Cardiac ischemia-reperfusion (IR) injury is the pathologic process underlying heart-attack (acute myocardial infarction, AMI). Despite decades of research, cardioprotective therapies are scant, and AMI kills >220,000 people annually in the US. In addition, >380,000 patients/yr. undergo predictable ischemia during cardiac surgery. The overall goal of this ongoing program is to develop new cardioprotective therapies for IR injury. This is a competing renewal application, and in the previous funding cycle we published 19 primary research articles directly attributable to this award (and 17 additional papers). During this time we identified two key signaling players in the endogenous cardioprotective phenomenon of acute ischemic preconditioning (IPC). First, we showed NO?derived nitro-lipids is generated in IPC, and covalently adducts mitochondrial adenine nucleotide translocase 1 (ANT1). This causes mild uncoupling of mitochondrial oxidative phosphorylation, which is independently known to protect against IR injury. Second, we showed that the lysine deacetylase SIRT1 is necessary for acute cardioprotective signaling, and that SIRT1 transgenic mice are endogenously protected against IR injury. While these mechanisms may initially appear distinct, our preliminary data show that nitro-lipids covalently modify SIRT1, suggesting cross-talk between nitro-lipid &SIRT1 signaling. The downstream mechanisms which mediate cardioprotection by nitro-lipids and SIRT1 are poorly defined, but our preliminary data suggest the importance of alterations in metabolism and the stimulation of mitophagy, both of which are implicated in cardioprotection. Furthermore, we have developed a cell-based screening platform applicable to adult primary cardiomycytes, enabling discovery of small molecules which can engage these mechanisms to protect the heart from IR injury in-vivo. Overall, these observations have led to the central hypothesis that nitro-lipids &SIRT1 act in concert to protect the heart from IR injury via alterations in metabolism and mitophagy. In this project, we will exploit these endogenous protective pathways for therapeutic benefit, by delivering small molecules that modulate them both prior to ischemia AND at reperfusion. The end goal is to deliver novel cardioprotective molecules for pre-clinical development. To achieve this goal and test our hypothesis, we will pursue three following specific aims:
Aim 1 will identify cardioprotective targets of nitro-lipid action, with a focus on ANT1 and mitophagy.
Aim 2 will investigate cardioprotective targets of SIRT1, with a focus on metabolism.
Aim 3 will develop screening hits, with a focus on molecules that impact mitophagy and metabolism. Addressing these aims will yield a series of small molecule candidates for pre-clinical development as cardioprotective therapeutics, and will enhance our understanding of the underlying mechanisms of cardioprotection.

Public Health Relevance

During a heart attack, blockage of a coronary artery starves the cardiac tissue of oxygen and nutrients, a condition termed ischemia. The goal of this project is to develop new drugs to protect the heart during ischemia. In the previous funding cycle, we identified two key endogenous signals which play a role in cardioprotection, and this new project will find out more about these signals and how they work, as well as exploit these signals to design new therapies. The first signal is a family of lipids termed nitro-lipids, and the second isa protein called SIRT1. We propose that these signals work together, to alter the metabolism of the heart, and to promote endogenous recycling mechanisms inside heart cells. Together this brings about a protected state. We have also developed a screening assay, which allows us to find new small molecules that can trigger these protective signals. Thus, we are in possession of a number of drug candidates, which the project will develop into therapeutics. Every year in the US, over 220,000 people die from a heart attack (acute myocardial infarction) and a further 380,000 undergo a transient ischemic event during cardiac surgery. It is hoped that the small molecules emerging from this project will offer therapeutic benefit to these individuals.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
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Special Emphasis Panel (ZRG1-CVRS-Q (02))
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Wong, Renee P
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University of Rochester
Schools of Dentistry
United States
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Nadtochiy, Sergiy M; Madukwe, Jerry; Hagen, Fred et al. (2014) Mitochondrially targeted nitro-linoleate: a new tool for the study of cardioprotection. Br J Pharmacol 171:2091-8
Kalifa, Lidza; Gewandter, Jennifer S; Staversky, Rhonda J et al. (2014) DNA double-strand breaks activate ATM independent of mitochondrial dysfunction in A549 cells. Free Radic Biol Med 75:30-9
Porter, George A; Urciuoli, William R; Brookes, Paul S et al. (2014) SIRT3 deficiency exacerbates ischemia-reperfusion injury: implication for aged hearts. Am J Physiol Heart Circ Physiol 306:H1602-9
Galloway, Chad A; Lee, Hakjoo; Brookes, Paul S et al. (2014) Decreasing mitochondrial fission alleviates hepatic steatosis in a murine model of nonalcoholic fatty liver disease. Am J Physiol Gastrointest Liver Physiol 307:G632-41
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Lagadinou, Eleni D; Sach, Alexander; Callahan, Kevin et al. (2013) BCL-2 inhibition targets oxidative phosphorylation and selectively eradicates quiescent human leukemia stem cells. Cell Stem Cell 12:329-41
Wojtovich, Andrew P; Smith, C Owen; Haynes, Cole M et al. (2013) Physiological consequences of complex II inhibition for aging, disease, and the mKATP channel. Biochim Biophys Acta 1827:598-611
Chouchani, Edward T; Methner, Carmen; Nadtochiy, Sergiy M et al. (2013) Cardioprotection by S-nitrosation of a cysteine switch on mitochondrial complex I. Nat Med 19:753-9
Guo, Stephanie; Olm-Shipman, Adam; Walters, Andrew et al. (2012) A cell-based phenotypic assay to identify cardioprotective agents. Circ Res 110:948-57
Wojtovich, Andrew P; Nadtochiy, Sergiy M; Brookes, Paul S et al. (2012) Ischemic preconditioning: the role of mitochondria and aging. Exp Gerontol 47:1-7

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