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INTRODUCTION: Myocardial infarction (MI) is the leading cause of death. When MI is not lethal, heart failure (HF) is a major consequence with high prevalence and poor prognosis. The targeting of autophagy represents a potentially therapeutic approach for the treatment of both pathologies. AREAS COVERED: PubMed searches were performed to discuss the current state of the art regarding the role of autophagy in MI and HF. We review available and potential approaches to modulate autophagy from a pharmacological and genetic perspective. We also discuss the targeting of autophagy in myocardial regeneration. Expert commentary: The targeting of autophagy has potential for the treatment of MI and HF. Autophagy is a process that takes place in virtually all cells of the body and thus, in order to evaluate this therapeutic approach in clinical trials, strategies that specifically target this process in the myocardium is required to avoid unwanted effects in other organs.
Assuntos
Autofagia , Insuficiência Cardíaca/terapia , Infarto do Miocárdio/terapia , Animais , Humanos , Miocárdio/patologiaRESUMO
The alpha2-adrenergic receptor agonist Dexmedetomidine (Dex) is a sedative medication used by anesthesiologists. Dex protects the heart against ischemia-reperfusion (IR) and can also act as a preconditioning mimetic. The mechanisms involved in Dex-dependent cardiac preconditioning, and whether this action occurs directly or indirectly on cardiomyocytes, still remain unclear. The endothelial nitric oxide synthase (eNOS)/nitric oxide (NO) signaling pathway and endothelial cells are known to play key roles in cardioprotection against IR injury. Therefore, the aims of this work were to evaluate whether the eNOS/NO pathway mediates the pharmacological cardiac effect of Dex, and whether endothelial cells are required in this cardioprotective action. Isolated adult rat hearts were treated with Dex (10nM) for 25min and the dimerization of eNOS and production of NO were measured. Hearts were then subjected to global IR (30/120min) and the role of the eNOS/NO pathway was evaluated. Dex promoted the activation of eNOS and production of NO. Dex reduced the infarct size and improved the left ventricle function recovery, but this effect was reversed when Dex was co-administered with inhibitors of the eNOS/NO/PKG pathway. In addition, Dex was unable to reduce cell death in isolated adult rat cardiomyocytes subjected to simulated IR. Cardiomyocyte death was attenuated by co-culturing them with endothelial cells pre-treated with Dex. In summary, our results show that Dex triggers cardiac protection by activating the eNOS/NO signaling pathway. This pharmacological effect of Dex requires its interaction with the endothelium.
Assuntos
Agonistas de Receptores Adrenérgicos alfa 2/farmacologia , Cardiotônicos/farmacologia , Dexmedetomidina/farmacologia , Traumatismo por Reperfusão Miocárdica/metabolismo , Óxido Nítrico Sintase Tipo III/metabolismo , Óxido Nítrico/metabolismo , Agonistas de Receptores Adrenérgicos alfa 2/uso terapêutico , Animais , Cardiotônicos/uso terapêutico , Células Cultivadas , Técnicas de Cocultura , Dexmedetomidina/uso terapêutico , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Coração/efeitos dos fármacos , Coração/fisiopatologia , Humanos , Masculino , Traumatismo por Reperfusão Miocárdica/tratamento farmacológico , Traumatismo por Reperfusão Miocárdica/fisiopatologia , Miocárdio/metabolismo , Miócitos Cardíacos/efeitos dos fármacos , Ratos Sprague-DawleyRESUMO
Insulin-like growth factor 1 (IGF-1) signaling regulates contractility, metabolism, hypertrophy, autophagy, senescence, and apoptosis in the heart. IGF-1 deficiency is associated with an increased risk of cardiovascular disease, whereas cardiac activation of IGF-1 receptor (IGF-1R) protects from the detrimental effects of a high-fat diet and myocardial infarction. IGF-1R activates multiple pathways through its intrinsic tyrosine kinase activity and through coupling to heterotrimeric G protein. These pathways involve classic second messengers, phosphorylation cascades, lipid signaling, Ca(2+) transients, and gene expression. In addition, IGF-1R triggers signaling in different subcellular locations including the plasma membrane, perinuclear T tubules, and also in internalized vesicles. In this review, we provide a fresh and updated view of the complex IGF-1 scenario in the heart, including a critical focus on therapeutic strategies.
