Theacrine Attenuates Myocardial Fibrosis After Myocardial Infarction Via the SIRT3/Β-Catenin/ Pparγ Pathway in Estrogen-Deficient Mice
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European Review for Medical and Pharmacological Sciences 2019; 23: 5477-5486 Theacrine attenuates myocardial fibrosis after myocardial infarction via the SIRT3/β-catenin/ PPARγ pathway in estrogen-deficient mice L.-L. SONG1, Y. ZHANG2, X.-R. ZHANG3, Y.-N. SONG4, H.-Z. DAI5 1Department of Critical Care Medicine, Weifang Hanting District People’s Hospital, Weifang, China 2Department of Respiratory Medicine, Weifang Hanting District People’s Hospital, Weifang, China 3Department of Pharmacology, Weifang Medical University, Weifang, China 4Department of Breast and Thyroid Surgery, The Traditional Chinese Medicine Hospital of Weifang, Weifang, China 5Department of Emergency, The Affiliated Hospital of Weifang Medical University, Weifang, China Abstract. – OBJECTIVE: To investigate the myocardial apoptosis were clearly aggravated, role of theacrine in the protection of ventricular and the SIRT3 expression was decreased at 28 remodeling and chronic heart failure after myo- days after myocardial infarction. The theacrine cardial infarction in the estrogen-deficient mice. could improve the cardiac function after the MATERIALS AND METHODS: Female myocardial infarction in estrogen-deficient mice C57BL/6 mice aged 8 weeks old were selected and relieve both myocardial fibrosis and myo- and then subjected to bilateral oophorectomy. cardial apoptosis during chronic remodeling af- At 7 days after surgery, the models of the myo- ter myocardial infarction in estrogen-deficient cardial infarction were established by ligating mice. After the intervention with theacrine, the the anterior descending coronary artery. On the estrogen-deficient mice with myocardial infarc- first day after myocardial infarction, Theacrine tion had up-regulated SIRT3 and PPARγ levels (20 mg/kg) was administered via gavage for con- and a reduced β-catenin level in the heart. tinuous 28 days. Thereafter, the cardiac function CONCLUSIONS: Theacrine is able to acti- in each group of mice was detected via cardiac vate SIRT3 and repress myocardial fibrosis and ultrasonography for small animals at 7, 14, and apoptosis after myocardial infarction in ovariec- 28 days after surgery. The mice were sacrificed tomized mice, thereby improving the cardiac after 28 days. The infarct size of mice was deter- function of ovariectomized mice with myocardi- mined through 2,3,5-triphenyltetrazolium chlo- al infarction through the possible downstream ride (TTC) and Evan blue double staining assay, signal pathway β-catenin/PPARγ. while the myocardial fibrosis was assessed via Key Words Masson staining assay. The expression levels of Theacrine, Myocardial infarction, Estrogen-defi- collagen-related proteins Collagen I, Collagen cient, Myocardial fibrosis, SIRT3/β-catenin/PPARγ. III, alpha-smooth muscle actin (α-SMA), and the transforming growth factor-β (TGF-β) were mea- sured by Western blotting (WB). The terminal deoxynucleotidyl transferase (TdT)-mediated dUTP nick end labeling (TUNEL) staining assay was applied to evaluate the myocardial apopto- Introduction sis, and the WB was employed to detect apop- tosis-associated proteins. The expression level Acute myocardial infarction is one of the most of silent information regulator 2 homologue 3 1 (SIRT3) protein was detected by immunohisto- severe coronary heart diseases . The mortality chemistry, and the expression levels of SIRT3, rate of coronary heart diseases shows a decreas- β-catenin and peroxisome proliferator-activated ing tendency in the past decade due to changes in receptor gamma (PPARγ) protein were measured evidence-based therapeutic methods and lifestyles, via WB. RESULTS: but myocardial infarction is still a global disease Compared with those in the Sham seriously endangering human health2. Moreover, group, the ejection fraction (EF) and fractional shortening (FS) in estrogen-deficient mice were the incidence and mortality rates of the coronary significantly lowered, the myocardial fibrosis and heart diseases are evidently increased in elderly Corresponding Author: Huizhen Dai, BM; e-mail: [email protected] 5477 L.-L. Song, Y. Zhang, X.-R. Zhang, Y.-N. Song, H.