Inhibition of GSK-3 to induce cardiomyocyte proliferation: a recipe for in situ cardiac regeneration

Cardiovasc Res. 2019 Jan 1;115(1):20-30. doi: 10.1093/cvr/cvy255.

Abstract

With an estimated 38 million current patients, heart failure (HF) is a leading cause of morbidity and mortality worldwide. Although the aetiology differs, HF is largely a disease of cardiomyocyte (CM) death or dysfunction. Due to the famously limited amount of regenerative capacity of the myocardium, the only viable option for advanced HF patients is cardiac transplantation; however, donor's hearts are in very short supply. Thus, novel regenerative strategies are urgently needed to reconstitute the injured hearts. Emerging data from our lab and others have elucidated that CM-specific deletion of glycogen synthase kinase (GSK)-3 family of kinases induces CM proliferation, and the degree of proliferation is amplified in the setting of cardiac stress. If this proliferation is sufficiently robust, one could induce meaningful regeneration without the need for delivering exogenous cells to the injured myocardium (i.e. cardiac regeneration in situ). Herein, we will discuss the emerging role of the GSK-3s in CM proliferation and differentiation, including their potential implications in cardiac regeneration. The underlying molecular interactions and cross-talk among signalling pathways will be discussed. We will also review the specificity and limitations of the available small molecule inhibitors targeting GSK-3 and their potential applications to stimulate the endogenous cardiac regenerative responses to repair the injured heart.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Animals
  • Cell Differentiation / drug effects
  • Cell Proliferation / drug effects*
  • ErbB Receptors / metabolism
  • Glycogen Synthase Kinase 3 / antagonists & inhibitors*
  • Glycogen Synthase Kinase 3 / metabolism
  • Heart Failure / drug therapy*
  • Heart Failure / enzymology
  • Heart Failure / pathology
  • Heart Failure / physiopathology
  • Hippo Signaling Pathway
  • Humans
  • Myocytes, Cardiac / drug effects*
  • Myocytes, Cardiac / enzymology
  • Myocytes, Cardiac / pathology
  • Neuregulin-1 / metabolism
  • Protein Kinase Inhibitors / therapeutic use*
  • Protein Serine-Threonine Kinases / metabolism
  • Regeneration / drug effects*
  • Signal Transduction

Substances

  • NRG1 protein, human
  • Neuregulin-1
  • Protein Kinase Inhibitors
  • EGFR protein, human
  • ErbB Receptors
  • Protein Serine-Threonine Kinases
  • Glycogen Synthase Kinase 3