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<p>Atherosclerosis is a chronic inflammatory disease of the arterial wall and is the primary cause of coronary artery disease, the most common cause of death in western societies. Risk factors for cardiovascular disease include dyslipidemia, diabetes, smoking, and obesity. These risk factors have also been shown to promote vascular endoplasmic reticulum (ER) stress; a cellular response characterized by the accumulation of misfolded proteins in the ER. Thickening and decreased stability of arterial plaque can lead to thrombosis and subsequent clinical complications of myocardial infarction and stroke. However, the exact mechanisms that lead to the development of atherosclerosis remain unclear. Here we show that inhibition, as well as a deficiency of glycogen synthase kinase (GSK)-3α, can protect against accelerated atherosclerosis in a low-density lipoprotein receptor (LDLR) knockout mouse model. Compared to LDLR^-/- controls, mice deficient in GSK-3α showed a decrease in lesion volume in the aortic root as well as protection against diet-induced hepatic steatosis. In addition, necrotic core volume was significantly reduced in LDLR^-/-GSK-3α^-/- mice compared to controls, a characteristic indicative of advanced plaque formation. Furthermore, hepatic and vascular ER stress levels were unaffected by the deletion of GSK-3α, a result that is consistent with the hypothesis that GSK-3α functions downstream of ER stress. Macrophages isolated from GSK-3α deficient mice had a reduction in unesterified cholesterol accumulation as well as a significant increase in the expression of the anti-inflammatory cytokine IL-10. Finally, BMT experiments showed a significant decrease in plaque size in the aortic sinus of LDLR^-/-GSK-3α^+/+ mice transplanted with GSK-3α deficient bone marrow. These results demonstrate a possible link between ER stress-induced activation of GSK-3α and the downstream effects leading to atherogenic initiation and progression.</p> / Master of Science (MSc)

Cigarette smoke contributes to 90% of lung cancer cases and 80% of COPD cases. These concerns loom large as lung cancer represents 13% of all cancer deaths and estimates report by 2020 COPD will be the third leading cause of death in the world. The master regulator of the ER stress response, IRE-1, in the context of cigarette smoke exposure lacks study. Interestingly, its downstream pathways are activated. In fact, the 2014 Surgeon General’s report on the health consequences of smoking highlighted the endoplasmic reticulum (ER) stress response as a potential mechanism leading to the development of lung cancer and Chronic Obstructive Pulmonary Disorder (COPD). Following acute cigarette smoke exposure, mouse lung homogenates exhibited increased levels of XBP-1 along with downstream mediators of IRE-1 activation— GRP-78 and CHOP. Specifically observing macrophages, an important immune cell and source of acute inflammation, cigarette smoke induced activation of IRE-1/XBP-1 pathway through splicing of XBP-1 mRNA. However, upon assaying for pro-inflammatory cytokines we were unable to determine that cigarette smoke directly caused inflammation in vitro. Furthermore, cigarette smoke inhibited the activation of M2 macrophages, an anti-inflammatory and tissue healing subset seen through CCL18 inhibition. A majority of M2 and M1 macrophage markers were decreased from IRE-1/XBP-1 inhibition. This suggests a different phenotype than classical M1 or M2 polarization being induced by cigarette smoke. In addition, it suggests the IRE-1/XBP-1 pathway having a robust role in controlling gene expression and balance of cellular proteomics. / Thesis / Master of Science (MSc) / Cigarette smoke exposure damages the lungs and over time places the user at risk for increased infections, progressive decreases in lung function and cancer. A specific cell of the immune system and found in the lungs, macrophages or “Big Eater” cells, responds first by picking up debris and responding to harmful foreign substances by releasing proteins signaling the immune system to become activated. Within all animal cells, an organelle called the Endoplasmic Reticulum (ER) manufactures a third of proteins produced allowing the cell to adapt to foreign substances, including cigarette smoke. Cigarette smoke could cause the ER, a plastic organelle, to change in size and function at a heightened level due to activation of a sensing protein integrated in the ER, Inositol Requiring Enzyme-1 (IRE-1). Both activation of the ER and cigarette smoke causes macrophages to behave as “tissue-healing” or M2 subsets that release factors promoting reconstruction of the lungs; alternatively, M1 macrophages fight diseases and promote further inflammation. Using genetic analysis of macrophages exposed to cigarette smoke in culture dishes and analyzing the proteins secreted, we determined cigarette smoke inhibits M1 macrophages and the “tissue-healing” subset, while increasing adhesion molecule expression. Overall, cigarette smoke affected the polarization of M1 and M2 phenotype, analyzed through proteins and genes expression. We observed an increase in sXBP-1, indicative of IRE-1/XBP-1 pathway activation, from cigarette smoke extract exposure in macrophages. However, the use of IRE-1 inhibitors increased ER stress markers while affecting M1 and M2 markers. This suggests ER compensation from the use of inhibiting one arm of the ER stress response.

