Molecular Inroads into the Anterior Heart Field

Bicuspid aortic valve and ascending aortic aneurysm are not associated with germline or somatic homeobox NKX2-5 gene polymorphism in 19 patients

BACKGROUND

Bicuspid aortic valve is the most common congenital anomaly, occurring in 1% to 2% of the population. It is the most common reason for aortic valve replacement, and such individuals are at significantly increased risk of aortic complications. Despite the clinical significance of bicuspid aortic valve, its genetic basis remains unclear. The homeobox gene NKX2-5 occupies a central position in the hierarchy of cardiac determinants, and mutations in this gene are associated with bicuspid aortic valve in mice. We therefore investigated the presence of mutations in NKX2-5 among patients with bicuspid aortic valve and associated aneurysm.

METHODS

Germline DNA was extracted from peripheral blood leukocytes and somatic DNA from diseased aortic tissues of 19 patients with bicuspid aortic valve and associated aortic aneurysm. Three patients with trileaflet aortic valve and aneurysm served as control subjects. The entire NKX2-5 coding sequence, including intron-exon boundaries, was screened for mutation by means of polymerase chain reaction, followed by DNA sequencing.

RESULTS

Direct sequencing revealed a change in somatic (aortic) DNA 239A-->G, leading to synonymous amino acid alteration of Glu21Glu in one patient with bicuspid aortic valve and 1 control subject. There were no other alterations detected in the coding regions of germline or somatic genes. A known polymorphic change in the 3' untranslated region adjacent to exon 2 was detected in both bicuspid aortic valve and control samples. Discrepancies between germline and somatic DNA sequences were observed.

CONCLUSION

Our study fails to demonstrate an association between bicuspid aortic valve and NKX2-5 mutation, as has been seen in mice. Our findings support the importance of sequencing somatic, as well as germline, DNA.

BMP and FGF regulate the differentiation of multipotential pericardial mesoderm into the myocardial or epicardial lineage

Proepicardial cells give rise to epicardium, coronary vasculature and cardiac fibroblasts. The proepicardium is derived from the mesodermal lining of the prospective pericardial cavity that simultaneously contributes myocardium to the venous pole of the elongating primitive heart tube. Using proepicardial explant cultures, we show that proepicardial cells have the potential to differentiate into cardiac muscle cells, reflecting the multipotency of this pericardial mesoderm. The differentiation into the myocardial or epicardial lineage is mediated by the cooperative action of BMP and FGF signaling. BMP2 is expressed in the distal IFT myocardium and stimulates cardiomyocyte formation. FGF2 is expressed in the proepicardium and stimulates differentiation into the epicardial lineage. In the base of the proepicardium, coexpression of BMP2 and FGF2 inhibits both myocardial and epicardial differentiation. We conclude that the epicardial/myocardial lineage decisions are mediated by an extrinsic, inductive mechanism, which is determined by the position of the cells in the pericardial mesoderm.

Isl1 is upstream of sonic hedgehog in a pathway required for cardiac morphogenesis

The LIM homeodomain transcription factor Islet1 (Isl1) is expressed in both foregut endoderm and cardiogenic mesoderm and is required for earliest stages of heart development. Here, we report that isl1 is also required upstream of Shh. We find that, in isl1 null mice, Sonic hedgehog (Shh) is downregulated in foregut endoderm. Shh signals through the unique activating receptor smoothened (Smo). To investigate the role of hedgehog signaling in the isl1 domain, we ablated smo utilizing isl1-cre. Isl1-cre;smo mutants exhibit cardiovascular defects similar to those observed in Shh null mice, defining a spatial requirement for hedgehog signaling within isl1 expression domains for aortic arch and outflow tract formation. Semaphorin signaling through neuropilin receptors npn1 and npn2 is required for aortic arch and outflow tract formation. We find that expression of npn2 is downregulated in isl1-cre;smo mutants, suggesting an isl1/Shh/npn pathway required to affect morphogenesis at the anterior pole of the heart.

