title: Onset of experimental severe cardiac fibrosis is mediated by overexpression of Angiotensin-converting enzyme 2.
abstract: Angiotensin-converting enzyme (ACE) 2 is a recently identified homologue of ACE. There is great interest in the therapeutic benefit for ACE2 overexpression in the heart. However, the role of ACE2 in the regulation of cardiac structure and function, as well as maintenance of systemic blood pressure, remains poorly understood. In cell culture, ACE2 overexpression led to markedly increased myocyte volume, assessed in primary rabbit myocytes. To assess ACE2 function in vivo, we used a recombinant adeno-associated virus 6 delivery system to provide 11-week overexpression of ACE2 in the myocardium of stroke-prone spontaneously hypertensive rats. ACE2, as well as the ACE inhibitor enalapril, significantly reduced systolic blood pressure. However, in the heart, ACE2 overexpression resulted in cardiac fibrosis, as assessed by histological analysis with concomitant deficits in ejection fraction and fractional shortening measured by echocardiography. Furthermore, global gene expression profiling demonstrated the activation of profibrotic pathways in the heart mediated by ACE2 gene delivery. This study demonstrates that sustained overexpression of ACE2 in the heart in vivo leads to the onset of severe fibrosis.
authors.affiliation: BHF GCRC, University of Glasgow, 126 University Place, Glasgow, G12 8TA United Kingdom.
authors.forename: Rachel
authors.initials: R
authors.lastname: Masson
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Nicklin
authors.forename: Margaret Anne
authors.initials: MA
authors.lastname: Craig
authors.forename: Martin
authors.initials: M
authors.lastname: McBride
authors.forename: Kirsten
authors.initials: K
authors.lastname: Gilday
authors.forename: Paul
authors.initials: P
authors.lastname: Gregorevic
authors.forename: James M
authors.initials: JM
authors.lastname: Allen
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Chamberlain
authors.forename: Godfrey
authors.initials: G
authors.lastname: Smith
authors.forename: Delyth
authors.initials: D
authors.lastname: Graham
authors.forename: Anna F
authors.initials: AF
authors.lastname: Dominiczak
authors.forename: Claudio
authors.initials: C
authors.lastname: Napoli
authors.forename: Andrew H
authors.initials: AH
authors.lastname: Baker
mesh_terms: D000085962:Angiotensin-Converting Enzyme 2; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000494:pharmacology; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D004195:Disease Models, Animal; D004656:Enalapril / Q000494:pharmacology; D005355:Fibrosis; D020869:Gene Expression Profiling; D015971:Gene Expression Regulation, Enzymologic; D018014:Gene Transfer Techniques; D006331:Heart Diseases / Q000000981:diagnostic imaging / Q000235:genetics* / Q000473:pathology*; D006973:Hypertension / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology*; D008297:Male; D032383:Myocytes, Cardiac / Q000473:pathology; D007703:Peptidyl-Dipeptidase A / Q000235:genetics*; D011134:Polysaccharides; D051381:Rats; D011918:Rats, Inbred SHR; D012720:Severity of Illness Index; D014161:Transduction, Genetic; D014463:Ultrasonography
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D011134:Polysaccharides; D004656:Enalapril; C040642:SHU 454; D007703:Peptidyl-Dipeptidase A; C000705329:Ace2 protein, rat; D000085962:Angiotensin-Converting Enzyme 2