Skip to main content
Top
Published in: Immunity & Ageing 1/2009

Open Access 01-12-2009 | Research

Alterations of T cell activation signalling and cytokine production by postmenopausal estrogen levels

Authors: Lowell T Ku, Cicek Gercel-Taylor, Steven T Nakajima, Douglas D Taylor

Published in: Immunity & Ageing | Issue 1/2009

Login to get access

Abstract

Background

Immunosenescence is an age-associated disorder occurring primarily in T cell compartments, including altered subset composition, functions, and activation. In women, evidence implicates diminished estrogen in the postmenopausal period as a contributing factor to diminished T cell responsiveness. Since hypoestrogenism is present in postmenopausal women, our objective focused on whether T cell activation, defined as signalling molecule expressions and activation, and function, identified as IL-2 production, were affected by low estrogen.

Methods

Using Jurkat 6.1 T cells, consequences of 4 pg/ml (corresponding to postmenopausal levels) or 40 pg/ml (premenopausal levels) of estradiol (E2) were analyzed on signalling proteins, CD3-zeta, JAK2, and JAK3, determined by Western immunoblotting. These consequences were correlated with corresponding gene expressions, quantified by real time-polymerase chain reaction. Tyrosine phosphorylation of CD3-zeta was defined by immunoprecipitation and western immunoblotting following activation by T cell receptor (TcR) cross-linking. CD3-zeta expression and modulation was also confirmed in T cells from pre- and postmenopausal women. To assess functional consequences, IL-2 production, induced by PMA and ionomycin, was determined using enzyme-linked immunosorbent spot assay (ELISpot).

Results

At 40 pg/ml E2, the level of signalling protein CD3-zeta was elevated 1.57-fold, compared with cells exposed to 4 pg/ml E2. The CD3-zeta proteins also exhibited altered levels of activation-induced phosphorylation in the presence of 40 pg/ml E2 versus 4 pg/ml: 23 kD phosphorylated form increased 2.64-fold and the 21 kD form was elevated 2.95-fold. Examination of kinases associated with activation signalling also demonstrated that, in the presence of 40 pg/ml E2, JAK2 protein expression was increased 1.64-fold (p < 0.001) and JAK3 enhanced 1.79-fold (p < 0.001) compared to 4 pg/ml. mRNA levels for CD3-zeta, JAK2, and JAK3 were significantly increased following exposure to 40 pg/ml E2 (2.39, 2.01, and 2.21 fold, respectively) versus 4 pg/ml. These findings were confirmed in vivo, since T cells from postmenopausal women exhibited 7.2-fold diminished CD3-zeta expression, compared to pre-menopausal controls and this expression was elevated 3.8-fold by addition of 40 pg/ml E2. Functionally, Jurkat cells exposed to 40 pg/ml E2 and activated exhibited significantly elevated numbers of IL-2 producing colonies compared to 4 pg/ml (75.3 ± 2.2 versus 55.7 ± 2.1 colonies, p < 0.0001).

