Cardiac hypertrophy in rats after supravalvular aortic constriction. I. Size and number of cardiomyocytes, endothelial and interstitial cells

Cardiomyocyte intercellular signalling increases oxidative stress and reprograms the global- and phospho-proteome of cardiac fibroblasts

Pathological reprogramming of cardiomyocyte and fibroblast proteome landscapes drive the initiation and progression of cardiac fibrosis. Although the secretome of dysfunctional cardiomyocytes is emerging as an important driver of pathological fibroblast reprogramming, our understanding of the downstream molecular players remains limited. Here, we show that cardiac fibroblast activation (αSMA+) and oxidative stress mediated by the secretome of TGFβ-stimulated cardiomyocytes is associated with a profound reprogramming of their proteome and phosphoproteome landscape. Within the fibroblast global proteome there was a striking dysregulation of proteins implicated in extracellular matrix, protein localisation/metabolism, KEAP1-NFE2L2 pathway, lysosomes, carbohydrate metabolism, and transcriptional regulation. Kinase substrate enrichment analysis of phosphopeptides revealed potential role of kinases (CK2, CDK2, PKC, GSK3B) during this remodelling. We verified upregulated activity of casein kinase 2 (CK2) in secretome-treated fibroblasts, and pharmacological CK2 inhibitor TBB (4,5,6,7-Tetrabromobenzotriazole) significantly abrogated fibroblast activation and oxidative stress. Our data provides molecular insights into cardiomyocyte to cardiac fibroblast crosstalk, and the potential role of CK2 in regulating cardiac fibroblast activation and oxidative stress.

The Transcription Factor EB (TFEB) Sensitizes the Heart to Chronic Pressure Overload

The transcription factor EB (TFEB) promotes protein degradation by the autophagy and lysosomal pathway (ALP) and overexpression of TFEB was suggested for the treatment of ALP-related diseases that often affect the heart. However, TFEB-mediated ALP induction may perturb cardiac stress response. We used adeno-associated viral vectors type 9 (AAV9) to overexpress TFEB (AAV9-Tfeb) or Luciferase-control (AAV9-Luc) in cardiomyocytes of 12-week-old male mice. Mice were subjected to transverse aortic constriction (TAC, 27G; AAV9-Luc: n = 9; AAV9-Tfeb: n = 14) or sham (AAV9-Luc: n = 9; AAV9-Tfeb: n = 9) surgery for 28 days. Heart morphology, echocardiography, gene expression, and protein levels were monitored. AAV9-Tfeb had no effect on cardiac structure and function in sham animals. TAC resulted in compensated left ventricular hypertrophy in AAV9-Luc mice. AAV9-Tfeb TAC mice showed a reduced LV ejection fraction and increased left ventricular diameters. Morphological, histological, and real-time PCR analyses showed increased heart weights, exaggerated fibrosis, and higher expression of stress markers and remodeling genes in AAV9-Tfeb TAC compared to AAV9-Luc TAC. RNA-sequencing, real-time PCR and Western Blot revealed a stronger ALP activation in the hearts of AAV9-Tfeb TAC mice. Cardiomyocyte-specific TFEB-overexpression promoted ALP gene expression during TAC, which was associated with heart failure. Treatment of ALP-related diseases by overexpression of TFEB warrants careful consideration.

The FGF-AKT pathway is necessary for cardiomyocyte survival for heart regeneration in zebrafish

Zebrafish have a remarkable ability to regenerate the myocardium after injury by proliferation of pre-existing cardiomyocytes. Fibroblast growth factor (FGF) signaling is known to play a critical role in zebrafish heart regeneration through promotion of neovascularization of the regenerating myocardium. Here, we define an additional function of FGF signaling in the zebrafish myocardium after injury. We find that FGF signaling is active in a small fraction of cardiomyocytes before injury, and that the number of FGF signaling-positive cardiomyocytes increases after amputation-induced injury. We show that ERK phosphorylation is prominent in endothelial cells, but not in cardiomyocytes. In contrast, basal levels of phospho-AKT positive cardiomyocytes are detected before injury, and the ratio of phosphorylated AKT-positive cardiomyocytes increases after injury, indicating a role of AKT signaling in cardiomyocytes following injury. Inhibition of FGF signaling reduced the number of phosphorylated AKT-positive cardiomyocytes and increased cardiomyocyte death without injury. Heart injury did not induce cardiomyocyte death; however, heart injury in combination with inhibition of FGF signaling caused significant increase in cardiomyocyte death. Pharmacological inhibition of AKT signaling after heart injury also caused increased cardiomyocyte death. Our data support the idea that FGF-AKT signaling-dependent cardiomyocyte survival is necessary for subsequent heart regeneration.

