Search

Congestive heart failure and chronic kidney disease are characterized by chronically elevated angiotensin II (Ang II) and muscle wasting. Ang II causes skeletal muscle wasting by reducing appetite and by enhancing catabolism. The serine/threonine kinase AMP-activated protein kinase (AMPK) functions mainly as a sensor of cellular energy status. It is energy sparing and favors ATP generation. We hypothesized that Ang II induces muscle wasting in part by inhibiting AMPK signaling and altering cellular energy balance. Our results show that Ang II infusion in mice reduced gastrocnemius muscle weight by 26% and depleted ATP by 74%. In addition, Ang II upregulated protein phosphatase 2Cα by 2.6-fold and reduced AMPK phosphorylation and signaling in muscle. Importantly, the pharmacological AMPK activator 5-aminoimidazole-4-carboxamide ribonucleoside restored AMPK activity to levels of pair-fed controls and reversed Ang II-mediated ATP depletion and muscle wasting. Moreover, 5-aminoimidazole-4-carboxamide ribonucleoside activated Akt and inhibited Ang II-induced increases in E3 ubiquitin ligase expression. These novel results demonstrate critical roles for energy depletion and AMPK inhibition in Ang II-induced skeletal muscle wasting and suggest a therapeutic potential for AMPK activators in diseases characterized by muscle wasting. [ABSTRACT FROM AUTHOR]

Purpose Of Review: Congestive heart failure is increasing in prevalence and represents a major public health problem. The syndrome of advanced heart failure often includes muscle wasting, commonly termed cardiac cachexia, which is a predictor of poor outcome. Mechanisms of cardiac cachexia are poorly understood, but there is recent evidence that increased angiotensin II, interacting with the insulin-like growth factor-1 system, plays an important role.Recent Findings: In animals, angiotensin II produces weight loss through a pressor-independent mechanism, accompanied by decreased levels of circulating and skeletal muscle insulin-like growth factor-1 and increased mRNA levels of the ubiquitin ligases atrogin-1 and Muscle RING finger-1 in skeletal muscle. Reduced insulin-like growth factor-1 action in muscle leads to increased proteolysis, through the ubiquitin-proteasome pathway, and increased apoptosis. These changes are blocked by muscle-specific expression of insulin-like growth factor-1, likely to be via the Akt/mTOR/p70S6K signaling pathway.Summary: The link between insulin-like growth factor-1, the ubiquitin-proteasome pathway, and angiotensin II effects has widespread clinical implications for the understanding of mechanisms of catabolic conditions. Therapeutic interventions targeting cross-talk mechanisms between angiotensin II and insulin-like growth factor-1 effects could provide new approaches for the treatment of muscle wasting. [ABSTRACT FROM AUTHOR]