Conclusion

Jurkat T cells exposed to 4 pg/ml E2 expressed significantly diminished activation signalling proteins, correlating with reduced IL-2 production. Lower signalling protein levels appear to result from decreased CD3-zeta, JAK2, and JAK3 gene expressions. These findings may provide a molecular basis for immunosenescence associated with the postmenopausal state.
Appendix
Available only for authorised users
Literature
1.
go back to reference Franceschi C, Bonafè M, Valensin S: Human immunosenescence: the prevailing of innate immunity, the failing of clonotypic immunity, and the filling of immunological space. Vaccine. 2000, 18: 1717-1720.CrossRefPubMed Franceschi C, Bonafè M, Valensin S: Human immunosenescence: the prevailing of innate immunity, the failing of clonotypic immunity, and the filling of immunological space. Vaccine. 2000, 18: 1717-1720.CrossRefPubMed
2.
go back to reference Linton PJ, Lustgarten J, Thoman M: T cell function in the aged: Lessons learned from animal models. Clin Appl Immunol Rev. 2006, 6: 73-97.CrossRef Linton PJ, Lustgarten J, Thoman M: T cell function in the aged: Lessons learned from animal models. Clin Appl Immunol Rev. 2006, 6: 73-97.CrossRef
3.
5.
go back to reference Nagel JE, Chopra RK, Chrest FJ, McCoy MT, Schneider EL, Holbrook NJ, Adler WH: Decreased proliferation, interleukin 2 synthesis, and interleukin 2 receptor expression are accompanied by decreased mRNA expression in phytohemagglutinin-stimulated cells from elderly donors. J Clin Invest. 1988, 81: 1096-1102.PubMedCentralCrossRefPubMed Nagel JE, Chopra RK, Chrest FJ, McCoy MT, Schneider EL, Holbrook NJ, Adler WH: Decreased proliferation, interleukin 2 synthesis, and interleukin 2 receptor expression are accompanied by decreased mRNA expression in phytohemagglutinin-stimulated cells from elderly donors. J Clin Invest. 1988, 81: 1096-1102.PubMedCentralCrossRefPubMed
6.
go back to reference Quadri RA, Plastre O, Phelouzat MA, Arbogast A, Proust JJ: Age-related tyrosine-specific protein phosphorylation defect in human T lymphocytes activated through CD3, CD4, CD8 or the IL-2 receptor. Mech Ageing Dev. 1996, 88: 125-138.CrossRefPubMed Quadri RA, Plastre O, Phelouzat MA, Arbogast A, Proust JJ: Age-related tyrosine-specific protein phosphorylation defect in human T lymphocytes activated through CD3, CD4, CD8 or the IL-2 receptor. Mech Ageing Dev. 1996, 88: 125-138.CrossRefPubMed
7.
go back to reference Miller RA, Garcia G, Kirk CJ, Witkowski JM: Early activation defects in T lymphocytes from aged mice. Immunol Rev. 1997, 160: 79-90.CrossRefPubMed Miller RA, Garcia G, Kirk CJ, Witkowski JM: Early activation defects in T lymphocytes from aged mice. Immunol Rev. 1997, 160: 79-90.CrossRefPubMed
8.
go back to reference Pahlavani MA: T cell signaling: effect of age. Front Biosci. 1998, 3 (1): D1120-1133.PubMed Pahlavani MA: T cell signaling: effect of age. Front Biosci. 1998, 3 (1): D1120-1133.PubMed
9.
go back to reference Whisler RL, Karanfilov CI, Newhouse YG, Fox CC, Lakshanan RR, Liu B: Phosphorylation and coupling of ζ-chains to activated T-cell receptor (TCR)/CD3 complexes from peripheral blood T-cells of elderly humans. Mech Aging Dev. 1998, 105: 115-135.CrossRefPubMed Whisler RL, Karanfilov CI, Newhouse YG, Fox CC, Lakshanan RR, Liu B: Phosphorylation and coupling of ζ-chains to activated T-cell receptor (TCR)/CD3 complexes from peripheral blood T-cells of elderly humans. Mech Aging Dev. 1998, 105: 115-135.CrossRefPubMed
10.
