Nogo-A mediated endoplasmic reticulum stress during myocardial ischemic-reperfusion injury in diabetic rats

Background: Diabetic myocardial ischemia reperfusion (MI/R) injury is aggravated after myocardial infarction, which leads to myocardial damage. Molecular mechanisms associated with the diabetic ischemia-related cardiac diseases are not yet fully understood. Nogo-A is an endoplasmic reticulum (ER) protein ubiquitously expressed in tissues including in the heart. However, the mechanisms that account for the Nogo-A in MI/R injury remain unknown. Methods: SD (Sprague Dawley) rats were subjected to 45 min of ischemia, followed by 3 h reperfusion. Rats were injection with streptozotocin (60mg/kg), tauroursodeoxycholic acid injection (100mg/kg) or corresponding controls just prior to MI/R. Blood and heart samples were collected at 3 h post-reperfusion. Serum LDH and CK-MB, myocardial infarct size, histopathologic changes, apotosis and ER stress were analyzed to evaluate MI/R injury. Signaling pathways were also investigated in vitro using embryonic rat cardiomyocyte-derived H9c2 cells cultures to identify underlying mechanisms for Nogo-A in diabetic MI/R injury. Results: TUDCA treatment significantly reduced Nogo-A, GRP78 and CHOP levels, diminished myocardial infarct areas, attenuated ER stress and decreased myocardial apoptosis after MI/R. ER stress signaling was significantly decreased in the TUDCA-treated MI/R group compared with controls. The effect of Nogo-A was abrogated by pretreatment with knockdown CHOP. A positive feedback loop between Nogo-A and CHOP was found leading to an enhanced ER stress in diabetic MI/R injure. Conclusions: Our data suggest that Nogo-A mediated ER stress plays a major role in diabetic MI/R injury and Nogo-A might be a key regulator of ER stress.