Inhibition of the Unfolded Protein Response Mechanism Prevents Cardiac FibrosisReport as inadecuate




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Background

Cardiac fibrosis attributed to excessive deposition of extracellular matrix proteins is a major cause of heart failure and death. Cardiac fibrosis is extremely difficult and challenging to treat in a clinical setting due to lack of understanding of molecular mechanisms leading to cardiac fibrosis and effective anti-fibrotic therapies. The objective in this study was to examine whether unfolded protein response UPR pathway mediates cardiac fibrosis and whether a pharmacological intervention to modulate UPR can prevent cardiac fibrosis and preserve heart function.

Methodology-Principal Findings

We demonstrate here that the mechanism leading to development of fibrosis in a mouse with increased expression of calreticulin, a model of heart failure, stems from impairment of endoplasmic reticulum ER homeostasis, transient activation of the unfolded protein response UPR pathway and stimulation of the TGFβ1-Smad2-3 signaling pathway. Remarkably, sustained pharmacologic inhibition of the UPR pathway by tauroursodeoxycholic acid TUDCA is sufficient to prevent cardiac fibrosis, and improved exercise tolerance.

Conclusions

We show that the mechanism leading to development of fibrosis in a mouse model of heart failure stems from transient activation of UPR pathway leading to persistent remodelling of cardiac tissue. Blocking the activation of the transiently activated UPR pathway by TUDCA prevented cardiac fibrosis, and improved prognosis. These findings offer a window for additional interventions that can preserve heart function.



Author: Jody Groenendyk , Dukgyu Lee , Joanna Jung, Jason R. B. Dyck, Gary D. Lopaschuk, Luis B. Agellon , Marek Michalak

Source: http://plos.srce.hr/



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