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2.
N Engl J Med ; 390(20): 1849-1861, 2024 May 30.
Article in English | MEDLINE | ID: mdl-38739079

ABSTRACT

BACKGROUND: One of the major determinants of exercise intolerance and limiting symptoms among patients with obstructive hypertrophic cardiomyopathy (HCM) is an elevated intracardiac pressure resulting from left ventricular outflow tract obstruction. Aficamten is an oral selective cardiac myosin inhibitor that reduces left ventricular outflow tract gradients by mitigating cardiac hypercontractility. METHODS: In this phase 3, double-blind trial, we randomly assigned adults with symptomatic obstructive HCM to receive aficamten (starting dose, 5 mg; maximum dose, 20 mg) or placebo for 24 weeks, with dose adjustment based on echocardiography results. The primary end point was the change from baseline to week 24 in the peak oxygen uptake as assessed by cardiopulmonary exercise testing. The 10 prespecified secondary end points (tested hierarchically) were change in the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS), improvement in the New York Heart Association (NYHA) functional class, change in the pressure gradient after the Valsalva maneuver, occurrence of a gradient of less than 30 mm Hg after the Valsalva maneuver, and duration of eligibility for septal reduction therapy (all assessed at week 24); change in the KCCQ-CSS, improvement in the NYHA functional class, change in the pressure gradient after the Valsalva maneuver, and occurrence of a gradient of less than 30 mm Hg after the Valsalva maneuver (all assessed at week 12); and change in the total workload as assessed by cardiopulmonary exercise testing at week 24. RESULTS: A total of 282 patients underwent randomization: 142 to the aficamten group and 140 to the placebo group. The mean age was 59.1 years, 59.2% were men, the baseline mean resting left ventricular outflow tract gradient was 55.1 mm Hg, and the baseline mean left ventricular ejection fraction was 74.8%. At 24 weeks, the mean change in the peak oxygen uptake was 1.8 ml per kilogram per minute (95% confidence interval [CI], 1.2 to 2.3) in the aficamten group and 0.0 ml per kilogram per minute (95% CI, -0.5 to 0.5) in the placebo group (least-squares mean between-group difference, 1.7 ml per kilogram per minute; 95% CI, 1.0 to 2.4; P<0.001). The results for all 10 secondary end points were significantly improved with aficamten as compared with placebo. The incidence of adverse events appeared to be similar in the two groups. CONCLUSIONS: Among patients with symptomatic obstructive HCM, treatment with aficamten resulted in a significantly greater improvement in peak oxygen uptake than placebo. (Funded by Cytokinetics; SEQUOIA-HCM ClinicalTrials.gov number, NCT05186818.).


Subject(s)
Cardiomyopathy, Hypertrophic , Cardiovascular Agents , Exercise Test , Aged , Female , Humans , Male , Middle Aged , Benzylamines , Cardiac Myosins/antagonists & inhibitors , Cardiomyopathy, Hypertrophic/drug therapy , Cardiomyopathy, Hypertrophic/physiopathology , Double-Blind Method , Exercise Tolerance/drug effects , Oxygen Consumption/drug effects , Uracil/analogs & derivatives , Valsalva Maneuver , Ventricular Outflow Obstruction/drug therapy , Ventricular Outflow Obstruction/physiopathology , Ventricular Outflow Obstruction/etiology , Cardiovascular Agents/pharmacology , Cardiovascular Agents/therapeutic use , Myocardial Contraction/drug effects , Myocardial Contraction/physiology , Administration, Oral
3.
Expert Opin Pharmacother ; 25(7): 915-924, 2024 May.
Article in English | MEDLINE | ID: mdl-38813944

ABSTRACT

INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is a heterogeneous genetic heart disease with an estimated prevalence in the general population of 0.2% to 0.6%. Clinically, HCM can range from no symptoms to severe symptoms such as heart failure or sudden cardiac death. Currently, the management of HCM involves lifestyle modifications, familial screening, genetic counseling, pharmacotherapy to manage symptoms, sudden cardiac death risk assessment, septal reduction therapy, and heart transplantation for specific patients. Multicenter randomized controlled trials have only recently explored the potential of cardiac myosin inhibitors (CMIs) such as mavacamten as a directed pharmacological approach for managing HCM. AREAS COVERED: We will assess the existing medical treatments for HCM: beta-blockers, calcium channel blockers, disopyramide, and different CMIs. We will also discuss future HCM pharmacotherapy guidelines and underline this patient population's unfulfilled needs. EXPERT OPINION: Mavacamten is the first-in-class CMI approved by the FDA to target HCM pathophysiology specifically. Mavacamten should be incorporated into the standard therapy for oHCM in case of symptom persistence despite using maximally tolerated beta blockers and/or calcium channel blockers. Potential drug-drug interactions should be assessed before initiating this drug. More studies are needed on the use of CMIs in patients with kidney and/or liver failure and pregnant/breastfeeding patients.


