Activation of AMP-activated Protein Kinase α1 Alleviates Endothelial Cell Apoptosis by Increasing the Expression of Anti-apoptotic Proteins Bcl-2 and Survivin*

Accumulating evidence suggests that AMP-activated protein kinase (AMPK) activation exerts anti-apoptotic effects in multiple types of cells. However, the underlying mechanisms remain poorly defined. The aim of the present study was to determine how AMPK suppresses apoptosis in endothelial cells exposed to hypoxia and glucose deprivation (OGD). AMPK activity, NF-κB activation, and endothelial cell apoptosis were assayed in cultured endothelial cells and mouse common carotid artery with or without OGD treatment. OGD markedly activated AMPK as early as 30 min, and AMPK activity reached maximal at 2 h of OGD. Endothelial apoptosis was not detected until 2 h of OGD but became markedly elevated at 6 h of OGD treatment. Furthermore, AMPK inhibition by Compound C or overexpression of dominant negative AMPK (AMPK-DN) exacerbated, whereas AMPK activation by pharmacologic (aminoimidazole carboxamide ribonucleotide (AICAR)) or genetic means (overexpression of constitutively active AMPK) suppressed endothelial cell apoptosis caused by OGD. Concomitantly, AMPK activation increased the expression of both Bcl-2 and Survivin, two potent anti-apoptotic proteins. Furthermore, AMPK activation significantly enhanced IκBα kinase activation, NF-κB nuclear translocation, and DNA binding activity of NF-κB. Consistently, selective inhibition of NF-κB, which abolished OGD-enhanced expression of Bcl-2 and Survivin, accentuated endothelial apoptosis caused by OGD. Finally, we found that genetic deletion of the AMPKα1, but not AMPKα2, suppressed OGD-enhanced NF-κB activation, the expression of Bcl-2 and Survivin, and endothelial apoptosis. Overall, our results suggest that AMPKα1, but not AMPKα2 activation, promotes cell survival by increasing NF-κB-mediated expression of anti-apoptotic proteins (Bcl-2 and Survivin) and intracellular ATP contents.

This article has been withdrawn by the authors except Bin Liang, who could not be reached. The Journal raised questions regarding the following. 1) The P-ACC immunoblot in Fig. 1A was spliced. 2) The PARP immunoblot in Fig. 3D appeared to be a composite. 3 AMPK by their impact on cellular metabolism and bioenergetics and these include hypoxia (27,28) and glucose deprivation (29,30). Yet others, such as oxidative stress (28,31), have been demonstrated to activate AMPK without strict dependence on changes in AMP. AMPK has been proposed to act as a cellular energy sensor that is activated by energy-deficient states to coordinate a switch from anabolic to catabolic activity to establish a positive energy balance. In addition, AMPK activation is reported to exert anti-apoptotic effects, whereas abrogation of AMPK activation results in increased apoptosis and injury in both cardiac myocytes and endothelial cells (32)(33)(34)(35). However, the mechanisms by which AMPK can modulate apoptotic injury are not well understood. Here we report that AMPK activation exerts anti-apoptotic effects by increasing NF-Bdependent expression of Bcl-2 and Survivin in endothelial cells subjected to oxygen and glucose deprivation (OGD).
Animals-Both AMPK␣1 Ϫ/Ϫ and AMPK␣2 Ϫ/Ϫ mice that had been backcrossed onto a C57BL/6 background were housed in temperature-controlled cages under a 12-h light-dark cycle and given free access to water and normal chow. Mice aged 8 -10 weeks were used for the ligation of the common carotid artery. Briefly, mice were anesthetized intraperitoneally with ketamine/xylazine (100 and 10 mg/kg). The bilateral common carotid arteries were exposed and carefully separated from carotid sheath, cervical sympathetic, and vagal nerves through a ventral cervical incision. The right common carotid artery was double-ligated with surgical sutures. The left common carotid artery without ligation served as control. 4 h after the ligation, common carotid arteries were dissected and immediately immersed in 10% formaldehyde, dehydrated, and then embedded in paraffin blocks. The animal protocol was reviewed and approved by the University of Oklahoma Institute Animal Care and Use Committee.
