1区 · 医学
Article
作者: Smith, Godfrey L ; Oldroyd, Keith G ; Shaukat, Aadil ; Corcoran, David ; Petrie, Mark C ; Berry, Colin ; Carrick, David ; Lee, Mathew M Y ; Hawksby, Catherine ; Nicklin, Stuart A ; McClure, John ; He, Weihong ; Martin, Tamara ; Eteiba, Hany ; Watkins, Stuart ; Channon, Keith M ; McArthur, Lisa ; Nather, Katrin ; Ford, Kristopher ; McEntegart, Margaret ; Loughrey, Christopher M ; Riddell, Alexandra ; McCarroll, Charlotte S ; Lindsay, Mitchell M ; Rocchiccioli, Paul ; Good, Richard ; Mangion, Kenneth ; Zaeri, Ali ; O’Toole, Dylan ; Elliott, Elspeth B ; Hood, Stuart ; Davie, Andrew
AbstractAimsIdentifying novel mediators of lethal myocardial reperfusion injury that can be targeted during primary percutaneous coronary intervention (PPCI) is key to limiting the progression of patients with ST-elevation myocardial infarction (STEMI) to heart failure. Here, we show through parallel clinical and integrative preclinical studies the significance of the protease cathepsin-L on cardiac function during reperfusion injury.Methods and resultsWe found that direct cardiac release of cathepsin-L in STEMI patients (n = 76) immediately post-PPCI leads to elevated serum cathepsin-L levels and that serum levels of cathepsin-L in the first 24 h post-reperfusion are associated with reduced cardiac contractile function and increased infarct size. Preclinical studies demonstrate that inhibition of cathepsin-L release following reperfusion injury with CAA0225 reduces infarct size and improves cardiac contractile function by limiting abnormal cardiomyocyte calcium handling and apoptosis.ConclusionOur findings suggest that cathepsin-L is a novel therapeutic target that could be exploited clinically to counteract the deleterious effects of acute reperfusion injury after an acute STEMI.