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Gaido OER, Pavlaki N, Granger JM, Mesubi OO, Liu B, Lin BL, Long A, Walker D, Mayourian J, Schole KL, Terrillion CE, Nkashama LJ, Hulsurkar MM, Dorn LE, Ferrero KM, Huganir RL, Müller FU, Wehrens XHT, Liu JO, Luczak ED, Bezzerides VJ, Anderson ME. An improved reporter identifies ruxolitinib as a potent and cardioprotective CaMKII inhibitor. Sci Transl Med 2023; 15:eabq7839. [PMID: 37343080 PMCID: PMC11022683 DOI: 10.1126/scitranslmed.abq7839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 05/31/2023] [Indexed: 06/23/2023]
Abstract
Ca2+/calmodulin-dependent protein kinase II (CaMKII) hyperactivity causes cardiac arrhythmias, a major source of morbidity and mortality worldwide. Despite proven benefits of CaMKII inhibition in numerous preclinical models of heart disease, translation of CaMKII antagonists into humans has been stymied by low potency, toxicity, and an enduring concern for adverse effects on cognition due to an established role of CaMKII in learning and memory. To address these challenges, we asked whether any clinically approved drugs, developed for other purposes, were potent CaMKII inhibitors. For this, we engineered an improved fluorescent reporter, CaMKAR (CaMKII activity reporter), which features superior sensitivity, kinetics, and tractability for high-throughput screening. Using this tool, we carried out a drug repurposing screen (4475 compounds in clinical use) in human cells expressing constitutively active CaMKII. This yielded five previously unrecognized CaMKII inhibitors with clinically relevant potency: ruxolitinib, baricitinib, silmitasertib, crenolanib, and abemaciclib. We found that ruxolitinib, an orally bioavailable and U.S. Food and Drug Administration-approved medication, inhibited CaMKII in cultured cardiomyocytes and in mice. Ruxolitinib abolished arrhythmogenesis in mouse and patient-derived models of CaMKII-driven arrhythmias. A 10-min pretreatment in vivo was sufficient to prevent catecholaminergic polymorphic ventricular tachycardia, a congenital source of pediatric cardiac arrest, and rescue atrial fibrillation, the most common clinical arrhythmia. At cardioprotective doses, ruxolitinib-treated mice did not show any adverse effects in established cognitive assays. Our results support further clinical investigation of ruxolitinib as a potential treatment for cardiac indications.
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Affiliation(s)
- Oscar E. Reyes Gaido
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Nikoleta Pavlaki
- Department of Cardiology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Jonathan M. Granger
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Olurotimi O. Mesubi
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Bian Liu
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Brian L. Lin
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Alan Long
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - David Walker
- Department of Cardiology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Joshua Mayourian
- Department of Cardiology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Kate L. Schole
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Chantelle E. Terrillion
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Lubika J. Nkashama
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Mohit M. Hulsurkar
- Cardiovascular Research Institute and Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Lauren E. Dorn
- Cardiovascular Research Institute and Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Kimberly M. Ferrero
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Richard L. Huganir
- Solomon H. Snyder Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Frank U. Müller
- Institute of Pharmacology and Toxicology, University of Münster, Münster 48149, Germany
| | - Xander H. T. Wehrens
- Cardiovascular Research Institute and Department of Integrative Physiology, Baylor College of Medicine, Houston, TX 77030, USA
- Departments of Medicine, Neuroscience, and Pediatrics, Center for Space Medicine, Baylor College of Medicine, Houston, TX 77030, USA
| | - Jun O. Liu
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Elizabeth D. Luczak
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
| | - Vassilios J. Bezzerides
- Department of Cardiology, Boston Children’s Hospital and Harvard Medical School, Boston, MA 02115, USA
| | - Mark E. Anderson
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA
- Division of Biological Sciences and the Pritzker School of Medicine, University of Chicago, Chicago, IL 60637, USA