Tissue fibrosis occurs in the advanced stages of various chronic diseases and can account for 45% of all deaths related to chronic diseases worldwide. The extracellular matrix (ECM) components comprising the fibrotic scar are primarily derived from myofibroblasts, which are contractile fibroblasts arising from the trans-differentiation of several cellular progenitors. Disturbances in immune cell infiltration and function could lead to the uncontrolled production of pro/anti-inflammatory mediators, which may alter the phenotype, state, and function of myofibroblasts progenitors, leading to aberrant wound repair and pathological fibrosis. A great deal of knowledge has implicated macrophages in the pathogenesis and exacerbation of the fibrotic process. Nonetheless, much remains to be elucidated on the potential mechanisms regulating macrophage accumulation and pro-fibrotic polarization, and whether these mechanisms can be further investigated to modulate tissue repair. The Endoplasmic reticulum (ER) stress has recently been implicated as a key mechanism that propagates the pathogenesis of the fibrotic process. How ER stress precisely impacts the fibrotic process is still unclear. This thesis partly explored how modulating the outcome of ER stress – the unfolded protein response (UPR), would affect the severity of lung fibrosis and addressed the role of IL-6 signalling in macrophages during fibrosis. The data demonstrated that UPR activation in pro-fibrotic macrophages and partial deficiency of Grp78, the master regulator of the UPR, abrogated pulmonary fibrotic changes and reduced the accumulation of pro-fibrotic (M2-like) macrophages. These findings were later associated with high TUNEL levels, 7AAD positive cells, Chop and cleaved caspase 3 levels, which are suggestive of GRP78 mediated apoptosis in this population. On the contrary, mice lacking a terminal UPR mediator of apoptosis, called Chop, had increased ECM deposition and greater persistence of non-apoptotic macrophages. These findings suggest that UPR-mediated macrophage polarization and apoptosis may alter lung wound repair processes. As IL-6 synergized the effect of IL-4 to promote a hyper M2 macrophage state, it provided a unique and compelling model to study the dynamics of macrophage alternative programming, which has set the stage to investigate whether the UPR was implicated in the generation of a hyper pro-fibrotic macrophage phenotype. This hyper M2 macrophage model led to the identification of ER expansion program and the IRE1-XBP1 arm of the UPR in pro-fibrotic macrophage polarization, and suggested an unprecedented in vivo role of IL-6 in priming macrophages in the injured lungs to possibly potentiate pathological wound repair. Looking forward, many questions remain to be answered in order to precisely identify the vital UPR axis regulating ER expansion in macrophages during pathological wound repair and to get closer to the understanding of whether the UPR modulates the pro-fibrotic/pro-resolving capacity of macrophages. Insights on these mechanisms may facilitate the development of therapeutics that better manage chronic fibrotic diseases which pose fatal consequences and increase public concern. / Thesis / Doctor of Philosophy (PhD)

While the impacts of maternal obesity on placental development have been extensively studied, the role of the father’s health in regulating placentation is less understood. Paternal obesity is associated with offspring metabolic dysfunction, but the mechanism regulating this association is unclear. We investigated how paternal diet-induced obesity impacted placental vascular development, associated cellular stress pathways, and markers of placental endocrine function and macronutrient transport across gestation in a murine model. We found that paternal obesity is associated with placental hypoxia as measured by CAIX and HIF1α at E14.5 which persisted to E18.5. Hypoxia was associated with increased VEGF protein levels, as well as its pro-angiogenic receptor, VEGFR2 in male and female E14.5 placentae, although, this increase was apparent only in females at E18.5. The proportion of placental tissue that was immunopositive for the endothelial cell marker CD31 was increased in female but not male E18.5 placentae. Paternal obesity was associated with cellular stress as measured by the three branches of the unfolded protein response (UPR): ATF6, PERK, and IRE1α. However, despite increased phosphorylation of PERK and IRE1α in placental tissue derived from obese fathers, there was no impact on downstream signal transducers. Pro-apoptotic Bcl2 family members’ transcript levels were reduced at E18.5 in placentae from obese fathers, but this did not correspond to any changes in cleaved casp-3 protein levels. Placental lactogen and macronutrient transporter transcript levels were similar between groups across gestation, although Igf2 transcripts were increased in female placenta from obese fathers at both mid and late gestation. Thus, paternal obesity results in placental hypoxia and VEGF mediated sex specific changes in vascularization with a pro-angiogenic response occurring in females. Future studies will investigate whether paternal obesity impairs early placental implantation, resulting in poor vascularization and hypoxia at E18.5. / Thesis / Master of Science (MSc)

