Defining novel therapeutic strategies for cardiovascular diseases, the leading cause of death worldwide, has long been a key area in my own work. By integrating the state-of-art technologies including super-resolution microscopy, single-molecule pulldown (SiM-pull), fluorescence resonance energy transfer (FRET) Microscopy (FRET), diverse animal models (myocardial infarction) induced ischemic heart model, high-fat-diet-induced diabetic cardiomyopathy model ,and chronic β-adrenergic stimulation induced heart failure model), and transgenic mice, I have provided multiple promising molecular targets for rescuing cardiac dysfunction targeting local adrenergic signaling at nanodomains and contributed to the successful translation of a drug candidate, SCM-198 from bench to bedside.
Cardiac contraction is orchestrated by compartmentalization of β-adrenergic signaling at distinct subcellular nanodomains. The highly organized architecture in cardiomyocytes provides spatial context for the subcellular localized cAMP/PKA signaling in the regulation of sophisticated EC-coupling, a process of heart to contract and relax. To visualize the cAMP/PKA nano-domains, we have developed a serial of genetical encoded Förster resonance energy transfer (FRET)-based biosensors anchoring at the distinct subcellular locations including plasma membrane (PM), sarcoplasmic reticulum (SR), myofilament (MF), and nuclear envelop. By collaborating with the world-leading experts, Prof. Donald M. Bers and Prof. Johannes W Hell and utilizing these powerful tools as well as the cutting-edge technologies, super-resolution imaging, proximity ligation assay (PLA, Figure 2), and singlemolecule pulldown (SIM), I discovered a pool of intracellular β-adrenergic receptors (βAR) at the SR is essential for PKA-phosphorylation of phospholamban and cardiac contractility (Wang et al 2021a Circulation Research).
Desensitization of β1AR signaling and depressed cardiac contractility are hallmarks of heart failure (HF). Therefore, we asked whether the SR-localized β1ARs are engaged in the HF. Using the HFrEF (HF with reduced ejection fraction) model induced by chronic adrenergic stimulation and an ischemic HF model induced by myocardial infarction, I found the elevation of monoamine oxidase A (MAO-A) desensitized intracellular β1ARs signaling in HF (Wang et al 2021b Circulation Research). Knockout or inhibition of MAO-A resensitizes intracellular β1AR signaling and inotropic responsiveness in failing mice (Wang, Circulation, Under review). My investigation of MAO-A-mediated intracellular β1AR/PKA signal cascade was granted by the prestigious American Heart Association Postdoctoral Fellowship.
The integrative control of intracellular catecholamine for subcellular β1AR signaling and cardiac function is lacking of investigation and presents as a promosing therapeutic target for HF. I have determined the regulation of compartmentalized β1AR-PKA signaling at the SR and plasma membrane (PM) microdomains by organic cation transporter 3 (OCT3) and monoamine oxidase A (MAO-A), two critical modulators of catecholamine uptake and homeostasis.
Our results show that MAO-A and OCT3 act in concert to fine-tune the intracellular β1AR-PKA signaling and cardiac fight-or-flight response. Further, we reveal a drug contraindication between anti-inflammatory corticosterone and anti-depressant MAOi in modulating adrenergic regulation in the heart, providing novel perspectives of these drugs with cardiac implications.