Integrative Physiology |
From The Hatter Institute for Cardiovascular Studies, Department of Academic and Clinical Cardiology (A.D., D.M.Y.), and Centre for Cardiopulmonary Biochemistry (J.P.), University College London Hospitals and Medical School, and Royal Free Hospital School of Medicine (M.S.), London, UK.
Correspondence to Prof D.M. Yellon, The Hatter Institute for Cardiovascular Studies, Department of Academic and Clinical Cardiology, University College London Hospitals and Medical School, Grafton Way, London WC1E 6DB, UK. E-mail hatter-institute{at}ucl.ac.uk
| Abstract |
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Key Words: adenosine myocardial infarction delayed preconditioning protein kinase heat shock protein
| Introduction |
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We have previously reported an important role for endogenous adenosine, released from the myocardium during PC ischemia, as a trigger of delayed protection against infarction in rabbit myocardium. We11 have shown that the delayed anti-infarct effects of ischemic PC are abolished by pretreatment with adenosine receptor antagonists. Conversely, transient adenosine A1 receptor (A1R) activation with the selective agonist 2-chloro-N6-cyclopentyladenosine (CCPA) induces a delayed and sustained protection against infarction in the rabbit11 12 13 and rat.14 These studies point to the crucial role of A1R in initiating the cellular events that result in delayed myocardial protection against infarction.
The intracellular signaling pathways downstream of A1R mediating this delayed cardioprotection have not been elucidated. Protein kinase C (PKC) has been shown to play an important role in A1R-induced signal transduction in myocardial tissue.15 16 17 Furthermore, several studies indicate the involvement of PKC in mediating both the early phase (reviewed in Reference 18 ) and the second window19 20 of ischemic PC. On the other hand, increasing evidence has recently implicated involvement of tyrosine kinase (TK) activation in the signaling mechanism of ischemic PC.21 22 23 24 25 26 27 TK signaling is activated by a number of G proteincoupled receptors28 29 30 31 and, as suggested by the study of Maulik et al,21 may form an early step in the mechanism of ischemic PC. Conversely, studies in noncardiac tissue suggest that tyrosine phosphorylation may occur downstream of PKC,32 33 a view that has been supported by recent evidence in rabbit myocardium subjected to ischemic PC protocols.22 25 On the other hand, Vahlhaus et al27 recently reported that blockade of both TK and PKC is necessary to abolish ischemic PC in pigs, suggesting that these enzymes may act in parallel pathways to mediate PC. However, the involvement of these 2 families of protein kinases in A1R-induced delayed PC has not been evaluated. Therefore, in the first part of the present study, we examined the role of PKC and TK signaling in acquisition of delayed tolerance to myocardial ischemia 24 hours after A1R activation in the rabbit.
Another important issue regarding the delayed protection against infarction conferred by transient adenosine A1R activation is the nature of the distal effector or target protein(s) mediating this protection. One potential end-effector protein that has been the subject of recent interest is the constitutively expressed 27-kDa heat shock protein (Hsp27). Overexpression of mammalian Hsp27 has been shown to confer significant cellular resistance against heat shock, tumor necrosis factor, oxidative stress, and a number of cytotoxic drugs.34 35 36 37 Importantly, recent evidence suggests that overexpression of Hsp27 in adult cardiac myocytes confers enhanced resistance against injury mediated by simulated ischemia.38 These small heat shock proteins can function in different, seemingly unrelated cytoprotective processes, such as RNA stabilization,35 molecular chaperoning and preventing unfolded proteins from irreversible aggregation,39 regulation of apoptosis,40 and interaction with and stabilization of the cytoskeleton.41 This latter function of Hsp27 seems to be dependent on its state of phosphorylation. Thus, unphosphorylated Hsp27 behaves as an F-actin capping protein and inhibits actin polymerization, whereas the phosphorylated Hsp27 isoforms promote polymerization, which confers resistance against stress-induced microfilament disorganization (reviewed in Reference 41 ). In this regard, it has been shown that cells overexpressing Hsp27 contain an actin cytoskeleton that is more resistant to disruption due to oxidative stress than control cells or those overexpressing a nonphosphorylatable mutant of Hsp27.36 42 Hsp27 is phosphorylated by the mitogen-activated protein kinase-activated protein kinase-2 (MAPKAPK-2), a stress-sensitive kinase that is sequentially phosphorylated in a cascade of kinases involving p38 mitogen-activated protein kinase (p38 MAPK).42 43 The p38 MAPK/MAPKAPK-2 pathway in the myocardium is activated by a number of stressful stimuli (reviewed in Reference 44 ), and several groups have demonstrated its activation by ischemic PC protocols.45 46 47 48 49 Importantly, recent evidence suggests that p38 MAPK/MAPKAPK-2 pathway is also activated after exposure to adenosine in both cultured cardiomyocytes50 and isolated perfused rat hearts.51
On the basis of the aforementioned, and considering the fact that cytoskeletal disruption is one of the determining events in the cascade of ischemia/reperfusion injury,52 we hypothesized that A1R-induced delayed cardioprotection may be mediated by activation of the p38 MAPK/MAPKAPK-2 pathway, resulting in enhanced cytoskeletal stabilization during the index ischemic insult. In the second part of the present study, we investigated this hypothesis by measuring p38 MAPK activity and expression and phosphorylation of Hsp27 in rabbit myocardium 24 hours after transient A1R activation.
| Materials and Methods |
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Male New Zealand White rabbits weighing 2.1 to 2.8 kg were used in
these experiments. On day 1, conscious animals were pharmacologically
preconditioned and/or received protein kinase inhibitors.
Animals were assigned to 6 experimental groups (Figure 1
). Group I (control) received an
IV bolus of sterile 0.9% saline (0.5 mL). Group II (CCPA) animals were
pharmacologically preconditioned with a single IV bolus of CCPA (100
µg/kg). Animals in groups I and II were also treated with the vehicle
used for protein kinase inhibitors (4% vol/vol ethanol in
sterile water). To examine the role of PKC in mediating
A1R-induced late PC, groups III (chelerythrine
chloride [CHE]+saline) and IV (CHE+CCPA) received the same treatment
as groups I and II, respectively; in addition, they were given an IV
infusion of the selective PKC inhibitor CHE (5 mg/kg) 10
minutes before the saline/CCPA bolus. Rabbits in groups V (lavendustin
A [LDA]+saline) and VI (LDA+CCPA) were given the same treatment as
those in groups I and II. To evaluate the potential role of TK in the
signaling pathway downstream of A1R, these
animals were also treated with the selective TK inhibitor
LDA (1.3 mg/kg) 10 minutes before the saline/CCPA bolus.
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Ischemia/Reperfusion Protocol In Vivo
On day 2, 24 hours after various treatments, rabbits were
anesthetized and underwent an infarction procedure in vivo,
consisting of 30-minute regional myocardial ischemia and 2-hour
reperfusion, as described previously.11 12 13 At the end of
reperfusion, myocardial area at risk was determined with
fluorescent microspheres, and infarct size was assessed
by triphenyl tetrazolium chloride staining, as previously
described.11 12 13 The areas of infarcted tissue
(I) and myocardium at risk (R) were
quantified by computerized planimetry, and infarct size was expressed
as a percentage of the risk area (I/R).
Analysis of Myocardial p38 MAPK Activity
In a different group of animals, 24 hours after the various
treatments outlined above, rabbits (n=3 per group) were euthanized by
an overdose of pentobarbital sodium, and hearts were immediately
excised and rinsed in ice-cold saline. Left ventricular
myocardial samples were rapidly frozen by immersion in liquid nitrogen
and stored at 80°C.
In these myocardial samples, p38 MAPK catalytic activity was determined by an in vitro kinase assay using recombinant activating transcription factor-2 (ATF2) as a substrate, according to the New England Biolabs instructions. After probing the immunoblots with the phospho-ATF2 antibody, filters were stripped and probed with antip38 MAPK. The ratio of phospho-ATF2 to p38 MAPK immunoreactivity was determined for each sample, and the results were expressed as fold activation over control.
