Molecular Cardiology Silent Information Regulator 1 Protects the Heart From Ischemia/Reperfusion

Background—Silent information regulator 1 (Sirt1), a class III histone deacetylase, retards aging and protects the heart from oxidative stress. We here examined whether Sirt1 is protective against myocardial ischemia/reperfusion (I/R). Methods and Results—Protein and mRNA expression of Sirt1 is significantly reduced by I/R. Cardiac-specific Sirt1 Ϫ/Ϫ mice exhibited a significant increase (44Ϯ5% versus 15Ϯ5%; Pϭ0.01) in the size of myocardial infarction/area at risk. In transgenic mice with cardiac-specific overexpression of Sirt1, both myocardial infarction/area at risk (15Ϯ4% versus 36Ϯ8%; Pϭ0.004) and terminal deoxynucleotidyl transferase dUTP nick end labeling–positive nuclei (4Ϯ3% versus 10Ϯ1%; PϽ0.003) were significantly reduced compared with nontransgenic mice. In Langendorff-perfused hearts, the functional recovery during reperfusion was significantly greater in transgenic mice with cardiac-specific overexpression of Sirt1 than in nontransgenic mice. Sirt1 positively regulates expression of prosurvival molecules, including manganese superoxide dismutase, thioredoxin-1, and Bcl-xL, whereas it negatively regulates the proapoptotic molecules Bax and cleaved caspase-3. The level of oxidative stress after I/R, as evaluated by anti-8-hydroxydeoxyguanosine staining, was negatively regulated by Sirt1. Sirt1 stimulates the transcriptional activity of FoxO1, which in turn plays an essential role in mediating Sirt1-induced upregulation of manganese superoxide dismutase and suppression of oxidative stress in cardiac myocytes. Sirt1 plays an important role in mediating I/R-induced increases in the nuclear localization of FoxO1 in vivo. Conclusions—These results suggest that Sirt1 protects the heart from I/R injury through upregulation of antioxidants and downregulation of proapoptotic molecules through activation of FoxO and decreases in oxidative stress. S ilent information regulator 1 (Sirt1) is a member of the sirtuin family of class III histone deacetylases. 1 The class III histone deacetylases are distinguished from histone deacetylases in the other classes by their requirement of NAD ϩ for their enzyme activity. 2 Sirt1 is involved in gene silencing, differentiation, cell survival, metabolism, and lon-gevity. 1 Sirt1 activity extends the lifespan of lower organisms , including yeast, Caenorhabditis elegans, and flies. 3,4 In addition, resveratrol, which stimulates Sirt1, extends the lifespan of mice fed a high-fat diet, suggesting that Sirt1 may affect aging and/or lifespan in mammals. 5 The beneficial effects of caloric restriction may be dependent on Sirt1. 6 – 8 Conversely, Sirt1 knockout mice exhibit developmental abnormalities , including septal and valvular heart defects. 9,10 Sirt1 regulates the function of transcription factors and cofactors, including MyoD, Ku, p53, PGC1, and the FoxO family of transcription factors, 11–19 through deacetylation. Activation of molecular mechanisms extending lifespan generally …