title: Glucose regulates the intrinsic inflammatory response of the heart to surgically induced hypothermic ischemic arrest and reperfusion.
abstract: We investigated the isolated working rat heart as a model to study early transcriptional remodeling induced in the setting of open heart surgery and stress hyperglycemia. Hearts of male Sprague Dawley rats were cold-arrested in Krebs-Henseleit buffer and subjected to 60 min normothermic reperfusion in the working mode with buffer supplemented with noncarbohydrate substrates plus glucose (25 mM) or mannitol (25 mM; osmotic control). Gene expression profiles were determined by microarray analysis and compared with those of nonperfused hearts. Perfused hearts displayed a transcriptional signature independent from the presence of glucose showing a more than twofold increase in expression of 71 genes connected to inflammation, cell proliferation, and apoptosis. These transcriptional alterations were very similar to the ones taking place in the hearts of open heart surgery patients. Prominent among those alterations was the upregulation of the three master regulators of metabolic reprogramming, MYC, NR4A1, and NR4A2. Targeted pathway analysis revealed an upregulation of metabolic processes associated with the proliferation and activation of macrophages and fibroblasts. Glucose potentiated the upregulation of a subset of genes associated with polarization of tissue reparative M2-like macrophages, an effect that was lost in perfused hearts from rats rendered insulin resistant by high-sucrose feeding. The results expose the heart as a significant source of proinflammatory mediators released in response to stress associated with cardiac surgery with cardiopulmonary bypass, and suggest a major role for glucose as a signal in the determination of resident cardiac macrophage polarization.
authors.affiliation: Department of Physiology and Biophysics, Mississippi Center for Obesity Research, and Mississippi Center for Heart Research, University of Mississippi Medical Center, Jackson, Mississippi; and.
authors.forename: Ahmed S
authors.initials: AS
authors.lastname: Bux
authors.affiliation: Department of Physiology and Biophysics, Mississippi Center for Obesity Research, and Mississippi Center for Heart Research, University of Mississippi Medical Center, Jackson, Mississippi; and.
authors.forename: Merry L
authors.identifier: 0000-0002-4090-0391
authors.initials: ML
authors.lastname: Lindsey
authors.affiliation: Department of Internal Medicine, Division of Cardiology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Hernan G
authors.initials: HG
authors.lastname: Vasquez
authors.affiliation: Department of Internal Medicine, Division of Cardiology, McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas.
authors.forename: Heinrich
authors.initials: H
authors.lastname: Taegtmeyer
authors.affiliation: Department of Physiology and Biophysics, Mississippi Center for Obesity Research, and Mississippi Center for Heart Research, University of Mississippi Medical Center, Jackson, Mississippi; and rharmancey@umc.edu.
authors.forename: Romain
authors.identifier: 0000-0002-5040-4500
authors.initials: R
authors.lastname: Harmancey
mesh_terms: D000818:Animals; D015415:Biomarkers / Q000378:metabolism*; D020869:Gene Expression Profiling; D005786:Gene Expression Regulation; D005947:Glucose / Q000008:administration & dosage*; D006321:Heart / Q000187:drug effects / Q000503:physiopathology*; D006324:Heart Arrest, Induced / Q000009:adverse effects*; D007249:Inflammation / Q000235:genetics / Q000276:immunology* / Q000473:pathology; D007333:Insulin Resistance; D008297:Male; D051379:Mice; D008810:Mice, Inbred C57BL; D015428:Myocardial Reperfusion Injury / Q000503:physiopathology* / Q000601:surgery; D051381:Rats; D017207:Rats, Sprague-Dawley
chemical_list: D015415:Biomarkers; D005947:Glucose
keywords: cardiac surgery; glucose; inflammation; insulin resistance; macrophage polarization