Abstract

Cardiovascular disease remains a leading cause of morbidity and mortality in HIV-positive patients, even in those whose viral loads are well controlled with antiretroviral therapy. However, the underlying molecular events responsible for the development of cardiac disease in the setting of HIV remain unknown. The HIV-encoded Tat protein plays a critical role in the activation of HIV gene expression and profoundly impacts homeostasis in both HIV-infected cells and uninfected cells that have taken up released Tat via a bystander effect. Since cardiomyocyte function, including excitation-contraction coupling, greatly depends on energy provided by the mitochondria, in this study, we performed a series of experiments to assess the impact of Tat on mitochondrial function and bioenergetics pathways in a primary cell culture model derived from neonatal rat ventricular cardiomyocytes (NRVCs). Our results show that the presence of Tat in cardiomyocytes is accompanied by a decrease in oxidative phosphorylation, a decline in the levels of ATP, and an accumulation of reactive oxygen species (ROS). Tat impairs the uptake of mitochondrial Ca2+ ([Ca2+ ]m ) and the electrophysiological activity of cardiomyocytes. Tat also affects the protein clearance pathway and autophagy in cardiomyocytes under stress due to hypoxia-reoxygenation conditions. A reduction in the level of ubiquitin along with dysregulated degradation of autophagy proteins including SQSTM1/p62 and a reduction of LC3 II were detected in cardiomyocytes harboring Tat. These results suggest that, by targeting mitochondria and protein quality control, Tat significantly impacts bioenergetics and autophagy resulting in dysregulation of cardiomyocyte health and homeostasis.

Highlights

  • HIV positive patients have been reported to be more vulnerable to the development of various cardiovascular disorders such as atherosclerosis, myocardial fibrosis and myocardial infarction [Manga et al, 2017, Eugenin et al, 2008]

  • In this study we demonstrate that HIV-1 Tat expression leads to a significant loss of mitochondrial metabolic function and an increase in the accumulation of toxic reactive oxygen species (ROS) in isolated rat cardiomyocytes

  • As a first step to investigate the impact of Tat on the bioenergetics pathway in cardiomyocytes, we measured cellular ATP levels in control and Tat expressing NRVCs using a luciferase-based ATP assay

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Summary

Introduction

HIV positive patients have been reported to be more vulnerable to the development of various cardiovascular disorders such as atherosclerosis, myocardial fibrosis and myocardial infarction [Manga et al, 2017, Eugenin et al, 2008]. HIV-infected individuals have a significantly increased risk of developing heart failure with reduced ejection fraction (HFrEF) even when adjusting for possible confounders [Freiberg et al 2017]. HIV can lead to a chronic inflammatory response and subsequent cardiac dysfunction by infecting myocardial endothelial cells [Manga et al, 2017]. HIV has been reported to infect vascular smooth muscle cells both in vivo and in vitro leading to the development of vascular disease [Eugenin et al, 2008]. Antiretroviral therapies have played an important role in suppressing HIV progression and reduced HIV mortality but they increase the risk of dyslipidemia and contribute to the development of heart disease [Domingo et al, 2008]. The precise molecular mechanisms through which HIV causes cardiac problems still remain to be elucidated

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