The global prevalence of chronic kidney disease (CKD) has risen at an accelerating rate, increasing the global healthcare burden for long-term and chronic care costs. Multiple risk factors including hypertension, diabetes, and dyslipidemia synergistically induce the progression of CKD. Chief among these factors are dyslipidemia and obesity; increased free fatty acid uptake due to excess consumption of lipid-rich diets has been shown to promote intra-renal lipid accumulation in several in vivo models and in patients in various stages of CKD. Furthermore, patients with renal disease are also at a substantially higher risk for atherosclerotic cardiovascular disease (CVD). In the general population, as well as in patients with renal disease, circulating low-density lipoprotein cholesterol (LDLc) is a well-established driver of atherosclerotic lesion development and CVD progression. In 2003, the proprotein convertase subtilisin/kexin type-9 (PCSK9) was identified as the third locus of familial hypercholesterolemia and was further characterized for its ability to enhance the degradation of the low-density lipoprotein receptor (LDLR). Since this seminal discovery, the development of monoclonal antibodies targeted against PCSK9 demonstrated a significant reduction in LDLc and subsequent CVD risk, establishing the remarkable ‘bench to bedside’ transition. However, the inherent role of PCSK9 in regulating lipid homeostasis remained unknown in different pathological conditions. In the first chapter of my thesis, I demonstrate that PCSK9 regulates the LDLR as a feedback mechanism to protect against non-alcoholic steatohepatitis (NASH) progression induced by a high-fat diet (HFD) challenge. Since its seminal discovery, PCSK9 was also characterized to modulate a wide variety of receptors known to play a crucial role in lipid metabolism including the cluster of differentiation 36 (CD36), the very low-density lipoprotein receptor (VLDLR), and the apolipoprotein E receptor 2 (ApoER2). Previously, we have demonstrated that the absence of PCSK9 promotes diet-induced non-alcoholic steatohepatitis and liver injury through increased surface expression of CD36. Given that these same receptors are well-expressed on renal epithelia, the second chapter of my thesis demonstrates that PCSK9 is also able to modulate renal lipid metabolism by attenuating tubular lipid accumulation and subsequent renal injury. Furthermore, when PCSK9 was first characterized by Seidah and colleagues in 2003, in situ hybridization of murine PCSK9 demonstrated that it was primarily expressed in the liver, but also well-expressed in the kidney cortex, cerebellum, and small intestines. Despite its expression in a wide range of tissues, the secretion of PCSK9 was exclusive to the liver, thus, questioning what the intracellular role of PCSK9 may be. Hence, my last chapter of my masters studies lies in establishing the role of intracellular PCSK9 expression in a cellular process known as endoplasmic reticulum (ER) stress in the kidney. ER stress is a phenomena which primarily occurs due to increased accumulation of misfolded polypeptides, and has been implicated in numerous metabolic diseases including hepatic steatosis, CKD, and neurodegenerative pathologies. Previously, we have demonstrated that overexpressing wild-type and variants of PCSK9 in a Pcsk9-/- mouse does not induce the activation of the unfolded protein response (UPR) and attenuates hepatic ER stress. Using a well-established CKD model, I show that Pcsk9-/- mice exhibit increased renal ER stress and injury relative to wild-type controls. Overall, my findings demonstrate for the first time that both extracellular and intracellular PCSK9 has the ability to modulate renal injury using two distinct mechanism to protect against CKD progression. / Thesis / Master of Health Sciences (MSc)

