Aldosterone And Osteopontin Promote Cardiac Fibrosis Via GRK2‐dependent β2‐Adrenergic Receptor Dysfunction
Authors: Pollard Celina Marie , Parker Barbara Marie , Pereyra Janelle Marie , Ferraino Krysten Elaine , Cora Natalie , Perez Arianna , Desimine Victoria Lynn , Wertz Shelby Lynn , Shehadeh Lina , Lymperopoulos Anastasios 
Published: April 2020

BackgroundCardiac β2‐adrenergic receptors (ARs) are known to inhibit collagen production and fibrosis in cardiac fibroblasts and myocytes. β2AR is a Gs protein‐coupled receptor (GPCR) and, upon its activation, stimulates generation of cyclic 3′, 5′‐adenosine monophosphate (cAMP). cAMP has two effectors: protein kinase A (PKA) and the exchange protein directly activated by cAMP (Epac1/2). Epac1 has been shown to inhibit cardiac fibroblast activation and fibrosis. Osteopontin (OPN) is a ubiquitous pro‐inflammatory and pro‐fibrotic cytokine, including in the heart. OPN expression is known to be induced by the cardiotoxic hormone aldosterone in various tissues and OPN has been reported to dysregulate β2AR signaling and function in bone cells. Thus, we hypothesized here that aldosterone upregulates OPN in the heart in order to perturb β2AR anti‐fibrotic function.MethodsWe used the rat cardiomyoblast cell line H9c2 and human cardiac fibroblasts (HCFs). We measured OPN levels and fibrosis markers via real time PCR and β2AR function via cAMP accumulation studies and co‐immunoprecipitation/western blotting for several downstream signaling mediators. We also deleted OPN via CRISPR/Cas9 to examine its role in cardiac β2AR function and fibrosis.ResultsAldosterone upregulates OPN via the mineralocorticoid receptor (MR) in H9c2 cardiomyocytes. This is prevented by β2AR activation with salbutamol (albuterol), which stimulates GPCR‐kinase (GRK)‐5 to phosphorylate the cardiac MR and inhibit its transcriptional activity. Importantly, CRISPR/Cas9‐mediated OPN gene deletion enhances β2AR‐dependent cAMP generation in H9c2 cardiomyocytes and upregulates Epac1 protein levels. The functional result of this is that β2AR’s inhibition of transforming growth factor (TGF)‐β‐dependent fibrosis in H9c2 cardiomyocytes is robustly augmented. In addition, pharmacological inhibition of GRK2, the major GRK that phosphorylates and desensitizes the cardiac β2AR, with Cmpd101 or OPN CRIPSR/Cas9‐mediated knockout completely abrogates isoproterenol (agonist)‐induced β2AR functional desensitization in HCFs (Isoproterenol’s ΔEC50: 94±16 μM in control HCFs, p<0.05, n=4; 6±7.2 μM in Cmpd101‐treated HCFs, Not significant at p=0.05, n=4; 5.3+6.1 μM in OPN knockout HCFs, Not significant at p=0.05, n=4). Mechanistically, OPN dysregulates the β2AR via enhancement of GRK2‐mediated functional desensitization, since OPN forms a multi‐protein complex with GRK2 and GRK2‐interacting protein (GIT)‐1 in HCFs, thereby facilitating GRK2 plasma membrane recruitment. This reduces β2AR’s anti‐fibrotic cAMP signaling in the heart.ConclusionsWe have uncovered a direct inhibitory effect of OPN on cardiac β2AR’s anti‐fibrotic signaling: facilitation of GRK2‐mediated receptor desensitization. Since aldosterone/MR upregulates OPN, a combination of an MR blocker with OPN or GRK2 blockade could be of value in cardiac fibrosis treatment.Support or Funding Information1) American Heart Association (A.L.)2) NSU President’s Faculty Research & Development Grant (A.L.)