Subject(s)
Cardiomyopathy, Hypertrophic , Adult , Humans , Benzylamines , Cardiac Myosins/genetics , Cardiac Myosins/antagonists & inhibitors , Cardiomyopathy, Hypertrophic/drug therapy , Death, Sudden, Cardiac/prevention & control , Death, Sudden, Cardiac/etiology , Drug Interactions , Randomized Controlled Trials as Topic , Uracil/analogs & derivatives
4.
J Am Coll Cardiol ; 78(25): 2518-2532, 2021 12 21.
Article in English | MEDLINE | ID: mdl-34915982

ABSTRACT

BACKGROUND: EXPLORER-HCM (Clinical Study to Evaluate Mavacamten [MYK-461] in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy) demonstrated that mavacamten, a cardiac myosin inhibitor, improves symptoms, exercise capacity, and left ventricular outflow tract (LVOT) obstruction in patients with obstructive hypertrophic cardiomyopathy (oHCM). OBJECTIVES: The purpose of this study was to evaluate mavacamten's effect on measures of cardiac structure and function and its association with changes in other clinical measures. METHODS: Key echocardiographic parameters from serial echocardiograms over 30 weeks from 251 symptomatic oHCM patients (mavacamten [n = 123], placebo [n = 128]) were assessed in a core laboratory. RESULTS: More patients on mavacamten (80.9%; n = 76 of 94) vs placebo (34.0%; n = 33 of 97) showed complete resolution of mitral valve systolic anterior motion after 30 weeks (difference, 46.8%; P < 0.0001). Mavacamten also improved measures of diastolic function vs placebo, including left atrial volume index (LAVI) (mean ± SD baseline: 40 ± 12 mL/m2 vs 41 ± 14 mL/m2; mean change from baseline of -7.5 mL/m2 [95% CI: -9.0 to -6.1 mL/m2] vs -0.09 mL/m2 [95% CI: -1.6 to 1.5 mL/m2]; P < 0.0001) and lateral E/e' (baseline, 15 ± 6 vs 15 ± 8; change of -3.8 [95% CI: -4.7 to -2.8] vs 0.04 [95% CI: -0.9 to 1.0]; P < 0.0001). Among mavacamten-treated patients, improvement in resting, Valsalva, and post-exercise LVOT gradients, LAVI, and lateral E/e' was associated with reduction in N-terminal pro-B-type natriuretic peptide (P ≤ 0.03 for all). Reduction in LAVI was associated with improved peak exercise oxygen consumption (P = 0.04). CONCLUSIONS: Mavacamten significantly improved measures of left ventricular diastolic function and systolic anterior motion. Improvement in LVOT obstruction, LAVI, and E/e' was associated with reduction in a biomarker of myocardial wall stress (N-terminal pro-B-type natriuretic peptide). These findings demonstrate improvement in important markers of the pathophysiology of oHCM with mavacamten. (Clinical Study to Evaluate Mavacamten [MYK-461] in Adults With Symptomatic Obstructive Hypertrophic Cardiomyopathy; NCT03470545).


Subject(s)
Benzylamines/therapeutic use , Cardiomyopathy, Hypertrophic/drug therapy , Heart/drug effects , Uracil/analogs & derivatives , Aged , Benzylamines/pharmacology , Biomarkers/blood , Cardiac Myosins/antagonists & inhibitors , Cardiomyopathy, Hypertrophic/blood , Cardiomyopathy, Hypertrophic/diagnostic imaging , Double-Blind Method , Echocardiography , Exercise Tolerance/drug effects , Female , Humans , Male , Middle Aged , Uracil/pharmacology , Uracil/therapeutic use
5.
Int J Mol Sci ; 22(12)2021 Jun 21.
Article in English | MEDLINE | ID: mdl-34205587

ABSTRACT

Heart failure (HF) is a syndrome encompassing several important etiologies that lead to the imbalance between oxygen demand and supply. Despite the usage of guideline-directed medical therapy for HF has shown better outcomes, novel therapeutic strategies are desirable, especially for patients with preserved or mildly reduced left ventricular ejection fraction. In this regard, understanding the molecular basis for cardiomyopathies is expected to fill in the knowledge gap and generate new therapies to improve prognosis for HF. This review discusses an evolutionary mechanism designed to regulate cardiac contraction and relaxation through the most often genetically determined cardiomyopathies associated with HF. In addition, both the myosin inhibitor and myosin activator are promising new treatments for cardiomyopathies. A comprehensive review from genetic mutations to the molecular basis of direct sarcomere modulators will help shed light on future studies for a better characterization of HF etiologies and potential therapeutic targets.


Subject(s)
Benzylamines/therapeutic use , Cardiac Myosins/genetics , Heart Failure/drug therapy , Molecular Targeted Therapy , Uracil/analogs & derivatives , Urea/analogs & derivatives , Benzylamines/pharmacology , Cardiac Myosins/antagonists & inhibitors , Heart Failure/genetics , Heart Failure/pathology , Humans , Myocytes, Cardiac/pathology , Uracil/pharmacology , Uracil/therapeutic use , Urea/pharmacology , Urea/therapeutic use
6.
J Mol Cell Cardiol ; 158: 11-25, 2021 09.
Article in English | MEDLINE | ID: mdl-33992697

