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(Circulation. 2007;115:1581-1590.)
© 2007 American Heart Association, Inc.
Molecular Cardiology |
From the Department of Anesthesiology and Intensive Care Medicine (T.E., D.K., K.U., H.K.E.), Department of Pharmacology and Toxicology (A.G., H.O.), and Institute of Brain Research (M.M.), Tübingen University Hospital, Tübingen, Germany; Bayer HealthCare AG, Wuppertal, Germany (T.K.); Institut de Recherches en Biologie Humaine et Moleculaire, Université Libre de Bruxelles, Brussels, Belgium (C.L.); Department of Pharmacology, Merck Research Laboratories, West Point, Pa (M.A.J.); and Immunobiology and Cancer Program, Oklahoma Medical Research Foundation, Oklahoma City (L.F.T.).
Correspondence to Holger K. Eltzschig, MD, PhD, Department of Anesthesiology and Intensive Care Medicine, Tübingen University Hospital, Hoppe-Seyler-Str 3, D-72076 Tübingen, Germany. E-mail heltzschig{at}partners.org
Received October 13, 2006; accepted January 17, 2007.
| Abstract |
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Methods and Results On the basis of observations of CD73 induction by ischemic preconditioning, we found that inhibition or targeted gene deletion of cd73 abolished infarct size-limiting effects. Moreover, 5'-nucleotidase treatment reconstituted cd73/ mice and attenuated infarct sizes in wild-type mice. Transcriptional profiling of adenosine receptors suggested a contribution of A2BAR because it was selectively induced by ischemic preconditioning. Specifically, in situ ischemic preconditioning conferred cardioprotection in A1AR/, A2AAR/, or A3AR/ mice but not in A2BAR/ mice or in wild-type mice after inhibition of the A2BAR. Moreover, A2BAR agonist treatment significantly reduced infarct sizes after ischemia.
Conclusions Taken together, pharmacological and genetic evidence demonstrate the importance of CD73-dependent adenosine generation and signaling through A2BAR for cardioprotection by ischemic preconditioning and suggests 5'-nucleotidase or A2BAR agonists as therapy for myocardial ischemia.
Key Words: adenosine infarction ischemia reperfusion nucleotidase
| Introduction |
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Clinical Perspective p 1590
Recent studies have implicated extracellular adenosine in the modulation of acute inflammation and tissue protection, particularly during conditions of hypoxia.15 Extracellular adenosine is derived mainly via phosphohydrolysis of AMP. Ecto-5'-nucleotidase (CD73), a ubiquitously expressed glycosyl phosphatidylinositol-anchored ectoenzyme, is the pacemaker of this reaction.6 Because of its transcriptional induction by hypoxia,6,7 CD73-dependent adenosine generation is particularly prominent during conditions of limited oxygen availability, as may occur during myocardial ischemia.2 Nevertheless, pharmacological studies on the role of CD73-dependent adenosine generation in cardioprotection during ischemia and reperfusion have yielded conflicting results.8,9
Extracellular adenosine produced by CD73 can signal through any of 4 extracellular adenosine receptors (A1AR, A2AAR, A2BAR, or A3AR). All 4 ARs have been associated with tissue protection in a variety of physiological settings.1,10,11 Although all 4 ARs are expressed in cardiac tissues,12 the contribution of individual receptors to cardioprotection from ischemia and reperfusion remains controversial13,14 and may in part be related to a lack of studies in which all 4 AR gene-targeted mice are subjected to the same IP protocol in parallel.
To elucidate the contribution of CD73-dependent adenosine generation and to clarify the role of individual ARs in cardioprotection during IP, we used a recently described model of murine in situ preconditioning incorporating a hanging weight system for intermittent coronary artery occlusion, thus minimizing the variability associated with knot-based coronary occlusion systems.15 In the present study, we applied this model in mice gene targeted for cd73 or each individual AR. In addition, we used specific pharmacological adenosine therapeutics to confirm the findings from gene-targeted mice. We found a critical role for CD73-dependent adenosine production and, surprisingly, signaling through the A2BAR for cardioprotection by IP. Consistent with these findings, we observed a significant reduction in infarct size after acute ischemia by treatment with soluble 5'-nucleotidase or a specific A2BAR agonist.
| Methods |
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Murine Model for Cardiac IP
In pharmacological studies, age-, gender- and weight-matched C57BL/6J mice were used. Cardiac IP was performed using a hanging weight system as described previously.15
Heart Enzyme Measurement
Blood was collected by central venous puncture for troponin I (cTnI) measurements using a quantitative rapid cTnI assay (Life Diagnostics, Inc, West Chester, Pa).
