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Circulation Research. 2002;90:377-379
Published online before print February 7, 2002, doi: 10.1161/01.RES.0000012567.95445.55
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(Circulation Research. 2002;90:377.)
© 2002 American Heart Association, Inc.


Reports

Phosphorylation of Glycogen Synthase Kinase-3ß During Preconditioning Through a Phosphatidylinositol-3-Kinase–Dependent Pathway Is Cardioprotective

Haiyan Tong, Kenichi Imahashi, Charles Steenbergen, Elizabeth Murphy

From the Laboratory of Signal Transduction (H.T, K.I. E.M.), National Institute of Environmental Health Sciences, Research Triangle Park, NC; and Department of Pathology (C.S.), Duke University Medical Center, Durham, NC.

Correspondence to Elizabeth Murphy, NIEHS, Research Triangle Park, NC 27709. E-mail murphy1{at}niehs.nih.gov

Abstract

We previously reported that activation of phosphatidylinositol-3-kinase (PI3-kinase) is involved in ischemic preconditioning (PC). Our goal was to determine downstream targets of PI3-kinase. In perfused rat hearts, PC (4 cycles of 5 minutes of ischemia and 5 minutes of reflow) increased phosphorylation of glycogen synthase kinase-3ß (GSK-3ß), a downstream target of PI3-kinase and protein kinase B (PKB), an effect that was blocked by wortmannin. Because phosphorylation inactivates GSK-3ß, we examined whether PC-induced phosphorylation and inhibition of GSK-3ß is important in PC by using two inhibitors of GSK-3ß, lithium and SB 216763. Pretreatment of perfused rat hearts with lithium or SB 216763, before ischemia, mimicked the protective effects of PC; hearts treated with either lithium or SB 216763 had improved postischemic function and reduced infarct size. These findings indicate that inhibition of GSK-3ß is protective and that this PI3-kinase–dependent signaling pathway may play an important role in ischemic preconditioning.


Key Words: ischemic preconditioning • phosphatidylinositol-3-kinase • glycogen synthase kinase-3ß

Brief intermittent periods of ischemia and reflow, termed ischemic preconditioning (PC), have been shown to protect the myocardium against injury produced by a subsequent sustained period of ischemia.1 PC has been shown to significantly reduce infarct size, arrhythmias, and postischemic contractile dysfunction. We previously reported that activation of phosphatidylinositol-3-kinase (PI3-kinase) is important in PC.2 PI3-kinase has been reported to enhance cell survival via phosphorylation of GSK-3ß.3 Expression of a mutant GSK that cannot be phosphorylated blocked the antiapoptotic action of PI3-kinase.3 We therefore examined the role of GSK-3ß in PC. Our results suggest that phosphorylation and subsequent inactivation of GSK-3ß play an important role in the protection afforded by PC in the heart.

Materials and Methods

Isolated Rat Heart Preparation
All rats received humane care in accordance with the NIH guidelines (NIH publication No. 8523, revised 1985). Hearts from male Sprague-Dawley rats (200 to 300 g; Taconic, Germantown, NY) were perfused in Langendorff mode under constant pressure (67 mm Hg) as described previously.2

Experimental Protocols
The protocol is illustrated in Figure 1. For studies assessing recovery of postischemic function, the protocol consisted of a 30-minute control period, a treatment period, 20 minutes of global normothermic ischemia, and 30 minutes of reperfusion. Recovery of left ventricular developed pressure (LVDP) was measured after 30 minutes of reflow and expressed as a percentage of the initial LVDP, before PC or drug administration. Group I hearts (control, n=19) were perfused with Krebs-Henseleit (KH) buffer. Group II hearts (PC, n=11) were preconditioned with four cycles of 5 minutes of ischemia (I) and 5 minutes of reflow (R). Group III hearts (SB, n=14) were treated with 3 µmol/L SB 216763 for 10 minutes. Group IV hearts (Li, n=6) were treated with 3 mmol/L LiCl for 10 minutes. For studies assessing infarct size, the groups (n=4 for all) and protocol were the same except that the period of ischemia was extended to 25 minutes and reperfusion was extended to 2 hours.



