Pathogenic involvement of heregulin-β(1) in anti-atherogenesis

Human heregulins are neuregulin-1 type I polypeptides that act as ligands of the ErbB family of receptor tyrosine kinases. These peptides play an essential role in the development of the cardiovascular system, including angiogenesis and compensation of cardiac function. Both heregulins and ErbB receptors are expressed at high levels in various types of vascular cells. The results of cell culture, animal, and clinical experiments have shown heregulin-β(1) to be a promising drug candidate for prevention of atherosclerosis. Various mechanisms have been suggested to be involved in this process, such as suppression of macrophage foam cell formation and vascular smooth muscle cell proliferation. Heregulin-β(1) retards pro-inflammatory responses by attenuating the expression of interleukin-1β, monocyte chemoattractant protein-1, intercellular adhesion molecule-1, matrix metalloproteinase-9, and cyclooxygenase-2 in monocytes. The peptide also has anti-oxidant and anti-apoptotic properties, and activates endothelial nitric oxide synthase in cardiomyocytes. Chronic infusion of heregulin-β(1) into apolipoprotein E-knockout mice suppresses the development of atherosclerotic lesions. In rat balloon injury models, heregulin-β(1) injection attenuates neointimal formation in the carotid artery. Clinical studies have shown that markedly reduced levels of heregulin-β(1) in the arterial wall and blood are closely associated with the progression of human coronary atherosclerotic lesions in patients with coronary artery disease. Therefore, these findings provide insight into the potential use of heregulin-β(1) as an extended therapeutic window for combating atherosclerosis and restenosis after coronary angioplasty.