Articles in PresS. Am J Physiol Heart Circ Physiol (August 15, 2014). doi:10.1152/ajpheart.00210.2014

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Title:

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AMPK activation by glucagon-like peptide-1 prevents NADPH oxidase

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activation induced by hyperglycemia in adult cardiomyocytes.

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Authors:

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Magali Balteau1, Anne Van Steenbergen1, Aurélie D. Timmermans1, Chantal

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Dessy2, Gaetane Behets-Wydemans2, Nicolas Tajeddine3, Diego Castanares-

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Zapatero1, Patrick Gilon4, Jean-Louis Vanoverschelde1,5, Sandrine Horman1,

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Louis Hue6, Luc Bertrand1, Christophe Beauloye1,5.

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Affiliation:

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et Clinique (IREC), Pôle de Recherche Cardiovasculaire, Brussels, Belgium

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et Clinique (IREC), Pôle de Pharmacothérapie et Thérapeutique, Brussels,

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Belgium

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Cell Physiology, Brussels, Belgium

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et Clinique (IREC), Pôle d'Endocrinologie, Diabète et Nutrition, Brussels,

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Belgium

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Cliniques universitaires Saint Luc, Division of Cardiology, Brussels, Belgium

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Université catholique de Louvain (UCL), de Duve Institute, Brussels, Belgium

Université catholique de Louvain (UCL), Institut de Recherche Expérimentale

Université catholique de Louvain (UCL), Institut de Recherche Expérimentale

Université catholique de Louvain (UCL), Institute of Neuroscience, Division of

Université catholique de Louvain (UCL), Institut de Recherche Expérimentale

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Running head :

1 Copyright © 2014 by the American Physiological Society.

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AMPK-mediated inhibition of ROS production by GLP-1

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Address for correspondence

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Christophe Beauloye, MD, PhD

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Université catholique de Louvain (UCL)

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Institut de Recherche Expérimentale et Clinique (IREC)

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Pôle de Recherche Cardiovasculaire

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55, Avenue Hippocrate

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1200 Brussels

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Belgium

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Phone: +32 2 764 55 66

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Fax: +32 2 764 5536

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e-mail: [email protected]

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Abstract:

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Exposure of cardiomyocytes to high glucose concentrations (HG) stimulates

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ROS production by NADPH oxidase (NOX2). NOX2 activation is triggered by

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enhanced glucose transport through a sodium-glucose co-transporter (SGLT)

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but not by a stimulation of glucose metabolism. The aim of this work was to

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identify potential therapeutic approaches to counteract this glucotoxicity.

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In cultured adult rat cardiomyocytes incubated with 21 mM glucose (HG), AMP-

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activated protein kinase (AMPK) activation by A769662 or phenformin nearly

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suppressed ROS production. Interestingly, GLP-1, a new anti-diabetic drug,

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concomitantly induced AMPK activation and prevented the HG-mediated ROS

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production (maximal effect at 100 nM). α2AMPK, the major isoform expressed in

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cardiomyocytes (but not α1AMPK), was activated in response to GLP-1. Anti-

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ROS properties of AMPK activators were not related to changes in glucose

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uptake or glycolysis. Using in situ proximity ligation assay, we demonstrated that

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AMPK activation prevented the HG-induced p47phox translocation to caveolae,

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whatever the AMPK activators used. NOX2 activation by either α-methyl-D-

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glucopyranoside, a glucose analog transported through SGLT, or angiotensin II

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was also counteracted by GLP-1. The crucial role of AMPK in limiting HG-

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mediated NOX2 activation was demonstrated by overexpressing a constitutively

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active form of α2AMPK using adenoviral infection. This overexpression

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prevented NOX2 activation in response to HG, whereas GLP-1 lost its protective

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action in α2AMPK deficient mouse cardiomyocytes. Under HG, the GLP-

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1/AMPK pathway inhibited PKCβ2 phosphorylation, a key element mediating

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p47phox translocation.