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Figure 1. Experimental protocol showing duration and time course of ischemia (I) and reperfusion (R). PC indicates preconditioning; SB, SB 216763; and LiCl, lithium chloride.

Western Blot Analysis
For Western blot analysis, four groups of rat hearts (n=4 each group) were snap-frozen at the end of the treatment period. Frozen hearts were homogenized in ice-cold lysis buffer and subjected to SDS-polyacrylamide gel electrophoresis as described previously.2 The membranes were probed with anti–phospho-GSK3ß (Cell Signaling Technology) (1:1000 dilution).

GSK-3ß Kinase Assay
GSK-3ß activity (n=3 to 5/group) was measured in control and PC hearts snap-frozen at the end of the treatment period and after 20 minutes of global ischemia. Frozen hearts were homogenized in ice-cold lysis buffer as described previously.2 Immunoprecipitated GSK-3ß (using GSK-3ß antibody [Transduction Laboratory]) activity was assessed by a kinase assay using 32P-[ATP] and glycogen synthase peptide-2 (Upstate Biotechnology) as substrate, as described by Haq et al.4

Infarct Size
At the end of 2 hours of reperfusion, hearts were perfused with 40 mL of 0.8% solution of 2,3,5-triphenyltetrazolium chloride (TTC) dissolved in KH buffer and then incubated in 0.8% TTC at 37°C for 15 minutes, followed by fixation in 10% formaldehyde. Cross-sectional slices through the ventricles were then photographed using a digital camera. Infarct size is expressed as the percent of total heart (LV+RV) that does not stain with TTC.

Statistics
Values are expressed as mean±SEM. Significance was determined using ANOVA (StatView). The level of statistical significance was taken as P<=0.05.

Results

PC Increases the Phosphorylation of GSK-3ß
In this study, we examined whether GSK-3ß, a downstream target of protein kinase B (PKB), is involved in PC. As shown in Figure 2A, PC caused an increase in GSK-3ß phosphorylation, and this increase was blocked by wortmannin (P<0.05 compared with PC). The addition of wortmannin alone had no effect on GSK-3ß phosphorylation.



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Figure 2. A, Phospho-GSK3ß levels in hearts at start of sustained ischemia. Top, Representative immunoblot. Bottom, Averaged densitometry data for each group (n=4) expressed as a percentage of control. *P<0.05 compared with control hearts; #P<0.05 compared with PC hearts. B, GSK-3ß activity before and at the end of sustained ischemia in PC and non-PC hearts. *P<0.05 compared with time-matched control, non-PC heart; #P<0.05 compared with t=0 (preischemic) control.

To confirm that PC-induced phosphorylation of GSK-3ß altered activity, we performed an immune complex kinase assay. As shown in Figure 2B, at the end of the PC protocol (time=0), PC hearts had significantly lower GSK-3ß activity compared with non-PC control hearts. During sustained ischemia, there was a similar decline in GSK-3ß in non-PC hearts and in PC hearts.

SB 216763 and Lithium Mimic the Protective Effect of PC on Recovery of Function
To investigate whether GSK-3ß might be involved in the cardioprotective effect of PC, we examined whether the inhibitors of GSK-3ß, lithium and SB 216763, would mimic the cardioprotective effect of PC. Treatment with the GSK-3ß inhibitors SB 216763 or lithium had no effect on preischemic LVDP, heart rate, or coronary flow rate. As shown in Figure 3A, PC resulted in a significant improvement in recovery of postischemic LVDP compared with control (50.3±4.4% versus 31.7±2.7% P<0.05). Similar to PC, lithium treatment significantly improved postischemic LVDP (59.2±6.3%, P<0.01 versus control). Similar to the results obtained with LiCl, we found that SB 216763 treatment significantly improved postischemic LVDP compared with control (41.7±3.0%, P<0.05 versus control).



