title: Selective decrease of components of the creatine kinase system and ATP synthase complex in chronic Chagas disease cardiomyopathy.
abstract: BACKGROUND
  Chronic Chagas disease cardiomyopathy (CCC) is an inflammatory dilated cardiomyopathy with a worse prognosis than other cardiomyopathies. CCC occurs in 30 % of individuals infected with Trypanosoma cruzi, endemic in Latin America. Heart failure is associated with impaired energy metabolism, which may be correlated to contractile dysfunction. We thus analyzed the myocardial gene and protein expression, as well as activity, of key mitochondrial enzymes related to ATP production, in myocardial samples of end-stage CCC, idiopathic dilated (IDC) and ischemic (IC) cardiomyopathies.
  
  
  RESULTS
  Myocardium homogenates from CCC (N=5), IC (N=5) and IDC (N=5) patients, as well as from heart donors (N=5) were analyzed for protein and mRNA expression of mitochondrial creatine kinase (CKMit) and muscular creatine kinase (CKM) and ATP synthase subunits aplha and beta by immunoblotting and by real-time RT-PCR. Total myocardial CK activity was also assessed. Protein levels of CKM and CK activity were reduced in all three cardiomyopathy groups. However, total CK activity, as well as ATP synthase alpha chain protein levels, were significantly lower in CCC samples than IC and IDC samples. CCC myocardium displayed selective reduction of protein levels and activity of enzymes crucial for maintaining cytoplasmic ATP levels.
  
  
  CONCLUSIONS
  The selective impairment of the CK system may be associated to the loss of inotropic reserve observed in CCC. Reduction of ATP synthase alpha levels is consistent with a decrease in myocardial ATP generation through oxidative phosphorylation. Together, these results suggest that the energetic deficit is more intense in the myocardium of CCC patients than in the other tested dilated cardiomyopathies.
authors: Laboratory of Immunology, Heart Institute, School of Medicine, University of São Paulo, São Paulo, Brazil.
authors: Priscila Camillo
authors: PC
authors: Teixeira
authors: Ronaldo Honorato Barros
authors: RH
authors: Santos
authors: Alfredo Inácio
authors: AI
authors: Fiorelli
authors: Angelina Morand Bianchi
authors: AM
authors: Bilate
authors: Luiz Alberto
authors: LA
authors: Benvenuti
authors: Noedir Antonio
authors: NA
authors: Stolf
authors: Jorge
authors: J
authors: Kalil
authors: Edecio
authors: E
authors: Cunha-Neto
mesh_terms: D025181:ATP Synthetase Complexes / Q000235:genetics / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D002598:Chagas Cardiomyopathy / Q000503:physiopathology*; D052281:Creatine Kinase, Mitochondrial Form / Q000235:genetics / Q000378:metabolism*; D020869:Gene Expression Profiling; D006801:Humans; D015151:Immunoblotting; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000201:enzymology*; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult
chemical_list: D052281:Creatine Kinase, Mitochondrial Form; D025181:ATP Synthetase Complexes