Modulating G protein-coupled receptors to effect reverse cardiac remodeling

G protein-coupled receptors (GPCRs) represent the largest known family of transmembrane receptors and therapeutic targets in cardiovascular medicine, accounting for a large number of marketed cardiovascular pharmaceuticals. Traditionally, GPCR stimulation promotes G protein signaling and, to limit unrestrained stimulation, activation of G protein-coupled receptor kinases (GRKs), leading to agonist-dependent receptor phosphorylation. In turn, GPCR phosphorylation promotes ß-arrestin binding to the receptors, which sterically prevents further G protein signaling and scaffold receptors to the internalization machinery. However, novel aspects of GPCR signaling have been recently appreciated, including G protein modulators, G protein-independent pathways, and GRK adrenal modulation of adrenergic drive. Since all currently used drugs have been developed using assays only testing G protein-dependent effects, the discovery of such novel signal transduction pathways might represent an important opportunity to identify additional therapeutic approaches to reverse or prevent cardiac remodeling and failure.

Duke Scholars

Author Howard Allan Rockman Medicine, Cardiology