Peroxisome proliferator-activated receptors and your ticker

Everyone knows by now that having diabetes raises the risk for heart disease in various forms. Wouldn't it be interesting to understand the biological reasons for this connection? Well, it turns out that various factors seem to be relevant, and one of them involves a variety of paths that all pass through the territory of a rather interesting protein called PPAR-γ.

Not only is PPAR-γ implicated in processes related to both diabetes and heart disease, but it turns out that some drugs used to control diabetes also affect the risk of heart disease – because of PPAR-γ.

We'll begin the discussion by looking at recent research on how PPAR-γ affects heart function.

First, of course, we should explain what a peroxisome proliferator-activated receptor is. The name is somewhat off-putting, and nowadays most people just write PPAR. It's also a bit of a historical artifact, in that this class of proteins was first investigated in connections with peroxisomes, which are cellular organelles that participate in the metabolism of fatty acids. That's an important clue right there, because if we are dealing with fat metabolism, there may well be connections with conditions such as obesity and cardiovascular disease.

It turns out that is only a part of what PPARs are connected with.

A PPAR is not a cell surface receptor. Instead it is a nuclear receptor, meaning that it's a protein found in the interior of cells that (like a surface receptor) is activated when it connects with hormones and similar molecules. Such molecules that bind to a receptor are called ligands.

Initially, the ligands in question were known to cause proliferation of peroxisomes, but now many other kinds of ligands that activate PPARs have been identified.

Once a PPAR has been activated it can affect the expression of many different genes, because it acts as a transcription factor.

Three important PPARs are known: PPAR-α, PPAR-β (also called PPAR-δ), and PPAR-γ. It's the last of these we'll be concerned with here. In fact, PPAR-γ seems to affect many cellular processes related to metabolism and other things. Recent research that we may discuss another time (see here) has shown that there are about 5300 sites in the DNA of a fat cell that PPAR-γ can bind to, and hence potentially affect the expression of nearby genes. So it's not surprising that PPAR-γ is involved in quite a lot of cellular business.

Incidentally, all three PPARs are produced from the same gene, with the variant forms being due to alternative splicing.

The research we want to highlight here deals with how PPAR-γ is linked with the daily rise and fall of heart rate and blood pressure. Such things that are part of the normal circadian rhythm, in animals, are usually regulated from the central nervous system. But that doesn't seem to be the only regulator:

What Makes The Heart 'Tick-tock' (12/2/08)

Researchers have new evidence to show that the heart beats to its own drummer, according to a report in the December issue of the journal Cell Metabolism. They've uncovered some of the molecular circuitry within the cardiovascular system itself that controls the daily rise and fall of blood pressure and heart rate. The findings might also explain why commonly used diabetes drugs come with cardiovascular benefits, according to the researchers.

"This is the first study to demonstrate that a peripheral clock plays a role in the circadian rhythm of blood pressure and heart rate," said Tianxin Yang of the University of Utah and Salt Lake Veterans Affairs Medical Center.

While much progress has been made over the years in understanding the body's master clock in the brain, the new study offers one of the first glimpses into the biological function of peripheral clocks in maintaining the circadian rhythms of tissues throughout the body, the researchers said.

There has already been reason to suspect that PPAR-γ is involved in this:

Earlier studies suggested a role for the nuclear receptor called peroxisome proliferator-activated receptor-γ (PPAR-γ) in clock function. PPAR-γ is perhaps best known as the molecular target for a class of widely prescribed and effective diabetes drugs called thiazolidinediones (TZDs), including rosiglitazone (trade name Avandia) and pioglitazone (trade name Actos). Those diabetes drugs are known to come with a side benefit: they have protective effects on the cardiovascular system.

The new research shows that the circadian variation in heart rate and blood pressure is disrupted simply by eliminating PPAR-γ from cardiovascular cells. The elimination was effected by working with two strains of mice in which suitable genes had been knocked out:

The researchers found that both knockout strains showed a significant reduction of circadian variations in blood pressure and heart rate. .... The mice also showed declines in variation of norepinephrine/epinephrine in their urine—a measure of activity of the sympathetic nervous system, which plays a key role in heart rate and blood pressure.

