Preclinical evidence for the therapeutic value of TBX5 normalization in arrhythmia control

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Franziska S. Rathjens - , University of Göttingen, Deutsches Zentrum für Herz-Kreislaufforschung (DZHK) (Author)
  • Alica Blenkle - , University of Göttingen (Author)
  • Lavanya M. Iyer - , University of Göttingen, Deutsches Zentrum für Herz-Kreislaufforschung (DZHK) (Author)
  • Anke Renger - , Humboldt University of Berlin (Author)
  • Fahima Syeda - , University of Birmingham (Author)
  • Claudia Noack - , University of Göttingen, Deutsches Zentrum für Herz-Kreislaufforschung (DZHK) (Author)
  • Andreas Jungmann - , Heidelberg University , German Center for Cardiovascular Disease (DZHK) Partner site Heidelberg/Mannheim (Author)
  • Matthias Dewenter - , German Center for Cardiovascular Disease (DZHK) Partner site Heidelberg/Mannheim, Heidelberg University  (Author)
  • Karl Toischer - , University of Göttingen (Author)
  • Ali El-Armouche - , Institute of Pharmacology and Toxicology, TUD Dresden University of Technology (Author)
  • Oliver J. Müller - , Kiel University (Author)
  • Larissa Fabritz - , University of Birmingham, University of Münster, University Hospitals Birmingham NHS Foundation Trust (Author)
  • Wolfram Hubertus Zimmermann - , University of Göttingen, Deutsches Zentrum für Herz-Kreislaufforschung (DZHK) (Author)
  • Laura C. Zelarayan - , University of Göttingen, Deutsches Zentrum für Herz-Kreislaufforschung (DZHK) (Author)
  • Maria Patapia Zafeiriou - , University of Göttingen, Deutsches Zentrum für Herz-Kreislaufforschung (DZHK) (Author)

Abstract

Aims Arrhythmias and sudden cardiac death (SCD) occur commonly in patients with heart failure. We found T-box 5 (TBX5) dysregulated in ventricular myocardium from heart failure patients and thus we hypothesized that TBX5 reduction contributes to arrhythmia development in these patients. To understand the underlying mechanisms, we aimed to reveal the ventricular TBX5-dependent transcriptional network and further test the therapeutic potential of TBX5 level normalization in mice with documented arrhythmias. Methods and results We used a mouse model of TBX5 conditional deletion in ventricular cardiomyocytes. Ventricular (v) TBX5 loss in mice resulted in mild cardiac dysfunction and arrhythmias and was associated with a high mortality rate (60%) due to SCD. Upon angiotensin stimulation, vTbx5KO mice showed exacerbated cardiac remodelling and dysfunction suggesting a cardioprotective role of TBX5. RNA-sequencing of a ventricular-specific TBX5KO mouse and TBX5 chromatin immunoprecipitation was used to dissect TBX5 transcriptional network in cardiac ventricular tissue. Overall, we identified 47 transcripts expressed under the control of TBX5, which may have contributed to the fatal arrhythmias in vTbx5KO mice. These included transcripts encoding for proteins implicated in cardiac conduction and contraction (Gja1, Kcnj5, Kcng2, Cacna1g, Chrm2), in cytoskeleton organization (Fstl4, Pdlim4, Emilin2, Cmya5), and cardiac protection upon stress (Fhl2, Gpr22, Fgf16). Interestingly, after TBX5 loss and arrhythmia development in vTbx5KO mice, TBX5 protein-level normalization by systemic adeno-associated-virus (AAV) 9 application, reestablished TBX5-dependent transcriptome. Consequently, cardiac dysfunction was ameliorated and the propensity of arrhythmia occurrence was reduced. Conclusions This study uncovers a novel cardioprotective role of TBX5 in the adult heart and provides preclinical evidence for the therapeutic value of TBX5 protein normalization in the control of arrhythmia.

Details

Original languageEnglish
Pages (from-to)1908-1922
Number of pages15
JournalCardiovascular research
Volume117
Issue number8
Publication statusPublished - 1 Jul 2021
Peer-reviewedYes

External IDs

PubMed 32777030
ORCID /0000-0003-2514-9429/work/151437830

Keywords

Keywords

  • AAV9 in vivo re-expression, Arrhythmia, Heart failure, Sudden cardiac death, T-box 5