Universitätsklinikum Leipzig, Klinik und Poliklinik für Kardiologie, Leipzig, Germany.
Universitätsklinikum des Saarlandes, Saarland University, Klinik für Innere Medizin III - Kardiologie, Angiologie und Internistische Intensivmedizin, Homburg, Saar, Germany.
Biochem Pharmacol. 2019 Oct;168:173-183. doi: 10.1016/j.bcp.2019.07.001. Epub 2019 Jul 5.
Mineralocorticoid receptor (MR) overactivation promotes cardiac fibrosis. We studied the ability of the non-steroidal MR antagonist finerenone to prevent fibrotic remodeling. In neonatal rat cardiac fibroblasts, finerenone prevented aldosterone-induced nuclear MR translocation. Treatment with finerenone decreased the expression of connective tissue growth factor (CTGF) (74 ± 15% of control, p = 0.005) and prevented aldosterone-induced upregulation of CTGF and lysyl oxidase (LOX) completely. Finerenone attenuated the upregulation of transforming growth factor ß (TGF-ß), which was induced by the Rac1 GTPase activator l-buthionine sulfoximine. Transgenic mice with cardiac-specific overexpression of Rac1 (RacET) showed increased left ventricular (LV) end-diastolic (63.7 ± 8.0 vs. 93.8 ± 25.6 µl, p = 0.027) and end-systolic (28.0 ± 4.0 vs. 49.5 ± 16.7 µl, p = 0.014) volumes compared to wild-type FVBN control mice. Treatment of RacET mice with 100 ppm finerenone over 5 months prevented LV dilatation. Systolic and diastolic LV function did not differ between the three groups. RacET mice exhibited overactivation of MR and 11ß hydroxysteroid dehydrogenase type 2. Both effects were reduced by finerenone (reduction about 36%, p = 0.030, and 40%, p = 0.032, respectively). RacET mice demonstrated overexpression of TGF-ß, CTGF, LOX, osteopontin as well as collagen and myocardial fibrosis in the left ventricle. In contrast, expression of these parameters did not differ between finerenone-treated RacET and control mice. Finerenone prevented left atrial dilatation (6.4 ± 1.5 vs. 4.7 ± 1.4 mg, p = 0.004) and left atrial fibrosis (17.8 ± 3.1 vs. 12.8 ± 3.1%, p = 0.046) compared to vehicle-treated RacET mice. In summary, finerenone prevented from MR-mediated structural remodeling in cardiac fibroblasts and in RacET mice. These data demonstrate anti-fibrotic myocardial effects of finerenone.
醛固酮受体 (MR) 过度激活可促进心肌纤维化。我们研究了非甾体类 MR 拮抗剂非奈利酮预防纤维重塑的能力。在新生大鼠心肌成纤维细胞中,非奈利酮可预防醛固酮诱导的核 MR 易位。用非奈利酮处理可降低结缔组织生长因子 (CTGF) 的表达(对照组的 74±15%,p=0.005),并完全阻止醛固酮诱导的 CTGF 和赖氨酰氧化酶 (LOX) 的上调。非奈利酮减弱了 Rac1 GTP 酶激活剂 L-丁硫氨酸亚砜亚胺诱导的转化生长因子-β (TGF-β) 的上调。心脏特异性过表达 Rac1 (RacET) 的转基因小鼠的左心室 (LV) 舒张末期(63.7±8.0 与 93.8±25.6 µl,p=0.027)和收缩末期(28.0±4.0 与 49.5±16.7 µl,p=0.014)容积增加。与野生型 FVBN 对照小鼠相比,用 100ppm 非奈利酮处理 RacET 小鼠 5 个月可预防 LV 扩张。三组之间的收缩和舒张 LV 功能没有差异。RacET 小鼠的 MR 和 11β羟类固醇脱氢酶 2 过度激活。非奈利酮均可降低这两种作用(约 36%,p=0.030 和 40%,p=0.032)。RacET 小鼠的 TGF-β、CTGF、LOX、骨桥蛋白以及胶原和心肌纤维化在左心室过度表达。相比之下,用非奈利酮处理的 RacET 小鼠与对照组相比,这些参数的表达没有差异。非奈利酮可预防左心房扩张(6.4±1.5 与 4.7±1.4 mg,p=0.004)和左心房纤维化(17.8±3.1 与 12.8±3.1%,p=0.046),与 vehicle 处理的 RacET 小鼠相比。总之,非奈利酮可预防心肌成纤维细胞和 RacET 小鼠中的 MR 介导的结构重塑。这些数据表明非奈利酮具有抗纤维化的心肌作用。