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Hu Y, Zhang C, Wang S, Xiong H, Xie W, Zeng Z, Cai H, Wang QK, Lu Z. 14-3-3ε/YWHAE regulates the transcriptional expression of cardiac sodium channel Na V1.5. Heart Rhythm 2024; 21:2320-2329. [PMID: 38750908 DOI: 10.1016/j.hrthm.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Cardiac voltage-gated sodium channel alpha subunit 5 (NaV1.5) encoded by SCN5A is associated with arrhythmia disorders. However, the molecular mechanism underlying NaV1.5 expression remains to be fully elucidated. Previous studies have reported that the 14-3-3 family acts as an adaptor involved in regulating kinetic characteristics of cardiac ion channels. OBJECTIVE The purpose of this study was to establish 14-3-3ε/YWHAE, a member of the 14-3-3 family, as a crucial regulator of NaV1.5 and to explore the potential role of 14-3-3ε in the heart. METHODS Western blotting, patch clamping, real-time reverse transcription-polymerase chain reaction, RNA immunoprecipitation, electrocardiogram recording, echocardiography, and histologic analysis were performed. RESULTS YWHAE overexpression significantly reduced the expression level of SCN5A mRNA and sodium current density, whereas YWHAE knockdown significantly increased SCN5A mRNA expression and sodium current density in HEK293/NaV1.5 and H9c2 cells. Similar results were observed in mice injected with adeno-associated virus serotype 9-mediated YWHAE knockdown. The effect of 14-3-3ε on NaV1.5 expression was abrogated by knockdown of TBX5, a transcription factor of NaV1.5. An interaction between 14-3-3ε protein and TBX5 mRNA was identified, and YWHAE overexpression significantly decreased TBX5 mRNA stability without affecting SCN5A mRNA stability. In addition, mice subjected to adeno-associated virus serotype 9-mediated YWHAE knockdown exhibited shorter R-R intervals and higher prevalence of premature ventricular contractions. CONCLUSION Our data unveil a novel regulatory mechanism of NaV1.5 by 14-3-3ε and highlight the significance of 14-3-3ε in transcriptional regulation of NaV1.5 expression and cardiac arrhythmias.
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Affiliation(s)
- Yushuang Hu
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China; Institute of Myocardial Injury and Repair, Wuhan University, Wuhan, Hubei, PR China
| | - Chi Zhang
- Center for Human Genome Research, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Shun Wang
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China; Institute of Myocardial Injury and Repair, Wuhan University, Wuhan, Hubei, PR China
| | - Hongbo Xiong
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China; Institute of Myocardial Injury and Repair, Wuhan University, Wuhan, Hubei, PR China
| | - Wen Xie
- Department of Basic Medicine, Xiamen Medical College, Xiamen, Fujian, PR China
| | - Ziyue Zeng
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China; Institute of Myocardial Injury and Repair, Wuhan University, Wuhan, Hubei, PR China
| | - HuanHuan Cai
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China; Institute of Myocardial Injury and Repair, Wuhan University, Wuhan, Hubei, PR China
| | - Qing Kenneth Wang
- Center for Human Genome Research, Key Laboratory of Molecular Biophysics of the Ministry of Education, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Zhibing Lu
- Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, PR China; Institute of Myocardial Injury and Repair, Wuhan University, Wuhan, Hubei, PR China.
