Abstract

Nuclear factor of activated T cells 5 (NFAT5)/Tonicity enhancer binding protein (TonEBP) is a transcription factor induced by hypertonic stress in the kidney. However, the function of NFAT5 in other organs has rarely been studied, even though it is ubiquitously expressed. Indeed, although NFAT5 was reported to be critical for heart development and function, its role in infectious heart diseases has remained obscure. In this study, we aimed to understand the mechanism by which NFAT5 interferes with infection of Coxsackievirus B3 (CVB3), a major cause of viral myocarditis. Our initial results demonstrated that although the mRNA level of NFAT5 remained constant during CVB3 infection, NFAT5 protein level decreased because the protein was cleaved. Bioinformatic prediction and verification of the predicted site by site-directed mutagenesis experiments determined that the NFAT5 protein was cleaved by CVB3 protease 2A at Glycine 503. Such cleavage led to the inactivation of NFAT5, and the 70-kDa N-terminal cleavage product (p70-NFAT5) exerted a dominant negative effect on the full-length NFAT5 protein. We further showed that elevated expression of NFAT5 to counteract viral protease cleavage, especially overexpression of a non-cleavable mutant of NFAT5, significantly inhibited CVB3 replication. Ectopic expression of NFAT5 resulted in elevated expression of inducible nitric oxide synthase (iNOS), a factor reported to inhibit CVB3 replication. The necessity of iNOS for the anti-CVB3 effect of NFAT5 was supported by the observation that inhibition of iNOS blocked the anti-CVB3 effect of NFAT5. In a murine model of viral myocarditis, we observed that treatment with hypertonic saline or mannitol solution upregulated NFAT5 and iNOS expression, inhibited CVB3 replication and reduced tissue damage in the heart. Taken together, our data demonstrate that the anti-CVB3 activity of NFAT5 is impaired during CVB3 infection due to 2A-mediated cleavage of NFAT5. Thus induction of NFAT5 by hypertonic agents may be a promising strategy for the development of anti-CVB3 therapeutics.

Highlights

  • Viral myocarditis is an inflammatory heart disease caused by viral infection

  • We showed that Nuclear factor of activated T cells 5 (NFAT5) was cleaved into several fragments during Coxsackievirus B3 (CVB3) infection, which blocked the activity of the protein

  • We demonstrated that intact NFAT5 inhibited CVB3 multiplication, but that such antiviral activity was impaired by NFAT5 cleavage products, indicating that CVB3 cleaves the NFAT5 protein as a survival strategy

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Summary

Introduction

Viral myocarditis is an inflammatory heart disease caused by viral infection. Acute viral myocarditis can be lethal in a short period of time and chronic viral myocarditis frequently progresses to dilated cardiomyopathy (DCM), a severe heart disease for which the only current treatment is heart transplantation [1,2,3]. Several well-documented examples of such cleavage are the cleavage of eukaryotic translation initiation factor 4G (eIF4G) by protease 2A, shutting down host cap-dependent translation [9, 10], as well as cleavage of poly-A binding protein (PABP), inhibiting host translation initiation [11], and cleavage of cardiac dystrophin, a structural protein required for maintenance of cardiomyocyte architecture, which results in structural damage [12] Both 2A and 3C cleave Bid, a Bax-like BH3 protein, inducing the intrinsic mitochondria-mediated apoptosis pathway and leading to cell death [10]

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