Neural tube derived signals and Fgf8 act antagonistically to specify eye versus mandibular arch muscles

Recent knockout experiments in the mouse generated amazing craniofacial skeletal muscle phenotypes. Yet none of the genes could be placed into a molecular network, because the programme to control the development of muscles in the head is not known. Here we show that antagonistic signals from the neural tube and the branchial arches specify extraocular versus branchiomeric muscles. Moreover, we identified Fgf8 as the branchial arch derived signal. However, this molecule has an additional function in supporting the proliferative state of myoblasts, suppressing their differentiation, while a further branchial arch derived signal, namely Bmp7, is an overall negative regulator of head myogenesis.

Forkhead transcription factors, Foxc1 and Foxc2, are required for the morphogenesis of the cardiac outflow tract

Previous studies have shown that Foxc1 and Foxc2, closely related Fox transcription factors, have interactive roles in cardiovascular development. However, little is known about their functional overlap during early heart morphogenesis. Here, we show that Foxc genes are coexpressed in a novel heart field, the second heart field, as well as the cardiac neural crest cells (NCCs), endocardium, and proepicardium. Notably, compound Foxc1; Foxc2 mutants have a wide spectrum of cardiac abnormalities, including hypoplasia or lack of the outflow tract (OFT) and right ventricle as well as the inflow tract, dysplasia of the OFT and atrioventricular cushions, and abnormal formation of the epicardium, in a dose-dependent manner. Most importantly, in the second heart field, compound mutants exhibit significant downregulation of Tbx1 and Fgf8/10 and a reduction in cell proliferation. Moreover, NCCs in compound mutants show extensive apoptosis during migration, leading to a failure of the OFT septation. Taken together, our results demonstrate that Foxc1 and Foxc2 play pivotal roles in the early processes of heart development, especially acting upstream of the Tbx1-FGF cascade during the morphogenesis of the OFT.

Formation of the venous pole of the heart from an Nkx2-5-negative precursor population requires Tbx18

The venous pole of the mammalian heart is a structurally and electrically complex region, yet the lineage and molecular mechanisms underlying its formation have remained largely unexplored. In contrast to classical studies that attribute the origin of the myocardial sinus horns to the embryonic venous pole, we find that the sinus horns form only after heart looping by differentiation of mesenchymal cells of the septum transversum region into myocardium. The myocardial sinus horns and their mesenchymal precursor cells never express Nkx2-5, a transcription factor critical for heart development. In addition, lineage studies show that the sinus horns do not derive from cells previously positive for Nkx2-5. In contrast, the sinus horns express the T-box transcription factor gene Tbx18. Mice deficient for Tbx18 fail to form sinus horns from the pericardial mesenchyme and have defective caval veins, whereas the pulmonary vein and atrial structures are unaffected. Our studies define a novel heart precursor population that contributes exclusively to the myocardium surrounding the sinus horns or systemic venous tributaries of the developing heart, which are a source of congenital malformation and cardiac arrhythmias.

Tbx1 affects asymmetric cardiac morphogenesis by regulating Pitx2 in the secondary heart field

Individuals with 22q11 deletion syndrome (22q11DS; DiGeorge/velo-cardio-facial syndrome) have multiple congenital malformations, including cardiovascular defects. Most individuals with this syndrome possess 1.5-3.0 Mb hemizygous 22q11.2 deletions. The T-box transcription factor TBX1, lies within the nested 1.5 Mb interval and is a strong candidate for its etiology. Inactivation of Tbx1 in the mouse results in neonatal lethality owing to the presence of a single cardiac outflow tract. One important goal is to understand the molecular pathogenesis of cardiovascular defects in this syndrome. However, the molecular pathways of Tbx1 are still largely unexplored. Here, we show that Tbx1 is co-expressed with the bicoid-like homeodomain transcription factor Pitx2 in secondary heart field cells in the pharyngeal mesenchyme. In situ hybridization studies in Tbx1(-/-) mouse embryos revealed downregulation of Pitx2 in these cells. To test for a possible genetic interaction, we intercrossed Tbx1(+/-) and Pitx2(+/-) mice. Tbx1(+/-); Pitx2(+/-) mice died perinatally with cardiac defects, including double outlet right ventricle, and atrial and ventricular septal defects, all occurring with variable penetrance. An enhancer located between exons 4 and 5 in which a putative T-half site was identified near an Nkx2.5-binding site regulates asymmetric expression of Pitx2. We show using in vitro studies that Tbx1 binds to this site and activates the Pitx2 enhancer with the synergistic action of Nkx2.5. The results presented in this study unravel a novel Tbx1-Pitx2 pathway linking Tbx1 to asymmetric cardiac morphogenesis.

