Cardiac hypertrophy is a major cause of human morbidity and mortality. Although much is known about the pathways that promote hypertrophic responses, mechanisms that antagonize these pathways have not been as clearly defined. Atrogin-1, also known as muscle atrophy F-box, is an F-box protein that inhibits pathologic cardiac hypertrophy by participating in a ubiquitin ligase complex that triggers degradation of calcineurin, a factor involved in promotion of pathologic hypertrophy. Here we demonstrated that atrogin-1 also disrupted Akt-dependent pathways responsible for physiologic cardiac hypertrophy. Our results indicate that atrogin-1 does not affect the activity of Akt itself, but serves as a coactivator for members of the Forkhead family of transcription factors that function downstream of Akt. This coactivator function of atrogin-1 was dependent on its ubiquitin ligase activity and the deposition of polyubiquitin chains on lysine 63 of Foxo1 and Foxo3a. Transgenic mice expressing atrogin-1 in the heart displayed increased Foxo1 ubiquitylation and upregulation of known Forkhead target genes concomitant with suppression of cardiac hypertrophy, while mice lacking atrogin-1 displayed the opposite physiologic phenotype. These experiments define a role for lysine 63-linked ubiquitin chains in transcriptional coactivation and demonstrate that atrogin-1 uses this mechanism to disrupt physiologic cardiac hypertrophic signaling through its effects on Forkhead transcription factors.
IntroductionFactors that increase LV afterload - such as hypertension, aortic stenosis, and age-related arterial stiffness - elicit cardiac hypertrophy as an adaptive mechanism to normalize wall stress. The shortterm hemodynamic benefits of hypertrophy occur at a cost: cardiac hypertrophy leads to diastolic dysfunction and heart failure and is a powerful predictor of cardiovascular mortality even in the absence of symptoms (1, 2). At the cellular level, cardiac hypertrophy is a consequence of increased cardiomyocyte cell volume (1, 2), a process that requires coordination of cellular signaling cascades, activation of fetal cardiac gene expression programs, increased protein synthesis, sarcomere assembly, and modulation of cellular energy sources. At the present time, no specific pharmacologic strategies to reverse cardiac hypertrophy have been approved for clinical use, so the delineation of hypertrophic mechanisms (especially those that prevent or reverse hypertrophy) remains a priority.Although complexity and redundancy exist in the signaling pathways that activate cardiac hypertrophy, 2 independent circuits that elicit distinct manifestations of hypertrophy are now recognized. Hypertrophy in response to stimuli such as pressure overload and adrenergic stimulation activates the calcineurin/ nuclear factor of activated T cell-dependent signaling pathway, resulting in so-called "pathological" hypertrophy that is associated with maladaptive features such as fibrosis, chamber dilatation,