Klotho Overexpression Suppresses Apoptosis by Regulating the Hsp70/Akt/Bad Pathway in H9c2(2-1) Cells

EXPERIMENTAL AND THERAPEUTIC MEDICINE 21: 486, 2021 Klotho overexpression suppresses apoptosis by regulating the Hsp70/Akt/Bad pathway in H9c2(2-1) cells JINPENG HU1,2*, BIN SU3*, XUEWEN LI2, YUMING LI4,5 and JIHONG ZHAO2 1Graduate School of Tianjin Medical University, Tianjin 300070; 2Department of Geriatric Medicine, Characteristic Medical Center of Chinese People's Armed Police Force; 3Ministry of Research, Characteristic Medical Center of The Chinese People's Armed Police Force; 4Angiocardiopathy Institute of Characteristic Medical Center of PAP, Tianjin 300162; 5TEDA International Cardiovascular Hospital, Tianjin Economic‑Technological Development Area, Tianjin 300457, P.R. China Received April 11, 2020; Accepted February 16, 2021 DOI: 10.3892/etm.2021.9917 Abstract. Early reperfusion is the most effective and impor‑ Introduction tant treatment for acute myocardial infarction. However, reperfusion therapy often leads to a certain degree of myocar‑ Globally, acute myocardial infarction (AMI) is associated with dial damage. The aim of the present study was to identify the high mortality and morbidity rates (1,2). Reperfusion therapy role of klotho, and the molecular mechanism underlying its is the most effective way to treat this disease in a clinical effects, in myocardial damage using a model of myocardial setting (3). Though the therapeutic aim is to restore blood hypoxia injury. Hypoxia/reoxygenation (H/R) was used to flow to the affected area, restoration of the blood supply often mimic ischemia/reperfusion (I/R) injury in vitro. The expres‑ activates a cascade of cellular damage mechanisms, which sion and distribution of klotho in H9c2(2‑1) cells was observed may further aggravate myocardial cell pathology, namely by fluorogenic scanning, and the apoptotic rate was deter‑ myocardial ischemia/reperfusion injury (MIRI) (4). Cellular mined by Annexin V‑FITC/propidium iodide dual staining. ischemic injury involves multiple injury mechanisms, such Cell viability was determined by MTT assay, and caspase‑3, as abnormal calcium regulation in cells (5,6), free radical cleaved caspase‑3, Bcl‑2, Bax, heat shock protein (Hsp) 70 production (7), mitochondrial damage (8) and the activation and Akt levels were assessed by western blotting. A lactate of apoptotic pathways (9). The cytotoxic cascade leads to the dehydrogenase test was performed to determine the degree of excessive production of reactive oxygen species (ROS), and is H9c2(2‑1) cell damage. The results revealed that klotho was considered to be the primary factor responsible for myocardial primarily located in the cytoplasm of H9c2(2‑1) cells. Klotho contractile dysfunction, cell death and inflammation (10). overexpression markedly suppressed H/R‑induced H9c2(2‑1) These injuries may have serious consequences, such as heart cell apoptosis. Furthermore, cell viability increased, and injury failure or death. Therefore, there is an urgent requirement decreased in response to klotho. Klotho also suppressed the for further investigation of the pathogenesis of AMI, and to activation of caspase‑3, upregulated Bcl2 and decreased Bax develop new therapeutic compounds and strategies. levels following H/R injury, as well as alleviating H/R injury The pathological mechanisms underlying ischemia‑reper‑ by upregulating the expression of Hsp70 and increasing the fusion injury (IRI) are complex, and include autophagy, levels of phosphorylated (p‑)Akt and Bad. In conclusion, these cardiomyocyte apoptosis, cellular infiltration, calcium results indicate that klotho suppressed H/R‑induced H9c2(2‑1) overload, oxidative stress, energy metabolism disorder and cell apoptosis by regulating the levels of Hsp70, p‑Akt and vascular endothelial dysfunction (11‑13). There are multiple p‑Bad, which suggest that klotho could be a novel agent for the signaling pathways involved in I/R injury, such as the matrix treatment of coronary disease. metalloenzyme‑associated, ATP‑sensitive potassium channel, angiotensin II and Fas signaling pathways. Klotho is a protein that is involved in human aging and the length of the human lifespan (14,15). A large number of previous studies have revealed that klotho is involved in the occurrence and Correspondence to: Dr Yuming Li, Angiocardiopathy Institute development of various human diseases, including chronic of Characteristic Medical Center of PAP, 220 ChengLin Road, kidney disease (15,16), arteriosclerosis (17), myocardial hyper‑ Tianjin 300162, P.R. China trophy (18,19), diabetes and obesity (20‑22), as well as various E‑mail: [email protected] types of cancer (23,24). *Contributed equally Klotho protein has been reported to exert anti‑ or pro‑apoptotic functions in different diseases (25,26). In Key words: klotho, hypoxia/reoxygenation injury, apoptosis, an acute pancreatitis model, klotho was found to alleviate H9c2(2‑1) cells inflammation and apoptosis (27). Sugiura et al (28) found that klotho is involved in the pathophysiology of renal IRI, and 2 HU et al: KLOTHO INHIBITS