Cell Culture-BAEC and MAEC were maintained in endothelial basal medium with 2% serum and growth factors before use. Isolation of MAEC was done as described previously (36). The characterization of MAEC was confirmed through their positive staining for endothelial nitric-oxide synthase, intercellular adhesion molecule 1, and vascular cell adhesion molecule-1. All cells were grown at 37°C in a humidified atmosphere of 5% CO 2 and 95% air. Experiments were performed on passage 3-8 grown to at Ͼ80% confluence. BAEC and MAEC were kept in serum-deprived media overnight before the experiments.
Adenoviral Infection-BAEC were infected with replicationdefective adenoviral vectors (multiplicity of infection 50) encoding green fluorescence protein (GFP), constitutively active AMPK (AMPK-CA), and a dominant negative AMPK (AMPK-DN), as described previously (37). After infection, the cells were cultured in media without serum for an additional 24 -72 h before experimentation. Under these conditions, infection efficiency was typically Ͼ80% as determined by GFP expression.
Hypoxia Combined with Glucose Deprivation (OGD)-OGD was carried out as described previously (38). Briefly, cells were placed in a 37°C anaerobic chamber with O 2 tension at 1.5%. Cells were washed 3 times and incubated with glucose-free balanced salt solution containing 125 mM NaCl, 5 mM KCl, 1.2 mM NaH 2 PO 4 , 26 mM NaHCO 3 , 1.8 mM CaCl 2 , 0.9 mM MgCl 2 , and 10 mM HEPES that had been deoxygenated by 10 min of sparging with nitrogen. Control wells were washed and incubated with standard (non-deoxygenated) balanced salt solution containing 5 mM glucose. pH was maintained at 7.2-7.4 throughout.
Cell Viability Assay-Cell viability was measured by MTT assay according to the manufacturer's instructions.
Assays of Caspase-3 Activity-Caspase-3 activity was quantified according to the manufacture's instructions by using highly sensitive assay kits obtained from Molecular Probes.
TUNEL Staining-The terminal deoxynucleotidyltransferase-mediated nick-end labeling assay was carried out according to a commercially available kit from Roche Applied Science.
Nuclear Protein Extraction-Nuclear extracts were prepared from BAEC and MAEC according to the instructions from Pierce.
Western Blot-Western blots were performed as described previously (28). The intensities (density area) of individual bands were measured by densitometry (Model GS-700, Imaging Densitometer, Bio-Rad). Background intensity was subtracted from all calculated areas.
Electrophoretic Mobility Shift and Supershift Assays-The nuclear extracts (10 g of protein) were incubated with the biotin-labeled NF-B oligonucleotide and subjected to electrophoresis on a 6% native gel and then transferred to a nylon membrane, immobilized, and detected according to the instructions from Pierce.
In Vitro Kinase Assay-IKK␤ activity was quantified by an in vitro kinase assay that evaluates the ability of immunoprecipitated IKK␤ to phosphorylate glutathione S-transferase-IB fusion protein in vitro as described previously (39).
NF-B-dependent Reporter Gene Expression Assay-Determination of NF-B-dependent reporter gene expression was performed according to the manufacturer's instructions from SABioscience Corp. (Frederick, MD).
Statistical Analysis-Statistical comparison was performed using a one-way analysis of variance followed by the Newman-Keuls post-hoc test. Data are expressed as the mean Ϯ S.E. p Ͻ 0.05 was considered significant.

