1
|
Henry JA, Couch LS, Rider OJ. Myocardial Metabolism in Heart Failure with Preserved Ejection Fraction. J Clin Med 2024; 13:1195. [PMID: 38592048 PMCID: PMC10931709 DOI: 10.3390/jcm13051195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/11/2024] [Accepted: 02/18/2024] [Indexed: 04/10/2024] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent and now accounts for half of all heart failure cases. This rise is largely attributed to growing rates of obesity, hypertension, and diabetes. Despite its prevalence, the pathophysiological mechanisms of HFpEF are not fully understood. The heart, being the most energy-demanding organ, appears to have a compromised bioenergetic capacity in heart failure, affecting all phenotypes and aetiologies. While metabolic disturbances in heart failure with reduced ejection fraction (HFrEF) have been extensively studied, similar insights into HFpEF are limited. This review collates evidence from both animal and human studies, highlighting metabolic dysregulations associated with HFpEF and its risk factors, such as obesity, hypertension, and diabetes. We discuss how changes in substrate utilisation, oxidative phosphorylation, and energy transport contribute to HFpEF. By delving into these pathological shifts in myocardial energy production, we aim to reveal novel therapeutic opportunities. Potential strategies include modulating energy substrates, improving metabolic efficiency, and enhancing critical metabolic pathways. Understanding these aspects could be key to developing more effective treatments for HFpEF.
Collapse
Affiliation(s)
- John Aaron Henry
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK (O.J.R.)
- Department of Cardiology, Jersey General Hospital, Gloucester Street, St. Helier JE1 3QS, Jersey, UK
| | - Liam S. Couch
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK (O.J.R.)
| | - Oliver J. Rider
- Oxford Centre for Clinical Magnetic Resonance Research, Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford OX3 9DU, UK (O.J.R.)
| |
Collapse
|
2
|
Ritterhoff J, Tian R. Metabolic mechanisms in physiological and pathological cardiac hypertrophy: new paradigms and challenges. Nat Rev Cardiol 2023; 20:812-829. [PMID: 37237146 DOI: 10.1038/s41569-023-00887-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/02/2023] [Indexed: 05/28/2023]
Abstract
Cardiac metabolism is vital for heart function. Given that cardiac contraction requires a continuous supply of ATP in large quantities, the role of fuel metabolism in the heart has been mostly considered from the perspective of energy production. However, the consequence of metabolic remodelling in the failing heart is not limited to a compromised energy supply. The rewired metabolic network generates metabolites that can directly regulate signalling cascades, protein function, gene transcription and epigenetic modifications, thereby affecting the overall stress response of the heart. In addition, metabolic changes in both cardiomyocytes and non-cardiomyocytes contribute to the development of cardiac pathologies. In this Review, we first summarize how energy metabolism is altered in cardiac hypertrophy and heart failure of different aetiologies, followed by a discussion of emerging concepts in cardiac metabolic remodelling, that is, the non-energy-generating function of metabolism. We highlight challenges and open questions in these areas and finish with a brief perspective on how mechanistic research can be translated into therapies for heart failure.
Collapse
Affiliation(s)
- Julia Ritterhoff
- Molecular and Translational Cardiology, Department of Internal Medicine III, Heidelberg University Hospital, Heidelberg, Germany.
- Mitochondria and Metabolism Center, Department of Anaesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
| | - Rong Tian
- Mitochondria and Metabolism Center, Department of Anaesthesiology and Pain Medicine, University of Washington, Seattle, WA, USA.
| |
Collapse
|
3
|
Gorący A, Rosik J, Szostak J, Szostak B, Retfiński S, Machaj F, Pawlik A. Improving mitochondrial function in preclinical models of heart failure: therapeutic targets for future clinical therapies? Expert Opin Ther Targets 2023; 27:593-608. [PMID: 37477241 DOI: 10.1080/14728222.2023.2240021] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/19/2023] [Indexed: 07/22/2023]
Abstract
INTRODUCTION Heart failure is a complex clinical syndrome resulting from the unsuccessful compensation of symptoms of myocardial damage. Mitochondrial dysfunction is a process that occurs because of an attempt to adapt to the disruption of metabolic and energetic pathways occurring in the myocardium. This, in turn, leads to further dysfunction in cardiomyocyte processes. Currently, many therapeutic strategies have been implemented to improve mitochondrial function, but their effectiveness varies widely. AREAS COVERED This review focuses on new models of therapeutic strategies targeting mitochondrial function in the treatment of heart failure. EXPERT OPINION Therapeutic strategies targeting mitochondria appear to be a valuable option for treating heart failure. Currently, the greatest challenge is to develop new research models that could restore the disrupted metabolic processes in mitochondria as comprehensively as possible. Only the development of therapies that focus on improving as many dysregulated mitochondrial processes as possible in patients with heart failure will be able to bring the expected clinical improvement, along with inhibition of disease progression. Combined strategies involving the reduction of the effects of oxidative stress and mitochondrial dysfunction, appear to be a promising possibility for developing new therapies for a complex and multifactorial disease such as heart failure.
Collapse
Affiliation(s)
- Anna Gorący
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, Szczecin, Poland
| | - Jakub Rosik
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Joanna Szostak
- Department of Experimental and Clinical Pharmacology, Pomeranian Medical University, Szczecin, Poland
| | - Bartosz Szostak
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Szymon Retfiński
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| | - Filip Machaj
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
- Department of Medical Biology, Medical University of Warsaw, Warsaw, Poland
| | - Andrzej Pawlik
- Department of Physiology, Pomeranian Medical University, Szczecin, Poland
| |
Collapse
|
4
|
Correale M, Tricarico L, Croella F, Alfieri S, Fioretti F, Brunetti ND, Inciardi RM, Nodari S. Novelties in the pharmacological approaches for chronic heart failure: new drugs and cardiovascular targets. Front Cardiovasc Med 2023; 10:1157472. [PMID: 37332581 PMCID: PMC10272855 DOI: 10.3389/fcvm.2023.1157472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 05/15/2023] [Indexed: 06/20/2023] Open
Abstract
Despite recent advances in chronic heart failure (HF) management, the prognosis of HF patients is poor. This highlights the need for researching new drugs targeting, beyond neurohumoral and hemodynamic modulation approach, such as cardiomyocyte metabolism, myocardial interstitium, intracellular regulation and NO-sGC pathway. In this review we report main novelties on new possible pharmacological targets for HF therapy, mainly on new drugs acting on cardiac metabolism, GCs-cGMP pathway, mitochondrial function and intracellular calcium dysregulation.
Collapse
Affiliation(s)
- Michele Correale
- Department of Cardiothoracic, Policlinico Riuniti University Hospital, Foggia, Italy
| | - Lucia Tricarico
- Department of Cardiothoracic, Policlinico Riuniti University Hospital, Foggia, Italy
| | - Francesca Croella
- Department of Medical & Surgical Sciences, University of Foggia, Foggia, Italy
| | - Simona Alfieri
- Department of Medical & Surgical Sciences, University of Foggia, Foggia, Italy
| | - Francesco Fioretti
- Cardiology Section, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili Hospital and University of Brescia, Brescia, Italy
| | | | - Riccardo M. Inciardi
- Cardiology Section, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili Hospital and University of Brescia, Brescia, Italy
| | - Savina Nodari
- Cardiology Section, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, ASST Spedali Civili Hospital and University of Brescia, Brescia, Italy
| |
Collapse
|
5
|
Schenkl C, Heyne E, Doenst T, Schulze PC, Nguyen TD. Targeting Mitochondrial Metabolism to Save the Failing Heart. Life (Basel) 2023; 13:life13041027. [PMID: 37109556 PMCID: PMC10143865 DOI: 10.3390/life13041027] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 03/28/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Despite considerable progress in treating cardiac disorders, the prevalence of heart failure (HF) keeps growing, making it a global medical and economic burden. HF is characterized by profound metabolic remodeling, which mostly occurs in the mitochondria. Although it is well established that the failing heart is energy-deficient, the role of mitochondria in the pathophysiology of HF extends beyond the energetic aspects. Changes in substrate oxidation, tricarboxylic acid cycle and the respiratory chain have emerged as key players in regulating myocardial energy homeostasis, Ca2+ handling, oxidative stress and inflammation. This work aims to highlight metabolic alterations in the mitochondria and their far-reaching effects on the pathophysiology of HF. Based on this knowledge, we will also discuss potential metabolic approaches to improve cardiac function.
Collapse
Affiliation(s)
- Christina Schenkl
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Estelle Heyne
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Torsten Doenst
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Paul Christian Schulze
- Department of Medicine I (Cardiology, Angiology, Critical Care Medicine), Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany
| | - Tien Dung Nguyen
- Department of Medicine I (Cardiology, Angiology, Critical Care Medicine), Jena University Hospital, Friedrich Schiller University Jena, Am Klinikum 1, 07747 Jena, Germany
| |
Collapse
|
6
|
Abstract
Chronic kidney disease is associated with an increased risk for the development and progression of cardiovascular disorders including hypertension, dyslipidemia, and coronary artery disease. Chronic kidney disease may also affect the myocardium through complex systemic changes, resulting in structural remodeling such as hypertrophy and fibrosis, as well as impairments in both diastolic and systolic function. These cardiac changes in the setting of chronic kidney disease define a specific cardiomyopathic phenotype known as uremic cardiomyopathy. Cardiac function is tightly linked to its metabolism, and research over the past 3 decades has revealed significant metabolic remodeling in the myocardium during the development of heart failure. Because the concept of uremic cardiomyopathy has only been recognized in recent years, there are limited data on metabolism in the uremic heart. Nonetheless, recent findings suggest overlapping mechanisms with heart failure. This work reviews key features of metabolic remodeling in the failing heart in the general population and extends this to patients with chronic kidney disease. The knowledge of similarities and differences in cardiac metabolism between heart failure and uremic cardiomyopathy may help identify new targets for mechanistic and therapeutic research on uremic cardiomyopathy.
