Background:
FoxO (Forkhead box) family of transcription factors play important roles in regulating the expression of genes involved in physiologic cellular functions that include 1) cell proliferation and growth, 2) oxidative stress and DNA repair, 3) apoptosis and autophagy, 4) energy metabolism and 5) immune system function. Many components of all 5 cellular functions are abnormal in the failing heart. FoxO1, FoxO3, and FoxO4 are members of the FoxO family and are expressed in adult cardiomyocytes. We previously showed that elamipretide (ELAM), a novel mitochondria-targeting peptide, reverses many of the abnormalities of the above captioned cellular function in dogs with advanced heart failure (HF). Abnormalities of expression and/or phosphorylation of FoxO1, FoxO3a and FoxO4 have been described in HF.
Objective:
This study examined the effects of chronic therapy with ELAM on levels of mRNA expression of FoxO1, FoxO3a and FoxO4 in LV myocardium of dogs with coronary microembolization-induced HF (LV ejection fraction ~30%).
Methods:
LV tissue from 14 HF dogs randomized to 3 months monotherapy with subcutaneous injections of ELAM (0.5 mg/kg once daily, n=7) or no therapy at all (control, CON, n=7) and tissue from 6 normal (NL) dogs was used in the study. Using specific primers, mRNA levels of FoxO1, FoxO3a, and FoxO4 normalized to β-actin, an internal control, were measured using real-time PCR in isolated RNA from LV tissue.
Results:
There were no differences in the levels of β-actin among the 3 study groups. mRNA expression levels of FoxO1 and 3a were significantly decreased and FoxO4 increased in HF-CON dogs compared to NL dogs (0.16, 0.19, and 2.48 fold change from NL respectively, p<0.05). Treatment of HF dogs with ELAM restored the expression of all 3 FoxO transcription factors to near NL (0.53, 0.65, and 1.21 fold change from NL respectively, P<0.05 vs. CON).
Conclusions:
mRNA levels of FoxO1 and FoxO3a are reduced and that of FoxO4 is increased in LV myocardium of HF dogs. Chronic therapy with ELAM normalizes expression of all 3 FoxO transcription factors. This improvement in FoxO expression is consistent with the observed reduction of oxidative stress, apoptosis and cytokines and improved energy metabolism in HF dogs following chronic therapy with ELAM.