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Pun-García A, Clemente-Moragón A, Villena-Gutierrez R, Gómez M, Sanz-Rosa D, Díaz-Guerra A, Prados B, Medina JP, Montó F, Ivorra MD, Márquez-López C, Cannavo A, Bernal JA, Koch WJ, Fuster V, de la Pompa JL, Oliver E, Ibanez B. Beta-3 adrenergic receptor overexpression reverses aortic stenosis-induced heart failure and restores balanced mitochondrial dynamics. Basic Res Cardiol 2022; 117:62. [PMID: 36445563 PMCID: PMC9708808 DOI: 10.1007/s00395-022-00966-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 10/31/2022] [Accepted: 10/31/2022] [Indexed: 11/30/2022]
Abstract
Aortic stenosis (AS) is associated with left ventricular (LV) hypertrophy and heart failure (HF). There is a lack of therapies able to prevent/revert AS-induced HF. Beta3 adrenergic receptor (β3AR) signaling is beneficial in several forms of HF. Here, we studied the potential beneficial effect of β3AR overexpression on AS-induced HF. Selective β3AR stimulation had a positive inotropic effect. Transgenic mice constitutively overexpressing human β3AR in the heart (c-hβ3tg) were protected from the development of HF in response to induced AS, and against cardiomyocyte mitochondrial dysfunction (fragmented mitochondria with remodeled cristae and metabolic reprogramming featuring altered substrate use). Similar beneficial effects were observed in wild-type mice inoculated with adeno-associated virus (AAV9) inducing cardiac-specific overexpression of human β3AR before AS induction. Moreover, AAV9-hβ3AR injection into wild-type mice at late disease stages, when cardiac hypertrophy and metabolic reprogramming are already advanced, reversed the HF phenotype and restored balanced mitochondrial dynamics, demonstrating the potential of gene-therapy-mediated β3AR overexpression in AS. Mice with cardiac specific ablation of Yme1l (cYKO), characterized by fragmented mitochondria, showed an increased mortality upon AS challenge. AAV9-hβ3AR injection in these mice before AS induction reverted the fragmented mitochondria phenotype and rescued them from death. In conclusion, our results step out that β3AR overexpression might have translational potential as a therapeutic strategy in AS-induced HF.
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Affiliation(s)
- Andrés Pun-García
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.510932.cCIBERCV, Madrid, Spain
| | - Agustín Clemente-Moragón
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.510932.cCIBERCV, Madrid, Spain
| | - Rocio Villena-Gutierrez
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain
| | - Monica Gómez
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain
| | - David Sanz-Rosa
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.510932.cCIBERCV, Madrid, Spain ,grid.119375.80000000121738416Universidad Europea de Madrid, Madrid, Spain
| | - Anabel Díaz-Guerra
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain
| | - Belén Prados
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.510932.cCIBERCV, Madrid, Spain ,grid.467824.b0000 0001 0125 7682Intercellular Signalling in Cardiovascular Development and Disease Laboratory, CNIC, Madrid, Spain
| | - Juan Pablo Medina
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.419651.e0000 0000 9538 1950Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
| | - Fermí Montó
- grid.5338.d0000 0001 2173 938XDepartamento de Farmacología, Facultad de Farmacia, ERI BIOTECMED, Universitat de València, Burjassot, Spain
| | - Maria Dolores Ivorra
- grid.5338.d0000 0001 2173 938XDepartamento de Farmacología, Facultad de Farmacia, ERI BIOTECMED, Universitat de València, Burjassot, Spain
| | - Cristina Márquez-López
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain
| | - Alessandro Cannavo
- grid.264727.20000 0001 2248 3398Center for Translational Medicine and Department of Pharmacology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA USA ,grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, Federico II University of Naples, Naples, Italy
| | - Juan A. Bernal
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.510932.cCIBERCV, Madrid, Spain
| | - Walter J. Koch
- grid.264727.20000 0001 2248 3398Center for Translational Medicine and Department of Pharmacology, Lewis Katz School of Medicine, Temple University, Philadelphia, PA USA
| | - Valentin Fuster
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.59734.3c0000 0001 0670 2351Icahn School of Medicine at Mount Sinai, New York, NY USA
| | - José Luis de la Pompa
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.510932.cCIBERCV, Madrid, Spain ,grid.467824.b0000 0001 0125 7682Intercellular Signalling in Cardiovascular Development and Disease Laboratory, CNIC, Madrid, Spain
