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Circulation Research. 2007;100:1569-1578
doi: 10.1161/CIRCRESAHA.106.144501
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Reviews

cAMP and cGMP Signaling Cross-Talk

Role of Phosphodiesterases and Implications for Cardiac Pathophysiology

Manuela Zaccolo, Matthew A. Movsesian

From the Dulbecco Telethon Institute at the Venetian Institute of Molecular Medicine (M.Z.), Padova, Italy; and the Cardiology Section, Veterans Affairs Salt Lake City Health Care System (M.A.M.), and Departments of Internal Medicine (Cardiology) and Pharmacology, University of Utah School of Medicine, Salt Lake City, Utah.

Correspondence to Dr Manuela Zaccolo, Venetian Institute for Molecular Medicine, Room G210, Via Orus 2, Padova 35129, Italy. E-mail manuela.zaccolo{at}unipd.it



This Review is part of a thematic series on Phosphodiesterases, which includes the following articles:

Compartmentation of Cyclic Nucleotide Signaling in the Heart: The Role of Cyclic Nucleotide Phosphodiesterases

Overview of PDEs and their Regulation

Regulation of Phosphodiesterase 3 (PDE3) and Inducible cAMP Early Repressor in the Heart

cAMP Specific Phosphodiesterase-4 Enzymes in the Cardiovascular System: A Molecular Toolbox for Generating Compartmentalized cAMP Signaling

cAMP and cGMP Signaling Cross-Talk: Role of Phosphodiesterases and Implications for Cardiac Pathophysiology

PDE5 and Regulation of Vessel and Heart Function
David A. Kass Editor


*    Abstract
up arrowTop
*Abstract
down arrowIntroduction
down arrowCyclic Nucleotide-Mediated...
down arrowSpatial Control of Cyclic...
down arrowcGMP-Stimulated cAMP...
down arrowcGMP-Inhibited cAMP...
down arrowCoordination of the Regulation...
down arrowReferences
 
Cyclic nucleotide phosphodiesterases regulate cAMP-mediated signaling by controlling intracellular cAMP content. The cAMP-hydrolyzing activity of several families of cyclic nucleotide phosphodiesterases found in human heart is regulated by cGMP. In the case of PDE2, this regulation primarily involves the allosteric stimulation of cAMP hydrolysis by cGMP. For PDE3, cGMP acts as a competitive inhibitor of cAMP hydrolysis. Several cGMP-mediated responses in cardiac cells, including a potentiation of Ca2+ currents and a diminution of the responsiveness to ß-adrenergic receptor agonists, have been shown to result from the effects of cGMP on cAMP hydrolysis. These effects appear to be dependent on the specific spatial distribution of the cGMP-generating and cAMP-hydrolyzing proteins, as well as on the intracellular concentrations of the two cyclic nucleotides. Gaining a more precise understanding of how these cross-talk mechanisms are individually regulated and coordinated is an important direction for future research.


Key Words: phosphodiesterases • signaling cross-talk • cAMP • cGMP • compartmentalization


*    Introduction
up arrowTop
up arrowAbstract
*Introduction
down arrowCyclic Nucleotide-Mediated...
down arrowSpatial Control of Cyclic...
down arrowcGMP-Stimulated cAMP...
down arrowcGMP-Inhibited cAMP...
down arrowCoordination of the Regulation...
down arrowReferences
 
The second messengers cAMP and cGMP are important regulators of cardiac function. cAMP, which is generated by adenylyl cyclases (AC) on G protein–coupled receptor stimulation by catecholamines, regulates the strength and frequency of cardiac contraction and relaxation. The main downstream effector of cAMP is protein kinase A (PKA),1 though cyclic nucleotide-gated ion channels and the exchange factor for Rap, Epac,2 are also cAMP targets. cGMP, which is generated by guanylyl cyclases (GC) in response to nitric oxide (NO) and natriuretic peptides, modulates inotropy and metabolic responses3 via the activation of its downstream effectors, protein kinase G (PKG) and cyclic nucleotide-gated channels. These two signaling pathways often exert opposing influences on cardiac function,3 in part as a consequence of the opposing effects of PKA- and PKG-mediated phosphorylation on target proteins.