Time Course of AMPK Activation in Endothelial Cells
Subjected to Oxygen and Glucose Deprivation-As defined by its name, AMPK is known to be activated by increased ratio of AMP to ATP. To determine the effects of endogenous AMPK activation on apoptosis, we first examined the time course of OGD on both AMPK and apoptosis. After being subjected to OGD for the times indicated, AMPK activation was monitored by the phosphorylation of AMPK-Thr-172 and ACC-Ser-79, a well characterized downstream enzyme of AMPK in endothelial cells (40). As depicted in Fig. 1, A and B, OGD significantly increased the detection of AMPK-Thr-172 phosphorylation and ACC-Ser-79 phosphorylation as early as within 30 min. Phosphorylation of AMPK and ACC was found to reach peak   (Fig. 1, C and D). Further analysis of the time curves of AMPK activation and the numbers of TUNEL-positive cells in OGD-treated cells revealed an inverse relationship of AMPK and apoptosis; i.e. apoptosis increased when AMPK activity declined (Fig. 1D), suggesting potential anti-apoptosis effects of AMPK in OGD-treated endothelial cells.
AMPK Activation Promotes Cell Survival and Suppresses Apoptosis-To further confirm if AMPK activation can suppress apoptosis and promote cell survival, we tested the effects of AICAR, a potent AMPK activator, and compound C, a potent AMPK inhibitor, on OGD-induced apoptosis and endothelial viability. As expected, short exposure of endothelial cells to AICAR increased, whereas Compound C inhibited AMPK-Thr-172 phosphorylation ( Fig. 2A). As depicted in Fig. 2B, OGD significantly reduced endothelial cell viability. AICAR alleviated OGD-induced cell death, although it alone did not affect endothelial viability in endothelial cells without OGD.
Conversely, inhibition of AMPK with compound C significantly further reduced viability (Fig. 2B).
To exclude potential off-target effects of AICAR or compound C, we investigated the effects of AMPK on endothelial viability by using genetic approaches. Adenoviral overexpression of constitutively active AMPK mutants (AMPK-CA) or dominant negative mutants (AMPK-DN) did not affect the MTT reduction in endothelial cells (Fig. 2C). However, overexpression of AMPK-CA alleviated OGD-induced reduction of cell viability, whereas overexpression of AMPK-DN accentuated the reduction of MTT caused by OGD (Fig. 2C).

AMPK Inhibition Increases the Numbers of TUNEL-positive Cells-
The potential beneficial effect of AMPK in endothelial cell viability was further evaluated by assaying TUNEL-positive cells, an established assay for apoptosis. Overexpression of AMPK-CA or AMPK-DN did not affect TUNEL-positive cells (Fig. 2D) under normal conditions. However, AMPK-CA alleviated OGD-increased TUNEL-positive cells, whereas AMPK-DN increased the numbers of TUNEL-positive cells caused by OGD (Fig. 2D).
We next determined if pharmacological alterations of AMPK activity affected OGD-enhanced TUNEL-positive cells in endothelial cells. As expected, neither AICAR nor compound C had effects on TUNEL-positive cells in normal oxygen/glucose condition (Fig. 2E). However, AICAR significantly reduced, whereas compound C significantly increased the numbers of TUNEL-positive cells caused by OGD treatment (Fig. 2E).
AMPK Activation Suppresses Caspase-3 Activity-Caspase-3 is partially or totally responsible for the proteolytic cleavage of many key proteins such as the nuclear enzyme PARP (41,42), a key executioner of apoptosis. The effects of AMPK on apoptosis were further investigated by monitoring caspase-3 activity and the cleavage of caspase-3 and PARP. To this end, we first assayed caspase-3 activity. As expected, OGD caused significant elevation of caspase-3 activity (Fig. 3A). Importantly, OGD-enhanced caspase-3 activity was suppressed by AICAR treatment (Fig. 3A). In contrast, AICAR suppressed caspase-3 activity enhanced by OGD (Fig. 3A). Consistently, overexpression of AMPK-CA suppressed caspase-3 activity, whereas overexpression of AMPK-DN aggravated caspase-3 activation in OGD-treated endothelial cells (Fig. 3B). Taken together, these results suggest that AMPK activation suppressed caspase-3 activation caused by OGD in endothelial cells. AMPK Activation Suppresses the Cleavage of Caspase-3 and PARP-Activation of caspase-3 requires proteolytic processing of its inactive zymogen, procaspase-3, into activated cleaved fragments. We next investigated if AMPK activation altered the proteolytic processing of its inactive zymogen, procaspase-3, into activated caspase-3. As expected, OGD activation increased the cleavage of both caspase-3 and PARP. Activation of AMPK by AICAR or AMPK-CA suppressed, whereas inhibition of AMPK with Compound C or overexpression of AMPK-DN increased the effects of OGD (Fig. 3, C and D).
