Fogle RL, Hollenbeak CS, Stanley BA, Vary TC, Kimball SR, Lynch CJ. Functional proteomic analysis reveals sexdependent differences in structural and energy-producing myocardial proteins in rat model of alcoholic cardiomyopathy. Physiol Genomics 43: 346 -356, 2011. First published January 18, 2011 doi:10.1152/physiolgenomics.00203.2010.-Long-term ethanol exposure leads to a sexually dimorphic response in both the susceptibility to cardiac pathology (protective effect of the female heart) and the expression of selected myocardial proteins. The purpose of the present study was to use proteomics to examine the effect of chronic alcohol consumption on a broader array of cardiac proteins and how these were affected between the sexes. Male and female rats were maintained for 18 wk on a 40% ethanol-containing diet in which alcohol was provided in drinking water and agar blocks. Differences in the content of specific cardiac proteins in isopycnic centrifugal fractions were determined using mass spectrometry on iTRAQlabeled tryptic fragments. A random effects model of meta-analysis was developed to combine the results from multiple iTRAQ experiments. Analysis of a network of proteins involved in cardiovascular system development and function showed that troponins were oppositely regulated by alcohol exposure in females (upregulated) vs. males (downregulated), and this effect was validated by Western blot analysis. Pathway analysis also revealed that alcohol-consuming males showed increased expression of proteins involved in various steps of oxidative phosphorylation including complexes I, III, IV, and V, whereas females showed no change or decreased content. One implication from these findings is that females may be protected from the toxic effects of alcohol due to their ability to maintain contractile function, maintain efficiency of force generation, and minimize oxidative stress. However, the alcohol-induced insult may lead to increased production of reactive oxygen species and structural abnormalities in male myocardium. iTRAQ; mass spectrometry; meta-analysis; random effects ALCOHOL ABUSE REMAINS ONE of the most common forms of drug abuse among both sexes in the United States. Although the risk of cardiovascular diseases is reduced with moderate alcohol consumption, potential consequences of excessive and chronic alcohol abuse, defined as Ͼ80 g of alcohol per day for longer than 5 yr, include heart dysfunction and heart failure (47). This quantity and frequency of ethanol consumption are sufficient to induce alcoholic heart muscle disease (AHMD) and, in approximately one-third of the cases, contributes to the development of a dilated cardiomyopathy (DCM: 48,50). AHMD is rarely the result of short-term ethanol intake but is more commonly observed in patients who consume excessive amounts of alcohol for prolonged periods (48, 50). This disease is clinically characterized by adverse alterations in both the structure and function of the myocardium, including ventricular dilation, thinning of the ventricular wall, and m...