ABSTRACT

We have created a novel in-vitro platform to study reverse remodeling of engineered heart tissue (EHT) after mechanical unloading. EHTs were created by seeding decellularized porcine myocardial sections with a mixture of primary neonatal rat ventricular myocytes and cardiac fibroblasts. Each end of the ribbon-like constructs was fixed to a plastic clip, allowing the tissues to be statically stretched or slackened. Inelastic deformation was introduced by stretching tissues by 20% of their original length. EHTs were subsequently unloaded by returning tissues to their original, shorter length. Mechanical characterization of EHTs immediately after unloading and at subsequent time points confirmed the presence of a reverse-remodeling process, through which stress-free tissue length was increased after chronic stretch but gradually decreased back to its original value within 9 days. When a cardiac myosin inhibitor was applied to tissues after unloading, EHTs failed to completely recover their passive and active mechanical properties, suggesting a role for actomyosin contraction in reverse remodeling. Selectively inhibiting cardiomyocyte contraction or fibroblast activity after mechanical unloading showed that contractile activity of both cell types was required to achieve full remodeling. Similar tests with EHTs formed from human induced pluripotent stem cell-derived cardiomyocytes also showed reverse remodeling that was enhanced when treated with omecamtiv mecarbil, a myosin activator. These experiments suggest essential roles for active sarcomeric contraction and fibroblast activity in reverse remodeling of myocardium after mechanical unloading. Our findings provide a mechanistic rationale for designing potential therapies to encourage reverse remodeling in patient hearts.


Subject(s)
Heart Failure/metabolism , Myocytes, Cardiac/metabolism , Myofibroblasts/metabolism , Sarcomeres/metabolism , Signal Transduction/drug effects , Tissue Engineering/methods , Ventricular Remodeling/drug effects , Actomyosin/metabolism , Animals , Animals, Newborn , Benzamides/pharmacology , Benzylamines/pharmacology , Cardiac Myosins/antagonists & inhibitors , Cardiac Myosins/metabolism , Cell Line , Dioxoles/pharmacology , Humans , Induced Pluripotent Stem Cells/metabolism , Myocardial Contraction/drug effects , Myocardium/metabolism , Myofibroblasts/drug effects , Rats , Rats, Sprague-Dawley , Receptor, Transforming Growth Factor-beta Type I/antagonists & inhibitors , Swine , Tissue Scaffolds , Uracil/analogs & derivatives , Uracil/pharmacology , Urea/analogs & derivatives , Urea/pharmacology
7.
Lancet ; 396(10253): 759-769, 2020 09 12.
Article in English | MEDLINE | ID: mdl-32871100

ABSTRACT

BACKGROUND: Cardiac muscle hypercontractility is a key pathophysiological abnormality in hypertrophic cardiomyopathy, and a major determinant of dynamic left ventricular outflow tract (LVOT) obstruction. Available pharmacological options for hypertrophic cardiomyopathy are inadequate or poorly tolerated and are not disease-specific. We aimed to assess the efficacy and safety of mavacamten, a first-in-class cardiac myosin inhibitor, in symptomatic obstructive hypertrophic cardiomyopathy. METHODS: In this phase 3, randomised, double-blind, placebo-controlled trial (EXPLORER-HCM) in 68 clinical cardiovascular centres in 13 countries, patients with hypertrophic cardiomyopathy with an LVOT gradient of 50 mm Hg or greater and New York Heart Association (NYHA) class II-III symptoms were assigned (1:1) to receive mavacamten (starting at 5 mg) or placebo for 30 weeks. Visits for assessment of patient status occurred every 2-4 weeks. Serial evaluations included echocardiogram, electrocardiogram, and blood collection for laboratory tests and mavacamten plasma concentration. The primary endpoint was a 1·5 mL/kg per min or greater increase in peak oxygen consumption (pVO2) and at least one NYHA class reduction or a 3·0 mL/kg per min or greater pVO2 increase without NYHA class worsening. Secondary endpoints assessed changes in post-exercise LVOT gradient, pVO2, NYHA class, Kansas City Cardiomyopathy Questionnaire-Clinical Summary Score (KCCQ-CSS), and Hypertrophic Cardiomyopathy Symptom Questionnaire Shortness-of-Breath subscore (HCMSQ-SoB). This study is registered with ClinicalTrials.gov, NCT03470545. FINDINGS: Between May 30, 2018, and July 12, 2019, 429 adults were assessed for eligibility, of whom 251 (59%) were enrolled and randomly assigned to mavacamten (n=123 [49%]) or placebo (n=128 [51%]). 45 (37%) of 123 patients on mavacamten versus 22 (17%) of 128 on placebo met the primary endpoint (difference +19·4%, 95% CI 8·7 to 30·1; p=0·0005). Patients on mavacamten had greater reductions than those on placebo in post-exercise LVOT gradient (-36 mm Hg, 95% CI -43·2 to -28·1; p<0·0001), greater increase in pVO2 (+1·4 mL/kg per min, 0·6 to 2·1; p=0·0006), and improved symptom scores (KCCQ-CSS +9·1, 5·5 to 12·7; HCMSQ-SoB -1·8, -2·4 to -1·2; p<0·0001). 34% more patients in the mavacamten group improved by at least one NYHA class (80 of 123 patients in the mavacamten group vs 40 of 128 patients in the placebo group; 95% CI 22·2 to 45·4; p<0·0001). Safety and tolerability were similar to placebo. Treatment-emergent adverse events were generally mild. One patient died by sudden death in the placebo group. INTERPRETATION: Treatment with mavacamten improved exercise capacity, LVOT obstruction, NYHA functional class, and health status in patients with obstructive hypertrophic cardiomyopathy. The results of this pivotal trial highlight the benefits of disease-specific treatment for this condition. FUNDING: MyoKardia.


