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Odogwu NM, Hagen C, Nelson TJ. Transcriptome studies of congenital heart diseases: identifying current gaps and therapeutic frontiers. Front Genet 2023; 14:1278747. [PMID: 38152655 PMCID: PMC10751320 DOI: 10.3389/fgene.2023.1278747] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/16/2023] [Indexed: 12/29/2023] Open
Abstract
Congenital heart disease (CHD) are genetically complex and comprise a wide range of structural defects that often predispose to - early heart failure, a common cause of neonatal morbidity and mortality. Transcriptome studies of CHD in human pediatric patients indicated a broad spectrum of diverse molecular signatures across various types of CHD. In order to advance research on congenital heart diseases (CHDs), we conducted a detailed review of transcriptome studies on this topic. Our analysis identified gaps in the literature, with a particular focus on the cardiac transcriptome signatures found in various biological specimens across different types of CHDs. In addition to translational studies involving human subjects, we also examined transcriptomic analyses of CHDs in a range of model systems, including iPSCs and animal models. We concluded that RNA-seq technology has revolutionized medical research and many of the discoveries from CHD transcriptome studies draw attention to biological pathways that concurrently open the door to a better understanding of cardiac development and related therapeutic avenue. While some crucial impediments to perfectly studying CHDs in this context remain obtaining pediatric cardiac tissue samples, phenotypic variation, and the lack of anatomical/spatial context with model systems. Combining model systems, RNA-seq technology, and integrating algorithms for analyzing transcriptomic data at both single-cell and high throughput spatial resolution is expected to continue uncovering unique biological pathways that are perturbed in CHDs, thus facilitating the development of novel therapy for congenital heart disease.
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Affiliation(s)
- Nkechi Martina Odogwu
- Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN, United States
| | - Clinton Hagen
- Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN, United States
| | - Timothy J. Nelson
- Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN, United States
- Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, United States
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN, United States
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN, United States
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States
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Morgan KM, Deshler LN, Nelson TJ, Sabater-Minarim D, Duran EAM, Banegas M, Anger J, Rose BS. Association of Transgender or Gender Non-Binary Identity on Disease Characteristics and Survival Outcomes in Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e420-e421. [PMID: 37785384 DOI: 10.1016/j.ijrobp.2023.06.1575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) While it is becoming increasingly common for people to identify as transgender or gender-non-binary, our understanding of the influence of gender identity on disease severity of hormone-sensitive malignancies, including prostate cancer (PC) is limited. The goal of this study is to compare the aggressiveness of disease and survival outcomes between transgender or gender non-binary (TG) and cis-gender (CG) patients with PC. MATERIALS/METHODS The cohort included patients diagnosed with PC between 1999 and 2022 within the Veterans Health Administration (VHA) Database. TG patients were identified with an ICD 9 or 10 diagnosis code that occurred prior to PC diagnosis. Treatment information and baseline disease characteristics were ascertained through the VHA electronic health records. Multivariable logistic regressions were performed to estimate the association between TG status and presenting with Gleason > = 8, PSA > 20 ng/mL, and metastatic disease at diagnosis. Covariates in these models included age at diagnosis, race, ethnicity, marital status, and smoking status. Metastases were identified through natural language processing from cancer or radiology documents. Time to metastases was defined as the time from PC diagnosis to metastases, with other causes of death considered as competing risks. The association between TG identity status and metastatic disease was calculated with a Cox regression model. The difference in overall survival was assessed with the Kaplan-Meier method and log-rank test. RESULTS The final cohort was composed of 282,264 individuals, 219 (0.08%) of which were identified as TG. TG patients have similar odds of presenting with presenting with Gleason Score ≥8 (Odds Ratio (OR) 1.18, p = 0.31), PSA >20 ng/mL (OR 0.78, p = 0.59), and metastasis at diagnosis (OR 0.47, p = 0.29). There were 34,918 patients who develop metastatic disease at any time, 24 of which were TG. The 10-year cumulative incidence of metastases for TG and CG individuals was 11.5% (95% Confidence Interval (CI): 6.6-16.1%) and 13.9% (CI: 13.7-14.0%), respectively. There was no significant difference between TG status and risk of developing metastases (Hazard Ratio (HR) 0.93, p = 0.71). The 10-year overall survival for TG and CG was 73.4% (CI: 66.5-80.9%) and 65.0% (CI: 64.8-65.2%), respectively. There was no significant difference between TG status and overall survival (Hazard Ratio (HR) 0.83, p = 0.13). CONCLUSION TG individuals do not appear to have a difference in disease characteristics at diagnosis or survival compared to CG individuals. Future research should be done to determine the effect of gender affirming treatment on these outcomes. Furthermore, it is unclear if diagnosis codes are accurately identifying TG individuals.
