The failing human heart expresses tumor necrosis factor-alpha (TNF-alpha). However, its pathophysiological significance is not clear. We previously reported that robust overexpression of TNF-alpha in the murine heart causes lethal myocarditis. In this study, we modified the transgene to reduce the production of TNF-alpha by preserving the destabilizing sequence in TNF-alpha cDNA. Expression was driven by the murine alpha-myosin heavy chain promoter. Use of this modified construct allowed to the establish a mutine transgenic line (TG). TG offspring were examined at 6, 12, and 24 weeks. All showed a significantly higher heart weight-to-body weight ratio. Northern blot analysis confirmed the expression of transgene in the heart, and enzyme-linked immunosorbent assay demonstrated the presence of TNF-alpha protein. The TG heart demonstrated a mild, diffuse, lymphohistiocytic interstitial inflammatory infiltrate. Cardiomyocyte necrosis and apoptosis were present but not abundant. Magnetic resonance imaging showed that the TG heart was significantly dilated with reduced ejection fraction. Although the left ventricular dP/dtmax was not different at baseline, its responsiveness to isoproterenol was significantly blunted in TG. Atrial natriuretic factor was expressed in the TG ventricle. A group of TG died spontaneously, and subsequent autopsies revealed exceptional dilation of the heart, increased lung weight, and pleural effusion, suggesting that they died of congestive heart failure. The cumulative mortality rate at 6 months was 23%. In conclusion, the mouse overexpressing TNF-alpha recapitulated the phenotype of congestive heart failure. This provides a novel model to elucidate the role of this cytokine in the development of congestive heart failure.

Upper bounds for neutral as well as charged Higgs boson masses in a two-doublet model are obtained on the basis of tree unitarity conditionsà la Lee, Quigg and Thacker. A wide variety of scattering processes are considered so extensively that our bounds are more restrictive than those obtained previously for neutral Higgs bosons and are also of a new kind for charged Higgs boson. It is argued that at least one of the Higgs bosons should be lighter than 580 GeV/c 2 . 1 IntroductionAlthough the success of the standard SU (2) W ×U (1) Y gauge theory of the electroweak interactions is overwhelming, the Higgs boson sector in charge of spontaneous symmetry breaking has so far eluded experimental verification and is still a mystery. We all agree that the Higgs boson is one of our central concerns of the present experimental search and will be so even more in the future colliders, JLC, SSC and LHC.It has been known by now rather well that the mass of the Higgs boson, which is proportional to the Higgs quartic coupling, may be bounded from above, provided that the quartic coupling is not so large as to violate the validity of perturbative calculations [1,2]. In fact in the minimal standard model with a single Higgs doublet, Lee, Quigg and Thacker (LQT) [1] deduced the constraint from the perturbative unitarity which turned out to be m h < (8π Casalbuoni et al. [6] have raised a question which has close bearings on LQT's, namely, at what energy strong interaction phenomena would start to show up whenever one or more Higgs masses are sufficiently large. They examined models with two doublets, a doublet plus a singlet and also a supersymmetric model where there exist three Higgs supermultiplets.Maalampi et al. [7] have recently studied the two-doublet model in the same vein as LQT. They derived an upper bound of the neutral Higgs boson mass by a numerical analysis, which gave them more or less the same bound as of LQT. It should be pointed out herewith that they did not consider a broad class of scattering processes to derive constraints on all of the charged and neutral Higgs boson masses.The purpose of the present paper is to reexamine the two-doublet model to see whether one can derive an upper bounds for neutral as well as charged Higgs boson masses in the method of LQT. We will answer to this question in the affirmative by taking into our considerations sufficiently large number of scattering processes. Overall allowed regions of three neutral and one charged Higgs boson masses are explored and their maximally possible values are presented (see Eqs. (45)- (48)). Moreover we will argue that at least one of the Higgs bosons ought to be lighter considerably than might have been expected from the LQT' work (see Eqs. (49) and (50)).

Recent studies have focused their attention on the role of the proinflammatory cytokine tumor necrosis factor (TNF) in the development of heart failure. First recognized as an endotoxin-induced serum factor that caused necrosis of tumors and cachexia, it is now recognized that TNF participates in the pathophysiology of a group of inflammatory diseases including rheumatoid arthritis and Crohn's disease. The normal heart does not express TNF; however, the failing heart produces robust quantities. Furthermore, there is a direct relationship between the level of TNF expression and the severity of disease. In addition, both in vivo and in vitro studies demonstrate that TNF effects cellular and biochemical changes that mirror those seen in patients with congestive heart failure. Furthermore, in animal models, the development of the heart failure phenotype can be abrogated at least in part by anticytokine therapy. Based on information from experimental studies, investigators are now evaluating the clinical efficacy of novel anticytokine and anti-TNF strategies in patients with heart failure; one such strategy is the use of a recombinantly produced chimeric TNF alpha soluble receptor. Thus, in view of the emerging importance of proinflammatory cytokines in the pathogenesis of heart disease, we review the biology of TNF, its role in inflammatory diseases, the effects of TNF on the physiology of the heart and the development of clinical strategies that target the cytokine pathways.

