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Cell Signaling Mechanisms Underlying the Cardiac Actions of Adipokines

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substrate-1 (IRS-1).86 Thus, the contribution of resistin to the etiology of heart disease in general and heart failure in particular and the underlying mechanistic bases for these e ects is important to clarify particularly as targeting this cytokine may represent a possible useful therapeutic strategy.

4.8.1Cardiac Actions of Resistin

Emerging evidence suggests that cardiovascular disease is accompanied by changes in resistin levels. For example, in women, plasma resistin levels are elevated in patients with coronary heart disease.88 What role resistin plays in the disease process is not known, although in patients with atherothrombotic strokes, plasma resistin levels are associated with elevated risk of 5-year mortality.89 Serum resistin concentrations have also been shown to be elevated in patients with heart failure with levels positively related to the severity of heart failure according to New York Heart Association functional classification.90 Although these studies do not indicate cause-and-e ect relationships, nonetheless increasing plasma resistin concentrations appear to be a predictor of poor prognosis in patients with cardiovascular disease.

4.8.1.1Experimental Studies on the Cardiac Actions of Resistin

Although resistin cell receptors have yet to be identified, direct action of resistin in the heart and specifically on cardiomyocytes has been described. Mouse adult cardiomyocytes treated with resistin show a reduction in insulin-stimulated glucose uptake.81 Furthermore, in contrast to liver, cardiomyocyte resistin signaling requires oligomerization of the ligand prior to receptor binding.81 The precise mechanisms by which resistin exerts its e ects on glucose transport is not completely understood but this appears to occur by impeding vesicular transport.81

The potential role of resistin in cardiac pathobiology has not been extensively studied, although a few studies have been carried out to assess the e ect of resistin on the ischemic and reperfused heart with contradictory results. In one report, resistin depressed functional recovery from ischemia in isolated perfused rat hearts, an e ect which appeared to be dependent on NF-kB activity.91 In contrast, resistin reduced infarct size in mice subjected to coronary artery occlusion and reperfusion.92 These authors also demonstrated that resistin improved functional recovery of isolated mouse hearts and reduced infarct size and proposed that the salutary e ect of resistin occurs via a PI3K/ Akt/PKC pathway. The obvious discrepancy between the two studies is di cult to explain at present but may reflect di erent concentrations of resistin, di erences in experimental model or species diversity.

4.9 Apelin

Apelin is an adipokine that was found to be the endogenous ligand for the G protein-coupled APJ receptor. Apelin has been shown to exert potent

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