Skip to main content
Top
Published in: Diabetologia 5/2007

01-05-2007 | Article

Atrial natriuretic peptide inhibits the production of adipokines and cytokines linked to inflammation and insulin resistance in human subcutaneous adipose tissue

Authors: C. Moro, E. Klimcakova, K. Lolmède, M. Berlan, M. Lafontan, V. Stich, A. Bouloumié, J. Galitzky, P. Arner, D. Langin

Published in: Diabetologia | Issue 5/2007

Login to get access

Abstract

Aims/hypothesis

Increased adipose tissue secretion of adipokines and cytokines has been implicated in the chronic low-grade inflammation state and insulin resistance associated with obesity. We tested here whether the cardiovascular and metabolic hormone atrial natriuretic peptide (ANP) was able to modulate adipose tissue secretion of several adipokines (derived from adipocytes) and cytokines (derived from adipose tissue macrophages).

Subjects and methods

We used protein array to measure the secretion of adipokines and cytokines after a 24-h culture of human subcutaneous adipose tissue pieces treated or not with a physiological concentration of ANP. The effect of ANP on protein secretion was also directly studied on isolated adipocytes and macrophages. Gene expression was measured by real-time RT-quantitative PCR.

Results

ANP decreased the secretion of the pro-inflammatory cytokines IL-6 and TNF-α, of several chemokines, and of the adipokines leptin and retinol-binding protein-4 (RBP-4). The secretion of the anti-inflammatory molecules IL-10 and adiponectin remained unaffected. The cytokines were mainly expressed in macrophages that expressed all components of the ANP-dependent signalling pathway. The adipokines, leptin, adiponectin and RBP-4 were specifically expressed in mature adipocytes. ANP directly inhibited the secretion of IL-6 and monocyte chemoattractant protein-1 by macrophages. The inhibitory effects of ANP on leptin and growth-related oncogene-α secretions were not seen under selective hormone-sensitive lipase inhibition.