go back to reference Naylor K, Li G, Vallejo AN, Lee WW, Koetz K, Bryl E, Witkowski J, Fulbright J, Weyand CM, Goronzy JJ: The influence of age on T cell generation and TCR diversity. J Immunol. 2005, 174: 7446-7452.CrossRefPubMed Naylor K, Li G, Vallejo AN, Lee WW, Koetz K, Bryl E, Witkowski J, Fulbright J, Weyand CM, Goronzy JJ: The influence of age on T cell generation and TCR diversity. J Immunol. 2005, 174: 7446-7452.CrossRefPubMed
12.
go back to reference Wick G, Grubeck-Loebenstein B: The aging immune system: primary and secondary alterations of immune reactivity in the elderly. Exp Gerontol. 1997, 32: 401-413.CrossRefPubMed Wick G, Grubeck-Loebenstein B: The aging immune system: primary and secondary alterations of immune reactivity in the elderly. Exp Gerontol. 1997, 32: 401-413.CrossRefPubMed
13.
go back to reference Murasko DM, Weiner P, Kaye D: Decline in mitogen induced proliferation of lymphocytes with increasing age. Clin Exp Immunol. 1987, 70: 440-8.PubMedCentralPubMed Murasko DM, Weiner P, Kaye D: Decline in mitogen induced proliferation of lymphocytes with increasing age. Clin Exp Immunol. 1987, 70: 440-8.PubMedCentralPubMed
14.
go back to reference Whisler RL, Beiqing L, Chen M: Age-related decreases in IL-2 production by human T cells are associated with impaired activation of nuclear transcriptional factors AP-1 and NF-AT. Cell Immunol. 1996, 169: 185-95.CrossRefPubMed Whisler RL, Beiqing L, Chen M: Age-related decreases in IL-2 production by human T cells are associated with impaired activation of nuclear transcriptional factors AP-1 and NF-AT. Cell Immunol. 1996, 169: 185-95.CrossRefPubMed
15.
go back to reference Nel AE, Slaughter N: T-cell activation through the antigen receptor. Part 2: role of signalling cascades in T-cell differentiation, anergy, immune senescence, and development of immunotherapy. J Allergy Clin Immunol. 2002, 109: 901-15.CrossRefPubMed Nel AE, Slaughter N: T-cell activation through the antigen receptor. Part 2: role of signalling cascades in T-cell differentiation, anergy, immune senescence, and development of immunotherapy. J Allergy Clin Immunol. 2002, 109: 901-15.CrossRefPubMed
16.
go back to reference Shi J, Miller RA: Tyrosine-specific protein phosphorylation in response to anti-CD3 antibody is diminished in old mice. J Gerontol. 1992, 47 (5): B147-B153.CrossRefPubMed Shi J, Miller RA: Tyrosine-specific protein phosphorylation in response to anti-CD3 antibody is diminished in old mice. J Gerontol. 1992, 47 (5): B147-B153.CrossRefPubMed
17.
go back to reference Johnston JA, Bacon CM, Finbloom DS, Rees RC, Kaplan D, Shibuya K, Ortaldo JR, Gupta S, Chen YO, Giri JD: Tyrosine phosphorylation and activation of STAT5, STAT3, and Janus kinases by interleukins 2 and 15. Proc Natl Acad Sci USA. 1995, 92: 8705-8709.PubMedCentralCrossRefPubMed Johnston JA, Bacon CM, Finbloom DS, Rees RC, Kaplan D, Shibuya K, Ortaldo JR, Gupta S, Chen YO, Giri JD: Tyrosine phosphorylation and activation of STAT5, STAT3, and Janus kinases by interleukins 2 and 15. Proc Natl Acad Sci USA. 1995, 92: 8705-8709.PubMedCentralCrossRefPubMed
18.
go back to reference Pietschmann P, Gollob E, Brosch S, Hahn P, Kudlacek S, Wilheim M, Woloszczuk W, Peterlik M, Tragl KH: The effect of age and gender on cytokine production by human peripheral nlood mononuclear cells and markers of bone metabolism. Exp Gerontol. 2003, 38 (10): 1119-1127.CrossRefPubMed Pietschmann P, Gollob E, Brosch S, Hahn P, Kudlacek S, Wilheim M, Woloszczuk W, Peterlik M, Tragl KH: The effect of age and gender on cytokine production by human peripheral nlood mononuclear cells and markers of bone metabolism. Exp Gerontol. 2003, 38 (10): 1119-1127.CrossRefPubMed
19.
