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Die ERK2Thr188-Autophosphoylierung stellt einen regulatorischen Signalweg dar, der infolge einer hypertrophen Stimulation die kardiale Hypertrophie begünstigt. Eine Hemmung dieser Phosphorylierung in Kardiomyozyten verhindert die Ausbildung der kardialen Hypertrophie ohne Beeinflussung der kardioprotektiven Funktionen von ERK1/2. Demgegenüber führt die dauerhafte Simulation zu einem gain-of-function-Phänotypen mit ausgeprägter Hypertophie, Fibrose und einer reduzierten Herzfunktion. In dieser Arbeit wurde die dauerhafte Simulation ERK2Thr188-Phosphorylierung (T188D) in einem Mausmodell mit ubiquitärer Expression dieser Mutation untersucht. Dabei konnte gezeigt werden, dass sich nach Stimulation durch TAC in diesen Tieren ein etwas stärkerer hypertropher Phänotyp mit vergrößerten Kardiomyozyten, gesteigerter interstitieller Fibrosierung und reduzierter Herzfunktion ausbildet als in Mäusen mit kardiomyozyten-spezifischer Überexpression diese Mutante. In Fibroblasten- und VSMC-Zelllinien wurde eine gesteigerte Proliferation der T188D-überexprimierenden Zellen im Vergleich zu Kontrollen festgestellt. Somit scheint die ERK2Thr188-Phosphorylierung auch in kardialen Nicht-Myozyten einen maladaptiven Einfluss auf das Herz auszuüben.
Integrins are transmembrane receptors transmitting mechanical signals from the extracellular matrix (ECM) to the cytoskeleton (outside-in-signaling). Many molecular defects in the link between cytoskeleton and ECM are known to induce cardiomyopathies. alpha v integrin appears to play a major role in several processes relevant to remodeling, such as binding and activation of matrix metalloproteinases as well as regulation of cell proliferation, migration, and differentiation. We hypothesized that alpha v integrin-mediated signaling is required for the compensatory hypertrophy after aortic banding (AB) and associated with the modulation of ECM protein expression. Mice were treated in vivo with a specific integrin alpha v inhibitor or vehicle via osmotic minipumps starting 1 day prior to aortic banding (AB). At day 2 and day 7 following AB or sham-operation, the mice were examined by echocardiography and hemodynamic analyses were performed. Treatment of alpha v Integrin inhibitor led to a dilated cardiomyopathy and congestive heart failure in AB mice (dilated left ventricle, depressed LV function, and pulmonary congestion), but not to hypertrophy as observed in mice without inhibitor treatment. Investigation of downstream signaling revealed significant activation of the p38 Mitogen-Activated Protein Kinase (MAPK), the Extracellular signal-Regulated Kinases 1 and 2 (Erk 1/2), Focal Adhesion Kinase (FAK) and tyrosine-phosphorylation of c-Src in mice 7 days after AB. This response was blunted in mice treated with integrin alpha v inhibitor. Microarrays probing for a total of 96 cell adhesion and ECM genes identified various genomic targets of integrin alpha v mediated signalling. 7 days after AB 18 ECM genes were up-regulated more than 2-fold (n=6), e.g. collagen (8.11 ± 2.2), fibronectin (2.32 ± 0.94), secreted protein, acidic and rich in cysteine (SPARC, 3.78 ± 0.12), A disintegrin-like and metalloprotease (reprolysin type) with trombospondin type 1 (Adamts-1, 3.51 ± 0.81) and Tissue inhibitor of metalloproteinase 2 (TIMP2, 2.23 ± 0.98), whereas this up-regulation was abolished in mice that were treatd by integrin alpha v inhibitor via mini pumps. We conclude that signaling downstream of integrin alpha v is mediated by the MAPK, FAK and c-Src pathways leading to an up-regulation of extracelluar matrix components necessary for the compensatory response of the heart under a condition of pressure overload.