Conclusions/interpretation

We suggest that ANP, either by direct action on adipocytes and macrophages or through activation of adipocyte hormone-sensitive lipase, inhibits the secretion of factors involved in inflammation and insulin resistance.
Literature
1.
go back to reference Festa A, D’Agostino R Jr, Howard G, Mykkanen L, Tracy RP, Haffner SM (2000) Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 102:42–47PubMed Festa A, D’Agostino R Jr, Howard G, Mykkanen L, Tracy RP, Haffner SM (2000) Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 102:42–47PubMed
2.
go back to reference Frohlich M, Imhof A, Berg G et al (2000) Association between C-reactive protein and features of the metabolic syndrome: a population-based study. Diabetes Care 23:1835–1839PubMedCrossRef Frohlich M, Imhof A, Berg G et al (2000) Association between C-reactive protein and features of the metabolic syndrome: a population-based study. Diabetes Care 23:1835–1839PubMedCrossRef
3.
go back to reference Pai JK, Pischon T, Ma J et al (2004) Inflammatory markers and the risk of coronary heart disease in men and women. N Engl J Med 351:2599–2610PubMedCrossRef Pai JK, Pischon T, Ma J et al (2004) Inflammatory markers and the risk of coronary heart disease in men and women. N Engl J Med 351:2599–2610PubMedCrossRef
4.
go back to reference Ridker PM (2005) C-reactive protein, inflammation, and cardiovascular disease: clinical update. Tex Heart Inst J 32:384–386PubMed Ridker PM (2005) C-reactive protein, inflammation, and cardiovascular disease: clinical update. Tex Heart Inst J 32:384–386PubMed
5.
go back to reference Vozarova B, Weyer C, Hanson K, Tataranni PA, Bogardus C, Pratley RE (2001) Circulating interleukin-6 in relation to adiposity, insulin action, and insulin secretion. Obes Res 9:414–417PubMedCrossRef Vozarova B, Weyer C, Hanson K, Tataranni PA, Bogardus C, Pratley RE (2001) Circulating interleukin-6 in relation to adiposity, insulin action, and insulin secretion. Obes Res 9:414–417PubMedCrossRef
6.
go back to reference Haffner SM (2006) The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am J Cardiol 97:3A–11APubMedCrossRef Haffner SM (2006) The metabolic syndrome: inflammation, diabetes mellitus, and cardiovascular disease. Am J Cardiol 97:3A–11APubMedCrossRef
7.
go back to reference Schindler TH, Cardenas J, Prior JO et al (2006) Relationship between increasing body weight, insulin resistance, inflammation, adipocytokine leptin, and coronary circulatory function. J Am Coll Cardiol 47:1188–1195PubMedCrossRef Schindler TH, Cardenas J, Prior JO et al (2006) Relationship between increasing body weight, insulin resistance, inflammation, adipocytokine leptin, and coronary circulatory function. J Am Coll Cardiol 47:1188–1195PubMedCrossRef
8.
go back to reference Kershaw EE, Flier JS (2004) Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 89:2548–2556PubMedCrossRef Kershaw EE, Flier JS (2004) Adipose tissue as an endocrine organ. J Clin Endocrinol Metab 89:2548–2556PubMedCrossRef
9.
go back to reference Moller DE (2000) Potential role of TNF-alpha in the pathogenesis of insulin resistance and type 2 diabetes. Trends Endocrinol Metab 11:212–217PubMedCrossRef Moller DE (2000) Potential role of TNF-alpha in the pathogenesis of insulin resistance and type 2 diabetes. Trends Endocrinol Metab 11:212–217PubMedCrossRef
10.
go back to reference Sartipy P, Loskutoff DJ (2003) Monocyte chemoattractant protein 1 in obesity and insulin resistance. Proc Natl Acad Sci USA 100:7265–7270PubMedCrossRef Sartipy P, Loskutoff DJ (2003) Monocyte chemoattractant protein 1 in obesity and insulin resistance. Proc Natl Acad Sci USA 100:7265–7270PubMedCrossRef
11.
