Abstract
Peripartum cardiomyopathy (PPCM) is a potentially life-threatening condition in which heart failure and systolic dysfunction occur late in pregnancy or within months following delivery. To date, no reliable biomarkers or therapeutic interventions for the condition exist, thus necessitating an urgent need for identification of novel PPCM drug targets and candidate biomarkers. Leads for novel treatments and biomarkers are therefore being investigated worldwide. Pregnancy is generally accompanied by dramatic hemodynamic changes, including a reduced afterload and a 50% increase in cardiac output. These increased cardiac stresses during pregnancy potentially impair protein folding processes within the cardiac tissue. The accumulation of misfolded proteins results in increased toxicity and cardiac insults that trigger heart failure. Under stress conditions, molecular chaperones such as heat shock proteins (Hsps) play crucial roles in maintaining cellular proteostasis. Here, we critically assess the potential role of Hsps in PPCM. We further predict specific associations between the Hsp types Hsp70, Hsp90 and small Hsps with several proteins implicated in PPCM pathophysiology. Furthermore, we explore the possibility of select Hsps as novel candidate PPCM biomarkers and drug targets. A better understanding of how these Hsps modulate PPCM pathogenesis holds promise in improving treatment, prognosis and management of the condition, and possibly other forms of acute heart failure.
Highlights
Protein folding processes are fundamental in the maintenance of cardiac tissue integrity [1]
We propose that heat shock proteins (Hsps) are important in peripartum cardiomyopathy (PPCM) since the heart is further burdened by pregnancy related stresses that may impair optimal protein folding processes in the cardiomyocytes
The involvement of Hsps in protein quality control systems has been reported in several cardiovascular disorders such as ischaemic heart disease and heart failure (HF)
Summary
Protein folding processes are fundamental in the maintenance of cardiac tissue integrity [1]. The metabolic and mechanical demands of the heart, such as its continuous contractile activities, place a burden for robust protein quality control systems [2]. Several cardiovascular diseases such as ischemic heart disease and heart failure (HF) are characterised by increased mechanical and oxidative pressures which trigger an accumulation of misfolded proteins in cardiomyocytes. Misfolded proteins are toxic to cardiomyocytes, potentially causing cardiac insults that lead to
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