Transgene Mausmodelle zur Charakterisierung der Funktion kardialer beta-adrenerger Rezeptoren
(2001)
In der vorliegenden Arbeit wurde die Funktion kardialer beta-adrenerger Rezeptoren mit Hilfe einer Kombination aus transgenen Mausmodellen und physiologischen und molekularbiologischen Methoden untersucht. Durch gezielte Überexpression des humanen beta1-adrenergen Rezeptors im Herzen transgener Mäuse konnte gezeigt werden, daß die chronische Aktivierung dieses Rezeptors eine trophische Wirkung auf die Herzmuskelzellen hat. Über einen Zeitraum von mehreren Monaten führte dies zur Entwicklung einer Herzinsuffizienz. In der menschlichen Herzinsuffizienz kommt es zu einem ähnlichen Phänomen: Durch deutlich erhöhte Freisetzung von endogenen Katecholaminen kommt es zu einer chronischen Dauerstimulation kardialer beta1-adrenerger Rezeptoren. Daß diese schädlich ist belegen das hier beschriebene Mausmodell und zudem einige neuere klinische Studien, die zeigen daß eine pharmakologische Blockade beta-adrenerger Rezeptoren zu einer Verminderung der Herzinsuffizienzmortalität führt. Dieses Mausmodell erlaubte es erstmals den beta1-adrenergen Rezeptor hinsichtlich seiner spontanen Rezeptoraktivität in einem physiologischen Modell zu untersuchen. Dabei zeigte sich, daß der humane beta1-adrenerge Rezeptor spontane Aktivität aufweist, jedoch in einem deutlich geringeren Ausmaß als der beta2-adrenerge Rezeptor. Dies könnte klinisch relevant sein, da klinisch verwendete beta-Rezeptor-Antagonisten die spontane Aktivität des beta1-adrenergen Rezeptors in unserem Modell unterschiedlich stark unterdrückten. In der vorliegenden Arbeit wurde zudem untersucht, ob sich die beiden kardial exprimierten Beta-Rezeptor-Subtypen Beta1 und Beta2 hinsichtlich ihrer Signaltransduktion unterscheiden. Ausgehend von dem Befund, daß die chronische Aktivierung der beiden Subtypen in transgenen Mausmodellen zu deutlich unterschiedlichen Phänotypen führt, wurden verschiedene intrazelluläre Signalwege auf ihre Aktivierung hin überprüft. Abweichend von publizierten, in vitro nach kurzzeitiger Rezeptorstimulation erhobenen Daten zeigte sich, daß die chronische Aktivierung der Rezeptorsubtypen zu einer unterschiedlichen Aktivierung der kardialen MAP-kinasen (ERK) führt. Die beta1-spezifische Aktivierung dieser Kinasen könnte die beobachtete unterschiedliche Hypertrophieentwicklung in diesen beiden Mausmodellen erklären. Einen weiteren Schwerpunkt bei der Aufklärung des Mechanismus beta-adrenerg induzierter Hypertrophie bildete die Untersuchung der zellulären Calcium-homöostase. Als früheste funktionelle Veränderung in der Entwicklung einer beta-adrenerg induzierten Herzhypertrophie und -insuffizienz trat dabei eine Störung des intrazellulären Calciumtransienten auf. Als möglicher Mechanismus für die Störung des Calciumhaushalts konnte eine zeitgleich auftretende veränderte Expression des Calcium-regulierenden Proteins Junctin beschrieben werden. Einen neuen therapeutischen Ansatz für die Therapie der Herzinsuffizienz könnten schließlich vielleicht die Untersuchungen zum kardialen Na/H-austauscher ergeben: Es konnte erstmals gezeigt werden, daß der kardiale Na/H-Austauscher maßgeblich an der beta-adrenerg induzierten Herzhypertrophie- und Fibrose-entstehung beteiligt ist und daß die pharmakologische Inhibition dieses Proteins sowohl Hypertrophie als auch die Fibrose wirksam unterdrücken kann.
ERK1/2 are known key players in the pathophysiology of heart failure, but the members of the ERK cascade, in particular Raf1, can also protect the heart from cell death and ischemic injury. An additional autophosphorylation (ERK1 at Thr208, ERK2 at Thr188) empowers ERK1/2 translocation to the nucleus and phosphorylation of nuclear targets which take part in the development of cardiac hypertrophy. Thereby, targeting this additional phosphorylation is a promising pharmacological approach.
In this thesis, an in silico model of ERK cascade in the cardiomyocyte is introduced. The model is a semi-quantitive model and its behavior was tested with different softwares (SQUAD and CellNetAnalyzer). Different phosphorylation states of ERK1/2 as well as different stimuli can be reproduced. The different types of stimuli include hypertrophic as well as non-hypertrophic stimuli. With the introduced in-silico model time courses and synergistic as well as antagonistic receptor stimuli combinations can be predicted. The simulated time courses were experimentally validated. SQUAD was mainly used to make predictions about time courses and thresholds, whereas CNA was used to analyze steady states and feedback loops.
