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Harper SC, Johnson J, Borghetti G, Zhao H, Wang T, Wallner M, Kubo H, Feldsott EA, Yang Y, Joo Y, Gou X, Sabri AK, Gupta P, Myzithras M, Khalil A, Franti M, Houser SR. GDF11 Decreases Pressure Overload-Induced Hypertrophy, but Can Cause Severe Cachexia and Premature Death. Circ Res 2019; 123:1220-1231. [PMID: 30571461 DOI: 10.1161/circresaha.118.312955] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
RATIONALE Possible beneficial effects of GDF11 (growth differentiation factor 11) on the normal, diseased, and aging heart have been reported, including reversing aging-induced hypertrophy. These effects have not been well validated. High levels of GDF11 have also been shown to cause cardiac and skeletal muscle wasting. These controversies could be resolved if dose-dependent effects of GDF11 were defined in normal and aged animals as well as in pressure overload-induced pathological hypertrophy. OBJECTIVE To determine dose-dependent effects of GDF11 on normal hearts and those with pressure overload-induced cardiac hypertrophy. METHODS AND RESULTS Twelve- to 13-week-old C57BL/6 mice underwent transverse aortic constriction (TAC) surgery. One-week post-TAC, these mice received rGDF11 (recombinant GDF11) at 1 of 3 doses: 0.5, 1.0, or 5.0 mg/kg for up to 14 days. Treatment with GDF11 increased plasma concentrations of GDF11 and p-SMAD2 in the heart. There were no significant differences in the peak pressure gradients across the aortic constriction between treatment groups at 1 week post-TAC. Two weeks of GDF11 treatment caused dose-dependent decreases in cardiac hypertrophy as measured by heart weight/tibia length ratio, myocyte cross-sectional area, and left ventricular mass. GDF11 improved cardiac pump function while preventing TAC-induced ventricular dilation and caused a dose-dependent decrease in interstitial fibrosis (in vivo), despite increasing markers of fibroblast activation and myofibroblast transdifferentiation (in vitro). Treatment with the highest dose (5.0 mg/kg) of GDF11 caused severe body weight loss, with significant decreases in both muscle and organ weights and death in both sham and TAC mice. CONCLUSIONS Although GDF11 treatment can reduce pathological cardiac hypertrophy and associated fibrosis while improving cardiac pump function in pressure overload, high doses of GDF11 cause severe cachexia and death. Use of GDF11 as a therapy could have potentially devastating actions on the heart and other tissues.
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Affiliation(s)
- Shavonn C Harper
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Jaslyn Johnson
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Giulia Borghetti
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Huaqing Zhao
- Department of Clinical Sciences (H.Z.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Tao Wang
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Markus Wallner
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA.,Division of Cardiology, Medical University of Graz, Austria (M.W.)
| | - Hajime Kubo
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Eric A Feldsott
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Yijun Yang
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Yunichel Joo
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Xinji Gou
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Abdel Karim Sabri
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
| | - Priyanka Gupta
- Biotherapeutics Discovery Research (P.G., M.M.), Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT
| | - Maria Myzithras
- Biotherapeutics Discovery Research (P.G., M.M.), Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT
| | - Ashraf Khalil
- Research Beyond Borders (A.K., M.F.), Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT
| | - Michael Franti
- Research Beyond Borders (A.K., M.F.), Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT
| | - Steven R Houser
- From the Cardiovascular Research Center (S.C.H., J.J., G.B., T.W., M.W., H.K., E.A.F., Y.Y., Y.J., X.G., A.K.S., S.R.H.), Lewis Katz School of Medicine, Temple University, Philadelphia, PA
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