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Figure 3. A, Bar graph showing recovery of LVDP (percent of initial) measured at 30 minutes of reflow after 20 minutes of ischemia. *P<0.05 compared with control hearts. B, Infarct size (percent whole heart) measured using TTC after 25 minutes of ischemia and 2 hours of reperfusion. *P<0.05 compared with control hearts.

As it is well established that PC reduces infarct size, we also examined whether lithium or SB 216763 treatment would reduce infarct size. As shown in Figure 3B, after 25 minutes of ischemia and 2 hours of reperfusion, PC hearts have significantly smaller infarcts compared with control non-PC hearts (37% infarct in control, non-PC hearts versus 6% in PC hearts). Similar to the protection afforded by PC, hearts treated with lithium or SB 216763 had infarcts that were significantly smaller than control. Taken together, these data suggest that inhibition of GSK-3ß, as occurs with PC, is cardioprotective.

Discussion

PI3-kinase has been shown to be involved in the signaling pathway of PC.2 The downstream targets of PI3-kinase and their role in preconditioning have not been identified. The data presented here provide the first evidence linking GSK-3ß to PC and cardioprotection. We found that PC results in phosphorylation and inactivation of GSK-3ß, consistent with a role for GSK-3ß in PC. We also found that the specific PI3-kinase inhibitor wortmannin blocks the PC-induced phosphorylation of GSK-3ß. Because phosphorylation leads to inhibition of GSK-3ß, we examined whether inhibitors of GSK-3ß, SB 216763 or lithium, would mimic the protective effects of PC. We used a specific inhibitor of GSK-3ß, SB 216763, which is a potent, cell-permeant competitive inhibitor of the ATP binding site of GSK-3ß.5 SB 216763 does not inhibit other related protein kinases, including PKB and PDK-1.5 Another inhibitor, lithium, has no known effects on other protein kinases, but does have effects on other enzymes, including the inositol monophosphatase and adenylyl cyclase.6 Lithium has been used extensively4,6 to study the effect of GSK-3ß. We found that treating hearts with lithium or SB 216763 before ischemia and reperfusion improved recovery of postischemic function and reduced infarct size, suggesting that inhibition of GSK-3ß is cardioprotective.

In contrast to many protein kinases, GSK-3 is active in resting cells and is inactivated by phosphorylation.7 On stimulation, GSK-3 is phosphorylated at serine 21 in GSK-3{alpha} or serine 9 in GSK-3ß, resulting in inhibition of GSK-3 kinase activity.79 PKB phosphorylates GSK-3 at both of these sites in vitro and in vivo.7,8 Inhibition of GSK-3ß has been shown to reduce apoptosis and enhance cell survival,3 providing a plausible mechanism by which phosphorylation and inhibition of GSK-3ß might mediate cardioprotection. Several groups have reported that a dominant-negative GSK-3ß or inhibitors of GSK-3ß prevent apoptosis.3,10 However, the precise mechanism by which GSK-3ß inhibits apoptosis is not clear. GSK-3 was originally identified as an enzyme that regulates glycogen synthesis in response to insulin.10 Recent studies have demonstrated a growing list of substrates for GSK-3ß, such as ß-catenin, tau, NF-AT, cyclin D1, c-myc, E-cadherin, and eIF2B,10 some of which may be involved in GSK inhibition of apoptosis. Data in Figure 2B show that at the start of sustained ischemia, GSK-3ß activity is significantly lower in PC versus non-PC hearts. During ischemia, GSK-3ß is inhibited in non-PC as well as PC hearts, but there is a trend toward lower activity in PC hearts. These data suggest that the lower GSK-3ß activity at the start of the sustained ischemia is protective.

Recent studies suggested that inhibition of GSK-3ß leads to cardiomyocyte hypertrophy.4,11 Myocytes that were transfected with a mutant GSK-3ß, which could not be phosphorylated, did not undergo hypertrophy.4,11 Hypertrophy is initially a compensatory mechanism, and although prolonged hypertrophy is associated with heart failure, the exact relationship between signals that activate hypertrophy and those that activate failure are not clearly delineated. Thus, the protective effects of GSK-3ß inhibition are not necessarily inconsistent with stimulation of hypertrophy. It is also possible that short-term activation of GSK-3ß is protective whereas long-term activation may have other detrimental effects.

