Session: 113. Sickle Cell Disease, Sickle Cell Trait, and Other Hemoglobinopathies, Excluding Thalassemias: Basic and Translational: Poster II
Hematology Disease Topics & Pathways:
Research, Fundamental Science, Combination therapy, Genetic Disorders, Diseases, Treatment Considerations
Methods: We blocked Ang-II receptor-I (ATR1) signaling in 5-8-week-old Townes SCD mice with losartan mixed in drinking water, or vehicle control for 3 months, 6 months, or 9 months in different experiments. Cardiac parameters were measured using echocardiograms and electrocardiograms. IL-18 and Galectin-3 levels were measured as plasma biomarkers of cardiomyopathy by ELISA, and qRT-PCR was performed on myocardial mRNA for candidate genes. At sacrifice, cardiac histopathology was performed using H&E staining, as well as staining for fibrosis using Mason-trichrome and Sirius red.
Results: Echocardiograms showed that there was improvement in diastolic function and restrictive physiology with losartan treatment. There was a significant reduction in left atrium size (P=0.04), and left ventricular hypertrophy (P=0.0003), and an increase in isovolumetric relaxation time (P=0.0006) in losartan-treated SCD mice compared to vehicle-control SCD mice. Electrocardiograms showed significantly shortened QRS duration (P=0.001) with losartan treatment. There was a significant reduction in CTGF (connective tissue growth factor) mRNA expression (P=0.03), and plasma levels of Galectin-3 (P=0.07) and IL-18 (P=0.0005). Histopathology confirmed reduced intramyocardial fibrosis in losartan-treated mice, which was quantified using Aperio ImageScope64 software (P=0.01). All of these occurred despite more anemia in losartan-treated vs. control SCD mice, as ATR1 signaling enhances erythropoiesis. We also treated losartan and control groups of mice with biweekly blood transfusions and compared them to the corresponding non-transfused mice for 3 months. With this, we observed a similar reduction in IL-18 and Galectin-3, although the duration of treatment was not sufficient to show differences in myocardial fibrosis. Losartan treatment resulted in reduced oxidative stress, which may have contributed to the improved cardiomyopathy.
Conclusion: Ang-II signaling plays an important role in the development of cardiac fibrosis and its downstream complications in SCD patients, which can be reversed by blockade of ATR1.
Disclosures: No relevant conflicts of interest to declare.
See more of: Oral and Poster Abstracts