Introduction: Patients with advanced congestive heart failure (CHF) or chronic kidney disease (CKD) often have increased angiotensin II (Ang II) levels and cachexia. We previously demonstrated that Ang II type 2 receptor (AT2R) potentiates skeletal muscle stem (satellite) cell (SC) differentiation and muscle regenerative capacity. However, mechanisms whereby AT2R regulates SC differentiation, and its potential involvement in cachexia development remain unknown. Methods: AT2R siRNA was transfected to primary cultured SCs and the changes in AT2R downstream signaling pathways were analyzed by phosphoprotein array, on which 1318 unique antibodies against various phosphoproteins are spotted. The identified signaling pathway was pharmacologically and genetically manipulated both in vitro and in vivo, and the skeletal muscle regenerative capacity was analyzed by qRT-PCR, western blotting and immunohistochemistry. Results: We found that 20 phosphoproteins were upregulated (>1.4 fold change) and 28 were downregulated (<0.7 fold change) after AT2R knockdown. Among these proteins, we found an increase in p-Akt (Ser473) and p-GSK-3β (Ser9) during SC differentiation both in vitro (SC culture) and in vivo (injury-induced skeletal muscle regeneration), suggesting an activation of β-catenin pathway. Consistently, β-catenin TCF/LEF reporter (TOPFlash) assay showed an increase in β-catenin activity both in vitro and in vivo. siRNA-mediated AT2R knockdown in cultured SCs significantly decreased p-Akt (Ser473) and p-GSK-3β(Ser9) phosphorylation and TOPFlash activity, and importantly, inhibited SC differentiation. Treatment of AT2R knocked-down SCs with GSK-3βinhibitor BIO or Wnt3A restored β-catenin activity, resulting in the restoration of SC differentiation. These data indicate that AT2R positively regulates SC differentiation via Akt/GSK-3β/β-catenin pathway. Importantly, we found that skeletal muscle regeneration was reduced (decreased regenerating myofiber size and myogenin/desmin expression) in a mouse myocardial infarction model of CHF, concomitant with marked reduction in AT2R expression and decreased β-catenin activity. In these mice, hindlimb injection of BIO restored β-catenin activity and muscle regenerative capacity. Conclusions: These data indicate that AT2R/Akt/GSK-3β/β-catenin pathway plays a critical role in regulating SC differentiation and muscle regeneration, and could be a novel therapeutic target in wasting disorders such as CHF and CKD. [ABSTRACT FROM AUTHOR]

Introduction: Patients with advanced congestive heart failure (CHF) or chronic kidney disease (CKD) often have increased angiotensin II (Ang II) levels and cachexia. We previously demonstrated that Ang II infusion in rodents causes skeletal muscle wasting, likely contributing to cachexia in CHF and CKD. We also demonstrated that Ang II type 1 receptor (AT1R) activation in skeletal muscle stem (satellite) cells (SCs) inhibits SC proliferation and muscle regenerative capacity. We hypothesize that Ang II-mediated SC inhibition contributes to the development of muscle wasting in high Ang II condition. Methods: We generated tamoxifen-inducible, SC-specific AT1R knockout mice (SC-AT1R-/-; generated by crossing SC-specific Pax7CreERand AT1R floxed mice). By breeding SC-AT1R-/-and control mice with Cre-reporter mouse line, SCs and their progenies were labeled with EYFP. These mice were infused with Ang II (1.5 μg/kg/min) and muscle regeneration and wasting were analyzed by qRT-PCR, western blotting and immunohistochemistry. Results: Ang II reduced skeletal muscle regeneration in vivo, indicated by the reduced number of regenerating myofibers in hindlimb muscles after cardiotoxin injury (71.9% decrease vs. control, p<0.001), and by the reduction of SC proliferation/differentiation markers MyoD and myogenin (56.5% and 62.5% decrease, respectively, by qRT-PCR, p<0.001). In contrast, hindlimb muscles of SC-AT1R-/-mice were protected against Ang II-mediated reduction in skeletal muscle regenerative capacity; the number of regenerating myofibers and expression of MyoD and myogenin were restored. Ang II inhibited primary cultured SC proliferation via AT1R signaling in vitro, and SC proliferative capacity was restored in AT1R null SCs. Importantly, we found that there was a significant recovery from Ang II-induced muscle wasting in SC-AT1R-/-mice. SC lineage tracing (EYFP labeling) and gene expression analyses revealed that AT1R-deficient SCs had significantly higher regenerative capacity in high Ang II condition, leading to increased number of newly formed/repaired myofibers (12.4±2.7% of total myofibers in SC-AT1R-/-and ND in control, p<0.001), resulting in the restoration of muscle mass and cross sectional area in SC-AT1R-/-mice. Conclusions: These data indicate that inhibition of AT1R signaling in SCs could have a therapeutic potential to treat muscle wasting in chronic diseases with high Ang II, such as CHF and CKD. [ABSTRACT FROM AUTHOR]