AMPK Activation Increases the Expression of Bcl-2 and Survivin-Next, we investigated if the inhibition of OGD-induced apoptosis by AMPK activation was mediated through an up-regulation of Bcl-2 and Survivin. Western blot analysis demonstrated that expression of these anti-apoptotic proteins was indeed enhanced by AICAR and predictably reduced by Compound C (Fig. 4, A and B).

Selective Inhibition of NF-B Abolishes the Effects of AMPK Activation on Both the Expression of Bcl-2 and Survivin and Apoptosis-
Earlier studies had reported an essential role of NF-B in the regulation of Bcl-2 and Survivin (43,44). Thus, it was interesting to examine if selective inhibition of NF-B abolished AICAR-enhanced expression of Bcl-2 and Survivin. To this end, the expression of Bcl-2 and Survivin was monitored in endothelial cells treated with a potent NF-B inhibitor with or without OGD treatment. As shown in Fig. 5, A and B, co-administration of this inhibitor alone did not alter the levels of Bcl-2 or Survivin. However, administration of this NF-B inhibitor, but not vehicle, significantly ablated AICAR-enhanced expression of both Bcl-2 and Survivin. Consistently, inhibition of NF-B markedly reduced the numbers of TUNEL-positive cells caused by OGD (Fig. 5C). Overall, these results indicate that AMPK activation in OGD, likely via an up-regulation of NF-B, increases the expression of Bcl-2 and Survivin.

AMPK Activation Increases NF-B Activation in Endothelial Cells
Subjected to OGD-Next, we determined if AMPK activation caused NF-B activation in OGDtreated cells. Because IKK␤ is a key upstream regulator of NF-B activation in the canonical NF-B pathway, we evaluated if AMPK activation affected the activity of IKK␤ by using an in vitro kinase assay. As expected, IKK␤ activity was increased in OGD. AICAR was able to further enhance this increase, whereas Compound C reduced it (Fig. 6A).  Once in the nucleus, NF-B is subject to further regulation mainly through phosphorylation of the p65 proteins (45,46), which are required for full induction of NF-B target genes. Phosphorylation of NF-B p65 at Ser-276 is reported to increase the transcriptional activity of NF-B p65 (46 -48). Therefore, we tested if AMPK activation altered OGD-induced phosphorylation and nuclear translocation of p65. As expected, AICAR increased the phosphorylation and nuclear localization of p65 (Fig. 6, B and C), whereas compound C reduced the phosphorylation and nuclear localization of p65 (Fig. 6, B and  C). Furthermore, AICAR increased, whereas Compound C reduced OGD-enhanced DNA binding activity and reporter assays of NF-B in endothelial cells (Fig. 6, D and E). In addition, overexpression of AMPK-CA increased, whereas overexpression of AMPK-DN reduced OGD-enhanced DNA binding activity of NF-B in endothelial cells (Fig. 6F). Taken together, these data suggest that AMPK activation in OGD-treated cells increased NF-B activation in endothelial cells.
