and NO production in response to inflammatory stimuli. Br J Pharmacol 2008; 155: 884-895.
  • 21 Revermann M, Schloss M, Mieth A. et al. Levosimendan attenuates pulmonary vascular remodeling. Intensive Care Med 2011; 37: 1368-1377.
  • 22 Rychli K, Kaun C, Hohensinner PJ. et al. The inflammatory mediator oncostatin M induces angiopoietin 2 expression in endothelial cells in vitro and in vivo. J Thromb Haemost 2010; 08: 596-604.
  • 23 Demyanets S, Konya V, Kastl SP. et al. Interleukin-33 induces expression of adhesion molecules and inflammatory activation in human endothelial cells and in human atherosclerotic plaques. Arterioscler Thromb Vasc Biol 2011; 31: 2080-2089.
  • 24 Macfelda K, Weiss TW, Kaun C. et al. Plasminogen activator inhibitor 1 expression is regulated by the inflammatory mediators interleukin-1alpha, tumor necrosis factor-alpha, transforming growth factor-beta and oncostatin M in human cardiac myocytes. J Mol Cell Cardiol 2002; 34: 1681-1691.
  • 25 Hohensinner PJ, Kaun C, Rychli K. et al. Monocyte chaemoattractant protein (MCP-1) is expressed in human cardiac cells and is differentially regulated by inflammatory mediators and hypoxia. FEBS Lett 2006; 580: 3532-3538.
  • 26 Weiss TW, Kvakan H, Kaun C. et al. The gp130 ligand oncostatin M regulates tissue inhibitor of metalloproteinases-1 through ERK1/2 and p38 in human adult cardiac myocytes and in human adult cardiac fibroblasts: a possible role for the gp130/gp130 ligand system in the modulation of extracellular matrix degradation in the human heart. J Mol Cell Cardiol 2005; 39: 545-551.
  • 27 Kastl SP, Speidl WS, Kaun C. et al. In human macrophages the complement component C5a induces the expression of oncostatin M via AP-1 activation. Arterioscler Thromb Vasc Biol 2008; 28: 498-503.
  • 28 Brostjan C, Anrather J, Csizmadia V. et al. Glucocorticoids inhibit E-selectin expression by targeting NF-kappaB and not ATF/c-Jun. J Immunol 1997; 158: 3836-3844.
  • 29 Eltzschig HK, Eckle T. Ischaemia and reperfusion--from mechanism to translation. Nat Med 2011; 17: 1391-1401.
  • 30 Kukielka GL, Smith CW, Manning AM. et al. Induction of interleukin-6 synthesis in the myocardium. Potential role in postreperfusion inflammatory injury. Circulation 1995; 92: 1866-1875.
  • 31 Kukielka GL, Smith CW, LaRosa GJ. et al. Interleukin-8 gene induction in the myocardium after ischaemia and reperfusion in vivo. J Clin Invest 1995; 95: 89-103.
  • 32 Kivikko M, Lehtonen L, Colucci WS. Sustained haemodynamic effects of intravenous levosimendan. Circulation 2003; 107: 81-86.
  • 33 Zhao ZQ, Lefer DJ, Sato H. et al. Monoclonal antibody to ICAM-1 preserves postischaemic blood flow and reduces infarct size after ischaemia-reperfusion in rabbit. J Leukoc Biol 1997; 62: 292-300.
  • 34 Ma XL, Tsao PS, Lefer AM. Antibody to CD-18 exerts endothelial and cardiac protective effects in myocardial ischaemia and reperfusion. J Clin Invest 1991; 88: 1237-1243.
  • 35 Ghosh CC, Ramaswami S, Juvekar A. et al. Gene-specific repression of proin-flammatory cytokines in stimulated human macrophages by nuclear IkappaBal-pha. J Immunol 2010; 185: 3685-3693.
  • 36 Kivikko M, Antila S, Eha J. et al. Pharmacokinetics of levosimendan and its metabolites during and after a 24-hour continuous infusion in patients with severe heart failure. Int J Clin Pharmacol Therapeut 2002; 40: 465-471.