Le peptide natriurétique auriculaire induit la différenciation cardiaque dans les cellules souches embryonnaires carcinomateuses de souris P19

Traditionally associated with female reproduction, oxytocin (OT), a peptidic hormone synthesized in the paraventricular and supraoptic nuclei of the hypothalamus and secreted by the posterior pituitary (neurohypophysis), was revisited recently and was revealed to have several new roles in the cardiovascular system. Indeed, our laboratory has shown that OT can induce the differentiation of embryonic stem cells (ESC) into functional cardiomyocytes (CM). On the model of embryonal carcinoma cell line P19, it has been shown that this process occurs following the release of cyclic guanosine monophosphate (cGMP)-dependent nitric oxide. Similarly, it is known that atrial natriuretic peptide (ANP), a peptide produced, stored and secreted by cardiac myocytes, can also induce the release of cGMP. However, the cellular mechanisms involved in cardiac differentiation are still poorly understood. Numerous studies have shown that the injured heart can be regenerated from an isolated population of transplanted stem and progenitor cells. One of these cell populations, frequently isolated from embryonic and adult animal organs, called "Side Population" (SP), is characterized by active efflux of the fluorescent dye Hoechst 33342 (Ho). SP cells express specific ATP-binding cassette transporter proteins which actively transport Ho out of their cytoplasm. The SP cell subpopulation isolated from the heart display enhanced differentiation potential into cardiac phenotype in response to OT treatment. Recently, the phenotypic and functional heterogeneity of embryonic stem cells has been demonstrated, and this was correlated with the presence of cell subpopulations much like the SP cells from the heart and these cells can be identified by flow cytometry (FACS) as a population of unmarked cells by the Ho and which exhibit sensitivity to the inhibitor of the family of ATP-binding cassette ABC, verapamil. Thus, the SP from ESC could be a good candidate to induce cell differentiation more effectively to the cardiac phenotype. Since ANP can induce the release of cGMP and it has been shown that cardiac differentiation was mediated by the release of cGMP through the nitric oxide (NO), then we therefore formulate the hypothesis that ANP could also induce cardiac differentiation. Since ESC are composed of a mixture of different cell types so as we emit the hypothesis that the use of a subpopulation of more homogeneous ESC strengthen the differentiation potential of ANP.  Methods: SP were isolated from P19 cells by FACS using the method of exclusion of fluorescent dye Hoechst and their phenotype was characterized by immunofluorescence (IF) for markers of the undifferentiated state, self-renewal and pluripotency OCT4 and SSEA1. Then, the optimal pharmacological dose of ANP was determined via cytotoxicity tests in P19 cells (MTT assay). For cardiac differentiation, cells in the form of spheroids were formed using the technique of "Hanging Drop" under the stimulation of ANP for 5 days. Then cuts were made in the spheroids via cryosection to highlight the presence of cardiac progenitor cell markers such as GATA4, Nkx2.5 and a specific mitochondrial marker Tom22. Next, the P19-SP cells were stimulated in cell spheroids by the treatment with ANP (10-7 M) or OT (10-7 M), the specific antagonist of particulate guanylate cyclase A71915 (10-6 M), and the combination of the inducers OT + ANP, OT + A71915, A71915 + ANP. After cell plating, the differentiation into cardiomyocytes has been identified by the appearance of beating cell colonies characteristics of contractile cardiac cells, by determining the cellular phenotype by IF, and finally by the extraction of RNA and proteins that were used for the determination of cGMP by RIA, the mRNA expression by RT-PCR and protein expression by western blotting. Results: The spheroids induced by ANP showed a significant increase in the presence of cardiac transcription factors GATA4 and Nkx2.5 as well as a greater number of mitochondria characterized by a greater presence of Tom22 compared with no induced cells suggesting a cardiomyogenic effect of ANP. In addition, ANP induced the appearance of beating cell colonies from day 7 (early stage) to day 14 (mature stage) similarly to OT. However, the combination of ANP with OT did not induce beating cell colonies suggesting a negative additive effect on cardiomyogenesis. The spheroids, obtained using the technique of "Hanging Drop", have shown a modest increase in mRNA expression as follows: OTR, ANP and GATA4 compared to cells grown in monolayers. By IF, we quantified (number of positive cells) and characterized, from day 6 to day 14 of differentiation, the cardiac phenotype of our cells using the following markers: Cardiac Troponin T, ANP, Connexines 40 and 43, Myosin Light Chain-2V, OTR. The SP differentiated under the stimulation of ANP showed a significant increase in intracellular cGMP compared with undifferentiated cells. Surprisingly, the antagonist A71915 induced a greater appearance of beating cell colonies compared to OT and ANP in early day of cardiac differentiation and the addition of OT or ANP potentiated its effects, further increasing the proportion of beating cells colonies. In addition, the size of beating cell colonies was even greater than under the simple stimulation of OT or ANP. Radioimmunoassay analysis in SP P19 cells stimulated with ANP, A71915 and the combination of both during 15min, 30min and 60min showed that ANP significantly stimulates the release of cGMP, however, A71915 does not abolish the effects of ANP and it rather stimulates the release of cGMP through partial agonist effects.   Conclusion: Our results demonstrate firstly that ANP induces the differentiation of P19-SP cells into functional CM. Moreover, it appears that the signaling pathway NPRA-B/pGC/cGMP seems to be involved in the mechanism of cardiac differentiation since the abolition of cGMP mediated by the pGC potentiates cardiac differentiation and it appears that this signaling pathway is additive to the signaling pathway induced by OT, NO/sGC/cGMP, since the addition of OT to the antagonist A71915 stimulates cardiac differentiation more strongly than OT or A71915 alone. This suggests that the therapeutic effect of natriuretic peptides observed in heart failure and vasodilatory properties of certain natriuretic peptide receptor antagonists included the stimulation of stem cell differentiation into cardiomyocytes. This would therefore suggest that the natriuretic peptides or natriuretic peptide receptor antagonists could be an attractive alternative to cell therapy to induce heart regeneration.

Keyphrases: ANP, cardiomyocytes, P19, induction, Side Population, Hoechst 33342, Oxytocin, stem cells, cGMP, differentiation, cardiomyogenesis