IMR Press / RCM / Volume 23 / Issue 4 / DOI: 10.31083/j.rcm2304127
Open Access Original Research
Increase of Oxidative Stress by Deficiency of The ALDH2/UCP2/Nrf2 Axis Exacerbates Cardiac Dysfunction in Chronic Kidney Disease
Lei Xu1,†Shasha Han1,2,†Zhaoyang Chen1,3,†Cheng Shen1,4Zihan Yao5,6Peng Wang1Yunzeng Zou1,7Aijun Sun1,7,*Junbo Ge1,7
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1 Department of Cardiology, Zhongshan Hospital, Fudan University, Shanghai Institute of Cardiovascular Diseases, 200032 Shanghai, China
2 Intensive Care Unit, Jining First People’s Hospital, 272002 Jining, Shandong, China
3 Heart Center of Fujian Province, Union Hospital, Fujian Medical University, 350401 Fuzhou, Fujian, China
4 Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining Key Laboratory for Diagnosis and Treatment of Cardiovascular Diseases, 272007 Jining, Shandong, China
5 Department of Clinical Pharmacy, People's Hospital of Putuo District, 200060 Shanghai, China
6 Health Service Center of Yadong County, Shigatse City, 857600 Tibetan Autonomous Region, China
7 Institute of Biomedical Science, Fudan University, 200032 Shanghai, China
*Correspondence: sun.aijun@zs-hospital.sh.cn (Aijun Sun)
These authors contributed equally.
Academic Editors: Zoltán Papp and Attila Kiss
Rev. Cardiovasc. Med. 2022, 23(4), 127; https://doi.org/10.31083/j.rcm2304127
Submitted: 21 November 2021 | Revised: 12 January 2022 | Accepted: 20 January 2022 | Published: 2 April 2022
(This article belongs to the Special Issue Cardiac Hypertrophy: from Basic Science to Clinical Application)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Both epidemiologic and experimental studies have evidenced that chronic kidney disease (CKD) could increase the incidence and risk of cardiac dysfunction, especially in aging patients. However, the underlying mechanisms are still not fully understood. Methods: In this study, we used 8 weeks old male wild-type (WT) C57BL/6 mice and ALDH2 knockout (ALDH2-/-) mice with C57BL/6 background. Here the 5/6 nephrectomy (NX) mouse model was constructed to study how CKD affects cardiac function and explored the related role of aldehyde dehydrogenase 2 (ALDH2), a well-established cardioprotective factor, in this process. Results: Compensatory cardiac hypertrophy was found in wild type (WT) mice 12 weeks post 5/6 NX as shown by increased left ventricular wall thickness (LVWD), cross-sectional area (CSA) of cardiomyocytes, and preserved left ventricular ejection fraction (EF) and fractional shorten (FS). Deficiency of ALDH2 (ALDH2-/-) significantly reduced EF and FS as compared with WT mice 12 weeks post 5/6 NX, while left ventricular hypertrophy was similar between the two NX groups. ALDH2-/- CKD groups showed more severe nephritic damages and increased fibrosis deposition in hearts. Besides, levels of reactive oxygen species (ROS) and apoptosis were also significantly upregulated in hearts of ALDH2-/- NX mice. The above changes were related with decreased expressions of uncoupling protein 2 (UCP2) and nuclear factor like 2 (Nrf2), as well as the downstream effectors of Nrf2 (heme oxygenase-1, HO-1 and superoxide dismutase 2, SOD2). Conclusions: Our data indicated that ALDH2 deficiency did not affect NX-induced left ventricular hypertrophy, but could increase oxidative stress and exacerbate CKD-induced cardiac dysfunction, partly via downregulation of UCP2 and Nrf2/ARE (antioxidant response element) pathways.

Keywords
aldehyde dehydrogenase 2 (ALDH2)
nephrectomy
cardiac hypertrophy
reactive oxygen species (ROS)
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