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Fumarate is cardioprotective via activation of the Nrf2 antioxidant pathway.


ABSTRACT: The citric acid cycle (CAC) metabolite fumarate has been proposed to be cardioprotective; however, its mechanisms of action remain to be determined. To augment cardiac fumarate levels and to assess fumarate's cardioprotective properties, we generated fumarate hydratase (Fh1) cardiac knockout (KO) mice. These fumarate-replete hearts were robustly protected from ischemia-reperfusion injury (I/R). To compensate for the loss of Fh1 activity, KO hearts maintain ATP levels in part by channeling amino acids into the CAC. In addition, by stabilizing the transcriptional regulator Nrf2, Fh1 KO hearts upregulate protective antioxidant response element genes. Supporting the importance of the latter mechanism, clinically relevant doses of dimethylfumarate upregulated Nrf2 and its target genes, hence protecting control hearts, but failed to similarly protect Nrf2-KO hearts in an in vivo model of myocardial infarction. We propose that clinically established fumarate derivatives activate the Nrf2 pathway and are readily testable cytoprotective agents.

SUBMITTER: Ashrafian H 

PROVIDER: S-EPMC3314920 | biostudies-literature | 2012 Mar

REPOSITORIES: biostudies-literature

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Fumarate is cardioprotective via activation of the Nrf2 antioxidant pathway.

Ashrafian Houman H   Czibik Gabor G   Bellahcene Mohamed M   Aksentijević Dunja D   Smith Anthony C AC   Mitchell Sarah J SJ   Dodd Michael S MS   Kirwan Jennifer J   Byrne Jonathan J JJ   Ludwig Christian C   Isackson Henrik H   Yavari Arash A   Støttrup Nicolaj B NB   Contractor Hussain H   Cahill Thomas J TJ   Sahgal Natasha N   Ball Daniel R DR   Birkler Rune I D RI   Hargreaves Iain I   Tennant Daniel A DA   Land John J   Lygate Craig A CA   Johannsen Mogens M   Kharbanda Rajesh K RK   Neubauer Stefan S   Redwood Charles C   de Cabo Rafael R   de Cabo Rafael R   Ahmet Ismayil I   Talan Mark M   Günther Ulrich L UL   Robinson Alan J AJ   Viant Mark R MR   Pollard Patrick J PJ   Tyler Damian J DJ   Watkins Hugh H  

Cell metabolism 20120301 3


The citric acid cycle (CAC) metabolite fumarate has been proposed to be cardioprotective; however, its mechanisms of action remain to be determined. To augment cardiac fumarate levels and to assess fumarate's cardioprotective properties, we generated fumarate hydratase (Fh1) cardiac knockout (KO) mice. These fumarate-replete hearts were robustly protected from ischemia-reperfusion injury (I/R). To compensate for the loss of Fh1 activity, KO hearts maintain ATP levels in part by channeling amino  ...[more]

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