L’amélioration constante du pronostic des pathologies cancéreuses est le fruit des progrès réalisés dans leur prévention, leur dépistage, leur diagnostic et leur traitement. Malgré l’avènement récent des thérapies ciblées, la chimiothérapie conventionnelle reste souvent le seul recours pour des patients atteints de cancer non opérable ou non éligibles pour ces thérapeutiques novatrices. Certaines chimiothérapies conventionnelles (anthracyclines et oxaliplatine notamment) ont la capacité d’entrainer une mort des cellules tumorales dont les caractéristiques permettent d’induire une réponse immunitaire antitumorale efficace. Cette réponse immunitaire antitumorale spécifique agirait en synergie avec l’effet cytotoxique direct de ces drogues, participant ainsi à leur efficacité. La réponse immunitaire antitumorale induite par la chimiothérapie dépend de plusieurs mécanismes moléculaires et cellulaires clefs identifiés récemment. L’induction d’un stress du réticulum endoplasmique (RE) est à l’origine de l’exposition d’une protéine chaperonne résidente du RE, la calréticuline (CRT), à la surface des cellules mourantes, servant alors de signal de phagocytose pour les cellules dendritiques. La libération dans le milieu extracellulaire de signaux de danger est également essentielle : la protéine nucléaire High Mobility Group Box 1 (HMGB1) sert ainsi de ligand pour le Toll-like récepteur 4 (TLR4), présent à la surface des cellules dendritiques et son activation favorise l’apprêtement et la présentation des antigènes tumoraux aux lymphocytes T cytotoxiques. L’adénosine-5'-triphosphate (ATP) est également libéré par les cellules tumorales, entrainant l’activation des récepteurs purinergiques P2RX7 présents à la surface des cellules dendritiques, activant l’inflammasome NLRP3 et entrainant la libération d’IL-1 par les cellules dendritiques, favorisant alors l’orientation de la réponse immunitaire vers une réponse de type TH1 et la production d’interféron  par les lymphocytes T cytotoxiques. Dans ce travail, nous avons cherché à comparer la capacité de deux drogues issues d’une même classe de chimiothérapie, les sels de platine, à induire une mort cellulaire immunogène des cellules tumorales. Grace à des expériences in vitro et in vivo (modèles murins de vaccination antitumorale et de chimiothérapie sur tumeurs établies), nous avons pu montrer que l’oxaliplatine (OXP), contrairement au cisplatine (CDDP), avait la capacité d’induire une mort immunogène des cellules de cancer colique et que cette différence intra-classe dépendait de la capacité respective de ces deux drogues à entrainer un des phénomènes clés de l’induction d’une mort cellulaire immunogène, l’exposition de la CRT à la surface des cellules tumorales mourantes. Nous avons également pu montrer que l’induction d’une mort cellulaire immunogène des cellules de cancer colique par l’oxaliplatine avait une relevance clinique chez l’homme, l’existence d’un polymorphisme perte-de-fonction du gène tlr4 affectant le pronostic (survie sans progression) de patients traités par chimiothérapie pour un cancer colique métastatique. Par la suite, nous avons mis au point des biosondes permettant d’étudier à grande échelle, à l’aide d’une plateforme de vidéo-microscopie automatisée, la capacité de différentes drogues à induire les différents phénomènes clefs de la mort cellulaire immunogène des cellules tumorales (exposition de la CRT, libération d’HMGB1 et d’ATP). Nous avons ainsi pu montrer que la correction pharmaceutique du défaut d’activation d’un stress du réticulum endoplasmique par le cisplatine permettait de restaurer l’immunogénicité de la mort cellulaire induite par cette chimiothérapie. Ces résultats ouvrent la voie à la découverte de nouvelles molécules susceptibles, à elles seules ou en association à d’autres thérapies connues, d’améliorer le pronostic des néoplasies. / The steady improvement of cancer prognosis is the result of progress in cancer prevention, screening, diagnosis and treatment. Despite the recent advent of targeted therapies, conventional chemotherapy often remains the only solution for patients with non-operable cancer or not eligible for these novel therapies.Some conventional chemotherapy (including anthracyclines and oxaliplatin) has the ability to cause tumor cells death with characteristics able to induce an effective antitumor immune response. This specific antitumor immune response would be synergistic with the direct cytotoxic effect of these drugs and contribute to their efficacy. The antitumor immune response induced by chemotherapy depends on several key cellular and molecular mechanisms recently identified. The induction of an endoplasmic reticulum (ER) stress is necessary for the exposure of calreticulin (CRT), an ER-resident chaperone protein, on the surface of dying cells, then acting as a phagocytosis signal for dendritic cells. Release of danger signals into the extracellular medium is also essential. The nuclear protein High Mobility Group Box 1 (HMGB1) is a ligand of the Toll-like receptor 