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Verjans R, Peters T, Beaumont FJ, van Leeuwen R, van Herwaarden T, Verhesen W, Munts C, Bijnen M, Henkens M, Diez J, de Windt LJ, van Nieuwenhoven FA, van Bilsen M, Goumans MJ, Heymans S, González A, Schroen B. MicroRNA-221/222 Family Counteracts Myocardial Fibrosis in Pressure Overload-Induced Heart Failure. Hypertension 2017; 71:280-288. [PMID: 29255073 DOI: 10.1161/hypertensionaha.117.10094] [Citation(s) in RCA: 112] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Revised: 08/21/2017] [Accepted: 11/29/2017] [Indexed: 02/06/2023]
Abstract
Pressure overload causes cardiac fibroblast activation and transdifferentiation, leading to increased interstitial fibrosis formation and subsequently myocardial stiffness, diastolic and systolic dysfunction, and eventually heart failure. A better understanding of the molecular mechanisms underlying pressure overload-induced cardiac remodeling and fibrosis will have implications for heart failure treatment strategies. The microRNA (miRNA)-221/222 family, consisting of miR-221-3p and miR-222-3p, is differentially regulated in mouse and human cardiac pathology and inversely associated with kidney and liver fibrosis. We investigated the role of this miRNA family during pressure overload-induced cardiac remodeling. In myocardial biopsies of patients with severe fibrosis and dilated cardiomyopathy or aortic stenosis, we found significantly lower miRNA-221/222 levels as compared to matched patients with nonsevere fibrosis. In addition, miRNA-221/222 levels in aortic stenosis patients correlated negatively with the extent of myocardial fibrosis and with left ventricular stiffness. Inhibition of both miRNAs during AngII (angiotensin II)-mediated pressure overload in mice led to increased fibrosis and aggravated left ventricular dilation and dysfunction. In rat cardiac fibroblasts, inhibition of miRNA-221/222 derepressed TGF-β (transforming growth factor-β)-mediated profibrotic SMAD2 (mothers against decapentaplegic homolog 2) signaling and downstream gene expression, whereas overexpression of both miRNAs blunted TGF-β-induced profibrotic signaling. We found that the miRNA-221/222 family may target several genes involved in TGF-β signaling, including JNK1 (c-Jun N-terminal kinase 1), TGF-β receptor 1 and TGF-β receptor 2, and ETS-1 (ETS proto-oncogene 1). Our findings show that heart failure-associated downregulation of the miRNA-221/222 family enables profibrotic signaling in the pressure-overloaded heart.
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Affiliation(s)
- Robin Verjans
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Tim Peters
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Francisco Javier Beaumont
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Rick van Leeuwen
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Tessa van Herwaarden
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Wouter Verhesen
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Chantal Munts
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Mitchell Bijnen
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Michiel Henkens
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Javier Diez
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Leon J de Windt
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Frans A van Nieuwenhoven
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Marc van Bilsen
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Marie José Goumans
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Stephane Heymans
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Arantxa González
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.)
| | - Blanche Schroen
- From the Department of Cardiology (R.V., T.P., R.v.L., W.V., M.H., L.J.d.W., S.H., B.S.), Department of Physiology (C.M., F.A.v.N., M.v.B.), and Department of Internal Medicine (M.B.), CARIM School for Cardiovascular Diseases, Maastricht University, The Netherlands; Program of Cardiovascular Diseases, Centre for Applied Medical Research, University of Navarra, Pamplona, Spain (F.J.B., J.D., A.G.); Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain (F.J.B., J.D., A.G.); CIBERCV, Carlos III Institute of Health, Madrid, Spain (F.J.B., J.D., A.G.); Department of Molecular Cell Biology, Leiden University Medical Biology Center, The Netherlands (T.v.H., M.J.G.); Department of Cardiology and Cardiac Surgery, University of Navarra Clinic, Pamplona, Spain (J.D.); Netherlands Heart Institute (ICIN), Utrecht; and Department of Cardiovascular Sciences, Centre for Molecular and Vascular Biology (CMVB), KU Leuven, Belgium (S.H.).
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