Differences in Expression of Mitochondrial Complexes Due to Genetic Variants May Alter Sensitivity to Radiation-Induced Cardiac Dysfunction

Radiation therapy is received by over half of all cancer patients. However, radiation doses may be constricted due to normal tissue side effects. In thoracic cancers, including breast and lung cancers, cardiac radiation is a major concern in treatment planning. There are currently no biomarkers of radiation-induced cardiotoxicity. Complex genetic modifiers can contribute to the risk of radiation-induced cardiotoxicities, yet these modifiers are largely unknown and poorly understood. We have previously reported the SS (Dahl salt-sensitive/Mcwi) rat strain is a highly sensitized model of radiation-induced cardiotoxicity compared to the more resistant Brown Norway (BN) rat strain. When rat chromosome 3 from the resistant BN rat strain is substituted into the SS background (SS.BN3 consomic), it significantly attenuates radiation-induced cardiotoxicity, demonstrating inherited genetic variants on rat chromosome 3 modify radiation sensitivity. Genes involved with mitochondrial function were differentially expressed in the hearts of SS and SS.BN3 rats 1 week after radiation. Here we further assessed differences in mitochondria-related genes between the sensitive SS and resistant SS.BN3 rats. We found mitochondrial-related gene expression differed in untreated hearts, while no differences in mitochondrial morphology were seen 1 week after localized heart radiation. At 12 weeks after localized cardiac radiation, differences in mitochondrial complex protein expression in the left ventricles were seen between the SS and SS.BN3 rats. These studies suggest that differences in mitochondrial gene expression caused by inherited genetic variants may contribute to differences in sensitivity to cardiac radiation.

Focal Adhesion Kinase-mediated Phosphorylation of Beclin1 Protein Suppresses Cardiomyocyte Autophagy and Initiates Hypertrophic Growth

Autophagy is an evolutionarily conserved intracellular degradation/recycling system that is essential for cellular homeostasis but is dysregulated in a number of diseases, including myocardial hypertrophy. Although it is clear that limiting or accelerating autophagic flux can result in pathological cardiac remodeling, the physiological signaling pathways that fine-tune cardiac autophagy are poorly understood. Herein, we demonstrated that stimulation of cardiomyocytes with phenylephrine (PE), a well known hypertrophic agonist, suppresses autophagy and that activation of focal adhesion kinase (FAK) is necessary for PE-stimulated autophagy suppression and subsequent initiation of hypertrophic growth. Mechanistically, we showed that FAK phosphorylates Beclin1, a core autophagy protein, on Tyr-233 and that this post-translational modification limits Beclin1 association with Atg14L and reduces Beclin1-dependent autophagosome formation. Remarkably, although ectopic expression of wild-type Beclin1 promoted cardiomyocyte atrophy, expression of a Y233E phosphomimetic variant of Beclin1 failed to affect cardiomyocyte size. Moreover, genetic depletion of Beclin1 attenuated PE-mediated/FAK-dependent initiation of myocyte hypertrophy in vivo Collectively, these findings identify FAK as a novel negative regulator of Beclin1-mediated autophagy and indicate that this pathway can facilitate the promotion of compensatory hypertrophic growth. This novel mechanism to limit Beclin1 activity has important implications for treating a variety of pathologies associated with altered autophagic flux.

Autophagy during cardiac remodeling

Despite progress in cardiovascular research and evidence-based therapies, heart failure is a leading cause of morbidity and mortality in industrialized countries. Cardiac remodeling is a chronic maladaptive process, characterized by progressive ventricular dilatation, cardiac hypertrophy, fibrosis, and deterioration of cardiac performance, and arises from interactions between adaptive modifications of cardiomyocytes and negative aspects of adaptation such as cardiomyocyte death and fibrosis. Autophagy has evolved as a conserved process for bulk degradation and recycling of cytoplasmic components, such as long-lived proteins and organelles. Accumulating evidence demonstrates that autophagy plays an essential role in cardiac remodeling to maintain cardiac function and cellular homeostasis in the heart. This review discusses some recent advances in understanding the role of autophagy during cardiac remodeling. This article is part of a Special Issue entitled: Autophagy in the Heart.