Collapse
Affiliation(s)
- T Dung Nguyen
- Department of Internal Medicine I, University Hospital Jena, Jena, Germany
| | | |
Collapse
|
7
|
Fischer JA, Monroe TO, Pesce LL, Sawicki KT, Quattrocelli M, Bauer R, Kearns SD, Wolf MJ, Puckelwartz MJ, McNally EM. Opposing effects of genetic variation in MTCH2 for obesity versus heart failure. Hum Mol Genet 2023; 32:15-29. [PMID: 35904451 PMCID: PMC9837833 DOI: 10.1093/hmg/ddac176] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Revised: 07/04/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
Genetic variation in genes regulating metabolism may be advantageous in some settings but not others. The non-failing adult heart relies heavily on fatty acids as a fuel substrate and source of ATP. In contrast, the failing heart favors glucose as a fuel source. A bootstrap analysis for genes with deviant allele frequencies in cardiomyopathy cases versus controls identified the MTCH2 gene as having unusual variation. MTCH2 encodes an outer mitochondrial membrane protein, and prior genome-wide studies associated MTCH2 variants with body mass index, consistent with its role in metabolism. We identified the referent allele of rs1064608 (p.Pro290) as being overrepresented in cardiomyopathy cases compared to controls, and linkage disequilibrium analysis associated this variant with the MTCH2 cis eQTL rs10838738 and lower MTCH2 expression. To evaluate MTCH2, we knocked down Mtch in Drosophila heart tubes which produced a dilated and poorly functioning heart tube, reduced adiposity and shortened life span. Cardiac Mtch mutants generated more lactate at baseline, and they displayed impaired oxygen consumption in the presence of glucose but not palmitate. Treatment of cardiac Mtch mutants with dichloroacetate, a pyruvate dehydrogenase kinase inhibitor, reduced lactate and rescued lifespan. Deletion of MTCH2 in human cells similarly impaired oxygen consumption in the presence of glucose but not fatty acids. These data support a model in which MTCH2 reduction may be favorable when fatty acids are the major fuel source, favoring lean body mass. However, in settings like heart failure, where the heart shifts toward using more glucose, reduction of MTCH2 is maladaptive.
Collapse
Affiliation(s)
- Julie A Fischer
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Tanner O Monroe
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Lorenzo L Pesce
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Konrad T Sawicki
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Mattia Quattrocelli
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Molecular Cardiovascular Biology, Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
| | - Rosemary Bauer
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Samuel D Kearns
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Matthew J Wolf
- Department of Medicine, Cardiovascular Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Megan J Puckelwartz
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Elizabeth M McNally
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| |
Collapse
|
8
|
Yurista SR, Chen S, Welsh A, Tang WHW, Nguyen CT. Targeting Myocardial Substrate Metabolism in the Failing Heart: Ready for Prime Time? Curr Heart Fail Rep 2022; 19:180-190. [PMID: 35567658 PMCID: PMC10950325 DOI: 10.1007/s11897-022-00554-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2022] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW We review the clinical benefits of altering myocardial substrate metabolism in heart failure. RECENT FINDINGS Modulation of cardiac substrates (fatty acid, glucose, or ketone metabolism) offers a wide range of therapeutic possibilities which may be applicable to heart failure. Augmenting ketone oxidation seems to offer great promise as a new therapeutic modality in heart failure. The heart has long been recognized as metabolic omnivore, meaning it can utilize a variety of energy substrates to maintain adequate ATP production. The adult heart uses fatty acid as a major fuel source, but it can also derive energy from other substrates including glucose and ketone, and to some extent pyruvate, lactate, and amino acids. However, cardiomyocytes of the failing heart endure remarkable metabolic remodeling including a shift in substrate utilization and reduced ATP production, which account for cardiac remodeling and dysfunction. Research to understand the implication of myocardial metabolic perturbation in heart failure has grown in recent years, and this has raised interest in targeting myocardial substrate metabolism for heart failure therapy. Due to the interdependency between different pathways, the main therapeutic metabolic approaches include inhibiting fatty acid uptake/fatty acid oxidation, reducing circulating fatty acid levels, increasing glucose oxidation, and augmenting ketone oxidation.
Collapse
Affiliation(s)
- Salva R Yurista
- Cardiovascular Research Center, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Boston, MA, 02129, USA.
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
| | - Shi Chen
- Cardiovascular Research Center, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Boston, MA, 02129, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Aidan Welsh
- Cardiovascular Research Center, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Boston, MA, 02129, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - W H Wilson Tang
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
- Cardiovascular Innovation Research Center, Cleveland Clinic, Cleveland, OH, USA
| | - Christopher T Nguyen
- Cardiovascular Research Center, Corrigan Minehan Heart Center, Massachusetts General Hospital, Harvard Medical School, 149 13th Street, Boston, MA, 02129, USA
- Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA
- Division of Health Science Technology, Harvard-Massachusetts Institute of Technology, Cambridge, MA, USA
- Cardiovascular Innovation Research Center, Cleveland Clinic, Cleveland, OH, USA
- Imaging Institute, Cleveland Clinic, Cleveland, OH, USA
| |
Collapse
|
9
|
Abstract
As a muscular pump that contracts incessantly throughout life, the heart must constantly generate cellular energy to support contractile function and fuel ionic pumps to maintain electrical homeostasis. Thus, mitochondrial metabolism of multiple metabolic substrates such as fatty acids, glucose, ketones, and lactate is essential to ensuring an uninterrupted supply of ATP. Multiple metabolic pathways converge to maintain myocardial energy homeostasis. The regulation of these cardiac metabolic pathways has been intensely studied for many decades. Rapid adaptation of these pathways is essential for mediating the myocardial adaptation to stress, and dysregulation of these pathways contributes to myocardial pathophysiology as occurs in heart failure and in metabolic disorders such as diabetes. The regulation of these pathways reflects the complex interactions of cell-specific regulatory pathways, neurohumoral signals, and changes in substrate availability in the circulation. Significant advances have been made in the ability to study metabolic regulation in the heart, and animal models have played a central role in contributing to this knowledge. This review will summarize metabolic pathways in the heart and describe their contribution to maintaining myocardial contractile function in health and disease. The review will summarize lessons learned from animal models with altered systemic metabolism and those in which specific metabolic regulatory pathways have been genetically altered within the heart. The relationship between intrinsic and extrinsic regulators of cardiac metabolism and the pathophysiology of heart failure and how these have been informed by animal models will be discussed.
Collapse
Affiliation(s)
- Heiko Bugger
- University Heart Center Graz, Department of Cardiology, Medical University of Graz, Graz, Austria, Austria (H.B., N.J.B.)
| | - Nikole J Byrne
- University Heart Center Graz, Department of Cardiology, Medical University of Graz, Graz, Austria, Austria (H.B., N.J.B.)
| | - E Dale Abel
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (E.D.A.)
| |
Collapse
|
10
|
Perez DM. The promise and problems of metabolic-based therapies for heart failure. Interv Cardiol 2021; 13:415-424. [PMID: 34970333 PMCID: PMC8715677] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
Despite standard therapies, heart failure patients have high rates of morbidity highlighting the need to develop alternative therapeutic approaches. Heart failure has been described as an energy-starved condition that is hypothesized to drive the pathological remodeling of the heart. Numerous studies have described the metabolic defects that occur when the heart fails and adaptive changes that take place to maintain the energy needed for the heart to function properly. In this review we will summarize the metabolic requirements of a normal heart and what happens during failure. We will also summarize the various metabolic therapeutic strategies that have been developed over the years to treat heart failure and their results from clinical trials.
Collapse
Affiliation(s)
- Dianne M. Perez
- Author for correspondence: Dianne M. Perez, The Lerner Research Institute, The Cleveland Clinic Foundation, 9500 Euclid Ave, Cleveland, OH 44195, USA,
| |
Collapse
|
11
|
Na YR, Jung D, Song J, Park JW, Hong JJ, Seok SH. Pyruvate dehydrogenase kinase is a negative regulator of interleukin-10 production in macrophages. J Mol Cell Biol 2021; 12:543-555. [PMID: 31900478 PMCID: PMC7493030 DOI: 10.1093/jmcb/mjz113] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Revised: 09/11/2019] [Accepted: 11/09/2019] [Indexed: 02/07/2023] Open
Abstract
Interleukin-10 (IL-10) is the most potent anti-inflammatory cytokine in the body and plays an essential role in determining outcomes of many inflammatory diseases. Cellular metabolism is a critical determinant of immune cell function; however, it is currently unclear whether metabolic processes are specifically involved in IL-10 production. In this study, we aimed to find the central metabolic molecule regulating IL-10 production of macrophages, which are the main producers of IL-10. Transcriptomic analysis identified that metabolic changes were predominantly enriched in Kupffer cells at the early inflammatory phase of a mouse endotoxemia model. Among them, pyruvate dehydrogenase kinase (PDK)-dependent acute glycolysis was negatively involved in IL-10 production. Inhibition or knockdown of PDK selectively increased macrophage IL-10 expression. Mechanistically, PDK inhibition increased IL-10 production via profound phosphorylation of adenosine monophosphate (AMP)-activated protein kinase alpha 1 (AMPKα1) by restricting glucose uptake in lipopolysaccharide-stimulated macrophages. AMPKα1 consequently activated p38 mitogen-activated protein kinase, c-Jun N-terminal kinase, and cyclic AMP-responsive element-binding protein to regulate IL-10 production. Our study uncovers a previously unknown regulatory mechanism of IL-10 in activated macrophages involving an immunometabolic function of PDK.