Hsp27 Expression and Phosphorylation
One- and two-dimensional gel electrophoresis was performed on
myocardial samples 24 hours after various pretreatments to assess
expression and posttranslational phosphorylation of
Hsp27. Sample preparation and 1-dimensional SDS-PAGE were carried out
as described previously.53 54 Two-dimensional gels were
carried out to determine the phosphorylation state of
Hsp27 using a Bio-Rad mini-protean II 2-dimensional cell
according to the Bio-Rad protocol.
Statistical Analysis
The data are presented as mean±SEM. The significance of
the differences in mean values of I, R, and
I/R between the experimental groups was evaluated by 1-way
ANOVA followed by the Fisher protected least significant difference.
Differences between hemodynamic measurements at
different time points were assessed by 2-way ANOVA with repeated
measures. The null hypothesis was rejected at P<0.05.
An expanded Materials and Methods section is available online at http://www.circresaha.org.
| Results |
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Systemic Hemodynamic Changes During
Ischemia/Reperfusion
Table 1
summarizes the changes in
heart rate, systolic blood pressure (SBP), and rate-pressure
product (RPP) during the infarction protocol in the 6 experimental
groups. There were no differences in baseline
hemodynamic performance between any of the
groups. There was a small decline in SBP and RPP during 30-minute
ischemia with no recovery during reperfusion. These
hemodynamic changes with time were very similar among
all the groups.
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Myocardial Risk and Infarct Size
Table 2
presents the body
weights and the volumes of risk and infarct zones in the 6 experimental
groups. In these groups, the mean volume of myocardial tissue at risk
during coronary artery occlusion was in the range 0.9 to 1.2
cm3, representing
40% to 45% of
total left ventricular tissue volume. There were no
significant differences in ischemic risk zone among the
experimental groups. The absolute infarct size was also similar between
the groups. Infarct size expressed as a percentage of area at risk
(I/R) in the 6 experimental groups is presented in
Figure 2
. Pretreatment with CCPA 24 hours
before myocardial infarction resulted in a significant 45% reduction
in I/R compared with saline-treated controls (23.7±3.1
versus 43.0±4.1%, respectively; P<0.05). Thus, in
accordance with previous studies in this
model,11 12 13 55 transient activation of
A1R induced a delayed PC effect against
infarction at 24 hours. The effect of inhibition of PKC was evaluated
by administering CHE before CCPA or saline injections. Prior treatment
with CHE 5 mg/kg completely abolished the infarct-limiting effect of
delayed pharmacological PC with CCPA, whereas it did not significantly
affect infarct size in saline-treated animals (I/R;
37.3±4.1 and 41.1±4.7%, respectively; P=NS versus
control). Similarly, inhibition of TK using the selective
antagonist LDA (1.3 mg/kg), administered before the CCPA
bolus, abrogated the limitation of infarction in these animals, whereas
LDA on its own had no effect on infarct size (I/R; 38.2±4.9
and 42.8±4.8%, respectively; P=NS versus control). These
results point to an important role for these 2 groups of protein
kinases in the signaling mechanism downstream of
A1R and in mediating its delayed cardioprotective
effects.
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p38 MAPK Activity
Activation of p38 MAPK in myocardial samples obtained from rabbits
pretreated 24 hours earlier was determined by measurement of its
catalytic activity using the in vitro kinase assay with recombinant
ATF2 as substrate. As seen in Figure 3
, pretreatment 24 hours earlier with the A1R
agonist CCPA resulted in an almost 7-fold increase in the activity of
p38 MAPK (689±63%, P<0.01). This increased activity was
abolished by prior inhibition of either PKC or TK. Pretreatment with
CHE or LDA alone did not significantly affect p38 MAPK activity at 24
hours. None of the above treatments affected total expression of p38
MAPK protein as seen when filters were reprobed with antip38 MAPK
antibody.