AMPK␣1 Deletion Exacerbates OGD-enhanced Endothelial Apoptosis-There are two isoforms of AMPK␣, each of which localizes to different subcellular compartments and downstream enzymes. It was important to determine the relative contribution of each isoform in OGD-enhanced cell death caused by OGD. To this end, MAEC isolated from AMPK␣1-KO, AMPK␣2-KO mice, or age-matched C57BL/6 mice were subjected to OGD. OGD significantly increased the cleavage of caspase-3 and PARP in both wild type and AMPK␣1 Ϫ/Ϫ (Fig. 8,   FIGURE 6. Inhibition of AMPK reduces NF-B activation in endothelial cells exposed to OGD for 4 h. A, an in vitro kinase assay for glutathione S-transferase-IB␣, with AICAR and compound C treatment with and without OGD (4 h) is shown. IKK␤ activity was analyzed by an in vitro kinase assay for glutathione S-transferase-IB␣. BAEC were treated with AICAR and compound C in the absence or presence of OGD for 4 h. n ϭ 3. B, effects of AICAR and Compound C on the phosphorylation of p65 with or without OGD are shown. The blot is representative of three blots obtained from three independent experiments. C, shown are the effects of AICAR and Compound C on the nuclear localization of p65 in endothelial cells with or without OGD. The blot is representative of three blots obtained from three independent experiments. D, effects of AICAR and Compound C on OGD-enhanced NF-B DNA binding activity in endothelial cells are shown. ࡔ, p Ͻ 0.05 OGD versus control; †, p Ͻ 0.05 AICAR versus OGD only; ‡, p Ͻ 0.05 Compound C with OGD versus OGD alone; n ϭ 3. E, AICAR enhances, whereas compound C suppresses NF-B-dependent reporter gene expression enhanced by OGD; data are reported as relative luciferase units Ϯ S.E. ࡔ, p Ͻ 0.05 OGD versus control; †, p Ͻ 0.05 AICAR versus OGD only; ‡, p Ͻ 0.05 Compound C with OGD versus OGD alone; n ϭ 3. F, overexpression of AMPK-CA increases, whereas overexpression of AMPK-DN suppresses NF-B DNA binding assay enhanced by OGD for 4 h. ࡔ, p Ͻ 0.05 OGD versus control; †, p Ͻ 0.05 AICAR versus OGD only; ‡, p Ͻ 0.05 Compound C with OGD versus OGD alone, n ϭ 3.
A and B). Compared with MAEC from wild type, increased cleavage of caspase-3 and PARP was found in MAEC isolated from AMPK␣1 Ϫ/Ϫ but not in AMPK␣2 Ϫ/Ϫ (Fig. 8, A and B). Compared with those in wild types, the expression of cleaved caspase-3 and PARP was dramatically enhanced in MAEC from AMPK␣1 Ϫ/Ϫ but not in AMPK␣2 Ϫ/Ϫ (Fig. 8, A and B).
AMPK␣1 Is Required for OGD-induced Up-regulation of Bcl-2 and Survivin in Endothelial Cells in Vivo-Finally, we determined if AMPK␣1-dependent expression of Bcl-2 and Survivin is operative in vivo. To the end, mouse common carotid arteries from wild type (C57BL/6), AMPK␣1 Ϫ/Ϫ , and AMPK␣2 Ϫ/Ϫ were ligated for 4 h in vivo. After the ligation, mouse carotid arteries were isolated and used for immunocytochemical staining of Bcl-2 and Survivin. In sham-treated mice, the levels of both Bcl-2 and Survivin in the endothelium of AMPK␣1 Ϫ/Ϫ mice appeared to be reduced when com-pared with those from WT and AMPK␣2 Ϫ/Ϫ mice (Fig. 9). Importantly, OGD markedly increased the levels of both Bcl-2 and Survivin in the endothelium of both WT and AMPK␣2 Ϫ/Ϫ mice (Fig. 9). In contrast, OGD did not alter either Bcl-2 or Survivin (Fig. 9), suggesting that AMPK␣1 but not AMPK␣2 Ϫ/Ϫ was required for OGD-enhanced expression of Bcl-2 and Survivin.

