Rationale:A key component of cardiac ischemia-reperfusion injury (IRI) is the increased generation of reactive oxygen species, leading to enhanced inflammation and tissue dysfunction in patients following intervention for myocardial infarction. We have previously shown that oxidative stress induces myocardial senescence, promoting adverse myocardial remodeling and cardiac dysfunction via the expression of a proinflammatory senescence-associated secretory phenotype (SASP). In this study we hypothesized that oxidative stress-induced senescence and SASP-mediated inflammation contribute to the pathophysiology of cardiac IRI and thus, senescence represents a novel therapeutic target.
Objective:To identify if cellular senescence contributes to the pathophysiology of IRI and to investigate if pharmacological elimination of senescent cells after ischemiareperfusion can improve cardiac outcomes.
Methods and Results:Using an established model of cardiac ischemia-reperfusion, we demonstrate that in young mice IRI induces cellular senescence in both cardiomyocytes and interstitial cell populations. Additionally, we show that treatment with the senolytic drug navitoclax improves left ventricular function, increases myocardial vascularization, and decreases scar size. SWATH-MS based proteomics revealed that biological processes associated with fibrosis and inflammation, which were increased following 2 ischemia-reperfusion, were attenuated upon senescent cell clearance. Furthermore, navitoclax treatment reduced the expression of proinflammatory, profibrotic and antiangiogenic cytokines, including interferon gamma-induced protein-10, TGF-β3, interleukin-11, interleukin-16 and fractalkine.
Conclusions:Our study provides proof-of-concept evidence that cellular senescence contributes to impaired heart function and adverse remodeling following cardiac ischemiareperfusion. We also establish that post-IRI the SASP plays a considerable role in the inflammatory response. Subsequently, senolytic treatment, at a clinically feasible time point, attenuates multiple components of this response and improves clinically important parameters. Thus, cellular senescence represents a potential novel therapeutic avenue to improve patient outcomes following cardiac ischemiareperfusion.