Apesar dos avanços dos últimos anos, a reposição de cardiomiócitos permanece como um dos maiores desafios da medicina regenerativa. A comprovação da existência de mecanismos endógenos de proliferação cardíaca nos impulsionou a buscar o entendimento dos eventos moleculares envolvidos na proliferação de cardiomiócitos na vida pós-natal. Neste trabalho foi testada a hipótese da influência do metabolismo energético mitocondrial na cardiomiogênese, e seu impacto na regeneração cardíaca. No primeiro momento, foi descrito pela primeira vez o modelo de ressecção apical cardíaca em ratos neonatos. Demonstrou-se que há um período restrito as primeiras 24 horas de vida em que o animal é capaz de regenerar o tecido cardíaco, formando novos cardiomiócitos e permitindo a manutenção da função cardíaca na vida adulta. Esta capacidade é perdida 7 dias após o nascimento, havendo apenas reparo com tecido fibroso e prejuízo à função cardíaca. De maneira interessante, os dados apontaram para hipoperfusão da região apical em ambos os animais ressectados. Isso possivelmente acarretou em dano mitocondrial na vida adulta, sem influenciar a função cardíaca. De maneira a investigar os eventos moleculares da regeneração cardíaca neonatal foi realizado o sequenciamento de RNA dos corações de ratos neonatos de 1 e 7 dias de vida, ressectados e sham, pela técnica de RNASeq, que apontou a relevância da idade nas diferenças de expressão de genes relacionados ao metabolismo, sendo que a intervenção da ressecção pouco influenciou o perfil de expressão gênica. Os resultados mostraram a troca de expressão de isoformas da via glicolítica com a maturação pós-natal, e a hiper-regulação da expressão de genes das vias da ?-oxidação, fosforilação oxidativa e ciclo do ácido tricarboxílico durante o mesmo período. Entretanto, os dados funcionais da atividade metabólica do tecido cardíaco e cultura de cardiomiócitos neonatais mostraram que tanto a glicólise anaeróbia quanto o consumo de oxigênio relacionado à oxidação mitocondrial estiveram elevados no neonato de 1 dia, e foram reduzidos com o desenvolvimento cardíaco. As elevadas taxas de consumo de oxigênio nas culturas de cardiomiócitos de 1 dia de vida foram relacionadas principalmente à produção de ATP. Esses cardiomiócitos foram capazes de proliferar em cultura na presença de soro como estimulador. Assim sendo, as análises de expressão gênica sozinhas pareceram ser indicadores parciais do estado funcional do metabolismo. A inibição não letal da fosforilação oxidativa evidenciou a importância do metabolismo mitocondrial na capacidade proliferativa dos cardiomiócitos na vida pós-natal. Os dados sugerem que o primeiro dia após o nascimento abrange uma alta demanda energética tanto para a diferenciação terminal quanto para a última fase robusta de proliferação de cardiomiócitos na vida pós-natal, e assim evidenciam a importância do metabolismo mitocondrial no processo regenerativo / Despite advances in recent years, the replacement of cardiomyocytes remains one of the biggest challenges in regenerative medicine. The existence of endogenous mechanisms of cardiac proliferation prompted us to seek the understanding of molecular events involved in cardiomyocyte proliferation in postnatal life. In this study, we investigated the influence of mitochondrial energy metabolism in cardiomyogenesis, and its impact on cardiac regeneration. At first, it was described for the first time the model of heart apical resection in neonatal rats, where there is a limited period the first 24 hours of life that animal is able to regenerate cardiac tissue, forming new cardiomyocytes and allowing the maintenance cardiac function in adulthood. This ability is lost seven days after birth, when repair is basically by fibrotic tissue and consequent impairment for heart function. Interestingly, data showed hypoperfusion of the apical region in both resected animals, which possibly resulted in mitochondrial damage in adulthood without affecting heart function. In order to investigate the molecular events of neonatal cardiac regeneration was performed RNA sequencing of hearts from newborn rats with 1 and 7 days of life, resected and sham, which pointed out the importance of age in the different expression of genes related to metabolism, and the intervention of resection had little influence on this. The results showed exchange of expression of enzymes isoforms from glycolytic pathway and hyperregulation of genes from beta-oxidation, oxidative phosphorylation and tricarboxylic acid cycle pathways, during postnatal maturation. However, the functional data of the metabolic activity of cardiac tissue and culture of neonatal cardiomyocytes showed that both anaerobic glycolysis and oxygen consumption related to mitochondrial oxidation were higher in 1-day-old newborns, and were reduced with cardiac development. The high rates of oxygen consumption in 1-day-old cardiomyocytes were related mainly to ATP production. These 1-day-old cardiomyocytes were able to proliferate in culture by serum stimulation. Therefore, the analysis of gene expression alone appeared to be a partial indicator of functional state of metabolism. The non-lethal inhibition of oxidative phosphorylation highlighted the importance of mitochondrial metabolism in the proliferative capacity of cardiomyocytes in postnatal life. Data suggest that the first day after birth covers a high energy demand for both terminal differentiation of cardiac cells and last robust phase of cardiomyocyte proliferation in postnatal life, and show the importance of mitochondrial metabolism in the regenerative process