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In conclusion, GLP-1 induces α2AMPK activation and blocks HG-induced

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p47phox

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glucotoxicity.

translocation

to

the

plasma

membrane,

thereby

preventing

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Keywords:

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Glucose, Heart, Oxidative stress, Glucagon-like peptide-1 (GLP-1), AMP-

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activated protein kinase (AMPK)

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Introduction.

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Hyperglycemia is a major risk factor for the development of cardiovascular

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diseases in diabetic patients. Indeed, chronic exposure to high glucose (HG)

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concentrations damages cardiomyocytes (13). This glucotoxicity involves a

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number of pathological mechanisms, the most substantial one being the

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exacerbated production of reactive oxygen species (ROS) (15).

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Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase plays a critical

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role in the glucose-induced oxidative stress in the heart (2). Initially described in

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macrophages, this multimeric enzyme has been later identified in other cell

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types, including cardiomyocytes (40). NOX2 and NOX4 are the two isoforms

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found in cardiac cells. They consist of a heterodimeric membrane-bound

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cytochrome b558 made of either NOX2 or NOX4 and p22phox subunits.

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Whereas NOX4 is constitutively active and regulated by expression, NOX2

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activation requires the association at the plasma membrane of four cytosolic

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partners, p40phox, p67phox, p47phox and Rac1, the two latter being considered

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as activator subunits (4). p47phox phosphorylation triggers its translocation to

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the membrane in neutrophils and can be catalysed by five PKCs: α, β, δ, ε and ζ

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(14).

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NOX2 is the isoform involved in HG toxicity in cardiomyocytes in culture (39).

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The mechanism is not solely dependent on glucose metabolism but seems to

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require a SGLT-type of glucose transporter (2). Increased glucose transport

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through this transporter triggers a signaling cascade leading to Rac1 activation

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and p47phox translocation with subsequent ROS generation by NOX2 and

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eventually cell death. Moreover, PKCβ2 activation in cardiac caveolae was

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recently shown to mediate glucotoxicity, although the link between PKCβ2

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activation and p47phox translocation leading to NOX2 activation remains to be

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demonstrated (22).

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The incretin glucagon-like peptide-1 (GLP-1) is a new therapeutic approach to

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control glycemia in diabetic patients (12). It is derived from the proglucagon

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precursor and is secreted by intestinal L-cells following nutrient ingestion. GLP-1

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(7-36) amide is rapidly degraded to GLP-1 (9-36) by the enzyme dipeptidyl

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peptidase-4 (DPP4). It acts through a G-coupled receptor (GLP-1R), which is

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present on pancreatic β-cells where it displays glucoregulatory and insulinotropic

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effects. This receptor is also expressed in other cell types, including

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cardiomyocytes, and several GLP-1 cardiovascular beneficial properties have

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been attributed to a direct effect of GLP-1 on heart, in animal models as well as

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in humans (34).

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GLP-1 has been reported to activate AMP-activated protein kinase (AMPK) in

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liver by a still unknown mechanism (5). AMPK is a serine/threonine kinase made

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of three subunits: the catalytic α-subunit, and two regulatory β and γ subunits

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(18). There are seven AMPK genes encoding two α (1 and 2), two β (1 and 2),

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and three γ (1, 2, and 3) isoforms respectively. AMPK is activated by

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phosphorylation of Thr172 in the catalytic domain by at least two upstream

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kinases. The first mechanism senses energy and involves AMP and LKB1,

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whereas the second implies changes in intracellular calcium ion concentration

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and is mediated by calmodulin-dependent kinase kinase β (CaMKKβ) (18).

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AMPK acts as an energy sensor regulating energy homeostasis although its role

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extends well beyond metabolism (19).

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In this work, we demonstrate that GLP-1 protects cardiomyocytes against HG-

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induced NOX2 activation through an AMPK-mediated mechanism.

