Department of Pharmacology, School of Medicine, University of California - San Diego, 9500 Gilman Drive, Biomedical Sciences Building, La Jolla, CA 92093, USA.
Aab Cardiovascular Research Institute, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box CVRI, Rochester, NY 14624, USA.
J Mol Cell Cardiol. 2019 Jul;132:1-12. doi: 10.1016/j.yjmcc.2019.04.023. Epub 2019 Apr 28.
Heart failure is the leading cause of morbidity and mortality worldwide. Several lines of evidence suggest that physical activity and exercise can pre-condition the heart to improve the response to acute cardiac injury such as myocardial infarction or ischemia/reperfusion injury, preventing the progression to heart failure. It is becoming more apparent that cardioprotection is a concerted effort between multiple cell types and converging signaling pathways. However, the molecular mechanisms of cardioprotection are not completely understood. What is clear is that the mechanisms underlying this protection involve acute activation of transcriptional activators and their corresponding gene expression programs. Here, we review the known stress-dependent transcriptional programs that are activated in cardiomyocytes and cardiac fibroblasts to preserve function in the adult heart after injury. Focus is given to prominent transcriptional pathways such as mechanical stress or reactive oxygen species (ROS)-dependent activation of myocardin-related transcription factors (MRTFs) and transforming growth factor beta (TGFβ), and gene expression that positively regulates protective PI3K/Akt signaling. Together, these pathways modulate both beneficial and pathological responses to cardiac injury in a cell-specific manner.
心力衰竭是全球发病率和死亡率的主要原因。有几条证据表明,体力活动和锻炼可以使心脏适应,改善对急性心脏损伤(如心肌梗死或缺血/再灌注损伤)的反应,防止进展为心力衰竭。越来越明显的是,心脏保护是多种细胞类型和汇聚信号通路之间的协同作用。然而,心脏保护的分子机制尚不完全清楚。可以肯定的是,这种保护的机制涉及转录激活因子的急性激活及其相应的基因表达程序。在这里,我们回顾了已知的应激依赖性转录程序,这些程序在心肌细胞和心肌成纤维细胞中被激活,以在损伤后保留成年心脏的功能。重点介绍了机械应激或活性氧(ROS)依赖性肌球蛋白相关转录因子(MRTFs)和转化生长因子β(TGFβ)的激活等突出的转录途径,以及正向调节保护性 PI3K/Akt 信号的基因表达。这些途径共同以细胞特异性的方式调节心脏损伤的有益和病理反应。