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      The cGAS–STING signaling in cardiovascular and metabolic diseases: Future novel target option for pharmacotherapy

      review-article
      a , , a , , a , a , a , b , a , b , a , b , a , b , c , , a , b ,
      Acta Pharmaceutica Sinica. B
      Elsevier
      STING, cGAS, Cardiovascular diseases, Metabolic diseases, Damage-associated molecular patterns, Inflammation, ER stress, Mitochondria, AA, amino acids, AAD, aortic aneurysm and dissection, AKT, protein kinase B, AMPK, AMP-activated protein kinase, Ang II, angiotensin II, ATP, adenosine triphosphate, CBD, C-binding domain, CDG, c-di-GMP, CDNs, cyclic dinucleotides, cGAMP, 2′,3′-cyclic GMP–AMP, cGAS, cyclic GMP–AMP synthase, CTD, C-terminal domain, CTT, C-terminal tail, CVDs, cardiovascular diseases, Cys, cysteine, DAMPs, danger-associated molecular patterns, DsbA-L, disulfide-bond A oxidoreductase-like protein, dsDNA, double-stranded DNA, ER, endoplasmic reticulum, GTP, guanosine triphosphate, HAQ, R71H-G230A-R293Q, HFD, high-fat diet, hSTING, human stimulator of interferon genes, ICAM-1, intracellular adhesion molecule 1, IFN, interferon, IFNAR, interferon receptors, IFN-I, type 1 interferon, IFNIC, interferon-inducible cells, IKK, IκB kinase, IL, interleukin, IRF3, interferon regulatory factor 3, ISGs, IRF-3-dependent interferon-stimulated genes, LBD, ligand-binding pocket, LPS, lipopolysaccharides, MI, myocardial infarction, MLKL, mixed lineage kinase domain-like protein, MST1, mammalian Ste20-like kinases 1, mtDNA, mitochondrial DNA, mTOR, mammalian target of rapamycin, NAFLD, nonalcoholic fatty liver disease, NASH, nonalcoholic steatohepatitis, NF-κB, nuclear factor-kappa B, NLRP3, NOD-, LRR- and pyrin domain-containing protein 3, NO2-FA, nitro-fatty acids, NTase, nucleotidyltransferase, PDE3B/4, phosphodiesterase-3B/4, PKA, protein kinase A, Poly: I.C, polyinosinic-polycytidylic acid, PPI, protein–protein interface, ROS, reactive oxygen species, SAVI, STING-associated vasculopathy with onset in infancy, Ser, serine, SNPs, single nucleotide polymorphisms, STIM1, stromal interaction molecule 1, STING, stimulator of interferon genes, TAK1, transforming growth factor β-activated kinase 1, TBK1, TANK-binding kinase 1, TFAM, mitochondrial transcription factor A, TLR, Toll-like receptors, TM, transmembrane, TNFα, tumor necrosis factor-alpha, TRAF6, tumor necrosis factor receptor-associated factor 6, TREX1, three prime repair exonuclease 1, YAP1, Yes-associated protein 1

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          Abstract

          The cyclic GMP–AMP synthase (cGAS)–stimulator of interferon genes (STING) signaling exert essential regulatory function in microbial-and onco-immunology through the induction of cytokines, primarily type I interferons. Recently, the aberrant and deranged signaling of the cGAS–STING axis is closely implicated in multiple sterile inflammatory diseases, including heart failure, myocardial infarction, cardiac hypertrophy, nonalcoholic fatty liver diseases, aortic aneurysm and dissection, obesity, etc. This is because of the massive loads of damage-associated molecular patterns (mitochondrial DNA, DNA in extracellular vesicles) liberated from recurrent injury to metabolic cellular organelles and tissues, which are sensed by the pathway. Also, the cGAS–STING pathway crosstalk with essential intracellular homeostasis processes like apoptosis, autophagy, and regulate cellular metabolism. Targeting derailed STING signaling has become necessary for chronic inflammatory diseases. Meanwhile, excessive type I interferons signaling impact on cardiovascular and metabolic health remain entirely elusive. In this review, we summarize the intimate connection between the cGAS–STING pathway and cardiovascular and metabolic disorders. We also discuss some potential small molecule inhibitors for the pathway. This review provides insight to stimulate interest in and support future research into understanding this signaling axis in cardiovascular and metabolic tissues and diseases.

          Graphical abstract

          The review summarizes the current impact of hyperactivation of the cGAS–STING signaling, with emphasis on the link with cardiovascular and metabolic diseases and the emerged pathway's inhibitors for therapeutic prospects.

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          Most cited references212

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          Cyclic GMP-AMP synthase is a cytosolic DNA sensor that activates the type I interferon pathway.

