Skip to main content
Top
Published in: Arthritis Research & Therapy 1/2010

Open Access 01-02-2010 | Research article

Mitochondrial dysfunction and mitophagy activation in blood mononuclear cells of fibromyalgia patients: implications in the pathogenesis of the disease

Authors: Mario D Cordero, Manuel De Miguel, Ana M Moreno Fernández, Inés M Carmona López, Juan Garrido Maraver, David Cotán, Lourdes Gómez Izquierdo, Pablo Bonal, Francisco Campa, Pedro Bullon, Plácido Navas, José A Sánchez Alcázar

Published in: Arthritis Research & Therapy | Issue 1/2010

Login to get access

Abstract

Introduction

Fibromyalgia is a chronic pain syndrome with unknown etiology. Recent studies have shown some evidence demonstrating that oxidative stress may have a role in the pathophysiology of fibromyalgia. However, it is still not clear whether oxidative stress is the cause or the effect of the abnormalities documented in fibromyalgia. Furthermore, the role of mitochondria in the redox imbalance reported in fibromyalgia also is controversial. We undertook this study to investigate the role of mitochondrial dysfunction, oxidative stress, and mitophagy in fibromyalgia.

Methods

We studied 20 patients (2 male, 18 female patients) from the database of the Sevillian Fibromyalgia Association and 10 healthy controls. We evaluated mitochondrial function in blood mononuclear cells from fibromyalgia patients measuring, coenzyme Q10 levels with high-performance liquid chromatography (HPLC), and mitochondrial membrane potential with flow cytometry. Oxidative stress was determined by measuring mitochondrial superoxide production with MitoSOX™ and lipid peroxidation in blood mononuclear cells and plasma from fibromyalgia patients. Autophagy activation was evaluated by quantifying the fluorescence intensity of LysoTracker™ Red staining of blood mononuclear cells. Mitophagy was confirmed by measuring citrate synthase activity and electron microscopy examination of blood mononuclear cells.

Results

We found reduced levels of coenzyme Q10, decreased mitochondrial membrane potential, increased levels of mitochondrial superoxide in blood mononuclear cells, and increased levels of lipid peroxidation in both blood mononuclear cells and plasma from fibromyalgia patients. Mitochondrial dysfunction was also associated with increased expression of autophagic genes and the elimination of dysfunctional mitochondria with mitophagy.