The animals had impairments in the rhythmicity of the major clock genes, including Bmal1, a transcription factor that controls the activity of other core clock components, they report. By treating the mice with the diabetes drug rosiglitazone, they were able to increase the activity of Bmal1 in the animals' aortas, the largest artery of the body that issues blood from the heart, and further study showed that the core clock gene is directly controlled by PPAR-γ.

What, more precisely, is the role of PPAR-γ in affecting rhythmicity? Apparently the effect is indirect, due to its abillity to activate Bmal1, which is known to be an important clock protein. This is indicated because rosiglitazone seems to be able to compensate for missing PPAR-γ.

Interestingly, other recent research has shown that the sirtuin protein SIRT1 also affects Bmal1. (See here.) this may be significant, since SIRT1 has gene-silencing effects that depend on nutritional factors.

What other processes is PPAR-γ involved with? Better-known than its effect on cardiovascular circadian rhythm is its role in fatty acid storage and glucose metabolism, and hence its connection with diabetes. But we'll have to look at that another time.

Further reading:

Protein Found to Set the Heart's Cadence (12/2/08) – Science News article

Tags: circadian rhythm

IGF-1, calorie restriction, exercise, and longevity

Loyal readers here (both of you) may recall that back here I mentioned the hormone IGF-1 and promised to deal with it more throughly. The occasion was that IGF-1 is a growth factor, like BDNF.

Basically, a growth factor is a protein for signaling between cells. Growth factors typically bind to specific receptors on a cell's surface, in order to promote cell survival, growth, or proliferation.

The following recent news item now gives me an excuse to make good on my promise:

Hormone May Hold Key To Helping Elderly Men Live Longer (5/27/08)

Elderly men with higher activity of the hormone IGF-1--or insulin-growth factor 1--appear to have greater life expectancy and reduced cardiovascular risk, according to a new study.

IGF-1 is a hormone similar in molecular structure to insulin. It is released from the liver and plays an important role in childhood growth and continues to have anabolic effects in adults. ...

Subjects with the lowest IGF-1 function had a significantly higher mortality rate than subjects with the highest IGF-1 bioactivity. These results were especially significant in individuals who have a high risk to die from cardiovascular complications.

So, does that mean we need to find ways to increase our body's IGF-1 production in order to extend lifespan? Well, not necessarily. It's more complicated than that, as we'll see shortly.

Any hint of longevity enhancement, of course, is something worth paying attention to, but in the case of IGF-1, there's a lot more to the story. It's actually kind of a big deal for several additional reasons.

To begin with, the full name of the hormone is insulin-like growth factor. It is so-named because, as the news item mentions, its molecular structure is similar to that of insulin.

But that's just the beginning of the similarity. Both IGF-1 and insulin affect metabolism. In fact, IGF-1 can bind to the same receptor that insulin does, although a lot less strongly. That, and the not coincidental structural similarity to insulin suggest that perhaps, sometime far back in evolution, the same gene may have coded for some ancestor of both insulin and IGF-1.

If you take into account a striking fact about the IGF-1 receptor, this hypothesis of a common origin for insulin and IGF-1 becomes even more intriguing. The fact is that the (gene for the) IGF-1 receptor is a homologue of the daf-2 gene of the nematode Caenorhabditis elegans (as is the gene for the insulin receptor also). In fact, DAF-2 (the protein product of daf-2) is the only insulin-like receptor in nematodes, so biologists now regard daf-2 as the ancestor of the mammalian receptors for IGF-1 and insulin.

I first mentioned this relationship back here, and went into more detail here, in connection with understanding the effect of sirtuin proteins on aging and longevity of C. elegans.

But the "coincidences" don't stop there. The important function of a receptor is the effect it has, when activated, upon signaling downstream inside the cell. All of the receptors we're talking about here are of the sort called tyrosine kinase receptors. Let's unbundle that term. Tyrosine is one of the 20 amino acids that make up proteins. A kinase is a type of protein enzyme whose function is to attach phosphate groups to specific kinds of amino acids in other proteins. This process is called phosphorylation. When another protein of the right sort is phosphorylated, it becomes able to act as a tyrosine kinase itself, and go on to affect yet other proteins.