          The presence of DNA in the cytoplasm of mammalian cells is a danger signal that triggers host immune responses such as the production of type I interferons. Cytosolic DNA induces interferons through the production of cyclic guanosine monophosphate-adenosine monophosphate (cyclic GMP-AMP, or cGAMP), which binds to and activates the adaptor protein STING. Through biochemical fractionation and quantitative mass spectrometry, we identified a cGAMP synthase (cGAS), which belongs to the nucleotidyltransferase family. Overexpression of cGAS activated the transcription factor IRF3 and induced interferon-β in a STING-dependent manner. Knockdown of cGAS inhibited IRF3 activation and interferon-β induction by DNA transfection or DNA virus infection. cGAS bound to DNA in the cytoplasm and catalyzed cGAMP synthesis. These results indicate that cGAS is a cytosolic DNA sensor that induces interferons by producing the second messenger cGAMP.
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            Regulation of type I interferon responses.

            Type I interferons (IFNs) activate intracellular antimicrobial programmes and influence the development of innate and adaptive immune responses. Canonical type I IFN signalling activates the Janus kinase (JAK)-signal transducer and activator of transcription (STAT) pathway, leading to transcription of IFN-stimulated genes (ISGs). Host, pathogen and environmental factors regulate the responses of cells to this signalling pathway and thus calibrate host defences while limiting tissue damage and preventing autoimmunity. Here, we summarize the signalling and epigenetic mechanisms that regulate type I IFN-induced STAT activation and ISG transcription and translation. These regulatory mechanisms determine the biological outcomes of type I IFN responses and whether pathogens are cleared effectively or chronic infection or autoimmune disease ensues.
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              STING an Endoplasmic Reticulum Adaptor that Facilitates Innate Immune Signaling

              We report here the identification, following expression cloning, of a molecule, STING (STimulator of INterferon Genes) that regulates innate immune signaling processes. STING, comprising 5 putative transmembrane (TM) regions, predominantly resides in the endoplasmic reticulum (ER) and is able to activate both NF-κB and IRF3 transcription pathways to induce type I IFN and exert a potent anti-viral state following expression. In contrast, loss of STING rendered murine embryonic fibroblasts (STING −/−MEFs) extremely susceptible to negative-stranded virus infection, including vesicular stomatitis virus, VSV. Further, STING ablation abrogated the ability of intracellular B-form DNA, as well as members of the herpes virus family, to induce IFNβ, but did not significantly affect the Toll-like receptor (TLR pathway). Yeast-two hybrid and co-immunprecipitation studies indicated that STING interacts with RIG-I and with Ssr2/TRAPβ, a member of the translocon-associated protein (TRAP) complex required for protein translocation across the ER membrane following translation[1, 2]. RNAi ablation of TRAPβ and translocon adaptor Sec61β was subsequently found to inhibit STING’s ability to stimulate IFNβ. Thus, aside from identifying a novel regulator of innate immune signaling, this data implicates for the first time a potential role for the translocon in innate signaling pathways activated by select viruses as well as intracellular DNA.
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                Author and article information

                Contributors
                Journal
                Acta Pharm Sin B
                Acta Pharm Sin B
                Acta Pharmaceutica Sinica. B
                Elsevier
                2211-3835
                2211-3843
                20 May 2021
                January 2022
                20 May 2021
                : 12
                : 1
                : 50-75
                Affiliations
                [a ]Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
                [b ]State Key Laboratory of Component-Based Chinese Medicine, Ministry of Education, Tianjin 301617, China
                [c ]Department of Pharmacology and Tianjin Key Laboratory of Inflammation Biology, School of Basic Medical Sciences, Tianjin Medical University, Tianjin 300070, China
                Author notes
                []Corresponding authors. Tel./fax: +86 22 83336517. dumei@ 123456tmu.edu.cn wangqilong_00@ 123456tjutcm.edu.cn
                [†]

                The authors made equal contributions to this work.

                Article
                S2211-3835(21)00177-5
                10.1016/j.apsb.2021.05.011
                8799861
                35127372
                ba7fb6b4-5fe3-49d6-8b39-dcb9ef2509c5
                © 2022 Chinese Pharmaceutical Association and Institute of Materia Medica, Chinese Academy of Medical Sciences. Production and hosting by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 25 January 2021
                : 5 April 2021
                : 15 April 2021
                Categories
                Review

