Enhanced parasympathetic cholinergic activity with galantamine inhibited lipid-induced oxidative stress in obese African Americans

Abstract Background African Americans (AAs) are disproportionately affected by cardiovascular disease (CVD), they are 20% more likely to die from CVD than whites, chronic exposure to inflammation and oxidative stress contributes to CVD. In previous studies, enhancing parasympathetic cholinergic acti...

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Main Authors: Dena Parsa, Luul A. Aden, Ashley Pitzer, Tan Ding, Chang Yu, Andre Diedrich, Ginger L. Milne, Annet Kirabo, Cyndya A. Shibao
Format: Article
Language:English
Published: BMC 2022-06-01
Series:Molecular Medicine
Subjects:
Online Access:https://doi.org/10.1186/s10020-022-00486-5
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author Dena Parsa
Luul A. Aden
Ashley Pitzer
Tan Ding
Chang Yu
Andre Diedrich
Ginger L. Milne
Annet Kirabo
Cyndya A. Shibao
author_facet Dena Parsa
Luul A. Aden
Ashley Pitzer
Tan Ding
Chang Yu
Andre Diedrich
Ginger L. Milne
Annet Kirabo
Cyndya A. Shibao
author_sort Dena Parsa
collection DOAJ
description Abstract Background African Americans (AAs) are disproportionately affected by cardiovascular disease (CVD), they are 20% more likely to die from CVD than whites, chronic exposure to inflammation and oxidative stress contributes to CVD. In previous studies, enhancing parasympathetic cholinergic activity has been shown to decrease inflammation. Considering that AAs have decreased parasympathetic activity compared to whites, we hypothesize that stimulating it with a central acetylcholinesterase (AChE) inhibitor, galantamine, would prevent lipid-induced oxidative stress. Objective To test the hypothesis that acute dose of galantamine, an AChE inhibitor, decreases lipid-induced oxidative stress in obese AAs. Methods Proof-of-concept, double-blind, randomized, placebo-controlled, crossover study that tested the effect of a single dose of 16 mg of galantamine versus placebo on lipid-induced oxidative stress in obese AAs. Subjects were studied on two separate days, one week apart. In each study day, 16 mg or matching placebo was administered before 20% intralipids infusion at doses of 0.8 mL/m2/min with heparin at doses of 200 U/h for 4 h. Outcomes were assessed at baseline, 2 and 4 h during the infusion. Main outcome measures Changes in F2-isoprostane (F2-IsoPs), marker of oxidative stress, measured in peripheral blood mononuclear cells (PBMC) and in plasma at baseline, 2, and 4-h post-lipid infusion. Secondary outcomes include changes in inflammatory cytokines (IL-6, TNF alpha). Results A total of 32 obese AA women were screened and fourteen completed the study (age 37.8 ± 10.70 years old, BMI 38.7 ± 3.40 kg/m2). Compared to placebo, 16 mg of galantamine significantly inhibited the increase in F2-IsoPs in PBMC (0.007 ± 0.008 vs. − 0.002 ± 0.006 ng/sample, P = 0.016), and plasma (0.01 ± 0.02 vs. − 0.003 ± 0.01 ng/mL, P = 0.023). Galantamine also decreased IL-6 (11.4 ± 18.45 vs. 7.7 ± 15.10 pg/mL, P = 0.021) and TNFα levels (18.6 ± 16.33 vs. 12.9 ± 6.16 pg/mL, P = 0.021, 4-h post lipid infusion) compared with placebo. These changes were associated with an increased plasma acetylcholine levels induced by galantamine (50.5 ± 10.49 vs. 43.6 ± 13.38 during placebo pg/uL, P = 0.025). Conclusions In this pilot, proof-of-concept study, enhancing parasympathetic nervous system (PNS) cholinergic activity with galantamine inhibited lipid-induced oxidative stress and inflammation induced by lipid infusion in obese AAs. Trial registration: ClinicalTrials.gov identifiers NCT02365285.