Furthermore, new targets of ERK1/2 which partially contribute, also in the formation of cardiac hypertrophy, were identified and the most promising of them were illuminated. Important further targets are Caspase 8, GAB2, Mxi-2, SMAD2, FHL2 and SPIN90.
Cardiomyocyte gene expression data sets were analyzed to verify involved components and to find further significantly altered genes after induced hypertrophy with TAC (transverse aortic constriction). Changes in the ultrastructure of the cardiomyocyte are the final result of induced hypertrophy.
The objective of this study was to identify unknown modulators of Calcineurin (Cn)-NFAT signaling. Measurement of NFAT reporter driven luciferase activity was therefore utilized to screen a human cardiac cDNA-library (~10\(^{7}\) primary clones) in C2C12 cells through serial dilutions until single clones could be identified. This extensive screening strategy culminated in the identification of SUMO2 as a most efficient Cn-NFAT activator. SUMO2-mediated activation of Cn-NFAT signaling in cardiomyocytes translated into a hypertrophic phenotype. Prohypertrophic effects were also observed in mice expressing SUMO2 in the heart using AAV9 (Adeno-associated virus), complementing the in vitro findings. In addition, increased SUMO2-mediated sumoylation in human cardiomyopathy patients and in mouse models of cardiomyopathy were observed. To decipher the underlying mechanism, we generated a sumoylation-deficient SUMO2 mutant (ΔGG). Surprisingly, ΔGG replicated Cn-NFAT-activation and the prohypertrophic effects of native SUMO2, both in vitro and in vivo, suggesting a sumoylation-independent mechanism. Finally, we discerned a direct interaction between SUMO2 and CnA, which promotes CnA nuclear localization. In conclusion, we identified SUMO2 as a novel activator of Cn-NFAT signaling in cardiomyocytes. In broader terms, these findings reveal an unexpected role for SUMO2 in cardiac hypertrophy and cardiomyopathy, which may open the possibility for therapeutic manipulation of this pathway.
Aims: Cardiac hypertrophy is a common and often lethal complication of arterial hypertension. Elevation of myocyte cyclic GMP levels by local actions of endogenous atrial natriuretic peptide (ANP) and C-type natriuretic peptide (CNP) or by pharmacological inhibition of phosphodiesterase-5 was shown to counter-regulate pathological hypertrophy. It was suggested that cGMP-dependent protein kinase I (cGKI) mediates this protective effect, although the role in vivo is under debate. Here, we investigated whether cGKI modulates myocyte growth and/or function in the intact organism.
Methods and results: To circumvent the systemic phenotype associated with germline ablation of cGKI, we inactivated the murine cGKI gene selectively in cardiomyocytes by Cre/loxP-mediated recombination. Mice with cardiomyocyte-restricted cGKI deletion exhibited unaltered cardiac morphology and function under resting conditions. Also, cardiac hypertrophic and contractile responses to β-adrenoreceptor stimulation by isoprenaline (at 40 mg/kg/day during 1 week) were unaltered. However, angiotensin II (Ang II, at 1000 ng/kg/min for 2 weeks) or transverse aortic constriction (for 3 weeks) provoked dilated cardiomyopathy with marked deterioration of cardiac function. This was accompanied by diminished expression of the \([Ca^{2+}]_i\)-regulating proteins SERCA2a and phospholamban (PLB) and a reduction in PLB phosphorylation at Ser16, the specific target site for cGKI, resulting in altered myocyte \(Ca^{2+}_i\) homeostasis. In isolated adult myocytes, CNP, but not ANP, stimulated PLB phosphorylation, \(Ca^{2+}_i\)-handling, and contractility via cGKI.
Conclusion: These results indicate that the loss of cGKI in cardiac myocytes compromises the hypertrophic program to pathological stimulation, rendering the heart more susceptible to dysfunction. In particular, cGKI mediates stimulatory effects of CNP on myocyte \(Ca^{2+}_i\) handling and contractility.
