Abstract
The N-myc downstream-regulated gene 2 (NDRG2) is involved in cell apoptosis and survival. Although reported to be highly expressed in the cardiac tissue, the biological function of NDRG2 in the heart remains to be established. Insulin exerts protective effects against myocardial ischemia/reperfusion (I/R) injury through the PI3K/Akt pathway. Here, we examined the changes in phosphorylation of NDRG2, a novel substrate and phosphoprotein of Akt, in insulin-induced protection against myocardial I/R. Rat hearts were subjected to 30 min regional ischemia followed by reperfusion with or without insulin at the onset of reperfusion. Reperfusion with insulin inhibited myocardial apoptosis and reduced infarct size, as well as significantly up-regulated myocardial Akt and NDRG2 phosphorylation levels compared with the I/R group. These effects of insulin were blocked by pretreatment with the PI3K inhibitor wortmannin or Akt inhibitor. To further ascertain the role of NDRG2 in insulin-induced cardioprotection, cardiomyocytes were transduced with a lentivirus encoding shRNA targeting NDRG2 (loss-of-function), which rendered the cells more susceptible to I/R injury and significantly blunted the anti-apoptotic effect of insulin. Moreover, the NDRG2 shRNA lentivirus was tested in vivo, and NDRG2 knockdown aggravated myocardial I/R injury and attenuated the insulin-mediated cardioprotection against I/R injury. Taken together, these results suggest a novel role of PI3K/Akt/NDRG2 signaling in the cardioprotective effect of insulin.
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Acknowledgments
This work was supported by grants from the National Natural Science Foundation of China (Nos. 81230043, 31171112, 81001161 and 81001123); National Basic Research Program of China (2012CB518101); Team Development Grant by China Department of Education (2010CXTD01) and China’s Ministry of Science and Technology 863 Program (2012AA02A603).
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On behalf of all authors, the corresponding author states that there is no conflict of interest.
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Z. Sun, G. Tong and N. Ma contributed equally to this work and should be considered as co-first authors.
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Supplemental Fig. 1 Fluorescence microscopy showing the transduction efficiency in primary cardiomyocytes inoculated with Lenti-GFP for 72 h. Scale bar = 100 μm (Tiff 6.14 mb)
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Supplemental Fig. 2 Local injection of lentivirus within myocardium and NDRG2 expression detection in different area after different treatment. (a) 2 × 109 TU/ml virus in 100 μl solution were divided into three equal volume and injected into 3 sites. In brief, 2 sites were on each side of the LAD, 2 mm lower than the future ligation site and 5 mm lateral to the LAD. The other site was the apex of heart. This pattern of injection was chosen to ensure universal distribution of virus in ischemic area-to-be. (b) Immunohistochemistry staining of NDRG2 protein in different areas of cardiac tissue. Scale bar = 25 um (c) Western blot analysis of NDRG2 expression in ischemic area and non-ischemic area post local lentivirus injection (Tiff 8.04 mb)
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Supplemental Fig. 3 Representative image of immunofluorescence staining of CD11b (leukocyte marker) for myocardial inflammation detection after injection. Scale bar = 25 um (Tiff 4.22 mb)
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Supplemental Fig. 4 Myocardial apoptosis, infarct size and cardiac function evaluation in rats subjected to I/R after NDRG2 knockdown. (a) Western blotting detection of NDRG2 expression in rat heart tissue after transduced with NDRG2 shRNA lentivirus or scramble shRNA lentivirus for 4 days. (b) Representative images of TUNEL-positive cardiomyocytes within ischemic area after different treatment. Scale bar = 50 um (c) The apoptotic index is expressed as the percentage of TUNEL-positive myocytes (up panel) over total nuclei determined by DAPI staining (low panel). (d) Representative illustrations of infarct size as stained by Evans Blue and TTC and statistical analysis of INF/AAR and AAR/LV values of two groups. (e) Representative M-mode images by echocardiography from rats 72 h after I/R injury and statistical analysis of LVEF and LVFS values of two groups (Tiff 2.79 mb)
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Supplemental Fig. 5 Effect of NDRG2 knockdown on the cardiomyocytes survival within the border area after insulin treatment. (a) Immunohistochemistry evaluation of NDRG2 expression within border area. Scale bar = 50 um (b–c) Representative images of TUNEL-positive cardiomyocytes within border area after injected with different lentivirus and statistical analysis of the apoptotic rate. Scale bar = 50 um (Tiff 5.54 mb)
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Supplemental Fig. 6 Comparison of apoptotic indexes and proteins levels between sham operation group and I/R group in vivo as well as between control group and SI/R group in vitro. (a) Western blotting detection of active-caspase3 expression in rat heart tissue. (b) Immunohistochemical staining of active-caspase3 protein in rat heart tissue. Scale bar = 50 um (c) Representative images of TUNEL-positive cardiomyocytes in rat heart tissue and statistical analysis of the apoptotic rate. Scale bar = 50 um **P < 0.01 versus sham operation group (d) Western blotting detection of both total and phosphorylated Akt and NDRG2 expression in rat heart tissue. (e) Western blotting detection of both total and phosphorylated Akt and NDRG2 expression in cultured cardiomyocytes. (f) Western blotting detection of active-caspase3 expression in cultured cardiomyocytes. (c) Representative images of TUNEL-positive cultured cardiomyocytes and statistical analysis of the apoptotic rate. Scale bar = 50 um **P < 0.01 versus control group (Tiff 2.94 mb)
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Supplemental Table 1 Basic hemodynamics parameters of rats before surgery (baseline), 30 min post ischemia and 1 h post reperfusion. Values are presented as mean ± SEM (Tiff 792 kb)
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Sun, Z., Tong, G., Ma, N. et al. NDRG2: a newly identified mediator of insulin cardioprotection against myocardial ischemia–reperfusion injury. Basic Res Cardiol 108, 341 (2013). https://doi.org/10.1007/s00395-013-0341-5
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DOI: https://doi.org/10.1007/s00395-013-0341-5