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Receptor IGF Tipo 1/metabolismo , Cálcio/metabolismo , Humanos , Infarto do Miocárdio/metabolismo , Miocárdio/metabolismo , Fosforilação , Transdução de Sinais/fisiologia , Células-Tronco/citologiaRESUMO
AIMS: Insulin-like growth factor 1 (IGF-1) is known to exert cardioprotective actions. However, it remains unknown if autophagy, a major adaptive response to nutritional stress, contributes to IGF-1-mediated cardioprotection. METHODS AND RESULTS: We subjected cultured neonatal rat cardiomyocytes, as well as live mice, to nutritional stress and assessed cell death and autophagic rates. Nutritional stress induced by serum/glucose deprivation strongly induced autophagy and cell death, and both responses were inhibited by IGF-1. The Akt/mammalian target of rapamycin (mTOR) pathway mediated the effects of IGF-1 upon autophagy. Importantly, starvation also decreased intracellular ATP levels and oxygen consumption leading to AMP-activated protein kinase (AMPK) activation; IGF-1 increased mitochondrial Ca(2+) uptake and mitochondrial respiration in nutrient-starved cells. IGF-1 also rescued ATP levels, reduced AMPK phosphorylation and increased p70(S6K) phosphorylation, which indicates that in addition to Akt/mTOR, IGF-1 inhibits autophagy by the AMPK/mTOR axis. In mice harbouring a liver-specific igf1 deletion, which dramatically reduces IGF-1 plasma levels, AMPK activity and autophagy were increased, and significant heart weight loss was observed in comparison with wild-type starved animals, revealing the importance of IGF-1 in maintaining cardiac adaptability to nutritional insults in vivo. CONCLUSION: Our data support the cardioprotective actions of IGF-1, which, by rescuing the mitochondrial metabolism and the energetic state of cells, reduces cell death and controls the potentially harmful autophagic response to nutritional challenges. IGF-1, therefore, may prove beneficial to mitigate damage induced by excessive nutrient-related stress, including ischaemic disease in multiple tissues.
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Autofagia/efeitos dos fármacos , Metabolismo Energético/efeitos dos fármacos , Fator de Crescimento Insulin-Like I/farmacologia , Miócitos Cardíacos/efeitos dos fármacos , Proteínas Quinases Ativadas por AMP/fisiologia , Trifosfato de Adenosina/metabolismo , Animais , Cálcio/metabolismo , Células Cultivadas , Camundongos , Miócitos Cardíacos/metabolismo , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/fisiologia , Serina-Treonina Quinases TOR/fisiologiaRESUMO
Increasing evidence indicates that endoplasmic reticulum (ER) stress is involved in various diseases. In the human heart, ischemia/reperfusion has been correlated to ER stress, and several markers of the unfolded protein response (UPR) participate during cardiac remodeling and fibrosis. Here, we used isoproterenol (ISO) injection as a model for in vivo cardiac fibrosis. ISO induced significant cardiomyocyte loss and collagen deposition in the damaged areas of the endocardium. These responses were accompanied by an increase in the protein levels of the luminal ER chaperones BIP and PDI, as well as an increase in the UPR effector CHOP. The use of the chemical chaperone 4-phenylbutyric acid (4-PBA) prevented the activation of the UPR, the increase in luminal chaperones and also, leads to decreased collagen deposition, cardiomyocyte loss into the damaged zones. Our results suggest that cardiac damage and fibrosis induced in vivo by the beta-adrenergic agonist ISO are tightly related to ER stress signaling pathways, and that increasing the ER luminal folding capacity with exogenously administrated 4-PBA is a powerful strategy for preventing the development of cardiac fibrosis. Additionally, 4-PBA might prevent the loss of cardiomyocytes. Our data suggests that the attenuation of ER stress pathways with pharmacological compounds such as the chemical chaperone 4-PBA can prevent the development of cardiac fibrosis and adverse remodeling.
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Agonistas Adrenérgicos beta/toxicidade , Estresse do Retículo Endoplasmático/efeitos dos fármacos , Isoproterenol/toxicidade , Miocárdio/patologia , Fenilbutiratos/uso terapêutico , Transdução de Sinais/efeitos dos fármacos , Animais , Fibrose/induzido quimicamente , Fibrose/patologia , Fibrose/prevenção & controle , Humanos , Masculino , Chaperonas Moleculares/química , Miócitos Cardíacos/efeitos dos fármacos , Dobramento de Proteína , Ratos , Ratos Sprague-Dawley , Fator de Transcrição CHOP/metabolismoRESUMO
Increasing evidence indicates that endoplasmic reticulum (ER) stress activates the adaptive unfolded protein response (UPR), but that beyond a certain degree of ER damage, this response triggers apoptotic pathways. The general mechanisms of the UPR and its apoptotic pathways are well characterized. However, the metabolic events that occur during the adaptive phase of ER stress, before the cell death response, remain unknown. Here, we show that, during the onset of ER stress, the reticular and mitochondrial networks are redistributed towards the perinuclear area and their points of connection are increased in a microtubule-dependent fashion. A localized increase in mitochondrial transmembrane potential is observed only in redistributed mitochondria, whereas mitochondria that remain in other subcellular zones display no significant changes. Spatial re-organization of these organelles correlates with an increase in ATP levels, oxygen consumption, reductive power and increased mitochondrial Ca²âº uptake. Accordingly, uncoupling of the organelles or blocking Ca²âº transfer impaired the metabolic response, rendering cells more vulnerable to ER stress. Overall, these data indicate that ER stress induces an early increase in mitochondrial metabolism that depends crucially upon organelle coupling and Ca²âº transfer, which, by enhancing cellular bioenergetics, establishes the metabolic basis for the adaptation to this response.
