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2014 ; 21
(17
): 2322-43
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Targeting the ubiquitin-proteasome system in heart disease: the basis for new
therapeutic strategies
#MMPMID25133688
Drews O
; Taegtmeyer H
Antioxid Redox Signal
2014[Dec]; 21
(17
): 2322-43
PMID25133688
show ga
SIGNIFICANCE: Novel therapeutic strategies to treat heart failure are greatly
needed. The ubiquitin-proteasome system (UPS) affects the structure and function
of cardiac cells through targeted degradation of signaling and structural
proteins. This review discusses both beneficial and detrimental consequences of
modulating the UPS in the heart. RECENT ADVANCES: Proteasome inhibitors were
first used to test the role of the UPS in cardiac disease phenotypes, indicating
therapeutic potential. In early cardiac remodeling and pathological hypertrophy
with increased proteasome activities, proteasome inhibition prevented or
restricted disease progression and contractile dysfunction. Conversely, enhancing
proteasome activities by genetic manipulation, pharmacological intervention, or
ischemic preconditioning also improved the outcome of cardiomyopathies and
infarcted hearts with impaired cardiac and UPS function, which is, at least in
part, caused by oxidative damage. CRITICAL ISSUES: An understanding of the UPS
status and the underlying mechanisms for its potential deregulation in cardiac
disease is critical for targeted interventions. Several studies indicate that
type and stage of cardiac disease influence the dynamics of UPS regulation in a
nonlinear and multifactorial manner. Proteasome inhibitors targeting all
proteasome complexes are associated with cardiotoxicity in humans. Furthermore,
the type and dosage of proteasome inhibitor impact the pathogenesis in nonuniform
ways. FUTURE DIRECTIONS: Systematic analysis and targeting of individual UPS
components with established and innovative tools will unravel and discriminate
regulatory mechanisms that contribute to and protect against the progression of
cardiac disease. Integrating this knowledge in drug design may reduce adverse
effects on the heart as observed in patients treated with proteasome inhibitors
against noncardiac diseases, especially cancer.