go back to reference Maachi M, Pieroni L, Bruckert E et al (2004) Systemic low-grade inflammation is related to both circulating and adipose tissue TNFalpha, leptin and IL-6 levels in obese women. Int J Obes 28:993–997CrossRef Maachi M, Pieroni L, Bruckert E et al (2004) Systemic low-grade inflammation is related to both circulating and adipose tissue TNFalpha, leptin and IL-6 levels in obese women. Int J Obes 28:993–997CrossRef
12.
go back to reference Yang Q, Graham TE, Mody N et al (2005) Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature 436:356–362PubMedCrossRef Yang Q, Graham TE, Mody N et al (2005) Serum retinol binding protein 4 contributes to insulin resistance in obesity and type 2 diabetes. Nature 436:356–362PubMedCrossRef
13.
go back to reference Cancello R, Henegar C, Viguerie N et al (2005) Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes 54:2277–2286PubMedCrossRef Cancello R, Henegar C, Viguerie N et al (2005) Reduction of macrophage infiltration and chemoattractant gene expression changes in white adipose tissue of morbidly obese subjects after surgery-induced weight loss. Diabetes 54:2277–2286PubMedCrossRef
14.
go back to reference Curat CA, Wegner V, Sengenes C et al (2006) Macrophages in human visceral adipose tissue: increased accumulation in obesity and a source of resistin and visfatin. Diabetologia 49:744–747PubMedCrossRef Curat CA, Wegner V, Sengenes C et al (2006) Macrophages in human visceral adipose tissue: increased accumulation in obesity and a source of resistin and visfatin. Diabetologia 49:744–747PubMedCrossRef
15.
go back to reference Cancello R, Tordjman J, Poitou C et al (2006) Increased infiltration of macrophages in omental adipose tissue is associated with marked hepatic lesions in morbid human obesity. Diabetes 55:1554–1561PubMedCrossRef Cancello R, Tordjman J, Poitou C et al (2006) Increased infiltration of macrophages in omental adipose tissue is associated with marked hepatic lesions in morbid human obesity. Diabetes 55:1554–1561PubMedCrossRef
16.
go back to reference Potter LR, Abbey-Hosch S, Dickey DM (2006) Natriuretic peptides, their receptors, and cyclic guanosine monophosphate-dependent signaling functions. Endocr Rev 27:47–72PubMedCrossRef Potter LR, Abbey-Hosch S, Dickey DM (2006) Natriuretic peptides, their receptors, and cyclic guanosine monophosphate-dependent signaling functions. Endocr Rev 27:47–72PubMedCrossRef
17.
go back to reference Sengenès C, Berlan M, de Glisezinski I, Lafontan M, Galitzky J (2000) Natriuretic peptides: a new lipolytic pathway in human adipocytes. FASEB J 14:1345–1351PubMedCrossRef Sengenès C, Berlan M, de Glisezinski I, Lafontan M, Galitzky J (2000) Natriuretic peptides: a new lipolytic pathway in human adipocytes. FASEB J 14:1345–1351PubMedCrossRef
18.
go back to reference Lafontan M, Moro C, Sengenes C, Galitzky J, Crampes F, Berlan M (2005) An unsuspected metabolic role for atrial natriuretic peptides: the control of lipolysis, lipid mobilization, and systemic nonesterified fatty acids levels in humans. Arterioscler Thromb Vasc Biol 25:2032–2042PubMedCrossRef Lafontan M, Moro C, Sengenes C, Galitzky J, Crampes F, Berlan M (2005) An unsuspected metabolic role for atrial natriuretic peptides: the control of lipolysis, lipid mobilization, and systemic nonesterified fatty acids levels in humans. Arterioscler Thromb Vasc Biol 25:2032–2042PubMedCrossRef
19.
go back to reference Smith U (1971) Morphologic studies of human subcutaneous adipose tissue in vitro. Anat Rec 169:97–104PubMedCrossRef Smith U (1971) Morphologic studies of human subcutaneous adipose tissue in vitro. Anat Rec 169:97–104PubMedCrossRef
20.
go back to reference Fried SK, Russell CD, Grauso NL, Brolin RE (1993) Lipoprotein lipase regulation by insulin and glucocorticoid in subcutaneous and omental adipose tissues of obese women and men. J Clin Invest 92:2191–2198PubMed Fried SK, Russell CD, Grauso NL, Brolin RE (1993) Lipoprotein lipase regulation by insulin and glucocorticoid in subcutaneous and omental adipose tissues of obese women and men. J Clin Invest 92:2191–2198PubMed
21.
