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Kant S, Holthöfer B, Magin TM, Krusche CA, Leube RE. Desmoglein 2-Dependent Arrhythmogenic Cardiomyopathy Is Caused by a Loss of Adhesive Function. ACTA ACUST UNITED AC 2015; 8:553-63. [PMID: 26085008 DOI: 10.1161/circgenetics.114.000974] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 06/09/2015] [Indexed: 01/01/2023]
Abstract
BACKGROUND The desmosomal cadherin desmoglein 2 (Dsg2) localizes to the intercalated disc coupling adjacent cardiomyocytes. Desmoglein 2 gene (DSG2) mutations cause arrhythmogenic cardiomyopathy (AC) in human and transgenic mice. AC is characterized by arrhythmia, cardiodilation, cardiomyocyte necrosis with replacement fibrosis, interstitial fibrosis, and intercalated disc dissociation. The genetic DSG2 constellations encountered are compatible with loss of adhesion and altered signaling. To further elucidate pathomechanisms, we examined whether heart-specific Dsg2 depletion triggers cardiomyopathy. METHODS AND RESULTS Because DSG2 knockouts die during early embryogenesis, mice were prepared with cardiomyocyte-specific DSG2 ablation. Healthy transgenic animals were born with a functional heart presenting intercalated discs with incorporated desmosomal proteins. Dsg2 protein expression was reduced below 3% in the heart. All animals developed AC during postnatal growth with pronounced chamber dilation, calcifying cardiomyocyte necrosis, aseptic inflammation, interstitial and focal replacement fibrosis, and conduction defects with altered connexin 43 distribution. Electron microscopy revealed absence of desmosome-like structures and regional loss of intercalated disc adhesion. Mice carrying 2 mutant DSG2 alleles coding for Dsg2 lacking part of the adhesive EC1-EC2 domains present an indistinguishable phenotype, which is similar to that observed in human AC patients. CONCLUSIONS The observations show that the presence of Dsg2 is not essential for late heart morphogenesis and for cardiac contractility to support postnatal life. On increasing mechanical demands, heart function is severely compromised as evidenced by the onset of cardiomyopathy with pronounced morphological alterations. We propose that loss of Dsg2 compromises adhesion, and that this is a major pathogenic mechanism in DSG2-related and probably other desmosome-related ACs.
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Affiliation(s)
- Sebastian Kant
- From the Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany (S.K., B.H., C.A.K., R.E.L.); and Institute of Biology and Translational Center for Regenerative Medicine, University of Leipzig, Leipzig, Germany (T.M.M.)
| | - Bastian Holthöfer
- From the Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany (S.K., B.H., C.A.K., R.E.L.); and Institute of Biology and Translational Center for Regenerative Medicine, University of Leipzig, Leipzig, Germany (T.M.M.)
| | - Thomas M Magin
- From the Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany (S.K., B.H., C.A.K., R.E.L.); and Institute of Biology and Translational Center for Regenerative Medicine, University of Leipzig, Leipzig, Germany (T.M.M.)
| | - Claudia A Krusche
- From the Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany (S.K., B.H., C.A.K., R.E.L.); and Institute of Biology and Translational Center for Regenerative Medicine, University of Leipzig, Leipzig, Germany (T.M.M.)
| | - Rudolf E Leube
- From the Institute of Molecular and Cellular Anatomy, RWTH Aachen University, Aachen, Germany (S.K., B.H., C.A.K., R.E.L.); and Institute of Biology and Translational Center for Regenerative Medicine, University of Leipzig, Leipzig, Germany (T.M.M.).
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54
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Muresian H. The clinical anatomy of the right ventricle. Clin Anat 2014; 29:380-98. [DOI: 10.1002/ca.22484] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2014] [Accepted: 10/12/2014] [Indexed: 01/26/2023]
Affiliation(s)
- Horia Muresian
- Cardiovascular Surgery Department; The University Hospital of Bucharest; 169 Splaiul Independentei Bucharest Romania
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55
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Etchegary H, Pullman D, Simmonds C, Young TL, Hodgkinson K. ‘It had to be done’: genetic testing decisions for arrhythmogenic right ventricular cardiomyopathy. Clin Genet 2014; 88:344-51. [DOI: 10.1111/cge.12513] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 09/23/2014] [Accepted: 09/23/2014] [Indexed: 01/08/2023]
Affiliation(s)
- H. Etchegary
- Clinical Epidemiology; Eastern Health and Memorial University; St. John's NL Canada
| | - D. Pullman
- Community Health and Humanities; Memorial University; St. John's NL Canada
| | - C. Simmonds
- Health Research Unit, Community Health and Humanities; Memorial University; St. John's NL Canada
| | - T.-L. Young
- Discipline of Genetics; Memorial University; St. John's NL Canada
| | - K. Hodgkinson
- Clinical Epidemiology and Discipline of Genetics; Memorial University; St. John's NL Canada
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56
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Abstract
Anomalous origin of a coronary artery from the aorta is a potentially serious anomaly that occurs in about 0.1-0.2% of the population. This percentage is small; however, it translates into about 4000 annual births with these anomalies. The clinical presentation of these anomalies is rare, and hence most are and will remain asymptomatic. The various anatomic anomalies are described, with anomalous origin of the left coronary artery that then passes between the aorta and pulmonary artery being the most serious of these anomalies. The pathophysiology resulting from these anomalies is described, as are methods for identifying those who require treatment; however, we still do not know the best methods of determining which patients need treatment.
