Signalling pathways in cardiac myocyte hypertrophy

In response to a requirement for increased contractile power in vivo, mammalian cardiac myocytes adapt through a hypertrophic response (cell enlargement in the absence of cell division). This response can be simulated by exposing isolated myocytes in primary culture to alpha-adrenergic agonists or the vasoactive peptide, endothelin-1. The signalling pathways responsible for hypertrophic growth have been actively studied, and it is likely that reversible protein phosphorylation and dephosphorylation are involved. Three signalling pathways show particular potential as regulators of the response, ie protein kinase C (PKC), mitogen-activated protein kinase (MAPK) cascades, and calcineurin. These species are thought to regulate the rate and specificity of gene transcription ultimately through modifying the transactivating activity of nuclear transcription factors. There are three pertinent MAPK cascades, the extracellular signal-regulated kinase (ERK) cascade, the c-Jun N-terminal kinase (JNK or SAPK1) cascade, and the p38-MAPK (SAPK2-5) cascade. PKC participates in the activation of the ERK cascade but does not contribute significantly to the activation of the two remaining cascades. Calcineurin (or protein phosphatase 2B) is activated by increases in [Ca2+i] through the [Ca2+]-sensing protein, calmodulin. In this review, I discuss the evidence for and against the involvement of these signalling proteins in the induction of myocyte hypertrophy and emphasize that the ERK cascade should perhaps feature more widely in the collective consciousness.