The University of Tokyo, Department of Cardiovascular Medicine , 7-3-1 Hongo, Bunkyo-ku, Tokyo , Japan.
Expert Opin Investig Drugs. 2014 Feb;23(2):149-62. doi: 10.1517/13543784.2014.855196. Epub 2013 Nov 11.
Mechanisms of cardiac dysfunction in myocarditis have not been fully elucidated. Though it remains controversial whether angiogenesis is beneficial or harmful in inflammatory disease, significant vascular destruction might possibly impair cardiac function in myocarditis. The prolyl hydroxylase domain-containing protein (PHD) inhibitor is a potential drug for promoting angiogenesis as it stabilizes hypoxia inducible transcription factor (HIF). The authors examine whether the PHD inhibitor TM6008 could affect cardiac function by promoting angiogenesis in experimental autoimmune myocarditis (EAM).
EAM was induced on BALB/c mice by immunizing them with a synthesized α myosin heavy-chain peptide. Every day, 200 mg/kg of TM6008 or vehicle was administered orally.
TM6008 improved left ventricular ejection fraction significantly on the 21st day of EAM. Though TM6008 did not affect the severity of myocardial cell infiltration, it tended to reduce cardiac fibrosis. Immunohistochemistry showed that CD31-positive blood vessels were preserved in the TM6008 group compared to the control group. Immunoblotting revealed that TM6008 increased the expression of HIF-1α, HIF-2α and vascular endothelial growth factor in myocarditis.
Inhibition of PHD could ameliorate cardiac dysfunction in EAM, partially through promoting neovascularization. Relief of tissue hypoxia via neovascularization could improve cardiac function in myocarditis.
心肌炎中心脏功能障碍的机制尚未完全阐明。尽管血管生成在炎症性疾病中是有益还是有害仍存在争议,但血管的大量破坏可能会损害心肌炎中的心脏功能。脯氨酰羟化酶结构域蛋白(PHD)抑制剂是一种促进血管生成的潜在药物,因为它可以稳定低氧诱导转录因子(HIF)。作者研究了 PHD 抑制剂 TM6008 是否可以通过促进实验性自身免疫性心肌炎(EAM)中的血管生成来影响心脏功能。
通过用合成的α肌球蛋白重链肽免疫 BALB/c 小鼠来诱导 EAM。每天口服 200mg/kg 的 TM6008 或载体。
TM6008 在 EAM 的第 21 天显著改善了左心室射血分数。尽管 TM6008 不影响心肌细胞浸润的严重程度,但它有减少心脏纤维化的趋势。免疫组织化学显示,与对照组相比,TM6008 组保留了更多的 CD31 阳性血管。免疫印迹显示,TM6008 在心肌炎中增加了 HIF-1α、HIF-2α 和血管内皮生长因子的表达。
PHD 的抑制可以改善 EAM 中的心脏功能障碍,部分通过促进新血管生成。通过新血管生成缓解组织缺氧可能改善心肌炎中的心脏功能。