Myosin II, das Motorprotein des kardialen Muskels, besteht aus zwei schweren und vier leichten Ketten. Der Hebelarmbereich der schweren Myosinkette (MyHC) enthält das IQ-Konsensus-Motiv für die Bindung der essentiellen leichten Myosinkette (ELC), welche wesentlich für eine normale Kraftentwicklung des Myosinmoleküls ist. Im Rahmen dieser Arbeit wurden fünf, mit hypertropher Kardiomyopathie assoziierte, Mutationen im humanen essentiellen ventrikulären leichten Myosinketten (hVLC1)-Gen (MYL3) untersucht (E56G, A57G, E143K, M149V, R154H). Von keiner dieser Mutationen war der Pathomechanismus bekannt. Ziel der Arbeit war es, die Effekte der Mutationen im MYL3-Gen auf Proteinstruktur und Funktion zu untersuchen und daraufhin einen möglichen Pathomechanismus zu formulieren. Dazu erfolgten Strukturanalysen (CD-Spektren, Schmelzkurven, FLIM), Versuche auf Protein- und Zellebene (Protein-Protein-Interaktionsstudien, Sorting Assay) sowie Untersuchungen in vitro (Zell-Verkürzungsmessungen, isoliert perfundierte Herzen nach Langendorff) und in vivo (Echokardiographie) im transgenen Mausmodell. / Myosin II, the motor protein of cardiac muscle, is composed of two heavy chains (MyHC) and four non-covalently linked light chains (MLC). The lever arm of the MyHC contains the IQ motif that binds the essential myosin light chain (ELC), which is necessary for the normal force production of the myosin molecule. Five with HCM associated mutations in the human ventricular essential myosin light chain (hVLC1) -gen (MYL3) were investigated in this study (E56G, A57G, E143K, M149V, R154H). The pathomechanisms of the mutations were not known. Aim of the study was i) to test the hypothesis that mutations in the ventricular essential myosin light chain affect the protein structure, the binding to the IQ motif of MyHC and the force production of the myosin molecule as well as ii) to postulate an accompanying pathomechanism. Structural analyses (circular dichroism, melting curves, fluorescence lifetime imaging microscopy), functional investigations (surface plasmon resonance spectroscopy, sorting assay) and in vivo (echocardiography) and in vitro studies in a transgenic mouse model were performed.

Es wurden die Effekte von Plättchenaktivierendem Faktor (PAF, 1-O-Alkyl-2-azetyl-sn-glyzero-3-phosphocholin) auf intrazelluläre Kalziumkonzentration und Zelllänge isolierter und feldstimulierter Kardiomyozyten der Ratte untersucht. Intrazelluläre Kalziumkonzentration und Zelllänge der feldstimulierten Zellen wurden mittels Laser-Raster-Mikroskopie simultan unter Verwendung des Kalzium-Fluoreszenzfarbstoffes Fluo-3 bestimmt. PAF (0.001nM - 10nM) inhibierte den systolischen Anstieg der intrazellulären Kalziumkonzentration zeit- und konzentrationsabhängig. Die maximalen Effekte wurden nach einer Inkubationszeit von 6-8 min beobachtet. Es kam zu 17% (0.001nM), 41% (0.1nM) und 52% (10nM PAF) Reduktion des systolischen Kalziumanstiegs. Zusätzlich konnte eine zeit- und konzentrationsabhängige Verringerung der simultan gemessenen Zellverkürzung nachgewiesen werden. Die Zellverkürzung war nach einer Inkubationszeit von 8 min um 10% (0.001nM), 32% (0.1nM) und 50% (10nM PAF) reduziert. Die Wirkungen von PAF konnten durch den Einsatz des spezifischen PAF-Rezeptorantagonisten WEB 2170 inhibiert werden. Diese Ergebnisse zeigen einen rezeptorvermittelten negativ inotropen Effekt von PAF, hervorgerufen durch eine Verringerung der systolischen intrazellulären Kalziumkonzentration ohne Desensibilisierung der Myofilamente. / We investigated the effects of platelet-activating factor (PAF, 1-O-alkyl-2-acetyl-sn-glycero-3-phosphocholine) on intracellular calciumconcentration and cell length in isolated and field-stimulated rat cardiomyocytes. Intracellular calciumconcentration and cell length of field-stimulated cells were determined simultaneously by confocal laser scan microscopy by using the fluorescent calcium dye Fluo-3. PAF (0.001nM - 10nM) inhibited systolic intracellular calciumconcentration increase in a time- and concentration-dependent manner. Maximal effects were observed after an incubation time of 6-8 min, resulting in a 17% (0.001nM), 41% (0.1nM) and 52% (10nM PAF) inhibiton of systolic calcium increase. A time- and concentration-dependent decrease in simultaneously measured cell shortening also was demonstrated. Cell shortening was inhibited by 10% (0.001nM), 32% (0.1nM) and 50% (10nM PAF) after an incubation time of 8 min. The effects of PAF could be antagonized by the PAF-receptor antagonist WEB 2170. These data demonstrate that PAF receptor-dependently induces a negativ inotropic effect, which is correlated with a decrease in systolic intracellular calciumconcentration and is most likely not due to a decrease in myofilament sensitivity.

