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Integrative Physiology |
From the Cardiovascular Research Institute, Department of Cell Biology and Molecular Medicine, University of Medicine and Dentistry New Jersey, New Jersey Medical School, Newark (C.D., L.W., X.S., H.Q., C.H., N.H., A.S., M.P., V.G., S.F.V.); Cardiovascular Research Unit, Louvain University Medical School, Brussels, Belgium (A.G., L.B.); Oncology Research Institute, Greenville Hospital System, Greenville, SC (T.W.).
Correspondence to Christophe Depre, Cardiovascular Research Institute, Department of Cell Biology and Molecular Medicine, University of Medicine and Dentistry of New Jersey (UMDNJ), New Jersey Medical School, 185 S Orange St, MSB G-609, Newark, NJ 07103. E-mail deprech{at}umdnj.edu
Ischemic preconditioning confers powerful protection against myocardial infarction through pre-emptive activation of survival signaling pathways, but it remains difficult to apply to patients with ischemic heart disease, and its effects are transient. Promoting a sustained activation of preconditioning mechanisms in vivo would represent a novel approach of cardioprotection. We tested the role of the protein H11 kinase (H11K), which accumulates by 4- to 6-fold in myocardium of patients with chronic ischemic heart disease and in experimental models of ischemia. This increased expression was quantitatively reproduced in cardiac myocytes using a transgenic (TG) mouse model. After 45 minutes of coronary artery occlusion and reperfusion, hearts from TG mice showed an 82±5% reduction in infarct size compared with wild-type (WT), which was similar to the 84±4% reduction of infarct size observed in WT after a protocol of ischemic preconditioning. Hearts from TG mice showed significant activation of survival kinases participating in preconditioning, including Akt and the 5'AMP-activated protein kinase (AMPK). H11K directly binds to both Akt and AMPK and promotes their nuclear translocation and their association in a multiprotein complex, which results in a stimulation of survival mechanisms in cytosol and nucleus, including inhibition of proapoptotic effectors (glycogen synthase kinase-3ß, Bad, and Foxo), activation of antiapoptotic effectors (protein kinase C
, endothelial and inducible NO synthase isoforms, and heat shock protein 70), increased expression of the hypoxia-inducible factor-1
, and genomic switch to glucose utilization. Therefore, activation of survival pathways by H11K preemptively triggers the antiapoptotic and metabolic response to ischemia and is sufficient to confer cardioprotection in vivo equally potent to preconditioning.
Key Words: Akt apoptosis AMPK cell survival ischemia
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