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Affiliation(s)
- K M Morgan
- UCSD Health, Department of Radiation Medicine and Applied Sciences, La Jolla, CA; VA San Diego Health Care System, La Jolla, CA
| | - L N Deshler
- VA San Diego Health Care System, La Jolla, CA; UCSD Health, Department of Radiation Medicine and Applied Science, La Jolla, CA
| | - T J Nelson
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - D Sabater-Minarim
- UCSD Health, Department of Radiation Medicine and Applied Science, La Jolla, CA
| | - E A M Duran
- VA San Diego Health Care System, La Jolla, CA; UCSD Health, Department of Radiation Medicine and Applied Science, La Jolla, CA
| | - M Banegas
- UCSD Health, Department of Radiation Medicine and Applied Science, La Jolla, CA
| | - J Anger
- UCSD Department of Urology, La Jolla, CA
| | - B S Rose
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
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Liu HC, Morse R, Nelson TJ, Williamson CW, Vitzthum L, Zakeri K, Henderson G, Thompson CA, Zou J, Gillison M, Mell LK. Effectiveness of Cisplatin in P16+ Oropharyngeal Cancer According to Relative Risk for Cancer Events: Ancillary Analysis of RTOG 1016. Int J Radiat Oncol Biol Phys 2023; 117:S69. [PMID: 37784554 DOI: 10.1016/j.ijrobp.2023.06.375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) To test the hypothesis that the effectiveness of cisplatin in p16+ oropharyngeal squamous cell carcinoma (OPSCC) increases with patients' relative risk for cancer events. MATERIALS/METHODS Ancillary analysis of 805 patients enrolled on RTOG 1016 accessed via Project DataSphere. Eligible patients had p16+ OPSCC, AJCC 7th T1-T2 N2a-N3 or T3-T4 N0-N3 M0, ECOG PS 0-1. Patients were randomized to RT with concurrent cisplatin vs. cetuximab. Relative risk for competing events was quantified using the Head and Neck Cancer Intergroup predictive classifier (omega score). Higher scores indicate higher relative risk for cancer events (LRF or distant metastasis) vs. competing mortality. We compared this to favorable, unfavorable/low, and unfavorable/intermediate risk groups using standard criteria: NRG HN005 eligible/low RTOG risk (Ang et al.), HN005 ineligible/low RTOG risk, and intermediate RTOG risk. Omega score cutoffs were selected to match numbers in standard risk strata. HRs for the effect of cisplatin vs. cetuximab on PFS and OS were compared for standard vs. relative risk strata. 1-tailed interaction tests were used to test whether cisplatin effectiveness increased within risk strata. RESULTS There were 354, 219, and 232 patients in standard favorable, unfavorable/low, and unfavorable/intermediate risk groups. Omega score cutoffs were 0.80 and 0.84 to define low, intermediate, and high relative risk groups. Discordant standard vs. relative risk classifications occurred in 559 patients (69.4%). Increasing omega score was associated with significantly higher relative HR (rHR) for cancer events (3.40, 95% CI: 1.66-6.96) and increasing effectiveness of cisplatin vs. cetuximab (Table), but standard risk grouping was not (rHR 0.80, 95% CI: 0.49-1.32). The effect of cisplatin on PFS significantly increased with higher omega score (interaction -0.30, p = .046), but decreased with increasing standard risk strata (interaction +0.27, p = NS). CONCLUSION The effectiveness of cisplatin in p16+ OPSCC increased with higher omega score but not with standard risk group. Relative risk for cancer events should be taken into account when designing deintensification strategies.
