Sysa-Shah Polina, Tocchetti Carlo G, Gupta Manveen, Rainer Peter P, Shen Xiaoxu, Kang Byung-Hak, Belmonte Frances, Li Jian, Xu Yi, Guo Xin, Bedja Djahida, Gao Wei Dong, Paolocci Nazareno, Rath Rutwik, Sawyer Douglas B, Naga Prasad Sathyamangla V, Gabrielson Kathleen
Department of Molecular and Comparative Pathobiology, Johns Hopkins Medical Institutions, MRB 807, 733 N. Broadway, Baltimore, MD 21205, USA.
Division of Internal Medicine, Department of Translational Medical Sciences, Federico II University, Naples, Italy.
Cardiovasc Res. 2016 Mar 1;109(3):358-73. doi: 10.1093/cvr/cvv274. Epub 2015 Dec 21.
Despite the observation that ErbB2 regulates sensitivity of the heart to doxorubicin or ErbB2-targeted cancer therapies, mechanisms that regulate ErbB2 expression and activity have not been studied. Since isoproterenol up-regulates ErbB2 in kidney and salivary glands and β2AR and ErbB2 complex in brain and heart, we hypothesized that β-adrenergic receptors (AR) modulate ErbB2 signalling status.
ErbB2 transfection of HEK293 cells up-regulates β2AR, and β2AR transfection of HEK293 up-regulates ErbB2. Interestingly, cardiomyocytes isolated from myocyte-specific ErbB2-overexpressing (ErbB2(tg)) mice have amplified response to selective β2-agonist zinterol, and right ventricular trabeculae baseline force generation is markedly reduced with β2-antagonist ICI-118 551. Consistently, receptor binding assays and western blotting demonstrate that β2ARs levels are markedly increased in ErbB2(tg) myocardium and reduced by EGFR/ErbB2 inhibitor, lapatinib. Intriguingly, acute treatment of mice with β1- and β2-AR agonist isoproterenol resulted in myocardial ErbB2 increase, while inhibition with either β1- or β2-AR antagonist did not completely prevent isoproterenol-induced ErbB2 expression. Furthermore, inhibition of ErbB2 kinase predisposed mice hearts to injury from chronic isoproterenol treatment while significantly reducing isoproterenol-induced pAKT and pERK levels, suggesting ErbB2's role in transactivation in the heart.
Our studies show that myocardial ErbB2 and βAR signalling are linked in a feedback loop with βAR activation leading to increased ErbB2 expression and activity, and increased ErbB2 activity regulating β2AR expression. Most importantly, ErbB2 kinase activity is crucial for cardioprotection in the setting of β-adrenergic stress, suggesting that this mechanism is important in the pathophysiology and treatment of cardiomyopathy induced by ErbB2-targeting antineoplastic drugs.
尽管已观察到ErbB2可调节心脏对多柔比星或ErbB2靶向癌症治疗的敏感性,但尚未对调节ErbB2表达和活性的机制进行研究。由于异丙肾上腺素可上调肾脏和唾液腺中的ErbB2以及脑和心脏中的β2肾上腺素能受体(β2AR)与ErbB2复合物,我们推测β-肾上腺素能受体(AR)可调节ErbB2信号状态。
将ErbB2转染至HEK293细胞可上调β2AR,而将β2AR转染至HEK293细胞则可上调ErbB2。有趣的是,从心肌细胞特异性ErbB2过表达(ErbB2(tg))小鼠分离出的心肌细胞对选择性β2激动剂齐帕特罗的反应增强,而β2拮抗剂ICI-118 551可使右心室小梁的基线力产生显著降低。一致地,受体结合试验和蛋白质印迹表明,β2ARs水平在ErbB2(tg)心肌中显著升高,并被表皮生长因子受体/ErbB2抑制剂拉帕替尼降低。有趣的是,用β1和β2-AR激动剂异丙肾上腺素对小鼠进行急性治疗导致心肌ErbB2增加,而用β1或β2-AR拮抗剂抑制并不能完全阻止异丙肾上腺素诱导的ErbB2表达。此外,抑制ErbB2激酶使小鼠心脏易受慢性异丙肾上腺素治疗的损伤,同时显著降低异丙肾上腺素诱导的pAKT和pERK水平,提示ErbB2在心脏反式激活中的作用。
我们的研究表明,心肌ErbB2和βAR信号通过反馈环相连,βAR激活导致ErbB2表达和活性增加,而增加的ErbB2活性调节β2AR表达。最重要的是,ErbB2激酶活性对于β-肾上腺素能应激情况下的心脏保护至关重要,表明该机制在靶向ErbB2的抗肿瘤药物诱导的心肌病的病理生理学和治疗中具有重要意义。