-Z. Dai women because of their decreased estrogen levels Materials and Methods after menopause3,4. Once myocardial infarction is detected, the mortality rate for women is signifi- Laboratory Animals and Models cantly higher than that for men5,6. Since the risks The subjects of this study were female C57BL/6 for cardiovascular diseases, as well as venous mice aged 8 weeks old and weighing 18-20 g, pur- thrombosis and stroke, are increased after estrogen chased from the Model Animal Research Center replacement therapy, estrogen is not recommended of Weifang Medical University. They were housed as a measure to prevent and treat coronary heart in the Specific Pathogen Free (SPF)-level animal diseases in postmenopausal women at present7,8. room. Experimentation on animals was approved Therefore, it is particularly important to find ef- by the Animal Ethics Committee of Weifang Med- fective drugs for preventing and treating coronary ical University. Bilateral oophorectomy: a mouse heart diseases in postmenopausal women. was anesthetized via intraperitoneal injection of More attention has been paid to the left the 400 mg/kg chloral hydrate and then fixed on an ventricular remodeling after myocardial infarc- operating table, followed by the disinfection of tion9-11. Left ventricular remodeling severely the skin. Thereafter, with the intersections of the weakens the left ventricular function in patients mouse’s right and left thigh root connection lines with myocardial infarction and significantly in- and the median line on the back as starting points, creases the complication and the mortality rates the surgical incisions (about 1 cm) directing to the in patients12,13. Myocardial fibrosis, whose extent head were made. Taking the right ovary as an ex- is one of the main factors determining the prog- ample, the skin incision was pulled to the right side nosis in patients with cardiovascular diseases, is by about 0.5 cm. The ovary is located in the fat an important feature of myocardial remodeling12. mass next to the lower kidney. Then, the muscle Sirtuins, a class of NAD+-dependent deacety- layer on the surface of the fat mass was bluntly sep- lases, play vital roles in regulating cell growth, arated, and the ovary was resected. Next, the left metabolism, senescence, stress, and apoptosis14. ovary was removed in the same way. After that, Among them, the silent information regulator 2 the skin was sutured, and the mouse was placed on homologue 3 (SIRT3) is important for the preven- a warm table for recovery. Establishment of myo- tion and treatment of cardiovascular diseases, and cardial infarction models: a mouse was intraperi- it is able to suppress the myocardial apoptosis and toneally injected with 400 mg/kg chloral hydrate delay the cardiac hypertrophy and heart failure15,16. for anesthetization, and then fixed on the operat- Besides, SIRT3 exerts an important protective ef- ing table in the supine position. After that, peroral fect on organ fibrosis17,18. The overexpression of non-invasive endotracheal intubation was conduct- SIRT3 protects bleomycin-induced pulmonary ed using a self-made trachea cannula, and a venti- fibrosis19. SIRT3-KO mice spontaneously have lator was connected to control breathing (frequen- myocardial fibrosis at the th8 week after birth20. cy: 90-100 breaths/min, tidal volume: 0.4-0.5 mL). Resveratrol activates SIRT3 and inhibits myo- Thereafter, the surgical area was disinfected, and a cardial fibrosis by regulating the transforming transverse incision was made on the skin in the left growth factor-β (TGF-β)/SMAD signaling path- fourth intercostal space, followed by blunt dissec- way, thereby improving cardiac function21. tion of the pectoralis major and anterior serratus to Theacrine, namely 1,3,7,9-tetramethyluric expose the heart. Next, the pericardium was cut to acid (molecular formula: C9H12N4O3), is a purine expose the left auricle and the left ventricle, and a alkaloid, which has a similar structure to that of 7-0 non-invasive surgical suture fine needle with caffeine. Studies22,23 on the pharmacological ac- thread was used to suture and ligature the coro- tivity of theacrine mainly focus on its regulato- nary artery at 2-3 mm below the lower edge of the ry role in the central nervous system. In recent left auricle. After the ligation succeeded, it could years, a research24 has discovered that theacrine be observed that the cardiac muscle in the ligated activates SIRT3 protein, and is a novel SIRT3 ag- area became white. The chest was closed layer by onist. So far, the effect of theacrine on myocardial layer, and the surgical incision was applied exter- infarction is not reported. Therefore, in this work, nally with erythromycin eye ointment, followed by the models of the myocardial infarction were es- observation. The tracheal intubation was removed tablished in estrogen-deficient mice to explore the after waking up, and then the mouse was put back influence of theacrine on cardiac function and to the rearing cage. On the first day after myocar- myocardial remodeling and investigate its possi- dial infarction, Theacrine (20 mg/kg) was admin- ble mechanism of action. istered via gavage for continuous 28 days. 5478 Theacrine attenuates myocardial fibrosis after myocardial infarction Determination of Cardiac Structure immersed with gradient ethanol for 3 min, and and Cardiac Function in Mice treated with Proteinase K working solution for