A separate level of cross-talk between the cAMP and cGMP signaling pathways involves the activity of the cyclic nucleotide-degrading enzymes, phosphodiesterases (PDEs). In the heart, cGMP acts as a regulator of the activity of cAMP-hydrolyzing PDEs, such that the intracellular concentration of cGMP can influence the intracellular concentration of cAMP. The modulatory effects of cGMP on cAMP-hydrolyzing PDEs occur at nanomolar to micromolar concentrations of cGMP. This concentration range is comparable to that at which cGMP activates canonical targets such as PKG (Ka{approx}100 nmol/L)4 and cyclic nucleotide-gated ion channels (Ka{approx}20 µmol/L).5 By virtue of this cross-talk mechanism, cAMP-hydrolyzing PDEs can serve as targets of cGMP-mediated signaling in the heart, and some of the effects of cGMP in cardiac myocytes may result from effects on the cAMP pathway.

Cardiac myocytes express several cGMP-regulated cAMP-hydrolyzing PDEs that differ with respect to subcellular localization, affinity, and specificity for cAMP and cGMP. As a consequence, cAMP and cGMP signaling pathways are connected in a complex network with a precise spatial organization. In this review, we focus on the mechanisms by which cGMP controls cAMP hydrolysis, and we examine how cGMP-regulated PDEs can impact cardiac function.


*    Cyclic Nucleotide-Mediated Signaling in the Heart Is Regulated by Cyclic Nucleotide-Hydrolyzing PDEs
up arrowTop
up arrowAbstract
up arrowIntroduction
*Cyclic Nucleotide-Mediated...
down arrowSpatial Control of Cyclic...
down arrowcGMP-Stimulated cAMP...
down arrowcGMP-Inhibited cAMP...
down arrowCoordination of the Regulation...
down arrowReferences
 
The intracellular level of cyclic nucleotides reflects the balance of their synthesis and their degradation. Adenylyl cyclases, which synthesize cAMP, are a family of nine membrane-bound proteins that differ for their susceptibility to unique regulatory mechanisms.6 Of these, AC5 and AC6, both of which are Ca2+-inhibited, are expressed in the heart. cGMP is synthesized by two types of guanylyl cyclase, the soluble (sGC) and the particulate (pGC) forms. sGC is a ubiquitous cytosolic receptor that is activated by NO.7 pGCs comprise a family of 7 proteins, including the receptors for A- and B-type natriuretic peptides (ANP and BNP), and are localized to cell membranes.8

cAMP and cGMP are hydrolyzed exclusively by cyclic nucleotide PDEs, which therefore have a key role in regulating the signal conveyed by cAMP and cGMP. PDEs are encoded by at least 21 different genes that are grouped, based on sequence similarity, mode of regulation, and preference for cAMP or cGMP as substrate, into 11 gene families.9–11 Transcription from different initiation sites in these genes and differential splicing of their mRNAs results in the generation of >90 isoforms, many of which vary with respect to tissue distribution, intracellular localization, and cross-talk with other signaling cascades.

In cardiac myocytes, PDE activity determines the basal intracellular concentration of cAMP by continuously hydrolyzing the cAMP synthesized by constitutively active cyclases.12 PDEs also control the amplitude12 and duration12,13 of the cAMP response to external stimuli. Not all PDEs are equally engaged in modulating the cAMP signal.14 Instead, the functional coupling between individual G protein–coupled receptors and selected PDEs allows these PDEs to have specific roles in shaping the amplitude, duration, and location of the cAMP response to a given stimulus. Thus, isoforms of the PDE412,14,15 family were shown to have the greatest role in the control of cAMP generated by ß-adrenergic stimulation in neonatal cardiac myocytes, whereas PDE3 isoforms appeared to be involved in regulating cAMP content in a functionally distinct pool.12 Further dissection of the role of individual receptors in the spatial compartmentation of the cAMP signal came from a recent study on adult mouse myocytes, in which cAMP generated in response to ß1-adrenergic receptor agonists was shown to be hydrolyzed entirely by PDE4, whereas cAMP generated in response to ß2-adrenergic receptor agonists was hydrolyzed by multiple PDE isoforms.16 In another study, using selective ß1- or ß2-adrenergic receptor knockout mice, PDE4D was shown to be selectively involved in the control of cAMP diffusion from activated ß2-adrenergic receptors. Under normal conditions, cAMP generated in response to ß1-adrenergic receptors activates PKA and increases the rate of contraction, whereas cAMP generated in response to ß2-adrenergic receptor agonists does not. In ß1-adrenergic receptor knockout mice, however, inhibition of PDE4D allows the cAMP generated in response to ß2-adrenergic receptor agonists to activate PKA and increase the rate of contraction.17 Thus, in addition to controlling steady-state levels of cAMP and the temporal aspect of the cAMP signal, PDEs have a role in defining the spatial component of cAMP signaling.18,19 The function of individual PDEs in this aspect of signal transduction appears to be strictly dependent on their distribution within the three-dimensional matrix of the cell and on their location with respect to other regulatory and effector elements (see below).