The results of the genotyping test for CYP2C19 seem to predict cure of H. pylori infection and peptic ulcer in patients who receive dual therapy with omeprazole and amoxicillin.

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. Targeted deletion of MMP-2 attenuates early LV rupture and late remodeling after experimental myocardial infarction. Am J Physiol Heart Circ Physiol 285: H1229-H1235, 2003. First published May 29, 2003 10.1152/ ajpheart.00207.2003.-Matrix metalloproteinase-2 (MMP-2) is prominently overexpressed both after myocardial infarction (MI) and in heart failure. However, its pathophysiological significance in these conditions is still unclear. We thus examined the effects of targeted deletion of MMP-2 on post-MI left ventricular (LV) remodeling and failure. Anterior MI was produced in 10-to 12-wk-old male MMP-2 knockout (KO) and sibling wild-type (WT) mice by ligating the left coronary artery. By day 28, MI resulted in a significant increase in mortality in association with LV cavity dilatation and dysfunction. The MMP-2 KO mice had a significantly better survival rate than WT mice (56% vs. 85%, P Ͻ 0.05), despite a comparable infarct size (50 Ϯ 3% vs. 51 Ϯ 3%, P ϭ not significant), heart rate, and arterial blood pressure. The KO mice had a significantly lower incidence of LV rupture (10% vs. 39%, P Ͻ 0.05), which occurred within 7 days of MI. The KO mice exerted less LV cavity dilatation and improved fractional shortening after MI by echocardiography. The LV zymographic MMP-2 level significantly increased in WT mice after coronary artery ligation; however, this was completely prevented in KO mice. In contrast, the increase in the LV zymographic MMP-9 level after MI was similar between KO and WT mice. MMP-2 activation is therefore considered to contribute to an early cardiac rupture as well as late LV remodeling after MI. The inhibition of MMP-2 activation may therefore be a potentially useful therapeutic strategy to manage post-MI hearts. matrix metalloproteinase; cardiac rupture; heart failure; myocyte; extracellular matrix; mouse MYOCARDIAL INFARCTION (MI) leads to complex structural alterations (remodeling) involving both the infarcted and noninfarcted left ventricular (LV) myocardium (21). Early remodeling as LV cavity dilatation occurs during the early phase of MI, which is likely due to wall thinning in the infarct region. This might lead to a cardiac rupture, thereby accounting for the 5-30% of in-hospital mortality after acute MI (1). During the first several days, LV enlargement follows, and, thereafter, a progressive dilatation of the noninfarcted LV occurs over weeks (21). These progressive changes in LV geometry contribute to the development of depressed cardiac function, clinical heart failure, and increased mortality. Accordingly, it is of critical importance to explore the mechanisms of LV remodeling and develop therapeutic strategies that will effectively inhibit this deleterious process.The dynamic synthesis and breakdown of extracellular matrix (ECM) proteins play an important role in post-MI LV remodeling. In particular, the increased expression and activation of matrix metalloproteinases (MMPs) have been implicated in this process (4,5). Several studies have demonstrated that MMPs are involved not...

Background-Tumor necrosis factor-␣ (TNF-␣) and angiotensin II (Ang II) are implicated in the development and further progression of heart failure, which might be, at least in part, mediated by the production of reactive oxygen species (ROS). However, the cause and consequences of this agonist-mediated ROS production in cardiac myocytes have not been well defined. Recently, we demonstrated that increased ROS production was associated with mitochondrial DNA (mtDNA) damage and dysfunction in failing hearts. We thus investigated whether the direct exposure of cardiac myocytes to TNF-␣ and Ang II in vitro could induce mtDNA damage via production of ROS. Methods and Results-TNF-␣ increased ROS production within cultured neonatal rat ventricular myocytes after 1 hour, as assessed by 2Ј,7Ј-dichlorofluorescin diacetate fluorescence microscopy. TNF-␣ also decreased mtDNA copy number by Southern blot analysis in association with complex III activity, which was prevented in the presence of the antioxidant ␣-tocopherol. A direct exposure of myocytes to H 2 O 2 caused a similar decrease in mtDNA copy number. In contrast, Ang II did not affect mtDNA copy number, despite the similar increase in ROS production. TNF-␣-mediated ROS production and a decrease in mtDNA copy number were inhibited by the sphingomyelinase inhibitor D609. Furthermore, N-acetylsphingosine (C2-ceramide), a synthetic cell-permeable ceramide analogue, increased myocyte ROS production, suggesting that TNF-␣-mediated ROS production and subsequent mtDNA damage were mediated by the sphingomyelin-ceramide signaling pathway. Conclusions-The intimate link between TNF-␣, ROS, and mtDNA damage might play an important role in myocardial remodeling and failure.

The present genotyping test confirmed that the frequency of CYP2C19 mutant gene m1 is about 2.2 times greater than another mutant gene, m2, among Japanese poor metabolizers. The genotyping of CYP2C19 discriminates between the two S-mephenytoin 4'-hydroxylation phenotypes completely in the Japanese subjects.