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Methods

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Animals and materials

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Animal handlings were approved by the Animal Research Committee of the

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Université catholique de Louvain (2012/UCL/MD/003) and conformed to the

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Guide for the Care and Use of Laboratory Animals published by the US National

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Institutes of Health (NIH Publication No. 85-23, revised 1996). All biochemicals

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were from Sigma, unless otherwise stated. SAMS and Exendin 9-39 peptides

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were kindly provided by V. Stroobant (Ludwig Institute, Brussels, Belgium). The

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antibodies

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phosphoAMPK (T172), acetyl-CoA Carboxylase (ACC), eukaryotic elongation

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factor

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Hemaglutinin (HA) (Cell Signaling); phosphoACC (S79) (Pierce); caveolin-3

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(Santa-Cruz); p47phox, Glut-4 (Millipore).

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used

(eEF2),

were:

α1

c-myc-tag,

and

α2AMPK

phosphoPKC

(Kinasource);

(pan)

(β2

total-αAMPK,

S660),

GAPDH,

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Isolation and culture of adult rat cardiomyocytes

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Adult male Wistar fed rats were anesthetized with pentobarbital 50 mg/kg IP and

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sacrificed by cervical dislocation before removing the heart. The cardiomyocytes

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were isolated by perfusion with collagenase type II (1 mg/ml, Worthington), and

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cultured as previously described (6). Briefly, cells were plated on laminin-coated

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dishes and incubated for 24 h in fresh medium 199 (Invitrogen, 5.5 mM D-

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glucose) containing 100 mg/l glutamine, 2 mM carnitine, 5 mM creatine, 5 mM

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taurine, 0.1 nM T3 and 0.2% (w/v) BSA (fatty acid free) in the presence of 100

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U/ml penicillin and 100 µg/ml streptomycin. Primary cultures of cardiomyocytes

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were incubated with the different concentrations of D-glucose and other

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additions, for the indicated periods of time and as detailed in the figure legends.

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Isolation and culture of adult mouse cardiomyocytes (WT and KO mice for

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AMPK α2 subunit)

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Adult male mice were anesthetized with ketamine (80 mg/kg) and xylazine (10

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mg/kg). Cardiomyocytes were isolated by perfusion with liberase DH enzyme

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(1.25mg/heart, Roche). Cells were then plated on laminin-coated dishes and

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incubated for 2 h in fresh medium 199 (Invitrogen, 5.5 mM D-glucose) containing

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100 U/ml penicillin and 100 µg/ml streptomycin. Primary cultures of mouse

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cardiomyocytes were treated as adult rat cardiomyocytes.

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Measurement of reactive oxygen species

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Intracellular ROS production was measured by evaluating oxidation of the cell

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permeable fluorescent probe 2’,7’-dihydrodichlorofluorescein diacetate (H2DCF-

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DA, Invitrogen), as previously described (2).

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Metabolic measurements

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Glucose uptake and glycolytic flux were measured by the rate of detritiation of

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[2-3H]glucose and [3-3H]glucose, respectively (43). Purine nucleotides were

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measured in neutralized perchloric acid extracts following their separation by

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HPLC (26).

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Glut4 translocation to the plasma membrane

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Adenovirus expressing HA-Glut4-GFP protein was kindly provided by Dr Corley

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Mastick (Department of Biochemistry and Molecular Biology, University of

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Nevada, USA) (27). Glut4 is labelled at the C-terminal part with GFP and, at the

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N-terminal part with HA. When Glut4 is translocated to the plasma membrane,

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HA can be detected at the cell surface. Experiments were performed 48 h after

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infection (multiplicity of infection 10). After treatment, cardiomyocytes were fixed

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with paraformaldehyde (4% v/v) on ice and placed in a blocking solution (bovine

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serum albumin, 5% w/v). Cells were first incubated with a primary antibody (anti-

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HA) followed by a secondary fluorescent antibody (Alexa Fluor 594). Glut4 at the

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plasma membrane appears as red fluorescent dots. Nuclei were stained with

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DAPI. Protein staining was visualized using a Zeiss.Imager.Z1 microscope

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equipped with an ApoTome device. Red fluorescent dots (HA) were quantified

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related to green (GFP) by the software Photoshop.

