加齢・肥満に伴る心不全発生の新たな原因物質を特定 ― 褐色脂肪由来PCPE-1が心臓線維化を促進 ―

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2026-04-30 国立循環器病研究センター

国立循環器病研究センターの研究グループは、加齢や肥満に伴う心不全(HFpEF)の新たな原因物質として、褐色脂肪組織由来の分泌タンパク質PCPE-1を特定した。PCPE-1はコラーゲン成熟を促進し、心臓線維化と拡張障害を引き起こすことが判明。ヒトやマウスで加齢・肥満に伴い血中PCPE-1が増加し、欠損させると心機能が改善、逆に過剰発現で悪化することが確認された。さらに、ROSやDNA損傷を介したシグナル経路がPCPE-1産生を制御することも解明された。従来の白色脂肪中心の理解に加え、褐色脂肪と心臓の新たな臓器間連関を示す成果であり、PCPE-1はバイオマーカーや治療標的として期待される。

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PCPE-1は加齢と肥満に伴う心臓線維化を促進する PCPE-1 promotes cardiac fibrosis with aging and obesity

Yung-Ting Hsiao, Yohko Yoshida, Hirotsugu Tsuchimochi, Jingyuan Tang, Tin May Aung, Chun-Han Chang, Agian Jeffilano Barinda, Zhihong Li, Nur Syakirah Binti Othman, Tom Yoshizaki, Yiwei Ling, Shujiro Okuda, Manabu Abe, Seiya Mizuno, Satoru Takahashi, Takayuki Inomata, Hidetaka Kioka, Yasushi Sakata, Daichi Maeda, Yuya Matsue, Takaaki Furihata, Hiroshi Iwata, James T. Pearson, Kinya Otsu, Kenneth Walsh, Akihito Ishigami, Tohru Minamino, and Ippei Shimizu
JCI Insight  Published: April 9, 2026
DOI:  https://doi.org/10.1172/jci.insight.195508

Abstract

Heart failure with preserved ejection fraction (HFpEF) is a multifactorial disease that develops in several clinical settings. Despite its complex pathogenesis, evidence indicates a central role for fibrosis in the progression of left ventricular (LV) diastolic dysfunction (LVDD). Through exploratory research into brown adipose tissue (BAT)-derived adipokines (BATokines), we identified a secreted-type pro-fibrotic protein, procollagen C-endopeptidase enhancer-1 (PCPE-1), whose expression increased in BAT with aging. PCPE-1 promotes the cleavage of procollagens and is a critical initiator of fibrillogenesis. This molecule was increased in the plasma of aged mice. In addition to aging, dietary obesity led to an increase in PCPE-1 expression in the LV of mice. Both systemic and BAT-specific PCPE-1 depletion ameliorated LV fibrosis and LVDD in the obese HFpEF model. Our data also showed that age-associated LVDD was ameliorated in the systemic PCPE-1 knockout mouse model fed with a normal chow diet. Conversely, the overexpression of PCPE-1 expression in BAT was shown to lead to aggravation of LV fibrosis and LVDD. Mechanistically, we found reactive oxygen species (ROS)/DNA damage/c-Fos/c-Jun signaling resulted in an increased production of PCPE-1 in brown adipocytes. These results indicate PCPE-1 may represent a druggable target for aging- and obesity-related HFpEF.

医療・健康
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