Conclusions

These findings may support the role of oxidative stress and mitophagy in the pathophysiology of fibromyalgia.
Appendix
Available only for authorised users
Literature
1.
go back to reference Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, Mccain GA, Reynolds WJ, Romano TJ, Russell IJ, Sheon RP: The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum. 1990, 33: 160-172.CrossRefPubMed Wolfe F, Smythe HA, Yunus MB, Bennett RM, Bombardier C, Goldenberg DL, Tugwell P, Campbell SM, Abeles M, Clark P, Fam AG, Farber SJ, Fiechtner JJ, Franklin CM, Gatter RA, Hamaty D, Lessard J, Lichtbroun AS, Masi AT, Mccain GA, Reynolds WJ, Romano TJ, Russell IJ, Sheon RP: The American College of Rheumatology 1990 criteria for the classification of fibromyalgia: report of the Multicenter Criteria Committee. Arthritis Rheum. 1990, 33: 160-172.CrossRefPubMed
2.
go back to reference Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F: Estimates of the prevalence of arthritis and other rheumatic conditions in the United States, Part II. Arthritis Rheum. 2008, 58: 26-35.PubMedCentralCrossRefPubMed Lawrence RC, Felson DT, Helmick CG, Arnold LM, Choi H, Deyo RA, Gabriel S, Hirsch R, Hochberg MC, Hunder GG, Jordan JM, Katz JN, Kremers HM, Wolfe F: Estimates of the prevalence of arthritis and other rheumatic conditions in the United States, Part II. Arthritis Rheum. 2008, 58: 26-35.PubMedCentralCrossRefPubMed
3.
go back to reference Ozgocmen S, Ozyurt H, Sogut S, Akyol O: Current concepts in the pathophysiology of fibromyalgia: the potential role of oxidative stress and nitric oxide. Rheumatol Int. 2006, 26: 585-597.CrossRefPubMed Ozgocmen S, Ozyurt H, Sogut S, Akyol O: Current concepts in the pathophysiology of fibromyalgia: the potential role of oxidative stress and nitric oxide. Rheumatol Int. 2006, 26: 585-597.CrossRefPubMed
4.
go back to reference Pieczenik SR, Neustadt J: Mitochondrial dysfunction and molecular pathways of disease. Exp Mol Pathol. 2007, 83: 84-92.CrossRefPubMed Pieczenik SR, Neustadt J: Mitochondrial dysfunction and molecular pathways of disease. Exp Mol Pathol. 2007, 83: 84-92.CrossRefPubMed
5.
go back to reference Cordero MD, Moreno-Fernandez AM, deMiguel M, Bonal P, Campa F, Jimenez-Jimenez LM, Ruiz-Losada A, Sanchez-Dominguez B, Sanchez Alcazar JA, Salviati L, Navas P: Coenzyme Q10 distribution in blood is altered in patients with fibromyalgia. Clin Biochem. 2009, 42: 732-735.CrossRefPubMed Cordero MD, Moreno-Fernandez AM, deMiguel M, Bonal P, Campa F, Jimenez-Jimenez LM, Ruiz-Losada A, Sanchez-Dominguez B, Sanchez Alcazar JA, Salviati L, Navas P: Coenzyme Q10 distribution in blood is altered in patients with fibromyalgia. Clin Biochem. 2009, 42: 732-735.CrossRefPubMed
6.
go back to reference Turunen M, Olsson J, Dallner G: Metabolism and function of coenzyme Q. Biochim Biophys Acta. 2004, 1660: 171-199.CrossRefPubMed Turunen M, Olsson J, Dallner G: Metabolism and function of coenzyme Q. Biochim Biophys Acta. 2004, 1660: 171-199.CrossRefPubMed
7.
go back to reference Haas RH, Parikh S, Falk MJ, Saneto RP, Wolf NI, Darin N, Wong LJ, Cohen BH, Naviaux RK: The in-depth evaluation of suspected mitochondrial disease. Mol Genet Metab. 2008, 94: 16-37.PubMedCentralCrossRefPubMed Haas RH, Parikh S, Falk MJ, Saneto RP, Wolf NI, Darin N, Wong LJ, Cohen BH, Naviaux RK: The in-depth evaluation of suspected mitochondrial disease. Mol Genet Metab. 2008, 94: 16-37.PubMedCentralCrossRefPubMed
8.
