Diabetes mellitus is complicated by the development of a
primary cardiomyopathy, which contributes to the excess morbidity and mortality of this disorder. The
protein kinase C (PKC) family of
isozymes plays a key role in the cardiac phenotype expressed during postnatal development and in response to pathological stimuli.
Hyperglycemia is an activating signal for cardiac PKC
isozymes that modulate a myriad of cell events including cell death and survival. The epsilon-
isozyme of the PKC family transmits a powerful survival signal in cardiac muscle cells. Accordingly, to test the hypothesis that endogenous activation of cardiac
PKC-epsilon will protect against hyperglycemic cell injury and
left ventricular dysfunction,
diabetes mellitus was induced using
streptozotocin in genetically engineered mice with cardiac-specific expression of the
PKC-epsilon translocation activator [psiepsilon-
receptors for activated C kinase (psiepsilon-RACK)]. The results demonstrate a striking
PKC-epsilon cardioprotective phenotype in diabetic psiepsilon-RACK (epsilon-agonist) mice that is characterized by inhibition of the
hyperglycemia apoptosis signal, attenuation of
hyperglycemia-mediated oxidative stress, and preservation of parameters of left ventricular pump function. Hearts of diabetic epsilon-agonist mice exhibited selective trafficking of
PKC-epsilon to membrane and mitochondrial compartments, phosphorylation/inactivation of the mitochondrial
Bad protein, and inhibition of
cytochrome c release. We conclude that activation of endogenous
PKC-epsilon in hearts of diabetic epsilon-agonist mice promotes the survival phenotype, attenuates markers of oxidative stress, and inhibits the negative inotropic properties of chronic
hyperglycemia.