In summary, the present study demonstrates that PC increases phosphorylation of GSK-3ß through a PI3-kinase–PKB-dependent pathway, since wortmannin blocks the PC-induced phosphorylation of GSK-3ß. The GSK-3ß inhibitors, SB 216763 and lithium, mimic the cardioprotective effect of PC, suggesting that inhibition of GSK-3ß is protective in classic PC. We conclude that GSK-3ß is involved in the cardioprotective effect of PC through a PI3-kinase–dependent pathway. These data indicate that pharmacological modulation of GSK-3ß activity could have utility for protecting the heart against ischemic injury.

Acknowledgments

H.T., K.I., and E.M. were supported by the National Institute of Environmental Health Sciences Intramural Program. C.S. was supported by NIH Grant HL-39752.

Received August 9, 2001; revision received January 28, 2002; accepted January 28, 2002.

References

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2. Tong H, Chen W, Steenbergen C, Murphy E. Ischemic preconditioning activates phosphatidylinositol-3-kinase upstream of protein kinase C. Circ Res. 2000; 87: 309–315.[Abstract/Free Full Text]

3. Pap M, Cooper GM. Role of glycogen synthase kinase-3 in the phosphatidylinositol-3-kinase/Akt cell survival pathway. J Biol Chem. 1998; 273: 19929–19932.[Abstract/Free Full Text]

4. Haq S, Choukroun G, Kang ZB, Ranu H, Matsui T, Rosenzweig A, Molkentin JD, Alessandrini A, Woodgett J, Hajjar R, Michael A, Force T. Glycogen synthase kinase-3ß is a negative regulator of cardiomyocyte hypertrophy. J Cell Biol. 2000; 151: 117–130.[Abstract/Free Full Text]

5. Coghlan MP, Culbert AA, Cross DA, Corcoran SL, Yates JW, Pearce NJ, Rausch OL, Murphy GJ, Carter PS, Roxbee-Cox L, Mills D, Brown MJ, Haigh D, Ward WR, Smith DG, Muray KJ, Reith AD, Holder JC. Selective small molecule inhibitors of glycogen synthase kinase-3 modulate glycogen metabolism and gene transcription. Chem Biol. 2000; 7: 793–803.[CrossRef][Medline] [Order article via Infotrieve]

6. Klein PS, Melton DA. A molecular mechanism for the effect of lithium on development. Proc Natl Acad Sci U S A. 1996; 93: 8455–8459.[Abstract/Free Full Text]

7. Cohen P, Frame S. The renaissance of GSK3. Nat Rev Mol Cell Biol. 2001; 2: 769–776.[CrossRef][Medline] [Order article via Infotrieve]

8. Cross DA, Alessi DR, Cohen P, Andjelkovich M, Hemmings BA. Inhibition of glycogen synthase kinase-3 by insulin mediated by protein kinase B. Nature. 1995; 378: 785–789.[CrossRef][Medline] [Order article via Infotrieve]

9. Stambolic V, Woodgett JR. Mitogen inactivation of glycogen synthase kinase-3ß in intact cells via serine 9 phosphorylation. Biochem J. 1994; 303: 701–704.[Medline] [Order article via Infotrieve]

10. Hoeflich KP, Luo J, Rubie EA, Tsao MS, Jin O, Woodgett JR. Requirement for glycogen synthase kinase-3ß in cell survival and NF-{kappa}B activation. Nature. 2000; 406: 86–90.[CrossRef][Medline] [Order article via Infotrieve]

11. Morisco C, Zebrowski D, Condorelli G, Tsichlis P, Vatner SF, Sadoshima J. The Akt-glycogen synthase kinase 3ß pathway regulates transcription of atrial natriuretic factor induced by ß-adrenergic receptor stimulation in cardiac myocytes. J Biol Chem. 2000; 275: 14466–14475.[Abstract/Free Full Text]