Transcriptional Analysis
To assess the influence of IP on cd73, A1AR, A2AAR, A2BAR, and A3AR transcript levels, 4 cycles of IP (5 minutes of ischemia, 5 minutes of reperfusion) were performed, the area at risk (AAR) was delineated by Evans blue staining, and excised and transcript levels were determined (see the expanded Materials and Methods section in the online Data Supplement).
Immunoblotting Experiments
In subsets of experiments, we determined CD73 and adenosine A2BAR protein content from the AAR as described previously.15
Ecto-5'-Nucleotidase Enzyme Assays
Ecto-5'-nucleotidase enzyme activity was evaluated as described previously.6
Adenosine Measurements
Tissue adenosine and AMP levels were determined via high-performance liquid chromatography as described previously.19
Neutrophil Depletion
In selected experiments, neutrophil depletion was achieved with an anti-Gr-1 monoclonal antibody (BD Biosciences/Pharmingen, San Jose, Calif) as described previously.20
Data Analysis
Data were compared by 2-factor ANOVA or Student t test where appropriate. Values are expressed as mean±SD from 4 to 6 animals per condition. For analysis of changes in transcript, data are expressed as mean±SEM, and the Dunnett test was used (P<0.05 was considered statistically significant).
The authors had full access to and take full responsibility for the integrity of the data. All authors have read and agree to the manuscript as written.
| Results |
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CD73 Inhibition Attenuates Cardioprotection by IP
We next pursued the functional contribution of CD73 to cardioprotection by IP by treating mice with an intra-arterial infusion of the specific CD73-inhibitor adenosine 5'-(
,ß-methylene) diphosphate (APCP; 40 mg · kg1 · h1) or vehicle control before cardiac IP and/or ischemia. As shown in Figure 2A, this resulted in a 3-fold reduction in cardiac CD73 enzyme activity. Similarly, AMP-induced bradycardia was significantly attenuated in APCP-treated animals (heart rate reduction from 480 to 360 bpm versus from 480 to 120 bpm in control mice; P<0.0001; Figure 2B). After having shown effective inhibition of cardiac CD73 enzyme activity with APCP, we investigated the role of CD73 in cardioprotection by IP by subjecting mice to 60 minutes of left coronary artery occlusion, followed by 2 hours of reperfusion with or without prior IP (4 cycles; 5 minutes of ischemia, 5 of minutes reperfusion) and with or without APCP. All mice survived this experiment. Heart rate and blood pressure did not differ between APCP-treated and untreated mice. To assess myocardial tissue damage, we measured plasma levels of a previously described marker for murine myocardial ischemia, cTnI.21 Consistent with previous studies,15 plasma cTnI concentrations were attenuated by IP (Figure 2C). However, APCP treatment abolished the cardioprotective effects of IP. Similarly, measurement of infarct size via 2,3,5-triphenyltetrazolium chloride (TTC) staining confirmed inhibition of cardioprotection by IP after APCP treatment (Figure 2D and 2E). Taken together, these data provide pharmacological evidence for a critical role of CD73 in cardioprotection by IP.
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Cardioprotection by IP Is Abolished in cd73/ Mice
To further demonstrate the importance of CD73 in the cardioprotective effects of IP, we next studied mice with targeted deletion of the cd73 gene.6 We first confirmed the absence of CD73 enzyme activity in the cardiac tissue of these mice (Figure 3A). Similarly, AMP-induced bradycardia was significantly attenuated in cd73/ mice compared with littermates (Figure 3B). We next performed IP in cd73/ mice and littermate controls. In striking contrast to results with wild-type mice, infarct sizes and increased plasma cTnI levels caused by 60 minutes of ischemia were not attenuated by IP in cd73/ mice (Figure 3C and 3D). The protection afforded by IP persisted for at least 90 minutes after the completion of IP in wild-type mice but was abolished in cd73/ mice (Data Supplement Figure II). Moreover, cd73/ mice had significantly bigger infarcts after 60 minutes of ischemia without IP compared with controls.