Este estudo apresenta o desenvolvimento e validação de uma nova abordagem para a avaliação do cálcio intracelular em culturas de cardiomiócitos derivados de células-tronco pluripotentes induzidas humanas (hiPSC-CM - do inglês human induced pluripotent stem cell-derived cardiomyocytes) que pode ser aplicada para avaliar o efeito de drogas no acoplamento excitação-contração. O método consiste na estimulação elétrica e medição conjunta da fluorescência de forma automatizada e foi viabilizado a partir da inclusão de um sistema de estimulação elétrica em um leitor de ELISA (do inglês Enzyme-Linked Immunosorbent Assay). Um estimulador eletrônico compacto foi projetado para operar junto a um leitor de placas gerando pulsos quadrados monofásicos com duração de 5 ms e campo elétrico de 8 Vcm-1 aplicados por microeletrodos metálicos de platina-irídio em células em cultura. Uma placa de cultura normalmente utilizada em leitor de placas foi modificada para permitir a colocação do estimulador e dos eletrodos. A intensidade de fluorescência do cálcio intracelular foi avaliada utilizando um leitor de ELISA durante a estimulação elétrica em culturas de células marcadas com o indicador de Ca2+ Fluo-4 AM. A estimulação elétrica das células resultou em contrações regulares nas frequências de 0,1 Hz; 0,2 Hz; 0,3 Hz e 0,5 Hz induzidas pelo estimulador. Parâmetros dos transientes de cálcio foram estudados após a exposição de culturas de células ao Verapamil (0,05; 0,5 e 5,0 µM), a amplitude e a inclinação máxima da fase de subida foram progressivamente reduzidas com doses crescentes da droga. Os dados obtidos demonstraram que o método apresentado permite a avaliação automatizada de transientes de cálcio durante a estimulação elétrica de culturas de hiPSC-CM utilizando o sistema de estimulação em um leitor de ELISA. Esses resultados validaram a aplicabilidade do sistema ao estudo das alterações da dinâmica do cálcio intracelular induzidas por drogas em células sob estimulação elétrica. O sistema de avaliação automatizada desenvolvido pode ser ampliado para realizar a triagem de alto rendimento em bibliotecas de compostos que tem como alvo o acoplamento excitação-contração em células cardíacas humanas in vitro. / This study presents the development and validation of a new approach for the evaluation of intracellular calcium in cultures of cardiomyocytes derived from human induced pluripotent stem cells (hiPSC-CM), which can be applied to evaluate the effect of drugs on excitation-contraction coupling. The method consists of electrical stimulation and joint measurement of fluorescence in an automated manner and was made possible by the inclusion of an electrical stimulation system in an ELISA (Enzyme-Linked Immunosorbent Assay). A compact electronic stimulator was designed to operate inside a plate reader generating monophasic square pulses with duration of 5 ms and electric field of 8 Vcm-1 applied by platinum-iridium metal microelectrodes to cells in culture. A culture plate used in a plate reader was modified to allow placement of the stimulator and electrodes. Fluorescence intensity of intracellular calcium was measured during electrical stimulation of cell cultures loaded with Ca2+ Fluo-4 AM indicator using a plate reader. The electrical stimulation of the cells generated regularly spaced contractions following the pace of the stimulator at the frequencies of 0.1 Hz, 0.2 Hz, 0.3 Hz and 0.5 Hz. Transient profile parameters were studied after treating cell cultures with Verapamil (0.05, 0.5 and 5.0 µM) the amplitude and the maximum slope of rising phase were progressively reduced with increasing verapamil doses. The data obtained demonstrated that the method presented allows the automated evaluation of calcium transients during the electrical stimulation of hiPSC-CM cultures using the stimulation system in an ELISA reader. These results demonstrated the applicability of the system to the study of changes in the intracellular calcium dynamics induced by drugs in electrically stimulated cells. The system developed is amenable to scaling thus allowing high content automated drug library screening for compounds that target the excitationcontraction coupling in human heart cells in vitro.