4 (TLR4) on the surface of dendritic cells. TLR4 activation promotes the processing of tumor antigens and their presentation to cytotoxic T lymphocytes. Adenosine-5'-triphosphate (ATP) is also released by tumor cells, leading to the activation of the purinergic receptors P2RX7 expressed on the surface of dendritic cells, activating the NLRP3 inflammasome and causing the release of IL-1β by dendritic cells, while promoting the orientation of the immune response towards a TH1 response and the production of γ-interferon by cytotoxic T lymphocytes.In this work, we aimed to compare the ability of two drugs of a same class of chemotherapy, the platinum derivates oxaliplatin (OXP) and cisplatin (CDDP), to induce immunogenic death of tumor cells. Thanks to in vitro and in vivo experiments (models of tumor vaccination and chemotherapy on established tumors in mice), we showed that OXP, in contrast to CDDP, has the ability to induce immunogenic death of colon cancer cells. This intra-class difference depends on the ability of each drug to cause one of the key phenomena of immunogenic cell death: the induction of the exposure of the CRT to the surface of dying tumor cells. We could also show that the induction of immunogenic death of colon cancer cells by OXP had clinical relevance in humans. Indeed, the existence of a loss-of-function polymorphism of tlr4 affects the prognosis (PFS) of patients treated with OXP-based chemotherapy regimen for a metastatic colorectal cancer. Subsequently, we developed biosensors to study the ability of different drugs to induce key phenomena of cell death immunogen tumor cells (CRT exposure, HMGB1 and ATP release) using high-content screening by an automated video-microscopy platform. We showed that a pharmaceutical correction of the inability of cisplatin to induce an endoplasmic reticulum stress could restore the immunogenicity of cisplatin-induced tumor cell death. These results open the way to the discovery of new molecules that, alone or in combination with other known therapies, could improve the prognosis of cancer.

P53 est un facteur de transcription qui se décline, chez l’homme, la souris ou la drosophile, en plusieurs isoformes. Chez la drosophile deux isoformes ont été caractérisées : la forme canonique Dp53 ; et une forme tronquée, D∆Np53, dont le domaine de transactivation est incomplet. Une des questions encore peu étudiée, concerne les mécanismes par lesquels p53 régule une grande variété de réponses cellulaires lors d’un stress. Pour répondre à cette question, nous avons étudié le rôle des isoformes de p53 dans la régulation de deux mécanismes antagoniste en lien avec la maladie de Parkinson (MP) : l’autophagie et l’apoptose en réponse à un stress délétère et un stress hormétique du système nerveux. Nous avons montré que les drosophiles portant une mutation nulle de p53 sont plus sensibles aux effets du paraquat (fort stress oxydant, modèle chimique de la maladie de Parkinson). En absence de p53, ce stress cause une forte inhibition de l’initiation et du flux de l’autophagie accompagné d’une augmentation des niveaux de caspases et de la mortalité. L’augmentation de la mortalité et des niveaux de caspases est similaire chez des mutants de l’autophagie pour lesquels le flux d’autophagie est constitutivement altéré. D’autre part, nous avons montré que les deux isoformes de p53 (Dp53 et D∆Np53) régulent différemment l’apoptose et l’autophagie dans les neurones photorécepteurs de drosophile : l’isoforme Dp53 présente un flux autophagique fonctionnel retardant la neurodégénérescence, tandis que, l’isoforme D∆Np53 inhibe le flux d’autophagie via l’activation des caspases Dcp1, Drice et Dronc. Enfin, nous avons établi un lien entre p53 et le stress du réticulum endoplasmique (RE). Dans un premier temps nous avons montré qu’un stress modéré du RE (pré-conditionnement) a un effet protecteur dépendant de l’activation de l’autophagie dans différents modèles de la MD. Ensuite, nous avons montré que les trois banches de la réponse au stress du RE (IRE1, Atf6 et PERK) sont impliquées dans cet effet protecteur. Enfin, nous avons montré que les drosophiles mutantes pour p53 perdent l’effet protecteur du pré-conditionnement. L’ensemble de nos résultats apporte de nouveaux éléments sur l’aspect multifonctionnel de p53 en réponse à un stress dans le système nerveux. Via ses multiples isoformes, p53 peut activer deux réponses antagonistes : l’autophagie et l’apoptose, permettant aux cellules une réponse flexible face à une situation de stress. La régulation de l’autophagie par p53 est protectrice et apparait comme étant une fonction ancestrale de p53. / P53 is a tumor suppressor gene, which has been showed to regulate several cellular pathways. Upon