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To suggest that the absence of cardioprotection by IP in cd73/ mice reflects a lack of extracellular adenosine, we reconstituted extracellular adenosine levels via intra-arterial infusion (200 µL/h, adenosine 8 mg/mL) with a dose we previously determined not to induce hypotension or bradycardia (data not shown). Indeed (Figure 3E), this treatment resulted in partial reconstitution of cardioprotection by IP in cd73/ mice. Similar treatment of wild-type mice resulted in attenuation of infarct sizes only after IP, suggesting additional mechanisms (eg, increases in AR-mediated signaling by IP). In additional experiments, we reconstituted cd73/ mice via intra-arterial soluble 5'-nucleotidase (1 U 5'-nucleotidase from Crotalus atrox venom). As shown in Figure 3F, 5'-nucleotidase treatment was associated with an almost complete reconstitution of a wild-type phenotype. Moreover, 5'-nucleotidase treatment was associated with a significant reduction in infarct size in wild-type animals (Figure 3F). Taken together, these data reveal for the first time genetic evidence for CD73-dependent cardioprotection by IP. Furthermore, we show treatment with soluble 5'-nucleotidase as a potential novel therapy during acute myocardial ischemia.
Increases in Cardiac Adenosine With IP Are Attenuated in cd73/ Mice
On the basis of the above findings of CD73 induction and abolished cardioprotection by IP in cd73/ mice, we hypothesized that increases in cardiac adenosine levels with IP are attenuated in cd73/ mice. Consistent with previous studies,9 cardiac adenosine and AMP concentrations measured within the AAR immediately after IP (Figure 4) were increased, suggesting that AMP is produced during IP treatment and leaks from the preconditioned tissue. In contrast, cd73/ mice exhibited attenuated adenosine levels in conjunction with increased AMP concentrations after IP treatment. Taken together, these studies demonstrate that CD73 functions to increase myocardial adenosine during preconditioning.
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Cardiac IP Is Associated With Selective Induction of the A2BAR
After having demonstrated that extracellular adenosine generation via CD73 is crucial for IP, we next investigated transcriptional consequences of cardiac IP on expressional levels of all 4 ARs (Figure 5A through 5D). These studies revealed selective induction of the A2BAR transcript with cardiac IP (14-fold induction 90 minutes after IP; P<0.0001). In contrast, mRNA levels for A1AR and A3AR remained unchanged, whereas that for A2AAR was significantly repressed. Similarly, immunohistochemistry confirmed the induction of A2BAR protein on cardiomyocytes and endomuscular capillaries 90 minutes after IP (Figure 5E). To show that increases in A2BAR expression are not merely caused by increases in A2BAR+ inflammatory cells penetrating the ischemic area during reperfusion, we demonstrated via Western blot that A2BAR protein was still induced after neutrophil depletion (Figure 5F). Furthermore, staining of cardiac tissues after IP treatment showed only scattered neutrophils (Data Supplement Figure III). Taken together, these data suggest selective and robust induction of A2BAR in cardiac tissues by IP.
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IP Is Abolished in A2BAR/ Mice
We next investigated the contribution of individual ARs to cardioprotection by IP using previously described A1AR/,16 A2AAR/,18 and A3AR/ mice,17 as well as commercially available A2BAR/ mice. Studies of myocardial A2BAR expression and function in these mice confirmed structural and functional deletion of the receptor (see Data Supplement Figure IV). Moreover, transcript levels of other ARs (A1AR, A2AAR, A3AR) were unaltered in A2BAR/ mice compared with controls (data not shown).
As shown in Figures 5G and 6B and 6
C, all AR genetargeted mice showed cardioprotection by IP, except A2BAR/ mice. Abolished infarct size reduction also was present in A2BAR/ mice at 90 minutes of reperfusion time after IP treatment (data not shown). The cardioprotective effects of IP as assessed by plasma cTnI levels also were abolished in A2BAR/ mice (Figure 6A). Because measurements of heart rate and blood pressure did not reveal any differences between gene-targeted mice (Data Supplement Tables I and II), it seems unlikely that abolished cardioprotection could be explained by hemodynamic alterations. Taken together, these data provide the first genetic evidence for a pivotal role of A2BAR in cardioprotection by IP. To confirm these findings using a pharmacological approach, we used the highly specific, water-soluble A2BAR antagonist PSB1115.22 As shown in Figure 6D, intra-arterial treatment with PSB1115 (5 mg · kg1 · h1) abolished infarct size attenuation by IP, thus confirming our findings in A2BAR/ mice. To demonstrate that PSB1115 does not exhibit its anticardioprotective effects through blockade of A1AR, we also treated A1AR/ mice with PSB1115. As shown in Figure 6E, cardioprotection by IP in A1AR/ mice was attenuated by specific blockade of A2BAR. Taken together, these studies provide genetic and pharmacological evidence for a role of A2BAR in cardioprotection by IP.