go back to reference Khosla S, Melton LJ, Atkinson EJ, O'Fallon WM, Klee GG, Riggs BL: Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: A key role of bioavailable estrogen. J Clin Endocrinol Metab. 1998, 83: 2266-2274.PubMed Khosla S, Melton LJ, Atkinson EJ, O'Fallon WM, Klee GG, Riggs BL: Relationship of serum sex steroid levels and bone turnover markers with bone mineral density in men and women: A key role of bioavailable estrogen. J Clin Endocrinol Metab. 1998, 83: 2266-2274.PubMed
20.
go back to reference Vermeulen A, Kaufman JM, Goemaere S, van Pottelberg I: Estradiol in elderly men. Aging Male. 2002, 5: 98-102.CrossRefPubMed Vermeulen A, Kaufman JM, Goemaere S, van Pottelberg I: Estradiol in elderly men. Aging Male. 2002, 5: 98-102.CrossRefPubMed
21.
go back to reference Dolomie-Fagour L, Gatta B, Nguyen TDT, Corcuff JB: Bioavailable estradiol in man: Relationship with age and testosterone. Clin Chim Acta. 2008, 398: 145-147.CrossRefPubMed Dolomie-Fagour L, Gatta B, Nguyen TDT, Corcuff JB: Bioavailable estradiol in man: Relationship with age and testosterone. Clin Chim Acta. 2008, 398: 145-147.CrossRefPubMed
22.
go back to reference Zhu BT, Han GZ, Shim JY, Wen Y, Jiang XR: Quantitative structure-activity relationship of various endogenous estrogen metabolites for human estrogen receptor α and β subtypes: Insights into the structural determinants favoring a differential subtype binding. Endocrinol. 2006, 147: 4132-4150.CrossRef Zhu BT, Han GZ, Shim JY, Wen Y, Jiang XR: Quantitative structure-activity relationship of various endogenous estrogen metabolites for human estrogen receptor α and β subtypes: Insights into the structural determinants favoring a differential subtype binding. Endocrinol. 2006, 147: 4132-4150.CrossRef
23.
go back to reference Li J, McMurray RW: Effects of estrogen subtype-selective agonists on immune functions in ovariectomized mice. Int Immunopharmacol. 2006, 6: 1413-1423.CrossRefPubMed Li J, McMurray RW: Effects of estrogen subtype-selective agonists on immune functions in ovariectomized mice. Int Immunopharmacol. 2006, 6: 1413-1423.CrossRefPubMed
24.
go back to reference Giglio T, Imro MA, Filaci G, Scudeletti M, Puppo F, De Cecco L, Indiveri F, Costantini S: Immune cell circulating subsets are affected by gonadal function. Life Sci. 1994, 54: 1305-1312.CrossRefPubMed Giglio T, Imro MA, Filaci G, Scudeletti M, Puppo F, De Cecco L, Indiveri F, Costantini S: Immune cell circulating subsets are affected by gonadal function. Life Sci. 1994, 54: 1305-1312.CrossRefPubMed
25.
26.
go back to reference Porter VR, Greendale GA, Schocken M, Zhu X, Effros RB: Immune effects of hormone replacement therapy in post-menopausal women. Exper Gerontol. 2001, 36: 311-326.CrossRef Porter VR, Greendale GA, Schocken M, Zhu X, Effros RB: Immune effects of hormone replacement therapy in post-menopausal women. Exper Gerontol. 2001, 36: 311-326.CrossRef
27.
go back to reference Kumru S, Godekmerdan A, Ytlmaz B: Immune effects of surgical menopause and estrogen replacement therapy in peri-menopausal women. J Reprod Immunol. 2004, 63: 31-38.CrossRefPubMed Kumru S, Godekmerdan A, Ytlmaz B: Immune effects of surgical menopause and estrogen replacement therapy in peri-menopausal women. J Reprod Immunol. 2004, 63: 31-38.CrossRefPubMed
28.
go back to reference Kahlke V, Angele MK, Ayala A, Schwacha MG, Cioffi WG, Bland KI, Chaudry H: Immune dysfunction following trauma-hemorrhage: influence of gender and age. Cytokine. 2000, 12: 69-77.CrossRefPubMed Kahlke V, Angele MK, Ayala A, Schwacha MG, Cioffi WG, Bland KI, Chaudry H: Immune dysfunction following trauma-hemorrhage: influence of gender and age. Cytokine. 2000, 12: 69-77.CrossRefPubMed
29.