go back to reference Quinzii CM, Lopez LC, Von-Moltke J, Naini A, Krishna S, Schuelke M, Salviati L, Navas P, Dimauro S, Hirano M: Respiratory chain dysfunction and oxidative stress correlate with severity of primary CoQ10 deficiency. FASEB J. 2008, 22: 1874-1885.PubMedCentralCrossRefPubMed Quinzii CM, Lopez LC, Von-Moltke J, Naini A, Krishna S, Schuelke M, Salviati L, Navas P, Dimauro S, Hirano M: Respiratory chain dysfunction and oxidative stress correlate with severity of primary CoQ10 deficiency. FASEB J. 2008, 22: 1874-1885.PubMedCentralCrossRefPubMed
9.
go back to reference Rodriguez-Hernandez A, Cordero MD, Salviati L, Artuch R, Pineda M, Briones P, Gomez Izquierdo L, Cotan D, Navas P, Sanchez-Alcazar JA: Coenzyme Q deficiency triggers mitochondria degradation by mitophagy. Autophagy. 2009, 5: 19-32.CrossRefPubMed Rodriguez-Hernandez A, Cordero MD, Salviati L, Artuch R, Pineda M, Briones P, Gomez Izquierdo L, Cotan D, Navas P, Sanchez-Alcazar JA: Coenzyme Q deficiency triggers mitochondria degradation by mitophagy. Autophagy. 2009, 5: 19-32.CrossRefPubMed
10.
go back to reference Montero R, Sanchez-Alcazar JA, Briones P, Hernandez AR, Cordero MD, Trevisson E, Salviati L, Pineda M, Garcia-Cazorla A, Navas P, Artuch R: Analysis of coenzyme Q10 in muscle and fibroblasts for the diagnosis of CoQ10 deficiency syndromes. Clin Biochem. 2008, 41: 697-700.CrossRefPubMed Montero R, Sanchez-Alcazar JA, Briones P, Hernandez AR, Cordero MD, Trevisson E, Salviati L, Pineda M, Garcia-Cazorla A, Navas P, Artuch R: Analysis of coenzyme Q10 in muscle and fibroblasts for the diagnosis of CoQ10 deficiency syndromes. Clin Biochem. 2008, 41: 697-700.CrossRefPubMed
11.
go back to reference Trounce IA, Kim YL, Jun AS, Wallace DC: Assessment of mitochondrial oxidative phosphorylation in patient muscle biopsies, lymphoblasts, and transmitochondrial cell lines. Methods Enzymol. 1996, 264: 484-509.CrossRefPubMed Trounce IA, Kim YL, Jun AS, Wallace DC: Assessment of mitochondrial oxidative phosphorylation in patient muscle biopsies, lymphoblasts, and transmitochondrial cell lines. Methods Enzymol. 1996, 264: 484-509.CrossRefPubMed
12.
go back to reference Bagis S, Tamer L, Sahin G, Bilgin R, Guler H, Ercan B, Erdogan C: Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder?. Rheumatol Int. 2005, 25: 188-190.CrossRefPubMed Bagis S, Tamer L, Sahin G, Bilgin R, Guler H, Ercan B, Erdogan C: Free radicals and antioxidants in primary fibromyalgia: an oxidative stress disorder?. Rheumatol Int. 2005, 25: 188-190.CrossRefPubMed
13.
go back to reference Garrabou G, Soriano A, Lopez S, Guallar JP, Giralt M, Villarroya F, Martinez JA, Casademont J, Cardellach F, Mensa J, Miro O: Reversible inhibition of mitochondrial protein synthesis during linezolid-related hyperlactatemia. Antimicrob Agents Chemother. 2007, 51: 962-967.PubMedCentralCrossRefPubMed Garrabou G, Soriano A, Lopez S, Guallar JP, Giralt M, Villarroya F, Martinez JA, Casademont J, Cardellach F, Mensa J, Miro O: Reversible inhibition of mitochondrial protein synthesis during linezolid-related hyperlactatemia. Antimicrob Agents Chemother. 2007, 51: 962-967.PubMedCentralCrossRefPubMed
15.
go back to reference Kowaltowski AJ, de Souza-Pinto NC, Castilho RF, Vercesi AE: Mitochondria and reactive oxygen species. Free Radic Biol Med. 2009, 47: 333-343.CrossRefPubMed Kowaltowski AJ, de Souza-Pinto NC, Castilho RF, Vercesi AE: Mitochondria and reactive oxygen species. Free Radic Biol Med. 2009, 47: 333-343.CrossRefPubMed
16.
