Inhibition of myocardial cathepsin-L release during reperfusion following myocardial infarction improves cardiac function and reduces infarct size

Cardiovascular Research

16 June 2021
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ESC Journals

Abstract

AbstractAims

Identifying novel mediators of lethal myocardial reperfusion injury that can be targeted during primary percutaneous coronary intervention (PPCI) is key to limiting the progression of patients with ST-elevation myocardial infarction (STEMI) to heart failure. Here, we show through parallel clinical and integrative preclinical studies the significance of the protease cathepsin-L on cardiac function during reperfusion injury.

Methods and results

We found that direct cardiac release of cathepsin-L in STEMI patients (n = 76) immediately post-PPCI leads to elevated serum cathepsin-L levels and that serum levels of cathepsin-L in the first 24 h post-reperfusion are associated with reduced cardiac contractile function and increased infarct size. Preclinical studies demonstrate that inhibition of cathepsin-L release following reperfusion injury with CAA0225 reduces infarct size and improves cardiac contractile function by limiting abnormal cardiomyocyte calcium handling and apoptosis.

Conclusion

Our findings suggest that cathepsin-L is a novel therapeutic target that could be exploited clinically to counteract the deleterious effects of acute reperfusion injury after an acute STEMI.

Contributors

Weihong He
Weihong He

Author

Sichuan University Chengdu - Sichuan , China

Kenneth Mangion
Kenneth Mangion

Author

Golden Jubilee National Hospital Glasgow , United Kingdom of Great Britain & Northern Ireland

Mathew M Y Lee
Mathew M Y Lee

Author

University of Glasgow Glasgow , United Kingdom of Great Britain & Northern Ireland

Colin Berry
Colin Berry

Author

University of Glasgow Glasgow , United Kingdom of Great Britain & Northern Ireland

Christopher M Loughrey
Christopher M Loughrey

Author

University of Glasgow Glasgow , United Kingdom of Great Britain & Northern Ireland