Collapse
Affiliation(s)
- Yi Rang Na
- Macrophage Lab, Department of Microbiology and Immunology and Institute of Endemic Disease, Seoul National University College of Medicine, Chongno-gu, Seoul 03080, Republic of Korea
| | - Daun Jung
- Macrophage Lab, Department of Microbiology and Immunology and Institute of Endemic Disease, Seoul National University College of Medicine, Chongno-gu, Seoul 03080, Republic of Korea
| | - Juha Song
- Macrophage Lab, Department of Microbiology and Immunology and Institute of Endemic Disease, Seoul National University College of Medicine, Chongno-gu, Seoul 03080, Republic of Korea
| | - Jong-Wan Park
- Department of Biomedical Science, BK21-Plus Education Program, Seoul National University College of Medicine, Jongno-gu, Seoul 03080, Republic of Korea.,Department of Pharmacology, Seoul National University College of Medicine, Jongno-gu, Seoul 03080, Republic of Korea.,Cancer Research Institute and Ischemic/Hypoxic Disease Institute, Seoul National University College of Medicine, Jongno-gu, Seoul 03080, Republic of Korea
| | - Jung Joo Hong
- National Primate Research Center, Korea Research Institute of Bioscience and Biotechnology, Cheongju 28116, Republic of Korea
| | - Seung Hyeok Seok
- Macrophage Lab, Department of Microbiology and Immunology and Institute of Endemic Disease, Seoul National University College of Medicine, Chongno-gu, Seoul 03080, Republic of Korea
| |
Collapse
|
12
|
Abstract
Alterations in cardiac energy metabolism contribute to the severity of heart failure. However, the energy metabolic changes that occur in heart failure are complex and are dependent not only on the severity and type of heart failure present but also on the co-existence of common comorbidities such as obesity and type 2 diabetes. The failing heart faces an energy deficit, primarily because of a decrease in mitochondrial oxidative capacity. This is partly compensated for by an increase in ATP production from glycolysis. The relative contribution of the different fuels for mitochondrial ATP production also changes, including a decrease in glucose and amino acid oxidation, and an increase in ketone oxidation. The oxidation of fatty acids by the heart increases or decreases, depending on the type of heart failure. For instance, in heart failure associated with diabetes and obesity, myocardial fatty acid oxidation increases, while in heart failure associated with hypertension or ischemia, myocardial fatty acid oxidation decreases. Combined, these energy metabolic changes result in the failing heart becoming less efficient (ie, a decrease in cardiac work/O2 consumed). The alterations in both glycolysis and mitochondrial oxidative metabolism in the failing heart are due to both transcriptional changes in key enzymes involved in these metabolic pathways, as well as alterations in NAD redox state (NAD+ and nicotinamide adenine dinucleotide levels) and metabolite signaling that contribute to posttranslational epigenetic changes in the control of expression of genes encoding energy metabolic enzymes. Alterations in the fate of glucose, beyond flux through glycolysis or glucose oxidation, also contribute to the pathology of heart failure. Of importance, pharmacological targeting of the energy metabolic pathways has emerged as a novel therapeutic approach to improving cardiac efficiency, decreasing the energy deficit and improving cardiac function in the failing heart.
Collapse
Affiliation(s)
- Gary D Lopaschuk
- Cardiovascular Research Centre, University of Alberta, Edmonton, Canada (G.D.L., Q.G.K.)
| | - Qutuba G Karwi
- Cardiovascular Research Centre, University of Alberta, Edmonton, Canada (G.D.L., Q.G.K.)
| | - Rong Tian
- Mitochondria and Metabolism Center, University of Washington, Seattle (R.T.)
| | - Adam R Wende
- Division of Molecular and Cellular Pathology, Department of Pathology, University of Alabama at Birmingham (A.R.W.)
| | - E Dale Abel
- Division of Endocrinology and Metabolism, University of Iowa Carver College of Medicine, Iowa City (E.D.A.).,Fraternal Order of Eagles Diabetes Research Center, University of Iowa Carver College of Medicine, Iowa City (E.D.A.)
| |
Collapse
|
13
|
Nguyen TD, Schulze PC. Lipid in the midst of metabolic remodeling - Therapeutic implications for the failing heart. Adv Drug Deliv Rev 2020; 159:120-132. [PMID: 32791076 DOI: 10.1016/j.addr.2020.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 08/07/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023]
Abstract
A healthy heart relies on an intact cardiac lipid metabolism. Fatty acids represent the major source for ATP production in the heart. Not less importantly, lipids are directly involved in critical processes such as cell growth, proliferation, and cell death by functioning as building blocks or signaling molecules. In the development of heart failure, perturbations in fatty acid utilization impair cardiac energetics. Furthermore, they may affect glucose and amino acid metabolism and induce the synthesis of several lipid intermediates, whose biological functions are still poorly understood. This work outlines the pivotal role of lipid metabolism in the heart and provides a lipocentric view of metabolic remodeling in heart failure. We will also critically revisit therapeutic attempts targeting cardiac lipid metabolism in heart failure and propose specific strategies for future investigations in this regard.
Collapse
|
14
|
Ge Z, Li A, McNamara J, Dos Remedios C, Lal S. Pathogenesis and pathophysiology of heart failure with reduced ejection fraction: translation to human studies. Heart Fail Rev 2020; 24:743-758. [PMID: 31209771 DOI: 10.1007/s10741-019-09806-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Heart failure represents the end result of different pathophysiologic processes, which culminate in functional impairment. Regardless of its aetiology, the presentation of heart failure usually involves symptoms of pump failure and congestion, which forms the basis for clinical diagnosis. Pathophysiologic descriptions of heart failure with reduced ejection fraction (HFrEF) are being established. Most commonly, HFrEF is centred on a reactive model where a significant initial insult leads to reduced cardiac output, further triggering a cascade of maladaptive processes. Predisposing factors include myocardial injury of any cause, chronically abnormal loading due to hypertension, valvular disease, or tachyarrhythmias. The pathophysiologic processes behind remodelling in heart failure are complex and reflect systemic neurohormonal activation, peripheral vascular effects and localised changes affecting the cardiac substrate. These abnormalities have been the subject of intense research. Much of the translational successes in HFrEF have come from targeting neurohormonal responses to reduced cardiac output, with blockade of the renin-angiotensin-aldosterone system (RAAS) and beta-adrenergic blockade being particularly fruitful. However, mortality and morbidity associated with heart failure remains high. Although systemic neurohormonal blockade slows disease progression, localised ventricular remodelling still adversely affects contractile function. Novel therapy targeted at improving cardiac contractile mechanics in HFrEF hold the promise of alleviating heart failure at its source, yet so far none has found success. Nevertheless, there are increasing calls for a proximal, 'cardiocentric' approach to therapy. In this review, we examine HFrEF therapy aimed at improving cardiac function with a focus on recent trials and emerging targets.
Collapse
Affiliation(s)
- Zijun Ge
- Sydney Medical School, University of Sydney, Camperdown, Australia
- Bosch Institute, School of Medical Sciences, University of Sydney, Camperdown, Australia
| | - Amy Li
- Bosch Institute, School of Medical Sciences, University of Sydney, Camperdown, Australia
- Department of Pharmacy and Biomedical Science, La Trobe University, Melbourne, Australia
| | - James McNamara
- Bosch Institute, School of Medical Sciences, University of Sydney, Camperdown, Australia
| | - Cris Dos Remedios
- Bosch Institute, School of Medical Sciences, University of Sydney, Camperdown, Australia
| | - Sean Lal
- Sydney Medical School, University of Sydney, Camperdown, Australia.
- Bosch Institute, School of Medical Sciences, University of Sydney, Camperdown, Australia.
- Department of Cardiology, Royal Prince Alfred Hospital, Sydney, Australia.
- Cardiac Research Laboratory, Discipline of Anatomy and Histology, University of Sydney, Anderson Stuart Building (F13), Camperdown, NSW, 2006, Australia.
| |
Collapse
|
15
|
Bøgh N, Hansen ESS, Omann C, Lindhardt J, Nielsen PM, Stephenson RS, Laustsen C, Hjortdal VE, Agger P. Increasing carbohydrate oxidation improves contractile reserves and prevents hypertrophy in porcine right heart failure. Sci Rep 2020; 10:8158. [PMID: 32424129 PMCID: PMC7235019 DOI: 10.1038/s41598-020-65098-7] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Accepted: 02/24/2020] [Indexed: 01/16/2023] Open
Abstract
In heart failure, myocardial overload causes vast metabolic changes that impair cardiac energy production and contribute to deterioration of contractile function. However, metabolic therapy is not used in heart failure care. We aimed to investigate the interplay between cardiac function and myocardial carbohydrate metabolism in a large animal heart failure model. Using magnetic resonance spectroscopy with hyperpolarized pyruvate and magnetic resonance imaging at rest and during pharmacological stress, we investigated the in-vivo cardiac pyruvate metabolism and contractility in a porcine model of chronic pulmonary insufficiency causing right ventricular volume overload. To assess if increasing the carbohydrate metabolic reserve improves the contractile reserve, a group of animals were fed dichloroacetate, an activator of pyruvate oxidation. Volume overload caused heart failure with decreased pyruvate dehydrogenase flux and poor ejection fraction reserve. The animals treated with dichloroacetate had a larger contractile response to dobutamine stress than non-treated animals. Further, dichloroacetate prevented myocardial hypertrophy. The in-vivo metabolic data were validated by mitochondrial respirometry, enzyme activity assays and gene expression analyses. Our results show that pyruvate dehydrogenase kinase inhibition improves the contractile reserve and decreases hypertrophy by augmenting carbohydrate metabolism in porcine heart failure. The approach is promising for metabolic heart failure therapy.
Collapse
Affiliation(s)
- Nikolaj Bøgh
- The Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark. .,The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.
| | - Esben S S Hansen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Camilla Omann
- The Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Jakob Lindhardt
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Per M Nielsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Robert S Stephenson
- Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark.,Institute of Clinical Sciences, College of Medical and Dental Science, The University of Birmingham, Birmingham, United Kingdom
| | - Christoffer Laustsen
- The MR Research Centre, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Vibeke E Hjortdal
- The Department of Cardiothoracic and Vascular Surgery, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| | - Peter Agger
- Comparative Medicine Lab, Department of Clinical Medicine, Aarhus University, Palle Juul-Jensens Boulevard 99, 8200, Aarhus N, Denmark
| |
Collapse
|
16
|
The Metabolic Interplay between Cancer and Other Diseases. Trends Cancer 2019; 5:809-821. [PMID: 31813458 DOI: 10.1016/j.trecan.2019.10.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 10/27/2019] [Accepted: 10/28/2019] [Indexed: 02/06/2023]
Abstract
Over the past decade, knowledge of cancer metabolism has expanded exponentially and has provided several clinically relevant targets for cancer therapy. Although these current approaches have shown promise, there are very few studies showing how seemingly unrelated metabolic processes in other diseases can readily occur in cancer. Moreover, the striking metabolic overlap between cancer and other diseases such as diabetes, cardiovascular, neurological, obesity, and aging has provided key therapeutic strategies that have even begun to be translated into clinical trials. These promising results necessitate consideration of the interconnected metabolic network while studying the metabolism of cancer. This review article discusses how cancer metabolism is intertwined with systemic metabolism and how knowledge from other diseases can help to broaden therapeutic opportunities for cancer.
