Liu Qingnian, Huang Jiniu, Ding Hao, Tao Yue, Nan Jinliang, Xiao Changchen, Wang Yingchao, Wu Rongrong, Ni Cheng, Zhong Zhiwei, Zhu Wei, Chen Jinghai, Zhang Chenyun, He Xiao, Xiong Danyang, Hu Xinyang, Wang Jian'an
Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Cardiovascular Key Laboratory of Zhejiang Province, Hangzhou, Zhejiang, China.
J Clin Invest. 2024 Oct 31;134(24):e177077. doi: 10.1172/JCI177077.
Myocardial infarction (MI) is characterized by massive cardiomyocyte (CM) death and cardiac dysfunction, and effective therapies to achieve cardioprotection are greatly needed. Here, we report that flavin-containing monooxygenase 2 (FMO2) levels were markedly increased in CMs in both ex vivo and in vivo models of ischemic injury. Genetic deletion of FMO2 resulted in reduced CM survival and enhanced cardiac dysfunction, whereas CM-specific FMO2 overexpression conferred a protective effect in infarcted rat hearts. Mechanistically, FMO2 inhibited the activation of ER stress-induced apoptotic proteins, including caspase 12 and C/EBP homologous protein (CHOP), by downregulating the unfolded protein response pathway. Furthermore, we identified FMO2 as a chaperone that catalyzes disulfide bond formation in unfolded and misfolded proteins through its GVSG motif. GVSG-mutated FMO2 failed to catalyze disulfide bond formation and lost its protection against ER stress and CM death. Finally, we demonstrated the protective effect of FMO2 in a human induced pluripotent stem cell-derived CM model. Collectively, this study highlights FMO2 as a key modulator of oxidative protein folding in CMs and underscores its therapeutic potential for treating ischemic heart disease.
心肌梗死(MI)的特征是大量心肌细胞(CM)死亡和心脏功能障碍,因此迫切需要有效的心脏保护疗法。在此,我们报告在离体和体内缺血性损伤模型的CM中,含黄素单加氧酶2(FMO2)水平均显著升高。FMO2基因缺失导致CM存活率降低和心脏功能障碍加重,而CM特异性FMO2过表达对梗死大鼠心脏具有保护作用。机制上,FMO2通过下调未折叠蛋白反应途径抑制内质网应激诱导的凋亡蛋白(包括半胱天冬酶12和C/EBP同源蛋白(CHOP))的激活。此外,我们鉴定出FMO2是一种伴侣蛋白,它通过其GVSG基序催化未折叠和错误折叠蛋白中的二硫键形成。GVSG突变的FMO2无法催化二硫键形成,并失去了对内质网应激和CM死亡的保护作用。最后,我们在人诱导多能干细胞衍生的CM模型中证明了FMO2的保护作用。总的来说,这项研究突出了FMO2作为CM中氧化蛋白折叠的关键调节因子,并强调了其治疗缺血性心脏病的潜力。