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P. S. Pagel, J. G. Krolikowski, D. A. Neff, D. Weihrauch, M. Bienengraeber, J. R. Kersten, and D. C. Warltier
Inhibition of glycogen synthase kinase enhances isoflurane-induced protection against myocardial infarction during early reperfusion in vivo.
Anesth. Analg., May 1, 2006; 102(5): 1348 - 1354.
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Cardiovasc ResHome page
E. R. Gross and G. J. Gross
Ligand triggers of classical preconditioning and postconditioning
Cardiovasc Res, May 1, 2006; 70(2): 212 - 221.
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Cardiovasc ResHome page
O. Gateau-Roesch, L. Argaud, and M. Ovize
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Cardiovasc Res, May 1, 2006; 70(2): 264 - 273.
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Cardiovasc ResHome page
D. Garcia-Dorado, A. Rodriguez-Sinovas, M. Ruiz-Meana, J. Inserte, L. Agullo, and A. Cabestrero
The end-effectors of preconditioning protection against myocardial cell death secondary to ischemia-reperfusion
Cardiovasc Res, May 1, 2006; 70(2): 274 - 285.
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Cardiovasc ResHome page
J. C. Kostyak, J. C. Hunter, and D. H. Korzick
Acute PKC{delta} inhibition limits ischaemia-reperfusion injury in the aged rat heart: Role of GSK-3{beta}
Cardiovasc Res, May 1, 2006; 70(2): 325 - 334.
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Physiol. GenomicsHome page
E. Lucchinetti, J. Feng, R. d. Silva, G. V. Tolstonog, M. C. Schaub, G. G. Schumann, and M. Zaugg
Inhibition of LINE-1 expression in the heart decreases ischemic damage by activation of Akt/PKB signaling
Physiol Genomics, April 13, 2006; 25(2): 314 - 324.
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Am. J. Physiol. Heart Circ. Physiol.Home page
L. M. Schwartz and C. J. Lagranha
Ischemic postconditioning during reperfusion activates Akt and ERK without protecting against lethal myocardial ischemia-reperfusion injury in pigs
Am J Physiol Heart Circ Physiol, March 1, 2006; 290(3): H1011 - H1018.
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Circ. Res.Home page
J. Sun, E. Picht, K. S. Ginsburg, D. M. Bers, C. Steenbergen, and E. Murphy
Hypercontractile Female Hearts Exhibit Increased S-Nitrosylation of the L-Type Ca2+ Channel {alpha}1 Subunit and Reduced Ischemia/Reperfusion Injury
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CirculationHome page
M. Eto, A. Kouroedov, F. Cosentino, and T. F. Luscher
Glycogen Synthase Kinase-3 Mediates Endothelial Cell Activation by Tumor Necrosis Factor-{alpha}
Circulation, August 30, 2005; 112(9): 1316 - 1322.
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L. Barandon, P. Dufourcq, P. Costet, C. Moreau, C. Allieres, D. Daret, P. D. Santos, J.-M. D. Lamaziere, T. Couffinhal, and C. Duplaa
Involvement of FrzA/sFRP-1 and the Wnt/Frizzled Pathway in Ischemic Preconditioning
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Am. J. Physiol. Heart Circ. Physiol.Home page
E. R. Gross, J. N. Peart, A. K. Hsu, J. A. Auchampach, and G. J. Gross
Extending the cardioprotective window using a novel {delta}-opioid agonist fentanyl isothiocyanate via the PI3-kinase pathway
Am J Physiol Heart Circ Physiol, June 1, 2005; 288(6): H2744 - H2749.
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DiabetesHome page
D. Montanari, H. Yin, E. Dobrzynski, J. Agata, H. Yoshida, J. Chao, and L. Chao
Kallikrein Gene Delivery Improves Serum Glucose and Lipid Profiles and Cardiac Function in Streptozotocin-Induced Diabetic Rats
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Cardiovasc ResHome page
M. Juhaszova, C. Rabuel, D. B. Zorov, E. G. Lakatta, and S. J. Sollott