In the heart, 7 PDE families have been described: PDE1,20 PDE2,20 PDE3,21 PDE4,22 PDE5,23 PDE8,24 and PDE925 (Figure 1). PDE1, PDE2, and PDE3 are dual-specificity enzymes that can hydrolyze both cAMP and cGMP; PDE4 and PDE8 selectively hydrolyze cAMP; and PDE5 and PDE9 selectively hydrolyze cGMP. Of the cAMP-hydrolyzing PDEs expressed in the heart, cGMP inhibits PDE3 and possibly PDE1, whereas PDE2 is activated by cGMP (Figure 2). These PDEs also differ with respect to their regulation through other signaling pathways (Figure 2). PDE1, for example, is unique among phosphodiesterases in being stimulated by Ca2+ and calmodulin. Furthermore, PKA-mediated phosphorylation of PDE1 reduces its affinity for Ca2+ and calmodulin, resulting in inhibition of its activity,26 whereas PKA-mediated phosphorylation enhances the catalytic activities of PDE327 and PDE4.28 In vitro, PDE5 activity has been shown to be increased both by PKA- and PKG-mediated phosphorylation.29 However, a role for PKA-mediated phosphorylation in vivo has not been firmly established, and, at least in smooth muscle cells, only PKG appears to be involved in PDE5 activation.30


Figure 1
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Figure 1. Schematic representation of the structure of PDEs expressed in the heart. The modular organization of PDEs is highlighted. The catalytic domain is shown in red and the carboxy-terminal domain in white. Ca/Cam indicates calcium/calmodulin; GAF, cGMP activated PDEs, Adenylyl cyclase, and Fh1A domain; UCR, upstream conserved region; PAS, Period, aryl-hydrocarbon receptor nuclear translocator (ARNT), and Single-minded domain. Red pins indicate phosphorylation sites. Adapted from Conti.122


Figure 2
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Figure 2. Regulatory network interconnecting cardiac phosphodiesterases. PDE1, -2, and -3 hydrolyze cAMP. PDE1 and PDE2 also hydrolyze cGMP. PDE4 selectively hydrolyzes cAMP, and PDE5 selectively hydrolyzes cGMP. cGMP inhibits the cAMP-hydrolyzing activity of PDE1 and PDE3 competitively and activates PDE2 via allosteric modification. Inversely, through competitive inhibition, high concentrations of cAMP may inhibit the cGMP-hydrolyzing activity of PDE1 and PDE2. cAMP also influences PDE3, PDE4, and PDE5 activity via PKA-mediated activation of these enzymes. PDE5 activity is also stimulated by PKG-mediated activation. Finally, PDE1 activity is stimulated by Ca2+-calmodulin and is inhibited by PKA-mediated phosphorylation. Arrows indicate activation; blunt-ends indicate inhibition or cyclic nucleotide hydrolysis.

It is clear that cyclic nucleotide signaling in heart cells is regulated by an array of different PDEs organized in a network of regulatory connections involving cAMP and cGMP, and that factors relating to the spatial organization and regulation of the network are of key importance in shaping the cyclic nucleotide response.


*    Spatial Control of Cyclic Nucleotide Signaling
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowCyclic Nucleotide-Mediated...
*Spatial Control of Cyclic...
down arrowcGMP-Stimulated cAMP...
down arrowcGMP-Inhibited cAMP...
down arrowCoordination of the Regulation...
down arrowReferences
 
The concept of compartmentalized cAMP signal transduction has been proposed to explain how the specificity of response necessary for appropriate functioning of the cell is attained.31 A particular focus has been placed on the localization of proteins of the cAMP signaling pathway to restricted intracellular domains.32 Such domains are organized by scaffolding proteins into complexes that may include receptors, effectors, modulators, and targets. This organization increases the probability of the molecular components of the pathway of interacting efficiently and selectively. PKA- ("A kinase")-anchoring proteins (AKAPs) have a key role in the compartmentation of cAMP/PKA signaling.32 AKAPs are multivalent scaffolding proteins that have been classified as a functional family based on their ability to anchor PKA via an amphipathic helix; more than 50 AKAPs have so far been identified. AKAPs tether PKA to specific intracellular locations in close proximity to specific modulators and targets, providing spatial regulation of PKA signaling events. Regulatory proteins, such as phosphatases (PP)33 and the PDEs34,35 themselves, are often included within such spatially confined signaling domains, providing a means to switch off the signal delivered by cAMP in specific locations. The notion that targeting of PDEs is important in cyclic nucleotide signaling came from work on PDE4s36,37; PDE4D3 has been shown to bind several AKAPs, including muscle-selective AKAP (mAKAP) in the heart.38