Introduction: Skeletal muscle atrophy occurs via two main systems, namely, autophagy and ubiquitin-proteasome system (UPS). Although we have previously shown that angiotensin II (Ang II) induces skeletal muscle atrophy via UPS activation, little is known about Ang II-mediated autophagy in skeletal muscle. Therefore, we aimed to investigate whether Ang II modulates autophagy in skeletal muscle in mice. Methods: FVB mice (10 -12 weeks-old) were infused with Ang II (1.0 μg/kg/day) for 7 days; pair-fed (PF) group was infused with saline and served as control. Tibialis anterior (TA) muscle was used for western blot, RT-qPCR, mitochondrial respiration assay, as well as enzymatic activity, and extensor digitorum longus muscle was used for Transmission Electronic Microscopy (TEM). Results: Ang II infusion reduced mouse body weight (12%, p=0.0001) and caused muscle loss (p&lt0.05). Ang II inhibited phosphorylation of UKL1 at Ser317 (p-ULK1), leading to suppressed p-beclin1 (Ser14) and p-ATG14 (Ser29), critical proteins to initiate autophagosome formation. Ang II also blunted the LC3B-II conversion and increased p62/SQTSM1 protein expression (hallmark of autophagosome cargo accumulation), whereas lysosomal enzymatic activities (cathepsins B and L) were not altered. These data indicate that Ang II impairs the initial step of autophagosome formation. TEM analysis revealed that Ang II caused an accumulation of mitochondria with abnormal cristae and swollen morphology, likely due to reduced autophagosomes. These changes were associated with increased PINK1 protein expression, decreased PGC-1α gene and protein expressions. Importantly, Ang II markedly reduced the oxygen consumption rate in isolated mitochondria. These data strongly indicate that Ang II impairs mitochondrial function and its clearance, which may potentially induce muscle wasting. Conclusions: Here we show that Ang II inhibits critical molecules involved in the initiation of autophagy, which leads to suppression autophagosome formation (e.g. reduced LC3B-II conversion). This likely promotes an accumulation of damaged mitochondria and ubiquitinated proteins. Our data strongly suggest that autophagy is critical to induce skeletal muscle deregulation in Ang II-infused mice and raises the possibility of a new therapeutic target in wasting disorders such as heart failure. [ABSTRACT FROM AUTHOR]

Background: We have previously shown that systemic infusion of insulin-like growth factor-1 (IGF-1) exerts anti-inflammatory and antioxidant effects and reduces atherosclerotic burden in apolipoprotein E (Apoe)-deficient mice. Monocytes/macrophages express high levels of IGF-1 receptor (IGF1R) and play a pivotal role in atherogenesis, but the potential effects of IGF-1 on their function are unknown., Methods and Results: To determine mechanisms whereby IGF-1 reduces atherosclerosis and to explore the potential involvement of monocytes/macrophages, we created monocyte/macrophage-specific IGF1R knockout (MΦ-IGF1R-KO) mice on an Apoe(-/-) background. We assessed atherosclerotic burden, plaque features of stability, and monocyte recruitment to atherosclerotic lesions. Phenotypic changes of IGF1R-deficient macrophages were investigated in culture. MΦ-IGF1R-KO significantly increased atherosclerotic lesion formation, as assessed by Oil Red O staining of en face aortas and aortic root cross-sections, and changed plaque composition to a less stable phenotype, characterized by increased macrophage and decreased α-smooth muscle actin-positive cell population, fibrous cap thinning, and decreased collagen content. Brachiocephalic artery lesions of MΦ-IGF1R-KO mice had histological features implying plaque vulnerability. Macrophages isolated from MΦ-IGF1R-KO mice showed enhanced proinflammatory responses on stimulation by interferon-γ and oxidized low-density lipoprotein and elevated antioxidant gene expression levels. Moreover, IGF1R-deficient macrophages had decreased expression of ABCA1 and ABCG1 and reduced lipid efflux., Conclusions: Our data indicate that macrophage IGF1R signaling suppresses macrophage and foam cell accumulation in lesions and reduces plaque vulnerability, providing a novel mechanism whereby IGF-1 exerts antiatherogenic effects., (© 2016 American Heart Association, Inc.)