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Rinné S, Kiper AK, Jacob R, Ortiz-Bonnin B, Schindler RF, Fischer S, Komadowski M, De Martino E, Schäfer MKH, Cornelius T, Fabritz L, Helker CS, Brand T, Decher N. Popeye domain containing proteins modulate the voltage-gated cardiac sodium channel Nav1.5. iScience 2024; 27:109696. [PMID: 38689644 PMCID: PMC11059135 DOI: 10.1016/j.isci.2024.109696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/15/2023] [Accepted: 04/05/2024] [Indexed: 05/02/2024] Open
Abstract
Popeye domain containing (POPDC) proteins are predominantly expressed in the heart and skeletal muscle, modulating the K2P potassium channel TREK-1 in a cAMP-dependent manner. POPDC1 and POPDC2 variants cause cardiac conduction disorders with or without muscular dystrophy. Searching for POPDC2-modulated ion channels using a functional co-expression screen in Xenopus oocytes, we found POPDC proteins to modulate the cardiac sodium channel Nav1.5. POPDC proteins downregulate Nav1.5 currents in a cAMP-dependent manner by reducing the surface expression of the channel. POPDC2 and Nav1.5 are both expressed in different regions of the murine heart and consistently POPDC2 co-immunoprecipitates with Nav1.5 from native cardiac tissue. Strikingly, the knock-down of popdc2 in embryonic zebrafish caused an increased upstroke velocity and overshoot of cardiac action potentials. The POPDC modulation of Nav1.5 provides a new mechanism to regulate cardiac sodium channel densities under sympathetic stimulation, which is likely to have a functional impact on cardiac physiology and inherited arrhythmias.
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Affiliation(s)
- Susanne Rinné
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, 30537 Marburg, Germany
| | - Aytug K. Kiper
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, 30537 Marburg, Germany
| | - Ralf Jacob
- Institute of Cytobiology, Center for Synthetic Microbiology, Philipps-University of Marburg, 35043 Marburg, Germany
| | - Beatriz Ortiz-Bonnin
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, 30537 Marburg, Germany
| | - Roland F.R. Schindler
- National Heart and Lung Institute, Imperial College London, Du Cane Road, London W12 0NN, UK
| | - Sabine Fischer
- Faculty of Biology, Cell Signaling and Dynamics, Philipps-University Marburg, 35043 Marburg, Germany
| | - Marlene Komadowski
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, 30537 Marburg, Germany
| | - Emilia De Martino
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, 30537 Marburg, Germany
| | - Martin K.-H. Schäfer
- Institute of Anatomy and Cell Biology, Philipps-University of Marburg, 35037 Marburg, Germany
| | - Tamina Cornelius
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, 30537 Marburg, Germany
| | - Larissa Fabritz
- Institute of Cardiovascular Sciences University of Birmingham, Birmingham B15 2TT, UK
- University Center of Cardiovascular Sciences & Department of Cardiology, University Heart and Vascular Center Hamburg, University Medical Center Hamburg Eppendorf, 20251 Hamburg and DZHK Hamburg/Kiel/Lübeck, Germany
| | - Christian S.M. Helker
- Faculty of Biology, Cell Signaling and Dynamics, Philipps-University Marburg, 35043 Marburg, Germany
| | - Thomas Brand
- National Heart and Lung Institute, Imperial College London, Du Cane Road, London W12 0NN, UK
| | - Niels Decher
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, 30537 Marburg, Germany
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Cao J, Chen Q, Qiu J, Wang Y, Lan W, Du X, Tan K. NGCN: Drug-target interaction prediction by integrating information and feature learning from heterogeneous network. J Cell Mol Med 2024; 28:e18224. [PMID: 38509739 PMCID: PMC10955156 DOI: 10.1111/jcmm.18224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/14/2024] [Accepted: 02/26/2024] [Indexed: 03/22/2024] Open
Abstract
Drug-target interaction (DTI) prediction is essential for new drug design and development. Constructing heterogeneous network based on diverse information about drugs, proteins and diseases provides new opportunities for DTI prediction. However, the inherent complexity, high dimensionality and noise of such a network prevent us from taking full advantage of these network characteristics. This article proposes a novel method, NGCN, to predict drug-target interactions from an integrated heterogeneous network, from which to extract relevant biological properties and association information while maintaining the topology information. It focuses on learning the topology representation of drugs and targets to improve the performance of DTI prediction. Unlike traditional methods, it focuses on learning the low-dimensional topology representation of drugs and targets via graph-based convolutional neural network. NGCN achieves substantial performance improvements over other state-of-the-art methods, such as a nearly 1.0% increase in AUPR value. Moreover, we verify the robustness of NGCN through benchmark tests, and the experimental results demonstrate it is an extensible framework capable of combining heterogeneous information for DTI prediction.