go back to reference Lowe DB, Magnuson S, Qi N et al (2004) In vitro SAR of (5-(2H)-isoxazolonyl) ureas, potent inhibitors of hormone-sensitive lipase. Bioorg Med Chem Lett 14:3155–3159PubMedCrossRef Lowe DB, Magnuson S, Qi N et al (2004) In vitro SAR of (5-(2H)-isoxazolonyl) ureas, potent inhibitors of hormone-sensitive lipase. Bioorg Med Chem Lett 14:3155–3159PubMedCrossRef
22.
go back to reference Langin D, Dicker A, Tavernier G et al (2005) Adipocyte lipases and defect of lipolysis in human obesity. Diabetes 54:3190–3197PubMedCrossRef Langin D, Dicker A, Tavernier G et al (2005) Adipocyte lipases and defect of lipolysis in human obesity. Diabetes 54:3190–3197PubMedCrossRef
23.
go back to reference Schlesinger JB, van Harmelen V, Alberti-Huber CE, Hauner H (2006) Albumin inhibits adipogenesis and stimulates cytokine release from human adipocytes. Am J Physiol Cell Physiol 291:C27–C33PubMedCrossRef Schlesinger JB, van Harmelen V, Alberti-Huber CE, Hauner H (2006) Albumin inhibits adipogenesis and stimulates cytokine release from human adipocytes. Am J Physiol Cell Physiol 291:C27–C33PubMedCrossRef
24.
go back to reference Xu Y, Kulkosky J, Acheampong E, Nunnari G, Sullivan J, Pomerantz RJ (2004) HIV-1-mediated apoptosis of neuronal cells: Proximal molecular mechanisms of HIV-1-induced encephalopathy. Proc Natl Acad Sci USA 101:7070–7075PubMedCrossRef Xu Y, Kulkosky J, Acheampong E, Nunnari G, Sullivan J, Pomerantz RJ (2004) HIV-1-mediated apoptosis of neuronal cells: Proximal molecular mechanisms of HIV-1-induced encephalopathy. Proc Natl Acad Sci USA 101:7070–7075PubMedCrossRef
25.
go back to reference Rodbell M (1964) Metabolism of isolated fat cells. Effects of hormones on glucose metabolism and lipolysis. J Biol Chem 29:375–380 Rodbell M (1964) Metabolism of isolated fat cells. Effects of hormones on glucose metabolism and lipolysis. J Biol Chem 29:375–380
26.
go back to reference Dole VP, Meinertz H (1960) Microdetermination of long-chain fatty acids in plasma and tissues. J Biol Chem 235:2595–2599PubMed Dole VP, Meinertz H (1960) Microdetermination of long-chain fatty acids in plasma and tissues. J Biol Chem 235:2595–2599PubMed
27.
go back to reference Curat CA, Miranville A, Sengenes C et al (2004) From blood monocytes to adipose tissue-resident macrophages: induction of diapedesis by human mature adipocytes. Diabetes 53:1285–1292PubMedCrossRef Curat CA, Miranville A, Sengenes C et al (2004) From blood monocytes to adipose tissue-resident macrophages: induction of diapedesis by human mature adipocytes. Diabetes 53:1285–1292PubMedCrossRef
28.
go back to reference Berlan M, Carpene C, Lafontan M, Dang-Tran L (1982) Alpha-2 adrenergic antilipolytic effect in dog fat cells: incidence of obesity and adipose tissue localization. Horm Metab Res 14:257–260PubMedCrossRef Berlan M, Carpene C, Lafontan M, Dang-Tran L (1982) Alpha-2 adrenergic antilipolytic effect in dog fat cells: incidence of obesity and adipose tissue localization. Horm Metab Res 14:257–260PubMedCrossRef
29.
go back to reference Xu H, Barnes GT, Yang Q et al (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112:1821–1830PubMedCrossRef Xu H, Barnes GT, Yang Q et al (2003) Chronic inflammation in fat plays a crucial role in the development of obesity-related insulin resistance. J Clin Invest 112:1821–1830PubMedCrossRef
30.
go back to reference Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW Jr (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 112:1796–1808PubMedCrossRef Weisberg SP, McCann D, Desai M, Rosenbaum M, Leibel RL, Ferrante AW Jr (2003) Obesity is associated with macrophage accumulation in adipose tissue. J Clin Invest 112:1796–1808PubMedCrossRef
31.
