Cardiovascular disease (CVD) represents the major source of morbidity and mortality. Despite maximal therapeutic intervention, significant risks remain. There is a critical need for discovery of pathways linked to CVD pathogenesis. The proposed studies combine unbiased metabolomics approaches, with more quantitative targeted analyses, and mechanistic animal models and human studies, to define novel analytes and pathways linked to CVD pathogenesis.
In aim 1, we propose new mechanistic studies in animal models of disease, and in humans, centered around a new and unpublished pathway discovered recently during performance of our initial unbiased metabolomics studies. We have accrued substantial preliminary data in both mouse models and human clinical investigations showing a dietary nutrient abundant in red meat is metabolized by gut flora and is linked to atherosclerosis. Unpublished targeted metabolomics studies, isotope tracer studies in germ free mice and humans antibiotic suppression, and additional mechanistic animal model studies, collectively indicate at least three distinct metabolites produced by gut flora may possess direct biological activity impacting upon atherosclerosis susceptibility and cholesterol metabolism.
In aim 2 we propose to substantially extend upon our initial unbiased metabolomics investigations using two distinct and well defined clinical cohorts. Studies in subjects undergoing elective cardiac evaluations and for whom long term follow-up is available will enable us to discover new analytes and pathways associated with development of atherosclerotic heart disease and its adverse complications heart attack, heart failure and death. While metabolomics studies in another, a clinical trial monitored by sequential coronary intravascular ultrasound [IVUS]), will allow us to define analytes and pathways associated with response to therapy for high potency statins. Successful completion of our proposed research program will provide opportunities for development of both novel diagnostic tests and therapeutic approaches for the treatment and prevention of atherosclerotic heart disease and its major complications. It will also further establish gut flora-dependent metabolism of an abundant nutrient in red meat as a new pathway for cardiovascular disease pathogenesis discovered through unbiased metabolomics.

Public Health Relevance

Despite the identification of numerous genetic and clinical risk factors for cardiovascular disease, we can still only explain in a small fraction of patients why that individual develops the disease, and many novel pathways contributing to disease still remain unexplored. The present studies will help identify novel pathways of clinical relevance with mechanistic links to cardiovascular disease pathogenesis and adverse sequelae such as myocardial infarction and heart failure, with the hope to better diagnose and treat or prevent disease progression. (End of Abstract)

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Exploratory Grants (P20)
Project #
5P20HL113452-04
Application #
8805848
Study Section
Special Emphasis Panel (ZHL1)
Program Officer
Srinivas, Pothur R
Project Start
2012-04-15
Project End
2016-02-29
Budget Start
2015-03-01
Budget End
2016-02-29
Support Year
4
Fiscal Year
2015
Total Cost
Indirect Cost
Name
Cleveland Clinic Lerner
Department
Other Basic Sciences
Type
Schools of Medicine
DUNS #
135781701
City
Cleveland
State
OH
Country
United States
Zip Code
44195
Norheim, Frode; Bjellaas, Thomas; Hui, Simon T et al. (2018) Genetic, dietary, and sex-specific regulation of hepatic ceramides and the relationship between hepatic ceramides and IR. J Lipid Res 59:1164-1174
Shimizu, Yuuki; Polavarapu, Rohini; Eskla, Kattri-Liis et al. (2018) Hydrogen sulfide regulates cardiac mitochondrial biogenesis via the activation of AMPK. J Mol Cell Cardiol 116:29-40
Albert, Chonyang L; Tang, W H Wilson (2018) Metabolic Biomarkers in Heart Failure. Heart Fail Clin 14:109-118
Li, Wei; Kennedy, David; Shao, Zhili et al. (2018) Paraoxonase 2 prevents the development of heart failure. Free Radic Biol Med 121:117-126
Li, Xinmin S; Wang, Zeneng; Cajka, Tomas et al. (2018) Untargeted metabolomics identifies trimethyllysine, a TMAO-producing nutrient precursor, as a predictor of incident cardiovascular disease risk. JCI Insight 3:
Tang, W H Wilson; Li, Daniel Y; Hazen, Stanley L (2018) Dietary metabolism, the gut microbiome, and heart failure. Nat Rev Cardiol :
Smits, Loek P; Kootte, Ruud S; Levin, Evgeni et al. (2018) Effect of Vegan Fecal Microbiota Transplantation on Carnitine- and Choline-Derived Trimethylamine-N-Oxide Production and Vascular Inflammation in Patients With Metabolic Syndrome. J Am Heart Assoc 7:
Li, Daniel Y; Tang, W H Wilson (2018) Contributory Role of Gut Microbiota and Their Metabolites Toward Cardiovascular Complications in Chronic Kidney Disease. Semin Nephrol 38:193-205
Cajka, Tomas; Fiehn, Oliver (2017) LC-MS-Based Lipidomics and Automated Identification of Lipids Using the LipidBlast In-Silico MS/MS Library. Methods Mol Biol 1609:149-170
Ahmadmehrabi, Shadi; Tang, W H Wilson (2017) Gut microbiome and its role in cardiovascular diseases. Curr Opin Cardiol 32:761-766

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