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Affiliation(s)
- Junyue Cao
- College of Life Science and TechnologyGuangxi UniversityNanningChina
| | - Qingfeng Chen
- School of Computer, Electronics and InformationGuangxi UniversityNanningChina
| | - Junlai Qiu
- School of Computer, Electronics and InformationGuangxi UniversityNanningChina
| | - Yiming Wang
- School of Computer, Electronics and InformationGuangxi UniversityNanningChina
| | - Wei Lan
- School of Computer, Electronics and InformationGuangxi UniversityNanningChina
| | - Xiaojing Du
- School of Computer, Electronics and InformationGuangxi UniversityNanningChina
| | - Kai Tan
- School of Computer, Electronics and InformationGuangxi UniversityNanningChina
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Absolute Quantification of Nav1.5 Expression by Targeted Mass Spectrometry. Int J Mol Sci 2022; 23:ijms23084177. [PMID: 35456996 PMCID: PMC9028338 DOI: 10.3390/ijms23084177] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 11/20/2022] Open
Abstract
Nav1.5 is the pore forming α-subunit of the cardiac voltage-gated sodium channel that initiates cardiac action potential and regulates the human heartbeat. A normal level of Nav1.5 is crucial to cardiac function and health. Over- or under-expression of Nav1.5 can cause various cardiac diseases ranging from short PR intervals to Brugada syndromes. An assay that can directly quantify the protein amount in biological samples would be a priori to accurately diagnose and treat Nav1.5-associated cardiac diseases. Due to its large size (>200 KD), multipass transmembrane domains (24 transmembrane passes), and heavy modifications, Nav1.5 poses special quantitation challenges. To date, only the relative quantities of this protein have been measured in biological samples. Here, we describe the first targeted and mass spectrometry (MS)-based quantitative assay that can provide the copy numbers of Nav1.5 in cells with a well-defined lower limit of quantification (LLOQ) and precision. Applying the developed assay, we successfully quantified transiently expressed Nav1.5 in as few as 1.5 million Chinese hamster ovary (CHO) cells. The obtained quantity was 3 ± 2 fmol on the column and 3 ± 2 × 104 copies/cell. To our knowledge, this is the first absolute quantity of Nav1.5 measured in a biological sample.
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Gu XY, Jin B, Qi ZD, Yin XF. MicroRNA is a potential target for therapies to improve the physiological function of skeletal muscle after trauma. Neural Regen Res 2021; 17:1617-1622. [PMID: 34916449 PMCID: PMC8771090 DOI: 10.4103/1673-5374.330620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
MicroRNAs can regulate the function of ion channels in many organs. Based on our previous study we propose that miR-142a-39, which is highly expressed in denervated skeletal muscle, might affect cell excitability through similar mechanisms. In this study, we overexpressed or knocked down miR-142a-3p in C2C12 cells using a lentivirus method. After 7 days of differentiation culture, whole-cell currents were recorded. The results showed that overexpression of miR-142a-3p reduced the cell membrane capacitance, increased potassium current density and decreased calcium current density. Knockdown of miR-142a-3p reduced sodium ion channel current density. The results showed that change in miR-142a-3p expression affected the ion channel currents in C2C12 cells, suggesting its possible roles in muscle cell electrophysiology. This study was approved by the Animal Ethics Committee of Peking University in July 2020 (approval No. LA2017128).