An example of how the cAMP signal is transduced through a multimeric signaling domain is the activation of the L-type Ca2+ channel on ß2-adrenergic receptor stimulation in hippocampal neurons. In these cells, a multiprotein assembly, comprising the ß2-adrenergic receptor, adenylyl cyclase, a heterotrimeric G protein, the AKAP MAP2B, PKA, the PKA-regulated Cav1.2 L-type Ca2+ channel, and the phosphatase PP2A, was identified.39 Activation of the ß2-adrenergic receptor was shown to lead to selective activation of the Cav1.2 channel, indicating that spatial confinement of the signaling molecules restricts signal propagation and results in local effector activation.39 Interestingly, a functional complex including a Ca2+-sensitive adenylyl cyclase, ß2-adrenergic receptor, PP2A, PKA, and Cav1.2 has recently been described in cardiac myocytes.40

An increasing body of evidence12,15,41–48 indicates that an additional mechanism that serves to maintain the compartmentalization of signaling events is one that allows the small, hydrophilic molecule cAMP to act as a "short-range" second messenger through limitation of its free diffusion.49 The hypothesis of the existence of separate pools of cAMP within cardiac myocytes was formulated more then 25 years ago on the basis of experimental data showing that the PKA recovered in particulate fractions of cardiac myocytes and the PKA recovered in soluble fractions were affected differently by the cAMP-raising hormone prostaglandin.50 The involvement of PDEs in this compartmentation had been suggested previously on the basis of biochemical studies.51,52 In the last decade, this hypothesis has received strong support thanks to the development of techniques that allow detection of cAMP in living cells. In experiments combining classical whole-cell patch clamp recordings of ICa and a double-barreled microperfusion system in frog ventricular myocytes, application of a ß2-adrenergic receptor agonist was shown to generate a localized increase of cAMP. In contrast, application of forskolin, a direct activator of AC, generated a more diffuse increase.42 It was only recently, though, that discrete microdomains with high cAMP content could be directly imaged in cardiac myocytes. By using a FRET-based real-time imaging approach that allows detection of cAMP with submicrometer spatial resolution,53 it was possible to directly visualize local pools of cAMP in cardiac myocytes in response to ß-adrenergic receptor stimulation.54 These microdomains of cAMP were completely abolished by the addition of PDE inhibitors,49 indicating a key role for these enzymes in determining the spatial information content of the cAMP signal.

Much less is known regarding the intracellular distribution and dynamics of cGMP. Some compartmentation of elements of the cGMP signaling pathway has been reported. Proteins such as myosin,55 the atrial natriuretic peptide receptor,56 and troponin T57, for example, seem to act as PKG-anchoring proteins. In addition, it has recently been reported that cGMP, like cAMP, shows restricted diffusion inside the cell, suggesting that spatial control may be as important for cGMP-mediated signaling as it is for cAMP-mediated signaling.58,59


*    cGMP-Stimulated cAMP Phosphodiesterases
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowCyclic Nucleotide-Mediated...
up arrowSpatial Control of Cyclic...
*cGMP-Stimulated cAMP...
down arrowcGMP-Inhibited cAMP...
down arrowCoordination of the Regulation...
down arrowReferences
 
Of the cAMP-hydrolyzing PDEs expressed in the heart, PDE2 is unique in being potently stimulated by cGMP. Three isoforms of PDE2—PDE2A1, PDE2A2 and PDE2A3—are generated from a single gene by alternative exon splicing.60 These 3 isoforms, some of which are expressed in the same cell,61 differ in their amino-terminal regions. The amino terminus of PDE2A2 is more hydrophobic than the amino termini of the PDE2A1 and PDE2A3 proteins (Figure 3). These differences in hydrophobicity may underlie the partitioning of PDE2A activity between the membrane-associated and soluble fractions of the cell.62 In cardiac myocytes, PDE2 has been found to be cytosolic as well as associated with the sarcolemma, the sarcoplasmic reticulum membrane,15,63 the Golgi apparatus,64 and the nuclear envelope.65 PDE2 hydrolyzes both cAMP and cGMP, with Km values of 30 µmol/L for cAMP and 10 µmol/L for cGMP.66 cGMP also binds to 1 of 2 regulatory GAF domains at the amino-terminus of PDE2, with a KD of approximately 0.3 µmol/L. This binding results in an allosteric modification of PDE2 that lowers the apparent Km for cAMP and results in activation of the cAMP-hydrolyzing activity of the enzyme.67,68 This allosteric stimulation of cAMP hydrolysis by cGMP is more important, quantitatively, than its competitive inhibition of cAMP hydrolysis, although cAMP hydrolysis can be inhibited in vitro by cGMP at high (>50 µmol/L) concentrations.69 Through such regulatory mechanisms, stimuli that elevate cGMP attenuate the cAMP signal.