Subject(s)
Benzylamines/therapeutic use , Cardiac Myosins/antagonists & inhibitors , Cardiomyopathy, Hypertrophic/drug therapy , Uracil/analogs & derivatives , Adrenergic beta-Antagonists/therapeutic use , Aged , Benzylamines/adverse effects , Calcium Channel Blockers/therapeutic use , Cardiomyopathy, Hypertrophic/physiopathology , Cardiovascular Agents/therapeutic use , Double-Blind Method , Exercise Tolerance/physiology , Female , Hemodynamics/physiology , Humans , Male , Middle Aged , Oxygen Consumption/physiology , Patient Outcome Assessment , Uracil/adverse effects , Uracil/therapeutic use
8.
Development ; 144(23): 4363-4376, 2017 12 01.
Article in English | MEDLINE | ID: mdl-28982683

ABSTRACT

The coordination of individual cell behaviors is a crucial step in the assembly and morphogenesis of tissues. Xenopus mesendoderm cells migrate collectively along a fibronectin (FN) substrate at gastrulation, but how the adhesive and mechanical forces required for these movements are generated and transmitted is unclear. Traction force microscopy (TFM) was used to establish that traction stresses are limited primarily to leading edge cells in mesendoderm explants, and that these forces are balanced by intercellular stresses in follower rows. This is further reflected in the morphology of these cells, with broad lamellipodial protrusions, mature focal adhesions and a gradient of activated Rac1 evident at the leading edge, while small protrusions, rapid turnover of immature focal adhesions and lack of a Rac1 activity gradient characterize cells in following rows. Depletion of keratin (krt8) with antisense morpholinos results in high traction stresses in follower row cells, misdirected protrusions and the formation of actin stress fibers anchored in streak-like focal adhesions. We propose that maintenance of mechanical integrity in the mesendoderm by keratin intermediate filaments is required to balance stresses within the tissue to regulate collective cell movements.


Subject(s)
Gastrulation/physiology , Keratins/physiology , Xenopus Proteins/physiology , Xenopus/embryology , Xenopus/physiology , Actins/physiology , Animals , Biomechanical Phenomena , Cardiac Myosins/antagonists & inhibitors , Cardiac Myosins/metabolism , Cell Movement/physiology , Endoderm/cytology , Endoderm/embryology , Endoderm/physiology , Focal Adhesions/physiology , Gene Knockdown Techniques , Intermediate Filaments/physiology , Keratin-8/antagonists & inhibitors , Keratin-8/genetics , Keratin-8/physiology , Mesoderm/cytology , Mesoderm/embryology , Mesoderm/physiology , Models, Biological , Morphogenesis/physiology , Myosin Light Chains/antagonists & inhibitors , Myosin Light Chains/metabolism , Signal Transduction , Stress, Mechanical , Xenopus/genetics , Xenopus Proteins/antagonists & inhibitors , Xenopus Proteins/genetics , rac1 GTP-Binding Protein/antagonists & inhibitors , rac1 GTP-Binding Protein/genetics , rac1 GTP-Binding Protein/physiology
9.
Mol Med Rep ; 14(5): 4293-4300, 2016 Nov.
Article in English | MEDLINE | ID: mdl-27748856

ABSTRACT

The role of myosin light chain II (MLC­II) in cellular differentiation of rat mandibular condylar chondrocytes (MCCs) induced by cyclical uniaxial compressive stress (CUCS) remains unclear. In the current study, a four­point bending system was used to apply CUCS to primary cultured MCCs from rats. It was identified that CUCS stimulated features of cellular differentiation including morphological alterations, cytoskeleton rearrangement and overproduction of proteoglycans. Furthermore, CUCS promoted runt­related transcription factor­2 (RUNX2) expression at mRNA (P<0.01) and protein levels (P<0.05) and elevated alkaline phosphatase (ALP) activity (P<0.01), which are both markers of osteogenic differentiation. Under conditions of stress, western blotting indicated that the ratio of phosphorylated MLC­II to total MLC­II was increased significantly (P<0.05). Silencing MLC­II by RNA interference reduced ALP activity (P<0.01), and eliminated RUNX2 mRNA expression (P<0.01). Addition of the MLC kinase inhibitor, ML­7, reduced the CUCS­associated upregulation of RUNX2 expression (P<0.01) and ALP activity (P<0.01). The data indicated that CUCS promoted cellular differentiation of rat primary MCCs, and this was suggested to be via the phosphorylation of MLC­II.