Patients with Fabry disease frequently develop left ventricular (LV) hypertrophy and renal fibrosis. Due to heat intolerance and an inability to sweat, patients tend to avoid exposure to sunlight. We hypothesized that subsequent vitamin D deficiency may contribute to Fabry cardiomyopathy. This study investigated the vitamin D status and its association with LV mass and adverse clinical symptoms in patients with Fabry disease. 25-hydroxyvitamin D (25[OH]D) was measured in 111 patients who were genetically proven to have Fabry disease. LV mass and cardiomyopathy were assessed by magnetic resonance imaging and echocardiography. In cross-sectional analyses, associations with adverse clinical outcomes were determined by linear and binary logistic regression analyses, respectively, and were adjusted for age, sex, BMI and season. Patients had a mean age of 40 ± 13 years (42 % males), and a mean 25(OH)D of 23.5 ± 11.4 ng/ml. Those with overt vitamin D deficiency (25[OH]D ≤ 15 ng/ml) had an adjusted six fold higher risk of cardiomyopathy, compared to those with sufficient 25(OH)D levels >30 ng/ml (p = 0.04). The mean LV mass was distinctively different with 170 ± 75 g in deficient, 154 ± 60 g in moderately deficient and 128 ± 58 g in vitamin D sufficient patients (p = 0.01). With increasing severity of vitamin D deficiency, the median levels of proteinuria increased, as well as the prevalences of depression, edema, cornea verticillata and the need for medical pain therapy. In conclusion, vitamin D deficiency was strongly associated with cardiomyopathy and adverse clinical symptoms in patients with Fabry disease. Whether vitamin D supplementation improves complications of Fabry disease, requires a randomized controlled trial.
DPF3 (BAF45c) is a member of the BAF chromatin remodeling complex. Two isoforms have been described, namely DPF3a and DPF3b. The latter binds to acetylated and methylated lysine residues of histones. Here, we elaborate on the role of DPF3a and describe a novel pathway of cardiac gene transcription leading to pathological cardiac hypertrophy. Upon hypertrophic stimuli, casein kinase 2 phosphorylates DPF3a at serine 348. This initiates the interaction of DPF3a with the transcriptional repressors HEY, followed by the release of HEY from the DNA. Moreover, BRG1 is bound by DPF3a, and is thus recruited to HEY genomic targets upon interaction of the two components. Consequently, the transcription of downstream targets such as NPPA and GATA4 is initiated and pathological cardiac hypertrophy is established. In human, DPF3a is significantly up-regulated in hypertrophic hearts of patients with hypertrophic cardiomyopathy or aortic stenosis. Taken together, we show that activation of DPF3a upon hypertrophic stimuli switches cardiac fetal gene expression from being silenced by HEY to being activated by BRG1. Thus, we present a novel pathway for pathological cardiac hypertrophy, whose inhibition is a long-term therapeutic goal for the treatment of the course of heart failure.
The incidence of cardiovascular diseases including cardiac hypertrophy and failure in pre-menopausal women is lower compared to age-matched men but the risk of heart disease increases substantially after the onset of menopause. It has been postulated that female sex hormones play an important role in cardiovascular health in pre-menopausal women. In animal studies including spontaneously hypertensive (SHR) rats, the development of cardiac hypertrophy is attenuated by 17β-estradiol treatment. Cardiac energy metabolism is crucial for normal function of the heart. In cardiac hypertrophy and heart failure, the myocardium undergoes a metabolic shift from fatty acid as primary cardiac energy source to glucose, which re-introduces the fetal type of metabolism that representing the glucose as a major source of energy. Many studies have reported that the disruption of the balance between glucose and fatty acid metabolism plays an important role in cardiac pathologies including hypertrophy, heart failure, diabetes, dilative cardiomyopathy and myocardial infarction. Glucose enters cardiomyocytes via GLUT1 and GLUT4 glucose transporters and GLUT4 is the major glucose transporter which is insulin-dependent. Cardiac-selective GLUT4 deficiency leads to cardiac hypertrophy. This shows that the decrease in cardiac glucose uptake may play a direct role in the pathogenesis of cardiac hypertrophy. Estrogens modulate glucose homeostasis in the liver and the skeletal muscle. But it is not known whether estrogens affect also cardiac glucose uptake which could provide another mechanism to explain the prevention of cardiac hypertrophy by female sex hormones. In the present study, SHR Rats were ovariectomized (OVX), not ovariectomized (sham) or ovariectomized and treated with subcutaneous 17β-estradiol. After 6 weeks of treatment, body weight, the serum levels of estrogen, insulin, intra-peritoneal glucose tolerance test (IP-GTT), myocardial glucose uptake by FDG-PET (2-(18F)-fluoro-deoxyglucose (18FDG) and Positron Emission Tomography), cardiac glucose transporter expression and localization and cardiac hexokinase activity were analyzed. As results of this study, PET analysis of female SHR revealed decreased cardiac glucose uptake in OVX animals compared to intact that was normalized by estrogen supplementation. Interestingly, there was no change in global glucose tolerance among the treatment groups. Serum insulin levels and cardiac hexokinase activity were elevated by E2 substitution. The protein content of cardiac glucose transporters GLUT-4 and GLUT-1, and their translocation as determined by fractionation studies and immuno-staining did not show any significant change by ovariectomy and estrogen replacement. Also levels of insulin receptor substrate-1 (IRS-1) and its tyrosine phosphorylation, which is required for activation and translocation of GLUT4, was un-affected in all groups of SHR. Cardiac gene expression analysis in SHR heart showed that ei4Ebp1 and Frap1 genes which are involved in the mTOR signaling pathway, were differentially expressed upon estrogen treatment. These genes are known to be activated in presence of glucose in the heart. As a conclusion of this study, reduced myocardial FDG uptake in ovariectomized spontaneously hypertensive rat is normalized by 17β-estradiol treatment. Increased myocardial hexokinase appears as a potential mechanism to explain increased myocardial glucose uptake by 17β-estradiol. Increased cardiac glucose uptake in response to 17β-estradiol in ovariectomized SHR may provide a novel mechanism to explain the reduction of cardiac hypertrophy in E2 treated SHR. Therefore, 17β-estradiol improves cardiac glucose utilization in ovariectomized SHR which may give rise to possible mechanism for its protective effects against cardiac hypertrophy.