H9c2(2‑1) CELL APOPTOSIS that it alleviated apoptosis in a renal IRI model via heat shock The transfected cells were cultured for 24 h and the target protein (Hsp) 70. In an oxidative damage model, klotho was proteins such as caspase‑3, Bcl2 and Bax were detected by reported to attenuate oxidant‑induced alveolar epithelial cell western blotting after H/R treatment. apoptosis and mitochondrial DNA damage (29). Moreover, Additionally, for shRNA lentiviral particles transduction, klotho was also found to suppress ROS‑induced apoptosis Klotho shRNA (m) and control shRNA lentiviral particles were to improve cardiac function (30). In a stress‑induced cardiac used in order to knockdown klotho, H9c2(2‑1) cells. Firstly, injury model, klotho inhibited cardiomyocyte apoptosis partly the cells were grown to ~50% confluency and a mixture of by suppressing the activation of the p38 and JNK pathways (31). complete DMEM medium with Polybrene® (cat. no. sc‑134220; Additionally, klotho inhibited the effects of dexamethasone via Santa Cruz Biotechnology, Inc.) at a ﬁnal concentration of the NF‑κB signaling pathway in MC3T3‑E1 osteoblasts (32). 5 µg/ml was prepared. 10 µl klotho shRNA lentivirus or 10 µl Moreover, in human umbilical vein endothelial cells, klotho control shRNA lentivirus was added and cultured at 37˚C for suppressed apoptosis by reducing the activation of the 24 h. Subsequently, the culture medium was removed and the PI3K/AKT pathway (33). Thus, klotho may be a potential complete DMEM medium (without Polybrene®) was replaced, therapeutic target for acute inflammatory disease. and the cells were cultured for another 24 h. The stable The present study aimed to identify whether klotho exerts clones expressing the shRNA were selected and the levels of a protective effect on hypoxia/reoxygenation (H/R) injury in klotho, p‑Akt and total Akt were detected by western blot‑ H9c2(2‑1) cells, as well as the potential molecular mechanisms ting. Percentages of apoptotic H9c2(2‑1) cells transfected with underlying this process. The results provide a useful reference klotho or control vector were subsequently investigated. for clarifying the molecular mechanisms of klotho during H/R progression, and suggest klotho as a potential therapeutic Flow cytometric analysis. H9c2(2‑1) cells were infected target for acute MIRI. with klotho lentivirus or control plasmid lentivirus for 24 h prior to H/R treatment. Apoptosis was assessed by Materials and methods Annexin V‑FITC/propidium iodide (PI) staining according to the kit protocols (Santa Cruz Biotechnology, Inc.). For flow Regents and cell lines. The H9c2(2‑1) rat heart myoblast cytometric analysis, the cells were digested with 0.25% trypsin cell line (ATCC® CRL‑1446™) was purchased from ATCC for 1 min and washed twice with precooled phosphate‑buffered and cultured in Dulbecco's modified Eagle's medium saline (PBS). The cells were then resuspended in 500 µl binding (DMEM) supplemented with 10% fetal bovine serum. buffer with Annexin V‑FITC (0.1 µg/µl) and PI (0.05 µg/µl) in The pCMV3‑C‑HA negative control vector (C‑terminal the dark for 15 min on ice. From each sample, 1x104 cells were HA‑tagged) and klotho cDNA ORF clone were purchased collected for detection. The samples were then run through a from Sino Biological, Inc. The klotho overexpression lenti‑ flow cytometer (BD LSRFortessa X‑20; BD Biosciences) and virus and control plasmid lentivirus were constructed by and the data was analyzed using FlowJo v10 software (FlowJo LLC). purchased from Kilton Biotechnology (Shanghai) Co., Ltd. Klotho shRNA (m) and control shRNA lentiviral particles MTT assay. Cell viability was determined with an MTT assay. (containing a scrambled shRNA sequence) were purchased Briefly, H9c2(2‑1) cells were transfected with klotho or nega‑ from Santa Cruz Biotechnology, Inc. tive control lentivirus for 24 h. Then, 3x104 cells/well were plated into 96‑well plates for 6 h and treated by H/R injury as H/R injury model. H9c2(2‑1) cells were precultured in aforementioned. Then, 10 µl MTT reagent was added to each serum‑free DMEM overnight prior to H/R injury. Then, the well and the plate was cultured for 4 h at 37˚C. The absor‑ cells were cultured and exposed to hypoxic conditions for 4 h bance was measured at 570 nm with a microplate reader, and using an AnaeroPack pouch (Mitsubishi Gas Chemical). The viability was calculated as follows: Cell viability = (OD570 nm of hypoxic conditions were 37˚C, 2% O2, and 5% CO2. After 4 h, treatment group‑OD570 nm of blank wells)/(OD570 nm of untreated reoxygenation was achieved by returning the cells to normal group‑OD570 nm of blank wells) x100%. culture conditions, which involved incubation at 37˚C in a humidiﬁed atmosphere containing 95% air and 5% CO2 for 4 h. Lactate dehydrogenase (LDH) assay. Cellular injury was evaluated using the LDH test. LDH is a stable and abundant Transfection. H9c2(2‑1) cells were plated into 6‑well plate at cytoplasmic enzyme that is unable to pass through the cell the cell density of 4x105 cells/well 10 h prior to transfection.

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