Collapse
|
17
|
Abstract
The heart consumes large amounts of energy in the form of ATP that is continuously replenished by oxidative phosphorylation in mitochondria and, to a lesser extent, by glycolysis. To adapt the ATP supply efficiently to the constantly varying demand of cardiac myocytes, a complex network of enzymatic and signalling pathways controls the metabolic flux of substrates towards their oxidation in mitochondria. In patients with heart failure, derangements of substrate utilization and intermediate metabolism, an energetic deficit, and oxidative stress are thought to underlie contractile dysfunction and the progression of the disease. In this Review, we give an overview of the physiological processes of cardiac energy metabolism and their pathological alterations in heart failure and diabetes mellitus. Although the energetic deficit in failing hearts - discovered >2 decades ago - might account for contractile dysfunction during maximal exertion, we suggest that the alterations of intermediate substrate metabolism and oxidative stress rather than an ATP deficit per se account for maladaptive cardiac remodelling and dysfunction under resting conditions. Treatments targeting substrate utilization and/or oxidative stress in mitochondria are currently being tested in patients with heart failure and might be promising tools to improve cardiac function beyond that achieved with neuroendocrine inhibition.
Collapse
|
18
|
Affiliation(s)
- Diem H Tran
- 1 Division of Cardiology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas TX
| | - Zhao V Wang
- 1 Division of Cardiology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas TX
| |
Collapse
|
19
|
Karlstaedt A, Schiffer W, Taegtmeyer H. Actionable Metabolic Pathways in Heart Failure and Cancer-Lessons From Cancer Cell Metabolism. Front Cardiovasc Med 2018; 5:71. [PMID: 29971237 PMCID: PMC6018530 DOI: 10.3389/fcvm.2018.00071] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 05/24/2018] [Indexed: 12/21/2022] Open
Abstract
Recent advances in cancer cell metabolism provide unprecedented opportunities for a new understanding of heart metabolism and may offer new approaches for the treatment of heart failure. Key questions driving the cancer field to understand how tumor cells reprogram metabolism and to benefit tumorigenesis are also applicable to the heart. Recent experimental and conceptual advances in cancer cell metabolism provide the cardiovascular field with the unique opportunity to target metabolism. This review compares cancer cell metabolism and cardiac metabolism with an emphasis on strategies of cellular adaptation, and how to exploit metabolic changes for therapeutic benefit.
Collapse
Affiliation(s)
- Anja Karlstaedt
- Division of Cardiology, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Walter Schiffer
- Division of Cardiology, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Heinrich Taegtmeyer
- Division of Cardiology, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, United States
| |
Collapse
|
20
|
Karwi QG, Uddin GM, Ho KL, Lopaschuk GD. Loss of Metabolic Flexibility in the Failing Heart. Front Cardiovasc Med 2018; 5:68. [PMID: 29928647 PMCID: PMC5997788 DOI: 10.3389/fcvm.2018.00068] [Citation(s) in RCA: 238] [Impact Index Per Article: 39.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Accepted: 05/18/2018] [Indexed: 12/15/2022] Open
Abstract
To maintain its high energy demand the heart is equipped with a highly complex and efficient enzymatic machinery that orchestrates ATP production using multiple energy substrates, namely fatty acids, carbohydrates (glucose and lactate), ketones and amino acids. The contribution of these individual substrates to ATP production can dramatically change, depending on such variables as substrate availability, hormonal status and energy demand. This "metabolic flexibility" is a remarkable virtue of the heart, which allows utilization of different energy substrates at different rates to maintain contractile function. In heart failure, cardiac function is reduced, which is accompanied by discernible energy metabolism perturbations and impaired metabolic flexibility. While it is generally agreed that overall mitochondrial ATP production is impaired in the failing heart, there is less consensus as to what actual switches in energy substrate preference occur. The failing heart shift toward a greater reliance on glycolysis and ketone body oxidation as a source of energy, with a decrease in the contribution of glucose oxidation to mitochondrial oxidative metabolism. The heart also becomes insulin resistant. However, there is less consensus as to what happens to fatty acid oxidation in heart failure. While it is generally believed that fatty acid oxidation decreases, a number of clinical and experimental studies suggest that fatty acid oxidation is either not changed or is increased in heart failure. Of importance, is that any metabolic shift that does occur has the potential to aggravate cardiac dysfunction and the progression of the heart failure. An increasing body of evidence shows that increasing cardiac ATP production and/or modulating cardiac energy substrate preference positively correlates with heart function and can lead to better outcomes. This includes increasing glucose and ketone oxidation and decreasing fatty acid oxidation. In this review we present the physiology of the energy metabolism pathways in the heart and the changes that occur in these pathways in heart failure. We also look at the interventions which are aimed at manipulating the myocardial metabolic pathways toward more efficient substrate utilization which will eventually improve cardiac performance.
Collapse
Affiliation(s)
| | | | | | - Gary D. Lopaschuk
- Cardiovascular Research Centre, University of Alberta, Edmonton, AB, Canada
| |
Collapse
|
21
|
Noordali H, Loudon BL, Frenneaux MP, Madhani M. Cardiac metabolism - A promising therapeutic target for heart failure. Pharmacol Ther 2017; 182:95-114. [PMID: 28821397 DOI: 10.1016/j.pharmthera.2017.08.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Both heart failure with reduced ejection fraction (HFrEF) and with preserved ejection fraction (HFpEF) are associated with high morbidity and mortality. Although many established pharmacological interventions exist for HFrEF, hospitalization and death rates remain high, and for those with HFpEF (approximately half of all heart failure patients), there are no effective therapies. Recently, the role of impaired cardiac energetic status in heart failure has gained increasing recognition with the identification of reduced capacity for both fatty acid and carbohydrate oxidation, impaired function of the electron transport chain, reduced capacity to transfer ATP to the cytosol, and inefficient utilization of the energy produced. These nodes in the genesis of cardiac energetic impairment provide potential therapeutic targets, and there is promising data from recent experimental and early-phase clinical studies evaluating modulators such as carnitine palmitoyltransferase 1 inhibitors, partial fatty acid oxidation inhibitors and mitochondrial-targeted antioxidants. Metabolic modulation may provide significant symptomatic and prognostic benefit for patients suffering from heart failure above and beyond guideline-directed therapy, but further clinical trials are needed.
Collapse
Affiliation(s)
- Hannah Noordali
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Brodie L Loudon
- Norwich Medical School, University of East Anglia, Norwich, UK
| | | | - Melanie Madhani
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK.
| |
Collapse
|
22
|
Heggermont WA, Papageorgiou AP, Quaegebeur A, Deckx S, Carai P, Verhesen W, Eelen G, Schoors S, van Leeuwen R, Alekseev S, Elzenaar I, Vinckier S, Pokreisz P, Walravens AS, Gijsbers R, Van Den Haute C, Nickel A, Schroen B, van Bilsen M, Janssens S, Maack C, Pinto Y, Carmeliet P, Heymans S. Inhibition of MicroRNA-146a and Overexpression of Its Target Dihydrolipoyl Succinyltransferase Protect Against Pressure Overload-Induced Cardiac Hypertrophy and Dysfunction. Circulation 2017; 136:747-761. [PMID: 28611091 DOI: 10.1161/circulationaha.116.024171] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2016] [Accepted: 05/10/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cardiovascular diseases remain the predominant cause of death worldwide, with the prevalence of heart failure continuing to increase. Despite increased knowledge of the metabolic alterations that occur in heart failure, novel therapies to treat the observed metabolic disturbances are still lacking. METHODS Mice were subjected to pressure overload by means of angiotensin-II infusion or transversal aortic constriction. MicroRNA-146a was either genetically or pharmacologically knocked out or genetically overexpressed in cardiomyocytes. Furthermore, overexpression of dihydrolipoyl succinyltransferase (DLST) in the murine heart was performed by means of an adeno-associated virus. RESULTS MicroRNA-146a was upregulated in whole heart tissue in multiple murine pressure overload models. Also, microRNA-146a levels were moderately increased in left ventricular biopsies of patients with aortic stenosis. Overexpression of microRNA-146a in cardiomyocytes provoked cardiac hypertrophy and left ventricular dysfunction in vivo, whereas genetic knockdown or pharmacological blockade of microRNA-146a blunted the hypertrophic response and attenuated cardiac dysfunction in vivo. Mechanistically, microRNA-146a reduced its target DLST-the E2 subcomponent of the α-ketoglutarate dehydrogenase complex, a rate-controlling tricarboxylic acid cycle enzyme. DLST protein levels significantly decreased on pressure overload in wild-type mice, paralleling a decreased oxidative metabolism, whereas DLST protein levels and hence oxidative metabolism were partially maintained in microRNA-146a knockout mice. Moreover, overexpression of DLST in wild-type mice protected against cardiac hypertrophy and dysfunction in vivo. CONCLUSIONS Altogether we show that the microRNA-146a and its target DLST are important metabolic players in left ventricular dysfunction.