DISCUSSION
In this study we have demonstrated that hypoxia combined with glucose deprivation in endothelial cells induces AMPK activation, and this appears to afford protection to these cells by preventing apoptosis via both an up-regulation of the NF-B-dependent expression of anti-apoptotic gene products and maintaining intracellular ATP in endothelial cells. This mechanism appears to be AMPK␣1-specific, as OGD markedly increased the levels of both Bcl-2 and Survivin in the endothelium of WT and AMPK␣2 Ϫ/Ϫ but not those from AMPK␣1 Ϫ/Ϫ mice. Overall, our results suggest that AMPK activation suppresses apoptosis by stimulation of the NF-B pathway in BAEC, and the deletion of the ␣1 subunit of AMPK enhances caspase-dependent apoptosis.
The most important finding of this study is that AMPK promotes cell survival by both up-regulating NF-B-dependent expression of Bcl-2 and Survivin and maintaining intracellular ATP levels (Fig. 10). The AMPK complex contains three subunits, with the ␣-subunit being catalytic, the ␤-subunit containing a glycogen-sensing domain, and the ␥-subunits containing two regulatory sites that bind the activating and inhibitory nucleotides, AMP and ATP. All subunits are necessary for full activity (49). Studies have indicated that the two ␣-subunit isoforms of AMPK have different functions (50 -52). Our study indicates that the AMPK catalytic isoform ␣1 critically contributes to the antiapoptotic effects of AMPK activation in oxygen and glucose deprivation, likely via the up-regulation of Bcl-2 and Survivin, two important ant-apoptotic proteins. Our observation is consolidated by a recent study which has also shown that Ca 2ϩ -dependent AMPK activation is required for p65/RelA binding to nuclear DNA in thrombin-stimulated endothelial cells, which is mediated by protein kinase C␦ and p38 MAPK (53). In support of our conclusion, other investigators have noted that  (n ϭ 3). ࡔ, p Ͻ 0.05 WT versus AMPK␣1 Ϫ/Ϫ without OGD; †, p Ͻ 0.05 WT versus WT with OGD; ‡, p Ͻ 0.05 WT with OGD versus AMPK␣1-KO with OGD; n ϭ 3. D and E, AMPK␣1, but not AMPK␣2 depletion, abolishes OGD-enhanced expression of Bcl-2 (D) and Survivin (E) in endothelial cells isolated from WT, AMPK␣1 Ϫ/Ϫ , and AMPK␣2 Ϫ/Ϫ with or without OGD (4 h). ␤-Actin serves as the loading control. ࡔ, p Ͻ 0.05 WT versus AMPK␣1 Ϫ/Ϫ without OGD; †, p Ͻ 0.05 WT versus WT with OGD; ‡, p Ͻ 0.05 WT with OGD versus AMPK␣1-KO with OGD, n ϭ 3. F, effects of OGD on the contents of ATP in the MAEC isolated from WT, AMPK␣1 Ϫ/Ϫ , and AMPK␣2 Ϫ/Ϫ . MAEC were treated with and without OGD for 2 h, and ATP contents were assayed by high performance liquid chromatography as described under "Experimental Procedures." ࡔ, p Ͻ 0.05 OGD versus w/o OGD; †, p Ͻ 0.05 WT with OGD versus AMPK␣1 Ϫ/Ϫ with OGD; ‡, p Ͻ 0.05 WT with OGD versus AMPK␣2-KO with OGD; n ϭ 3.
