Li Longhu, Takemura Genzou, Li Yiwen, Miyata Shusaku, Esaki Masayasu, Okada Hideshi, Kanamori Hiromitsu, Ogino Atsushi, Maruyama Rumi, Nakagawa Munehiro, Minatoguchi Shinya, Fujiwara Takako, Fujiwara Hisayoshi
Second Department of Internal Medicine, Gifu University School of Medicine, Gifu, Japan.
Lab Invest. 2007 May;87(5):440-55. doi: 10.1038/labinvest.3700530. Epub 2007 Mar 5.
It is not well-known yet how granulocyte colony-stimulating factor (G-CSF) affects nonischemic cardiomyopathy, though its beneficial effects on acute myocardial infarction are well-established. We hypothesize that G-CSF beneficially might affect nonischemic cardiomyopathy through the direct cardioprotective effects. Here, we show that a single injection of doxorubicin (DOX, 15 mg/kg) induced left ventricular dilatation and dysfunction in mice within 2 weeks, and that these effects were significantly attenuated by human recombinant G-CSF (100 microg/kg/day for 5 days). G-CSF also protected hearts against DOX-induced cardiomyocyte atrophy/degeneration, fibrosis, inflammatory cell infiltration and down regulation of GATA-4 and sarcomeric proteins, myosin heavy chain, troponin I and desmin, both in vivo and in vitro. Cardiac cyclooxygenase-2 was upregulated and G-CSF receptor was downregulated in DOX-induced cardiomyopathy, but both of those effects were largely reversed by G-CSF. No DOX-induced apoptotic effects were seen, nor were there any changes in tumor necrosis factor-alpha or transforming growth factor-beta1 levels. Among downstream mediators of G-CSF receptor signaling, DOX-induced cardiomyopathy involved inactivation of extracellular signal-regulated protein kinase (ERK); the ERK inactivation was reversed by G-CSF. Inhibition of ERK activation, but not cyclooxygenase-2 inhibition, completely abolished beneficial effect of G-CSF on cardiac function. G-CSF did not promote differentiation of bone marrow cells into cardiomyocytes according to the experiment using green fluorescent protein-chimeric mice, and inhibition of CXCR4+ cell homing using AMD3100 did not diminish the effect of G-CSF. Finally, G-CSF was also effective when administered after cardiomyopathy was established. In conclusion, these findings imply the therapeutic usefulness of G-CSF mainly through restoring ERK activation against DOX-induced nonischemic cardiomyopathy.
尽管粒细胞集落刺激因子(G-CSF)对急性心肌梗死的有益作用已得到充分证实,但其如何影响非缺血性心肌病尚不为人所知。我们推测,G-CSF可能通过直接的心脏保护作用对非缺血性心肌病产生有益影响。在此,我们表明,单次注射阿霉素(DOX,15mg/kg)可在2周内诱导小鼠左心室扩张和功能障碍,而人重组G-CSF(100μg/kg/天,共5天)可显著减轻这些影响。G-CSF在体内和体外还能保护心脏免受DOX诱导的心肌细胞萎缩/变性、纤维化、炎性细胞浸润以及GATA-4和肌节蛋白、肌球蛋白重链、肌钙蛋白I和结蛋白的下调。在DOX诱导的心肌病中,心脏环氧化酶-2上调,G-CSF受体下调,但G-CSF在很大程度上逆转了这两种效应。未观察到DOX诱导的凋亡效应,肿瘤坏死因子-α或转化生长因子-β1水平也无变化。在G-CSF受体信号传导的下游介质中,DOX诱导的心肌病涉及细胞外信号调节蛋白激酶(ERK)的失活;G-CSF可逆转ERK的失活。抑制ERK激活而非抑制环氧化酶-2可完全消除G-CSF对心脏功能的有益作用。根据使用绿色荧光蛋白嵌合小鼠的实验,G-CSF未促进骨髓细胞向心肌细胞分化,使用AMD3100抑制CXCR4+细胞归巢也未减弱G-CSF的作用。最后,在心肌病形成后给予G-CSF也有效。总之,这些发现表明G-CSF主要通过恢复ERK激活对DOX诱导的非缺血性心肌病具有治疗作用。