Collapse
Affiliation(s)
- Ward A Heggermont
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Anna-Pia Papageorgiou
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Annelies Quaegebeur
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Sophie Deckx
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Paolo Carai
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Wouter Verhesen
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Guy Eelen
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Sandra Schoors
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Rick van Leeuwen
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Sergey Alekseev
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Ies Elzenaar
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Stefan Vinckier
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Peter Pokreisz
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Ann-Sophie Walravens
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Rik Gijsbers
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Chris Van Den Haute
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Alexander Nickel
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Blanche Schroen
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Marc van Bilsen
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Stefan Janssens
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Christoph Maack
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Yigal Pinto
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Peter Carmeliet
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.)
| | - Stephane Heymans
- From Center for Molecular and Vascular Research, Leuven, Belgium (W.H., A.P., S.D., Pa.C., P.P., A.S.W., S.J., S.H.); Center for Heart Failure Research, Department of Cardiology, CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands (W.H., A.P., S.D., Pa.C., W.V., R.v.L., B.S., M.v.B., S.H.); Cardiovascular Research Center, OLV Hospital, Aalst, Belgium (W.H.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Department of Oncology, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Laboratory of Angiogenesis and Vascular Metabolism, Vesalius Research Center, Leuven, Belgium (A.Q., G.E., S.S., S.V., Pe.C.); Amsterdam Medical Center, Amsterdam University, The Netherlands (S.A., I.E., Y.P.); Laboratory for Viral Vector Technology and Gene Therapy, Department of Pharmaceutical and Pharmacological Sciences (R.G., C.V.D.H.), Laboratory for Neurobiology and Gene Therapy, Department of Neurosciences (R.G., C.V.D.H.), Leuven Viral Vector Core, Belgium (R.G., C.V.D.H.); and Klinik für Innere Medezin III, Universitätsklinikum des Saarlandes, Homburg, Germany (A.N., C.M.).
| |
Collapse
|
23
|
Subramani K, Lu S, Warren M, Chu X, Toque HA, Caldwell RW, Diamond MP, Raju R. Mitochondrial targeting by dichloroacetate improves outcome following hemorrhagic shock. Sci Rep 2017; 7:2671. [PMID: 28572638 PMCID: PMC5453974 DOI: 10.1038/s41598-017-02495-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 04/12/2017] [Indexed: 12/16/2022] Open
Abstract
Hemorrhagic shock is a leading cause of death in people under the age of 45 and accounts for almost half of trauma-related deaths. In order to develop a treatment strategy based on potentiating mitochondrial function, we investigated the effect of the orphan drug dichloroacetate (DCA) on survival in an animal model of hemorrhagic shock in the absence of fluid resuscitation. Hemorrhagic shock was induced in rats by withdrawing 60% of the blood volume and maintaining a hypotensive state. The studies demonstrated prolonged survival of rats subjected to hemorrhagic injury (HI) when treated with DCA. In separate experiments, using a fluid resuscitation model we studied mitochondrial functional alterations and changes in metabolic networks connected to mitochondria following HI and treatment with DCA. DCA treatment restored cardiac mitochondrial membrane potential and tissue ATP in the rats following HI. Treatment with DCA resulted in normalization of several metabolic and molecular parameters including plasma lactate and p-AMPK/AMPK, as well as Ach-mediated vascular relaxation. In conclusion we demonstrate that DCA can be successfully used in the treatment of hemorrhagic shock in the absence of fluid resuscitation; therefore DCA may be a good candidate in prolonged field care following severe blood loss.
Collapse
Affiliation(s)
- Kumar Subramani
- Department of Laboratory Sciences, Augusta University, Augusta, GA, 30912, United States of America
| | - Sumin Lu
- Department of Laboratory Sciences, Augusta University, Augusta, GA, 30912, United States of America
| | - Marie Warren
- Department of Laboratory Sciences, Augusta University, Augusta, GA, 30912, United States of America
| | - Xiaogang Chu
- Department of Laboratory Sciences, Augusta University, Augusta, GA, 30912, United States of America
| | - Haroldo A Toque
- Department of Pharmacology and Toxicology, Augusta University, Augusta, GA, 30912, United States of America
| | - R William Caldwell
- Department of Pharmacology and Toxicology, Augusta University, Augusta, GA, 30912, United States of America
| | - Michael P Diamond
- Department of Obstetrics and Gynaecology, Augusta University, Augusta, GA, 30912, United States of America
| | - Raghavan Raju
- Department of Laboratory Sciences, Augusta University, Augusta, GA, 30912, United States of America. .,Department of Surgery, Augusta University, Augusta, GA, 30912, United States of America. .,Department of Biochemistry and Molecular Biology, Augusta University, Augusta, GA, 30912, United States of America.
| |
Collapse
|
24
|
Targeting Metabolic Modulation and Mitochondrial Dysfunction in the Treatment of Heart Failure. Diseases 2017; 5:diseases5020014. [PMID: 28933367 PMCID: PMC5547981 DOI: 10.3390/diseases5020014] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 04/21/2017] [Accepted: 04/27/2017] [Indexed: 12/11/2022] Open
Abstract
Despite significant improvements in morbidity and mortality with current evidence-based pharmaceutical-based treatment of heart failure (HF) over the previous decades, the burden of HF remains high. An alternative approach is currently being developed, which targets myocardial energy efficiency and the dysfunction of the cardiac mitochondria. Emerging evidence suggests that the insufficient availability of ATP to the failing myocardium can be attributed to abnormalities in the myocardial utilisation of its substrates rather than an overall lack of substrate availability. Therefore, the development of potential metabolic therapeutics has commenced including trimetazidine, ranolazine and perhexiline, as well as specific mitochondrial-targeting pharmaceuticals, such as elamipretide. Large randomised controlled trials are required to confirm the role of metabolic-modulating drugs in the treatment of heart failure, but early studies have been promising in their possible efficacy for the management of heart failure in the future.
Collapse
|
25
|
Molecular targets of the Warburg effect and inflammatory cytokines in the pathogenesis of pulmonary artery hypertension. Clin Chim Acta 2017; 466:98-104. [DOI: 10.1016/j.cca.2017.01.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 01/09/2017] [Accepted: 01/12/2017] [Indexed: 02/01/2023]
|
26
|
Salamon S, Podbregar E, Kubatka P, Büsselberg D, Caprnda M, Opatrilova R, Valentova V, Adamek M, Kruzliak P, Podbregar M. Glucose Metabolism in Cancer and Ischemia: Possible Therapeutic Consequences of the Warburg Effect. Nutr Cancer 2017; 69:177-183. [DOI: 10.1080/01635581.2017.1263751] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Spela Salamon
- Medical Faculty, University of Maribor, Maribor, Slovenia
| | - Eva Podbregar
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Peter Kubatka
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
- Division of Oncology, Biomedical Center Martin, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | - Dietrich Büsselberg
- Weill Cornell Medicine in Qatar, Qatar Foundation-Education City, Doha, Qatar
| | - Martin Caprnda
- 2nd Department of Internal Medicine, Faculty of Medicine, Comenius University and University Hospital, Bratislava, Slovakia
| | - Radka Opatrilova
- Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
| | - Vanda Valentova
- Department of Medical Biology, Jessenius Faculty of Medicine, Comenius University in Bratislava, Martin, Slovakia
| | - Mariusz Adamek
- Department of Thoracic Surgery, Faculty of Medicine and Dentistry, Medical University of Silesia, Katowice, Poland
| | - Peter Kruzliak
- Department of Chemical Drugs, Faculty of Pharmacy, University of Veterinary and Pharmaceutical Sciences, Brno, Czech Republic
- Department of Medical Physics and Biophysics, Faculty of Medicine, Pavol Jozef Safarik University, Kosice, Slovakia
- 2nd Department of Surgery, Faculty of Medicine, St. Anne's University Hospital and Masaryk University, Brno, Czech Republic
| | - Matej Podbregar
- Clinical Department for Anesthesiology and Intensive Care, University Medical Center Ljubljana, Slovenia
| |
Collapse
|
27
|
Heggermont WA, Papageorgiou AP, Heymans S, van Bilsen M. Metabolic support for the heart: complementary therapy for heart failure? Eur J Heart Fail 2016; 18:1420-1429. [DOI: 10.1002/ejhf.678] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 09/12/2016] [Accepted: 09/18/2016] [Indexed: 01/10/2023] Open
Affiliation(s)
- Ward A. Heggermont
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Research; University of Leuven; Belgium
- Cardiovascular Research Institute Maastricht; University of Maastricht; The Netherlands
- Cardiovascular Research Centre, Cardiology Service; OLV Hospital Aalst; Aalst Belgium
| | - Anna-Pia Papageorgiou
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Research; University of Leuven; Belgium
- Cardiovascular Research Institute Maastricht; University of Maastricht; The Netherlands
| | - Stephane Heymans
- Centre for Molecular and Vascular Biology, Department of Cardiovascular Research; University of Leuven; Belgium
- Cardiovascular Research Institute Maastricht; University of Maastricht; The Netherlands
| | - Marc van Bilsen
- Cardiovascular Research Institute Maastricht; University of Maastricht; The Netherlands
| |
Collapse
|
28
|
Abstract
Cardiomyopathy is an inherited or acquired disease of the myocardium, which can result in severe ventricular dysfunction. Mitochondrial dysfunction is involved in the pathological process of cardiomyopathy. Many dysfunctions in cardiac mitochondria are consequences of mutations in nuclear or mitochondrial DNA followed by alterations in transcriptional regulation, mitochondrial protein function, and mitochondrial dynamics and energetics, presenting with associated multisystem mitochondrial disorders. To ensure correct diagnosis and optimal management of mitochondrial dysfunction in cardiomyopathy caused by multiple pathogenesis, multidisciplinary approaches are required, and to integrate between clinical and basic sciences, ideal translational models are needed. In this review, we will focus on experimental models to provide insights into basic mitochondrial physiology and detailed underlying mechanisms of cardiomyopathy and current mitochondria-targeted therapies for cardiomyopathy. [BMB Reports 2015; 48(10): 541-548]
Collapse
Affiliation(s)
- Youn Wook Chung
- Yonsei Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul 03722, Korea
| | - Seok-Min Kang
- Yonsei Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul 03722; Cardiology Division, Severance Cardiovascular Hospital, Seoul 03722; Severance Integrative Research Institute for Cerebral and Cardiovascular Diseases (SIRIC), Yonsei University Health System, Seoul 03722, Korea
| |
Collapse
|
29
|
Bonsu KO, Owusu IK, Buabeng KO, Reidpath DD, Kadirvelu A. Review of novel therapeutic targets for improving heart failure treatment based on experimental and clinical studies. Ther Clin Risk Manag 2016; 12:887-906. [PMID: 27350750 PMCID: PMC4902145 DOI: 10.2147/tcrm.s106065] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Heart failure (HF) is a major public health priority due to its epidemiological transition and the world's aging population. HF is typified by continuous loss of contractile function with reduced, normal, or preserved ejection fraction, elevated vascular resistance, fluid and autonomic imbalance, and ventricular dilatation. Despite considerable advances in the treatment of HF over the past few decades, mortality remains substantial. Pharmacological treatments including β-blockers, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, and aldosterone antagonists have been proven to prolong the survival of patients with HF. However, there are still instances where patients remain symptomatic, despite optimal use of existing therapeutic agents. This understanding that patients with chronic HF progress into advanced stages despite receiving optimal treatment has increased the quest for alternatives, exploring the roles of additional pathways that contribute to the development and progression of HF. Several pharmacological targets associated with pathogenesis of HF have been identified and novel therapies have emerged. In this work, we review recent evidence from proposed mechanisms to the outcomes of experimental and clinical studies of the novel pharmacological agents that have emerged for the treatment of HF.