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Affiliation(s)
- H C Liu
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - R Morse
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - T J Nelson
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - C W Williamson
- UCSD Radiation Oncology and Applied Medicine, La Jolla, CA
| | - L Vitzthum
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - K Zakeri
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
| | - G Henderson
- University of California San Diego, Department of Radiation Medicine & Applied Sciences, La Jolla, CA
| | - C A Thompson
- University of North Carolina, Department of Epidemiology, Chapel Hill, NC
| | - J Zou
- Department of Family Medicine and Public Health and Department of Mathematics, University of California San Diego, La Jolla, CA
| | - M Gillison
- The University of Texas MD Anderson Cancer Center, Houston, TX
| | - L K Mell
- University of California San Diego, La Jolla, CA
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Morse R, Nelson TJ, Liu HC, Williamson CW, Sacco A, Chitti BS, Henderson G, Todd J, Chen X, Gan GN, Rahn D, Sharabi A, Thompson CA, Zou J, Lominska CE, Shen C, Chera BS, Mell LK. Comparison of Standard vs. Relative Risk Models to Define Candidates for Deintensification in Locoregionally Advanced P16+ Oropharyngeal Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e608-e609. [PMID: 37785830 DOI: 10.1016/j.ijrobp.2023.06.1979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Various methods to identify candidates for treatment deintensification with p16+ oropharyngeal squamous cell carcinoma (OPSCC) have been used, but the optimal approach is unknown. MATERIALS/METHODS Multi-institutional cohort study of 385 patients with previously untreated p16+ OPSCC undergoing definitive radiotherapy (RT) with or without systemic therapy between 2009-2020. Chemotherapy intensity was categorized as high (bolus cisplatin and/or induction chemotherapy), medium (weekly cisplatin), or low (non-cisplatin or RT alone). Standard favorable vs. unfavorable risk was defined using NRG HN005 eligibility criteria. High vs. low relative risk (RR) group was defined using the HNCIG omega score (≥ 0.80 vs. < 0.80), which quantifies the proportion of a patient's overall event risk due to cancer. We used multivariable ordinal logistic regression to estimate effects of age (yrs), sex, performance status (PS), Charlson comorbidity index (CCI), T/N (AJCC 8th), current smoking, and pack-years (> 10 vs. ≤ 10) on treatment allocation. Effects on relative event hazards were estimated using generalized competing event regression. RESULTS Median follow-up time was 44.2 months. Chemotherapy intensity was high in 206 (54%), medium in 108 (28%), and low in 71 (18%). 280 patients (73%) were unfavorable risk and 197 (51%) were high RR. 178 patients (46%) had discordant risk classification. On univariable analysis, significant predictors of higher intensity chemotherapy (normalized odds ratio (OR)) were CCI 0-1 (OR 1.49, 95% CI: 1.23-1.79), high omega score (OR 1.46; 1.20-1.77), decreased age (OR 1.43; 1.18-1.74), and PS 0 (OR 1.22; 1.01-1.48). Controlling for CCI, higher omega score was associated with significantly higher odds of intensive chemotherapy (OR 1.35; 1.10-1.65, but unfavorable risk (HN005 ineligibility) was not (OR 1.19; 0.98-1.44). Higher omega score was also associated with significantly higher RR for cancer recurrence (Rec) vs. competing mortality (CM) events (relative HR (rHR) 1.76; 1.12-2.75), but unfavorable risk was not (rHR 1.05; 0.63-1.75). Among patients receiving cisplatin, 50 favorable risk patients (58%) had high RR; all of their event risk was due to cancer recurrence (Table). The 110 unfavorable risk patients (48%) with low omega score had significantly lower RR for cancer events compared to the high omega score group (rHR 0.49; 0.29-0.84). CONCLUSION Many patients with favorable risk p16+ OPSCC have high relative risk for cancer events, which correlates with a benefit of intensive treatment. The HNCIG omega score is a strong predictor of allocation to intensive chemotherapy and may help identify candidates for deintensification.
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Affiliation(s)
- R Morse
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - T J Nelson
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - H C Liu
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - C W Williamson
- UCSD Radiation Oncology and Applied Medicine, La Jolla, CA
| | - A Sacco
- University of California San Diego, San Diego
| | - B S Chitti
- Northwell Health Cancer Institute, Lake Success, NY
| | - G Henderson
- University of California San Diego, Department of Radiation Medicine & Applied Sciences, La Jolla, CA
| | - J Todd
- Yale University, New Haven, CT
| | - X Chen
- Department of Radiation Oncology, University of North Carolina School of Medicine, Chapel Hill, NC
| | - G N Gan
- Department of Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS
| | - D Rahn
- University of California San Diego, Department of Radiation Medicine & Applied Sciences, La Jolla, CA
| | - A Sharabi
- UC San Diego, Moores Cancer Center, Department of Radiation Medicine and Applied Sciences, La Jolla, CA
| | - C A Thompson
- University of North Carolina, Department of Epidemiology, Chapel Hill, NC
| | - J Zou
- Department of Family Medicine and Public Health and Department of Mathematics, University of California San Diego, La Jolla, CA
| | - C E Lominska
- Department of Radiation Oncology, University of Kansas School of Medicine, Kansas City, KS
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - B S Chera
- Department of Radiation Oncology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - L K Mell
