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Age-Induced Accumulation of Succinate Promotes Cardiac Fibrogenesis

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机构: [1]Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, China [2]Department of Cardiology and Nephrology, The 82nd Group Army Hospital of PLA (252 Hospital of PLA), Baoding, Hebei, China [3]Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China [4]Beijing Key Laboratory of Cancer Invasion and Metastasis Research, China [5]Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China [6]Department of Colorectal Surgery, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China [7]Comprehensive Oncology Department, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China [8]Department of Medical Laboratory, Affiliated Cancer Hospital of Cheng du Medical College, Cheng du Seventh People's Hospital, Sichuan, China [9]School of Clinical Medicine, The First Affiliated Hospital of Chengdu Medical College, Sichuan, China [10]Shigatse Branch, Xinqiao Hospital, Army 953 Hospital, Army Medical University, China [11]National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China [12]Laboratory for Clinical Medicine, Capital Medical University, Beijing, China
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关键词: aging apoptosis resistance diastolic dysfunction fibroblast activation succinate

摘要:
Age-related cardiac fibrosis is a risk factor for heart failure and a marker for heart aging. However, the mechanisms underlying age-related cardiac fibrosis remain unclear. Ischemia and hypoxia are inevitable events in the aging process, which are direct causes of mitochondrial dysfunction and metabolic alterations. In this study, we identified metabolic changes and determined the mechanisms by which succinate (a tricarboxylic acid cycle intermediate) accumulation promotes fibroblast activation and apoptosis resistance in the aging heart. We also assessed its significance in relation to cardiac fibrosis and diastolic dysfunction.We first investigated how aging promotes persistent cardiac fibrosis. Following this, the metabolic alterations of the aging heart were identified by untargeted metabolomics, and the succinate level was verified via quantitative analysis. Furthermore, the correlations between succinate and fibrosis or diastolic dysfunction in older mice/people were assessed. We also described the role of succinate and its receptor SUCNR1/GPR91 in establishing a fibrosis network during diastolic dysfunction with age using SUCNR1-/- mouse model and an AAV9-based approach. We further identified the specific mechanisms involved in PKM2 dimerization, which regulate fibroblast activation and apoptosis resistance.We demonstrated that aging promotes fibrogenesis and diastolic dysfunction, which are linked to fibroblast activation and apoptosis resistance in the heart. Succinate levels were correlated with diastolic dysfunction and cardiac fibrosis in older mice and people. Functionally, succinate promoted fibroblast activation and apoptosis resistance, which aggravate cardiac fibrosis formation in both young and old mice. This was attributed to the ability of succinate to stimulate PKM2 dimerization via succinate receptor SUCNR1. Furthermore, dimeric PKM2 translocated to the nucleus and mitochondria, where it promoted fibroblast activation and apoptosis resistance, respectively. Accumulated PKM2 in the nucleus interacted with HIF-1α, increasing the DNA binding of HIF-1α and the expression of fibrogenic genes, resulting in fibroblast activation. In the mitochondria, accumulated PKM2 phosphorylated VDAC1 at T93 and increased VDAC1 degradation by promoting SYVN1-based E3 ligase binding to VDAC1, which is associated with increased apoptosis resistance and fibrosis persistence. We found that targeting succinate accumulation by metformin can inhibit fibroblast activation and apoptosis resistance in mice, which is a potential strategy to control age-related cardiac fibrosis and diastolic dysfunction.Our findings indicate that targeting metabolic dysregulation has significant implications for the treatment of age-related cardiac fibrosis and diastolic dysfunction. We further demonstrate a novel mechanism by which succinate induces fibroblast activation and apoptosis resistance by promoting PKM2 dimerization. Hence, inhibiting succinate generation or blocking its downstream effects is potentially a promising new strategy for slowing the heart aging.

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出版当年[2022]版:
大类 | 1 区 医学
小类 | 1 区 心脏和心血管系统 1 区 外周血管病 1 区 血液学
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 心脏和心血管系统 1 区 血液学 1 区 外周血管病
第一作者:
第一作者机构: [1]Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, China [2]Department of Cardiology and Nephrology, The 82nd Group Army Hospital of PLA (252 Hospital of PLA), Baoding, Hebei, China [3]Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China [4]Beijing Key Laboratory of Cancer Invasion and Metastasis Research, China
通讯作者:
通讯机构: [1]Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, China [2]Department of Cardiology and Nephrology, The 82nd Group Army Hospital of PLA (252 Hospital of PLA), Baoding, Hebei, China [3]Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China [4]Beijing Key Laboratory of Cancer Invasion and Metastasis Research, China [5]Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, Beijing, China [11]National Clinical Research Center for Geriatric Diseases, Xuanwu Hospital, Capital Medical University, Beijing, China [12]Laboratory for Clinical Medicine, Capital Medical University, Beijing, China [*1]Department of Histology and Embryology, School of Basic Medical Sciences, Capital Medical University, No. 10, Xitoutiao, You’anmen Wai, Fengtai District, Beijing, 100069, China [*2]Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, No. 10, Tieyi Rd, Yangfangdian, Haidian District, Beijing, 100069, China [*3]Department of Cardiology and Nephrology, The 82nd Group Army Hospital of PLA (252 Hospital of PLA), No. 991, Baihua E Rd, Lianchi District, Baoding, Hebei, 071000, China
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