Collapse
Affiliation(s)
- Kwadwo Osei Bonsu
- School of Medicine and Health Sciences, Monash University Sunway Campus, Jalan Lagoon Selatan, Bandar Sunway, Subang Jaya, Selangor, Malaysia
- Accident and Emergency Directorate, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Isaac Kofi Owusu
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Kwame Ohene Buabeng
- Department of Clinical and Social Pharmacy, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Daniel Diamond Reidpath
- School of Medicine and Health Sciences, Monash University Sunway Campus, Jalan Lagoon Selatan, Bandar Sunway, Subang Jaya, Selangor, Malaysia
| | - Amudha Kadirvelu
- School of Medicine and Health Sciences, Monash University Sunway Campus, Jalan Lagoon Selatan, Bandar Sunway, Subang Jaya, Selangor, Malaysia
| |
Collapse
|
30
|
Abstract
PURPOSE OF REVIEW This article provides an overview, highlighting recent findings, of a major mechanism of gene regulation and its relevance to the pathophysiology of heart failure. RECENT FINDINGS The syndrome of heart failure is a complex and highly prevalent condition, one in which the heart undergoes substantial structural remodeling. Triggered by a wide range of disease-related cues, heart failure pathophysiology is governed by both genetic and epigenetic events. Epigenetic mechanisms, such as chromatin/DNA modifications and noncoding RNAs, have emerged as molecular transducers of environmental stimuli to control gene expression. Here, we emphasize metabolic milieu, aging, and hemodynamic stress as they impact the epigenetic landscape of the myocardium. SUMMARY Recent studies in multiple fields, including cancer, stem cells, development, and cardiovascular biology, have uncovered biochemical ties linking epigenetic machinery and cellular energetics and mitochondrial function. Elucidation of these connections will afford molecular insights into long-established epidemiological observations. With time, exploitation of the epigenetic machinery therapeutically may emerge with clinical relevance.
Collapse
Affiliation(s)
- Soo Young Kim
- Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Cyndi Morales
- Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Thomas G. Gillette
- Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Joseph A. Hill
- Department of Internal Medicine (Cardiology), University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| |
Collapse
|
31
|
Sankaralingam S, Lopaschuk GD. Cardiac energy metabolic alterations in pressure overload-induced left and right heart failure (2013 Grover Conference Series). Pulm Circ 2015; 5:15-28. [PMID: 25992268 DOI: 10.1086/679608] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 07/29/2014] [Indexed: 01/07/2023] Open
Abstract
Pressure overload of the heart, such as seen with pulmonary hypertension and/or systemic hypertension, can result in cardiac hypertrophy and the eventual development of heart failure. The development of hypertrophy and heart failure is accompanied by numerous molecular changes in the heart, including alterations in cardiac energy metabolism. Under normal conditions, the high energy (adenosine triphosphate [ATP]) demands of the heart are primarily provided by the mitochondrial oxidation of fatty acids, carbohydrates (glucose and lactate), and ketones. In contrast, the hypertrophied failing heart is energy deficient because of its inability to produce adequate amounts of ATP. This can be attributed to a reduction in mitochondrial oxidative metabolism, with the heart becoming more reliant on glycolysis as a source of ATP production. If glycolysis is uncoupled from glucose oxidation, a decrease in cardiac efficiency can occur, which can contribute to the severity of heart failure due to pressure-overload hypertrophy. These metabolic changes are accompanied by alterations in the enzymes that are involved in the regulation of fatty acid and carbohydrate metabolism. It is now becoming clear that optimizing both energy production and the source of energy production are potential targets for pharmacological intervention aimed at improving cardiac function in the hypertrophied failing heart. In this review, we will focus on what alterations in energy metabolism occur in pressure overload induced left and right heart failure. We will also discuss potential targets and pharmacological approaches that can be used to treat heart failure occurring secondary to pulmonary hypertension and/or systemic hypertension.
Collapse
Affiliation(s)
| | - Gary D Lopaschuk
- Department of Pediatrics, Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Canada
| |
Collapse
|
32
|
Matsuhashi T, Hishiki T, Zhou H, Ono T, Kaneda R, Iso T, Yamaguchi A, Endo J, Katsumata Y, Atsushi A, Yamamoto T, Shirakawa K, Yan X, Shinmura K, Suematsu M, Fukuda K, Sano M. Activation of pyruvate dehydrogenase by dichloroacetate has the potential to induce epigenetic remodeling in the heart. J Mol Cell Cardiol 2015; 82:116-24. [PMID: 25744081 DOI: 10.1016/j.yjmcc.2015.02.021] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 02/02/2015] [Accepted: 02/23/2015] [Indexed: 12/16/2022]
Abstract
Dichloroacetate (DCA) promotes pyruvate entry into the Krebs cycle by inhibiting pyruvate dehydrogenase (PDH) kinase and thereby maintaining PDH in the active dephosphorylated state. DCA has recently gained attention as a potential metabolic-targeting therapy for heart failure but the molecular basis of the therapeutic effect of DCA in the heart remains a mystery. Once-daily oral administration of DCA alleviates pressure overload-induced left ventricular remodeling. We examined changes in the metabolic fate of pyruvate carbon (derived from glucose) entering the Krebs cycle by metabolic interventions of DCA. (13)C6-glucose pathway tracing analysis revealed that instead of being completely oxidized in the mitochondria for ATP production, DCA-mediated PDH dephosphorylation results in an increased acetyl-CoA pool both in control and pressure-overloaded hearts. DCA induces hyperacetylation of histone H3K9 and H4 in a dose-dependent manner in parallel to the dephosphorylation of PDH in cultured cardiomyocytes. DCA administration increases histone H3K9 acetylation in in vivo mouse heart. Interestingly, DCA-dependent histone acetylation was associated with an up-regulation of 2.3% of genes (545 out of 23,474 examined). Gene ontology analysis revealed that these genes are highly enriched in transcription-related categories. This evidence suggests that sustained activation of PDH by DCA results in an overproduction of acetyl-CoA, which exceeds oxidation in the Krebs cycle and results in histone acetylation. We propose that DCA-mediated PDH activation has the potential to induce epigenetic remodeling in the heart, which, at least in part, forms the molecular basis for the therapeutic effect of DCA in the heart.
Collapse
Affiliation(s)
| | - Takako Hishiki
- Department of Biochemistry, Keio University, School of Medicine, Tokyo, Japan; Japan Science and Technology Agency, Exploratory Research for Advanced Technology, Suematsu Gas Biology Project, Tokyo, Japan
| | - Heping Zhou
- Department of Cardiovascular Surgery, First affiliated Hospital, Fourth Military Medical University, Xi'an, China
| | - Tomohiko Ono
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan
| | - Ruri Kaneda
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan; Precursory Research for Embryonic Science and Technology (PRESTO), Japan Science and Technology Agency, Tokyo, Japan
| | - Tatsuya Iso
- Department of Medicine and Biological Science, Gunma University, Graduate School of Medicine, Gunma, Japan; Education and Research Support Center, Gunma University, Graduate School of Medicine, Gunma, Japan
| | - Aiko Yamaguchi
- Department of Bioimaging Information Analysis, Gunma University, Graduate School of Medicine, Gunma, Japan
| | - Jin Endo
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan
| | | | - Anzai Atsushi
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan
| | - Tsunehisa Yamamoto
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan
| | - Kohsuke Shirakawa
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan
| | - Xiaoxiang Yan
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan
| | - Ken Shinmura
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan
| | - Makoto Suematsu
- Department of Biochemistry, Keio University, School of Medicine, Tokyo, Japan; Japan Science and Technology Agency, Exploratory Research for Advanced Technology, Suematsu Gas Biology Project, Tokyo, Japan
| | - Keiichi Fukuda
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan
| | - Motoaki Sano
- Department of Cardiology, Keio University, School of Medicine, Tokyo, Japan; Precursory Research for Embryonic Science and Technology (PRESTO), Japan Science and Technology Agency, Tokyo, Japan.
| |
Collapse
|
33
|
Wang W, Lopaschuk GD. Metabolic therapy for the treatment of ischemic heart disease: reality and expectations. Expert Rev Cardiovasc Ther 2014; 5:1123-34. [DOI: 10.1586/14779072.5.6.1123] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
34
|
Abstract
The heart has a high rate of ATP production and turnover that is required to maintain its continuous mechanical work. Perturbations in ATP-generating processes may therefore affect contractile function directly. Characterizing cardiac metabolism in heart failure (HF) revealed several metabolic alterations called metabolic remodeling, ranging from changes in substrate use to mitochondrial dysfunction, ultimately resulting in ATP deficiency and impaired contractility. However, ATP depletion is not the only relevant consequence of metabolic remodeling during HF. By providing cellular building blocks and signaling molecules, metabolic pathways control essential processes such as cell growth and regeneration. Thus, alterations in cardiac metabolism may also affect the progression to HF by mechanisms beyond ATP supply. Our aim is therefore to highlight that metabolic remodeling in HF not only results in impaired cardiac energetics but also induces other processes implicated in the development of HF such as structural remodeling and oxidative stress. Accordingly, modulating cardiac metabolism in HF may have significant therapeutic relevance that goes beyond the energetic aspect.
Collapse
Affiliation(s)
- Torsten Doenst
- Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University Jena, Germany.
| | | | | |
Collapse
|
35
|
Cottrill KA, Chan SY. Metabolic dysfunction in pulmonary hypertension: the expanding relevance of the Warburg effect. Eur J Clin Invest 2013; 43:855-65. [PMID: 23617881 PMCID: PMC3736346 DOI: 10.1111/eci.12104] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 04/04/2013] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pulmonary hypertension (PH) is an enigmatic vascular syndrome characterized by increased pulmonary arterial pressure and adverse remodelling of the pulmonary arterioles and often of the right ventricle. Drawing parallels with tumourigenesis, recent endeavours have explored the relationship between metabolic dysregulation and PH pathogenesis. DESIGN We will discuss the general mechanisms by which cellular stressors such as hypoxia and inflammation alter cellular metabolism. Based on those principles, we will explore the development of a corresponding metabolic pathophenotype in PH, with a focus on WHO Groups I and III, and the implications that these alterations may have for future treatment of this disease. RESULTS Investigation of metabolic dysregulation in both the pulmonary vasculature and right ventricle during PH pathogenesis has provided a more unifying understanding of how disparate disease triggers coordinate end-stage disease manifestations. Namely, as defined originally in various cancers, the Warburg effect describes a chronic shift in energy production from mitochondrial oxidative phosphorylation to glycolysis. In many cases, this Warburg phenotype may serve as a central causative mechanism for PH progression, largely driving cellular hyperproliferation and resistance to apoptosis. Consequently, new therapeutic strategies have been increasingly pursued that target the Warburg phenotype. Finally, new technologies are increasingly becoming available to probe more completely the complexities of metabolic cellular reprogramming and may reveal distinct metabolic pathways beyond the Warburg effect that drive PH. CONCLUSION Studies of metabolic dysregulation in PH are just emerging but may offer powerful therapeutic means to prevent or even reverse disease progression at the molecular level.