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Affiliation(s)
- Xin-Yi Gu
- Department of Orthopedics and Traumatology, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration (Peking University), Beijing, China
| | - Bo Jin
- Department of Orthopedics, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province, China
| | - Zhi-Dan Qi
- Department of Orthopedics and Traumatology, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration (Peking University), Beijing, China
| | - Xiao-Feng Yin
- Department of Orthopedics and Traumatology, Peking University People's Hospital; Key Laboratory of Trauma and Neural Regeneration (Peking University), Beijing, China
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Rivaud MR, Delmar M, Remme CA. Heritable arrhythmia syndromes associated with abnormal cardiac sodium channel function: ionic and non-ionic mechanisms. Cardiovasc Res 2021; 116:1557-1570. [PMID: 32251506 PMCID: PMC7341171 DOI: 10.1093/cvr/cvaa082] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 03/01/2020] [Accepted: 04/01/2020] [Indexed: 12/19/2022] Open
Abstract
The cardiac sodium channel NaV1.5, encoded by the SCN5A gene, is responsible for the fast upstroke of the action potential. Mutations in SCN5A may cause sodium channel dysfunction by decreasing peak sodium current, which slows conduction and facilitates reentry-based arrhythmias, and by enhancing late sodium current, which prolongs the action potential and sets the stage for early afterdepolarization and arrhythmias. Yet, some NaV1.5-related disorders, in particular structural abnormalities, cannot be directly or solely explained on the basis of defective NaV1.5 expression or biophysics. An emerging concept that may explain the large disease spectrum associated with SCN5A mutations centres around the multifunctionality of the NaV1.5 complex. In this alternative view, alterations in NaV1.5 affect processes that are independent of its canonical ion-conducting role. We here propose a novel classification of NaV1.5 (dys)function, categorized into (i) direct ionic effects of sodium influx through NaV1.5 on membrane potential and consequent action potential generation, (ii) indirect ionic effects of sodium influx on intracellular homeostasis and signalling, and (iii) non-ionic effects of NaV1.5, independent of sodium influx, through interactions with macromolecular complexes within the different microdomains of the cardiomyocyte. These indirect ionic and non-ionic processes may, acting alone or in concert, contribute significantly to arrhythmogenesis. Hence, further exploration of these multifunctional effects of NaV1.5 is essential for the development of novel preventive and therapeutic strategies.
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Affiliation(s)
- Mathilde R Rivaud
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam Cardiovascular Sciences, Meigberdreef 15, 1105AZ Amsterdam, The Netherlands
| | - Mario Delmar
- The Leon H. Charney Division of Cardiology, New York University School of Medicine, 435 E 30th St, NSB 707, New York, NY 10016, USA
| | - Carol Ann Remme
- Department of Clinical and Experimental Cardiology, Heart Center, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam Cardiovascular Sciences, Meigberdreef 15, 1105AZ Amsterdam, The Netherlands
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7
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Doisne N, Grauso M, Mougenot N, Clergue M, Souil C, Coulombe A, Guicheney P, Neyroud N. In vivo Dominant-Negative Effect of an SCN5A Brugada Syndrome Variant. Front Physiol 2021; 12:661413. [PMID: 34122134 PMCID: PMC8195286 DOI: 10.3389/fphys.2021.661413] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 04/21/2021] [Indexed: 12/23/2022] Open
Abstract
Loss-of-function mutations in the cardiac Na+ channel α-subunit Nav1.5, encoded by SCN5A, cause Brugada syndrome (BrS), a hereditary disease characterized by sudden cardiac death due to ventricular fibrillation. We previously evidenced in vitro the dominant-negative effect of the BrS Nav1.5-R104W variant, inducing retention of wild-type (WT) channels and leading to a drastic reduction of the resulting Na+ current (INa). To explore this dominant-negative effect in vivo, we created a murine model using adeno-associated viruses (AAVs).