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Retículo Endoplasmático/metabolismo , Metabolismo Energético , Mitocôndrias/metabolismo , Estresse Fisiológico , Antibacterianos/farmacologia , Apoptose/fisiologia , Cálcio/metabolismo , Respiração Celular , Inibidores Enzimáticos/farmacologia , Células HeLa , Agonistas dos Receptores Histamínicos/farmacologia , Humanos , Potencial da Membrana Mitocondrial , Consumo de Oxigênio/efeitos dos fármacos , Fosfatos de Fosfatidilinositol/metabolismo , Transdução de Sinais/fisiologiaRESUMO
Autophagy is a physiological degradative process key to cell survival during nutrient deprivation, cell differentiation and development. It plays a major role in the turnover of damaged macromolecules and organelles, and it has been involved in the pathogenesis of different cardiovascular diseases. Activation of the adrenergic system is commonly associated with cardiac fibrosis and remodeling, and cardiac fibroblasts are key players in these processes. Whether adrenergic stimulation modulates cardiac fibroblast autophagy remains unexplored. In the present study, we aimed at this question and evaluated the effects of b(2)-adrenergic stimulation upon autophagy. Cultured adult rat cardiac fibroblasts were treated with agonists or antagonists of beta-adrenergic receptors (b-AR), and autophagy was assessed by electron microscopy, GFP-LC3 subcellular distribution, and immunowesternblot of endogenous LC3. The predominant expression of b(2)-ARs was determined and characterized by radioligand binding assays using [(3)H]dihydroalprenolol. Both, isoproterenol and norepinephrine (non-selective b-AR agonists), as well as salbutamol (selective b(2)-AR agonist) increased autophagic flux, and these effects were blocked by propanolol (b-AR antagonist), ICI-118,551 (selective b(2)-AR antagonist), 3-methyladenine but not by atenolol (selective b(1)-AR antagonist). The increase in autophagy was correlated with an enhanced degradation of collagen, and this effect was abrogated by the inhibition of autophagic flux. Overall, our data suggest that b(2)-adrenergic stimulation triggers autophagy in cardiac fibroblasts, and that this response could contribute to reduce the deleterious effects of high adrenergic stimulation upon cardiac fibrosis.
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Autofagia/fisiologia , Colágeno/metabolismo , Fibroblastos/fisiologia , Receptores Adrenérgicos beta 2/fisiologia , Adenina/análogos & derivados , Adenina/farmacologia , Agonistas Adrenérgicos beta/farmacologia , Antagonistas Adrenérgicos beta/farmacologia , Animais , Autofagia/efeitos dos fármacos , Western Blotting , Células Cultivadas , Di-Hidroalprenolol/metabolismo , Relação Dose-Resposta a Droga , Fibroblastos/metabolismo , Fibroblastos/ultraestrutura , Isoproterenol/farmacologia , Masculino , Microscopia Eletrônica de Transmissão , Miocárdio/citologia , Norepinefrina/farmacologia , Propanolaminas/farmacologia , Ensaio Radioligante , Ratos , Ratos Sprague-Dawley , Receptores Adrenérgicos beta 2/metabolismo , TrítioRESUMO
Substantial progress has been made throughout the last decades in the elucidation of the key players and mechanisms responsible for Ca2+ signal generation in both excitable and non-excitable cells. Importantly, these studies led also to the recognition that a close correlation exists between the deregulation of cellular Ca2+ homeostasis and the development of several human pathologies, including neurodegenerative disease. Notwithstanding this advances, much less is certain about the targets and mechanisms by which compromised Ca2+ signaling exerts its effects on cell function and survival. Recently it has been proposed that deregulation of cellular energy metabolism and protein turnover (synthesis, folding and degradation) are also fundamental pathomechanisms of neurodegenerative disease, pointing to the pivotal role of autophagy, a major cellular pathway controlling metabolic homeostasis. Indeed, activation of autophagy has been shown to represent a highly successful strategy to restore normal neuronal function in a variety of models of neurodegenerative disease. Here we review recent advances in elucidating Ca2+ regulation of autophagy and will highlight its relationship to neurodegeneration.