go back to reference Dietze-Schroeder D, Sell H, Uhlig M, Koenen M, Eckel J (2005) Autocrine action of adiponectin on human fat cells prevents the release of insulin resistance-inducing factors. Diabetes 54:2003–2011PubMedCrossRef Dietze-Schroeder D, Sell H, Uhlig M, Koenen M, Eckel J (2005) Autocrine action of adiponectin on human fat cells prevents the release of insulin resistance-inducing factors. Diabetes 54:2003–2011PubMedCrossRef
32.
go back to reference Fain J, Kanu A, Bahouth S, Cowan G, Lloyd Hiler M (2003) Inhibition of leptin release by atrial natriuretic peptide (ANP) in human adipocytes. Biochem Pharmacol 65:1883–1888PubMed Fain J, Kanu A, Bahouth S, Cowan G, Lloyd Hiler M (2003) Inhibition of leptin release by atrial natriuretic peptide (ANP) in human adipocytes. Biochem Pharmacol 65:1883–1888PubMed
33.
go back to reference Fantuzzi G (2005) Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 115:911–919, (quiz 920)PubMedCrossRef Fantuzzi G (2005) Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol 115:911–919, (quiz 920)PubMedCrossRef
34.
35.
go back to reference Plomgaard P, Bouzakri K, Krogh-Madsen R, Mittendorfer B, Zierath JR, Pedersen BK (2005) Tumor necrosis factor-alpha induces skeletal muscle insulin resistance in healthy human subjects via inhibition of Akt substrate 160 phosphorylation. Diabetes 54:2939–2945PubMedCrossRef Plomgaard P, Bouzakri K, Krogh-Madsen R, Mittendorfer B, Zierath JR, Pedersen BK (2005) Tumor necrosis factor-alpha induces skeletal muscle insulin resistance in healthy human subjects via inhibition of Akt substrate 160 phosphorylation. Diabetes 54:2939–2945PubMedCrossRef
36.
go back to reference Carey AL, Steinberg GR, Macaulay SL et al (2006) Interleukin-6 increases insulin-stimulated glucose disposal in humans and glucose uptake and fatty acid oxidation in vitro via AMP-activated protein kinase. Diabetes 55:2688–2697PubMedCrossRef Carey AL, Steinberg GR, Macaulay SL et al (2006) Interleukin-6 increases insulin-stimulated glucose disposal in humans and glucose uptake and fatty acid oxidation in vitro via AMP-activated protein kinase. Diabetes 55:2688–2697PubMedCrossRef
37.
go back to reference Tamori Y, Sakaue H, Kasuga M (2006) RBP4, an unexpected adipokine. Nat Med 12:30–31, discussion 31PubMedCrossRef Tamori Y, Sakaue H, Kasuga M (2006) RBP4, an unexpected adipokine. Nat Med 12:30–31, discussion 31PubMedCrossRef
38.
go back to reference Graham TE, Yang Q, Bluher M et al (2006) Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. N Engl J Med 354:2552–2563PubMedCrossRef Graham TE, Yang Q, Bluher M et al (2006) Retinol-binding protein 4 and insulin resistance in lean, obese, and diabetic subjects. N Engl J Med 354:2552–2563PubMedCrossRef
39.
go back to reference Weisberg SP, Hunter D, Huber R et al (2006) CCR2 modulates inflammatory and metabolic effects of high-fat feeding. J Clin Invest 116:115–124PubMedCrossRef Weisberg SP, Hunter D, Huber R et al (2006) CCR2 modulates inflammatory and metabolic effects of high-fat feeding. J Clin Invest 116:115–124PubMedCrossRef
40.
go back to reference Becker S, Quay J, Koren HS, Haskill JS (1994) Constitutive and stimulated MCP-1, GRO alpha, beta, and gamma expression in human airway epithelium and bronchoalveolar macrophages. Am J Physiol 266:L278–L286PubMed Becker S, Quay J, Koren HS, Haskill JS (1994) Constitutive and stimulated MCP-1, GRO alpha, beta, and gamma expression in human airway epithelium and bronchoalveolar macrophages. Am J Physiol 266:L278–L286PubMed
41.
go back to reference Jinquan T, Frydenberg J, Mukaida N et al (1995) Recombinant human growth-regulated oncogene-alpha induces T lymphocyte chemotaxis. A process regulated via IL-8 receptors by IFN-gamma, TNF-alpha, IL-4, IL-10, and IL-13. J Immunol 155:5359–5368PubMed Jinquan T, Frydenberg J, Mukaida N et al (1995) Recombinant human growth-regulated oncogene-alpha induces T lymphocyte chemotaxis. A process regulated via IL-8 receptors by IFN-gamma, TNF-alpha, IL-4, IL-10, and IL-13. J Immunol 155:5359–5368PubMed
42.