Scientific research is propelled by two objectives: Understanding and recognizing the essential biology of life, and deciphering this to uncover possible therapeutics in order to improve quality of life as well as relieve pain from disease. The aim of the work described in this thesis was to dissect the fundamental requirements of induced pluripotent stem cells both in pluripotency and differentiation with a particular focus on atrial specificity. Drug targeting of atrial-specific ion channels has been difficult because of lack of availability of appropriate cardiac cells, and preclinical testing studies have been carried out in non-cardiac cell lines, heterogeneous cardiac populations or animal models that have been unable to accurately represent human cardiomyocyte physiology. Therefore, we sought out to develop a preparation of cardiomyocytes showing an atrial phenotype with adult characteristics from human induced-pluripotent stem cells. A culture programme involving the use of Gremlin 2 allowed differentiation of cardiomyocytes with an atrial phenotype from human induced-pluripotent stem cells. When these differentiated cultures were dissociated into single myocytes a substantial fraction of cells showed a rod-shaped morphology with a single central nucleus that was broadly similar to that observed in cells isolated from atrial chambers of the heart. Immunolabelling of these myocytes for cardiac proteins (including RyR2 receptors, actinin-2, F-actin) showed striations with a sarcomere spacing of slightly less than 2um. The isolated rod-shaped cells were electrically quiescent unless stimulated to fire action potentials with an amplitude of 100 mV from a resting potential of approximately -70 mV. Proteins expressed included those for IK₁, IK_ur channels. Ca²⁺ Transients recorded from spontaneously beating cultures showed increases in amplitude in response to stimulation of adrenoceptors (both alpha and beta). With the aim of identifying key signaling mechanisms in directing cell fate, our new protocol allowed differentiation of human myocytes with an atrial phenotype and adult characteristics that show functional adrenoceptor signaling pathways and are suitable for investigation of drug effects.

As doenças cardiovasculares são a principal causa de morte no mundo, sendo a cardiomiopatia isquêmica a mais prevalente. Independente da sua etiologia, a via final comum da maioria das doenças cardiovasculares é a insuficiência cardíaca. Nos últimos anos, tem sido reportado que o acúmulo de proteínas mal enoveladas no retículo endoplasmático (estresse do RE) pode contribuir para redução da função cardíaca e instalação da insuficiência cardíaca. Apesar do mecanismo responsável pela disfunção contrátil induzida pelo estresse do RE ainda não ser conhecido, evidências sugerem que a inibição da via de sinalização PI3K/AKT pela proteína JNK pode estar envolvida nessa resposta. Na primeira parte desta tese, verificamos que a indução do estresse do RE em cardiomiócitos isolados ativou a JNK, mas não inibiu a via de sinalização PI3K/AKT. A inativação de JNK reverteu a disfunção contrátil e a redução da amplitude do transiente de Ca+2 de cardiomiócitos causados pelo estresse do RE. Pelo fato da via sinalização PI3K/AKT não estar envolvida na disfunção contrátil causada pelo estresse do RE, analisamos outro alvo de JNK, a proteína BNIP3, proteína pró-apoptótica e envolvida no controle de qualidade mitocondrial promovendo mitofagia quando ativada. O estresse do RE aumentou a expressão de BNIP3, a qual foi atenuada pela inibição de JNK. A depleção de BNIP3 impediu a disfunção contrátil dos cardiomiócitos e a redução da amplitude do transiente de Ca+2 induzidos pelo estresse do RE. Na segunda parte da tese, o objetivo foi avaliar se os efeitos observados em cardiomiócitos submetidos a estresse do RE poderiam ser observados em modelo experimental de doença cardiovascular. Nesse sentido, observamos que a disfunção cardíaca provocada pelo infarto do miocárdio em ratos foi acompanhada pelo quadro de estresse do RE e pela ativação da via de sinalização JNK/BNIP3. Entretanto, o treinamento físico aeróbico (TFA), uma das principais terapias não farmacológicas mais eficazes das doenças cardiovasculares, foi capaz de atenuar o estresse RE, a ativação da via de sinalização JNK/BNIP3 e a disfunção cardíaca de ratos infartados. Na terceira parte da tese, verificamos que o TFA aumentou a expressão proteica de DERLIN-1, uma proteína que atua retro-translocando proteínas mal enoveladas para o citosol, no miocárdio de ratos saudáveis. O aumento dos níveis proteicos de DERLIN-1 observado em ratos infartados foi atenuado pelo TFA. Apesar do aumento da proteína DERLIN-1, observamos que nos animais infartados as proteínas mal enoveladas acumulavam na forma de oligômeros e que o TFA atenuou essa resposta. Em conjunto, os resultados da presente tese sugerem que a ativação da via de sinalização JNK/BNIP3 pelo estresse do RE causa disfunção contrátil de cardiomiócitos e que o TFA é capaz de atenuar essa resposta no coração de ratos infartados, melhorando o controle de qualidade de proteína no músculo cardíaco / Cardiovascular diseases are currently the main cause of death worldwide, with the ischemic cardiomyopathy as the most prevalent ethiology. This is of particular interest, since ischemic cardiomyopathy advances to heart failure, a common endpoint of the most cardiovascular disease. In the last years, it has been showed that accumulation of unfolded protein in the endoplasmic reticulum (ER stress) may cause cardiac dysfunction and heart failure development. Despite the mechanisms behind this cardiac deterioration is still unknown, evidences suggest that ER stress-induced cardiomyocytes contractile dysfunction results from PI3K/AKT signaling pathway inhibition, which would be caused by JNK activation. In the first part of this thesis, we found that the ER stress activated JNK, but different from our hypothesis it was not accompanied by an inactivation of PI3K/AKT signaling pathway. The inhibition of JNK mitigated the reduction in cardiomyocytes shortening and amplitude of Ca+2 transient caused by ER stress. Once the PI3K/AKT signaling pathway was not involved in the ER stress-induced cardiomyocytes contractile dysfunction, we have analyzed protein expression of BNIP3, another JNK target involved in apoptosis and mitochondria quality control. We observed that the elevation in BNIP3 proteins levels after ER stress induction was prevented by inhibition of JNK. BNIP3 depletion attenuated the reduction in cardiomyocytes contractility and amplitude of Ca+2 transient induced by ER stress. In the second part of the thesis, we found that myocardial infarction-induced cardiac dysfunction in rats was accompanied by ER stress and activation of JNK/BNIP3 signaling pathway. However, the AET mitigated ER stress, activation of JNK/BNIP3 signaling pathway and cardiac dysfunction in infarcted rats. In third part of the thesis, we have identified that AET increased the protein expression of DERLIN-1 an ER membrane protein that retro-translocates unfolded proteins to cytosol in the myocardial of healthy rats. We observed that the increased DERLIN-1 protein levels in infarcted rats were mitigated by AET. Despite increased DERLIN-1 protein expression, we found high levels of oligomers in the myocardium of infarcted rat, which was reduced by AET. It suggests that unfolded protein degradation was reduced in infarcted hearts. Taken together, these results suggest that ER stress causes cardiomyocytes contractile dysfunction through JNK/BNIP3 signaling pathway activation and that AET mitigates the myocardial infarction-induced ER stress and activation of JNK/BNIP3 signaling pathway by restoring of ER-associated protein quality control in the cardiac muscle