Subject(s)
Cardiac Myosins/genetics , Chondrocytes/cytology , Core Binding Factor Alpha 1 Subunit/biosynthesis , Mandibular Condyle/growth & development , Myosin Light Chains/genetics , Osteogenesis/genetics , Alkaline Phosphatase/antagonists & inhibitors , Alkaline Phosphatase/genetics , Animals , Azepines/administration & dosage , Cardiac Myosins/antagonists & inhibitors , Cardiac Myosins/biosynthesis , Cell Differentiation/genetics , Chondrocytes/metabolism , Core Binding Factor Alpha 1 Subunit/genetics , Cytoskeleton/genetics , Cytoskeleton/metabolism , Gene Expression Regulation, Developmental , Mandibular Condyle/cytology , Mandibular Condyle/metabolism , Myosin Light Chains/antagonists & inhibitors , Myosin Light Chains/biosynthesis , Naphthalenes/administration & dosage , Phosphorylation , Pressure , RNA Interference , RNA, Messenger/biosynthesis , RNA, Messenger/genetics , Rats
10.
Int J Mol Sci ; 17(10)2016 Oct 10.
Article in English | MEDLINE | ID: mdl-27735862

ABSTRACT

As a physiological small molecular product from the microbial fermentation of dietary fibers, butyrate plays an important role in maintaining intestinal health. Our previous works have proved that the effect of sodium butyrate (NaB) on the intestinal barrier function is mediated by activation of AMP-activated protein kinase (AMPK). However, the detailed pathway involved remains unknown. Using the calcium switch assay in the Caco-2 cell monolayer model, we found here that NaB activated AMPK mainly by increasing the calcium level, but not the ATP concentration, via promoting store-operated calcium entry (SOCE). Upon the activation of AMPK, NaB promoted the reassembly of tight junctions (TJs) based on reducing the phosphorylation of myosin II regulatory light chain (MLC2) at Ser19 and increasing phosphorylation of protein kinase C ß2 (PKCß2) at Ser660. Inhibiting (protein kinase C ß) PKCß blocked the reassembly of TJs induced by NaB in the barrier monolayer model. These results indicated that NaB could activate the calcium/calmodulin-dependent protein kinase kinase ß (CaMKKß) pathway to mediate AMPK phosphorylating, which then inhibited the phosphorylation of MLC2 and promoted the phosphorylation of PKCß2, respectively, so that the downstream molecules of AMPK coordinately contributed to the reassembly of TJs in the Caco-2 barrier model. These results suggested a potential mechanism of butyrate for intestine homeostasis and protection.


Subject(s)
Butyric Acid/pharmacology , Cardiac Myosins/metabolism , Myosin Light Chains/metabolism , Myosin-Light-Chain Kinase/metabolism , Protein Kinase C beta/metabolism , Tight Junctions/drug effects , AMP-Activated Protein Kinases/metabolism , Blotting, Western , Caco-2 Cells , Calcium-Calmodulin-Dependent Protein Kinase Kinase/metabolism , Cardiac Myosins/antagonists & inhibitors , Humans , Immunoprecipitation , Myosin Light Chains/antagonists & inhibitors , Myosin-Light-Chain Kinase/antagonists & inhibitors , Phosphorylation/drug effects , Tight Junctions/metabolism
11.
Peptides ; 81: 29-37, 2016 07.
Article in English | MEDLINE | ID: mdl-27020249

ABSTRACT

Adropin is a peptide encoded by the energy homeostasis associated gene (Enho) and plays a critical role in the regulation of lipid metabolism, insulin sensitivity, and endothelial function. Little is known of the effects of adropin in the brain and whether this peptide modulates ischemia-induced blood-brain barrier (BBB) injury. Here, we used an in vitro BBB model of rat brain microvascular endothelial cells (RBE4) and hypothesized that adropin would reduce endothelial permeability during ischemic conditions. To mimic ischemic conditions in vitro, RBE4 cell monolayers were subjected to 16h hypoxia/low glucose (HLG). This resulted in a significant increase in paracellular permeability to FITC-labeled dextran (40kDa), a dramatic upregulation of vascular endothelial growth factor (VEGF), and the loss of junction proteins occludin and VE-cadherin. Notably, HLG also significantly decreased Enho expression and adropin levels. Treatment of RBE4 cells with synthetic adropin (1, 10 and 100ng/ml) concentration-dependently reduced endothelial permeability after HLG, but this was not mediated through protection to junction proteins or through reduced levels of VEGF. We found that HLG dramatically increased myosin light chain 2 (MLC2) phosphorylation in RBE4 cells, which was significantly reduced by adropin treatment. We also found that HLG significantly increased Rho-associated kinase (ROCK) activity, a critical upstream effector of MLC2 phosphorylation, and that adropin treatment attenuated that effect. These data indicate that treatment with adropin reduces endothelial cell permeability after HLG insult by inhibition of the ROCK-MLC2 signaling pathway. These promising findings suggest that adropin protects against endothelial barrier dysfunction during ischemic conditions.