This whole process is called signal transduction. The process begins (in the case here) with a receptor tyrosine kinase, which is a cell surface receptor protein that is also a tyrosine kinase – for example DAF-2, and the receptors for IGF-1 and insulin. There may be a number of intermediate steps, but the eventual result is the phosphorylation of a transcription factor, which enters the cell nucleus and facilitates the transcription of certain genes in order to produce new proteins.

In C. elegans, DAF-16 is the transcription factor that is activated by signaling mediated by DAF-2. We discussed DAF-16 in the aforementioned posts here and here. DAF-16 belongs to a family of transcription factors called forkhead box proteins. We have discussed these before too, or rather the subclass called FoxO transcription factors.

We're getting pretty far into the technical weeds here, so if you want more details on this stuff, refer to the earlier posts.

To make the long story short, the effects of the external signaling hormones like insulin and IGF-1 ultimately result from proteins coded for by the genes expressed because of the appropriate transcription factors that were activated by the signaling cascade. There are probably many proteins involved, and sorting them all out, figuring out how they collectively affect longevity, is very much an ongoing project.

The story is interesting to understand because longevity is one of its main themes. In addition to the news item already mentioned, there's more recent news with the same theme. Here are summaries of some of these research announcements:

When It Comes To Living Longer, It's Better To Go Hungry Than Go Running, Mouse Study Suggests (5/14/08)

It is once again verified that a low-calorie diet can extend the lifespan of rodents. This benefit is beyond what can be achieved with a higher-calorie diet offset by exercise. However, rats that consumed the most calories, and has less longevity, also had the highest levels of IGF-1. Rats that consumed the fewest calories had the best longevity and the lowest levels of IGF-1. Exercise could only partially counteract the higher IGF-1 levels and reduced longevity of rats on a high-calorie diet. In this study, IGF-1 levels were inversely correlated with longevity. This is a "live-fast, die-young" scenario, which is especially typical of rodents, but not necessarily of humans.

More on this study: here

Shorter Women May Have Very Long Lives: Gene Mutation Found (3/4/08)

This study focused attention on the (adult) daugheters of especially long-lived Ashkenazi Jews. A control group consisted of daughters of the same age as the others, but whose families had no history of unusual longevity. The finding was that female children of long-lived individuals (aged 95-110) were on average 2.5 cm shorter than female controls. It was also found that both the centenarians and their daughters were much more likely than the controls to have mutations in the genes for their IGF-1 receptors. However, the daughters also had blood plasma levels of IGF-1 that were 35% higher than the levels in the control group. The interpretation is that the higher IGF-1 levels were due to an attempt to compensate for disruption of IGF-1 signaling due to irregularities of the receptor proteins. This would be consistent with a number of animal studies in which reduced IGF-1 signaling correlates with increased longevity.

More on this study: here, here, here

Interestingly enough, IGF-1 had already been recognized to have an effect on body size – in mice and dogs. The dog research is described here:

One gene between tiny dogs and giant ones? (10/13/06)

Nate Sutter, a geneticist at the National Human Genome Research Institute in Bethesda, Maryland, wanted to know the reason why big dogs, such as Irish wolfhounds, can grow up to 50 times larger than other members of their own species, such as chihuahuas. So he started out looking at large and small dogs of one breed — the Portuguese water dog. ...

The team found that one of the few differences in these Portuguese water dogs occurred in a gene called 'insulin-like growth factor 1', or Igf-1 .

This is one of many genes already known to influence the size of mice: when Igf-1 is knocked out, the animals grow up to be mini-mice.

(The article is subscription-only, but you can find another reference to it here.)

The researchers went on to do further analysis of the IGF-1 gene in many different dog breeds of all sizes, and also in foxes and wolves. They found that almost all of the small breeds had the same variant of the IGF-1 gene as the small Portuguese water dogs had, while almost none of the large breeds had that variant. The team concluded that the IGF-1 variant in small breeds is responsible for the difference because it reduces production of the growth factor.

