Activation of AMP-activated protein kinase by human EGF receptor 2/EGF receptor tyrosine kinase inhibitor protects cardiac cells

Proc Natl Acad Sci U S A. 2007 Jun 19;104(25):10607-12. doi: 10.1073/pnas.0701286104. Epub 2007 Jun 7.

Abstract

The human EGF receptor (HER) 2 receptor tyrosine kinase is a survival factor for human cardiomyocytes, and its inhibition may explain the increased incidence of cardiomyopathy associated with the anti-HER2 monoclonal antibody trastuzumab (Genentech, South San Francisco, CA), particularly in patients with prior exposure to cardiotoxic chemotherapies e.g., anthracyclines. Here, we show that GW2974 (HER2/EGF receptor tyrosine kinase inhibitor), but not trastuzumab, activates AMP-activated protein kinase (AMPK), initiating a metabolic stress response in human cardiomyocytes that protects against TNFalpha-induced cell death. GW2974 stimulates calcium dependent fatty acid oxidation in vitro and in the myocardium of GW2974-treated rodents. Calcium chelation or siRNA-targeted AMPK knockdown blocks GW2974 induced fatty acid oxidation. In addition, inhibition of AMPK by a specific inhibitor resulted in increased killing of cardiomyocytes. Elucidating the effects of HER2-targeted therapies on AMPK may predict for risk of cardiomyopathy and provide a novel HER2-targeted strategy designed to protect myocardium from the pro-apoptotic effects of pro-inflammatory cytokines released in response to cardiac injury by chemotherapy or acute ischemia.

MeSH terms

  • AMP-Activated Protein Kinases
  • Adenosine Triphosphate / analysis
  • Adenosine Triphosphate / biosynthesis
  • Animals
  • Apoptosis / drug effects
  • Calcium / metabolism
  • Cells, Cultured
  • Enzyme Activation / drug effects
  • ErbB Receptors / antagonists & inhibitors*
  • Fatty Acids / metabolism
  • Female
  • Gene Expression
  • Humans
  • Models, Biological
  • Multienzyme Complexes / metabolism*
  • Myocardium / metabolism
  • Myocytes, Cardiac / metabolism*
  • Oxidation-Reduction
  • Phosphorylation / drug effects
  • Protein Serine-Threonine Kinases / metabolism*
  • Protein-Tyrosine Kinases / antagonists & inhibitors*
  • Quinazolines / pharmacology
  • Rats
  • Rats, Sprague-Dawley
  • Receptor, ErbB-2 / metabolism*

Substances

  • Fatty Acids
  • GW2974
  • Multienzyme Complexes
  • Quinazolines
  • Adenosine Triphosphate
  • ErbB Receptors
  • Protein-Tyrosine Kinases
  • Receptor, ErbB-2
  • Protein Serine-Threonine Kinases
  • AMP-Activated Protein Kinases
  • Calcium