Die chronische Herzinsuffizienz stellt nach wie vor eine der häufigsten Todesursachen weltweit dar. Trotz intensiver Forschung ist es bisher nicht möglich die pathophysiologischen Prozesse aufzuhalten. Es wird nach neuen Strategien gesucht, hier therapeutisch eingreifen zu können. Kleine nicht-kodierende RNAs, sogenannte microRNAs (miRNAs), wurden als wichtige Faktoren bei verschiedenen Herzkrankheiten beschrieben. Die Mehrzahl der bisherigen Studien fokussierte sich dabei auf die am stärksten deregulierten miRNAs im erkrankten Herz. In einer automatisierten Analyse im 96 Well-Format untersuchten wir 230 miRNAs auf ihr Potential, in das Größenwachstum von primären Kardiomyozyten einzugreifen. Aus den miRNAs mit den größten Effekten selektierten wir diejenigen, die eine hohe endogene Expression aufwiesen, und unterzogen sie einem Validierungsprozess. Hier konnten wir die Effekte aller pro- (miR-22, miR-30c, miR-30d, miR-212, miR-365) und anti-hypertrophen (miR-27a, miR-27b, miR-133a) miRNAs bestätigen. Die Mehrzahl dieser miRNAs wurde hiermit erstmalig beschrieben, dass sie eine wichtige Rolle beim Größenwachstum von Kardiomyozyten spielen. Sie wären daher interessante Kandidaten für detaillierte funktionelle Studien mit dem Ziel ihr therapeutisches Potential zu evaluieren. In einem früheren genetischen Screen zur Identifizierung von kardialen, sezernierten Faktoren wurde der Protease Inhibitor 16 (PI16) entdeckt, der sich im insuffizienten Herz durch eine starke Akkumulation auszeichnet. Gegenstand des zweiten Teils dieser Arbeit war es, eine Mauslinie zu generieren, in der PI16 global oder konditionell mit Hilfe des Cre/LoxP-Systems ausgeschaltet werden kann. Nach Elektroporation des Pi16floxneo Targeting Vektors in embryonale Stammzellen und Blastozysteninjektion erhielten wir eine Mauslinie, die Träger der zielgerichteten Modifikation des Pi16 Allels war. Mit der globalen genetischen Deletion des LoxP-flankierten Abschnitts von Exon 3 bis 4 konnten wir die Expression des Pi16 Gens komplett unterbinden. Die PI16 Defizienz führte weder im Herz noch in anderen Organen per se zu pathologischen Veränderungen. Zudem war unbekannt, dass PI16 in der gesunden Maus in der kardialen Fibroblastenfraktion enthalten sowie in den Zilien der Epididymis und der Trachea und im Lumen der Schilddrüse lokalisiert ist. Im insuffizienten Herz bestätigten wir eine Akkumulation von PI16, die sich vor allem auf die fibrotischen Bereiche beschränkte. Das lässt Grund zur Annahme, dass die kardiale Funktion von PI16 erst dann offensichtlich wird, wenn man die defizienten Mäuse zukünftig entsprechenden Stressmodellen aussetzt. Das wird zu einem umfassenden Verständnis der kardialen Funktion von PI16 und dessen Potential als therapeutisches Zielmolekül führen.