Figure 3
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Figure 3. Comparison of the amino-terminal sequence of PDE2A1, PDE2A2, and PDE2A3. Sequences are from bovine (PDE2A1),123 rat (PDE2A2),62 and human (PDE2A3).60 Hydrophobic regions are highlighted in gray.

Cross-talk between the cAMP and cGMP signaling pathways through PDE2 has important physiological functions. One example is the ANP-mediated control of blood pressure, in which stimulation of the glomerulosa cells in the adrenal cortex by ANP induces cGMP synthesis, leading to activation of PDE2 and a consequent decrease in intracellular cAMP concentration; this, in turn, is responsible for a reduction in aldosterone secretion.70 Cross-talk through PDE2 is also important in the heart. Activation of a cGMP-stimulated cAMP-hydrolyzing PDE is responsible for cholinergic attenuation of ß-adrenergic signaling in rabbit atrioventricular nodal cells.71 Similarly, in pacemaker cells, the effect of NO on heart rate is mediated, at least in part, by inhibition of L-type Ca2+ current (ICa) via a signaling pathway involving guanylyl cyclase activation, synthesis of cGMP and stimulation of a cGMP-stimulated PDE.72 In amphibian ventricular myocytes73 and human atrial myocytes, cGMP inhibits cAMP-enhanced ICa via activation of a cGMP-stimulated PDE.74 More recently, the activation of PDE2 by cGMP was shown to influence the cAMP response to ß-adrenergic stimulation in rat ventricular myocytes.15 In these cells, activation of soluble guanylyl cyclase by sodium nitroprusside leads to activation of PDE2 and a 50% reduction in the amplitude of the cAMP response to 10 µmol/L norepinephrine; this is accompanied by a profound reduction in the amplitude of intracellular Ca2+ transients and in the fractional shortening of the myocyte.

The contribution of PDE2 to the regulation of cAMP-mediated signaling is particularly selective. PDE2 is essentially ineffective in blocking the rise in intracellular cAMP levels in response to forskolin, which activates adenylyl cyclases nonselectively. In contrast, PDE2 blocks the rise in cAMP levels induced by ß-adrenergic receptor agonists.15 The mechanism by which norepinephrine recruits PDE2 for the hydrolysis of cAMP occurs, at least in part, via activation of ß3-adrenergic receptors and a consequent activation of endothelial nitric oxide synthase (eNOS). Activated eNOS generates NO, which stimulates cGMP synthesis by soluble guanylyl cyclase; this in turn activates the cAMP-hydrolyzing activity of PDE2.15 The selective effect of PDE2 on cAMP generated by ß-agonists suggests that PDE2 is tightly coupled to the ß-adrenergic receptor, so that PDE2 activity is highly compartmentalized to a limited pool of cAMP within the cell.

Such a mechanism, whereby catecholamines induce a rise of cAMP and simultaneously activate PDE2 to hydrolyze cAMP, may protect against excessive activation of the ß-adrenergic pathway in normal hearts, but may decrease contractile reserve in failing hearts, in which ß1- and ß2-adrenergic receptors are downregulated and cAMP/PKA signaling is blunted.75 cGMP-mediated activation of PDE2 and the resulting increase in cAMP hydrolysis may occur through two pathways. First, soluble guanylyl cyclase can be activated by NO generated by all 3 isoforms of NOS. These can be activated through a variety of mechanisms,76 including binding to calmodulin and phosphorylation by kinases such as PI3K/Akt,77 protein kinase C78, and PKA.76 In addition, cGMP is synthesized by particulate guanylyl cyclases, the receptors for natriuretic peptides. These mechanisms may contribute to the negative inotropic effects and attenuated responses to cAMP-raising agents that have been observed in association with increases in intracellular cGMP content.79–82 From this perspective, selective inhibition of PDE2 may be a potential new approach to the treatment of heart failure.

On the other hand, both NO83 and natriuretic peptides84 exert antihypertrophic effects on the heart85 that have been attributed, at least in part, to activation of cGMP-activated protein kinase (PKG) and its inhibitory effect on the L-type Ca2+ channel.86 Whether cGMP-mediated activation of PDE2 and consequent degradation of cAMP contribute to such antihypertrophic effects remains to be determined.