Subject(s)
Blood-Brain Barrier/drug effects , Brain Ischemia/physiopathology , Capillary Permeability/drug effects , Cardiac Myosins/antagonists & inhibitors , Myosin Light Chains/antagonists & inhibitors , rho-Associated Kinases/antagonists & inhibitors , Adherens Junctions/drug effects , Adherens Junctions/metabolism , Animals , Antigens, CD/metabolism , Blood Proteins/genetics , Blood Proteins/metabolism , Blood-Brain Barrier/metabolism , Cadherins/metabolism , Cell Line , Dose-Response Relationship, Drug , Endothelial Cells/drug effects , Glucose/metabolism , Occludin/metabolism , Peptides/genetics , Peptides/metabolism , Phosphorylation , Rats , Tight Junctions/drug effects , Tight Junctions/metabolism , Up-Regulation/drug effects , Vascular Endothelial Growth Factor A/metabolism
13.
Science ; 351(6273): 617-21, 2016 Feb 05.
Article in English | MEDLINE | ID: mdl-26912705

ABSTRACT

Hypertrophic cardiomyopathy (HCM) is an inherited disease of heart muscle that can be caused by mutations in sarcomere proteins. Clinical diagnosis depends on an abnormal thickening of the heart, but the earliest signs of disease are hyperdynamic contraction and impaired relaxation. Whereas some in vitro studies of power generation by mutant and wild-type sarcomere proteins are consistent with mutant sarcomeres exhibiting enhanced contractile power, others are not. We identified a small molecule, MYK-461, that reduces contractility by decreasing the adenosine triphosphatase activity of the cardiac myosin heavy chain. Here we demonstrate that early, chronic administration of MYK-461 suppresses the development of ventricular hypertrophy, cardiomyocyte disarray, and myocardial fibrosis and attenuates hypertrophic and profibrotic gene expression in mice harboring heterozygous human mutations in the myosin heavy chain. These data indicate that hyperdynamic contraction is essential for HCM pathobiology and that inhibitors of sarcomere contraction may be a valuable therapeutic approach for HCM.


Subject(s)
Adenosine Triphosphatases/antagonists & inhibitors , Benzylamines/administration & dosage , Cardiac Myosins/antagonists & inhibitors , Cardiomyopathy, Hypertrophic, Familial/drug therapy , Myocardial Contraction/drug effects , Myosin Heavy Chains/antagonists & inhibitors , Sarcomeres/drug effects , Uracil/analogs & derivatives , Animals , Benzylamines/chemistry , Cardiac Myosins/genetics , Cardiomyopathy, Hypertrophic, Familial/pathology , Cardiomyopathy, Hypertrophic, Familial/physiopathology , Cells, Cultured , Disease Models, Animal , Fibrosis , Heart Ventricles/drug effects , Heart Ventricles/pathology , Heterozygote , Humans , Male , Mice , Mice, Inbred Strains , Mutation , Myocardium/pathology , Myocytes, Cardiac/drug effects , Myocytes, Cardiac/pathology , Myosin Heavy Chains/genetics , Rats , Uracil/administration & dosage , Uracil/chemistry
14.
PLoS One ; 9(8): e105435, 2014.
Article in English | MEDLINE | ID: mdl-25144196

ABSTRACT

Neuronal morphogenesis is implicated in neuronal function and development with rearrangement of cytoskeletal organization. Ezrin, a member of Ezrin/Radixin/Moesin (ERM) proteins links between membrane proteins and actin cytoskeleton, and contributes to maintenance of cellular function and morphology. In cultured hippocampal neurons, suppression of both radixin and moesin showed deficits in growth cone morphology and neurite extensions. Down-regulation of ezrin using siRNA caused impairment of netrin-1-induced axon outgrowth in cultured cortical neurons. However, roles of ezrin in the neuronal morphogenesis of the cultured neurons have been poorly understood. In this report, we performed detailed studies on the roles of ezrin in the cultured cortical neurons prepared from the ezrin knockdown (Vil2(kd/kd)) mice embryo that showed a very small amount of ezrin expression compared with the wild-type (Vil2(+/+)) neurons. Ezrin was mainly expressed in cell body in the cultured cortical neurons. We demonstrated that the cultured cortical neurons prepared from the Vil2(kd/kd) mice embryo exhibited impairment of neuritogenesis. Moreover, we observed increased RhoA activity and phosphorylation of myosin light chain 2 (MLC2), as a downstream effector of RhoA in the Vil2(kd/kd) neurons. In addition, inhibition of Rho kinase and myosin II rescued the impairment of neuritogenesis in the Vil2(kd/kd) neurons. These data altogether suggest a novel role of ezrin in the neuritogenesis of the cultured cortical neurons through down-regulation of RhoA activity.


Subject(s)
Cytoskeletal Proteins/genetics , Membrane Proteins/genetics , Neurogenesis/physiology , Neurons/physiology , rhoA GTP-Binding Protein/metabolism , Amides/pharmacology , Animals , Cardiac Myosins/antagonists & inhibitors , Cardiac Myosins/metabolism , Cerebral Cortex/cytology , Cerebral Cortex/metabolism , Cytoskeletal Proteins/metabolism , Down-Regulation , Enzyme Activation , Enzyme Inhibitors/pharmacology , Membrane Proteins/metabolism , Mice , Mice, Knockout , Myosin Light Chains/antagonists & inhibitors , Myosin Light Chains/metabolism , Neurogenesis/drug effects , Neurons/pathology , Phosphorylation , Protein Transport , Pyramidal Cells/physiology , Pyridines/pharmacology , Signal Transduction , rhoA GTP-Binding Protein/antagonists & inhibitors
15.
Curr Biol ; 23(23): 2434-9, 2013 Dec 02.
Article in English | MEDLINE | ID: mdl-24268417