Regulation of mammalian autophagy in physiology and pathophysiology

(Macro)autophagy is a bulk degradation process that mediates the clearance of long-lived proteins and organelles. Autophagy is initiated by double-membraned structures, which engulf portions of cytoplasm. The resulting autophagosomes ultimately fuse with lysosomes, where their contents are degraded. Although the term autophagy was first used in 1963, the field has witnessed dramatic growth in the last 5 years, partly as a consequence of the discovery of key components of its cellular machinery. In this review we focus on mammalian autophagy, and we give an overview of the understanding of its machinery and the signaling cascades that regulate it. As recent studies have also shown that autophagy is critical in a range of normal human physiological processes, and defective autophagy is associated with diverse diseases, including neurodegeneration, lysosomal storage diseases, cancers, and Crohn's disease, we discuss the roles of autophagy in health and disease, while trying to critically evaluate if the coincidence between autophagy and these conditions is causal or an epiphenomenon. Finally, we consider the possibility of autophagy upregulation as a therapeutic approach for various conditions.

Cardiomyocyte loss in experimental renal failure: prevention by ramipril

BACKGROUND

The development of left ventricular hypertrophy (LVH) and of structural abnormalities of the heart is a key abnormality in renal failure that potentially contributes to the high rate of cardiac death. In renal failure, the behavior of cardiomyocyte volume and number in the development of LVH has so far not been investigated. A potential role of the (local) renin-angiotensin system (RAS) in the genesis of LVH has been suspected. It was the aim of the present study in short-term experimental renal failure (1) to characterize cardiomyocyte volume and number and (2) to study whether they are affected by the angiotensin-converting enzyme (ACE) inhibitor ramipril.

METHODS

Sprague-Dawley rats (N = 8 to 10 per group) had a subtotal nephrectomy (SNX) or sham operation and followed for 8 weeks. One SNX group received the ACE inhibitor ramipril (0.5 mg/kg body weight) in the drinking fluid. After perfusion fixation, the morphology of the heart was investigated using stereologic techniques.

RESULTS

Systolic blood pressure was slightly, but not significantly, higher in untreated SNX, but the left ventricular (LV) weight and LV weight/body weight ratio (2.32 +/- 0.20 mg/g) were significantly higher in SNX than in sham-operated animals (1.90 +/- 0.16 mg/g). Sarcomeric length was not significantly different between SNX and sham-operated animals. There was an increase in the number of terminal deoxynucleotidyl transferase-mediated uridine triphosphate nick end labeling (TUNEL)-positive myocytes in SNX compared to sham-operated animals and a significant increase in cardiomyocyte volume (15,713 +/- 4557 microm3 vs. 10,067 +/- 2242 microm3, P < 0.01) as well as a decrease of cardiomyocyte numbers per unit myocardial volume (61.2 +/- 16.2 vs. 92.2 +/- 20.9 x 103/mm3) and per left ventricle (70.9 +/- 16.5 x 106 vs. 94.8 +/- 18.1 x 106, P < 0.05). Both abnormalities were abrogated by treatment with ramipril (6347 +/- 972.4 microm3 and 106 +/- 18.9 103/mm3 or 118 +/- 39.5 x 106, respectively), which also completely prevented the increase in LV weight/body weight ratio (1.83 +/- 0.14 mg/g).

CONCLUSION

LVH in renal failure is characterized by cardiomyocyte hypertrophy, but also cardiomyocyte drop out. A role of the RAS is suggested by the beneficial effect of ramipril treatment that is not accounted for by differences in blood pressure.