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Immunoblot analysis and AMPK activity measurement

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Cells were lyzed in cold buffer containing 50 mM Hepes (pH 7.5), 50 mM KF, 1

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mM KPi, 5 mM EDTA, 5 mM EGTA, 15 mM β-mercaptoethanol, 1 µg/ml

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leupeptin, 1 mM benzamidin, 1 mM phenylmethylsulfonyl fluoride, 1 mM

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vanadate, and 1 % v/v Triton X-100. Protein content was measured with bovine

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serum albumin as a standard (9). Immunoblots were performed with total

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extracts separated on 10% SDS-PAGE and transferred to polyvinylidene

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difluoride membranes. The membranes were blocked with milk or bovine serum

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albumin (5% w/v) and then blotted with the corresponding antibodies.

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incubation with the appropriate secondary antibody, proteins were visualized

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using electrochemical luminescence (Pierce) and quantified using Image J.

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Band intensities were normalized relative to those of loading on the same gel.

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The loading control used was eEF-2 except for PKC (GAPDH). Immunoblotting

After

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with respective anti-total antibodies was performed on a separate gel to verify

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the absence of any modification in protein expression.

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Total AMPK activity was measured after PEG fractionation and α1AMPK and

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α2AMPK activities were measured on respective immunoprecipitates, as

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previously described (48).

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Proteins co-localisation using in situ proximity ligation assay (PLA)

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This technique allows visualization of a co-localisation of two proteins (24). After

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treatment, cardiomyocytes were fixed with paraformaldehyde (4% v/v),

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permeabilized with triton X-100 (0.2% v/v in PBS), and placed in a blocking

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solution at 37°C. Cells were then incubated overnight at 4°C with two primary

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antibodies (from two different species) raised against the two proteins of interest.

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Secondary antibodies raised against the two different species and coupled with

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special oligonucleotides dyes were then added. If the proteins are at less than

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40 nm from each other, a ligase creates a circle-shaped structure

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(‘concatemer’), which is amplified by a polymerase. This amplified product is

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finally detected with complementary fluorescently labelled oligonucleotides that

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hybridize to the concatemers. The result is observed as red fluorescent dots

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appearing when proteins co-localise. Nuclei were stained with DAPI. Protein

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staining was visualized using a Zeiss.Imager.Z1 microscope equipped with an

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ApoTome device. Red fluorescent dots were quantified (AxioVision Rel 4.8.).

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Adenoviral infection

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Adult rat cardiomyocytes were infected (multiplicity of infection 100) as

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described (6) with two different adenoviral constructions, one expressing

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constitutively active form of α2AMPK and the other expressing GFP alone.

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Experiments were performed 48 h after infection.

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Quantitative PCR

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Total mRNA was extracted from cardiomyocytes using a chloroform/isopropanol

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procedure (Tripure, Roche). Reverse transcription was performed for 1h at 37°C

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with 1µg RNA using an iScriptTM cDNA synthesis kit (Bio-Rad laboratories).

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Quantitative PCR was performed on IQ5 (Bio-Rad) using the qPCR Core kit for

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Sybergreen (Eurogentec). The mRNA level for each gene in each sample was

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normalized to the housekeeping gene hypoxanthine guanine phosphoribosyl

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transferase 1 (Hprt1), after ΔΔCt correction. The nucleotide sequences of

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primers used were: p47phox: 5’-TCACCGAGATCTACGAGTTC-3’ (sense) and

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5’-TCCCATGAGGCTGTTGAAGT-3’

(antisense),

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GTCCCAGCGTCGTGATTAGT-3’

(sense)

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ACAGAGGGCCACAATGTGAT-3’ (antisense).

Hprt1 and

5’5’-

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Statistical analysis

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All the values are expressed as mean ± SEM. Comparisons were performed

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using ANOVA followed by a Bonferroni post-hoc correction. p

AMPK activation by glucagon-like peptide-1 prevents NADPH oxidase activation induced by hyperglycemia in adult cardiomyocytes.

Exposure of cardiomyocytes to high glucose concentrations (HG) stimulates reactive oxygen species (ROS) production by NADPH oxidase (NOX2). NOX2 activ...
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