- University of California San Diego, La Jolla, CA
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Duran EAM, Morgan KM, Deshler LN, Nelson TJ, Sabater-Minarim D, Guram K, Banegas M, Rose BS. Association between National Area Deprivation Index Rank on Disease Characteristics in Prostate Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e380. [PMID: 37785287 DOI: 10.1016/j.ijrobp.2023.06.2490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Social determinants of health (SDH) play a large role in an individual's health; in recent years, there has been a push to examine the impact of one's neighborhood or "place." Previous studies have showed that living in a disadvantage neighborhood is associated with worth health outcomes. We hypothesize that equal access care will diminish the effects of living in a disadvantaged neighborhood. MATERIALS/METHODS We identified non-Hispanic African American (AA) and White (NHW) men diagnosed with PC between 2012 and 2015 in the Veterans Health Administration (VHA). Patient SDH was measured using census tract level 2015 Area Deprivation Index (ADI) information. The ADI is a composite measure that includes factor such as housing quality, income, health care access etc. We measured both National and State ADI rank as a continuous variable from 1 to 10 with 10 being highest deprivation. Patient information was gathered at the census tract level while ADI is assigned at the census block group. In order to get all information on the same geographic level, we averaged the ADI to its corresponding census tract. Associations between ADI and disease characteristics at diagnosis were measured using multivariable logistic regression models including age, race, and marital status as covariates. RESULTS The final cohort was composed of 25,222 men (8,384 AA and 16,838 NHW.) At the national level, there was no significant association between ADI and Gleason Score ≥8 (Odds Rations (OR) 0.99 [95% Confidence Interval (CI):0.98 - 1.00]), PSA >20 ng/mL (OR 0.99 [95% CI: 0.98 - 1.01]), and metastasis at diagnosis (OR 1.01 [CI: 0.98-1.04]). CONCLUSION Our results are consistent with our hypothesis that equal access care diminishes the impacts of living within a disadvantaged neighborhood. Future research should investigate the interaction between health care access and social and demographic factors.
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Affiliation(s)
- E A M Duran
- VA San Diego Health Care System, La Jolla, CA; Department of Radiation Medicine and Applied Sciences, UC San Diego, La Jolla, CA
| | - K M Morgan
- UCSD Center for Health Equity, Education, and Research, La Jolla, CA
| | - L N Deshler
- UCSD Center for Health Equity, Education, and Research, La Jolla, CA
| | - T J Nelson
- Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, CA
| | - D Sabater-Minarim
- UCSD Health, Department of Radiation Medicine and Applied Science, La Jolla, CA
| | - K Guram
- University of California, San Diego Moores Cancer Center, La Jolla, CA
| | - M Banegas
- UCSD Health, Department of Radiation Medicine and Applied Science, La Jolla, CA
| | - B S Rose
- UCSD Center for Health Equity, Education, and Research, La Jolla, CA
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Birker K, Ge S, Kirkland NJ, Theis JL, Marchant J, Fogarty ZC, Missinato MA, Kalvakuri S, Grossfeld P, Engler AJ, Ocorr K, Nelson TJ, Colas AR, Olson TM, Vogler G, Bodmer R. Mitochondrial MICOS complex genes, implicated in hypoplastic left heart syndrome, maintain cardiac contractility and actomyosin integrity. eLife 2023; 12:e83385. [PMID: 37404133 PMCID: PMC10361721 DOI: 10.7554/elife.83385] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 07/04/2023] [Indexed: 07/06/2023] Open
Abstract
Hypoplastic left heart syndrome (HLHS) is a severe congenital heart disease (CHD) with a likely oligogenic etiology, but our understanding of the genetic complexities and pathogenic mechanisms leading to HLHS is limited. We therefore performed whole genome sequencing (WGS) on a large cohort of HLHS patients and their families to identify candidate genes that were then tested in Drosophila heart model for functional and structural requirements. Bioinformatic analysis of WGS data from an index family comprised of a HLHS proband born to consanguineous parents and postulated to have a homozygous recessive disease etiology, prioritized 9 candidate genes with rare, predicted damaging homozygous variants. Of the candidate HLHS gene homologs tested, cardiac-specific knockdown (KD) of mitochondrial MICOS complex subunit Chchd3/6 resulted in drastically compromised heart contractility, diminished levels of sarcomeric actin and myosin, reduced cardiac ATP levels, and mitochondrial fission-fusion defects. Interestingly, these heart defects were similar to those inflicted by cardiac KD of ATP synthase subunits of the electron transport chain (ETC), consistent with the MICOS complex's role in maintaining cristae morphology and ETC complex assembly. Analysis of 183 genomes of HLHS patient-parent trios revealed five additional HLHS probands with rare, predicted damaging variants in CHCHD3 or CHCHD6. Hypothesizing an oligogenic basis for HLHS, we tested 60 additional prioritized candidate genes in these cases for genetic interactions with Chchd3/6 in sensitized fly hearts. Moderate KD of Chchd3/6 in combination with Cdk12 (activator of RNA polymerase II), RNF149 (goliath, gol, E3 ubiquitin ligase), or SPTBN1 (β Spectrin, β-Spec, scaffolding protein) caused synergistic heart defects, suggesting the potential involvement of a diverse set of pathways in HLHS. Further elucidation of novel candidate genes and genetic interactions of potentially disease-contributing pathways is expected to lead to a better understanding of HLHS and other CHDs.
