Among the investigated causes of cardiovascular disease (CVD), the prolonged use of nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin and Meclofenamate Sodium (MS), which are used to reduce pain and fever, has been associated with increased risk of heart failure. The molecular mechanism by which NSAIDs induce cardiac dysfunction has yet to be completely elucidated, but a study using aspirin has demonstrated inhibition of proteasome activity in mouse Neuro 2a cells. The proteasome is a multi-catalytic protease complex that degrades unneeded or damaged intracellular proteins to maintain intracellular homeostasis. After 4 hours of incubation, 30μM MS was found to decrease the beta 5 chymotrypsin-like proteasome activity by 30% in H9c2 rat cardiac cells. Unlike aspirin, which was not found to directly inhibit the proteasome, MS directly modulated all three proteolytic activities of purified 20S mouse proteasome. MS significantly increased the beta 1 caspase-like and beta 2 trypsin-like activities of purified 20S proteasomes in a concentration-dependent manner. However, 500μM MS inhibited the beta 5 activity of purified 20S proteasomes by approximately 15%. Addition of 50μM MS to mouse heart homogenates decreased the 26S beta 5 proteasome activity by 20%. At MS concentrations found in the plasma of persons taking MS, MS was found to severely hinder myotube formation during C2C12 mouse skeletal myoblast cell differentiation. This is the first report of any NSAID directly affecting proteasome activity in cardiac cells and could explain why NSAIDs like MS should not be given to patients prior to heart surgery. Supported by NIH grant HL096819.
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