AMPK can attenuate apoptotic signaling in biological systems other than the endothelium, such as cardiomyocytes (54,55). Capano and Crompton (56) were one of the first investigators to bridge the gaps between AMPK signaling, p38 MAPK, and apoptotic cell death in ischemic hearts. They applied a model of simulated ischemia in cultured rat neonatal cardiomyocytes and documented Bax translocation from the cytosol to the mitochondria. They reported that ischemia induced this translocation. In addition, these investigators also demonstrated that Bax accumulation in the mitochondria was preceded by rapid phosphorylation and activation of p38 MAPK. Furthermore, AMPK activation was also noted in this system, with phosphorylated AMPK becoming detectable after ischemia and remaining elevated for at least 3 h. The protective effect of AMPK in the context of apoptosis has been noted in a variety of other experimental systems with relevance to human disease. For example, Nyblom et al. (57) have recently reported that AICAR (a potent activator of AMPK) can improve pancreatic ␤-cell function and attenuate apoptosis in the face of prolonged hypoglycemia in a dosedependent manner. Cao et al. (58) have compellingly shown that skin dendritic cells appear to be critically dependent on LKB1/AMPK signaling (as well as MAPK, phosphatidylinositol 3-kinase/Akt/mTOR/S6K signaling) in protecting themselves from UV-induced apoptosis (the main blight of dermal tissue). They reported data demonstrating that epidermal growth factor receptor (EGFR)-deficient cells had impairments in all of these signaling cascades after UV irradiation, suggesting that EGFR signaling was linked to these cellular systems in guarding against apoptotic death (58). AMPK is reported to be highly expressed in rat cortical neurons and promoted neuronal survival after glucose derivation (59). Saito et al. (60) have reported more recently that ethanol-induced apoptotic neurodegeneration in mice is accompanied by alterations in AMPK activity in that the AMPK phosphorylation at Thr-172 was significantly reduced in the brain exposed to ethanol at concentrations high enough to induce apoptosis. However, the exact mechanism of how the specificity of the ␣-subunit isoform plays into the anti-apoptotic effect of AMPK has not been addressed by our study, and this will require further exploration.
By virtue of their location at the interface between blood and tissue, the endothelium and its constituent cells are exposed to a wide variety of physiological and pathological stimuli with the potential to promote apoptosis. Loss of endothelial cells could lead to vascular leak and expose the flowing bloodstream to the potently thrombogenic subendothelial matrix. In addition, as apoptotic endothelial cells become pro-adhesive to platelets and leukocytes (9, 10) as well as thrombogenic (11), they could promote coagulation in situ before engulfment or detachment or in the circulation once detached (61). Indeed, apoptotic endothelial cell death critically contributes to the pathogenesis of diverse vascular diseases (1,2). Metformin and statins are known to have beneficial vascular effects in animal studies and, most importantly, in clinical studies. The study of AMPK and FIGURE 8. AMPK␣1 depletion increases the cleavage of caspase-3 and PARP in endothelial cells exposed to OGD for 4 h. A, AMPK␣1 Ϫ/Ϫ depletion, but not AMPK␣2 Ϫ/Ϫ , increases caspase-3 cleavage in isolated MAEC with/without OGD (4 h). Caspase-3 cleavage is reported as % of control Ϯ S.E. ␤-Actin served as the respective loading controls (n ϭ 3). ࡔ, p Ͻ 0.05 WT with OGD versus WT without OGD; †, p Ͻ 0.05 AMPK␣1-KO with OGD versus WT with OGD; ‡, p Ͻ 0.05 AMPK␣1-KO with OGD versus AMPK␣2-KO with OGD; n ϭ 3. B, effects of AMPK␣1 Ϫ/Ϫ depletion and AMPK␣2 Ϫ/Ϫ on OGD-induced PARP cleavage in isolated MAEC with or without OGD (4 h) are shown. Histone 3 is used as a control for nuclear protein. The blot is representative of three blots obtained from three individual experiments. C, shown are the effects of AMPK␣1 Ϫ/Ϫ depletion and AMPK␣2 Ϫ/Ϫ on OGD-induced apoptosis in isolated MAEC with/without OGD (4 h). Data are reported as % of TUNEL-positive cells in a microscopic field. ࡔ, p Ͻ 0.05 versus control; †, p Ͻ 0.05 WT with OGD versus AMPK␣1 Ϫ/Ϫ with OGD; n ϭ 5. cardiovascular diseases has become all the more important since it was recently demonstrated that metformin and statin exert their therapeutic effect in cardiovascular diseases by activating AMPK. Thus, anti-apoptotic effects of AMPK might be an important target for treating cardiovascular diseases.