Protein and genomic organisation of vertebrate MyoR and Capsulin genes and their expression during avian development

The related bHLH transcription factors MyoR and Capsulin control craniofacial myogenesis and the development of a number of mesoderm-derived organs in the mouse. However, their molecular function as regulators of differentiation processes is conversely debated. One approach to clarify the roles of these genes is to comparatively analyse their biological and molecular function in various vertebrate models. For this, a prerequisite is the determination of their similarity and their expression patterns. Here we show that vertebrate MyoR and Capsulin are paralogous genes with a high level of conservation regarding their protein sequence, their cDNA sequence and their chromosomal organisation. In the chick, both genes are co-expressed in the developing branchiomeric muscles, the anterior heart field and the splanchnopleura lining the foregut. However, both genes show unique expression domains in trunk skeletal muscle precursors, in the lateral and intermediate mesoderm.

T-box transcription factors and their roles in regulatory hierarchies in the developing heart

T-box transcription factors are important players in the molecular circuitry that generates lineage diversity and form in the developing embryo. At least seven family members are expressed in the developing mammalian heart, and the human T-box genes TBX1 and TBX5 are mutated in cardiac congenital anomaly syndromes. Here, we review T-box gene function during mammalian heart development in the light of new insights into heart morphogenesis. We see for the first time how hierarchies of transcriptional activation and repression involving multiple T-box factors play out in three-dimensional space to establish the cardiac progenitors fields, to define their subservient lineages, and to generate heart form and function.

Les cellules souches embryonnaires : Du développement myocardique à la médecine régénératrice

Embryonic stem cells are capable to recapitulate the first stages of myocardial development. Using mouse embryonic stem cells, transcriptional networks specifying the cardiac fate can be delineated. Furthermore, using members of the TGFbeta superfamily to commit mouse ES cells toward a cardiac lineage, recent studies showed that ESC-derived cardiomyocytes were capable to repair post-infarcted myocardium of small and large animals. The next challenges are to validate such results using human ESCs in order to better comprehend cardiac congenital diseases and to foresee a cell therapy of heart failure. double dagger.

Apoptosis as an instrument in cardiovascular development

Cell death as a phenomenon in embryonic development was first described over 100 years ago. Approximately 30 years ago the process was named apoptosis, and its involvement is now recognized in many life processes, in virtually every animal species, and from fertilization to the death of an organism. In cardiovascular development, it coincides with major developmental processes in specific time windows. Both intrinsic (controlled by mitochondrial activity) and extrinsic (starting with death receptors) apoptotic pathways co-regulate developmental mechanisms. During cardiac development, many cell populations are recruited to the heart, where they differentiate into cardiomyocytes, fibroblasts, smooth muscle cells, endocardial and endothelial cells lining the inner surfaces, and epicardial cells lining the outer contours. In particular, neural crest-derived cell populations, which migrate to specific locations in the heart, are prone to apoptosis. During the complex geometric changes that occur in the primary heart tube and connected vessel segments, proper interaction of the respective cell populations guarantees the ensuing steps of differentiation. Growth factors, including endothelin, VEGF, and TGF-beta, as well as other factors, such as FasL, play dominant roles in these phases. Transgenic and knockout studies have provided strong evidence for aberrant patterns of apoptosis resulting in congenital malformations and syndromic malformations, including septation anomalies, interrupted aortic arch segments, coronary anomalies, and DiGeorge syndrome. Embryonic remodeling of the arterial system, including the coronary arteries, is accompanied by apoptosis patterns, the disruption of which results in severe malformations. It is interesting to note that hemodynamic factors, such as flow-driven shear stress, regulate the expression of genes that are important for signaling molecules such as endothelin and NO-synthase. In general, high shear stress protects against apoptosis, thus preventing the onset of disease processes in the fully-grown vasculature, and regulating the remodeling of the vascular system in the embryo.