Myocyte loss in early left ventricular hypertrophy of experimental renovascular hypertension

Left ventricular hypertrophy (LVH) develops very early in experimental renovascular hypertension after clipping of one renal artery and is accompanied by a remodeling of cardiac structure which has not yet been investigated in detail. It was the aim of the present study to analyze changes in cardiomyocyte number and volume in LVH after 2 weeks of renovascular hypertension. Sprague-Dawley rats were subjected to clipping of the left renal artery (2K1C) or sham operation (sham). One group of 2K1C rats received antihypertensive treatment with dihydralazine. The experiment was terminated after 2 weeks. Hearts were investigated using stereological methods, electron microscopy, immunohistology for the proliferation marker proliferating cell nuclear antigen, the pro- and anti-apoptotic proteins Bax and Bcl-2 as well as the TUNEL technique. After 2 weeks, systolic blood pressure and relative left ventricular weight were significantly higher in untreated 2K1C animals than in sham and dihydralazine-treated 2K1C rats. Volume fraction of interstitial tissue and capillary length density were not different, whereas wall thickness of intramyocardial arteries was significantly higher in untreated 2K1C (5.12+/-0.7 micro m) than in sham (3.92+/-0.6 micro m) and in dihydralazine-treated 2K1C (3.91+/-0.7 micro m) rats. Cardiomyocyte diameter and volume were significantly higher in untreated 2K1C than in sham animals. The number of cardiomyocytes per left ventricle was significantly lower in untreated 2K1C rats (5.5+/-1.6 vs 3.9+/-6.9 x10(7)). Using immunohistochemistry, no direct evidence of apoptosis was found, but a relative higher expression of the anti-apoptotic protein bcl-2 expression was seen in untreated 2K1C than in sham animals. This may reflect a protective mechanism as a consequence of earlier occurring apoptosis. These observations document that experimental renovascular hypertension induces a rapidly developing LVH characterized by marked cardiac remodeling and substantial loss of cadiomyocytes.

Spin-spin relaxation times in myocardial hypertrophy induced by endocrine agents in rat

Magnetic resonance techniques afford a significant advantage for noninvasive diagnosis of cardiovascular pathology. The purpose of our present study was to assay the proton nuclear magnetic resonance (1H-NMR) sensitivity in the differential diagnosis of certain endocrine cardiovascular complications. In this context, we investigated the water state and content in the hypertrophied myocardium. Male and female Wistar rats were treated with different hormones (hydrocortisone acetate, testosterone, estradiol, thyroid hormones) in combination with isoproterenol (a synthetic catecholamine that induces myocardial ischemia and hypertrophy). The animals were sacrificed after 20 days of treatment and samples of integral myocardium and left ventricular myocardium were analyzed on a 1H-NMR AREMI spectrometer (0.6 T; proton resonance at 25 MHz). The estimation of T2 was made by Carr Purcell-Meiboom-Gill pulse sequence. The data were fitted to a bi-exponential curve, yielding short (T21) values for bound water and long (T22) values for free water. In order to evaluate the myocardial hypertrophy, the following ratios were calculated: integral myocardium to body weight; left ventricle to body weight; left ventricle to integral myocardium. The first two ratios were also calculated for dried tissue, in order to estimate its contribution to myocardial hypertrophy. Our findings demonstrate that myocardial hypertrophy is associated with a decrease of T22, as a consequence of the increase in the dried component (i.e. proteins) of the tissue, while the total tissue water (H2Ot%), measured by gravimetry) was not significantly modified. Nevertheless, it is reasonable that the increase in the protein content would be proportional with the increase in H2Ot%. The decrease of T21 seems to be proportional with the level of left ventricle hypertrophy in female groups. The 1H-NMR measurements were much sensitive for the differential diagnosis of myocardial hypertrophy in the case of left ventricle.

Different response of cellular DNA content to cardiac hypertrophy in human and rat heart myocytes

1. Rat and human heart myocytes adapt to overload-induced hypertrophy differently. 2. Human myocyte nuclei respond with polyploidization and multinucleation, thus increasing the DNA content per myocyte from 20 to 40 pg. As a result, nuclear DNA content per 10,000 microns3 of cell volume decreases from 12 to 10 pg. 3. In rat hearts with aortic constriction nuclear DNA content remains constant (13 pg), and the DNA content per 10,000 microns3 of myocyte volume falls from 9 to 6 pg. 4. We hypothesize that "dilution" of nuclear DNA in the hypertrophied rat heart myocyte limits the capacity to hypertrophy (much less than 100%). 5. The human heart myocyte, which is able to compensate for dilution of nuclear DNA, may increase in size more than three-fold. 6. The lower limit of DNA content per unit of myocyte volume is 6 pg/10,000 microns3 in both species.

