β 1 -Blockade Prevents Post-Ischemic Myocardial Decompensation Via β 3 AR-Dependent Protective Sphingosine-1 Phosphate Signaling

Alessandro Cannavo, Giuseppe Rengo, Daniela Liccardo, Andres Pun, Ehre Gao, Alvin J. George, Giuseppina Gambino, Antonio Rapacciuolo, Dario Leosco, Borja Ibanez, Nicola Ferrara, Nazareno Paolocci, Walter J. Koch

Research output: Contribution to journalArticlepeer-review

Abstract

Background Although β-blockers increase survival in patients with heart failure (HF), the mechanisms behind this protection are not fully understood, and not all patients with HF respond favorably to them. We recently showed that, in cardiomyocytes, a reciprocal down-regulation occurs between β 1 -adrenergic receptors (ARs) and the cardioprotective sphingosine-1-phosphate (S1P) receptor- 1 (S1PR 1 ). Objectives The authors hypothesized that, in addition to salutary actions due to direct β 1 AR-blockade, agents such as metoprolol (Meto) may improve post–myocardial infarction (MI) structural and functional outcomes via restored S1PR 1 signaling, and sought to determine mechanisms accounting for this effect. Methods We tested the in vitro effects of Meto in HEK293 cells and in ventricular cardiomyocytes isolated from neonatal rats. In vivo, we assessed the effects of Meto in MI wild-type and β 3 AR knockout mice. Results Here we report that, in vitro, Meto prevents catecholamine-induced down-regulation of S1PR 1 , a major cardiac protective signaling pathway. In vivo, we show that Meto arrests post-MI HF progression in mice as much as chronic S1P treatment. Importantly, human HF subjects receiving β 1 AR-blockers display elevated circulating S1P levels, confirming that Meto promotes S1P secretion/signaling. Mechanistically, we found that Meto-induced S1P secretion is β 3 AR-dependent because Meto infusion in β 3 AR knockout mice does not elevate circulating S1P levels, nor does it ameliorate post-MI dysfunction, as in wild-type mice. Conclusions Our study uncovers a previously unrecognized mechanism by which β 1 -blockers prevent HF progression in patients with ischemia, suggesting that β 3 AR dysfunction may account for limited/null efficacy in β 1 AR-blocker–insensitive HF subjects.

Original languageEnglish (US)
Pages (from-to)182-192
Number of pages11
JournalJournal of the American College of Cardiology
Volume70
Issue number2
DOIs
StatePublished - Jul 11 2017

Keywords

  • myocardial infarction
  • sphingosine 1-phosphate
  • β-adrenergic receptors
  • β-blocker

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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