Protection in the aged heart: preventing the heart-break of old age?
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CirculationHome page
T. Aoyama, T. Matsui, M. Novikov, J. Park, B. Hemmings, and A. Rosenzweig
Serum and Glucocorticoid-Responsive Kinase-1 Regulates Cardiomyocyte Survival and Hypertrophic Response
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J. Biol. Chem.Home page
H. Yin, L. Chao, and J. Chao
Kallikrein/Kinin Protects against Myocardial Apoptosis after Ischemia/Reperfusion via Akt-Glycogen Synthase Kinase-3 and Akt-Bad{middle dot}14-3-3 Signaling Pathways
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DiabetesHome page
T.-L. Yue, W. Bao, J.-L. Gu, J. Cui, L. Tao, X.-L. Ma, E. H. Ohlstein, and B. M. Jucker
Rosiglitazone Treatment in Zucker Diabetic Fatty Rats Is Associated With Ameliorated Cardiac Insulin Resistance and Protection From Ischemia/Reperfusion-Induced Myocardial Injury
Diabetes, February 1, 2005; 54(2): 554 - 562.
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Am. J. Physiol. Heart Circ. Physiol.Home page
J. Zhang, C. P. Baines, C. Zong, E. M. Cardwell, G. Wang, T. M. Vondriska, and P. Ping
Functional proteomic analysis of a three-tier PKC{varepsilon}-Akt-eNOS signaling module in cardiac protection
Am J Physiol Heart Circ Physiol, February 1, 2005; 288(2): H954 - H961.
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Circ. Res.Home page
E. R. Gross, A. K. Hsu, and G. J. Gross
Opioid-Induced Cardioprotection Occurs via Glycogen Synthase Kinase {beta} Inhibition During Reperfusion in Intact Rat Hearts
Circ. Res., April 16, 2004; 94(7): 960 - 966.
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CirculationHome page
T. Force, K. Kuida, M. Namchuk, K. Parang, and J. M. Kyriakis
Inhibitors of Protein Kinase Signaling Pathways: Emerging Therapies for Cardiovascular Disease
Circulation, March 16, 2004; 109(10): 1196 - 1205.
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Cardiovasc ResHome page
S. C Armstrong
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Cardiovasc Res, February 15, 2004; 61(3): 427 - 436.
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E. Murphy
Primary and Secondary Signaling Pathways in Early Preconditioning That Converge on the Mitochondria to Produce Cardioprotection
Circ. Res., January 9, 2004; 94(1): 7 - 16.
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HypertensionHome page
H. Yin, L. Chao, and J. Chao
Adrenomedullin Protects Against Myocardial Apoptosis After Ischemia/Reperfusion Through Activation of Akt-GSK Signaling
Hypertension, January 1, 2004; 43(1): 109 - 116.
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Circ. Res.Home page
P. H. Sugden
Ras, Akt, and Mechanotransduction in the Cardiac Myocyte
Circ. Res., December 12, 2003; 93(12): 1179 - 1192.
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Circ. Res.Home page
S.-J. Kim, A. Peppas, S.-K. Hong, G. Yang, Y. Huang, G. Diaz, J. Sadoshima, D. E. Vatner, and S. F. Vatner
Persistent Stunning Induces Myocardial Hibernation and Protection: Flow/Function and Metabolic Mechanisms
Circ. Res., June 13, 2003; 92(11): 1233 - 1239.
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J. Biol. Chem.Home page
L. Song, P. De Sarno, and R. S. Jope
Central Role of Glycogen Synthase Kinase-3beta in Endoplasmic Reticulum Stress-induced Caspase-3 Activation
J. Biol. Chem., November 15, 2002; 277(47): 44701 - 44708.
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Circ. Res.Home page
S. E. Hardt and J. Sadoshima
Glycogen Synthase Kinase-3{beta}: A Novel Regulator of Cardiac Hypertrophy and Development
Circ. Res., May 31, 2002; 90(10): 1055 - 1063.
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