Abstract
Cardiac hypertrophy, in its aspects of localized thickening of the interventricular septum and concentric increase of the left ventricle, constitutes a risk factor of heart failure. Myocardial hypertrophy, in the presence of different degree of myocardial fibrosis, is paralleled by significant molecular, cellular, and histological changes inducing alteration of cardiac extracellular matrix composition as well as sarcomeres and cytoskeleton remodeling. Previous studies indicate osteopontin (OPN) and more recently survivin (SURV) overexpression as the hallmarks of heart failure although SURV function in the heart is not completely clarified. In this study, we investigated the involvement of SURV in intracellular signaling of hypertrophic cardiomyocytes and the impact of its transcriptional silencing, laying the foundation for novel target gene therapy in cardiac hypertrophy. Oligonucleotide-based molecules, like theranostic optical nanosensors (molecular beacons) and siRNAs, targeting SURV and OPN mRNAs, were developed. Their diagnostic and therapeutic potential was evaluated in vitro in hypertrophic FGF23-induced human cardiomyocytes and in vivo in transverse aortic constriction hypertrophic mouse model. Engineered erythrocyte was used as shuttle to selectively target and transfer siRNA molecules into unhealthy cardiac cells in vivo. The results highlight how the SURV knockdown could negatively influence the expression of genes involved in myocardial fibrosis in vitro and restores structural, functional, and morphometric features in vivo. Together, these data suggested that SURV is a key factor in inducing cardiomyocytes hypertrophy, and its shutdown is crucial in slowing disease progression as well as reversing cardiac hypertrophy. In the perspective, targeted delivery of siRNAs through engineered erythrocytes can represent a promising therapeutic strategy to treat cardiac hypertrophy.
Graphical abstract
Theranostic SURV molecular beacon (MB-SURV), transfected into FGF23-induced hypertrophic human cardiomyocytes, significantly dampened SURV overexpression. SURV down–regulation determines the tuning down of MMP9, TIMP1 and TIMP4 extracellular matrix remodeling factors while induces the overexpression of the cardioprotective MCAD factor, which counterbalance the absence of pro-survival and anti-apoptotic SURV activity to protect cardiomyocytes from death. In transverse aortic constriction (TAC) mouse model, the SURV silencing restores the LV mass levels to values not different from the sham group and counteracts the progressive decline of EF, maintaining its values always higher with respect to TAC group. These data demonstrate the central role of SURV in the cardiac reverse remodeling and its therapeutic potential to reverse cardiac hypertrophy.
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Abbreviations
- ANP:
-
Atrial natriuretic peptide
- BBQ:
-
Blackberry Quencher 650
- β-MHC:
-
Beta- myosin heavy chain
- BNP:
-
Brain natriuretic peptide
- CLSM:
-
Confocal laser scanning microscopy
- CSA:
-
Cross-sectional area
- EF:
-
Ejection fraction
- EGR1:
-
Early growth response 1
- EMHV:
-
Erythro-Magneto-Ha virosome
- ERK:
-
Extracellular signal-regulated kinases
- FGF23:
-
Fibroblast growth factor 23
- FHA:
-
Filamentous hemagglutinin
- FS:
-
Fractional shortening
- GADPH:
-
Glyceraldehyde-3-phosphate dehydrogenase
- HCM:
-
Human cardiomyocyte
- HF:
-
Heart failure
- HRP:
-
Horseradish peroxidase
- HW:
-
Heart weight
- IHC:
-
Immunohistochemistry
- IVSTd :
-
Interventricular septum thickness, diastolic
- LC:
-
Left carotid
- LV:
-
Left ventricle
- LVAD:
-
Left ventricular assist device
- LVPWTd :
-
Left ventricle posterior wall thickness, diastolic
- MB:
-
Molecular beacon
- MCAD:
-
Medium-chain acyl-CoA dehydrogenase
- MMP:
-
Matrix metalloproteinase
- NO:
-
Nitric oxide
- NOX4:
-
NADPH oxidase 4
- OPN:
-
Osteopontin
- PFS:
-
Pixel fluorescence signal
- RC:
-
Right carotid
- sk-α-actin:
-
Skeletal-alpha-actin
- SPION:
-
Super-paramagnetic iron oxide nanoparticles
- SURV:
-
Survivin
- TAC:
-
Transverse aortic constriction
- TIMP:
-
Tissue inhibitor of metalloproteinase
- TL:
-
Tibia length
- UHFUS:
-
Ultra high-frequency ultrasound
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Acknowledgements
The authors thank Dr. Silvia Burchielli for supporting animal protocol preparation and internal ethical committee.
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This work was supported by National Flagship project NANOMAX-ENCODER of the Italian Ministry of Education, University and Research.
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Kusmic, C., Vizzoca, A., Taranta, M. et al. Silencing Survivin: a Key Therapeutic Strategy for Cardiac Hypertrophy. J. of Cardiovasc. Trans. Res. 15, 391–407 (2022). https://doi.org/10.1007/s12265-021-10165-1
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DOI: https://doi.org/10.1007/s12265-021-10165-1