Interference with cell signaling and calcium transients [16,17] |
MAPK, TGF-β, PKC, PPARγ, MMPs, NF-κβ, PAI-1 |
Decrease in excitation-contraction coupling mechanisms [17,18,19] |
intracellular [Ca]2+ transients,
L-type Ca2+ channel |
Induction of oxidative damage [20,21] |
ROS, SOD, acetaldehyde |
Pro-inflammatory effect [22] |
IL-2, TNF-α, NF-κβ |
Induction of apoptosis [23,24] |
FAS, TNF-α, TGF-β, Bax-Bcl-2, caspases 3,6 |
Induction of fibrosis [25] |
TLR-4, TGF-β |
Protein-adduct formation [26] |
protein-ethanol-adducts |
malondialdehyde-DNA adducts |
Disruption in protein synthesis [27] |
decrease in ribosomal protein synthesis, actin, myosin, troponin, titin |
Increased glycogen deposition [28,29] |
glycogen synthase kinase-3β, PARP |
Renin-angiotensin-aldosterone activation [30] |
renin, angiotensin, aldosterone, p38 MAPK/Smad |
Interference in hormone-growth factors [31,32] |
myostatin, ghrelin, leptin, IGF-1 |
Interference in regulatory cardiomyokines [33,34] |
FGF21 |
Decrease in myocyte regeneration [35] |
myostatin, IGF-1 |
Impairment of extracellular matrix turnover [16] |
cytoskeletal structure, connexin channel, desmosome contacts |
Imbalance between cardiac lesions/repair mechanisms [9] |
cell apoptosis and necrosis increased myocardial fibrosis decreased myocyte regeneration |