*    cGMP-Inhibited cAMP Phosphodiesterases
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowCyclic Nucleotide-Mediated...
up arrowSpatial Control of Cyclic...
up arrowcGMP-Stimulated cAMP...
*cGMP-Inhibited cAMP...
down arrowCoordination of the Regulation...
down arrowReferences
 
PDE3 cyclic nucleotide phosphodiesterases are perhaps the best characterized phosphodiesterases in human hearts, owing to the use of inhibitors of these enzymes as therapeutic agents in the treatment of heart failure for more than 2 decades. These enzymes bind with high affinity to both cAMP (Km{approx}80 nmol/L) and cGMP (Km{approx}20 nmol/L), which are mutually competitive substrates. Because of their much higher catalytic rates (kcat’s) for cAMP than for cGMP, PDE3 phosphodiesterases appear to function principally as cGMP-inhibited cAMP-hydrolyzing enzymes.87 In human heart, 3 isoforms, which appear to be generated by alternative transcription and alternative translation from the PDE3A gene, have been identified.88–90 Their amino acid sequences are identical except for the presence of different lengths of N-terminal sequence, in which domains involved in intracellular localization and sites for activation by phosphorylation are found (Figure 4). PDE3A1 (originally identified as PDE3A-136) is a 136-kDa protein recovered exclusively in microsomal fractions of human myocardium. It contains 2 intracellular localizing domains, NHR1 and NHR2. NHR1 consists of hydrophobic loops that insert into intracellular membranes, whereas NHR2 appears to localize the enzyme through protein–protein interactions.91,92 PDE3A1 also contains a recently-confirmed site for phosphorylation and activation by PKB93 and sites for phosphorylation by PKA. PDE3A2 (formerly PDE3A-118), a 118-kDa protein recovered in both microsomal and cytosolic fractions, lacks NHR1 and probably lacks the PKB site, but retains NHR2 and the PKA sites. PDE3A3 (formerly PDE3A-94), a 94-kDa protein whose distribution is primarily cytosolic, lacks NHR1, NHR2, and the 3 phosphorylation sites. All 3 isoforms contain the C-terminal catalytic region, and are identical with respect to catalytic activity and sensitivity to cGMP and other inhibitors of cAMP hydrolysis.90 PDE3 isoforms account for most of cAMP-hydrolyzing activity in membrane-enriched fractions of human myocardium. Their contribution to cytosolic cAMP-hydrolyzing activity varies from >50% to <20% depending on the conditions under which activity is measured.90 In mouse hearts, PDE3B1, an isoform transcribed from the PDE3B gene, is expressed.21,94,95 Although the NHR1 sequence is longer in PDE3B1 than in PDE3A1, and the amino acid sequences of the 2 isoforms differ in the N erminus, their domain structures are similar.


Figure 4
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Figure 4. PDE3A isoforms in human cardiac myocytes. Their amino acid sequences are identical except for the presence of different lengths of N-terminal sequence, in which regulatory and intracellular targeting domains are found.

A second family of cAMP phosphodiesterases whose cAMP-hydrolyzing activity might be inhibited by cGMP is PDE1. It should be emphasized, however, that while a role for cGMP in the regulation of cAMP signaling via PDE2 and PDE3 has been demonstrated both in vitro and in vivo, cGMP-mediated inhibition of the cAMP-hydrolyzing activity of PDE1 has been demonstrated only in vitro, and its relevance in vivo remains unestablished. PDE1 activity is represented abundantly in human heart.90,96 Whether this activity is relevant in human cardiac myocytes remains uncertain, as a study in rat ventricle identified PDE1 activity in whole myocardium but not in isolated myocytes.97 These phosphodiesterases, which are activated by Ca2+ and calmodulin, also hydrolyze cAMP and cGMP in a mutually competitive manner.26 Three PDE1 genes, PDE1A, PDE1B, and PDE1C, have been identified, with several splice variants.98,99 All 3 gene products exhibit a similar affinity for cGMP (Km=1 to 5 µmol/L), but differ in their affinity for cAMP: PDE1A has the lowest affinity (Km=50 to 100 µmol/L), PDE1B has an intermediate affinity (Km=7 to 24 µmol/L), and PDE1C has the highest affinity (Km<1 µmol/L).20 For all PDE1 isoforms, therefore, cAMP-hydrolyzing activity can be inhibited by cGMP; in the case of PDE1C, reciprocal and competitive inhibition between cAMP and cGMP has been reported in vitro.20,98 Recent studies indicate that PDE1 activity represents a relatively small amount of the cGMP-inhibited cAMP-hydrolyzing activity in membrane-enriched fractions of human myocardium, but may represent the major fraction of cGMP-inhibited cAMP-hydrolyzing activity in cytosolic fractions.90 Although the relative affinities and Vmax for cAMP and cGMP may support a possible role for PDE1 in cGMP-mediated cAMP hydrolysis, the access of PDE1 to cGMP pools in vivo is unclear. The lack of widely accessible specific inhibitors of PDE1 has been a limiting factor in experimental approaches, and the fact that the activity of these enzymes is highly dependent on intracellular Ca2+ concentrations adds to the complexity of this line of investigation, especially in cardiac myocytes.