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A2BAR Agonist Treatment Results in Smaller Infarcts During Acute Myocardial Ischemia
Next, we pursued a potential therapeutic role of a novel specific A2BAR agonist (BAY 606583). The chemical structure and selectivity are displayed in Figure 7A and 7B, and functional in vivo evidence in shown in Data Supplement Figure IV. Wild-type, but not A2BAR/, mice treated with a single bolus of intra-arterial BAY 606583 (10 µg/kg body weight) over 40 minutes before 60 minutes of myocardial ischemia exhibited a significant attenuation of infarct size (Figure 7C and 7D). These studies confirm the specificity of the cardioprotective effects of BAY 606583 through A2BAR signaling and provide strong rationale for therapeutically targeting A2BAR during myocardial ischemia.
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| Discussion |
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Previous studies on adaptation to hypoxia have revealed coordinated transcriptional induction of cd73 and A2BAR by hypoxia inducible factor (HIF)-1. In fact, hypoxia exposure of intestinal epithelia (Caco2 cells) or human endothelia (HMEC-1) was associated with robust induction of cd73 transcript, protein, and function.2,7 Furthermore, hypoxia exposure of cd73/ mice resulted in dramatic increases in vascular leakage, suggesting a functional role of CD73-dependent adenosine production in maintaining vascular barrier function during limited oxygen availability. Moreover, examination of the cd73 gene promoter identified a site for HIF-1
binding, and further studies with promoter constructs and site-directed mutagenesis of the HIF-1
binding site confirmed an HIF-1
dependent regulatory pathway for cd73 induction.7 Similarly, hypoxia exposure of endothelia (HMEC-1) resulted in a selective induction of A2BAR mRNA.2 Further studies examining HIF-1
DNA binding and HIF-1
loss and gain of function confirmed strong dependence of A2BAR induction by HIF-1
in vitro and in vivo.23 Therefore, it is not surprising that repeated episodes of ischemia/hypoxia as used during cardiac IP resulted in coordinated transcriptional induction of cd73 and A2BAR mRNA. In addition, mice with normoxic stabilization of HIF-1
by in vivo siRNA knockdown of HIF-1
-prolyl-4-hydroxylase-2 showed cardioprotection from ischemia and reperfusion.24 Therefore, it is likely that the observed cardioprotective effects of CD73-dependent adenosine production and signaling through the A2BAR during cardiac IP are related to a transcriptional response coordinated by HIF-1
.
Previous studies on the contribution of AR signaling to cardioprotection during IP have revealed conflicting results on the role of individual ARs. For example, a very thorough study using 3 different A1AR antagonists [CPX (1,3-dipropyl-8-cyclopentylxanthine), BG 9719, or BG 9928] did not block cardioprotection by IP, suggesting that receptor subtypes other than A1AR may be involved in this phenomenon.13 In contrast, other studies found an absence of the infarct sizelimiting effects of IP in A1AR gene-targeted mice, whereas A1AR-overexpressing mice were protected.14 Why the results of these latter studies disagree with our own is not clearly understood. Because previous studies suggest that adenosine signaling through the A1AR is responsible for activation of protein kinase C (PKC)25,26 and PKC is critically important for activation of CD73,27 it is conceivable that A1AR signaling may result in PKC activation, which in turn activates CD73. In fact, we found that transcriptional induction of cd73 by IP was abolished after PKC inhibition or in A1AR/ mice. Similarly, infarct sizelimiting effects by IP were attenuated by PKC inhibition (Data Supplement Figure VI). In conjunction with our findings that cardioprotection afforded by IP was less in A1AR/ than in wild-type mice, it becomes possible that signaling through A1AR or
-adrenergic receptors28 activates PKC, which in turn is responsible for CD73 activation, production of extracellular adenosine, and subsequent signaling through A2BAR. In vitro studies have indicated a critical role of signaling through the A2BAR in resealing of endothelia during transendothelial migration of neutrophils, particularly during conditions of limited oxygen availability.2 Moreover, pharmacological inhibition of A2BAR during hypoxia exposure is associated with increased pulmonary edema and vascular leakage.6 Thus, the findings of the present study are consistent with previous work on adenosine signaling, transcriptional responses of A2BAR after myocardial ischemia, and reperfusion,12 as well as studies suggesting a cardioprotective role of A2BAR during ischemic postconditioning,29 but highlight for the first time a pivotal role of A2BAR signaling in cardioprotection by IP.
