MLN-4760

Doxorubicin (DOX) cardiotoxicity involves dysregulated autophagy, yet the role of ACE2 in this process remains unclear. We aimed to determine if ACE2 protects against DOX-induced injury by modulating the AMPK/mTOR-autophagy axis. DOX-induced cardiotoxicity was established in mice and primary cardiomyocytes. The effects of modulating ACE2 and mTOR signaling were investigated using the agonist Diminazene Aceturate (DIZE), inhibitor MLN-4760, activator MHY1485 (MHY), and inhibitor Rapamycin (Rapa). Cardiac injury, apoptosis, autophagy, and key molecules in the RAS and AMPK/mTOR pathways were evaluated. DOX induced cardiac dysfunction, apoptosis, and excessive autophagy, accompanied by ACE2 downregulation, AMPK activation, and mTOR inhibition. ACE2 activation via DIZE reversed these pathologies both in vivo and in vitro. Mechanistically, the cardioprotective effects of DIZE were mimicked by mTOR activation and, importantly, abolished by mTOR inhibition with Rapamycin. Our findings demonstrate that ACE2 protects against DOX-induced cardiotoxicity by suppressing excessive autophagy. This effect is causally dependent on its ability to inhibit AMPK and activate mTOR signaling. Thus, targeting the ACE2-mTOR axis represents a promising therapeutic strategy to mitigate DOX cardiotoxicity.

Tissue expansion is a clinically established technique for addressing severe soft tissue defects and organ deformities. However, its advancement is limited by suboptimal efficiency and related complications. Elucidating the molecular and cellular mechanisms of skin regeneration during tissue expansion is therefore critical for enhancing therapeutic efficacy and minimizing adverse events. Angiotensin-converting enzyme 2 (ACE2) plays pivotal roles in tissue remodeling and regeneration. Our prior work identified ACE2 as mechanosensitive gene activated by mechanical stretch. Nevertheless, its regulatory mechanisms in epidermal regeneration during tissue expansion remain unclear.

HaCaT cells were treated with the ACE2 inhibitor MLN-4760, siRNA, and overexpression plasmids. Cell proliferation and migration were assessed by EdU assay and wound healing assay respectively. Transcriptomic sequencing was conducted to identify the differentially expressed genes (DEGs) after ACE2 knockdown in keratinocytes, which highlighted tenascin-C (TNC) as a critical DEG associated with epidermal regeneration. TNC silencing in HaCaT cells was analyzed via EdU and wound healing assays. In vivo, MLN-4760 was topically applied to the expanded rat skin, with epidermal regeneration assessed by H&E and PCNA immunofluorescence staining, while western blotting was used to evaluate the expression of proteins involved in TNC/PI3K/AKT/mTOR pathway.

Both pharmacological inhibition and genetic knockdown of ACE2 enhanced the proliferation and migration of HaCaT cells, whereas ACE2 overexpression suppressed these activities. Mechanistically, ACE2 modulated cell behaviors and function through the TNC. In vivo, topical MLN-4760 application in a rat skin expansion model increased epidermal thickness, promoted keratinocyte proliferation, upregulated TNC expression, and activated PI3K/AKT/mTOR signaling in expanded skin.

ACE2 negatively regulates epidermal regeneration during tissue expansion by suppressing TNC expression and the PI3K/AKT/mTOR pathway.