A growing body of evidence shows that the heart secretes factors to maintain its performance and coordinate cellular activities in response to stress/ or injury. Collectively, we refer to these cardiac-secreted factors as cardiokines. The identification and study of cardiokines is significant because it will provide information about intertissue communication within the heart, and these secreted factors may serve useful therapeutic or diagnostic functions. Via high throughput transcript analyses, we identified the secreted glycoprotein Follistatin-like 1 (Fstl1), also referred to as TSC36 and FRP, as a novel cardiokine. We demonstrated that Fstl1 is markedly upregulated by cardiac stress including ischemia-reperfusion injury, pressure overload and permanent left anterior descending coronary artery (LAD) ligation. We recently showed that acute overexpression of Fstl1 will protect the heart from ischemia-reperfusion injury and will promote revascularization of ischemic hind limbs in murine models. However, the functional role of Fstl1 in post- myocardial infarction (MI) cardiac remodeling is unknown, nor is it known how Fstl1 production by different cell types in the heart influence the remodeling process. In collaborative efforts with clinical laboratories we have found that Fstl1 can be detected in human serum, and these levels are prognostic for clinical outcomes in patients with either acute coronary syndrome or heart failure. Our pilot work in experimental models show that Fstl1 induction occurs both in cardiac myocytes and macrophages recruited to the infarct, suggesting that Fstl1 is involved in cardiac myocyte-macrophage crosstalk that coordinates the wound healing response in heart failure. Here we will evaluate the relative contributions of myocyte- versus macrophage-derived Fstl1 in post-MI remodeling. We will also explore the regulatory mechanisms and significance of Fstl1-mediated GDF15 regulation, whose importance is underscored by clinical data showing that these two factors participate in a """"""""biomarker network."""""""" Finally, we will examine the role of Dip2a, a recentl identified Fstl1 receptor molecule, in mediating the cardioprotective actions of Fstl1 on the heart To assess the role of Fstl1 in these processes, we will employ novel conditional knockout and overexpression models that have been created for these studies.

Public Health Relevance

We will investigate the role of cardiac myocyte-derived Fstl1 in post-MI heart failure using genetic models and investigate the role of macrophage-derived Fstl1 in post-MI heart failure using genetic models. We will also evaluate the Fstl1-GDF15 signaling axis and the functional role of GDF15 in mediating the cardioprotective actions of Fstl1. Finally, we will analyze the role of Dip2a, a Fstl1 receptor, in heart using conditional knockout mice.

National Institute of Health (NIH)
National Heart, Lung, and Blood Institute (NHLBI)
Research Project (R01)
Project #
Application #
Study Section
Myocardial Ischemia and Metabolism Study Section (MIM)
Program Officer
Adhikari, Bishow B
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Boston University
Internal Medicine/Medicine
Schools of Medicine
United States
Zip Code
Nakamura, Kazuto; Sano, Soichi; Fuster, José J et al. (2016) Secreted Frizzled-related Protein 5 Diminishes Cardiac Inflammation and Protects the Heart from Ischemia/Reperfusion Injury. J Biol Chem 291:2566-75
Lee, Richard T; Walsh, Kenneth (2016) The Future of Cardiovascular Regenerative Medicine. Circulation 133:2618-25
Hayakawa, Satoko; Ohashi, Koji; Shibata, Rei et al. (2015) Cardiac myocyte-derived follistatin-like 1 prevents renal injury in a subtotal nephrectomy model. J Am Soc Nephrol 26:636-46
Fuster, José J; Zuriaga, María A; Ngo, Doan Thi-Minh et al. (2015) Noncanonical Wnt signaling promotes obesity-induced adipose tissue inflammation and metabolic dysfunction independent of adipose tissue expansion. Diabetes 64:1235-48
Wei, Ke; Serpooshan, Vahid; Hurtado, Cecilia et al. (2015) Epicardial FSTL1 reconstitution regenerates the adult mammalian heart. Nature 525:479-85
Shimizu, Ippei; Walsh, Kenneth (2015) The Whitening of Brown Fat and Its Implications for Weight Management in Obesity. Curr Obes Rep 4:224-9
Romero, Freddy; Shah, Dilip; Duong, Michelle et al. (2015) A pneumocyte-macrophage paracrine lipid axis drives the lung toward fibrosis. Am J Respir Cell Mol Biol 53:74-86
Miller, Edward J; Calamaras, Timothy; Elezaby, Aly et al. (2015) Partial Liver Kinase B1 (LKB1) Deficiency Promotes Diastolic Dysfunction, De Novo Systolic Dysfunction, Apoptosis, and Mitochondrial Dysfunction With Dietary Metabolic Challenge. J Am Heart Assoc 5:
Cheng, Kian-Kai; Akasaki, Yuichi; Lecommandeur, Emmanuelle et al. (2015) Metabolomic analysis of akt1-mediated muscle hypertrophy in models of diet-induced obesity and age-related fat accumulation. J Proteome Res 14:342-52
Miyabe, Megumi; Ohashi, Koji; Shibata, Rei et al. (2014) Muscle-derived follistatin-like 1 functions to reduce neointimal formation after vascular injury. Cardiovasc Res 103:111-20

Showing the most recent 10 out of 16 publications