Emergency Intensive Care Unit (EICU), The Affiliated Hospital of Yangzhou University, Yangzhou University, Jiangsu Province, 225000, China.
Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, 200032, China.
Inflamm Res. 2022 Dec;71(12):1589-1602. doi: 10.1007/s00011-022-01628-5. Epub 2022 Oct 28.
Cardiac dysfunction and remodeling are serious complications of sepsis and are the main causes of death in sepsis. RCAN1 is a feedback regulator of cardiac hypertrophy. Here, we aim to investigate the role of RCAN1 in septic cardiomyopathy.
Mice were randomly divided into control-WT, control-RCAN1, LPS-induced WT and LPS-induced RCAN1 groups, some with Midiv-1 or KN93 treatment. The protein levels of RCAN1, p-ERK1/2, NFAT3, Drp1, p-Drp1, p-CaMKII in mouse hearts or cultured cardiomyocytes were determined by Western blotting. Myocardial function was assessed by echocardiography. Cardiac hypertrophy and fibrosis were detected by H&E and Masson's trichrome staining. Mitochondrial morphology was examined by transmission electron microscope. Serum level of LDH was detected by ELISA.
Our data show that RCAN1 was downregulated in septic mouse heart and LPS-induced cardiomyocytes. RCAN1 mice showed a severe impairment of cardiac function, and increased myocardial hypertrophy and fibrosis. The protein levels of NFAT3 and p-ERK1/2 were significantly increased in the heart tissues of RCAN1 mice. Further, RCAN1 deficiency aggravated sepsis-induced cardiac mitochondrial injury as indicated by increased ROS production, pathological fission and the loss of mitochondrial membrane potential. Inhibition of fission with Mdivi-1 reversed LPS-induced cardiac hypertrophy, fibrosis and dysfunction in RCAN1 mice. Moreover, RCAN1 depletion promoted mitochondrial translocation of CaMKII, which enhanced fission and septic hypertrophy, while inhibition of CaMKII with KN93 reduced excessive fission, improved LPS-mediated cardiac remodeling and dysfunction in RCAN1 mice.
Our finding demonstrated that RCAN1 deficiency aggravated mitochondrial injury and septic cardiomyopathy through activating CaMKII. RCAN1 serves as a novel therapeutic target for treatment of sepsis-related cardiac remodeling and dysfunction.
心功能障碍和重构是脓毒症的严重并发症,也是脓毒症患者死亡的主要原因。RCAN1 是心肌肥厚的反馈调节剂。本研究旨在探讨 RCAN1 在脓毒性心肌病中的作用。
将小鼠随机分为对照组-WT、对照组-RCAN1、脂多糖诱导的 WT 组和脂多糖诱导的 RCAN1 组,部分给予 Midiv-1 或 KN93 治疗。通过 Western blot 测定小鼠心脏或培养的心肌细胞中 RCAN1、p-ERK1/2、NFAT3、Drp1、p-Drp1、p-CaMKII 的蛋白水平。通过超声心动图评估心肌功能。通过 H&E 和 Masson 三色染色检测心肌肥大和纤维化。通过透射电镜观察线粒体形态。通过 ELISA 检测血清中 LDH 水平。
我们的数据表明,RCAN1 在脓毒症小鼠心脏和脂多糖诱导的心肌细胞中下调。RCAN1 小鼠心脏功能严重受损,心肌肥大和纤维化增加。RCAN1 小鼠心脏组织中 NFAT3 和 p-ERK1/2 蛋白水平显著升高。此外,RCAN1 缺失加剧了脓毒症引起的心脏线粒体损伤,表现为 ROS 产生增加、病理性分裂和线粒体膜电位丧失。用 Mdivi-1 抑制分裂可逆转 RCAN1 小鼠中 LPS 诱导的心肌肥大、纤维化和功能障碍。此外,RCAN1 缺失促进 CaMKII 向线粒体易位,增强分裂和脓毒性肥大,而用 KN93 抑制 CaMKII 可减少过度分裂,改善 RCAN1 小鼠中 LPS 介导的心脏重构和功能障碍。
本研究发现,RCAN1 通过激活 CaMKII 加重线粒体损伤和脓毒性心肌病。RCAN1 可作为治疗与脓毒症相关的心脏重构和功能障碍的新治疗靶点。