go back to reference Vollmar AM (2005) The role of atrial natriuretic peptide in the immune system. Peptides 26:1086–1094PubMedCrossRef Vollmar AM (2005) The role of atrial natriuretic peptide in the immune system. Peptides 26:1086–1094PubMedCrossRef
43.
go back to reference Kiemer AK, Hartung T, Vollmar AM (2000) cGMP-mediated inhibition of TNF-alpha production by the atrial natriuretic peptide in murine macrophages. J Immunol 165:175–181PubMed Kiemer AK, Hartung T, Vollmar AM (2000) cGMP-mediated inhibition of TNF-alpha production by the atrial natriuretic peptide in murine macrophages. J Immunol 165:175–181PubMed
44.
go back to reference Kiemer AK, Vollmar AM (2001) The atrial natriuretic peptide regulates the production of inflammatory mediators in macrophages. Ann Rheum Dis 60(Suppl 3):iii68–iii70PubMed Kiemer AK, Vollmar AM (2001) The atrial natriuretic peptide regulates the production of inflammatory mediators in macrophages. Ann Rheum Dis 60(Suppl 3):iii68–iii70PubMed
45.
go back to reference Kiemer AK, Baron A, Gerbes AL, Bilzer M, Vollmar AM (2002) The atrial natriuretic peptide as a regulator of Kupffer cell functions. Shock 17:365–371PubMedCrossRef Kiemer AK, Baron A, Gerbes AL, Bilzer M, Vollmar AM (2002) The atrial natriuretic peptide as a regulator of Kupffer cell functions. Shock 17:365–371PubMedCrossRef
46.
go back to reference Suganami T, Nishida J, Ogawa Y (2005) A paracrine loop between adipocytes and macrophages aggravates inflammatory changes: role of free fatty acids and tumor necrosis factor alpha. Arterioscler Thromb Vasc Biol 25:2062–2068PubMedCrossRef Suganami T, Nishida J, Ogawa Y (2005) A paracrine loop between adipocytes and macrophages aggravates inflammatory changes: role of free fatty acids and tumor necrosis factor alpha. Arterioscler Thromb Vasc Biol 25:2062–2068PubMedCrossRef
47.
go back to reference Villarroya F, Giralt M, Iglesias R (1999) Retinoids and adipose tissues: metabolism, cell differentiation and gene expression. Int J Obes 23:1–6CrossRef Villarroya F, Giralt M, Iglesias R (1999) Retinoids and adipose tissues: metabolism, cell differentiation and gene expression. Int J Obes 23:1–6CrossRef
48.
go back to reference Wei S, Lai K, Patel S et al (1997) Retinyl ester hydrolysis and retinol efflux from BFC-1beta adipocytes. J Biol Chem 272:14159–14165PubMedCrossRef Wei S, Lai K, Patel S et al (1997) Retinyl ester hydrolysis and retinol efflux from BFC-1beta adipocytes. J Biol Chem 272:14159–14165PubMedCrossRef
49.
go back to reference Niessner A, Ziegler S, Slany J, Billensteiner E, Woloszczuk W, Geyer G (2003) Increases in plasma levels of atrial and brain natriuretic peptides after running a marathon: are their effects partly counterbalanced by adrenocortical steroids? Eur J Endocrinol 149:555–559PubMedCrossRef Niessner A, Ziegler S, Slany J, Billensteiner E, Woloszczuk W, Geyer G (2003) Increases in plasma levels of atrial and brain natriuretic peptides after running a marathon: are their effects partly counterbalanced by adrenocortical steroids? Eur J Endocrinol 149:555–559PubMedCrossRef
50.
go back to reference Wang TJ, Larson MG, Levy D et al (2004) Impact of obesity on plasma natriuretic peptide levels. Circulation 109:594–600PubMedCrossRef Wang TJ, Larson MG, Levy D et al (2004) Impact of obesity on plasma natriuretic peptide levels. Circulation 109:594–600PubMedCrossRef
Metadata
Title
Atrial natriuretic peptide inhibits the production of adipokines and cytokines linked to inflammation and insulin resistance in human subcutaneous adipose tissue
Authors
C. Moro
E. Klimcakova
K. Lolmède
M. Berlan
M. Lafontan
V. Stich
A. Bouloumié
J. Galitzky
P. Arner
D. Langin
Publication date
01-05-2007
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 5/2007
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-007-0614-3

Other articles of this Issue 5/2007

Diabetologia 5/2007 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.