Development of smooth muscle: ultrastructural study of the chick embryo gizzard

The growth and differentiation of smooth muscle in the chicken gizzard were studied by electron microscopy from the 10th day in ovo to 6 months after hatching; during this period the organ grows 1000-fold in weight. At the earliest stage studied, smooth muscle cells, interstitial cells, and fibroblasts are immature but can already be clearly distinguished. The structural components of muscle cells develop in a characteristic sequence. Mitochondria are more abundant in immature muscle cells (8% in 14 days embryos and 7% in 19 days embryos) than in the adult (5%). Caveolae are virtually absent in the 11 day embryo; they become more common at the end of embryonic life, but continue to increase in relative frequency after hatching. Gap junctions appear around the 16th day in ovo as minute aggregates of connexons, which then grow in size, probably by addition of new connexons. In the earliest stages studied, myofilaments occupy 25% of the cell profile and are assembled into bundles accompanied by dense bodies and surrounded by loosely arranged intermediate filaments. By contrast, membrane-bound dense bands are scarce until the latter part of embryonic life, an observation suggesting that myofilament formation and alignment is not a process initiated near the cell membrane or directed by the cell membrane, and that only late in development bundles of myofilaments become extensively anchored to dense bands over the entire cell surface: at that time myofilaments occupy more than 75% of the cell volume. The muscle cells increase about four-fold in volume over the period studied; the 1000-fold increase in muscle volume is mainly accounted for by an increase in muscle cell number. Mitoses are found in the gizzard musculature at all embryonic ages with a peak at 17-19 days; they occur in muscle cells with a high degree of differentiation. These cells divide at a stage when they are packed with myofilaments and form junctions with neighbouring cells: the mitotic process affects the middle portion of the cell, which takes up an ovoid shape and eventually divides, whereas the remaining portions of the cell do not differ in appearance from the surrounding muscle cells. At all stages of development the population of muscle cells has a uniform appearance (apart from the cells in mitosis), and the growth and differentiation seem to proceed at the same pace in all the cells. There are no undifferentiated cells left behind in the tissue for later development.

Comparison of regional differences in cardiac myocyte dimensions in rats, hamsters, and guinea pigs

Isolated myocytes were prepared from Sprague Dawley rats, golden Syrian hamsters, and Hartley guinea pigs to investigate regional variations in myocyte size. Cell volume (V) was measured with a Coulter Channelyzer, cell length (L) was measured directly, and cross-sectional area (CSA) was calculated from V/L. Compared to values from the left ventricle (LV), right ventricular L was shorter in the rat (P less than .01) and hamster (P less than .05) and longer in the guinea pig (P less than .01). Guinea pig atrial L was shorter (P less than .01) than L in the right ventricle (RV) but did not differ from L in the LV. No significant differences in L existed between endomyocardium, middle myocardium, and epimyocardium of the LV in all three species. In rats and hamsters, myocytes from the RV had smaller V and CSA values (P less than .01) compared to any region of the LV. A transmural gradient of cellular dimensions existed in the LV of the rat, but not in hamster, with V and CSA of endomyocardium being largest and epimyocardium smallest (P less than .01). Endomyocardial V and CSA were larger (P less than .01) than all other regions in the hamster, but the difference was not significant compared to epimyocardial V. In the guinea pig, no significant differences in V existed between RV and LV or between the three LV regions. No pattern of regional differences was seen between ventricular CSA values in the guinea pig. Guinea pig atrial V and CSA values were smaller (P less than .01) than those for ventricular myocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Synergistic effects of diabetes mellitus and renovascular hypertension on the rat heart--stereological investigations on papillary muscles

