RATIONALE: Cardiac myocyte hypertrophy is the main compensatory response to chronic stress in the heart. p90 ribosomal S6 kinase (RSK) family members are effectors for extracellular signal-regulated kinases that induce myocyte growth. RSK3 contains a unique N-terminal domain that mediates RSK3 binding to the muscle A-kinase anchoring protein (mAKAPβ) scaffold. We have previously published that disruption of RSK3-mAKAPβ complexes using a competing peptide inhibited the phenylephrine-induced hypertrophy of neonatal ventricular myocytes in vitro. In vivo, RSK3 gene deletion in mice attenuated the concentric cardiac hypertrophy induced by pressure overload. We hypothesize that RSK3 anchoring to mAKAPβ in myocytes is required for cardiac hypertrophy in vivo.
METHODS AND RESULTS: Adeno-associated viruses (AAV) are gene therapy vectors in development for the treatment of human diseases owing to their nonpathogenic capability for transducing non-dividing cells and their long-term transgene expression. We have used a recombinant AAV2/9 vector to express a mAKAPβ RSK3-binding domain (RBD)-GFP fusion protein under the control of the cardiac myocyte-specific cardiac troponin T promoter. 3 day-old C57BL/6 mice were injected intraperitoneally with either AAV-RBD-GFP or AAV-GFP control virus. At 8 weeks of age mice were subjected to transverse aortic constriction to induce pressure overload (TAC) for two weeks. Cardiac hypertrophy was attenuated in mice injected with the AAV-RBD-GFP virus (biventricular weight indexed to tibial length (mg/mm): 7.7, 8.6, and 9.2 for AAV-RBD, AAV-GFP and non-injected TAC cohorts, respectively; p<0.05 vs. both controls). Echocardiography both corroborated the inhibition of hypertrophy and revealed no deleterious effect on cardiac function attributable to the AAV-RBD-GFP vector.
CONCLUSIONS: Anchored RSK3 regulates pathologic myocyte growth. AAV can successfully deliver a competing peptide inhibiting pathological hypertrophy and should be investigated further as a prevention and/or treatment for heart failure.