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Asimaki A, Saffitz JE. Remodeling of cell-cell junctions in arrhythmogenic cardiomyopathy. ACTA ACUST UNITED AC 2014; 21:13-23. [PMID: 24460198 DOI: 10.3109/15419061.2013.876016] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Arrhythmogenic cardiomyopathy (AC) is a primary myocardial disorder characterized by a high incidence of ventricular arrhythmias often preceding the onset of ventricular remodeling and dysfunction. Approximately 50% of patients diagnosed with AC have one or more mutations in genes encoding desmosomal proteins, although non-desmosomal genes have also been associated with the disease. Increasing evidence implicates remodeling of intercalated disk proteins reflecting abnormal responses to mechanical load and aberrant cell signaling pathways in the pathogenesis of AC. This review summarizes recent advances in understanding disease mechanisms in AC that have come from studies of human myocardium and experimental models.
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Affiliation(s)
- Angeliki Asimaki
- Department of Pathology, Beth Israel Deaconess Medical Center and Harvard Medical School , Boston, MA , USA
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58
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Schlipp A, Schinner C, Spindler V, Vielmuth F, Gehmlich K, Syrris P, Mckenna WJ, Dendorfer A, Hartlieb E, Waschke J. Desmoglein-2 interaction is crucial for cardiomyocyte cohesion and function. Cardiovasc Res 2014; 104:245-57. [DOI: 10.1093/cvr/cvu206] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
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59
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Lear-Kaul KC. Investigation of Sudden Death in Athletes: The Fittest Bodies in the Morgue. Acad Forensic Pathol 2014. [DOI: 10.23907/2014.049] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Sporting events are generally viewed as regulated activities with fit and healthy participants; therefore, when deaths occur, they draw considerable public interest. Athletic participants can be considered a vulnerable population based on inherent risks within certain sports and the associated physiologic stresses, which may complicate underlying medical conditions. Sudden deaths in young athletes participating in high school and collegiate organized sports occur at an average of four to six deaths per year; however, sudden deaths related to exercise outside of an organized sport setting remain unaccounted for in the overall prevalence of these deaths. A typical forensic pathology practice will see not only these higher-profile deaths occurring during an organized sporting event, but also lower-profile occurrences of individuals dying during more recreational or unstructured exercise. Sport-related deaths can essentially be categorized as those that occur due to dangers inherent in the sport itself, such as forms of heat-related illnesses, blunt force trauma, and water-related deaths, and those that occur due to susceptibilities of a given predisposed participant, including sickle cell trait, hypertrophic cardiomyopathy, and other cardiovascular diseases. This article will address both types of vulnerabilities and provide guidance for appropriate and specific medicolegal death investigation and autopsy procedures in these deaths.
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Affiliation(s)
- Kelly C. Lear-Kaul
- Forensic Pathologist and the Coroner at the Arapahoe County (Colorado) Coroner's Office and University of Colorado Anschutz Medical Campus
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60
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The MOGE(S) Classification of Cardiomyopathy for Clinicians. J Am Coll Cardiol 2014; 64:304-18. [DOI: 10.1016/j.jacc.2014.05.027] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 05/27/2014] [Accepted: 05/28/2014] [Indexed: 02/08/2023]
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Gu Q, Chen XT, Xiao YB, Chen L, Wang XF, Fang J, Chen BC, Hao J. Identification of differently expressed genes and small molecule drugs for Tetralogy of Fallot by bioinformatics strategy. Pediatr Cardiol 2014; 35:863-9. [PMID: 24463614 DOI: 10.1007/s00246-014-0868-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 01/03/2014] [Indexed: 12/20/2022]
Abstract
This study aimed to screen out differentially expressed genes (DEGs) and explore small molecule drugs for Tetralogy of Fallot (TOF). The gene expression profile of TOF GSE26125 was downloaded from the Gene Expression Omnibus database, including 16 idiopathic TOF samples and five healthy controls. The DEGs were identified by the Limma package in R language and underwent functional enrichment analysis via Database for Annotation, Visualization and Integrated Discovery tools. A protein-protein interaction (PPI) network of DEGs was then constructed and the significant clusters were selected for functional analysis. In addition, the DEGs were mapped to the connectivity map (CMap) database to identify potential small-molecule drugs. As a result, a total of 499 DEGs were selected between TOF and healthy controls. Meanwhile, the functional changes of DEGs related to TOF were mainly associated with cellular respiration and energy metabolism. Furthermore, in the PPI network, two clusters were identified via cluster 1 analysis. And only cluster 1 was significantly enriched into gene ontology terms, including respiratory chain, electron transport chain, and oxidation reduction. The hub gene of cluster 1 was NDUFAB1. Additionally, small molecules, such as harmine, solanine, and testosterone, may have the potential to repair the disordered metabolic pathways of TOF.
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Affiliation(s)
- Qiang Gu
- Institute of Cardiovascular Surgery, Second Affiliated Hospital of Third Military, Medical University, No.183 Xinqiao Street, Shapingba District, Chongqing, 400037, People's Republic of China,
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