At present, the source of extracellular adenosine generated during conditions of hypoxia or ischemia remains unknown. Previous reports have indicated that polymorphonuclear neutrophils release ATP during conditions of inflammation or hypoxia.30 Such extracellular ATP either may signal directly to vascular ATP receptors or may function as a metabolic substrate for conversion to adenosine via ecto-apyrase (CD39, conversion of ATP/ADP to AMP) and ecto-5'-nucleotidase. Under such conditions, adenosine is available to activate ARs. Besides polymorphonuclear neutrophils, platelets may be an important source for extracellular ATP.31 In addition, the exact cellular location of A2BAR involved in cardioprotection by IP is currently unknown. As we show here, A2BAR transcript levels and protein are induced in cardiac tissues by IP, suggesting a role of cardiac A2BAR. However, a very carefully executed study on the role of A2AAR signaling during myocardial ischemia suggested infarct size reduction by activation of A2AAR on T lymphocytes.32 Further studies are necessary to reveal which A2BAR-expressing cells are responsible for the cardioprotective effects of IP.
In summary, the present study reveals cardioprotection during myocardial ischemia via CD73-dependent generation of extracellular adenosine and signaling through the A2BAR. In fact, genetically targeted mice with deficiencies in the major extracellular pathway of adenosine generation (CD73) or in A2BAR show increased susceptibility to acute myocardial ischemia and are not protected by IP. In addition, soluble 5'-nucleotidase or selective A2BAR agonist treatment significantly attenuates infarct sizes after ischemia, suggesting possible new strategies to ameliorate the consequences of myocardial infarction. Future challenges include the development of approaches to deal with AR desensitization and delivery of AR agonists to specific anatomic sites.
| Acknowledgments |
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Sources of Funding
This work was supported by a Fortune grant 141600, Interdisciplinary Centre for Clinical Research (IZKF) Verbundprojekt 159700 from the University of Tübingen, and German Research Foundation (DFG) grant EL274/22HKE and IZKF Nachwuchsgruppe 160500 (to Dr Eckle), as well as NIH grant AI18220 (to Dr Thompson). Dr Thompson holds the Putnam City Schools Distinguished Chair in Cancer Research.
Disclosures
D. Köhler and Drs Eckle, Grenz, Mittelbronn, Osswald, Unertl, and Eltzschig are employees of the Tübingen University Hospital. Use of soluble 5'-nucleotidase is currently under consideration for a patent in the treatment of myocardial ischemia by the Tübingen University Hospital. Dr Krahn is employee of Bayer HealthCare. Bayer HealthCare has filed patents on the use of BAY 606583. The other authors report no conflicts.
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J. Reutershan, I. Vollmer, S. Stark, R. Wagner, K.-C. Ngamsri, and H. K. Eltzschig Adenosine and inflammation: CD39 and CD73 are critical mediators in LPS-induced PMN trafficking into the lungs FASEB J, February 1, 2009; 23(2): 473 - 482. [Abstract] [Full Text] [PDF] |
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H. K. Eltzschig, D. Kohler, T. Eckle, T. Kong, S. C. Robson, and S. P. Colgan Central role of Sp1-regulated CD39 in hypoxia/ischemia protection Blood, January 1, 2009; 113(1): 224 - 232. [Abstract] [Full Text] [PDF] |
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T. Hasegawa, D. Bouis, H. Liao, S. H. Visovatti, and D. J. Pinsky Ecto-5' Nucleotidase (CD73)-Mediated Adenosine Generation and Signaling in Murine Cardiac Allograft Vasculopathy Circ. Res., December 5, 2008; 103(12): 1410 - 1421. [Abstract] [Full Text] [PDF] |
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T. Eckle, L. Fullbier, A. Grenz, and H. K. Eltzschig Usefulness of pressure-controlled ventilation at high inspiratory pressures to induce acute lung injury in mice Am J Physiol Lung Cell Mol Physiol, October 1, 2008; 295(4): L718 - L724. [Abstract] [Full Text] [PDF] |