Abstract Cardiac and skeletal muscle cell contraction is a result of excitation-contraction coupling (ECC), where an electrical signal leads to a rise in intracellular calcium levels and contraction. This process is carefully regulated to meet physiological demand and heavily dependent on an adequate energy supply. Disturbed ECC can have severe consequences on muscle cell function and underlies many cardiac and skeletal muscle pathologies. Cell stress, changing intracellular Ca2+ concentrations, and calcium signal dynamics can all play a role in the transcriptional regulation of genes involved in myocyte Ca2+-handling. In this thesis project, the transcriptional control of ECC was studied in skeletal and cardiac myocytes. Skeletal myocyte calsequestrin (CASQ1) was downregulated in a mouse model of mitochondrial myopathy and it contributed to the decreased SR Ca2+ load and impaired Ca2+ handling in Tfam-/- skeletal myocytes. In cultured neonatal cardiomyocytes, mitochondrial uncoupler FCCP-induced mitochondrial dysfunction led to downregulation of cardiac calsequestrin (CASQ2) and similarly impaired Ca2+ handling. Whereas there was no increase in reactive oxygen species (ROS) levels in Tfam-/- myocytes, cultured cells exposed to FCCP did display increased ROS, an effect that was counteracted by coexposure with the ROS scavenger (NAC). NAC attenuated FCCP-induced CASQ2 downregulation and restored Ca2+ handling. Therefore, mitochondrial dysfunction led to CASQ1/2 downregulation and impaired Ca2+ handling in these two cell types, but by different mechanisms. This project also looked at the role of Ca2+ dynamics on the transcriptional regulation of Ca2+ handling genes. Increased intracellular Ca2+ levels and β-adrenergic stimulation of cardiomyocytes activate Ca2+-calmodulin kinase II (CaMKII) and can trigger hypertrophic remodeling. It was found that CaMKII downregulated expression of the L-type Ca2+ channel α1c-subunit (Cacna1c) in cultured cardiomyocytes. Analysis of the Cacna1c promoter revealed that the transcriptional repressor DREAM bound to a putative downstream regulatory element. The results shed light on the complex interplay between muscle cell energetics and transcriptional regulation of SR Ca2+ handling proteins. A unique pathway for Cacna1c transcriptional regulation by CaMKII and DREAM was also described. / Tiivistelmä Sydän- ja luustolihassolujen supistuminen on seurausta ärsytys-supistuskytkennästä (ECC), jossa sähköinen ärsytys kohottaa solunsisäistä kalsiumpitoisuutta ja aiheuttaa supistuksen. Tätä säädellään tarkasti fysiologisen tarpeen mukaan, ja se riippuu riittävästä energian saannista. Häiriintynyt ECC voi aiheuttaa vakavia seurauksia lihassolujen toiminnalle, ja se on mukana monien sydän- ja luustolihasten sairauksien synnyssä. Tässä tutkimuksessa ECC:n transkriptionaalista säätelyä tutkittiin luustolihasten ja sydämen lihassoluissa. Luustolihassolujen kalsekvestriinin (CASQ1) väheneminen pienensi SR:n Ca2+-määrää mitokondrioiden myopatian hiirimallissa ja heikensi Ca2+-tasapainon ylläpitoa Tfam-/--luustolihassoluissa. Viljellyissä vastasyntyneiden kammio-sydänlihassoluissa mitokondrio-irtikytkijän FCCP:n aiheuttama mitokondrioiden toimintahäiriö johti sydämen kalsekvestriinin (CASQ2) vähenemiseen ja heikensi samalla tavalla Ca2+-tasapainon ylläpitoa. Vaikka Tfam-/--myosyyteissä reaktiivisten happilajien (ROS) tasot eivät olleet koholla, FCCP:lle altistetuissa viljellyissä soluissa ROS kuitenkin lisääntyi. Vaikutusta esti ROS-puhdistaja NAC, joka heikensi FCCP:n aiheuttamaa CASQ2:n laskua ja palautti Ca2+-säätelyn normaaliksi. Mitokondrioiden toimintahäiriö siis johti CASQ1/2:n vähenemiseen ja Ca2+-säätelyn heikentymiseen molemmissa solutyypeissä, mutta eri mekanismeilla. Tässä tutkimuksessa tarkasteltiin myös Ca2+-dynamiikan osuutta Ca2+-tasapainoon osallistuvien geenien transkription säätelyssä. Lisääntynyt solunsisäinen Ca2+-taso ja sydänlihassolujen β-adrenerginen stimulointi aktivoivat Ca2+-kalmoduliinikinaasi II:n (CaMKII), ja ne voivat laukaista sydämen hypertrofisen uudelleenmuovautumisen. Havaittiin, että CaMKII vähensi L-tyypin Ca2+-kanavan a1c-alayksikön (Cacna1c) ilmentymistä viljellyissä sydänlihassoluissa. Promoottorianalyysi osoitti tämän johtuvan transkription repressorin DREAM:n sitoutumisesta oletettuun DRE:hen (alavirrassa sijaitseva säätelyelementti). Nämä tulokset tuovat uutta tietoa lihassolujen energiatalouden ja SR:n Ca2+:n vaikuttavien proteiinien transkription säätelyn vuorovaikutuksesta. Lisäksi havaittiin ainutlaatuinen Cacna1c-transkription säätelyn reitti, johon osallistuvat CaMKII ja DREAM.

