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Role of kallistatin in prevention of cardiac remodeling after chronic myocardial infarction.

Abstract
Oxidative stress causes cardiomyocyte death and subsequent ventricular dysfunction and cardiac remodeling after myocardial infarction (MI), thus contributing to high mortality in chronic heart failure patients. We investigated the effects of kallistatin in cardiac remodeling in a chronic MI rat model and in primary cardiac cells. Human kallistatin gene was injected intramyocardially 20 min after ligation of the left coronary artery. At 4 weeks after MI, expression of human kallistatin in rat hearts was identified by reverse transcription-polymerase chain reaction, immunohistochemistry and ELISA. Kallistatin administration improved cardiac performance, increased mean arterial pressure, decreased myocardial infarct size and restored left ventricular wall thickness. Kallistatin treatment significantly attenuated cardiomyocyte size and atrial natriuretic peptide expression. Kallistatin also reduced collagen accumulation, collagen fraction volume and expression of collagen types I and III, transforming growth factor-beta1 (TGF-beta1) and plasminogen activator inhibitor-1 in the myocardium. Inhibition of cardiac hypertrophy and fibrosis by kallistatin was associated with increased cardiac nitric oxide (NO) levels and decreased superoxide formation, NADH oxidase activity and p22-phox expression. Moreover, in both primary cultured rat cardiomyocytes and myofibroblasts, recombinant kallistatin inhibited intracellular superoxide formation induced by H(2)O(2), and the antioxidant effect of kallistatin was abolished by Nomega-nitro-L-arginine methyl ester (L-NAME), indicating a NO-mediated event. Kallistatin promoted survival of cardiomyocytes subjected to H(2)O(2) treatment, and inhibited H(2)O(2)-induced Akt and ERK phosphorylation, as well as NF-kappaB activation. Furthermore, kallistatin abrogated TGF-beta-induced collagen synthesis and secretion in cultured myofibroblasts. This is the first study to demonstrate that kallistatin improves cardiac performance and prevents post-MI-induced cardiac hypertrophy and fibrosis through its antioxidant action.
AuthorsLin Gao, Hang Yin, Robert S Smith Jr, Lee Chao, Julie Chao
JournalLaboratory investigation; a journal of technical methods and pathology (Lab Invest) Vol. 88 Issue 11 Pg. 1157-66 (Nov 2008) ISSN: 1530-0307 [Electronic] United States
PMID18762777 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
Chemical References
  • Reactive Oxygen Species
  • Serpins
  • Transforming Growth Factor beta1
  • kallistatin
  • Nitric Oxide
Topics
  • Animals
  • Cells, Cultured
  • Disease Models, Animal
  • Fibroblasts
  • Fibrosis (physiopathology)
  • Genetic Therapy
  • Heart Failure (physiopathology)
  • Humans
  • Myocardial Infarction (physiopathology)
  • Myocytes, Cardiac
  • Nitric Oxide (metabolism)
  • Rats
  • Reactive Oxygen Species (metabolism)
  • Serpins (physiology)
  • Transforming Growth Factor beta1 (physiology)
  • Ventricular Remodeling (physiology)

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