Centre for Cardiovascular Biology and Disease, Institute for Stem Cell Biology and Regenerative Medicine (inStem), Bangalore, India.
Department of Cardiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Sci Rep. 2019 Apr 10;9(1):5872. doi: 10.1038/s41598-019-42009-z.
Cardiorenal syndrome is defined by primary heart failure conditions influencing or leading to renal injury or dysfunction. Dilated cardiomyopathy (DCM) is a major co-existing form of heart failure (HF) with renal diseases. Myocardin (MYOCD), a cardiac-specific co-activator of serum response factor (SRF), is increased in DCM porcine and patient cardiac tissues and plays a crucial role in the pathophysiology of DCM. Inhibiting the increased MYOCD has shown to be partially rescuing the DCM phenotype in porcine model. However, expression levels of MYOCD in the cardiac tissues of the cardiorenal syndromic patients and the effect of inhibiting MYOCD in a cardiorenal syndrome model remains to be explored. Here, we analyzed the expression levels of MYOCD in the DCM patients with and without renal diseases. We also explored, whether cardiac specific silencing of MYOCD expression could ameliorate the cardiac remodeling and improve cardiac function in a renal artery ligated rat model (RAL). We observed an increase in MYOCD levels in the endomyocardial biopsies of DCM patients associated with renal failure compared to DCM alone. Silencing of MYOCD in RAL rats by a cardiac homing peptide conjugated MYOCD siRNA resulted in attenuation of cardiac hypertrophy, fibrosis and restoration of the left ventricular functions. Our data suggest hyper-activation of MYOCD in the pathogenesis of the cardiorenal failure cases. Also, MYOCD silencing showed beneficial effects by rescuing cardiac hypertrophy, fibrosis, size and function in a cardiorenal rat model.
心肾综合征定义为原发性心力衰竭状况影响或导致肾脏损伤或功能障碍。扩张型心肌病(DCM)是心力衰竭(HF)与肾脏疾病的主要共存形式。心肌营养素(MYOCD)是血清反应因子(SRF)的心脏特异性共激活因子,在 DCM 猪和患者心脏组织中增加,并在 DCM 的病理生理学中发挥关键作用。抑制增加的 MYOCD 已显示出部分挽救猪模型中的 DCM 表型。然而,心肾综合征患者心脏组织中的 MYOCD 表达水平以及抑制 MYOCD 在心肾综合征模型中的作用仍有待探索。在这里,我们分析了伴有和不伴有肾脏疾病的 DCM 患者的 MYOCD 表达水平。我们还探讨了心脏特异性沉默 MYOCD 表达是否可以改善结扎大鼠模型(RAL)中的心脏重塑并改善心脏功能。与单纯 DCM 相比,我们观察到心力衰竭相关 DCM 患者的心肌活检中 MYOCD 水平增加。通过心脏归巢肽缀合的 MYOCD siRNA 在心肾大鼠中沉默 MYOCD 导致心脏肥大、纤维化减轻和左心室功能恢复。我们的数据表明,在心力衰竭病例的发病机制中,MYOCD 的过度激活。此外,通过在心脏肾大鼠模型中挽救心脏肥大、纤维化、大小和功能,沉默 MYOCD 显示出有益的效果。