Researchers and pharmaceutical companies have long been interested in developing new medicines that activate a heart protein called APJ. This interest has been a part of their quest to treat cardiovascular disease. In spite of this researchers at Sanford-Burnham Medical Research Institute (Sanford-Burnham) and the Stanford University School of Medicine have now uncovered a second, previously unknown, function for APJ—it senses mechanical changes when the heart is in danger and sets the body on a course toward heart failure. This means that activating APJ could actually be harmful in some cases—potentially eye-opening information for some heart drug makers. The study appears July 18 in Nature.
"Just finding a molecule that activates APJ is not enough. What's important to heart failure is not if this receptor is 'on' or 'off,' but the way it's activated," said Pilar Ruiz-Lozano, Ph.D., who led the study. Ruiz-Lozano, formerly assistant professor at Sanford-Burnham, is now associate professor of pediatrics in the Stanford University School of Medicine and adjunct faculty member at Sanford-Burnham.
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APJ is a receptor that sits on the cell surface in many organs, where it senses the external environment. When a hormone called apelin comes along and binds APJ, it sets off a molecular chain reaction that influences a number of cellular functions. Many previous studies have shown that apelin-APJ activity directs beneficial processes such as embryonic heart development, maintenance of normal blood pressure, and new blood vessel formation.
According to Ruiz-Lozano's latest study, however, APJ can also be activated a second, more harmful, way that doesn't involve apelin. In this pathway, APJ senses and responds to mechanical changes in the heart.
To better understand these mechanical changes, let's look at a person with high blood pressure. In this case, the person's heart has to work harder to pump the same amount of blood at the same rate as a healthy person. To meet the increased demand, individual heart muscle cells start making more proteins, making the cells bigger. Eventually, cell membranes stretch and each cell begins to pull away from its neighbor. This leads to an enlarged heart—a condition known as hypertrophy. In pathological (disease) conditions, hypertrophy can lead to heart failure.