A Critical Role for Peroxisomal Proliferator-Activated Receptor-α Nuclear Receptors in the Development of Cardiomyocyte Degeneration and Necrosis

Peroxisomal proliferator-activated receptor (PPAR)-α is a ligand-activated transcriptional factor that regulates genes involved in lipid metabolism and energy homeostasis. PPAR-α activators, including fibrates, have been used to treat dyslipidemia for several decades. In contrast to their known effects on lipids, the pharmacological consequences of PPAR-α activation on cardiac metabolism and function are not well understood. Therefore, we evaluated the role that PPAR-α receptors play in the heart. Our studies demonstrate that activation of PPAR-α receptors using a selective PPAR-α ligand results in cardiomyocyte necrosis in mice. Studies in PPAR-α-deficient mice demonstrated that cardiomyocyte necrosis is a consequence of the activation of PPAR-α receptors. Cardiac fatty acyl-CoA oxidase mRNA levels increased at doses in which cardiac damage was observed and temporally preceded cardiomyocyte degeneration, suggesting that peroxisomal β-oxidation correlates with the appearance of microscopic injury and cardiac injury biomarkers. Increased myocardial oxidative stress was evident in mice treated with the PPAR-α agonists coinciding with increased peroxisomal biomarkers of fatty acid oxidation. These findings suggest that activation of PPAR-α leads to increased cardiac fatty acid oxidation and subsequent accumulation of oxidative stress intermediates resulting in cardiomyocyte necrosis.