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Hsp27 Expression and Phosphorylation
One-dimensional PAGE was used to assess expression of Hsp27
protein in myocardial samples obtained 24 hours after various treatment
protocols. There were no differences in total Hsp27 protein content
among the 6 experimental groups (data not shown). Because the
stabilizing activity of Hsp27 on the actin cytoskeleton seems to depend
on its phosphorylation state,36 56 57 we
next used 2-dimensional PAGE to analyze changes in
posttranslational phosphorylation of Hsp27 that might
be induced by the A1R agonist. The results of
2-dimensional PAGE are presented with the acidic region (anode,
positive charge) on the left and the basic region (cathode, negative
charge) on the right. Phosphorylation of Hsp27 can
occur on up to 3 sites (Ser15, Ser78, and Ser82).58 59
This increases the total negative charge of the protein, with a
resultant decrease in isoelectric point and an increased leftward
mobility of Hsp27 into the acidic (anode) region of the isoelectric
focusing gel. The 4 major phosphorylation isoforms of
Hsp27 are the nonphosphorylated and the mono-, di-, and
triphosphorylated. As seen in Figure 4
, in the control hearts Hsp27 was
detected primarily in the nonphosphorylated form (the
most positively charged), with minor contribution from the
monophosphorylated isoforms. Prior treatment with CCPA
(100 µg/kg) 24 hours earlier resulted in an acidic shift in the
position of the Hsp27 isoforms corresponding to increased
phosphorylation of the protein and probably
representing the di- and
triphosphorylated isoforms of Hsp27. This
phosphorylation pattern was completely inhibited by
prior inhibition of either PKC or TK, so that 2-dimensional gels of
myocardial samples from these animals were similar to that from
controls (Figure 4
). Prior treatment with CHE or LDA alone had
no effect on Hsp27 phosphorylation (data not shown).
These results indicate that adenosine A1R
activation induces phosphorylation of Hsp27 at a time
point that corresponds to the delayed infarct-limiting effects of this
treatment and that Hsp27 phosphorylation is mediated by
a PKC- and TK-dependent signaling pathway.
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An expanded Materials and Methods section is available online at http://www.circresaha.org.
| Discussion |
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Role of Protein Kinases in Delayed PC
Previous studies have implicated PKC in mediating delayed
cardioprotection after ischemic PC.19 20 60 In the
present study, we have shown that PKC also mediates
A1R-induced late protection against infarction.
We used CHE, a potent inhibitor of PKC
(IC50,
0.7 µmol/L) with very high
selectivity for PKC compared with protein kinase A (PKA; 250:1) or
protein TK (150:1),61 at a dose (5 mg/kg) that has been
shown to abolish delayed ischemic PC against both
infarction19 and stunning20 in rabbit
myocardium. Furthermore, Ping et al60 have
reported that a PC protocol of six 4-minute coronary
occlusions/4-minute reperfusions in conscious rabbits induces
translocation of PKC isoforms
and
from the cytosolic to the
particulate fraction, which is prevented by prior treatment with CHE at
the same dose as that used in the present study. Similarly, Wilson
et al62 reported an association between development of
delayed cardioprotection against ventricular
arrhythmias 24 hours after rapid cardiac pacing in dogs and
sustained translocation of PKC
to the membrane fraction. Gray et
al63 have implicated PKC
in hypoxic PC of cardiac
myocytes using PKC
-selective inhibitor peptide. On the
other hand, Kawamura et al64 have suggested that in
addition to PKC
, the
isoform is also translocated to the
membrane fraction after ischemic PC in isolated rat hearts and
is involved in the development of protection against
postischemic left ventricular dysfunction.
Mitchell et al65 have reported similar results in the rat
heart. These apparent inconsistencies may be due to the different
species and models used in the above studies. Although some evidence
suggests that A1R activation results in transient
translocation of PKC
in rat ventricular
myocytes,17 it is currently not known which other PKC
isoforms may be activated in the myocardium
downstream of A1R and mediate its delayed PC
effect against infarction.