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A. Kuno, N. V. Solenkova, V. Solodushko, T. Dost, Y. Liu, X.-M. Yang, M. V. Cohen, and J. M. Downey Infarct limitation by a protein kinase G activator at reperfusion in rabbit hearts is dependent on sensitizing the heart to A2b agonists by protein kinase C Am J Physiol Heart Circ Physiol, September 1, 2008; 295(3): H1288 - H1295. [Abstract] [Full Text] [PDF] |
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M. L. Hart, M. Henn, D. Kohler, D. Kloor, M. Mittelbronn, I. C. Gorzolla, G. L. Stahl, and H. K. Eltzschig Role of extracellular nucleotide phosphohydrolysis in intestinal ischemia-reperfusion injury FASEB J, August 1, 2008; 22(8): 2784 - 2797. [Abstract] [Full Text] [PDF] |
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M. L. Hart, D. Kohler, T. Eckle, D. Kloor, G. L. Stahl, and H. K. Eltzschig Direct Treatment of Mouse or Human Blood With Soluble 5'-Nucleotidase Inhibits Platelet Aggregation Arterioscler Thromb Vasc Biol, August 1, 2008; 28(8): 1477 - 1483. [Abstract] [Full Text] [PDF] |
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T. Eckle, D. Kohler, R. Lehmann, K. C. El Kasmi, and H. K. Eltzschig Hypoxia-Inducible Factor-1 Is Central to Cardioprotection: A New Paradigm for Ischemic Preconditioning Circulation, July 8, 2008; 118(2): 166 - 175. [Abstract] [Full Text] [PDF] |
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A. Mikhailov, A. Sokolovskaya, G. G. Yegutkin, H. Amdahl, A. West, H. Yagita, R. Lahesmaa, L. F. Thompson, S. Jalkanen, D. Blokhin, et al. CD73 Participates in Cellular Multiresistance Program and Protects against TRAIL-Induced Apoptosis J. Immunol., July 1, 2008; 181(1): 464 - 475. [Abstract] [Full Text] [PDF] |
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J. C. Morote-Garcia, P. Rosenberger, J. Kuhlicke, and H. K. Eltzschig HIF-1-dependent repression of adenosine kinase attenuates hypoxia-induced vascular leak Blood, June 15, 2008; 111(12): 5571 - 5580. [Abstract] [Full Text] [PDF] |
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X. Xu, J. Fassett, X. Hu, G. Zhu, Z. Lu, Y. Li, J. Schnermann, R. J. Bache, and Y. Chen Ecto-5'-Nucleotidase Deficiency Exacerbates Pressure-Overload-Induced Left Ventricular Hypertrophy and Dysfunction Hypertension, June 1, 2008; 51(6): 1557 - 1564. [Abstract] [Full Text] [PDF] |
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M. Takedachi, D. Qu, Y. Ebisuno, H. Oohara, M. L. Joachims, S. T. McGee, E. Maeda, R. P. McEver, T. Tanaka, M. Miyasaka, et al. CD73-Generated Adenosine Restricts Lymphocyte Migration into Draining Lymph Nodes J. Immunol., May 1, 2008; 180(9): 6288 - 6296. [Abstract] [Full Text] [PDF] |
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T. Eckle, M. Faigle, A. Grenz, S. Laucher, L. F. Thompson, and H. K. Eltzschig A2B adenosine receptor dampens hypoxia-induced vascular leak Blood, February 15, 2008; 111(4): 2024 - 2035. [Abstract] [Full Text] [PDF] |
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S. Jalkanen and M. Salmi VAP-1 and CD73, Endothelial Cell Surface Enzymes in Leukocyte Extravasation Arterioscler Thromb Vasc Biol, January 1, 2008; 28(1): 18 - 26. [Abstract] [Full Text] [PDF] |
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A. Grenz, H. Zhang, J. Weingart, S. von Wietersheim, T. Eckle, J. Schnermann, C. Kohle, D. Kloor, C. H. Gleiter, V. Vallon, et al. Lack of effect of extracellular adenosine generation and signaling on renal erythropoietin secretion during hypoxia Am J Physiol Renal Physiol, November 1, 2007; 293(5): F1501 - F1511. [Abstract] [Full Text] [PDF] |
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D. Kohler, T. Eckle, M. Faigle, A. Grenz, M. Mittelbronn, S. Laucher, M. L. Hart, S. C. Robson, C. E. Muller, and H. K. Eltzschig CD39/Ectonucleoside Triphosphate Diphosphohydrolase 1 Provides Myocardial Protection During Cardiac Ischemia/Reperfusion Injury Circulation, October 16, 2007; 116(16): 1784 - 1794. [Abstract] [Full Text] [PDF] |
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T. Eckle, L. Fullbier, M. Wehrmann, J. Khoury, M. Mittelbronn, J. Ibla, P. Rosenberger, and H. K. Eltzschig Identification of Ectonucleotidases CD39 and CD73 in Innate Protection during Acute Lung Injury J. Immunol., June 15, 2007; 178(12): 8127 - 8137. [Abstract] [Full Text] [PDF] |
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