KLF15 Regulates Oxidative Stress Response in Cardiomyocytes through NAD

KLF15 has recently emerged as a central regulator of metabolism. Although its connection to oxidative stress has been suspected, there has not been any study to date that directly demonstrates the molecular link. In this study, we sought to determine the role of KLF15 in cardiac oxidative stress. We found that KLF15 deficiency in the heart is associated with increased oxidative stress. Acute deficiency of KLF15 in neonatal rat ventricular myocytes (NRVMs) leads to the defective clearance of reactive oxygen species (ROS) and an exaggerated cell death following a variety of oxidative stresses. Mechanistically, we found that KLF15 deficiency leads to reduced amounts of the rate-limiting NAD⁺ salvage enzyme NAMPT and to NAD⁺ deficiency. The resultant SIRT3-dependent hyperacetylation and the inactivation of mitochondrial antioxidants can be rescued by MnSOD mimetics or NAD⁺ precursors. Collectively, these findings suggest that KLF15 regulates cardiac ROS clearance through the regulation of NAD⁺ levels. Our findings establish KLF15 as a central coordinator of cardiac metabolism and ROS clearance.