Imagawa et al23 first demonstrated the involvement of TK
in ischemic PC-induced second window of protection against
infarction, using the TK inhibitor genistein. However,
genistein, originally considered to be selective for TK, seems to have
other nonselective effects such as inhibition of serine/threonine
kinases (eg, PKC and PKA) at higher concentrations.66
Importantly, genistein has also been reported to inhibit
A1R in noncardiac cells,67 although
Imagawa et al23 showed that it did not abolish the
hemodynamic effects of A1R
receptor activation in rabbits. We therefore chose to use a more
selective TK inhibitor, LDA, in the present study. LDA
is a potent inhibitor of protein TK
(IC50, 0.5 µmol/L) and the epidermal
growth factor receptor kinase (IC50, 29 nmol/L),
with much weaker actions at inhibiting PKC or PKA
(IC50, >200 µmol/L).68 In
the present study, we used LDA at a dose of 1.3 mg/kg, which,
assuming distribution in total body water, would yield an approximate
plasma concentration of 5 µmol/L, 10-fold higher than the
IC50 for inhibition of protein TK but well below
that for other protein kinases. This dose of LDA completely abrogated
the protection induced by pretreatment with CCPA 24 hours earlier,
whereas LDA alone had no effect on infarct size (Figure 2
). A
similar dose of LDA (1 mg/kg) has been shown to abolish the late PC
effect against stunning in a conscious rabbit model.24
Moreover, Ping et al25 have recently demonstrated that a
PC protocol of six 4-minute coronary occlusions/4-minute
reperfusions in conscious rabbits induces selective activation
of 2 members of the Src family of protein TKs (Src and Lck) in the
myocardium, with no effect on epidermal growth factor
receptor kinases, and that this activation is abolished by pretreatment
with LDA, at a dose similar to that used in the present study. In
that study, LDA did not affect the translocation of PKC
after
ischemic PC, thereby pointing to the selectivity of LDA. It is
therefore very unlikely that LDA, at the dose used in our study,
inhibited any protein kinases other than protein TK.
Taken together, the results of the present study indicate a crucial role for both PKC and TK in mediating delayed PC against infarction after A1R activation in rabbits. We did not examine the relative positions of PKC and TK in the signaling pathway downstream of A1R, although the fact that inhibition of either group of enzymes completely abolished CCPA-induced late PC would suggest that these kinases function in the same, rather than parallel, signaling pathways. Recent evidence suggests that after ischemic PC in rabbits, TK activation occurs downstream of and is dependent on PKC activation.22 25 It is also noteworthy that recent evidence in rats and pigs suggests that these 2 groups of enzymes may act in parallel to mediate early ischemic PC.26 27 Further studies are necessary to address the relative positions of these enzymes in the signaling cascade downstream of A1R.
In the present study we have also shown, in myocardium not subjected to ischemia/reperfusion, that 24 hours after treatment with CCPA, p38 MAPK activity was significantly increased compared with saline-treated controls. Previous studies have demonstrated activation of myocardial p38 MAPK after a number of stresses, including ischemia/reperfusion (reviewed in Reference 44 ), and also after activation of G proteincoupled receptors, including A1R.49 51 69 However, all of these studies have examined the acute profile of p38 MAPK activation. For example, Haq et al51 showed, in the isolated perfused rat heart, that infusion of adenosine resulted in rapid activation of p38 MAPK that was maximal at 5 minutes and declined thereafter. To the best of our knowledge, the present study is the first to show that transient A1R activation also induces a second phase of enhanced p38 MAPK activity at 24 hours in rabbit myocardium. Moreover, we have shown that this delayed p38 MAPK activation is downstream of, and dependent on, PKC and TK activation, given that pretreatment with either CHE or LDA, at doses that abrogated delayed protection at 24 hours, completely abolished the enhanced p38 MAPK activity. This is consistent with other reports of a role for PKC and TK in activation of p38 MAPK in both noncardiac tissue and myocytes.30 69 70 Taken together, these results point to a potential role for p38 MAPK in mediating delayed A1R-induced PC in the rabbit. In support of this concept, preliminary results by Carroll and Yellon71 have shown, in an adult human-derived cardiac myoblast cell line, that pretreatment with the selective p38 MAPK inhibitor SB203580 completely abolishes delayed protection 24 hours after ischemic or adenosine-induced PC. Similarly, Zhao et al72 have recently reported preliminary data suggesting that A1R-induced PC against infarction in mice is associated with delayed activation of p38 MAPK via a TK-sensitive mechanism.