This should also explain what dog people have always known – that small breed dogs generally live longer than large ones.

Here's a later report of the same research:

What Makes Little Dogs Small? Researchers Identify Gene Involved In Dog Size (4/5/07)

In their study, researchers explored the genetic basis for size variation among dogs by comparing the DNA of various small dog breeds, including Chihuahuas, Toy Fox Terriers and Pomeranians, to an array of larger dog breeds, including Irish Wolfhounds, Saint Bernards and Great Danes. Their investigation found that variation in one gene - IGF-1, which codes for a protein hormone called insulin-like growth factor 1 - is very strongly associated with small stature across all dog breeds studied.

Further reading:

Scientists Explore Queen Bee Longevity (5/8/07) – press release describing research on various factors, including IGF-1 signaling, in queen bee longevity

Mechanisms of lifespan regulation by IGF-I (2/25/08) – blog post that considers some of the paradoxical effects of IGF-1 that may be beneficial in some ways but also shorten lifespan

Not so fast, daf-2: IGF-I is all kinds of good for you (1/23/08) – another blog post on the paradoxical effects of IGF-1

IGF-1 attenuates cardiac aging (11/15/06) – blog post about research on cardioprotective properties of IGF-1

It’s not easy being wee: Does IGF-1 deficiency slow down the brain? (8/30/06) – one more blog post on paradoxical effects of IGF-1

A Single IGF1 Allele Is a Major Determinant of Small Size in Dogs – 4/6/07 research article in Science (sub. rqd.)

Tags: IGF-1, calorie restriction, longevity, aging

When The Going Gets Tough, Maybe You Should Quit

This caught my eye, because of the connection with "stress", as discussed here and here:

When The Going Gets Tough, Maybe You Should Quit

Are there times when it is better to simply give up? Psychologists have been exploring this question, and more specifically a possible link between tenacity and both physical and mental health.

It would seem that persistence would be tonic over the long haul; hanging tough should increase the odds that you’ll succeed, and personal success is closely linked to well-being. But what if the goal is extremely unlikely? When does an admirable trait like perseverance start to look more like beating your head against the wall?

To test this in the laboratory, psychologists Gregory Miller and Carsten Wrosch developed a psychological instrument that can reliably distinguish between people who when faced with a difficult goal either persist or let go of it. In a series of experiments, the psychologists exhaustively studied these two personality types to see how healthy and well adjusted they are.

In their most recent study, published in the September issue of Psychological Science, a journal of the Association for Psychological Science, the psychologists followed teenagers for a full year. Over that time, individuals who did not persist obtaining hard to reach goals had much lower levels of a protein called CRP [C-reactive protein], an indicator of bodily inflammation. Inflammation has recently been linked to several serious diseases, including diabetes and heart disease.

Well, is it really surprising that there are health benefits associated with having a more easy going, "laid back" personality?

There's a very good book that delves into this in great detail – Why Zebras Don't Get Ulcers, by Stanford professor Robert Sapolsky. (Quick summary is here.)

And while we're on the subject, there's this press release that just came out:

Relationship Between Environmental Stress And Cancer Elucidated

One way environmental stress causes cancer is by reducing the activity level of an enzyme that causes cell death, researchers say.

They found that stress-inducing agents, such as oxidative stress, recruit a protein called SENP1 that cuts a regulator called SUMO1 away from the enzyme SIRT1 so its activity level drops, says Dr. Yonghua Yang, postdoctoral fellow in the laboratory of Dr. Kapil Bhalla, director of the MCG Cancer Center.

This fundamental finding about the relationship between stress and cancer opens the door for treatments that increase SENP1 activity, making it easier for cells that are becoming cancerous to die.

In yet another example of how deeply interrelated different biological processes are, it's worth noting that SIRT1 is a HDAC enzyme, whose activity seems to be enhanced by both resveratrol and calorie restriction. By mechanisms that are still somewhat mysterious, this in turn may be beneficial for longevity. If indeed oxidative stress has the effect of decreasing SIRT1 activity and hence promoting cancer, this may help explain at least some of the longevity benefit of SIRT1.