go back to reference Lambert AJ, Brand MD: Reactive oxygen species production by mitochondria. Methods Mol Biol. 2009, 554: 165-181.CrossRefPubMed Lambert AJ, Brand MD: Reactive oxygen species production by mitochondria. Methods Mol Biol. 2009, 554: 165-181.CrossRefPubMed
20.
go back to reference Hein G, Franke S: Are advanced glycation end-product-modified proteins of pathogenetic importance in fibromyalgia?. Rheumatology (Oxford). 2002, 41: 1163-1167.CrossRef Hein G, Franke S: Are advanced glycation end-product-modified proteins of pathogenetic importance in fibromyalgia?. Rheumatology (Oxford). 2002, 41: 1163-1167.CrossRef
21.
go back to reference Ozgocmen S, Ozyurt H, Sogut S, Akyol O, Ardicoglu O, Yildizhan H: Antioxidant status, lipid peroxidation and nitric oxide in fibromyalgia: etiologic and therapeutic concerns. Rheumatol Int. 2006, 26: 598-603.CrossRefPubMed Ozgocmen S, Ozyurt H, Sogut S, Akyol O, Ardicoglu O, Yildizhan H: Antioxidant status, lipid peroxidation and nitric oxide in fibromyalgia: etiologic and therapeutic concerns. Rheumatol Int. 2006, 26: 598-603.CrossRefPubMed
22.
go back to reference Bazzichi L, Giannaccini G, Betti L, Fabbrini L, Schmid L, Palego L, Giacomelli C, Rossi A, Giusti L, De Feo F, Giuliano T, Mascia G, Bombardieri S, Lucacchini A: ATP, calcium and magnesium levels in platelets of patients with primary fibromyalgia. Clin Biochem. 2008, 41: 1084-1090.CrossRefPubMed Bazzichi L, Giannaccini G, Betti L, Fabbrini L, Schmid L, Palego L, Giacomelli C, Rossi A, Giusti L, De Feo F, Giuliano T, Mascia G, Bombardieri S, Lucacchini A: ATP, calcium and magnesium levels in platelets of patients with primary fibromyalgia. Clin Biochem. 2008, 41: 1084-1090.CrossRefPubMed
23.
go back to reference Wang ZQ, Porreca F, Cuzzocrea S, Galen K, Lightfoot R, Masini E, Muscoli C, Mollace V, Ndengele M, Ischiropoulos H, Salvemini D: A newly identified role for superoxide in inflammatory pain. J Pharmacol Exp Ther. 2004, 309: 869-878.CrossRefPubMed Wang ZQ, Porreca F, Cuzzocrea S, Galen K, Lightfoot R, Masini E, Muscoli C, Mollace V, Ndengele M, Ischiropoulos H, Salvemini D: A newly identified role for superoxide in inflammatory pain. J Pharmacol Exp Ther. 2004, 309: 869-878.CrossRefPubMed
24.
go back to reference Manuel y Keenoy B, Moorkens G, Vertommen J, De Leeuw I: Antioxidant status and lipoprotein peroxidation in chronic fatigue syndrome. Life Sci. 2001, 68: 2037-2049.CrossRefPubMed Manuel y Keenoy B, Moorkens G, Vertommen J, De Leeuw I: Antioxidant status and lipoprotein peroxidation in chronic fatigue syndrome. Life Sci. 2001, 68: 2037-2049.CrossRefPubMed
25.
go back to reference Vecchiet J, Cipollone F, Falasca K, Mezzetti A, Pizzigallo E, Bucciarelli T, De Laurentis S, Affaitati G, De Cesare D, Giamberardino MA: Relationship between musculoskeletal symptoms and blood markers of oxidative stress in patients with chronic fatigue syndrome. Neurosci Lett. 2003, 335: 151-154.CrossRefPubMed Vecchiet J, Cipollone F, Falasca K, Mezzetti A, Pizzigallo E, Bucciarelli T, De Laurentis S, Affaitati G, De Cesare D, Giamberardino MA: Relationship between musculoskeletal symptoms and blood markers of oxidative stress in patients with chronic fatigue syndrome. Neurosci Lett. 2003, 335: 151-154.CrossRefPubMed
26.
go back to reference Evans PH: Free radicals in brain metabolism and pathology. Br Med Bull. 1993, 49: 577-587.PubMed Evans PH: Free radicals in brain metabolism and pathology. Br Med Bull. 1993, 49: 577-587.PubMed
27.
