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Wu I, Zeng A, Greer-Short A, Aycinena JA, Tefera AE, Shenwai R, Farshidfar F, Van Pell M, Xu E, Reid C, Rodriguez N, Lim B, Chung TW, Woods J, Scott A, Jones S, Dee-Hoskins C, Gutierrez CG, Madariaga J, Robinson K, Hatter Y, Butler R, Steltzer S, Ho J, Priest JR, Song X, Jing F, Green K, Ivey KN, Hoey T, Yang J, Yang ZJ. AAV9:PKP2 improves heart function and survival in a Pkp2-deficient mouse model of arrhythmogenic right ventricular cardiomyopathy. Commun Med (Lond) 2024; 4:38. [PMID: 38499690 PMCID: PMC10948840 DOI: 10.1038/s43856-024-00450-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/01/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a familial cardiac disease associated with ventricular arrhythmias and an increased risk of sudden cardiac death. Currently, there are no approved treatments that address the underlying genetic cause of this disease, representing a significant unmet need. Mutations in Plakophilin-2 (PKP2), encoding a desmosomal protein, account for approximately 40% of ARVC cases and result in reduced gene expression. METHODS Our goal is to examine the feasibility and the efficacy of adeno-associated virus 9 (AAV9)-mediated restoration of PKP2 expression in a cardiac specific knock-out mouse model of Pkp2. RESULTS We show that a single dose of AAV9:PKP2 gene delivery prevents disease development before the onset of cardiomyopathy and attenuates disease progression after overt cardiomyopathy. Restoration of PKP2 expression leads to a significant extension of lifespan by restoring cellular structures of desmosomes and gap junctions, preventing or halting decline in left ventricular ejection fraction, preventing or reversing dilation of the right ventricle, ameliorating ventricular arrhythmia event frequency and severity, and preventing adverse fibrotic remodeling. RNA sequencing analyses show that restoration of PKP2 expression leads to highly coordinated and durable correction of PKP2-associated transcriptional networks beyond desmosomes, revealing a broad spectrum of biological perturbances behind ARVC disease etiology. CONCLUSIONS We identify fundamental mechanisms of PKP2-associated ARVC beyond disruption of desmosome function. The observed PKP2 dose-function relationship indicates that cardiac-selective AAV9:PKP2 gene therapy may be a promising therapeutic approach to treat ARVC patients with PKP2 mutations.
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Affiliation(s)
- Iris Wu
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
- University of Michigan, Department of Molecular and Integrative Physiology, Ann Arbor, MI, 48109-5622, USA
| | - Aliya Zeng
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | | | | | - Anley E Tefera
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Reva Shenwai
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | | | | | - Emma Xu
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Chris Reid
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | | | - Beatriz Lim
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Tae Won Chung
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Joseph Woods
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Aquilla Scott
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Samantha Jones
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | | | | | | | - Kevin Robinson
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Yolanda Hatter
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Renee Butler
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | | | - Jaclyn Ho
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - James R Priest
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Xiaomei Song
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Frank Jing
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Kristina Green
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Kathryn N Ivey
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Timothy Hoey
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
| | - Jin Yang
- Tenaya Therapeutics, South San Francisco, CA, 94080, USA
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Ranjbarvaziri S, Zeng A, Wu I, Greer-Short A, Farshidfar F, Budan A, Xu E, Shenwai R, Kozubov M, Li C, Van Pell M, Grafton F, MacKay CE, Song X, Priest JR, Argast G, Mandegar MA, Hoey T, Yang J. Targeting HDAC6 to treat heart failure with preserved ejection fraction in mice. Nat Commun 2024; 15:1352. [PMID: 38409164 PMCID: PMC10897156 DOI: 10.1038/s41467-024-45440-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 01/22/2024] [Indexed: 02/28/2024] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) poses therapeutic challenges due to the limited treatment options. Building upon our previous research that demonstrates the efficacy of histone deacetylase 6 (HDAC6) inhibition in a genetic cardiomyopathy model, we investigate HDAC6's role in HFpEF due to their shared mechanisms of inflammation and metabolism. Here, we show that inhibiting HDAC6 with TYA-018 effectively reverses established heart failure and its associated symptoms in male HFpEF mouse models. Additionally, in male mice lacking Hdac6 gene, HFpEF progression is delayed and they are resistant to TYA-018's effects. The efficacy of TYA-018 is comparable to a sodium-glucose cotransporter 2 (SGLT2) inhibitor, and the combination shows enhanced effects. Mechanistically, TYA-018 restores gene expression related to hypertrophy, fibrosis, and mitochondrial energy production in HFpEF heart tissues. Furthermore, TYA-018 also inhibits activation of human cardiac fibroblasts and enhances mitochondrial respiratory capacity in cardiomyocytes. In this work, our findings show that HDAC6 impacts on heart pathophysiology and is a promising target for HFpEF treatment.
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Affiliation(s)
| | - Aliya Zeng
- Tenaya Therapeutics, South San Francisco, CA, USA
| | - Iris Wu
- Tenaya Therapeutics, South San Francisco, CA, USA
| | | | | | - Ana Budan
- Tenaya Therapeutics, South San Francisco, CA, USA
| | - Emma Xu
- Tenaya Therapeutics, South San Francisco, CA, USA
| | - Reva Shenwai
- Tenaya Therapeutics, South San Francisco, CA, USA
| | | | - Cindy Li
- Tenaya Therapeutics, South San Francisco, CA, USA
| | | | | | | | - Xiaomei Song
- Tenaya Therapeutics, South San Francisco, CA, USA
| | | | | | | | - Timothy Hoey
- Tenaya Therapeutics, South San Francisco, CA, USA
| | - Jin Yang
- Tenaya Therapeutics, South San Francisco, CA, USA.
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