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The cannabinoid receptor type 2 promotes cardiac myocyte and fibroblast survival and protects against ischemia/reperfusion-induced cardiomyopathy

Nicole Defer^*,,1, Jinghong Wan^*,,1, Richard Souktani^,, Brigitte Escoubet, Magali Perier^*,, Philippe Caramelle^*,, Sylvie Manin^*,, Vanessa Deveaux^*,, Marie-Claude Bourin^*,, Andreas Zimmer^||, Sophie Lotersztajn^*,, Françoise Pecker^*,,¶ and Catherine Pavoine^*,,2

^* INSERM, Unite 955, Créteil, France;

Universite Paris 12, Faculte de Medecine, UMR-S 955, Créteil, France;

IFR10-IM3, Plate-Forme Petit Animal, Creteil, France;

Université Paris 7, UFR Médicale; INSERM Unite 872, Assistance Publique-Hôpitaux de Paris, Hopital Bichat, Paris, France;

^|| Institute of Molecular Psychiatry, University of Bonn, Bonn, Germany; and

^¶ Assistance Publique-Hôpitaux de Paris, Groupe Hospitalier Henri-Mondor Albert-Chenevier, Fédération de Cardiologie, Créteil, France

² Correspondence: INSERM, Unité 955, IMRB, Hôpital Henri Mondor, 94010 Créteil, France. E-mail: catherine.pavoine{at}inserm.fr

Post-myocardial infarction (MI) heart failure is a major public health problem in Western countries and results from ischemia/reperfusion (IR)-induced cell death, remodeling, and contractile dysfunction. Ex vivo studies have demonstrated the cardioprotective anti-inflammatory effect of the cannabinoid type 2 (CB2) receptor agonists within hours after IR. Herein, we evaluated the in vivo effect of CB2 receptors on IR-induced cell death, fibrosis, and cardiac dysfunction and investigated the target role of cardiac myocytes and fibroblasts. The infarct size was increased 24 h after IR in CB2^–/– vs. wild-type (WT) hearts and decreased when WT hearts were injected with the CB2 agonist JWH133 (3 mg/kg) at reperfusion. Compared with WT hearts, CB2^–/– hearts showed widespread injury 3 d after IR, with enhanced apoptosis and remodeling affecting the remote myocardium. Finally, CB2^–/– hearts exhibited exacerbated fibrosis, associated with left ventricular dysfunction 4 wk after IR, whereas their WT counterparts recovered normal function. Cardiac myocytes and fibroblasts isolated from CB2^–/– hearts displayed a higher H₂O₂-induced death than WT cells, whereas 1 µM JWH133 triggered survival effects. Furthermore, H₂O₂-induced myofibroblast activation was increased in CB2^–/– fibroblasts but decreased in 1 µM JWH133-treated WT fibroblasts, compared with that in WT cells. Therefore, CB2 receptor activation may protect against post-IR heart failure through direct inhibition of cardiac myocyte and fibroblast death and prevention of myofibroblast activation.—Defer, N., Wan, J., Souktani, R., Escoubet, B., Perier, M., Caramelle, P., Manin, S., Deveaux, V., Bourin, M.-C., Zimmer, A., Lotersztajn, S., Pecker, F., Pavoine, C. The cannabinoid receptor type 2 promotes cardiac myocyte and fibroblast survival and protects against ischemia/reperfusion-induced cardiomyopathy.

Key Words: in vivo • remodeling • apoptosis • heart failure • signaling • fibrosis