Department of Cardiology & Beijing Key Laboratory of Hypertension Disease, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, PR China.
Scand Cardiovasc J. 2021 Jun;55(3):160-167. doi: 10.1080/14017431.2020.1869300. Epub 2021 Jan 7.
Peripartum cardiomyopathy (PPCM) is a pregnancy-associated and life-threatening cardiac disease. However, the causes and pathogenesis are not fully understood. Accumulating studies show that cardiomyopathy often appears to be associated with elevated levels of β1-adrenoceptor (β1AR) antibodies, indicating a possible involvement of β1AR antibodies in the development of PPCM.
We injected the antigen peptide segment of the β1AR into the postpartum Wistar rats to make the immune models and their cardiac function was detected by echocardiography. Also, the concentration of β1AR antibodies and apoptosis rate of left ventricular myocytes was tested by SA-ELISA, TUNEL, HE staining, qRT-PCR and western blot methods. Finally, the expression of peroxisome proliferator-activated receptor γ coactivator-1α (PGC-1α) and its related proteins were examined by qRT-PCR and western blot methods.
We found that the level of β1AR antibodies in the serum was significantly increased and the postpartum rats exhibited symptoms of PPCM after autoimmunity. Moreover, the expression of peroxisome PGC-1α, which was a master regulator of mitochondrial metabolism, and its downstream transcript vascular endothelial growth factor (VEGF), was decreased in autoimmune perinatal rats. In addition, the expression of the apoptosis factor caspase 3 as well as the apoptosis rate of left ventricular myocytes was significantly increased.
The results suggested that the symptoms of PPCM that appeared in autoimmune perinatal rats may be due to the increase of β1AR antibodies, which inhibited the pathway associated with peroxisome PGC-1α.
围产期心肌病(PPCM)是一种与妊娠相关且危及生命的心脏病。然而,其病因和发病机制尚未完全阐明。越来越多的研究表明,心肌病似乎常与β1-肾上腺素能受体(β1AR)抗体水平升高有关,这表明β1AR 抗体可能参与 PPCM 的发生。
我们将β1AR 的抗原肽段注射到产后 Wistar 大鼠体内,制造免疫模型,并通过超声心动图检测其心功能。同时,通过 SA-ELISA、TUNEL、HE 染色、qRT-PCR 和 Western blot 方法检测β1AR 抗体浓度和左心室心肌细胞凋亡率。最后,通过 qRT-PCR 和 Western blot 方法检测过氧化物酶体增殖物激活受体 γ 共激活因子-1α(PGC-1α)及其相关蛋白的表达。
我们发现,血清中β1AR 抗体水平显著升高,自身免疫后产后大鼠出现 PPCM 症状。此外,过氧化物酶体 PGC-1α 的表达及其下游转录血管内皮生长因子(VEGF)作为线粒体代谢的主要调节因子减少,自身免疫围产期大鼠中凋亡因子 caspase 3 的表达以及左心室心肌细胞的凋亡率显著增加。
结果表明,自身免疫围产期大鼠出现的 PPCM 症状可能是由于β1AR 抗体的增加,抑制了与过氧化物酶体 PGC-1α 相关的通路。