go back to reference De la Fuente M, Baeza I, Guayerbas N, Alvarez P, Alvarado C: Changes with aging in several leukocyte functions of male and female rats. Biogerontology. 2004, 5 (6): 389-400.CrossRefPubMed De la Fuente M, Baeza I, Guayerbas N, Alvarez P, Alvarado C: Changes with aging in several leukocyte functions of male and female rats. Biogerontology. 2004, 5 (6): 389-400.CrossRefPubMed
30.
go back to reference Juby AG, Davis P: Prevalence and disease associations of certain autoantibodies in elderly patients. Clin Investig Med. 1998, 21 (1): 4-11. Juby AG, Davis P: Prevalence and disease associations of certain autoantibodies in elderly patients. Clin Investig Med. 1998, 21 (1): 4-11.
31.
go back to reference Rogers A, Eastell R: Effects of estrogen therapy of postmenopausal women on cytokines measured in peripheral blood. J Bone Miner Res. 1998, 13: 1577-1586.CrossRefPubMed Rogers A, Eastell R: Effects of estrogen therapy of postmenopausal women on cytokines measured in peripheral blood. J Bone Miner Res. 1998, 13: 1577-1586.CrossRefPubMed
32.
go back to reference Kamada M, Irahara M, Maegawa M, Ohmoto Y, Takeji T, Yasui T, Aono T: Postmenopausal changes in serum cytokine levels and hormone replacement therapy. Am J Obstet Gynecol. 2001, 184: 309-313.CrossRefPubMed Kamada M, Irahara M, Maegawa M, Ohmoto Y, Takeji T, Yasui T, Aono T: Postmenopausal changes in serum cytokine levels and hormone replacement therapy. Am J Obstet Gynecol. 2001, 184: 309-313.CrossRefPubMed
33.
go back to reference Ferguson FG, Wikby A, Maxson P, Olsson J, Johansson B: Immune parameters in a longitudinal study of very old population of Swedish people: A comparison between survivors and nonsurvivors. J Gerontol A Biol Sci Med Sci. 1995, 50 (6): B378-B382.CrossRefPubMed Ferguson FG, Wikby A, Maxson P, Olsson J, Johansson B: Immune parameters in a longitudinal study of very old population of Swedish people: A comparison between survivors and nonsurvivors. J Gerontol A Biol Sci Med Sci. 1995, 50 (6): B378-B382.CrossRefPubMed
34.
go back to reference Hasler P, Zouali M: Immune receptor signalling, aging, and autoimmunty. Cell Immunol. 2005, 233: 102-108.CrossRefPubMed Hasler P, Zouali M: Immune receptor signalling, aging, and autoimmunty. Cell Immunol. 2005, 233: 102-108.CrossRefPubMed
35.
go back to reference Simpson ER, Misso M, Hewitt KN, Hill RA, Boon WC, Jones ME, Kovacic A, Zhou J, Clyne CD: Estrogen: the good, the bad and the unexpected. Endocrine Rev. 2005, 26: 322-330.CrossRef Simpson ER, Misso M, Hewitt KN, Hill RA, Boon WC, Jones ME, Kovacic A, Zhou J, Clyne CD: Estrogen: the good, the bad and the unexpected. Endocrine Rev. 2005, 26: 322-330.CrossRef
36.
go back to reference Simpson ER, Davis SR: Aromatase and the regulation of estrogen biosynthesis: Some new perspectives. Endocrinology. 2001, 142 (11): 4589-4594.PubMed Simpson ER, Davis SR: Aromatase and the regulation of estrogen biosynthesis: Some new perspectives. Endocrinology. 2001, 142 (11): 4589-4594.PubMed
37.
go back to reference Simpson E, Davis S: Why do the clinical sequelae of estrogen deficiency affect women more than men?. J Clin Endocrinol Metab. 1998, 83 (6): 2214-CrossRefPubMed Simpson E, Davis S: Why do the clinical sequelae of estrogen deficiency affect women more than men?. J Clin Endocrinol Metab. 1998, 83 (6): 2214-CrossRefPubMed
38.
go back to reference McDonnell DP, Norris JD: Connections and regulation of the human estrogen receptor. Science. 2002, 296: 1642-1644.CrossRefPubMed McDonnell DP, Norris JD: Connections and regulation of the human estrogen receptor. Science. 2002, 296: 1642-1644.CrossRefPubMed
39.