Role of Hsp27 in Delayed PC
One substrate for p38 MAPK is the protein kinase MAPKAPK-2, which
itself phosphorylates Hsp27.
Phosphorylation of Hsp27 has been shown to increase its
cytoprotective activity, an action that involves changes in the
oligomeric structure of Hsp27 and stabilization of the actin
cytoskeleton (reviewed in Reference 41 ). In the
present study we did not find enhanced expression of Hsp27 at 24
hours after CCPA treatment. This is consistent with a
preliminary report by Heads et al,73 who found no change
in Hsp27 expression 24 hours after CCPA or ischemic PC in
rabbit myocardium, but showed in subcellular fractionation
studies that these PC protocols resulted in redistribution of Hsp27
from the membrane to the soluble fraction. In the present study, we
have extended these findings and have shown that, whereas Hsp27 from
control hearts is mainly nonphosphorylated, 24 hours
after pharmacological PC with CCPA, Hsp27 is primarily in a
phosphorylated form, and that this pattern of
phosphorylation is mediated by a signaling mechanism
dependent on both PKC and TK activation. Although our results are
correlative and do not allow us to establish a direct causal
relationship between Hsp27 phosphorylation and delayed
A1R-induced infarct limitation, their temporal
relationship and the fact that both are blocked by pretreatment with
either CHE or LDA are strongly suggestive.
Other Mediators of A1R-Induced Delayed PC
Other cytoprotective proteins have been implicated as potential
end effectors mediating delayed cardioprotection after
A1R activation in the rabbit heart. For example,
we and others have demonstrated that A1R-induced
delayed PC is dependent on opening of the ATP-sensitive
K+ channels (KATP) during
the index ischemic insult.55 74 These studies
showed that the delayed infarct-limiting effect of CCPA was abrogated
by 5-hydroxydecanoate, a proposed selective blocker of the
mitochondrial rather than the sarcolemmal KATP
channels,75 therefore suggesting that opening of the
mitochondrial KATP channels may mediate the
delayed cardioprotective effects of A1R
agonists.55 Recent evidence has shown that the integrity
of the actin cytoskeleton may have a regulatory function in gating of
cardiac KATP channels.76 77 78 More
importantly, Baines et al79 have recently demonstrated
that pharmacological disruption of the cytoskeleton by cytochalasin D
completely abolishes the protection conferred to
cardiomyocytes by direct opening of the mitochondrial
KATP channels with diazoxide. It may therefore be
of interest to speculate that A1R-induced delayed
PC, by activation of the p38 MAPK/Hsp27 pathway, may result in
preservation of actin microfilaments during the sustained
ischemic insult. This in turn may maintain opening of
mitochondrial KATP channels with ultimate
reduction in ischemia/reperfusion-induced myocardial injury,
although the mechanisms by which opening of these channels confers
protection to the ischemic myocardium are by no
means certain.
In conclusion, we have shown that the delayed myocardial protection 24 hours after transient A1R activation with CCPA in rabbits is mediated by a signaling mechanism involving both PKC and TK. This signaling cascade in turn results in activation of p38 MAPK and phosphorylation of Hsp27. These results provide the first direct evidence for activation of the p38 MAPK/Hsp27 pathway 24 hours after A1R activation, and although correlative, point to an important role for this pathway as a distal mediator of A1R-induced delayed PC in rabbits. Further confirmatory studies using specific pharmacological inhibitors of this pathway are needed to establish its role as a distal effector of A1R-induced delayed cardioprotection.
| Acknowledgments |
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Received November 10, 1999; accepted February 29, 2000.
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