L'objectif du travail est d'étudier les mécanismes de régulation in situ de la respiration mitochondriale des cellules musculaires afin de comprendre l'interdépendance entre la régulation de la respiration, les flux énergétiques et l'organisation structurale des cellules.<br />Pour cela, nous avons analysé la cinétique de la régulation de la respiration des cellules cardiaques perméabilisées en présence d'un système mimant les effets du système glycolytique in situ, et par microscopie confocal, l'organisation mitochondriale a été étudiée. <br />Les résultats montrent que les propriétés cinétiques de la MtCK in situ diffèrent significativement de celles des mitochondries isolées et que la régulation de la respiration in vivo est une propriété dépendant du niveau d'organisation du système, comprenant les interactions mitochondries-cytosquelette, les MgATPases cellulaires, le système d'enzymes glycolytiques du cytoplasme et les mécanismes de phosphotransfert via la navette PCr/CK, ceci afin de faire face aux restrictions hautement sélectives de la diffusion au niveau de la membrane externe mitochondriale in situ.<br />De plus, l'effet cardiotoxique de la doxorubicine sur les fibres cardiaques a été étudié, se traduisant par la perte du couplage fonctionnel de la MtCK avec l'oxydation phosphorylante.<br />Ce protocole a également été appliqué lors d'investigations cliniques sur des biopsies du muscle vaste latéral externe, chez les patients atteints de bronchopneumopathie chronique obstructive. Le dysfonctionnement musculaire est caractérisé par une affinité élevée pour l'ADP libre de l'oxydation phosphorylante et par une affinité importante de la MtCK pour la créatine qui ne change pas après l'entrainement.

The mammalian Na+/H+ exchanger isoform 1 (NHE1) is a ubiquitously expressed membrane protein that regulates intracellular pH. In the myocardium, NHE1 has been implicated in ischemia/reperfusion (I/R) and cardiac hypertrophy (CH). Hormonal, autocrine and paracrine stimuli, acidosis, cardiotoxic metabolites released during I/R and CH increases NHE1 protein expression and activity. The involvement of NHE1 in CH and I/R has been further supported with the use of NHE1 inhibitors, which have been beneficial in the prevention/regression of several models of CH and I/R injury. Despite the fact that elevation of NHE1 expression and activity have been demonstrated in several models of heart disease, it was unclear whether elevation of NHE1 protein expression was sufficient to induce a specific cardiac pathology, or whether activation of the protein was required. To understand the direct role of NHE1 in CH and I/R, an in vivo and in vitro gain-of-function model, expressing varying levels and activities of NHE1 were examined. In vivo, our N-line mice expressed wild type NHE1 and our K-line mice expressed constitutively active NHE1. In vitro, neonatal rat ventricular cardiomyocytes were infected with the IRM adenovirus containing wild type NHE1 or the K-IRM adenovirus containing active NHE1. We demonstrated that expression of constitutively active NHE1 promotes CH to a much greater degree than expression of wild type NHE1 alone, both in vivo and in vitro. This NHE1-dependent hypertrophic response occurred independent of signaling pathways involved in CH including, mitogen activated protein kinases, p90 ribosomal S6 kinase, calcineurin and glycogen synthase kinase. The NHE1-dependent hypertrophic effect also occurred independent of gender. In addition, the expression of active NHE1 increased the susceptibility of intact mice to neurohormonal stimulation and progressed the hypertrophic response. When these hearts expressing active NHE1 were subjected to I/R using the ex vivo working heart perfusion model, fatty acid (FA) oxidation and glycolysis rates increased, thus generating greater ATP production rates. This was associated with cardioprotective effects in the myocardium, as well as a more energetically efficient myocardium. Expression of the endoplasmic reticulum (ER) stress response proteins, calreticulin and PDI were also shown to be increased relative to controls, and may contribute to the cardioprotection observed. We demonstrate that active NHE1 induces cardioprotection and alters cardiac metabolism in working hearts subjected to I/R. Overall, our results suggest that expression of active NHE1 has a double edged sword effect, on one side it induces CH while on the other side, it protects the heart against I/R injury.