go back to reference Jick SS, Hagberg KW, Kaye JA, Jick H: Postmenopausal estrogen-containing hormone therapy and the risk of breast cancer. Obstet Gynecol. 2009, 113: 74-80.CrossRefPubMed Jick SS, Hagberg KW, Kaye JA, Jick H: Postmenopausal estrogen-containing hormone therapy and the risk of breast cancer. Obstet Gynecol. 2009, 113: 74-80.CrossRefPubMed
40.
go back to reference Marriott I, Huet-Hudson YM: Sexual dimorphism in innate immune responses to infectious organisms. Immunol Res. 2006, 34: 177-192.CrossRefPubMed Marriott I, Huet-Hudson YM: Sexual dimorphism in innate immune responses to infectious organisms. Immunol Res. 2006, 34: 177-192.CrossRefPubMed
41.
42.
go back to reference Meyers BR, Sherman E, Mendelson MH, Velasquez G, Srulevitch-Chin E, Hubbard M, Hirschman SZ: Blood stream infections in the elderly. Am J Med. 1989, 86: 379-384.CrossRefPubMed Meyers BR, Sherman E, Mendelson MH, Velasquez G, Srulevitch-Chin E, Hubbard M, Hirschman SZ: Blood stream infections in the elderly. Am J Med. 1989, 86: 379-384.CrossRefPubMed
43.
go back to reference Kammer GM, Tsokos GC: Emerging concepts of the molecular basis for estrogen effects on T lymphocytes in systemic lupus erythematosus. Clin Immunol Immunopathol. 1998, 89: 192-195.CrossRefPubMed Kammer GM, Tsokos GC: Emerging concepts of the molecular basis for estrogen effects on T lymphocytes in systemic lupus erythematosus. Clin Immunol Immunopathol. 1998, 89: 192-195.CrossRefPubMed
44.
go back to reference Huang AJ, Ettinger B, Vittinghoff E, Ensrud KE, Johnson KC, Cummings SR: Endogenous estrogen levels and the effects of ultra-low-dose transdermal estradiol therapy on bone turnover and BMD in postmenopausal women. J Bone Miner Res. 2007, 22: 1791-1797.CrossRefPubMed Huang AJ, Ettinger B, Vittinghoff E, Ensrud KE, Johnson KC, Cummings SR: Endogenous estrogen levels and the effects of ultra-low-dose transdermal estradiol therapy on bone turnover and BMD in postmenopausal women. J Bone Miner Res. 2007, 22: 1791-1797.CrossRefPubMed
45.
go back to reference Detti L, Saed GM, Jiang ZL, Kruger ML, Diamond MP: The effect of estradiol on the expression of estrogen, progesterone, androgen, and prolactin receptors in human peritoneal fibroblasts. J Assist Reprod Genet. 2008, 25: 245-250.PubMedCentralCrossRefPubMed Detti L, Saed GM, Jiang ZL, Kruger ML, Diamond MP: The effect of estradiol on the expression of estrogen, progesterone, androgen, and prolactin receptors in human peritoneal fibroblasts. J Assist Reprod Genet. 2008, 25: 245-250.PubMedCentralCrossRefPubMed
46.
go back to reference Laemmli UK: Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature. 1970, 227: 680-685.CrossRefPubMed Laemmli UK: Cleavage of structural proteins during the assembly of the head of bacteriophage T4. Nature. 1970, 227: 680-685.CrossRefPubMed
47.
go back to reference Brown R, Clugston C, Burns P, Edlin A, Vasey P, Vojtesek B, Kaye SB: Increased accumulation of p53 protein in cisplatin-resistant ovarian cell lines. Int J Cancer. 1993, 55: 678-684.CrossRefPubMed Brown R, Clugston C, Burns P, Edlin A, Vasey P, Vojtesek B, Kaye SB: Increased accumulation of p53 protein in cisplatin-resistant ovarian cell lines. Int J Cancer. 1993, 55: 678-684.CrossRefPubMed
Metadata
Title
Alterations of T cell activation signalling and cytokine production by postmenopausal estrogen levels
Authors
Lowell T Ku
Cicek Gercel-Taylor
Steven T Nakajima
Douglas D Taylor
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Immunity & Ageing / Issue 1/2009
Electronic ISSN: 1742-4933
DOI
https://doi.org/10.1186/1742-4933-6-1

Other articles of this Issue 1/2009

Immunity & Ageing 1/2009 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.