Abstract Tu040: A Novel Anti-Thrombotic and Anti-AF Drug without an Adverse Bleeding Problem

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Introduction: Aging is an independent risk factor of atrial fibrillation (AF), which leads to a high mortality due to thromboembolic stroke. But available antithrombotic therapies are limited for the aged AF patients due to aging-associated bleeding risk. We recently revealed critical roles of activated cardiac stress kinase JNK2 in both enhanced AF risk and thrombogenesis in aging through a mechanism of heart-platelet crosstalk. Here, we assessed anti-thrombotic potentials of JNK2 inhibition. Methods: Young (Yg) and aged (2 vs 24 mo) wildtype (WT) mice with and without a JNK2-specific inhibitor (JNK2I, 5 mg/kg i.p.; every other day/4 doses) or meloxicam (0.5 mg/kg/day, i.p.; five days) treatment were used for in vivo FeCl 3 -induced carotid artery occlusion (thrombus formation) and tail bleeding assays. The effects of cardiac JNK2-specific inhibition in thrombogenesis and bleeding were assessed in our unique cardiac-specific mice of MKK7D (inducible overexpression of active MKK7D, a JNK upstream activator) and MKK7D-JNK2dn (overexpressed inactive dominant negative (dn) JNK2 to competitively inhibit endogenous JNK2 in MKK7D mice). Results: Aged mice had a shortened artery occlusion time compared to Yg (5.8±0.2 min vs. 7.1±0.2 min, p<0.001, n=12,7). JNK2I reversed the occlusion time in aged mice to that seen in Yg (p=NS, n=8,7). Yg MKK7D mice also showed a shortened occlusion time compared to WT-controls (p<0.001, n=9,8) that was rescued by cardiac-specific JNK2 inhibition in MKK-JNK2dn mice (p=NS, n=5,8), suggesting a key role of cardiac JNK2 in thrombus formation. Next, we found that 40% of aged WT mice had continuous bleeding compared to its absence in Yg WT. However, meloxicam (an anti-platelet NSAID drug) increased continuous bleeding risk in both aged (83% had it) and Yg (20%) and prolonged the initial clotting time in aged mice (385±56s vs 84±18s in aged controls; p<0.001, n=8,6). In contrast, JNK2I eliminated this bleeding issue, evidenced from the absence of continuous bleeding and shortened initial clotting time compared to aged controls (p=NS, n=8,8). Conclusion: Heart JNK2 enhances thrombotic risk in the blood. JNK2 inhibition could be a promising anti-thrombotic and anti-AF therapeutic approach without adverse bleeding for aged AF patients.