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Wang J, Chandrasekhar V, Abbadessa G, Yu Y, Schwartz B, Kontaridis MI. In vivo efficacy of the AKT inhibitor ARQ 092 in Noonan Syndrome with multiple lentigines-associated hypertrophic cardiomyopathy. PLoS One 2017; 12:e0178905. [PMID: 28582432 PMCID: PMC5459472 DOI: 10.1371/journal.pone.0178905] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 05/19/2017] [Indexed: 11/18/2022] Open
Abstract
Noonan Syndrome with Multiple Lentigines (NSML, formerly LEOPARD syndrome) is an autosomal dominant "RASopathy" disorder manifesting in congenital heart disease. Most cases of NSML are caused by catalytically inactivating mutations in the protein tyrosine phosphatase (PTP), non-receptor type 11 (PTPN11), encoding the SH2 domain-containing PTP-2 (SHP2) protein. We previously generated knock-in mice harboring the PTPN11 mutation Y279C, one of the most common NSML alleles; these now-termed SHP2Y279C/+ mice recapitulate the human disorder and develop hypertrophic cardiomyopathy (HCM) by 12 weeks of age. Functionally, heart and/or cardiomyocyte lysates from SHP2Y279C/+ mice exhibit increased basal and agonist-induced AKT and mTOR activities. Here, we sought to determine whether we could reverse the hypertrophy in SHP2Y279C/+ mice using ARQ 092, an oral and selective allosteric AKT inhibitor currently in clinical trials for patients with PI3K/AKT-driven tumors or Proteus syndrome. We obtained echocardiographs of SHP2Y279C/+ and wildtype (SHP2+/+) littermates, either in the presence or absence of ARQ 092 at 12, 14, and 16 weeks of age. While SHP2Y279C/+ mice developed significant left ventricular hypertrophy by 12 weeks, as indicated by decreased chamber dimension and increased posterior wall thickness, treatment of SHP2Y279C/+ mice with ARQ 092 normalized the hypertrophy in as early as 2 weeks following treatment, with hearts comparable in size to those in wildtype (SHP2+/+) mice. In addition, we observed an increase in fractional shortening (FS%) in SHP2Y279C/+ mice, an effect of increased compensatory hypertrophy, which was not apparent in SHP2Y279C/+ mice treated with ARQ 092, suggesting functional improvement of HCM upon treatment with the AKT inhibitor. Finally, we found that ARQ 092 specifically inhibited AKT activity, as well as its downstream effectors, PRAS and S6RP in NSML mice. Taken together, these data suggest ARQ 092 may be a promising novel therapy for treatment of hypertrophy in NSML patients.
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Affiliation(s)
- Jianxun Wang
- Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | - Vasanth Chandrasekhar
- Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America
| | | | - Yi Yu
- ArQule, Inc., Burlington, Massachusetts, United States of America
| | - Brian Schwartz
- ArQule, Inc., Burlington, Massachusetts, United States of America
| | - Maria I Kontaridis
- Department of Medicine, Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, United States of America.,Department of Biological Chemistry and Molecular Pharmacology, Harvard Medical School, Boston, Massachusetts, United States of America
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Pablo Kaski J, Syrris P, Shaw A, Alapi KZ, Cordeddu V, Esteban MTT, Jenkins S, Ashworth M, Hammond P, Tartaglia M, McKenna WJ, Elliott PM. Prevalence of Sequence Variants in the RAS-Mitogen Activated Protein Kinase Signaling Pathway in Pre-Adolescent Children With Hypertrophic Cardiomyopathy. ACTA ACUST UNITED AC 2012; 5:317-26. [DOI: 10.1161/circgenetics.111.960468] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Background—
Most cases of apparently idiopathic hypertrophic cardiomyopathy (HCM) in children are caused by mutations in cardiac sarcomere protein genes. HCM also commonly occurs as an associated feature in some patients with disorders caused by mutations in genes encoding components of the RAS-mitogen activated protein kinase (MAPK) signaling pathway. Although diagnosis of these disorders is based on typical phenotypic features, the dysmorphic manifestations can be subtle and therefore overlooked. The aim of this study was to determine the prevalence of mutations in RAS-MAPK genes in preadolescent children with idiopathic HCM.
Methods and Results—
Seventy-eight patients diagnosed with apparently nonsyndromic HCM aged ≤13 years underwent clinical and genetic evaluation. The entire protein coding sequence of 9 genes implicated in Noonan syndrome and related conditions (
PTPN11
,
SOS1
,
HRAS
,
KRAS
,
NRAS
,
BRAF
,
RAF1
,
MAP2K1,
and
MAP2K2
), together with
CBL
(exons 8 and 9) and
SHOC2
(4A>G), were screened for mutations. Five probands (6.4%) carried novel sequence variants in
SOS1
(2 individuals),
BRAF
,
MAP2K1,
and
MAP2K2
. Structural and molecular data suggest that these variants may have functional significance. Nine cardiac sarcomere protein genes were screened also; 2 individuals also had mutations in
MYBPC.
Conclusions—
This study reports novel and potentially pathogenic sequence variants in genes of the RAS-MAPK pathway, suggesting that genetic lesions promoting signaling dysregulation through RAS contribute to disease pathogenesis or progression in children with HCM.
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Affiliation(s)
- Juan Pablo Kaski
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Petros Syrris
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Adam Shaw
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Krisztina Zuborne Alapi
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Viviana Cordeddu
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Maria Teresa Tome Esteban
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Sharon Jenkins
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Michael Ashworth
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Peter Hammond
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Marco Tartaglia
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - William J. McKenna
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
| | - Perry M. Elliott
- From the Institute of Child Health (J.P.K., P.H., W.J.M., P.M.E.), Department of Medicine (P.S., K.Z.A., W.J.M., P.M.E.), University College, London, United Kingdom; Department of Cardiology (J.P.K., M.T.T.E.), Department of Clinical Genetics (A.S.), Department of Histopathology (M.A.), Great Ormond Street Hospital, London, United Kingdom; Department of Hematology, Oncology and Molecular Medicine, Istituto Superiore di Sanità, Rome, Italy (V.C., M.T.); The Heart Hospital, University College London
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