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Cardiomyocyte-Restricted Expression of IL11 Causes Cardiac Fibrosis, Inflammation, and Dysfunction

ABSTRACT: Background: Cardiac fibrosis is a common pathological process in heart disease and represents a therapeutic target. TGFβ is the canonical driver of cardiac fibrosis and was recently shown to be dependent on IL11 for its profibrotic effects in fibroblasts. In the opposite direction, recombinant human IL11 has been reported as anti-fibrotic and also anti-inflammatory in the mouse heart. Objectives: In this study, we determined the effects of IL11 expression in cardiomyocytes on cardiac pathobiology and function. Methods: We used the Cre-loxP system to generate a tamoxifen-inducible mouse with cardiomyocyte-restricted murine Il11 expression. Using protein assays, bulk RNA-sequencing and in vivo imaging we analysed the effects of IL11 on myocardial fibrosis, inflammation and cardiac function and challenge previous reports suggesting cardioprotective potential of IL11. Results: TGFβ stimulation of cardiomyocytes caused Il11 upregulation. As compared to wild-type controls, Il11 expressing hearts demonstrated severe cardiac fibrosis and inflammation that was associated with the upregulation of cytokines, chemokines, complement factors and increased inflammatory cells. IL11 expression also activated a programme of endothelial-to-mesenchymal transition and resulted in left ventricular dysfunction. Conclusion: Our data define species-matched IL11 as strongly profibrotic and proinflammatory when secreted from cardiomyocytes and further establish IL11 as a disease factor.

ORGANISM(S): Mus musculus

PROVIDER: GSE236854 | GEO | 2023/08/21

REPOSITORIES: GEO

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Project description:Background: Interleukin-11 (IL11) was initially identified as a fibroblast secreted factor that supports haematopoietic cell function. This led to its development as a drug to increase platelet counts in patients with thrombocytopenia. However, IL11 was later found redundant for hematopoiesis and its use in humans causes severe and unexplained cardiac side effects. Here we identify and dissect mechanisms underlying previously unappreciated cardiac toxicities associated with IL11 therapy. Methods: We injected recombinant mouse lL11 (rmIl11) at clinically relevant doses to study its effects on myocardial signalling using immunoblotting and genomic variation using qRT-PCR, RNA-seq and ATAC-seq. The physiological impact of Il11 was assessed by echocardiography in vivo and cardiomyocyte contractility assays in vitro. To determine the specific activity of IL11 in cardiomyocytes we generated two distinct cardiomyocyte-specific IL11 receptor knockout (CMKO) mouse models using either AAV9-mediated, Tnnt2-restricted (vCMKO) or mhy6 (m6CMKO) Cre expression in an Il11ra1 floxed mouse strain. In pharmacologic studies, we studied the effects of JAK/STAT inhibition following rmIl11 injection to mice.Results: Injection of rmIl11 to mice caused dose-dependent impairment of left ventricular ejection fraction (LVEF: saline, 64.2%±1.62; rmIl11 (50 mg/kg), 31.6±2.0; p<0.0001). RNA-seq of hearts one and three hours following rmIl11 injection revealed strong upregulation of the TNF, NFkB and JAK/STAT pathways as well as increased Nppa and Rrad levels. vCMKO mice were protected from rmIl11-induced STAT3 activation, Rrad upregulation and LV impairment. Similarly, m6CMKO mice of both sexes, were protected from the molecular, cellular and whole organ cardiac toxicities associated with Il11. Administration of JAK inhibitors prevented rmIl11-induced STAT3 activation and preserved cardiac function. Conclusions: Here we show that Il11 injection to mice is strongly proinflammatory in the heart. Furthermore, Il11 has profound negative inotropic effects that are mediated via its on-target activation of JAK/STAT3 signalling in cardiomyocytes. Our data explain the cardiac side effects associated with IL11 therapy and question its continued use in patients.

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Cardiomyocyte-Restricted Expression of IL11 Causes Cardiac Fibrosis, Inflammation, and Dysfunction

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