Alterations in Janus Kinase (JAK)-Signal Transducers and Activators of Transcription (STAT) Signaling in Patients With End-Stage Dilated Cardiomyopathy

Background— Experimental studies indicate that interleukin-6 (IL-6)–related cytokines, signaling via the shared receptor gp130, Janus kinases (JAKs), and signal transducers and activators of transcription (STATs), provide a critical cardiomyocyte survival pathway in vivo. Little is known about the activation of this signaling pathway in the myocardia of patients with end-stage dilated cardiomyopathy (DCM). Methods and Results— We performed a comprehensive expression and activation analysis of IL-6–related cytokines, receptors, signal transducers, and signal transduction inhibitors in left ventricular (LV) myocardia from patients with DCM (n=10) and non-failing (NF) donor hearts (n=5). Differential expression (DCM versus NF) was observed by immunoblotting at each level of the signaling cascade, including receptor ligands (IL-6: −59%, P <0.01; leukemia inhibitory factor [LIF]: +54%, P <0.05), receptor subunits (LIF receptor: −16%, P <0.05), signaling molecules (the Janus kinase TYK2: −48%, P <0.01; STAT3: −47%, P <0.01), and suppressors of cytokine signaling (SOCS1: +97%, P <0.05; SOCS3: −49%, P <0.01). Tyrosine-phosphorylation status of gp130 was increased (+60%, P <0.05), whereas tyrosine-phosphorylation status of JAK2 was reduced in DCM (−72%, P <0.01). Moreover, as shown by immunohistochemistry, the number of STAT3-positive cardiomyocytes was reduced in DCM (−42%, P <0.01). Conclusion— Signaling via gp130 and JAK-STAT is profoundly altered in DCM. Importantly, tyrosine-phosphorylation of JAK2 is reduced in the face of increased gp130 phosphorylation, indicating impaired downstream activation of this critical pathway in DCM.