Collapse
Affiliation(s)
- Katherine A Cottrill
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|
36
|
Walters AM, Porter GA, Brookes PS. Mitochondria as a drug target in ischemic heart disease and cardiomyopathy. Circ Res 2013; 111:1222-36. [PMID: 23065345 DOI: 10.1161/circresaha.112.265660] [Citation(s) in RCA: 199] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Ischemic heart disease is a significant cause of morbidity and mortality in Western society. Although interventions, such as thrombolysis and percutaneous coronary intervention, have proven efficacious in ischemia and reperfusion injury, the underlying pathological process of ischemic heart disease, laboratory studies suggest further protection is possible, and an expansive research effort is aimed at bringing new therapeutic options to the clinic. Mitochondrial dysfunction plays a key role in the pathogenesis of ischemia and reperfusion injury and cardiomyopathy. However, despite promising mitochondria-targeted drugs emerging from the laboratory, very few have successfully completed clinical trials. As such, the mitochondrion is a potential untapped target for new ischemic heart disease and cardiomyopathy therapies. Notably, there are a number of overlapping therapies for both these diseases, and as such novel therapeutic options for one condition may find use in the other. This review summarizes efforts to date in targeting mitochondria for ischemic heart disease and cardiomyopathy therapy and outlines emerging drug targets in this field.
Collapse
Affiliation(s)
- Andrew M Walters
- School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY 14642, USA
| | | | | |
Collapse
|
37
|
Kato T, Niizuma S, Inuzuka Y, Kawashima T, Okuda J, Tamaki Y, Iwanaga Y, Narazaki M, Matsuda T, Soga T, Kita T, Kimura T, Shioi T. Analysis of Metabolic Remodeling in Compensated Left Ventricular Hypertrophy and Heart Failure. Circ Heart Fail 2010; 3:420-30. [DOI: 10.1161/circheartfailure.109.888479] [Citation(s) in RCA: 199] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Takao Kato
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Shinichiro Niizuma
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Yasutaka Inuzuka
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Tsuneaki Kawashima
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Junji Okuda
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Yodo Tamaki
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Yoshitaka Iwanaga
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Michiko Narazaki
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Tetsuya Matsuda
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Tomoyoshi Soga
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Toru Kita
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Takeshi Kimura
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| | - Tetsuo Shioi
- From the Department of Cardiovascular Medicine (T. Kato, S.N., Y.I., T. Kawashima, J.O., Y.T., Y.I., T. Kita, T. Kimura, T.S.), Graduate School of Medicine, and Department of Systems Science (M.N., T.M.), Graduate School of Informatics, Kyoto University, Kyoto, and Institute for Advanced Bioscience (T.S.), Keio University, Yamagata, Japan
| |
Collapse
|
38
|
Mytas DZ, Stougiannos PN, Zairis MN, Foussas SG, Pyrgakis VN, Kyriazis IA. Diabetic myocardial disease: pathophysiology, early diagnosis and therapeutic options. J Diabetes Complications 2009; 23:273-82. [PMID: 18413201 DOI: 10.1016/j.jdiacomp.2007.12.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2007] [Accepted: 12/07/2007] [Indexed: 02/07/2023]
Abstract
Diabetes mellitus is a powerful risk factor for cardiovascular disease associated with high morbidity and mortality rates. Diabetic patients also have an increased incidence of heart failure which has been traditionally attributed to the concurrent presence of ischemic or hypertensive heart disease. Yet, nowadays, according to recent scientific evidence, diabetic myocardial disease (DMD) is more and more being considered as a distinct nosologic entity, independent of the co-existence of coronary artery disease, arterial hypertension or other risk factors, with the potential to lead to a self-existent progressive development of heart failure. In this article, we review the possible pathophysiologic mechanisms involved in the development of DMD as well as the structural and functional changes in the diabetic heart. We emphasize the importance of early detection of the syndrome, especially by novel echocardiographic techniques. Finally, we refer to the various therapeutic options for the optimal management of DMD according to the recent literature.
Collapse
|
39
|
Rhodes CJ, Davidson A, Gibbs JSR, Wharton J, Wilkins MR. Therapeutic targets in pulmonary arterial hypertension. Pharmacol Ther 2008; 121:69-88. [PMID: 19010350 DOI: 10.1016/j.pharmthera.2008.10.002] [Citation(s) in RCA: 67] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2008] [Accepted: 10/07/2008] [Indexed: 01/02/2023]
Abstract
Pulmonary arterial hypertension is a progressive, fatal disease. Current treatments including prostanoids, endothelin-1 (ET-1) antagonists, and phosphodiesterase (PDE) inhibitors, have sought to address the pulmonary vascular endothelial dysfunction and vasoconstriction associated with the condition. These treatments may slow the progression of the disease but do not afford a cure. Future treatments must target more directly the structural vascular changes that impair blood flow through the pulmonary circulation. Several novel therapeutic targets have been proposed and are under active investigation, including soluble guanylyl cyclase, phosphodiesterases, tetrahydrobiopterin, 5-HT2B receptors, vasoactive intestinal peptide, receptor tyrosine kinases, adrenomedullin, Rho kinase, elastases, endogenous steroids, endothelial progenitor cells, immune cells, bone morphogenetic protein and its receptors, potassium channels, metabolic pathways, and nuclear factor of activated T cells. Tyrosine kinase inhibitors, statins, 5-HT2B receptor antagonists, EPCs and soluble guanylyl cyclase activators are among the most advanced, having produced encouraging results in animal models, and human trials are underway. This review summarises the current research in this area and speculates on their likely success.
Collapse
Affiliation(s)
- Christopher J Rhodes
- Department of Experimental Medicine and Toxicology, Imperial College London, and National Pulmonary Hypertension Service, Hammersmith Hospital, United Kingdom
| | | | | | | | | |
Collapse
|
40
|
Impaired energetics in heart failure — A new therapeutic target. Pharmacol Ther 2008; 119:264-74. [DOI: 10.1016/j.pharmthera.2008.05.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2008] [Accepted: 05/09/2008] [Indexed: 11/20/2022]
|
41
|
Nagendran J, Gurtu V, Fu DZ, Dyck JRB, Haromy A, Ross DB, Rebeyka IM, Michelakis ED. A dynamic and chamber-specific mitochondrial remodeling in right ventricular hypertrophy can be therapeutically targeted. J Thorac Cardiovasc Surg 2008; 136:168-78, 178.e1-3. [PMID: 18603070 DOI: 10.1016/j.jtcvs.2008.01.040] [Citation(s) in RCA: 83] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2007] [Revised: 12/04/2007] [Accepted: 01/29/2008] [Indexed: 11/16/2022]
Abstract
OBJECTIVES The right ventricle fails quickly after increases in its afterload (ie, pulmonary hypertension) compared with the left ventricle (ie, systemic hypertension), resulting in significant morbidity and mortality. We hypothesized that the poor performance of the hypertrophied right ventricle is caused, at least in part, by a suboptimal mitochondrial/metabolic remodeling. METHODS/RESULTS We studied mitochondrial membrane potential, a surrogate for mitochondrial function, in human (n = 11) and rat hearts with physiologic (neonatal) and pathologic (pulmonary hypertension) right ventricular hypertrophy in vivo and in vitro. Mitochondrial membrane potential is higher in the normal left ventricle compared with the right ventricle but is highest in the hypertrophied right ventricle, both in myocardium and in isolated cardiomyocytes (P < .01). Mitochondrial membrane potential correlated positively with the degree of right ventricular hypertrophy in vivo and was recapitulated in phenylephrine-treated neonatal cardiomyocytes, an in vitro model of hypertrophy. The phenylephrine-induced mitochondrial hyperpolarization was reversed by VIVIT, an inhibitor of the nuclear factor of activated T lymphocytes, a transcription factor regulating the expression of several mitochondrial enzymes during cardiac development and hypertrophy. The clinically used drug dichloroacetate, known to increase the mitochondria-based glucose oxidation, reversed both the phenylephrine-induced mitochondrial hyperpolarization and nuclear factor of activated T lymphocytes (NFAT) activation. In Langendorff perfusions, dichloroacetate increased rat right ventricular inotropy in hypertrophied right ventricles (P < .01) but not in normal right ventricles, suggesting that mitochondrial hyperpolarization in right ventricular hypertrophy might be associated with its suboptimal performance. CONCLUSIONS The dynamic changes in mitochondrial membrane potential during right ventricular hypertrophy are chamber-specific, associated with activation of NFAT, and can be pharmacologically reversed leading to improved contractility. This mitochondrial remodeling might provide a framework for development of novel right ventricle-specific therapies.
Collapse
Affiliation(s)
- Jayan Nagendran
- Pulmonary Hypertension Program, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Guías de práctica clínica sobre diabetes, prediabetes y enfermedades cardiovasculares: versión resumida. Rev Esp Cardiol 2007. [DOI: 10.1016/s0300-8932(07)75070-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
|
43
|
Mori M, Yamagata T, Goto T, Saito S, Momoi MY. Dichloroacetate treatment for mitochondrial cytopathy: long-term effects in MELAS. Brain Dev 2004; 26:453-8. [PMID: 15351081 DOI: 10.1016/j.braindev.2003.12.009] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2003] [Revised: 12/26/2003] [Accepted: 12/26/2003] [Indexed: 11/19/2022]
Abstract
The long-term effects of the sodium salt of dichloroacetic acid (DCA) were evaluated in four patients with mitochondrial encephalomyelopathy with lactic acidosis and stroke-like episodes (MELAS) carrying A3243G mutation. Oral administration of DCA in MELAS patients was followed for an average of 5 years 4 months. Serum levels of lactate and pyruvate were maintained at around 10 and 0.6 mg/dl, respectively. Serum levels of DCA were 40-136 microg/ml. Symptoms responding to treatment included persistent headache, abdominal pain, muscle weakness, and stroke-like episodes. In contrast, no improvements in mental status, deafness, short stature, or neuroelectrophysiological findings were observed. Adverse effects included mild liver dysfunction in all patients, hypocalcemia in three and peripheral neuropathy in one. None of these adverse events was severe enough to require discontinuation of treatment. To determine suitable indications for DCA therapy, analysis of many more patients who have undergone DCA administration is required.