Just as the expression of PDE2 provides a mechanism whereby stimuli that elevate cGMP can decrease cAMP-mediated signaling, the expression of PDE3 and, potentially, of PDE1 in human myocardium provides mechanisms through which stimuli that elevate cGMP can augment cAMP-mediated signaling.87 Several examples in which the regulation of the cAMP-hydrolyzing activity of PDE3 by cGMP has physiological consequences have been reported. In noncardiac cells, inhibition of the cAMP-hydrolyzing activity of PDE3 by cGMP contributes to the stimulation of renin secretion, the potentiation of vasodilatory responses to adrenomedullin, and the inhibition of TNF-{alpha}–induced NF-{kappa}B–dependent inflammatory responses in vascular smooth muscle cells.100–102 In cardiac sinoatrial cells, inhibition of cAMP hydrolysis by PDE3 appears to contribute to the potentiation of delayed rectifier K+ currents by cGMP.103 In frog ventricular myocytes, agents that raise intracellular cGMP content by stimulating soluble guanylyl cyclase potentiate L-type Ca2+ currents via inhibition of PDE3.104 A similar PDE3-dependent potentiation of L-type Ca2+ currents by cGMP-raising agents has been described in human atrial myocytes.105


*    Coordination of the Regulation of cAMP Metabolism by cGMP
up arrowTop
up arrowAbstract
up arrowIntroduction
up arrowCyclic Nucleotide-Mediated...
up arrowSpatial Control of Cyclic...
up arrowcGMP-Stimulated cAMP...
up arrowcGMP-Inhibited cAMP...
*Coordination of the Regulation...
down arrowReferences
 
The observations described above provide reasons to conclude that cGMP regulates cAMP-mediated signaling in cardiac myocytes by activating or inhibiting cAMP-hydrolyzing PDEs. An important question is whether the effects of cGMP on individual PDEs can be controlled independently. It seems to us there are at least 3 mechanisms through which this can occur. One has to do with the intracellular concentrations of cyclic nucleotides. The binding affinities of PDE1, PDE2, and PDE3 for cGMP vary by 2 orders of magnitude. Based on these differences, small elevations in cGMP levels might be predicted to cause selective inhibition of PDE3 isoforms; with intermediate cGMP levels, stimulation of PDE2 would also occur; and with higher cGMP levels, PDE1 activity could be potentially inhibited (Figure 5). Experimental evidence supports this mechanism. In human atrial myocytes cGMP was reported to regulate ICa by controlling the intracellular concentration of cAMP through opposing actions: intracellular perfusion with low concentrations of cGMP stimulated ICa, presumably by inhibiting PDE3, whereas perfusion with high concentrations of cGMP inhibited ICa, presumably by activating PDE2.73 A problem in determining whether different concentrations of cGMP can physiologically affect the activity of individual PDEs is that the actual concentrations of cGMP in the cell are unknown. Furthermore, in the case of competitive inhibitors, the action of cGMP would depend on the concurrent concentration of cAMP, and this, as has been noted, is highly compartment-specific.


Figure 5
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Figure 5. The impact of cGMP on cAMP-hydrolyzing PDEs depends on the intracellular concentration of cGMP. As a consequence of the different sensitivity to cGMP of the cAMP-hydrolyzing PDEs, cGMP, at concentrations <50 nmol/L, exclusively inhibits PDE3, whereas cGMP concentrations between 200 to 500 nmol/L are necessary to activate PDE2. PDE1 can be inhibited at cGMP concentrations >1 µmol/L, although the relevance of this mechanism has not been demonstrated in vivo (question mark). Black lines and symbols indicate pathways activated by cGMP; gray lines and symbols indicate cGMP-independent pathways.

