Key result
Activated alpha-2 macroglobulin limits cholesterol, boosts insulin response, and protects LDL-exposed cardiomyocytes.
Why the study?
The link between cholesteryl ester accumulation, insulin action, and cardiac dysfunction in cardiomyocytes remains largely unknown.
Activated alpha-2 Macroglobulin counteracts the deleterious effects of aggregated LDL in cardiomyocytes, improving insulin response and reducing cardiac damage via LRP1.
Hypothesis-generating for alpha-2 macroglobulin in LDL-driven cardiomyocyte injury; requires in vivo and human validation before any clinical consideration.
Activated alpha-2 Macroglobulin (α2M*) is specifically recognized by the cluster I/II of LRP1 (Low-density lipoprotein Receptor-related Protein-1). LRP1 is a scaffold protein for insulin receptor involved in the insulin-induced glucose transporter type 4 (GLUT4) translocation to plasma membrane and glucose uptake in different types of cells. Moreover, the cluster II of LRP1 plays a critical role in the internalization of atherogenic lipoproteins, such as aggregated Low-density Lipoproteins (aggLDL), promoting intracellular cholesteryl ester (CE) accumulation mainly in arterial intima and myocardium. The aggLDL uptake by LRP1 impairs GLUT4 traffic and the insulin response in cardiomyocytes. However, the link between CE accumulation, insulin action, and cardiac dysfunction are largely unknown. Here, we found that α2M* increased GLUT4 expression on cell surface by Rab4, Rab8A, and Rab10-mediated recycling through PI3K/Akt and MAPK/ERK signaling activation. Moreover, α2M* enhanced the insulin response increasing insulin-induced glucose uptake rate in the myocardium under normal conditions. On the other hand, α2M* blocked the intracellular CE accumulation, improved the insulin response and reduced cardiac damage in HL-1 cardiomyocytes exposed to aggLDL. In conclusion, α2M* by its agonist action on LRP1, counteracts the deleterious effects of aggLDL in cardiomyocytes, which may have therapeutic implications in cardiovascular diseases associated with hypercholesterolemia.
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Dato et al. (2021) studied Lipid-loaded cardiomyocytes. Activated alpha-2 Macroglobulin (α2M) was evaluated on GLUT4 expression, insulin response, and intracellular cholesteryl ester accumulation. Activated alpha-2 Macroglobulin blocked intracellular cholesteryl ester accumulation, improved insulin response, and reduced cardiac damage in HL-1 cardiomyocytes exposed to aggregated LDL.
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