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spelling doaj.art-8046d167012f4120a913aa214b2a64612022-12-22T03:31:02ZengBMCMolecular Medicine1076-15511528-36582022-06-0128111110.1186/s10020-022-00486-5Enhanced parasympathetic cholinergic activity with galantamine inhibited lipid-induced oxidative stress in obese African AmericansDena Parsa0Luul A. Aden1Ashley Pitzer2Tan Ding3Chang Yu4Andre Diedrich5Ginger L. Milne6Annet Kirabo7Cyndya A. Shibao8Division of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical CenterDivision of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical CenterDivision of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical CenterDepartment of Biostatistics, Vanderbilt University Medical CenterDepartment of Biostatistics, Vanderbilt University Medical CenterDivision of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical CenterDivision of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical CenterDivision of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical CenterDivision of Clinical Pharmacology, Department of Medicine, Vanderbilt University Medical CenterAbstract Background African Americans (AAs) are disproportionately affected by cardiovascular disease (CVD), they are 20% more likely to die from CVD than whites, chronic exposure to inflammation and oxidative stress contributes to CVD. In previous studies, enhancing parasympathetic cholinergic activity has been shown to decrease inflammation. Considering that AAs have decreased parasympathetic activity compared to whites, we hypothesize that stimulating it with a central acetylcholinesterase (AChE) inhibitor, galantamine, would prevent lipid-induced oxidative stress. Objective To test the hypothesis that acute dose of galantamine, an AChE inhibitor, decreases lipid-induced oxidative stress in obese AAs. Methods Proof-of-concept, double-blind, randomized, placebo-controlled, crossover study that tested the effect of a single dose of 16 mg of galantamine versus placebo on lipid-induced oxidative stress in obese AAs. Subjects were studied on two separate days, one week apart. In each study day, 16 mg or matching placebo was administered before 20% intralipids infusion at doses of 0.8 mL/m2/min with heparin at doses of 200 U/h for 4 h. Outcomes were assessed at baseline, 2 and 4 h during the infusion. Main outcome measures Changes in F2-isoprostane (F2-IsoPs), marker of oxidative stress, measured in peripheral blood mononuclear cells (PBMC) and in plasma at baseline, 2, and 4-h post-lipid infusion. Secondary outcomes include changes in inflammatory cytokines (IL-6, TNF alpha). Results A total of 32 obese AA women were screened and fourteen completed the study (age 37.8 ± 10.70 years old, BMI 38.7 ± 3.40 kg/m2). Compared to placebo, 16 mg of galantamine significantly inhibited the increase in F2-IsoPs in PBMC (0.007 ± 0.008 vs. − 0.002 ± 0.006 ng/sample, P = 0.016), and plasma (0.01 ± 0.02 vs. − 0.003 ± 0.01 ng/mL, P = 0.023). Galantamine also decreased IL-6 (11.4 ± 18.45 vs. 7.7 ± 15.10 pg/mL, P = 0.021) and TNFα levels (18.6 ± 16.33 vs. 12.9 ± 6.16 pg/mL, P = 0.021, 4-h post lipid infusion) compared with placebo. These changes were associated with an increased plasma acetylcholine levels induced by galantamine (50.5 ± 10.49 vs. 43.6 ± 13.38 during placebo pg/uL, P = 0.025). Conclusions In this pilot, proof-of-concept study, enhancing parasympathetic nervous system (PNS) cholinergic activity with galantamine inhibited lipid-induced oxidative stress and inflammation induced by lipid infusion in obese AAs. Trial registration: ClinicalTrials.gov identifiers NCT02365285.https://doi.org/10.1186/s10020-022-00486-5Oxidative stressAfrican AmericanLipidsF2-isoprostanesCentral acetylcholinesterase inhibitor
spellingShingle Dena Parsa
Luul A. Aden
Ashley Pitzer
Tan Ding
Chang Yu
Andre Diedrich
Ginger L. Milne
Annet Kirabo
Cyndya A. Shibao
Enhanced parasympathetic cholinergic activity with galantamine inhibited lipid-induced oxidative stress in obese African Americans
Molecular Medicine
Oxidative stress
African American
Lipids
F2-isoprostanes
Central acetylcholinesterase inhibitor
title Enhanced parasympathetic cholinergic activity with galantamine inhibited lipid-induced oxidative stress in obese African Americans
title_full Enhanced parasympathetic cholinergic activity with galantamine inhibited lipid-induced oxidative stress in obese African Americans
title_fullStr Enhanced parasympathetic cholinergic activity with galantamine inhibited lipid-induced oxidative stress in obese African Americans
title_full_unstemmed Enhanced parasympathetic cholinergic activity with galantamine inhibited lipid-induced oxidative stress in obese African Americans
title_short Enhanced parasympathetic cholinergic activity with galantamine inhibited lipid-induced oxidative stress in obese African Americans
title_sort enhanced parasympathetic cholinergic activity with galantamine inhibited lipid induced oxidative stress in obese african americans
topic Oxidative stress
African American
Lipids
F2-isoprostanes
Central acetylcholinesterase inhibitor
url https://doi.org/10.1186/s10020-022-00486-5
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