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Sun P, Li Y, Li Y, Ji H, Mang G, Fu S, Jiang S, Choi S, Wang X, Tong Z, Wang C, Gao F, Wan P, Chen S, Li Y, Zhao P, Leng X, Zhang M, Tian J. Low-intensity pulsed ultrasound protects from inflammatory dilated cardiomyopathy through inciting extracellular vesicles. Cardiovasc Res 2024; 120:1177-1190. [PMID: 38696702 DOI: 10.1093/cvr/cvae096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/30/2023] [Accepted: 02/14/2024] [Indexed: 05/04/2024] Open
Abstract
AIMS CD4+ T cells are activated during inflammatory dilated cardiomyopathy (iDCM) development to induce immunogenic responses that damage the myocardium. Low-intensity pulsed ultrasound (LIPUS), a novel physiotherapy for cardiovascular diseases, has recently been shown to modulate inflammatory responses. However, its efficacy in iDCM remains unknown. Here, we investigated whether LIPUS could improve the severity of iDCM by orchestrating immune responses and explored its therapeutic mechanisms. METHODS AND RESULTS In iDCM mice, LIPUS treatment reduced cardiac remodelling and dysfunction. Additionally, CD4+ T-cell inflammatory responses were suppressed. LIPUS increased Treg cells while decreasing Th17 cells. LIPUS mechanically stimulates endothelial cells, resulting in increased secretion of extracellular vesicles (EVs), which are taken up by CD4+ T cells and alter their differentiation and metabolic patterns. Moreover, EVs selectively loaded with microRNA (miR)-99a are responsible for the therapeutic effects of LIPUS. The hnRNPA2B1 translocation from the nucleus to the cytoplasm and binding to caveolin-1 and miR-99a confirmed the upstream mechanism of miR-99a transport. This complex is loaded into EVs and taken up by CD4+ T cells, which further suppress mTOR and TRIB2 expression to modulate cellular differentiation. CONCLUSION Our findings revealed that LIPUS uses an EVs-dependent molecular mechanism to protect against iDCM progression. Therefore, LIPUS is a promising new treatment option for iDCM.
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MESH Headings
- Animals
- Extracellular Vesicles/metabolism
- Extracellular Vesicles/transplantation
- Cardiomyopathy, Dilated/metabolism
- Cardiomyopathy, Dilated/therapy
- Cardiomyopathy, Dilated/pathology
- Cardiomyopathy, Dilated/genetics
- Cardiomyopathy, Dilated/immunology
- Cardiomyopathy, Dilated/physiopathology
- Disease Models, Animal
- MicroRNAs/metabolism
- MicroRNAs/genetics
- Mice, Inbred C57BL
- Signal Transduction
- Ultrasonic Therapy
- Ventricular Function, Left
- Ultrasonic Waves
- Ventricular Remodeling
- Male
- Th17 Cells/immunology
- Th17 Cells/metabolism
- T-Lymphocytes, Regulatory/immunology
- T-Lymphocytes, Regulatory/metabolism
- Caveolin 1/metabolism
- Caveolin 1/genetics
- TOR Serine-Threonine Kinases/metabolism
- Cells, Cultured
- Humans
- Mice
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Affiliation(s)
- Ping Sun
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Yi Li
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Yifei Li
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Huan Ji
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Ge Mang
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Shuai Fu
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Shuangquan Jiang
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Stephen Choi
- SXULTRASONIC (Shenzhen) Ltd. Kerry Rehabilitation Medicine Research Institute, 126 Zhongkang Road, Shang Mei LinFutian, Shenzhen, 518000, Guangdong Province, China
| | - Xiaoqi Wang
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Zhonghua Tong
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Chao Wang
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Fei Gao
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Pingping Wan
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Shuang Chen
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - You Li
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Peng Zhao
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Xiaoping Leng
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Maomao Zhang
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
| | - Jiawei Tian
- Department of Ultrasound, Second Affiliated Hospital of Harbin Medical University, No. 246 XueFu Road, Nan Gang Dist., Harbin, 150086, Heilongjiang Province, China
- Ultrasound Molecular Imaging Joint Laboratory of Heilongjiang Province, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education, No. 246 XueFu Road, Nan Gang Dist, Harbin, 150086, Heilongjiang Province, China
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