Die Präeklampsie ist eine schwangerschaftsspezifische Bluthochdruck-Erkrankung, die im Allgemeinen nach der 20. Schwangerschaftswoche auftritt. Neben der Hypertonie sind die Proteinurie und die Ödembildung charakteristische Symptome der Präeklampsie. Obwohl heute die Pathophysiologie der Präeklampsie zum großen Teil verstanden ist, ist die Ätiologie dieser Erkrankung noch unklar. 1999 konnten wir in den Seren von Präeklampsie-Patientinnen agonistische Autoantikörper, die gegen den Angiotensin II AT1-Rezeptor gerichtet sind (AT1-AAK), nachweisen. Diese AT1-AAK gehören zur Antikörpersubklasse IgG3.<br /> Die AT1-AAK führen in Kulturen neonataler Rattenkardiomyozyten AT1-Rezeptor spezifisch zu einem positiv chronotropen Effekt. Mittels Immunpräzipitation wurde gezeigt, dass AT1-AAK spezifisch den AT1-Rezeptor präzipitieren. Kontrollproben, aus denen die AT1-AAK entfernt wurden, führen zu keiner Präzipitation des AT1-Rezeptors. Die Präzipitation des AT1-Rezeptors bleibt ebenfalls aus, wenn die AT1-AAK mit einem Peptid, welches der Aminosäuresequenz des zweiten extrazellulären Loops des humanen AT1-Rezeptors entspricht, behandelt wurden. Eine Langzeitbehandlung der Kulturen neonataler Rattenherzzellen mit AT1-AAK vermindert die funktionelle Ansprechbarkeit der Zellen auf einen erneuten AT1-Rezeptor-Stimulus.<br /> Eine veränderte AT1-Rezeptorexpression wurde nicht nachgewiesen. In guter Übereinstimmung mit den in vitro-Expressionsdaten wurde gezeigt, dass die plazentare AT1-Rezeptorexpression bei Präeklampsie-Patientinnen nicht verschieden von der plazentaren AT1-Rezeptorexpression gesunder Schwangerer mit nicht pathogen verändertem Blutdruck ist. Im Zellsystem der neonatalen Rattenherzzellen führen die AT1-AAK zur Aktivierung von Gi-Proteinen und zu verringerten intrazellulären cAMP-Spiegeln.<br /> Des Weiteren wurde gezeigt, dass die AT1-AAK in Kulturen neonataler Rattenherzzellen die Transkriptionsfaktoren AP-1 und NFkB aktivieren. Die Aktivierung des Transkriptionsfaktors NFkB wurde vornehmlich in den Nicht-Myozyten der Rattenherzzellkultur nachgewiesen. Generell wurde festgestellt, dass sich die AT1-AAK pharmakologisch wie der natürliche Agonist des AT1-Rezeptors, Angiotensin II, verhalten.<br /> Erste Daten dieser Arbeit deuten auf einen eventuellen Einfluss der AT1-AAK auf die Expression von Komponenten der extrazellulären Matrix bzw. assoziierter Faktoren (Kollagen III, MMP-2, TIMP-2, Colligin) hin. In allen in dieser Arbeit untersuchten Seren von klinisch diagnostizierten Präeklampsie-Patientinnen wurden agonistische AT1-AAK nachgewiesen. Wir vermuten daher, dass die AT1-AAK möglicherweise bedeutend in der Pathogenese der Präeklampsie sind. / Preeclampsia is a serious, pregnancy-specific disorder that usually occurs after week 20 of gestation and is characterized by hypertension, proteinuria, and oedema. While the pathophysiology is clear, little is known about etiology of preeclampsia.<br /> In 1999, we showed that sera from preeclamptic patients contain autoantibodies directed against angiotensin II AT1 receptor (AT1-AAB). These autoantibodies are immunoglobuliens of the IgG3 subclass.<br /> AT1-AAB accelerate the beating rate of neonatal rat cardiomyocytes. The agonistic effect can be blocked with the AT1 receptor blocker losartan.<br /> Co-immunoprecipitation studies have shown that AT1-AAB specifically precipitate the AT1 receptor while control samples lacking AT1-AAB do not. The AT1 receptor could not be precipitated following neutralization of the AT1-AAB by a peptide corresponding to the AT1 receptors second extracellular loop. In further studies on neonatal rat heart cells, we showed long-term stimulation of the AT1 receptor whereby AT1-AAB down-regulated the AT1 receptor-mediated response to a second agonistic receptor-stimulation.<br /> After long-term stimulation of neonatal rat heart cells, no changes in AT1 receptor expression could be identified. Corresponding to these in vitro-expression data, no difference was seen in placental AT1 receptor expression between patients with preeclampsia and healthy pregnant women. Next, we tested if the AT1-AAB lead to activation of AT1 receptor signaling in angiotensin II fashion. In neonatal rat heart cell cultures, AT1-AAB lead to activation of Gi-protein with reduced cAMP levels. AT1-AAB are able to activate the transcription factors AP-1 and NFkB in this cell system. In all observations, the agonistic AT1-AAB behave pharmacologically in a similar fashion to angiotensin II.<br /> Initial data suggest that AT1-AAB may have an effect on extracellular matrix components (ECM).<br /> We have found AT1-AAB in all women meeting the clinical criteria of preeclampsia and, therefore, suggest that AT1-AAB may be important to the pathogenesis of the disease.