# Sensory Neurons Release Cardioprotective Factors in an In Vitro Ischemia Model

## TL;DR

Sensory neurons release protective substances that help heart cells survive during simulated ischemia and reperfusion.

## Contribution

The study identifies that sensory neurons secrete cardioprotective factors, independent of neurotransmitters or extracellular vesicles.

## Key findings

- Conditioned supernatant from sensory neurons improves cardiomyocyte survival during ischemia-reperfusion.
- The protective effect is due to a hydrophilic agent that remains active after dilution and protease exposure.
- Metabolomic analysis reveals 64 altered metabolites and lipids in the conditioned solution.

## Abstract

Sensory neurons densely innervate the myocardium. The role of their sensing and response to acute and prolonged ischemia is largely unclear. In a cellular model of ischemia-reperfusion injury, the presence of sensory neurons increases cardiomyocyte survival. Here, after the exclusion of classical neurotransmitter release, and measurement of cytokine release, we modified the experiment from a direct co-culture of primary murine cardiomyocytes and sensory neurons to a transfer of the supernatant. Sensory neurons were exposed to ischemia and the resulting conditioned supernatant was transferred onto cardiomyocytes. This approach largely increased the tolerance of cardiomyocytes to ischemia and reperfusion. Towards the identification of the mechanism, it was demonstrated that after ten-fold dilution, the conditioned solution lost its protective effect. The effect remained after removal of extracellular vesicles by ultracentrifugation, and was not affected by exposure to protease activity, and fractionation pointed towards a hydrophilic agent. Solutions conditioned by HEK293t cells or 3T3 fibroblasts also increase cardiomyocyte survival, but to a lower degree. A metabolomic search identified 64 at least two-fold changed metabolites and lipids. Many of these could be identified and are involved in essential cellular functions. In the presented model for ischemia-reperfusion, sensory neurons secrete one or more cardioprotective substances that can improve cardiomyocyte survival.