Tags: stress, inflammation, SIRT1, sirtuins, cancer

The role of hostility, anger, and depression in inflammation

Hasn't it "always" been known that anger and hostility raises one's blood pressure? However that may be, a recent study shows that the connection of hypertension with chronic anger and hostility may involve a disturbed immune system and inflammation – in addition to the well-known blood vessel constriction that is a part of the "fight or flight" stress response.

Hostile Men Could Have Greater Risk For Heart Disease

Men who are hostile and prone to frequent intense feelings of anger and depression could be harming their immune systems and putting themselves at risk for coronary heart disease as well as related disorders like type 2 diabetes and high blood pressure, a new study finds.

The results were found in a 10-year study of U. S. veterans of the Vietnam war.

The men had a series of blood levels taken on three occasions between 1992 and 2002. Researchers measured two immune system proteins known as C3 and C4. Both are markers of inflammation, which is the body’s response to injury or infection. Changes in C3 and C4 are associated with a number of diseases, including some that negatively can affect the arteries around the heart, such as diabetes.

Men whose psychological screening showed the highest level of hostility, depressive symptoms and anger had a 7.1 percent increase in their C3 levels, while men with low levels of these attributes showed no change over the 10-year study period.

Here's another report on this research: Hostility, anger linked to chronic inflammation

But a 2004 study had already demonstrated a stronger correlation between psychological variables and a marker of inflammation (C-reactive protein):

Anger, Hostility And Depressive Symptoms Linked To High C-reactive Protein Levels

Researchers at Duke University Medical Center have discovered that otherwise healthy people who are prone to anger, hostility and mild to moderate depressive symptoms produce higher levels of a substance that promotes cardiovascular disease and stroke.

The substance, C-reactive protein (CRP), has garnered considerable attention for its role in both promoting and predicting cardiovascular disease and stroke in initially healthy people. It is produced by the liver in response to inflammation, and inflammation has recently been shown to underlie the plaque that forms inside arteries as they clog.

The Duke study is the first to link this combination of negative psychological attributes with higher levels of CRP in people without traditional risk factors for heart disease...

More specifically,

121 healthy men and women were asked to complete standard personality questionnaires in which they described their psychological attributes, including anger, hostility and depression. The volunteers did not have any pre-existing conditions -- such as smoking, high blood pressure, diabetes or heart disease -- that would predispose them to having high CRP levels. High-sensitivity blood tests were then conducted to measure CRP levels.

Respondents who were prone to anger, had high hostility levels, and showed mild to moderate symptoms of depression had two to three times higher CRP levels than their calmer counterparts. The more pronounced their negative moods, the higher CRP levels they had, the study showed.

In addition, the researcher had previously shown a relation between the psychological variables and another inflammatory substance (interleukin-6):

[H]ostile people who exhibit symptoms of depression have higher levels of stress hormones and circulating levels of an inflammatory substance called interleukin 6, another marker of inflammation that has been shown to predict heart disease in initially healthy people.

A number of other studies have demonstrated relationships between psychological stress conditions and disease states that involve the immune system, such as this one from 2006:

Anger And Hostility Speed Up Decline In Lung Power

The authors point out that hostility and anger have been associated with cardiovascular disease, death, and asthma, and that previous research has suggested that changes in mood can have short term effects on the lungs.

Anger and hostility will alter neurological and hormonal processes, which in turn may disturb immune system activity, producing chronic inflammation, suggest the authors.

An accompanying editorial comments that the physiological components of anger and stress overlap, and stress is well known to affect the immune system.

Bottom line: Get control over anger and depression if you want to stay healthy.

Of course, this is all closely related to what I discussed just a couple of weeks ago on stress and weight gain and in particular the extensive research of Robert Sapolsky summarized here.

Additional references:

• Coping With Stress Improves Cholesterol
  
• High Hostility May Predict Heart Disease More Than Other Risk Factors Such as Cholesterol and Smoking
  
• Hostility is among best predictors of heart disease in men
  

Tags: inflammation, stress, anger, hostility, depression, cardiovascular disease, hypertension