Review Article Activated Protein C: A Potential Cardioprotective Factor Against Ischemic Injury During Ischemia/Reperfusion
Jingying Wang, Ji Li
Department of Pharmacology and Toxicology, University at Buffalo, State University of New York, Buffalo, NY
Received June 11, 2009; accepted June, 2009; available online June, 2009
Abstract: Activated protein C (APC) is a vitamin-K dependent natural anticoagulant protein. With its function in blood clotting reaction, APC can reduce the risk of venous thrombosis to prevent ischemic disease. A number of in vivo and in vitro studies over the past few decades have revealed that APC can also decrease the mortality caused by endotoxin, sepsis, and brain ischemic stroke. The direct cytoprotective effects requires APC binding to the endothelial protein C receptor (EPCR) and activating protease activated receptor-1 (PAR-1). It is now believed that the benefitial characters of APC are partially independent from its anticoagulant activity, though more studies need to be done to demostrate the exact molecular mechanism. In this review, we have linked the cytoprotective effects of APC including the anti-inflammatory and anti-apoptosis activities with myocardial ischemic injury caused by cardiac ischemia reperfusion. Specifically, we have tried to combine the potential signaling pathways initiated by APC with the well-known adaptive signaling such as AMP-activated protein kinase (AMPK), Akt/PI3K and ERK/MAPK pathways that contribute to the cardioprotection against myocardial ischemia injury. We speculate that APC protects against cardiac ischemia injury via triggering crucial cardioprotective signaling pathways, and these effects are mostly associated with its cytoprotective activity but independent on its anticoagulant activity. (AJTR906001).
Key words: Activated protein C (APC), myocardial ischemia, anti-inflammation, anti-apoptosis, AMP-activated protein kinase (AMPK) pathway, Akt/PI3K pathway, ERK/MAPK pathway
Address all correspondence to: Ji Li, PhD Department of Pharmacology and Toxicology University at Buffalo-SUNY 147 Biomed Educations Bldg 3435 Main St Buffalo, NY 14214 Tel: 307-399-2167 Eamil: email@example.com; firstname.lastname@example.org