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Affiliation(s)
- Katja Birker
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Shuchao Ge
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Natalie J Kirkland
- Department of Bioengineering, University of California, San Diego, San Diego, United States
| | - Jeanne L Theis
- Cardiovascular Genetics Research Laboratory, Mayo Clinic, Rochester, United States
| | - James Marchant
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Zachary C Fogarty
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, United States
| | - Maria A Missinato
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Sreehari Kalvakuri
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Paul Grossfeld
- Department of Pediatrics, University of California, San Diego, San Diego, United States
| | - Adam J Engler
- Department of Bioengineering, University of California, San Diego, San Diego, United States
| | - Karen Ocorr
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Timothy J Nelson
- Center for Regenerative Medicine, Mayo Clinic, Rochester, United States
| | - Alexandre R Colas
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Timothy M Olson
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, United States
| | - Georg Vogler
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
| | - Rolf Bodmer
- Development, Aging and Regeneration Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, United States
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Clemens DJ, Ye D, Zhou W, Kim CSJ, Pease DR, Navaratnarajah CK, Barkhymer A, Tester DJ, Nelson TJ, Cattaneo R, Schneider JW, Ackerman MJ. SARS-CoV-2 spike protein-mediated cardiomyocyte fusion may contribute to increased arrhythmic risk in COVID-19. PLoS One 2023; 18:e0282151. [PMID: 36888581 PMCID: PMC9994677 DOI: 10.1371/journal.pone.0282151] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 02/07/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND SARS-CoV-2-mediated COVID-19 may cause sudden cardiac death (SCD). Factors contributing to this increased risk of potentially fatal arrhythmias include thrombosis, exaggerated immune response, and treatment with QT-prolonging drugs. However, the intrinsic arrhythmic potential of direct SARS-CoV-2 infection of the heart remains unknown. OBJECTIVE To assess the cellular and electrophysiological effects of direct SARS-CoV-2 infection of the heart using human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs). METHODS hiPSC-CMs were transfected with recombinant SARS-CoV-2 spike protein (CoV-2 S) or CoV-2 S fused to a modified Emerald fluorescence protein (CoV-2 S-mEm). Cell morphology was visualized using immunofluorescence microscopy. Action potential duration (APD) and cellular arrhythmias were measured by whole cell patch-clamp. Calcium handling was assessed using the Fluo-4 Ca2+ indicator. RESULTS Transfection of hiPSC-CMs with CoV-2 S-mEm produced multinucleated giant cells (syncytia) displaying increased cellular capacitance (75±7 pF, n = 10 vs. 26±3 pF, n = 10; P<0.0001) consistent with increased cell size. The APD90 was prolonged significantly from 419±26 ms (n = 10) in untransfected hiPSC-CMs to 590±67 ms (n = 10; P<0.05) in CoV-2 S-mEm-transfected hiPSC-CMs. CoV-2 S-induced syncytia displayed delayed afterdepolarizations, erratic beating frequency, and calcium handling abnormalities including calcium sparks, large "tsunami"-like waves, and increased calcium transient amplitude. After furin protease inhibitor treatment or mutating the CoV-2 S furin cleavage site, cell-cell fusion was no longer evident and Ca2+ handling returned to normal. CONCLUSION The SARS-CoV-2 spike protein can directly perturb both the cardiomyocyte's repolarization reserve and intracellular calcium handling that may confer the intrinsic, mechanistic substrate for the increased risk of SCD observed during this COVID-19 pandemic.
