Gai-biased apelin analog protects against isoproterenol-induced myocardial dysfunction in rats

Apelin receptor (APJ) activation by apelin-13 (APLN-13) engages both Gai proteins and b-arrestins, stimulating distinct intracellular pathways and triggering physiological responses like enhanced cardiac contractility. Substituting the C-terminal phenylalanine of APLN-13 with a-methyl-L-phenylalanine [(L-a-Me)Phe] or p-benzoyl-L-phenylalanine (Bpa) generates biased analogs inducing APJ functional selectivity toward Gai proteins. Using these original analogs, we proposed to investigate how the canonical Gai signaling of APJ regulates the cardiac function and to assess their therapeutic impact in a rat model of isoproterenol-induced myocardial dysfunction. In vivo and ex vivo infusions of either Bpa or (L-a-Me)Phe analogs failed to enhance rats’ left ventricular (LV) contractility compared with APLN-13. Inhibition of Gai with pertussis toxin injection optimized the cardiotropic effect of APLN-13 and revealed the inotropic impact of Bpa. Moreover, both APLN-13 and Bpa efficiently limited the forskolin-induced and PKA-dependent phosphorylation of phospholamban at the Ser16 in neonatal rat ventricular myocytes. However, only Bpa significantly reduced the inotropic effect of forskolin infusion in isolated-perfused heart, highlighting its efficient bias toward Gai. Compared with APLN-13, Bpa also markedly improved isoproterenol-induced myocardial systolic and diastolic dysfunctions. Bpa prevented cardiac weight increase, normalized both ANP and BNP mRNA expressions, and decreased LV fibrosis in isoproterenol-treated rats. Our results show that APJ-driven Gai/adenylyl cyclase signaling is functional in cardiomyocytes and acts as negative feedback of the APLN-APJ-dependent inotropic response. Biased APJ signaling toward Gai over the b-arrestin pathway offers a promising strategy in the treatment of cardiovascular diseases related to myocardial hypertrophy and high catecholamine levels. NEW & NOTEWORTHY By using more potent Gai-biased APJ agonists that strongly inhibit cAMP production, these data point to the negative inotropic effect of APJ-mediated Gai signaling in the heart and highlight the potential protective impact of APJ-dependent Gai signaling in cardiovascular diseases associated with left ventricular hypertrophy.