ABSTRACT

In development and differentiation, morphological changes often accompany mechanical changes [1], but it is unclear whether or when cells in embryos sense tissue elasticity. The earliest embryo is uniformly pliable, while adult tissues vary widely in mechanics from soft brain and stiff heart to rigid bone [2]. However, cell sensitivity to microenvironment elasticity is debated based in part on results from complex three-dimensional culture models [3]. Regenerative cardiology provides strong motivation to clarify any cell-level sensitivities to tissue elasticity because rigid postinfarct regions limit pumping by the adult heart [4]. Here, we focus on the spontaneously beating embryonic heart and sparsely cultured cardiomyocytes, including cells derived from pluripotent stem cells. Tissue elasticity, Et, increases daily for heart to 1-2 kPa by embryonic day 4 (E4), and although this is ~10-fold softer than adult heart, the beating contractions of E4 cardiomyocytes prove optimal at ~Et,E4 both in vivo and in vitro. Proteomics reveals daily increases in a small subset of proteins, namely collagen plus cardiac-specific excitation-contraction proteins. Rapid softening of the heart's matrix with collagenase or stiffening it with enzymatic crosslinking suppresses beating. Sparsely cultured E4 cardiomyocytes on collagen-coated gels likewise show maximal contraction on matrices with native E4 stiffness, highlighting cell-intrinsic mechanosensitivity. While an optimal elasticity for striation proves consistent with the mathematics of force-driven sarcomere registration, contraction wave speed is linear in Et as theorized for excitation-contraction coupled to matrix elasticity. Pluripotent stem cell-derived cardiomyocytes also prove to be mechanosensitive to matrix and thus generalize the main observation that myosin II organization and contractile function are optimally matched to the load contributed by matrix elasticity.


Subject(s)
Extracellular Matrix Proteins/biosynthesis , Heart Rate , Heart/embryology , Myocardial Contraction/physiology , Myosins/biosynthesis , Cardiac Myosins/antagonists & inhibitors , Cell Differentiation , Cells, Cultured , Collagen/biosynthesis , Collagenases/pharmacology , Elasticity , Embryonic Stem Cells/metabolism , Heterocyclic Compounds, 4 or More Rings/pharmacology , Humans , Induced Pluripotent Stem Cells/metabolism , Myocytes, Cardiac/cytology , Myofibrils/physiology , Sarcomeres/physiology
16.
Mol Pharmacol ; 83(2): 454-69, 2013 Feb.
Article in English | MEDLINE | ID: mdl-23188716

ABSTRACT

The iron-regulated metastasis suppressor, N-myc downstream-regulated gene 1 (NDRG1), is up-regulated by cellular iron depletion mediated by iron chelators and can inhibit cancer cell migration. However, the mechanism of how NDRG1 achieves this effect remains unclear. In this study, we implemented established and newly constructed NDRG1 overexpression and knockdown models using the DU145, HT29, and HCT116 cancer cell lines to investigate the molecular basis by which NDRG1 exerts its inhibitory effect on cell migration. Using these models, we demonstrated that NDRG1 overexpression inhibits cell migration by preventing actin-filament polymerization, stress fiber assembly and formation. In contrast, NDRG1 knockdown had the opposite effect. Moreover, we identified that NDRG1 inhibited an important regulatory pathway mediated by the Rho-associated, coiled-coil containing protein kinase 1 (ROCK1)/phosphorylated myosin light chain 2 (pMLC2) pathway that modulates stress fiber assembly. The phosphorylation of MLC2 is a key process in inducing stress fiber contraction, and this was shown to be markedly decreased or increased by NDRG1 overexpression or knockdown, respectively. The mechanism involved in the inhibition of MLC2 phosphorylation by NDRG1 was mediated by a significant (P < 0.001) decrease in ROCK1 expression that is a key kinase involved in MLC2 phosphorylation. Considering that NDRG1 is up-regulated after cellular iron depletion, novel thiosemicarbazone iron chelators (e.g., di-2-pyridylketone 4,4-dimethyl-3-thiosemicarbazone) were demonstrated to inhibit ROCK1/pMLC2-modulated actin-filament polymerization, stress fiber assembly, and formation via a mechanism involving NDRG1. These results highlight the role of the ROCK1/pMLC2 pathway in the NDRG1-mediated antimetastatic signaling network and the therapeutic potential of iron chelators at inhibiting metastasis.


Subject(s)
Cardiac Myosins/metabolism , Cell Cycle Proteins/metabolism , Cell Movement/drug effects , Intracellular Signaling Peptides and Proteins/metabolism , Iron Chelating Agents/pharmacology , Myosin Light Chains/metabolism , Stress Fibers/metabolism , rho-Associated Kinases/metabolism , Actins/genetics , Actins/metabolism , Cardiac Myosins/antagonists & inhibitors , Cardiac Myosins/genetics , Cell Cycle Proteins/genetics , Cell Line, Tumor , Cell Movement/genetics , Gene Knockdown Techniques , HCT116 Cells , HT29 Cells , Humans , Intracellular Signaling Peptides and Proteins/genetics , Molecular Targeted Therapy , Myosin Light Chains/antagonists & inhibitors , Myosin Light Chains/genetics , Neoplasm Metastasis , Phosphorylation/drug effects , Signal Transduction/drug effects , Signal Transduction/genetics , Thiosemicarbazones/pharmacology , rho-Associated Kinases/antagonists & inhibitors , rho-Associated Kinases/genetics
17.
Cancer Cell ; 19(1): 45-57, 2011 Jan 18.
Article in English | MEDLINE | ID: mdl-21215707