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Affiliation(s)
- Daniel J. Clemens
- Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, United States of America
| | - Dan Ye
- Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, United States of America
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, MN, United States of America
| | - Wei Zhou
- Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, United States of America
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, MN, United States of America
| | - C. S. John Kim
- Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, United States of America
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, MN, United States of America
| | - David R. Pease
- Discovery Engine/Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN, United States of America
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN, United States of America
| | | | - Alison Barkhymer
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - David J. Tester
- Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, United States of America
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, MN, United States of America
| | - Timothy J. Nelson
- Discovery Engine/Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN, United States of America
- Wanek Family Program for HLHS-Stem Cell Pipeline, Mayo Clinic, Rochester, MN, United States of America
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Roberto Cattaneo
- Department of Molecular Medicine, Mayo Clinic, Rochester, MN, United States of America
| | - Jay W. Schneider
- Discovery Engine/Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN, United States of America
| | - Michael J. Ackerman
- Department of Molecular Pharmacology & Experimental Therapeutics, Windland Smith Rice Sudden Death Genomics Laboratory, Mayo Clinic, Rochester, MN, United States of America
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Windland Smith Rice Genetic Heart Rhythm Clinic, Mayo Clinic, Rochester, MN, United States of America
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, United States of America
- * E-mail:
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Minter-Dykhouse K, Nelson TJ, Folmes CD. Uncoupling of Proliferative Capacity from Developmental Stage During Directed Cardiac Differentiation of Pluripotent Stem Cells. Stem Cells Dev 2022; 31:521-528. [PMID: 35726436 PMCID: PMC9641990 DOI: 10.1089/scd.2022.0041] [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: 02/02/2022] [Accepted: 06/17/2022] [Indexed: 11/13/2022] Open
Abstract
Lineage-specific differentiation of human-induced pluripotent stem cells (hiPSCs) into cardiomyocytes (CMs) offers a patient-specific model to dissect development and disease pathogenesis in a dish. However, challenges exist with this model system, such as the relative immaturity of iPSC-derived CMs, which evoke the question of whether this model faithfully recapitulates in vivo cardiac development. As in vivo cardiac developmental stage is intimately linked with the proliferative capacity (or maturation is inversely correlated to proliferative capacity), we sought to understand how proliferation is regulated during hiPSC CM differentiation and how it compares with in vivo mouse cardiac development. Using standard Chemically Defined Media 3 differentiation, gene expression profiles demonstrate that hiPSC-derived cardiomyocytes (hiPSC-CMs) do not progress past the equivalent of embryonic day 14.5 of murine cardiac development. Throughout differentiation, overall DNA synthesis rapidly declines with <5% of hiPSC-CMs actively synthesizing DNA at the end of the differentiation period despite their immaturity. Bivariate cell cycle analysis demonstrated that hiPSC-CMs have a cell cycle profile distinct from their non-cardiac counterparts from the same differentiation, with significantly fewer cells within G1 and a marked accumulation of cells in G2/M than their non-cardiac counterparts throughout differentiation. Pulse-chase analysis demonstrated that non-cardiac cells progressed completely through the cell cycle within a 24-h period, whereas hiPSC-CMs had restricted progression with only a small proportion of cells undergoing cytokinesis with the remainder stalling in late S-phase or G2/M. This cell cycle arrest phenotype is associated with abbreviated expression of cell cycle promoting genes compared with expression throughout murine embryonic cardiac development. In summary, directed differentiation of hiPSCs into CMs uncouples the developmental stage from cell cycle regulation compared with in vivo mouse cardiac development, leading to a premature exit of hiPSC-CMs from the cell cycle despite their relative immaturity.
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Affiliation(s)
- Katherine Minter-Dykhouse
- Stem Cell and Regenerative Metabolism Laboratory, Departments of Cardiovascular Diseases, Biochemistry and Molecular Biology, and Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Scottsdale, Arizona, USA
| | - Timothy J. Nelson
- Todd and Karen Wanek Family Program for Hypoplastic Left Heart Syndrome, Departments of General Internal Medicine and Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Clifford D.L. Folmes
- Address correspondence to: Clifford D. L. Folmes, PhD, Stem Cell and Regenerative Metabolism Laboratory, Departments of Cardiovascular Diseases, Biochemistry and Molecular Biology, Mayo Clinic, 13400 E Shea Boulevard, Scottsdale, AZ 85259, USA
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9
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Yu Z, Zhou X, Liu Z, Pastrana-Gomez V, Liu Y, Guo M, Tian L, Nelson TJ, Wang N, Mital S, Chitayat D, Wu JC, Rabinovitch M, Wu SM, Snyder MP, Miao Y, Gu M. KMT2D-NOTCH Mediates Coronary Abnormalities in Hypoplastic Left Heart Syndrome. Circ Res 2022; 131:280-282. [PMID: 35762338 DOI: 10.1161/circresaha.122.320783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Zhiyun Yu
- Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., M.G., Y.M., M.G.).,Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., Y.M., M.G.).,University of Cincinnati School of Medicine, OH (Z.Y., M.G., Y.M., M.G.)
| | - Xin Zhou
- Department of Genetics, Stanford School of Medicine, CA. (X.Z., M.P.S.).,Cardiovascular Institute, Stanford School of Medicine, CA. (X.Z., Y.L., L.T., J.C.W., M.R., S.M.W., Y.M., M.G.)
| | - Ziyi Liu
- Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., M.G., Y.M., M.G.).,Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., Y.M., M.G.)