| | - Eduardo Oliver
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.510932.cCIBERCV, Madrid, Spain ,grid.4711.30000 0001 2183 4846Centro de Investigaciones Biológicas Margarita Salas (CIB), CSIC, Madrid, Spain
| | - Borja Ibanez
- grid.467824.b0000 0001 0125 7682Centro Nacional de Investigaciones Cardiovasculares (CNIC), IIS-Fundación Jiménez Díaz University Hospital, Melchor Fernandez Almagro, 3, 28029 Madrid, Spain ,grid.510932.cCIBERCV, Madrid, Spain ,grid.419651.e0000 0000 9538 1950Cardiology Department, IIS-Fundación Jiménez Díaz University Hospital, Madrid, Spain
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Reinhardt F, Beneke K, Pavlidou NG, Conradi L, Reichenspurner H, Hove-Madsen L, Molina CE. Abnormal Calcium Handling in Atrial Fibrillation Is Linked to Changes in Cyclic AMP Dependent Signaling. Cells 2021; 10:cells10113042. [PMID: 34831263 PMCID: PMC8616167 DOI: 10.3390/cells10113042] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/22/2021] [Accepted: 11/02/2021] [Indexed: 01/03/2023] Open
Abstract
Both, the decreased L-type Ca2+ current (ICa,L) density and increased spontaneous Ca2+ release from the sarcoplasmic reticulum (SR), have been associated with atrial fibrillation (AF). In this study, we tested the hypothesis that remodeling of 3′,5′-cyclic adenosine monophosphate (cAMP)-dependent protein kinase A (PKA) signaling is linked to these compartment-specific changes (up- or down-regulation) in Ca2+-handling. Perforated patch-clamp experiments were performed in atrial myocytes from 53 patients with AF and 104 patients in sinus rhythm (Ctl). A significantly higher frequency of transient inward currents (ITI) activated by spontaneous Ca2+ release was confirmed in myocytes from AF patients. Next, inhibition of PKA by H-89 promoted a stronger effect on the ITI frequency in these myocytes compared to myocytes from Ctl patients (7.6-fold vs. 2.5-fold reduction), while the β-agonist isoproterenol (ISO) caused a greater increase in Ctl patients (5.5-fold vs. 2.1-fold). ICa,L density was larger in myocytes from Ctl patients at baseline (p < 0.05). However, the effect of ISO on ICa,L density was only slightly stronger in AF than in Ctl myocytes (3.6-fold vs. 2.7-fold). Interestingly, a significant reduction of ICa,L and Ca2+ sparks was observed upon Ca2+/Calmodulin-dependent protein kinase II inhibition by KN-93, but this inhibition had no effect on ITI. Fluorescence resonance energy transfer (FRET) experiments showed that although AF promoted cytosolic desensitization to β-adrenergic stimulation, ISO increased cAMP to similar levels in both groups of patients in the L-type Ca2+ channel and ryanodine receptor compartments. Basal cAMP signaling also showed compartment-specific regulation by phosphodiesterases in atrial myocytes from 44 Ctl and 43 AF patients. Our results suggest that AF is associated with opposite changes in compartmentalized PKA/cAMP-dependent regulation of ICa,L (down-regulation) and ITI (up-regulation).
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Affiliation(s)
- Franziska Reinhardt
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg UKE, 20251 Hamburg, Germany; (F.R.); (L.C.); (H.R.)
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20251 Hamburg, Germany; (K.B.); (N.G.P.)
| | - Kira Beneke
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20251 Hamburg, Germany; (K.B.); (N.G.P.)
- Institute of Experimental Cardiovascular Research, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Nefeli Grammatica Pavlidou
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20251 Hamburg, Germany; (K.B.); (N.G.P.)
- Institute of Experimental Cardiovascular Research, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Lenard Conradi
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg UKE, 20251 Hamburg, Germany; (F.R.); (L.C.); (H.R.)
| | - Hermann Reichenspurner
- Department of Cardiovascular Surgery, University Heart & Vascular Center Hamburg UKE, 20251 Hamburg, Germany; (F.R.); (L.C.); (H.R.)
- Institute of Experimental Cardiovascular Research, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
| | - Leif Hove-Madsen
- Biomedical Research Institute Barcelona, IIBB-CSIC and IIB Sant Pau, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain;
| | - Cristina E. Molina
- German Center for Cardiovascular Research (DZHK), Partner Site Hamburg/Kiel/Lübeck, 20251 Hamburg, Germany; (K.B.); (N.G.P.)
- Institute of Experimental Cardiovascular Research, University Medical Center Hamburg-Eppendorf (UKE), 20251 Hamburg, Germany
- Correspondence: ; Tel.: +49-407-4105-7095
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