go back to reference Bilici M, Efe H, Koroglu MA, Uydu HA, Bekaroglu M, Deger O: Antioxidative enzyme activities and lipid peroxidation in major depression: alterations by antidepressant treatments. J Affect Disord. 2001, 64: 43-51.CrossRefPubMed Bilici M, Efe H, Koroglu MA, Uydu HA, Bekaroglu M, Deger O: Antioxidative enzyme activities and lipid peroxidation in major depression: alterations by antidepressant treatments. J Affect Disord. 2001, 64: 43-51.CrossRefPubMed
28.
go back to reference Duncan AJ, Heales SJ, Mills K, Eaton S, Land JM, Hargreaves IP: Determination of coenzyme Q10 status in blood mononuclear cells, skeletal muscle, and plasma by HPLC with di-propoxy-coenzyme Q10 as an internal standard. Clin Chem. 2005, 51: 2380-2382.CrossRefPubMed Duncan AJ, Heales SJ, Mills K, Eaton S, Land JM, Hargreaves IP: Determination of coenzyme Q10 status in blood mononuclear cells, skeletal muscle, and plasma by HPLC with di-propoxy-coenzyme Q10 as an internal standard. Clin Chem. 2005, 51: 2380-2382.CrossRefPubMed
29.
go back to reference Land JM, Heales SJ, Duncan AJ, Hargreaves IP: Some observations upon biochemical causes of ataxia and a new disease entity ubiquinone, CoQ10 deficiency. Neurochem Res. 2007, 32: 837-843.CrossRefPubMed Land JM, Heales SJ, Duncan AJ, Hargreaves IP: Some observations upon biochemical causes of ataxia and a new disease entity ubiquinone, CoQ10 deficiency. Neurochem Res. 2007, 32: 837-843.CrossRefPubMed
30.
go back to reference Park JH, Niermann KJ, Olsen N: Evidence for metabolic abnormalities in the muscles of patients with fibromyalgia. Curr Rheumatol Rep. 2000, 2: 131-140.CrossRefPubMed Park JH, Niermann KJ, Olsen N: Evidence for metabolic abnormalities in the muscles of patients with fibromyalgia. Curr Rheumatol Rep. 2000, 2: 131-140.CrossRefPubMed
31.
go back to reference Sprott H, Salemi S, Gay RE, Bradley LA, Alarcon GS, Oh SJ, Michel BA, Gay S: Increased DNA fragmentation and ultrastructural changes in fibromyalgic muscle fibres. Ann Rheum Dis. 2004, 63: 245-251.PubMedCentralCrossRefPubMed Sprott H, Salemi S, Gay RE, Bradley LA, Alarcon GS, Oh SJ, Michel BA, Gay S: Increased DNA fragmentation and ultrastructural changes in fibromyalgic muscle fibres. Ann Rheum Dis. 2004, 63: 245-251.PubMedCentralCrossRefPubMed
32.
go back to reference Yunus MB, Kalyan-Raman UP, Kalyan-Raman K: Primary fibromyalgia syndrome and myofascial pain syndrome: clinical features and muscle pathology. Arch Phys Med Rehabil. 1988, 69: 451-454.PubMed Yunus MB, Kalyan-Raman UP, Kalyan-Raman K: Primary fibromyalgia syndrome and myofascial pain syndrome: clinical features and muscle pathology. Arch Phys Med Rehabil. 1988, 69: 451-454.PubMed
33.
go back to reference Bennett RM, Clark SR, Goldberg L, Nelson D, Bonafede RP, Porter J, Specht D: Aerobic fitness in patients with fibrositis: a controlled study of respiratory gas exchange and 133xenon clearance from exercising muscle. Arthritis Rheum. 1989, 32: 454-460.CrossRefPubMed Bennett RM, Clark SR, Goldberg L, Nelson D, Bonafede RP, Porter J, Specht D: Aerobic fitness in patients with fibrositis: a controlled study of respiratory gas exchange and 133xenon clearance from exercising muscle. Arthritis Rheum. 1989, 32: 454-460.CrossRefPubMed
34.
go back to reference Jacobsen S, Danneskiold-Samsoe B: Dynamic muscular endurance in primary fibromyalgia compared with chronic myofascial pain syndrome. Arch Phys Med Rehabil. 1992, 73: 170-173.PubMed Jacobsen S, Danneskiold-Samsoe B: Dynamic muscular endurance in primary fibromyalgia compared with chronic myofascial pain syndrome. Arch Phys Med Rehabil. 1992, 73: 170-173.PubMed