                sting,cgas,cardiovascular diseases,metabolic diseases,damage-associated molecular patterns,inflammation,er stress,mitochondria,aa, amino acids,aad, aortic aneurysm and dissection,akt, protein kinase b,ampk, amp-activated protein kinase,ang ii, angiotensin ii,atp, adenosine triphosphate,cbd, c-binding domain,cdg, c-di-gmp,cdns, cyclic dinucleotides,cgamp, 2′,3′-cyclic gmp–amp,cgas, cyclic gmp–amp synthase,ctd, c-terminal domain,ctt, c-terminal tail,cvds, cardiovascular diseases,cys, cysteine,damps, danger-associated molecular patterns,dsba-l, disulfide-bond a oxidoreductase-like protein,dsdna, double-stranded dna,er, endoplasmic reticulum,gtp, guanosine triphosphate,haq, r71h-g230a-r293q,hfd, high-fat diet,hsting, human stimulator of interferon genes,icam-1, intracellular adhesion molecule 1,ifn, interferon,ifnar, interferon receptors,ifn-i, type 1 interferon,ifnic, interferon-inducible cells,ikk, iκb kinase,il, interleukin,irf3, interferon regulatory factor 3,isgs, irf-3-dependent interferon-stimulated genes,lbd, ligand-binding pocket,lps, lipopolysaccharides,mi, myocardial infarction,mlkl, mixed lineage kinase domain-like protein,mst1, mammalian ste20-like kinases 1,mtdna, mitochondrial dna,mtor, mammalian target of rapamycin,nafld, nonalcoholic fatty liver disease,nash, nonalcoholic steatohepatitis,nf-κb, nuclear factor-kappa b,nlrp3, nod-, lrr- and pyrin domain-containing protein 3,no2-fa, nitro-fatty acids,ntase, nucleotidyltransferase,pde3b/4, phosphodiesterase-3b/4,pka, protein kinase a,poly: i.c, polyinosinic-polycytidylic acid,ppi, protein–protein interface,ros, reactive oxygen species,savi, sting-associated vasculopathy with onset in infancy,ser, serine,snps, single nucleotide polymorphisms,stim1, stromal interaction molecule 1,sting, stimulator of interferon genes,tak1, transforming growth factor β-activated kinase 1,tbk1, tank-binding kinase 1,tfam, mitochondrial transcription factor a,tlr, toll-like receptors,tm, transmembrane,tnfα, tumor necrosis factor-alpha,traf6, tumor necrosis factor receptor-associated factor 6,trex1, three prime repair exonuclease 1,yap1, yes-associated protein 1
                sting, cgas, cardiovascular diseases, metabolic diseases, damage-associated molecular patterns, inflammation, er stress, mitochondria, aa, amino acids, aad, aortic aneurysm and dissection, akt, protein kinase b, ampk, amp-activated protein kinase, ang ii, angiotensin ii, atp, adenosine triphosphate, cbd, c-binding domain, cdg, c-di-gmp, cdns, cyclic dinucleotides, cgamp, 2′,3′-cyclic gmp–amp, cgas, cyclic gmp–amp synthase, ctd, c-terminal domain, ctt, c-terminal tail, cvds, cardiovascular diseases, cys, cysteine, damps, danger-associated molecular patterns, dsba-l, disulfide-bond a oxidoreductase-like protein, dsdna, double-stranded dna, er, endoplasmic reticulum, gtp, guanosine triphosphate, haq, r71h-g230a-r293q, hfd, high-fat diet, hsting, human stimulator of interferon genes, icam-1, intracellular adhesion molecule 1, ifn, interferon, ifnar, interferon receptors, ifn-i, type 1 interferon, ifnic, interferon-inducible cells, ikk, iκb kinase, il, interleukin, irf3, interferon regulatory factor 3, isgs, irf-3-dependent interferon-stimulated genes, lbd, ligand-binding pocket, lps, lipopolysaccharides, mi, myocardial infarction, mlkl, mixed lineage kinase domain-like protein, mst1, mammalian ste20-like kinases 1, mtdna, mitochondrial dna, mtor, mammalian target of rapamycin, nafld, nonalcoholic fatty liver disease, nash, nonalcoholic steatohepatitis, nf-κb, nuclear factor-kappa b, nlrp3, nod-, lrr- and pyrin domain-containing protein 3, no2-fa, nitro-fatty acids, ntase, nucleotidyltransferase, pde3b/4, phosphodiesterase-3b/4, pka, protein kinase a, poly: i.c, polyinosinic-polycytidylic acid, ppi, protein–protein interface, ros, reactive oxygen species, savi, sting-associated vasculopathy with onset in infancy, ser, serine, snps, single nucleotide polymorphisms, stim1, stromal interaction molecule 1, sting, stimulator of interferon genes, tak1, transforming growth factor β-activated kinase 1, tbk1, tank-binding kinase 1, tfam, mitochondrial transcription factor a, tlr, toll-like receptors, tm, transmembrane, tnfα, tumor necrosis factor-alpha, traf6, tumor necrosis factor receptor-associated factor 6, trex1, three prime repair exonuclease 1, yap1, yes-associated protein 1

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