Background: Chronic kidney disease is a risk factor for heart failure (HF). Patients with chronic kidney disease without diagnosed HF have an increased burden of symptoms characteristic of HF. It is not known whether these symptoms are associated with occurrence of new onset HF., Methods and Results: We studied the association of a modified Kansas City Cardiomyopathy Questionnaire with newly identified cases of hospitalized HF among 3093 participants enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study who did not report HF at baseline. The annually updated Kansas City Cardiomyopathy Questionnaire score was categorized into quartiles (Q1-4) with the lower scores representing the worse symptoms. Multivariable-adjusted repeated measure logistic regression models were adjusted for demographic characteristics, clinical risk factors for HF, N-terminal probrain natriuretic peptide level and left ventricular hypertrophy, left ventricular systolic and diastolic dysfunction. Over a mean (±SD) follow-up period of 4.3±1.6 years, there were 211 new cases of HF hospitalizations. The risk of HF hospitalization increased with increasing symptom quartiles; 2.62, 1.85, 1.14, and 0.74 events per 100 person-years, respectively. The median number of annual Kansas City Cardiomyopathy Questionnaire assessments per participant was 5 (interquartile range, 3-6). The annually updated Kansas City Cardiomyopathy Questionnaire score was independently associated with higher risk of incident HF hospitalization in multivariable-adjusted models (odds ratio, 3.30 [1.66-6.52]; P=0.001 for Q1 compared with Q4)., Conclusions: Symptoms characteristic of HF are common in patients with chronic kidney disease and are associated with higher short-term risk for new hospitalization for HF, independent of level of kidney function, and other known HF risk factors., (© 2015 American Heart Association, Inc.)

Objective: Growth factors may play a permissive role in atherosclerosis initiation and progression, in part via their promotion of vascular smooth muscle cell (VSMC) accumulation in plaques. However, unstable human plaques often have a relative paucity of VSMC, which has been suggested to contribute to plaque rupture and erosion and to clinical events. Insulin-like growth factor-1 (IGF-1) is an endocrine and autocrine/paracrine growth factor that is a mitogen for VSMC, but when infused into Apoe(-/-) mice it paradoxically reduces atherosclerosis burden., Methods and Results: To determine the effect of stimulation of VSMC growth on atherosclerotic plaque development and to understand mechanisms of IGF-1's atheroprotective effect, we assessed atherosclerotic plaques in mice overexpressing IGF-1 in smooth muscle cells (SMC) under the control of the α-smooth muscle actin promoter, after backcrossing to the Apoe(-/-) background (SMP8/Apoe(-/-)). Compared with Apoe(-/-) mice, these SMP8/Apoe(-/-) mice developed a comparable plaque burden after 12 weeks on a Western diet, suggesting that the ability of increased circulating IGF-1 to reduce plaque burden was mediated in large part via non-SMC target cells. However, advanced plaques in SMP8/Apoe(-/-) mice displayed several features of plaque stability, including increased fibrous cap area, α-smooth muscle actin-positive SMC and collagen content, and reduced necrotic cores., Conclusions: These findings indicate that stimulation of VSMC IGF-1 signaling does not alter total atherosclerotic plaque burden and may improve atherosclerotic plaque stability.

