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Journal of Molecular Medicine

, Volume 91, Issue 10, pp 1185–1197 | Cite as

Cardiac glutaminolysis: a maladaptive cancer metabolism pathway in the right ventricle in pulmonary hypertension

  • Lin Piao
  • Yong-Hu Fang
  • Kishan Parikh
  • John J. Ryan
  • Peter T. Toth
  • Stephen L. ArcherEmail author
Original Article

Abstract

The rapid growth of cancer cells is permitted by metabolic changes, notably increased aerobic glycolysis and increased glutaminolysis. Aerobic glycolysis is also evident in the hypertrophying myocytes in right ventricular hypertrophy (RVH), particularly in association with pulmonary arterial hypertension (PAH). It is unknown whether glutaminolysis occurs in the heart. We hypothesized that glutaminolysis occurs in RVH and assessed the precipitating factors, transcriptional mechanisms, and physiological consequences of this metabolic pathway. RVH was induced in two models, one with PAH (Monocrotaline-RVH) and the other without PAH (pulmonary artery banding, PAB-RVH). Despite similar RVH, ischemia as determined by reductions in RV VEGFα, coronary blood flow, and microvascular density was greater in Monocrotaline-RVH versus PAB-RVH. A sixfold increase in 14C-glutamine metabolism occurred in Monocrotaline-RVH but not in PAB-RVH. In the RV working heart model, the glutamine antagonist 6-diazo-5-oxo-l-norleucine (DON) decreased glutaminolysis, caused a reciprocal increase in glucose oxidation, and elevated cardiac output. Consistent with the increased glutaminolysis in RVH, RV expressions of glutamine transporters (SLC1A5 and SLC7A5) and mitochondrial malic enzyme were elevated (Monocrotaline-RVH > PAB-RVH > control). Capillary rarefaction and glutamine transporter upregulation also occurred in RVH in patients with PAH. cMyc and Max, known to mediate transcriptional upregulation of glutaminolysis, were increased in Monocrotaline-RVH. In vivo, DON (0.5 mg/kg/day × 3 weeks) restored pyruvate dehydrogenase activity, reduced RVH, and increased cardiac output (89 ± 8, vs. 55 ± 13 ml/min, p < 0.05) and treadmill distance (194 ± 71, vs. 36 ±7 m, p < 0.05) in Monocrotaline-RVH. Glutaminolysis is induced in the RV in PAH by cMyc–Max, likely as a consequence of RV ischemia. Inhibition of glutaminolysis restores glucose oxidation and has a therapeutic benefit in vivo.

Key message

  • Patients with pulmonary artery hypertension (PAH) have evidence of cardiac glutaminolysis.

  • Cardiac glutaminolysis is associated with microvascular rarefaction/ischemia.

  • As in cancer, cardiac glutaminolysis results from activation of cMyc-Max.

  • The specific glutaminolysis inhibitor DON regresses right ventricular hypertrophy.

  • DON improves cardiac function and exercise capacity in an animal model of PAH.

Keywords

Warburg effect cMyc 6-Diazo-5-oxo-l-norleucine (DON) Glucose oxidation WHO group 1 pulmonary hypertension (PAH) Anapleurosis Congenital heart disease Scleroderma 

Notes

Acknowledgments

Dr. Archer is supported by NIH-RO1-HL071115 and 1RC1HL099462-01 and the American Heart Association. The authors thank Dr. E. Kenneth Weir for his help in critiquing this manuscript.

Disclosures

The authors have no conflicts to disclose.

Supplementary material

109_2013_1064_MOESM1_ESM.pdf (766 kb)
ESM 1 (PDF 765 kb)

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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  • Lin Piao
    • 1
  • Yong-Hu Fang
    • 1
  • Kishan Parikh
    • 1
  • John J. Ryan
    • 2
  • Peter T. Toth
    • 1
  • Stephen L. Archer
    • 3
    Email author
  1. 1.Section of Cardiology, Department of MedicineUniversity of ChicagoChicagoUSA
  2. 2.Division of Cardiology, Department of MedicineUniversity of UtahSalt Lake CityUSA
  3. 3.Department of MedicineQueen’s UniversityKingstonCanada

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