| | - Victor Pastrana-Gomez
- Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., M.G., Y.M., M.G.).,Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., Y.M., M.G.)
| | - Yu Liu
- Cardiovascular Institute, Stanford School of Medicine, CA. (X.Z., Y.L., L.T., J.C.W., M.R., S.M.W., Y.M., M.G.).,Department of Medicine, Division of Cardiovascular Medicine, Stanford School of Medicine, CA. (Y.L., J.C.W., S.M.W.)
| | - Minzhe Guo
- Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., M.G., Y.M., M.G.).,University of Cincinnati School of Medicine, OH (Z.Y., M.G., Y.M., M.G.)
| | - Lei Tian
- Cardiovascular Institute, Stanford School of Medicine, CA. (X.Z., Y.L., L.T., J.C.W., M.R., S.M.W., Y.M., M.G.)
| | - Timothy J Nelson
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN. (T.J.N.).,Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN. (T.J.N.).,General Internal Medicine and Transplant Center, Department of Internal Medicine, Mayo Clinic, Rochester, MN. (T.J.N.).,Center for Regenerative Medicine, Mayo Clinic, Rochester, MN. (T.J.N.)
| | - Nian Wang
- Department of Radiology and Imaging Sciences, Indiana University, Indianapolis. (N.W.).,Stark Neurosciences Research Institute, Indiana University, Indianapolis. (N.W.)
| | - Seema Mital
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, ON, Canada. (S.M.)
| | - David Chitayat
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, ON, Canada. (D.C.).,The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, ON, Canada. (D.C.)
| | - Joseph C Wu
- Cardiovascular Institute, Stanford School of Medicine, CA. (X.Z., Y.L., L.T., J.C.W., M.R., S.M.W., Y.M., M.G.).,Department of Medicine, Division of Cardiovascular Medicine, Stanford School of Medicine, CA. (Y.L., J.C.W., S.M.W.).,Institute for Stem Cell Biology and Regenerative Medicine, Stanford School of Medicine, CA. (J.C.W., S.M.W.).,Department of Radiology, Stanford School of Medicine, CA. (J.C.W.)
| | - Marlene Rabinovitch
- Cardiovascular Institute, Stanford School of Medicine, CA. (X.Z., Y.L., L.T., J.C.W., M.R., S.M.W., Y.M., M.G.).,Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, CA. (M.R., S.M.W., Y.M., M.G.)
| | - Sean M Wu
- Cardiovascular Institute, Stanford School of Medicine, CA. (X.Z., Y.L., L.T., J.C.W., M.R., S.M.W., Y.M., M.G.).,Department of Medicine, Division of Cardiovascular Medicine, Stanford School of Medicine, CA. (Y.L., J.C.W., S.M.W.).,Institute for Stem Cell Biology and Regenerative Medicine, Stanford School of Medicine, CA. (J.C.W., S.M.W.).,Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, CA. (M.R., S.M.W., Y.M., M.G.)
| | - Michael P Snyder
- Department of Genetics, Stanford School of Medicine, CA. (X.Z., M.P.S.)
| | - Yifei Miao
- Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., M.G., Y.M., M.G.).,Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., Y.M., M.G.).,University of Cincinnati School of Medicine, OH (Z.Y., M.G., Y.M., M.G.).,Cardiovascular Institute, Stanford School of Medicine, CA. (X.Z., Y.L., L.T., J.C.W., M.R., S.M.W., Y.M., M.G.).,Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, CA. (M.R., S.M.W., Y.M., M.G.)
| | - Mingxia Gu
- Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., M.G., Y.M., M.G.).,Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, OH (Z.Y., Z.L., V.P.-G., Y.M., M.G.).,University of Cincinnati School of Medicine, OH (Z.Y., M.G., Y.M., M.G.).,Cardiovascular Institute, Stanford School of Medicine, CA. (X.Z., Y.L., L.T., J.C.W., M.R., S.M.W., Y.M., M.G.).,Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, CA. (M.R., S.M.W., Y.M., M.G.)