This leads to consideration of a second mechanism, involving the roles of individual PDEs in regulating cAMP content. As noted earlier, the contribution of different PDEs to the regulation of cAMP metabolism is itself dependent on cAMP concentration, as well as on intracellular Ca2+ concentrations. One can imagine, therefore, that inhibition of PDE3 activity by cGMP may be more important at low concentrations of cAMP and Ca2+, whereas effects of cGMP on PDE2 and possibly on PDE1 may be more important under other conditions.90

A third mechanism has to do with the likelihood that the concentration of cGMP is not uniform within the cardiac myocyte at any one time. To the contrary, cGMP metabolism appears, like cAMP metabolism, to be regulated on a compartment-selective basis.58,59 Some of this selectivity has been demonstrated through experiments involving the coexpression in cardiac myocytes of pGC and sGC, which show distinct subcellular localization and are activated by different stimuli. In native tissue, an increase in cGMP signaling mediated through the stimulation of pGC by natriuretic peptides has been shown to have positive chronotropic and inotropic effects in cardiac myocytes.106–108 In contrast, stimulation of sGC by NO donors appears to have a negative inotropic effect in cardiac myocytes that is dependent on the phosphorylation of troponin I by PKG and the consequent decrease in myofilament Ca2+ sensitivity.80,81,109 In another study, performed in perfused rabbit atria, cGMP-mediated inhibition of PDE3 was shown to affect cAMP levels, atrial dynamics, and myocyte ANP release differently depending on whether cGMP was produced by pGC or sGC.110 Consistent with these studies, spatial confinement of cGMP was recently reported in rat adult ventricular myocytes. In these cells, stimulation of either sGC or pGC leads to the synthesis of cGMP in functionally independent pools having restricted access to individual cGMP-hydrolyzing PDEs. Thus, PDE2 and PDE5 appear to be engaged in degrading cGMP synthesized by sGC, whereas cGMP synthesized by pGC is hydrolyzed solely by PDE2.58 Based on this third mechanism, it is possible to predict the existence, within cardiac myocytes, of multiple independent signaling units through which distinct pools of cGMP can selectively affect specific cAMP-hydrolyzing PDEs and the associated pools of cAMP. This would lead, in turn, to changes in the phosphorylation of specific PKA substrates, with specific functional sequelae (Figure 6). PDE5 is likely to have a role in this process, and establishing which cGMP pool is controlled by PDE5 will be important. PDE5 has been shown to be localized to discrete compartments in cardiac myocytes111 and to have access only to a fraction of the cGMP produced in these cells,58 suggesting that it too has a spatially specific role.


Figure 6
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Figure 6. Schematic representation of cGMP–cAMP signaling units. Each unit is composed of a cGMP pool which affects a cAMP-hydrolyzing PDE which, in turn, controls a cAMP pool. cGMP-mediated inhibition of PDE1 has not been shown in vivo and is therefore highlighted with a question mark. Uncertainty on the relationship between PDE5 and individual cGMP pools is highlighted by question marks. PKA- and PKG-mediated control over PDEs activity is not shown.

All of the above considerations demonstrate the importance and the complexity of the mechanisms through which cGMP regulates cAMP hydrolysis in cardiac muscle. Much remains to be learned. One question relates to the possible contribution of effects on cAMP hydrolysis to other actions of cGMP in cardiac muscle. Hypertrophic responses to pressure overload and ß-adrenergic receptor stimulation in animal models are decreased when cGMP content is increased by PDE5 inhibition.86,112–117 PDE5 inhibition has been shown to reduce infarct size after coronary occlusion in animal models and to reduce necrosis and apoptosis in cultured cardiac myocytes subjected to hypoxia.118–120 Antiapoptotic effects of PDE5 inhibition have also been described in cardiac myocytes exposed to doxorubicin, together with a reduction in left ventricular dysfunction in animals treated with doxorubicin.121 Are effects of cGMP on cAMP hydrolysis involved in these actions?

Other questions relate to the signaling networks themselves. What is the topographical organization of the cGMP pools that are generated in response to different extracellular stimuli? What is the PDE composition of each signaling unit? What are the specific targets affected by each signaling unit? Are the individual units independent of each other? If not, to what extent are they interconnected? And, finally, are the answers to these questions different in normal and diseased myocardium? Future work focused on these issues will further our understanding of the architecture of the cAMP/cGMP signaling network, and may lead to new insights into the pathophysiology of heart disease and new strategies for its treatment.


*    Acknowledgments
 
We thank Dr Marco Berrera for helping with some of the figures.

Sources of Funding

This work was supported by grants from Telethon Italy (TCP00089 and GGP05113), the Italian Cystic Fibrosis Research Foundation, the Fondazione Compagnia di San Paolo, the HFSPO (RGP0001/2005-C), and the EC (LSHB-CT-2006-037189) to M.Z.; a Merit Review Award from the United States Department of Veterans Affairs to M.A.M.; and a grant from the Fondation Leducq (O6 CVD 02) to M.Z. and M.A.M.

Disclosures

None.


*    Footnotes
 
Original received November 11, 2006; revision received March 20, 2007; accepted March 27, 2007.


*    References
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*References
 
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