A Link Between Methylglyoxal and Heart Failure During HIV-1 Infection

Prasanta K Dash; Fadhel A Alomar; Jesse L Cox; JoEllyn McMillan; Bryan T Hackfort; Edward Makarov; Brenda Morsey; Howard S Fox; Howard E Gendelman; Santhi Gorantla; Keshore R Bidasee

doi:10.3389/fcvm.2021.792180

A Link Between Methylglyoxal and Heart Failure During HIV-1 Infection

Front Cardiovasc Med. 2021 Dec 14:8:792180. doi: 10.3389/fcvm.2021.792180. eCollection 2021.

Authors

Affiliations

¹ Departments of Pharmacology and Experimental Neuroscience, University of Nebraska Medical Center, Omaha, NE, United States.
² Department of Pharmacology and Toxicology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
³ Departments of Pathology and Microbiology, University of Nebraska Medical Center, Omaha, NE, United States.
⁴ Departments of Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, NE, United States.
⁵ Departments of Neurological Sciences, University of Nebraska Medical Center, Omaha, NE, United States.
⁶ Departments of Environment and Occupational Health, University of Nebraska Medical Center, Omaha, NE, United States.
⁷ Nebraska Redox Biology Center, Lincoln, NE, United States.

Abstract

Early-onset heart failure (HF) continues to be a major cause of morbidity and mortality in people living with human immunodeficiency virus type one (HIV-1) infection (PLWH), yet the molecular causes for this remain poorly understood. Herein NOD.Cg-Prkdc^scidIl2rg^tm1Wjl/SzJ humanized mice (Hu-mice), plasma from PLWH, and autopsied cardiac tissues from deceased HIV seropositive individuals were used to assess if there is a link between the glycolysis byproduct methylglyoxal (MG) and HF in the setting of HIV-1 infection. At five weeks post HIV infection, Hu-mice developed grade III-IV diastolic dysfunction (DD) with an associated two-fold increase in plasma MG. At sixteen-seventeen weeks post infection, cardiac ejection fraction and fractional shortening also declined by 26 and 35%, and plasma MG increased to four-fold higher than uninfected controls. Histopathological and biochemical analyses of cardiac tissues from Hu-mice 17 weeks post-infection affirmed MG increase with a concomitant decrease in expression of the MG-degrading enzyme glyoxalase-1 (Glo1). The endothelial cell marker CD31 was found to be lower, and coronary microvascular leakage and myocardial fibrosis were prominent. Increasing expression of Glo1 in Hu-mice five weeks post-infection using a single dose of an engineered AAV2/9 (1.7 × 10¹² virion particles/kg), attenuated the increases in plasma and cardiac MG levels. Increasing Glo1 also blunted microvascular leakage, fibrosis, and HF seen at sixteen weeks post-infection, without changes in plasma viral loads. In plasma from virally suppressed PLWH, MG was also 3.7-fold higher. In autopsied cardiac tissues from seropositive, HIV individuals with low viral log, MG was 4.2-fold higher and Glo1 was 50% lower compared to uninfected controls. These data show for the first time a causal link between accumulation of MG and HF in the setting of HIV infection.

Keywords: HIV-1; echocardiography; heart failure; humanized mice; methylglyoxal.

Abstract

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