The effect of hypoxia on nitric oxide and endothelial nitric oxide synthase in the whole heart and isolated cardiac cells: the role of the PI3–K / PKB pathway as a possible mediator.

Chamane, Nontuthuko Zoleka Lynette (Stellenbosch : University of Stellenbosch, 2009-03)

Thesis (MScMedSc (Biomedical Sciences. Medical Physiology))--University of Stellenbosch, 2009.


In the heart, endothelial nitric oxide synthase (eNOS) is regarded as the most important constitutively expressed enzymatic source of nitric oxide (NO), a major cardiac signalling molecule. On the whole, NO is regarded as a cardioprotective molecule. The role of eNOS during ischaemia / hypoxia is controversial; however, it is generally accepted that ischaemia / hypoxia results in increased cardiac NO production. Most studies focus either on the whole heart or isolated cell models. As yet, no study has compared findings with regard to NO metabolism in these two distinct models, in a single study. We hypothesise that observations in a whole heart model with regard to increased NO production and eNOS involvement in ischaemia are the result of events on cellular level and that the increase in NO production observed during hypoxia in cardiomyocytes and endothelial cells is at least in part due to the increase in expression and / or activation of eNOS. Furthermore, we hypothesize that these effects are mediated via the PI3-K / PKB pathway. We aimed to measure and compare NO-production and eNOS expression and activation in the whole heart and isolated cardiac cells and measure PKB expression and activation in the cells under normoxic and ischaemic / hypoxic conditions. We also aimed to determine the effects of PI3-K / PKB pathway inhibition on NO production and eNOS expression and activation in isolated cardiac cells under normoxic and hypoxic conditions. Adult rat hearts were perfused and global ischaemia induced for 15 and 20 min. Tissue homogenates of perfused hearts were used for the measurement of nitrites and determination of expression and activation of eNOS. Expression of eNOS in the heart was also determined by immunohistochemical (IHC) analysis. Cardiomyocytes were isolated from adult rat hearts by collagenase-perfusion, and adult rat cardiac microvascular endothelial cells (CMEC) purchased commercially. In the cells, hypoxia was induced by covering cell pellets with mineral oil for 60 min. Cell viability was determined by trypan blue and propidium iodide (PI) staining and intracellular NO production measured by FACS analysis of the NO-specific probe, DAF-2/DA and by measurement of nitrite levels (Griess reagent). Results show that in ischaemic hearts, nitrite production increased by 12 % after 15 min ischaemia and 7 % after 20 min ischaemia. Total eNOS expression remained unchanged (Western Blot and IHC) and activated eNOS (phospho-eNOS Ser1177) increased by 38 % after 15 min ischaemia and decreased by 43% after 20 min ischaemia. In the cells, both viability techniques verified that the hypoxia-protocol induced significant damage. In isolated cardiomyocytes, NO-production increased 1.2-fold (by DAF-2/DA fluorescence), total eNOS expression increased 2-fold and activated eNOS increased 1.8-fold over control. In CMECs, NO-production increased 1.6-fold (by DAF-2/DA fluorescence), total eNOS increased by 1.8- fold and activated eNOS by 3-fold. With regards to our PI3-K / PKB investigations, results showed an increase of 84 % and 88 % in expression vii and activation of PKB (phospho Ser473) in hypoxic cardiomyocytes, respectively. In hypoxic CMECs, there was no change in PKB expression but there was a 69 % increase in phosphorylated PKB. NO production in wortmannin-treated hypoxic cardiomyocytes decreased by 12 % as compared to untreated hypoxic cells. In treated hypoxic CMECs, NO production decreased by 58 % as compared to untreated hypoxic cells. Treatment with wortmannin did not change the expression of eNOS protein in the cardiomyocytes, however, activated eNOS decreased by 41 % and 23 % under baseline and hypoxic conditions in treated cells respectively. There was a significant increase in NO production after exposure to O2 deficient conditions in all models investigated, a trend similar to what previous studies in literature found. However, the source of this NO is not fully understood although it has been discovered that NOS plays a role. Our data reveals similar trends in 15 min ischaemia in whole hearts and 60 min hypoxia in the cells; however, the trends observed at 20 min ischaemia are in conflict with our cell data (i.e. decrease in activated eNOS). This may be due to the severity of the ischaemic insult in whole hearts and/or the presence of other cell types and paracrine factors in the whole heart. Hypoxia increased the activation of PKB in the isolated cardiac cells. Inhibition of the PI3-K / PKB pathway reduced NO production and hypoxia-induced eNOS activation in cardiomyocytes. In conclusion, we have, for the first time, demonstrated that the increase in NO production during hypoxia is due (at least in part) to an increase in eNOS phosphorylation at Ser1177 and that this is mediated via the PI3-K / PKB pathway.

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