36.
go back to reference Lemasters JJ: Selective mitochondrial autophagy, or mitophagy, as a targeted defense against oxidative stress, mitochondrial dysfunction, and aging. Rejuvenation Res. 2005, 8: 3-5.CrossRefPubMed Lemasters JJ: Selective mitochondrial autophagy, or mitophagy, as a targeted defense against oxidative stress, mitochondrial dysfunction, and aging. Rejuvenation Res. 2005, 8: 3-5.CrossRefPubMed
37.
go back to reference Rodriguez-Enriquez S, Kim I, Currin RT, Lemasters JJ: Tracker dyes to probe mitochondrial autophagy (mitophagy) in rat hepatocytes. Autophagy. 2006, 2: 39-46.PubMedCentralCrossRefPubMed Rodriguez-Enriquez S, Kim I, Currin RT, Lemasters JJ: Tracker dyes to probe mitochondrial autophagy (mitophagy) in rat hepatocytes. Autophagy. 2006, 2: 39-46.PubMedCentralCrossRefPubMed
38.
39.
go back to reference Codogno P, Meijer AJ: Autophagy and signaling: their role in cell survival and cell death. Cell Death Differ. 2005, 12 (suppl 2): 1509-1518.CrossRefPubMed Codogno P, Meijer AJ: Autophagy and signaling: their role in cell survival and cell death. Cell Death Differ. 2005, 12 (suppl 2): 1509-1518.CrossRefPubMed
40.
go back to reference Gozuacik D, Kimchi A: Autophagy as a cell death and tumor suppressor mechanism. Oncogene. 2004, 23: 2891-2906.CrossRefPubMed Gozuacik D, Kimchi A: Autophagy as a cell death and tumor suppressor mechanism. Oncogene. 2004, 23: 2891-2906.CrossRefPubMed
42.
go back to reference Marino G, Lopez-Otin C: Autophagy: molecular mechanisms, physiological functions and relevance in human pathology. Cell Mol Life Sci. 2004, 61: 1439-1454.CrossRefPubMed Marino G, Lopez-Otin C: Autophagy: molecular mechanisms, physiological functions and relevance in human pathology. Cell Mol Life Sci. 2004, 61: 1439-1454.CrossRefPubMed
43.
go back to reference Matsui Y, Takagi H, Qu X, Abdellatif M, Sakoda H, Asano T, Levine B, Sadoshima J: Distinct roles of autophagy in the heart during ischemia and reperfusion: roles of AMP-activated protein kinase and Beclin 1 in mediating autophagy. Circ Res. 2007, 100: 914-922.CrossRefPubMed Matsui Y, Takagi H, Qu X, Abdellatif M, Sakoda H, Asano T, Levine B, Sadoshima J: Distinct roles of autophagy in the heart during ischemia and reperfusion: roles of AMP-activated protein kinase and Beclin 1 in mediating autophagy. Circ Res. 2007, 100: 914-922.CrossRefPubMed
44.
go back to reference Scherz-Shouval R, Shvets E, Fass E, Shorer H, Gil L, Elazar Z: Reactive oxygen species are essential for autophagy and specifically regulate the activity of Atg4. EMBO J. 2007, 26: 1749-1760.PubMedCentralCrossRefPubMed Scherz-Shouval R, Shvets E, Fass E, Shorer H, Gil L, Elazar Z: Reactive oxygen species are essential for autophagy and specifically regulate the activity of Atg4. EMBO J. 2007, 26: 1749-1760.PubMedCentralCrossRefPubMed
Metadata
Title
Mitochondrial dysfunction and mitophagy activation in blood mononuclear cells of fibromyalgia patients: implications in the pathogenesis of the disease
Authors
Mario D Cordero
Manuel De Miguel
Ana M Moreno Fernández
Inés M Carmona López
Juan Garrido Maraver
David Cotán
Lourdes Gómez Izquierdo
Pablo Bonal
Francisco Campa
Pedro Bullon
Plácido Navas
José A Sánchez Alcázar
Publication date
01-02-2010
Publisher
BioMed Central
Published in
Arthritis Research & Therapy / Issue 1/2010
Electronic ISSN: 1478-6362
DOI
https://doi.org/10.1186/ar2918

Other articles of this Issue 1/2010

Arthritis Research & Therapy 1/2010 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.