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Autofagia , Sinalização do Cálcio , Cálcio/metabolismo , Animais , Metabolismo Energético , Humanos , Doenças Neurodegenerativas , Complexo de Endopeptidases do Proteassoma/metabolismoRESUMO
Antecedentes: La metaloproteinasas (MMPs) son enzimas proteolíticas que participan en la inestabilidad de la placa aterosclerótica. En cultivos celulares, la actividad de metaloproteinasas-2 y 9 (MMP-2 y MMP-9) aumenta en presencia de radicales libres del oxígeno. En una experiencia preliminar en pacientes con síndrome coronario agudo (SCA) hemos encontrado una posible asociación entre ambos fenómenos. Objetivo: Evaluar la relación entre actividad de enzimas de degradación de la matriz extracelular y estrés oxidativo (EO) en el SCA. Métodos: Estudiamos en forma prospectiva a 40 pacientes con SCA sin supradesnivel del segmento ST, puntaje TIMI ≥ 3 y alteraciones al electrocardiograma o elevación de Troponina I, que no presentaran un proceso inflamatorio. Se midió actividad de MMP-2 y MMP-9 (por zimografía en geles), malondialdehido (MDA) (mediante sustancias reactivas al ácido tiobarbitúrico) y PCR ultrasensible (PCRus) (ELISA), al ingreso y al quinto día. Se utilizó test t de Student para muestras pareadas y correlación lineal de Pearson. Resultados: De los 40 pacientes, 31 fueron hombres, la edad promedio fue 61+/-12 (38-85) años, todos con elevación de Troponina I. El puntaje TIMI fue de 4 (3-7). El 85 por ciento de los pacientes presentaron elevación de PCRus al ingreso (15,0+/-28,7 mg/L) y ésta aumentó al día 5 (35,3+/-38 mg/L, p=0,01); los niveles plasmáticos de MDA se encontraron elevados al ingreso (1,54+/-0,75 µM/L) y descendieron al quinto día (1,04+/-0,32 µM/L, p<0,0001). Al quinto día, la actividad de MMP-9 cayó a un 74+/-27 por ciento del valor basal (p<0,0001). No se observó cambio en la actividad de MMP-2. Se demostró una correlación positiva entre las fracciones de cambio de MDA y MMP-9 (r=0,43, p<0,0001). Conclusiones: En pacientes con SCA se observa un aumento precoz en el grado de inflamación, actividad de MMP-9 y de EO...
Background: Metalloproteinases are proteolytic enzymes that participate in atherosclerotic plaque instability. In cellular cultures there is increased activity of metalloproteinases-2 and 9 (MMP-2 and MMP-9) in the presence of free oxygen radicals. In a preliminary experience in patients with acute coronary syndrome (ACS) we have found a possible association between both phenomena. Objective: To evaluate the relation between activity of matrix degradation proteins and oxidative stress (OS) in acute coronary syndrome. Methods: Fourty patients with non-ST segment elevation acute coronary syndrome were prospectively studied. All had a TIMI risk score ≥ 3, ischemic changes on electrocardiogram or Troponin I elevation, without a concomitant inflammatory condition. We determined MMP-2 and MMP-9 activities (gel zymography), malondialdehyde (MDA) (thiobarbituric acid reactive species) and high sensitive C reactive protein (hsCRP) plasma levels at admission and 5 days later. Paired samples Student t test and Pearsons lineal correlation were used for statistical analysis. Results: Of the 40 patients, 31 were male, mean age 61+/-12 years old (range 38-85), all of them with Troponin I elevation. The TIMI risk score was 4 (3-7). 85 percent presented hsCRP elevation (15.0+/-28,7 mg/L at admission and 35.3+/-38 mg/L at day 5). MDA plasma levels were increased at admission (1,54+/-0,75 µM/L) and diminished at day 5 (1,04+/-0,32 µM/L, p<0,0001). Compared to basal values, MMP-9 activity decreased to 74+/- 27 percent at day 5, (p<0,001). No significant change was observed in MMP-2 activity between both measurements. A significant positive correlation was found between change fractions of MDA levels and MMP-9 activity (r=0,43, p<0,0001). Conclusions: In patients with ACS we observed an early increase in inflammation markers, MMP-9 activity and OS. The correlation demonstrated between MMP-9 activity and OS suggests a common role of both phenomena in the pathophysiology...