Key result
SERCA2a Thr484Ala mutation impairs calcium re-uptake and reduces baseline LVEF in mice.
Why the study?
Diabetic cardiomyopathy is a progressive complication in type 2 diabetic patients, but the underlying mechanisms involving metabolic insults and insulin resistance remain poorly understood.
Does impaired phosphorylation of SERCA2a at Thr484 cause cardiac insulin resistance and contractile dysfunction in the early pathogenesis of diabetic cardiomyopathy in mice?
Does impaired phosphorylation of SERCA2a at Thr484 cause cardiac insulin resistance and contractile dysfunction in the early pathogenesis of diabetic cardiomyopathy in mice?
This preclinical study identifies a bidirectional vicious cycle between impaired SERCA2a-Thr484 phosphorylation and cardiac insulin resistance mediated by lysosomal degradation of FURIN, defining an early pathogenic phase of diabetic cardiomyopathy.
No immediate clinical implications in diabetic cardiomyopathy; leaves open SERCA2a-Thr484 as a mechanistic target in mice.
Diabetic cardiomyopathy (DCM) is currently a progressive and nonstoppable complication in type 2 diabetic patients. Metabolic insults and insulin resistance are involved in its pathogenesis; however, the underlying mechanisms are still not clearly understood. Here we show that calcium dysregulation can be both a cause and a consequence of cardiac insulin resistance that leads to DCM. A western diet induces the development of DCM through at least three phases in mice, among which an early phase depends on impaired Thr484-phosphorylation of sarcoplasmic/endoplasmic reticulum calcium ATPase 2a (SERCA2a) elicited by insulin resistance. Mutation of SERCA2a-Thr484 to a nonphosphorylatable alanine delays calcium re-uptake into the sarcoplasmic reticulum in the cardiomyocytes and decreases cardiac function at the baseline. Importantly, this mutation blunts the early phase of DCM, but has no effect on disease progression in the following phases. Interestingly, impairment of sarcoplasmic reticulum calcium re-uptake caused by the SERCA2a-Thr484 mutation inhibited processing of insulin receptor precursor through FURIN convertase, resulting in cardiac insulin resistance. Collectively, these data reveal a bidirectional relationship between insulin resistance and impairment of calcium homeostasis, which may underlie the early pathogenesis of DCM. Our findings have therapeutic implications for early intervention of DCM.
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Quan et al. (2022) studied Diabetic cardiomyopathy (DCM). SERCA2a-Thr484Ala knockin mutation and Western diet vs. Wild-type littermates and normal chow diet was evaluated on Left ventricular ejection fraction (EF) and fractional shortening (FS), sarcoplasmic reticulum Ca2+ re-uptake, and FURIN-dependent insulin receptor precursor processing (p=<0.05). Mutation of SERCA2a-Thr484 to alanine delayed sarcoplasmic reticulum Ca2+ re-uptake, promoted lysosomal FURIN degradation, and significantly decreased baseline EF (p<0.05) and FS (p<0.01) in mice.
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