stress, p53 triggers multiple cellular pathways including DNA repair system, cell cycle arrest, apoptosis and autophagy. Thus, p53 is involved in both cellular protection and death pathways. One of the major questions is to understand how a single protein can promote so many different pathways. Here I address the putative role of p53 isoforms in the regulation of autophagy and apoptosis and their role in neuron survival in the context of Parkinson’s disease (PD). We show that p53 mutants are more susceptible to paraquat toxicity (chemical model of PD), indicating a protective role for p53. We also found that Atg8 mutant, which display an impaired autophagy, behave similarly to p53 upon paraquat treatment. In addition, we show that p53 is required for the activation of autophagy with a functional autophagy flux upon paraquat treatment and that lack of p53 or Atg8 results in an accumulation of activated caspases after paraquat treatment. Moreover, we found that autophagy and apoptosis were differentially regulated by different p53 isoforms. The Dp53 (p53B) isoform induced protective autophagy, whereas the D∆Np53 (p53A) isoform inhibited autophagy by activating the caspases Dronc, Drice and Dcp-1 in differentiated neurons. Our results demonstrate that a combination of the differential use of p53 isoforms and the antagonism between apoptosis and autophagy favors the generation of an appropriate p53 biological response to stress. In addition, we have defined in vitro and in vivo experimental conditions in which the activation of the Unfolded Protein Response (UPR) does not induce cell or organism lethality but rather promotes an adaptive response that protects from apoptotic stimuli. We show that this mild activation, known as ER-preconditioning is protective in several models of PD in an autophagy-dependent fashion. We showed that the three branches of the UPR are involved in the protective effect induced by ER-preconditioning. We then demonstrated that p53 is necessary to mediate the protection by ER-preconditioning suggesting that p53 may be a key factor in the integration of stress responses. Together our results reveal new aspects of the multi-functionality of p53. Activation of the antagonist pathways: autophagy and apoptosis by p53 isoforms, leads to flexible and adaptive response to stress. In addition, our results suggest that the regulation of autophagy by p53 is a ancestral protective function of p53.

Crohn’s disease (CD) affects about 780,000 people in the United States alone, and it is estimated that 6-15 per 100,000 persons will receive a diagnosis of this disease each year. There currently is no cure for Crohn’s disease, and available medical therapies simply serve to alleviate the inflammation. This does not help treat fibrostenosis that Crohn’s disease patients may develop, which can only be treated surgically. Finding alternatives to treat CD requires an understanding of mechanisms at the biochemical level. In this thesis, we attempted to gain a better understanding of certain pathways found to be active in Crohn’s disease-affected ileal smooth muscle cells. We found an upregulation of the ER stress pathway via expression of its surrogate, the GRP78 protein. We also showed evidence that the phosphoinositide 3-kinase (PI3K) pathway, a key proliferative pathway, is linked to ER stress in these cells, and is an upstream driving force of the ER stress response. Further research on the link between the PI3K and ER stress pathways needs to be conducted, and can potentially serve as a target for therapeutics to help reduce proliferation in fibrostenotic Crohn’s disease-affected ileal smooth muscle cells.

Cardiac function is regulated by the molecular components of the sarco/endoplasmic reticulum (ER/SR). Disruptions in homeostatic balance of these proteins and calcium regulation results in activation of ER stress response. Sarcolemmal membrane-associated proteins (SLMAPs) are found in cell membrane, SR/ER, and mitochondria. Overexpression of SLMAP in the myocardium has shown to impair excitation-contraction (E-C) coupling in the transgenic (Tg) mice. ER stress response was examined in Tg mice overexpressing SLMAP in the myocardium. In Tg hearts, changes observed in the expression of proteins involved in ER stress were dependent on the age and sex. SLMAP overexpression results in maladaptive ER stress response, as the mice age. Neonatal cardiomyocytes isolated from the Tg hearts showed decreased viability, upregulation of ER stress response proteins, which were sensitized to thapsigargin-induced stress, and desensitized to palmitate-induced oxidative stress. These findings suggest that normal SLMAP levels are important for proper cardiac function, and cell viability.