c-Cbl inhibition improves cardiac function and survival in response to myocardial ischemia

Circulation. 2014 May 20;129(20):2031-43. doi: 10.1161/CIRCULATIONAHA.113.007004. Epub 2014 Feb 28.

Abstract

Background: The proto-oncogene Casitas b-lineage lymphoma (c-Cbl) is an adaptor protein with an intrinsic E3 ubiquitin ligase activity that targets receptor and nonreceptor tyrosine kinases, resulting in their ubiquitination and downregulation. However, the function of c-Cbl in the control of cardiac function is currently unknown. In this study, we examined the role of c-Cbl in myocyte death and cardiac function after myocardial ischemia.

Methods and results: We show increased c-Cbl expression in human ischemic and dilated cardiomyopathy hearts and in response to pathological stress stimuli in mice. c-Cbl-deficient mice demonstrated a more robust functional recovery after myocardial ischemia/reperfusion injury and significantly reduced myocyte apoptosis and improved cardiac function. Ubiquitination and downregulation of key survival c-Cbl targets, epidermal growth factor receptors and focal adhesion kinase, were significantly reduced in c-Cbl knockout mice. Inhibition of c-Cbl expression or its ubiquitin ligase activity in cardiac myocytes offered protection against H2O2 stress. Interestingly, c-Cbl deletion reduced the risk of death and increased cardiac functional recovery after chronic myocardial ischemia. This beneficial effect of c-Cbl deletion was associated with enhanced neoangiogenesis and increased expression of vascular endothelial growth factor-a and vascular endothelial growth factor receptor type 2 in the infarcted region.

Conclusions: c-Cbl activation promotes myocyte apoptosis, inhibits angiogenesis, and causes adverse cardiac remodeling after myocardial infarction. These findings point to c-Cbl as a potential therapeutic target for the maintenance of cardiac function and remodeling after myocardial ischemia.

Keywords: angiogenesis; apoptosis; myocardial ischemia; ubiquitin.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Aged
  • Animals
  • Apoptosis / physiology
  • Cardiac Catheterization
  • Cardiomyopathy, Dilated / genetics
  • Cardiomyopathy, Dilated / pathology
  • Cardiomyopathy, Dilated / physiopathology*
  • Echocardiography
  • Electrocardiography
  • Female
  • Heart Failure / genetics
  • Heart Failure / pathology
  • Heart Failure / physiopathology*
  • Humans
  • Male
  • Mice
  • Mice, Knockout
  • Middle Aged
  • Myocardial Infarction / genetics
  • Myocardial Infarction / pathology
  • Myocardial Infarction / physiopathology
  • Myocardial Ischemia / genetics
  • Myocardial Ischemia / pathology
  • Myocardial Ischemia / physiopathology*
  • Myocytes, Cardiac / cytology
  • Myocytes, Cardiac / physiology
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins c-cbl / genetics
  • Proto-Oncogene Proteins c-cbl / physiology*
  • Rats
  • Rats, Sprague-Dawley
  • Ubiquitin-Protein Ligases / metabolism

Substances

  • MAS1 protein, human
  • Proto-Oncogene Mas
  • Proto-Oncogene Proteins c-cbl
  • Ubiquitin-Protein Ligases
  • CBL protein, human
  • Cbl protein, mouse