Collapse
Affiliation(s)
- Masato Mori
- Department of Pediatrics, Jichi Medical School, 3311-1 Yakushiji, Minamikawachi, Tochigi 329-0498, Japan.
| | | | | | | | | |
Collapse
|
44
|
Thrainsdottir IS, von Bibra H, Malmberg K, Rydén L. Effects of trimetazidine on left ventricular function in patients with type 2 diabetes and heart failure. J Cardiovasc Pharmacol 2004; 44:101-8. [PMID: 15175564 DOI: 10.1097/00005344-200407000-00014] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
UNLABELLED Congestive heart failure and type 2 diabetes have a deleterious prognosis when combined. Trimetazidine, a metabolic agent with anti-ischemic properties, reduces fatty acid beta-oxidation via decreased 3-ketoacyl-coenzyme-A thiolase activity thereby facilitating energy production via the glycolytic pathway. OBJECTIVES To assess myocardial function by Tissue Doppler Imaging (TDI) after one month of trimetazidine (Vastarel) added-on conventional treatment in patients with type 2 diabetes and heart failure. METHODS Twenty diabetic patients with ischemic heart failure (mean age 66 years; NYHA class II-III) were randomized to trimetazidine (60 mg daily) or placebo in a double-blind crossover design. Exercise tolerance, 2-dimensional echocardiograms, and TDI (rest and exercise) were studied before and during treatment. RESULTS Changes in exercise tolerance did not differ in the two groups. Ejection fraction at rest and moderate exercise only improved significantly with trimetazidine when analyzed for the first treatment period. TDI velocities did not change significantly during treatment periods. CONCLUSION In this early pilot investigation of the effects of trimetazidine in patients with diabetes and heart failure there were only weak signs of improved systolic myocardial function at rest and exercise. The present observations indicate the need of further research to explore the effect of trimetazidine during longer treatment period or with more selected patient population.
Collapse
|
45
|
L'Her E, Sebert P. Effects of dichloroacetate and ubiquinone infusions on glycolysis activity and thermal sensitivity during sepsis. ACTA ACUST UNITED AC 2004; 143:352-7. [PMID: 15192651 DOI: 10.1016/j.lab.2004.03.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Energy-metabolism disturbances during sepsis are characterized by enhanced glycolytic fluxes and reduced mitochondrial respiration. However, it is not known whether these abnormalities are the result of a specific mitochondrial alteration, decreased pyruvate dehydrogenase (PDH) complex activity, depletion of ubiquinone (CoQ(10); electron donor for the mitochondrial complex III), or all 3. In this study we sought to specify metabolism disturbances in a murine model of sepsis, using either a PDH-activator infusion (dichloroacetate, DCA) or CoQ(10) supplementation. After anesthesia, Sprague-Dawley rats received intravenous saline solution (control; n = 5), DCA (n = 5; 20 mg/100 g), or CoQ(10) (n = 5; 1 mg/100 g), before the induction of sepsis. Increased plasma lactate levels and increased muscle glucose content were observed after 4 hours in the control group. In the DCA group, a decrease in the muscle content of lactate (P <.05) and an increase in muscle glucose content (P <.05) were observed at 4 hours, but no lactatemia variation was noted. In the CoQ(10) group, only increased plasma lactate levels were observed. Increased muscle glycolysis fluxes were observed after 4 hours in the control group, but to a slighter degree in both the DCA and CoQ(10) groups. Only DCA restored a normal temperature sensitivity in the hyperthermia range, but we noted no differences in survival time. In conclusion, only DCA infusion restores normal glycolysis function.
Collapse
Affiliation(s)
- Erwan L'Her
- Reánimation et Urgences Médicales, Centre Hospitalier Universitaire de la Cavale Blanche, Brest, France.
| | | |
Collapse
|
46
|
Michelakis ED, Dyck JR, McMurtry MS, Wang S, Wu XC, Moudgil R, Hashimoto K, Puttagunta L, Archer SL. Gene transfer and metabolic modulators as new therapies for pulmonary hypertension. Increasing expression and activity of potassium channels in rat and human models. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2002; 502:401-18. [PMID: 11950153 DOI: 10.1007/978-1-4757-3401-0_26] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
UNLABELLED Chronic Hypoxic Pulmonary Hypertension (CH-PHT) is characterized by pulmonary artery (PA) vasoconstriction and cell proliferation/hypertrophy. PA smooth muscle cell (PASMC) contractility and proliferation are controlled by cytosolic Ca++ levels, which are largely determined by membrane potential (E(M)). E(M) is depolarized in CH-PHT due to decreased expression and functional inhibition of several redox-regulated, 4-aminopyridine (4-AP) sensitive, voltage-gated K+ channels (Kv1.5 and Kv2.1). Humans with Pulmonary Arterial Hypertension (PAH) also have decreased PASMC expression of Kv1.5 and Kv2.1. We speculate this "K+-channelopathy" contributes to PASMC depolarization and Ca++ overload thus promoting vasoconstriction and PASMC proliferation. We hypothesized that restoration of Kv channel expression in PHT and might eventually be beneficial. METHODS Two strategies were used to increase Kv channel expression in PASMCs: oral administration of a metabolic modulator drug (Dichloroacetate, DCA) and direct Kv gene transfer using an adenovirus (Ad5-Kv2.1). DCA a pyruvate dehydrogenase kinase inhibitor, promotes a more oxidized redox state mimicking normoxia and previously has been noted to increase K+ current in myocytes. Rats were given DCA in the drinking water after the development of CH-PHT and hemodynamics were measured approximately 5 days later. We also tested the ability of Ad5-Kv2.1 to increase Kv2.1 channel expression and function in human PAs ex vivo. RESULTS The DCA-treated rats had decreased PVR, RVH and PA remodeling compared to the control CH-PHT rats (n=5/group, p<0.05). DCA restored Kv2.1 expression and PASMC Kv current density to near normoxic levels. Adenoviral gene transfer increased expression of Kv2.1 channels and enhanced 4-AP constriction in human PAs. CONCLUSION Increasing Kv channel function in PAs is feasible and might be beneficial.
Collapse
Affiliation(s)
- E D Michelakis
- Department of Medicine (Cardiology), University of Alberta, Edmonton, Canada
| | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Michelakis ED, McMurtry MS, Wu XC, Dyck JRB, Moudgil R, Hopkins TA, Lopaschuk GD, Puttagunta L, Waite R, Archer SL. Dichloroacetate, a metabolic modulator, prevents and reverses chronic hypoxic pulmonary hypertension in rats: role of increased expression and activity of voltage-gated potassium channels. Circulation 2002; 105:244-50. [PMID: 11790708 DOI: 10.1161/hc0202.101974] [Citation(s) in RCA: 254] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Chronic hypoxic pulmonary hypertension (CH-PHT) is associated with suppressed expression and function of voltage-gated K(+) channels (Kv) in pulmonary artery (PA) smooth muscle cells (SMCs) and a shift in cellular redox balance toward a reduced state. We hypothesized that dichloroacetate (DCA), a metabolic modulator that can shift redox balance toward an oxidized state and increase Kv current in myocardial cells, would reverse CH-PHT. METHODS AND RESULTS We studied 4 groups of rats: normoxic, normoxic+DCA (DCA 70 mg. kg(-1). d(-1) PO), chronically hypoxic (CH), and CH+DCA. CH and CH+DCA rats were kept in a hypoxic chamber (10% FiO(2)) for 2 to 3 weeks. DCA was given either at day 1 to prevent or at day 10 to reverse CH-PHT. We used micromanometer-tipped catheters and measured hemodynamics in closed-chest rats on days 14 to 18. CH+DCA rats had significantly reduced pulmonary vascular resistance, right ventricular hypertrophy, and PA remodeling compared with the CH rats. CH inhibited I(K), eliminated the acute hypoxia-sensitive I(K), and decreased Kv2.1 channel expression. In the short term, low-dose DCA (1 micromol/L) increased I(K) in CH-PASMCs. In a mammalian expression system, DCA activated Kv2.1 by a tyrosine kinase-dependent mechanism. When given long-term, DCA partially restored I(K) and Kv2.1 expression in PASMCs without altering right ventricular pyruvate dehydrogenase activity, suggesting that the beneficial effects of DCA occur by nonmetabolic mechanisms. CONCLUSIONS DCA both prevents and reverses CH-PHT by a mechanism involving restoration of expression and function of Kv channels. DCA has previously been used in humans and may potentially be a therapeutic agent for pulmonary hypertension.
Collapse
MESH Headings
- Animals
- CHO Cells
- Cells, Cultured
- Chronic Disease
- Cricetinae
- Delayed Rectifier Potassium Channels
- Dichloroacetic Acid/pharmacology
- Electric Conductivity
- Enzyme Inhibitors/pharmacology
- Hemodynamics/drug effects
- Hypertension, Pulmonary/metabolism
- Hypertension, Pulmonary/pathology
- Hypertension, Pulmonary/physiopathology
- Hypertension, Pulmonary/prevention & control
- Hypoxia/metabolism
- Hypoxia/physiopathology
- Hypoxia/prevention & control
- Immunoblotting
- Male
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/physiology
- Potassium Channels/metabolism
- Potassium Channels, Voltage-Gated/biosynthesis
- Potassium Channels, Voltage-Gated/metabolism
- Potassium Channels, Voltage-Gated/physiology
- Protein Kinase Inhibitors
- Protein Kinases
- Protein Serine-Threonine Kinases
- Pulmonary Artery/drug effects
- Pulmonary Artery/pathology
- Pyruvate Dehydrogenase Acetyl-Transferring Kinase
- Pyruvate Dehydrogenase Complex/metabolism
- Rats
- Rats, Sprague-Dawley
- Shab Potassium Channels
Collapse
|