Rationale: Hyperglycemic memory may explain why intensive glucose control has failed to improve cardiovascular outcomes in patients with diabetes. Indeed, hyperglycemia promotes vascular dysfunction even after glucose normalization. However, the molecular mechanisms of this phenomenon remain to be elucidated.Objective: The present study investigated the role of mitochondrial adaptor p66 Shc in this setting.
Methods and Results:In human aortic endothelial cells (HAECs) exposed to high glucose and aortas of diabetic mice, activation of p66Shc by protein kinase C II (PKCII) persisted after returning to normoglycemia.
Persistent p66Shc upregulation and mitochondrial translocation were associated with continued reactive oxygen species (ROS) production, reduced nitric oxide bioavailability, and apoptosis. We show that p66Shc gene overexpression was epigenetically regulated by promoter CpG hypomethylation and general control nonderepressible 5-induced histone 3 acetylation. Furthermore, p66Shc -derived ROS production maintained PKCII upregulation and PKCII-dependent inhibitory phosphorylation of endothelial nitric oxide synthase at Thr-495, leading to a detrimental vicious cycle despite restoration of normoglycemia. Moreover, p66Shc activation accounted for the persistent elevation of the advanced glycated end product precursor methylglyoxal. In vitro and in vivo gene silencing of p66Shc , performed at the time of glucose normalization, blunted ROS production, restored endothelium-dependent vasorelaxation, and attenuated apoptosis by limiting cytochrome c release, caspase 3 activity, and cleavage of poly (ADP-ribose) polymerase.
Conclusions: p66Shc is the key effector driving vascular hyperglycemic memory in diabetes. Our study provides molecular insights for the progression of diabetic vascular complications despite glycemic control and may help to define novel therapeutic targets. (Circ Res. 2012;111:278-289.) Key Words: vascular disease Ⅲ diabetes mellitus Ⅲ free radicals Ⅲ endothelium T he prevalence of diabetes has dramatically increased worldwide, with a further rise anticipated in the next decades. 1,2 Morbidity and mortality from cardiovascular disease is 2-to 8-fold higher in subjects with than in those without diabetes. 3
Editorial, see p 262Recent prospective clinical trials have failed to confirm unequivocal benefits from normalization of glycemia on cardiovascular outcomes. 4 -8 In these trials, intensive glucoselowering therapy was started after a median duration of diabetes ranging from 8 to 11 years. 4 -8 By contrast, early treatment of hyperglycemia reduces the risk of myocardial infarction, diabetes-related deaths, and all-cause mortality. 9 -11 These observations support the concept that hyperglycemic environment may be remembered in the vasculature. 12 Reactive oxygen species (ROS) are probably involved in this phenomenon defined "hyperglycemic memory," but the underlying molecular mechanisms remain unknown. [13][14][15] Overproduction of ROS by mitochondria is considered as a causal link betwe...