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Affiliation(s)
- Nicolas Doisne
- INSERM, UMR_S 1166 ICAN, Paris, France.,UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Marta Grauso
- INSERM, UMR_S 1166 ICAN, Paris, France.,UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Nathalie Mougenot
- INSERM, UMR_S 1166 ICAN, Paris, France.,UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France.,UMS_28, Sorbonne Université, Paris, France
| | - Michel Clergue
- INSERM, UMR_S 1166 ICAN, Paris, France.,UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Charlotte Souil
- INSERM, UMR_S 1166 ICAN, Paris, France.,UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Alain Coulombe
- INSERM, UMR_S 1166 ICAN, Paris, France.,UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Pascale Guicheney
- INSERM, UMR_S 1166 ICAN, Paris, France.,UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
| | - Nathalie Neyroud
- INSERM, UMR_S 1166 ICAN, Paris, France.,UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, Sorbonne Université, Paris, France
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Nam JM, Lim JE, Ha TW, Oh B, Kang JO. Cardiac-specific inactivation of Prdm16 effects cardiac conduction abnormalities and cardiomyopathy-associated phenotypes. Am J Physiol Heart Circ Physiol 2020; 318:H764-H777. [PMID: 32083975 DOI: 10.1152/ajpheart.00647.2019] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A variant in the PRDM16 locus has been correlated with QRS duration in an electrocardiogram genome-wide association study, and the deletion of PRDM16 has been implicated as a causal factor of the dilated cardiomyopathy that is linked to 1p36 deletion syndrome. We aimed to determine how a null mutation of Prdm16 affects cardiac function and study the underlying mechanism of the resulting phenotype in an appropriate mouse model. We used cardiac-specific Prdm16 conditional knockout mice to examine cardiac function by electrocardiography. QRS duration and QTc interval increased significantly in cardiac-specific Prdm16 knockout animals compared with wild-type mice. Further, we assessed cardiomyopathy-associated features by trichrome staining, densitometry, and hydroxyproline assay. Prdm16-null hearts showed greater fibrosis and cardiomyocyte hypertrophy. By quantitative real-time PCR, Prdm16-null hearts upregulated extracellular matrix-related genes (Ctgf, Timp1) and α-smooth muscle actin (Acta2), a myofibroblast marker. Moreover, TGF-β signaling was activated in Prdm16-null hearts, as evidenced by increased Tgfb1-3 transcript levels and phosphorylated Smad2. However, the inhibition of TGF-β receptor did not reverse the aberrations in conduction in cardiac-specific Prdm16 knockout mice. To determine the underlying mechanisms, we performed RNA-seq using mouse left ventricular tissue. By functional analysis, Prdm16-null hearts experienced dysregulated expression of ion channel genes, including Kcne1, Scn5a, Cacna1h, and Cacna2d2. Mice with Prdm16-null hearts develop abnormalities in cardiac conduction and cardiomyopathy-associated phenotypes, including fibrosis and cellular hypertrophy. Further, the RNA-seq findings suggest that impairments in ion homeostasis (Ca2+, K+, and Na+) may at least partially underlie the abnormal conduction in cardiac-specific Prdm16 knockout mice.NEW & NOTEWORTHY This is the first study that describes aberrant cardiac function and cardiomyopathy-associated phenotypes in an appropriate murine genetic model with cardiomyocyte-specific Prdm16-null mutation. It is noteworthy that the correlation of PRDM16 with QRS duration is replicated in a murine animal model and the potential underlying mechanism may be the impairment of ion homeostasis.
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Affiliation(s)
- Jeong Min Nam
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Ji Eun Lim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Tae Woong Ha
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Bermseok Oh
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Ji-One Kang
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, Korea
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Abstract
The rate and rhythm of heart muscle contractions are coordinated by the cardiac conduction system (CCS), a generic term for a collection of different specialized muscular tissues within the heart. The CCS components initiate the electrical impulse at the sinoatrial node, propagate it from atria to ventricles via the atrioventricular node and bundle branches, and distribute it to the ventricular muscle mass via the Purkinje fibre network. The CCS thereby controls the rate and rhythm of alternating contractions of the atria and ventricles. CCS function is well conserved across vertebrates from fish to mammals, although particular specialized aspects of CCS function are found only in endotherms (mammals and birds). The development and homeostasis of the CCS involves transcriptional and regulatory networks that act in an embryonic-stage-dependent, tissue-dependent, and dose-dependent manner. This Review describes emerging data from animal studies, stem cell models, and genome-wide association studies that have provided novel insights into the transcriptional networks underlying CCS formation and function. How these insights can be applied to develop disease models and therapies is also discussed.
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