The vascular insulin-like growth factor (IGF)-1 system includes the IGFs, the IGF-1 receptor (IGF-1R), and multiple binding proteins. This growth factor system exerts multiple physiologic effects on the vasculature through both endocrine and autocrine/paracrine mechanisms. The effects of IGF-1 are mediated principally through the IGF-1R but are modulated by complex interactions with multiple IGF binding proteins that themselves are regulated by phosphorylation, proteolysis, polymerization, and cell or matrix association. During the last decade, a significant body of evidence has accumulated, indicating that expression of the components of the IGF system are regulated by multiple factors, including growth factors, cytokines, lipoproteins, reactive oxygen species, and hemodynamic forces. In addition, cross-talk between the IGF system and other growth factors and integrin receptors has been demonstrated. There is accumulating evidence of a role for IGF-1 in multiple vascular pathologies, including atherosclerosis, hypertension, restenosis, angiogenesis, and diabetic vascular disease. This review will discuss the regulation of expression of IGF-1, IGF-1R, and IGF binding proteins in the vasculature and summarize evidence implicating involvement of this system in vascular diseases.

Background: Peptide growth factors induce vascular smooth muscle cell (SMC) proliferation and migration after vascular injury, leading to arterial stenosis. Estrogen provides vasculoprotective effects by regulating endothelial and vascular SMC function., Methods: We performed aortic denudations in male Wistar rats. One group received 17beta-estradiol, 0.25 mg/kg per day subcutaneously, and the other group vehicle. Growth factor and receptor mRNA in the aorta wall was quantitated at 15 minutes, 3 days, and 7 days after denudation. Western blotting and immunohistochemistry were used to quantify and localize the protein., Results: Aortic injury caused SMC proliferation in the intima and media, indicated by an increase in the number of intimal nuclei and area. Quantitative reverse-transcriptase polymerase chain reaction and Western blotting showed concomitant up-regulation of insulin-like growth factor (IGF)-1, platelet-derived growth factor (PDGF)-B, and PDGF-receptor (R)alpha. 17beta-estradiol significantly inhibited SMC proliferation and intimal thickening. Similarly, estrogen administration completely suppressed IGF-1 mRNA (P=0.004) and protein but had no effect on IGF-1R. Estrogen had virtually no effect on PDGF-A mRNA or protein levels; however, on day 7, it inhibited PDGF-Ralpha mRNA by 74% (P=0.005) and protein by 67%. On day 7, it also inhibited PDGF-B mRNA expression by 36% (P=0.04) but had little effect on protein. PDGF-Rbeta expression was unaffected by estrogen. Estradiol treatment reduced immunoreactivity of IGF-1, PDGF-A, PDGF-Ralpha, and PDGF-B in vascular lesions, whereas no changes were seen with respect to IGF-1R and PDGF-Rbeta., Conclusions: Our findings demonstrate that estrogen regulates IGF-1, PDGF-A, PDGF-B, and PDGF-Ralpha, which may be related to the vasculoprotective effect of estrogen, but has no effect on IGF-1R or PDGF-Rbeta.

Objective: We have shown previously that oxidized LDL decreases insulin-like growth factor-1 (IGF-1) and IGF-1 receptor expression in vascular smooth muscle cells and that IGF-1 and IGF-1 receptor expression are reduced in the deep intima of early atherosclerotic lesions. Because oxidized LDL is potentially important for the depletion of vascular smooth muscle cells contributing to plaque destabilization, we studied the role of IGF-1 in oxidized LDL-induced apoptosis., Methods and Results: We provide evidence that oxidized LDL-induced apoptosis is caused by decreased mitochondrial membrane potential and increased cytochrome C release in human aortic vascular smooth muscle cells. Overexpression of the IGF-1 receptor by using an adenovirus completely abrogated these effects. The antiapoptotic function of the IGF-1 receptor was associated with increased Akt kinase activity and increased expression of phosphorylated Bad. Moreover, a dominant-negative p85 phosphatidylinositol 3-kinase adenovirus blocked the capacity of the IGF-1 receptor to prevent oxidized LDL-induced apoptosis., Conclusions: Our data demonstrate that IGF-1 receptor activation inhibits oxidized LDL-induced cytochrome C release and apoptosis through the phosphatidylinositol 3-kinase/Akt signaling pathway and suggest that genetic or pharmacological activation of the IGF-1 receptor may be a useful strategy to stabilize atherosclerotic plaques.