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Review
. 2021 Jun 19;10(6):1552.
doi: 10.3390/cells10061552.

Impact of Aldosterone on the Failing Myocardium: Insights from Mitochondria and Adrenergic Receptors Signaling and Function

Affiliations
Review

Impact of Aldosterone on the Failing Myocardium: Insights from Mitochondria and Adrenergic Receptors Signaling and Function

Mariona Guitart-Mampel et al. Cells. .

Abstract

The mineralocorticoid aldosterone regulates electrolyte and blood volume homeostasis, but it also adversely modulates the structure and function of the chronically failing heart, through its elevated production in chronic human post-myocardial infarction (MI) heart failure (HF). By activating the mineralocorticoid receptor (MR), a ligand-regulated transcription factor, aldosterone promotes inflammation and fibrosis of the heart, while increasing oxidative stress, ultimately induding mitochondrial dysfunction in the failing myocardium. To reduce morbidity and mortality in advanced stage HF, MR antagonist drugs, such as spironolactone and eplerenone, are used. In addition to the MR, aldosterone can bind and stimulate other receptors, such as the plasma membrane-residing G protein-coupled estrogen receptor (GPER), further complicating it signaling properties in the myocardium. Given the salient role that adrenergic receptor (ARs)-particularly βARs-play in cardiac physiology and pathology, unsurprisingly, that part of the impact of aldosterone on the failing heart is mediated by its effects on the signaling and function of these receptors. Aldosterone can significantly precipitate the well-documented derangement of cardiac AR signaling and impairment of AR function, critically underlying chronic human HF. One of the main consequences of HF in mammalian models at the cellular level is the presence of mitochondrial dysfunction. As such, preventing mitochondrial dysfunction could be a valid pharmacological _target in this condition. This review summarizes the current experimental evidence for this aldosterone/AR crosstalk in both the healthy and failing heart, and the impact of mitochondrial dysfunction in HF. Recent findings from signaling studies focusing on MR and AR crosstalk via non-conventional signaling of molecules that normally terminate the signaling of ARs in the heart, i.e., the G protein-coupled receptor-kinases (GRKs), are also highlighted.

Keywords: G protein-coupled receptor (GPCR); adverse remodeling; aldosterone; heart failure; mineralocorticoid receptor; mitochondria; mitochondrial bioenergetics; mitochondrial dynamics; mitochondrial dysfunction; signaling crosstalk.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Five emerging molecular points of aldosterone–AR signaling crosstalk in the heart. 1. OPN is transcriptionally upregulated by aldosterone and, in turn, dampens the cAMP-mediated anti-fibrotic signaling of the β2AR; 2. β2AR-stimulated GRK5 “sheds” from the plasma membrane to the cytoplasm, wherein it phosphorylates and inhibits MR (prevents MR nuclear translocation); 3. Aldosterone enhances catecholamine (βAR)-mediated ERK activation resulting in enhanced fibrosis; 4. MR inhibits CREB (usually activated by βARs) via CLN/PP2B; 5. α1AR-activated PKC enhances aldosterone-induced hypertrophy and adverse remodeling. Adapted from Parker at al., 2018 [3].

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