ABSTRACT

We show that in melanoma cells oncogenic BRAF, acting through MEK and the transcription factor BRN2, downregulates the cGMP-specific phosphodiesterase PDE5A. Although PDE5A downregulation causes a small decrease in proliferation, its major impact is to stimulate a dramatic increase in melanoma cell invasion. This is because PDE5A downregulation leads to an increase in cGMP, which induces an increase in cytosolic Ca(2+), stimulating increased contractility and inducing invasion. PDE5A downregulation also this leads to an increase in short-term and long-term colonization of the lungs by melanoma cells. We do not observe this pathway in NRAS mutant melanoma or BRAF mutant colorectal cells. Thus, we show that in melanoma cells oncogenic BRAF induces invasion through downregulation of PDE5A.


Subject(s)
Cyclic Nucleotide Phosphodiesterases, Type 5/metabolism , Down-Regulation/genetics , Gene Expression Regulation, Neoplastic/physiology , Melanoma/pathology , Proto-Oncogene Proteins B-raf/metabolism , Animals , Calcimycin/pharmacology , Calcium/antagonists & inhibitors , Calcium/metabolism , Cardiac Myosins/antagonists & inhibitors , Cardiac Myosins/metabolism , Cell Line, Tumor , Cell Movement/drug effects , Cell Movement/genetics , Cell Proliferation , Cyclic GMP/analogs & derivatives , Cyclic GMP/metabolism , Cyclic GMP/pharmacology , Cyclic Nucleotide Phosphodiesterases, Type 5/genetics , Gene Expression/drug effects , Gene Expression/genetics , Gene Expression Regulation, Neoplastic/drug effects , Heterocyclic Compounds, 4 or More Rings/pharmacology , Homeodomain Proteins/metabolism , Humans , Lung Neoplasms/pathology , Lung Neoplasms/prevention & control , Lung Neoplasms/secondary , Melanoma/metabolism , Mice , Mice, Nude , Myosin Light Chains/antagonists & inhibitors , Myosin Light Chains/metabolism , Neoplasm Invasiveness/pathology , Neoplasm Invasiveness/prevention & control , POU Domain Factors/metabolism , Phosphodiesterase 5 Inhibitors/pharmacology , Phosphorylation/drug effects , Promoter Regions, Genetic/genetics , Protein Binding/genetics , Protein Kinase Inhibitors/pharmacology , Proto-Oncogene Proteins B-raf/antagonists & inhibitors , Proto-Oncogene Proteins B-raf/genetics , RNA, Small Interfering/genetics , Transplantation, Heterologous/pathology
18.
Cell Motil Cytoskeleton ; 65(2): 100-15, 2008 Feb.
Article in English | MEDLINE | ID: mdl-17968985

ABSTRACT

Phosphorylation of myosin regulatory light chain (RLC) at Ser19 (mono-phosphorylation) promotes filament assembly and enhances actin-activated ATPase activity of non-muscle myosin, while phosphorylation at both Ser19 and Thr18 (di-phosphorylation) further enhances the ATPase activity. However, it has not well been addressed which type of phosphorylation is important in regulating myosin during cytokinesis. Here, we investigated subcellular localization in sea urchin eggs of mono-phosphorylated and di-phosphorylated RLC by both quantitative biochemical and spatiotemporal cytological approaches. Mono-phosphorylated RLC was dominant in the equatorial cortex throughout the whole process of cytokinesis. Inhibition of myosin light chain kinase (MLCK) decreased mono-phosphorylated RLC both in the cortex and in the cleavage furrow, and blocked both formation and contraction of the contractile ring. Two different types of ROCK inhibitor gave inconsistent results: H1152 blocked both RLC mono-phosphorylation in the cleavage furrow and contraction of the contractile ring, while Y27632 affected neither the mono-phosphorylation nor cell division. These results suggest that there may be other targets of H1152 than ROCK, which is involved in the RLC phosphorylation in the cleavage furrow. Furthermore, it was revealed that localization of myosin heavy chain in the cleavage furrow, but not in the cortex, was perturbed by inhibition of RLC mono-phosphorylation. These results suggested that RLC mono-phosphorylation by more than two RLC kinases play a main role in regulation and localization of myosin in the dividing sea urchin eggs.


Subject(s)
Cardiac Myosins/metabolism , Cleavage Stage, Ovum/cytology , Cleavage Stage, Ovum/metabolism , Myosin Light Chains/metabolism , Ovum/cytology , Ovum/metabolism , Adenosine Triphosphatases/metabolism , Amides/pharmacology , Aniline Compounds , Animals , Azepines/pharmacology , Cardiac Myosins/antagonists & inhibitors , Cell Division/physiology , Cells, Cultured , Cloning, Molecular , Cytokinesis/physiology , Dose-Response Relationship, Drug , Enzyme Inhibitors/pharmacology , Myosin Light Chains/antagonists & inhibitors , Myosin-Light-Chain Kinase/metabolism , Naphthalenes/pharmacology , Phosphorylation , Pyridines/pharmacology , Sea Urchins , Serine/metabolism , rho-Associated Kinases/metabolism
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