The effects of combined renovascular hypertension and diabetes mellitus on the rat heart were investigated in order to detect possible synergistic effects of the two conditions. Hypertensive diabetic and hypertensive nondiabetic young male Wistar rats were compared with diabetic and non-diabetic controls. Since the normal body weight increase of the diabetic animals was markedly suppressed a weight-matched nondiabetic control group was introduced in addition. Hypertension was established for eight weeks by a surgical stenosis of the left renal artery, diabetes mellitus was maintained for four weeks after a single intraperitoneal injection of 75 mg/kg streptozotocin. Light and electron microscopic stereological parameters were obtained for the left ventricular papillary muscles. The whole hearts were also investigated histologically. Qualitative morphology failed to substantiate synergistic effects in the hypertensive diabetic rats. Vascular abnormalities were not observed. The stereological parameters, however, revealed microstructural reactions which were observed exclusively in the hypertensive diabetic group: the volume ratio of mitochondria-to-myofibrils was decreased, the surface-to-volume ratio of mitochondria was increased (reduction of mitochondrial size) and the mean cross sectional area of capillaries was decreased. Similar quantitative mitochondrial changes have been frequently described in long-standing hypertension, but in the present investigation, they were not found in the nondiabetic hypertensive group. It is therefore concluded that diabetes mellitus potentiates the effects of chronic pressure overload on myocardial cells. However, the myocardial fibrosis which has been found by other groups at later stages of hypertension and/or diabetes mellitus was not detected in the present study. The reduced mean cross sectional area of capillaries in hypertensive-diabetic rats may be correlated with early molecular changes of the myocardial interstitium or with early abnormalities of small arteries. Thus our stereological results support the hypothesis that a non-coronary hypertensive diabetic cardiomyopathy occurs in mammalian hearts.

Morphological reaction patterns in experimental cardiac hypertrophy--a quantitative stereological study

Four experimental models of myocardial hypertrophy were investigated in rats: 1. Mild hypertrophy induced by physical exercise, 2. mild hypertrophy induced by chronic pressure overload (24 weeks), 3. moderate hypertrophy induced by chronic pressure overload (8 weeks), 4. moderate hypertrophy in diabetes induced by chronic pressure overload (8 weeks). Stereological investigations on left ventricular papillary muscles disclosed different morphological reaction patterns: 1. The capillary bed of the myocardium responded differently in mild hypertrophy:physical training, but not mild chronic pressure overload, evoked neoformation of capillaries. 2. Mild hypertrophy and moderate hypertrophy induced by chronic pressure overload were not associated with quantitative structural reactions of myofibrils and mitochondria. Those alterations appeared, however, in hypertensive-diabetic rats with moderate hypertrophy. Our data provide further experimental evidence for the existence of a hypertensive-diabetic cardiomyopathy.

Intracellular turnover and cardiac hypertrophy

Ultrastructural evidence is presented that intracellular autophagic degradation of cytoplasmic constituents is reduced during pressure induced hypertrophy of left ventricular myocardium after supravalvular aortic constriction in rats. This anti-catabolic reaction has to be considered as an important mechanism for shifting the balance between synthesis and degradation to the positive side. Short term studies after administration of isoproterenol suggest a close functional relationship between work load on the one hand and the anti-catabolic reaction on the other.

Cardiac hypertrophy in rats after supravalvular aortic constriction. II. Inhibition of cellular autophagy in hypertrophying cardiomyocytes

Adult male Sprague-Dawley rats were killed by retrograde perfusion fixation 3, 7, 14, 21 and 35 days after supravalvular aortic constriction (n = 33) or sham-operation (n = 25). Subepicardial specimens of the left ventricular myocardium were evaluated by conventional electron microscopic morphometry, and in addition were examined for the occurrence of autophagic vacuoles (AVs) using large test areas (3.9 X 10(4) micron 2 per animal). The quotient of mitochondrial to myofibrillar volume fraction was largely unchanged during hypertrophy but was reduced by 25% compared with controls after termination of growth at 35 days. During the process of hypertrophy which eventually led to an increase in average single cell volume of the cardiomyocytes by 78%, the volume fraction and the numerical density of AVs was significantly lower than in sham-operated rats. The most striking difference was observed 7 days after the operations, the stage at which the growth rate of the cardiomyocytes relative to controls was at its maximum of 4.5% per day. At this point the volume fraction as well as the numerical density of AVs were reduced by about 50% compared with controls. At 14 and 21 days after operation, when the relative growth rate of the hypertrophying cardiomyocytes was still 2% and 1% per day, the AV volume fraction was reduced to a lesser extent (by 47% and 28%, respectively). After termination of adaptive growth at 35 days significant differences in fractional volume and numerical density of AVs were no longer detectable. These results suggest that degradation of cytoplasmic components is inhibited in cardiomyocytes undergoing hypertrophy. Such an anticatabolic reaction seems to play an important role in establishing the positive balance of cellular metabolism generally required for growth processes.