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10
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Oommen S, Cantero Peral S, Qureshi MY, Holst KA, Burkhart HM, Hathcock MA, Kremers WK, Brandt EB, Larsen BT, Dearani JA, Edwards BS, Maleszewski JJ, Nelson TJ. Autologous Umbilical Cord Blood-Derived Mononuclear Cell Therapy Promotes Cardiac Proliferation and Adaptation in a Porcine Model of Right Ventricle Pressure Overload. Cell Transplant 2022; 31:9636897221120434. [PMID: 36086821 PMCID: PMC9465577 DOI: 10.1177/09636897221120434] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 07/19/2022] [Accepted: 07/31/2022] [Indexed: 11/29/2022] Open
Abstract
Congenital heart diseases, including single ventricle circulations, are clinically challenging due to chronic pressure overload and the inability of the myocardium to compensate for lifelong physiological demands. To determine the clinical relevance of autologous umbilical cord blood-derived mononuclear cells (UCB-MNCs) as a therapy to augment cardiac adaptation following surgical management of congenital heart disease, a validated model system of right ventricular pressure overload due to pulmonary artery banding (PAB) in juvenile pigs has been employed. PAB in a juvenile porcine model and intramyocardial delivery of UCB-MNCs was evaluated in three distinct 12-week studies utilizing serial cardiac imaging and end-of-study pathology evaluations. PAB reproducibly induced pressure overload leading to chronic right ventricular remodeling including significant myocardial fibrosis and elevation of heart failure biomarkers. High-dose UCB-MNCs (3 million/kg) delivered into the right ventricular myocardium did not cause any detectable safety issues in the context of arrhythmias or abnormal cardiac physiology. In addition, this high-dose treatment compared with placebo controls demonstrated that UCB-MNCs promoted a significant increase in Ki-67-positive cardiomyocytes coupled with an increase in the number of CD31+ endothelium. Furthermore, the incorporation of BrdU-labeled cells within the myocardium confirmed the biological potency of the high-dose UCB-MNC treatment. Finally, the cell-based treatment augmented the physiological adaptation compared with controls with a trend toward increased right ventricular mass within the 12 weeks of the follow-up period. Despite these adaptations, functional changes as measured by echocardiography and magnetic resonance imaging did not demonstrate differences between cohorts in this surgical model system. Therefore, this randomized, double-blinded, placebo-controlled pre-clinical trial establishes the safety of UCB-MNCs delivered via intramyocardial injections in a dysfunctional right ventricle and validates the induction of cardiac proliferation and angiogenesis as transient paracrine mechanisms that may be important to optimize long-term outcomes for surgically repaired congenital heart diseases.
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Affiliation(s)
- Saji Oommen
- Division of Cardiovascular Diseases,
Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA
| | - Susana Cantero Peral
- Division of Cardiovascular Diseases,
Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Kimberly A. Holst
- Department of Cardiovascular Surgery,
Mayo Clinic, Rochester, MN, USA
| | - Harold M. Burkhart
- Pediatric Cardiothoracic Surgery, The
University of Oklahoma, Oklahoma City, OK, USA
| | | | - Walter K. Kremers
- Biomedical Statistics and Informatics,
Mayo Clinic, Rochester, MN, USA
| | - Emma B. Brandt
- Division of Cardiovascular Diseases,
Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA
| | | | - Joseph A. Dearani
- Department of Cardiovascular Surgery,
Mayo Clinic, Rochester, MN, USA
| | | | | | - Timothy J. Nelson
- Division of Cardiovascular Diseases,
Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA
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11
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O'Leary PW, Qureshi MY, Cetta F, Nelson TJ, Holst KA, Dearani JA. Cone Reconstruction for Ebstein Anomaly: Ventricular Remodeling and Preliminary Impact of Stem Cell Therapy. Mayo Clin Proc 2021; 96:3053-3061. [PMID: 34479739 DOI: 10.1016/j.mayocp.2021.02.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/02/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To define the impact of tricuspid valve cone reconstruction (CR) on ventricular performance in Ebstein anomaly, both independently and after stem cell therapy. PATIENTS AND METHODS The control group included 257 patients who had CR between June 2007 and December 2019. Ten subjects of a phase I stem cell therapy trial (May 2017 - March 2019) were compared with the controls to assess the echocardiographic impact on ventricular remodeling. RESULTS After CR, right ventricular (RV) size decreased and left ventricular (LV) volume increased in all patients. Apical and biplane RV fractional area change (FAC) initially decreased, but rebounded by 6 months postoperation. Short-axis FAC increased early and was maintained at 6 months post-CR in the control group. At 6 months post-CR, cell therapy patients showed a significantly larger increase in short-axis FAC (24.4% vs 29.9%, P=.003). In addition, whereas LV ejection fraction (EF) was unchanged at 6 months post-CR in controls, cell therapy patients showed a significant increase in EF relative to baseline and to controls (55.6% vs 65.0%, P=.007). CONCLUSION Cone reconstruction reduces tricuspid regurgitation and RV size, but is also associated with increased RV FAC and LV volume. Furthermore, injection of bone marrow-derived stem cells augmented the increase in RV FAC and was associated with improved LV EF at 6 months post-CR. This is evidence of a favorable interventricular interaction. These findings provide motivation for continued investigation into the potential benefits of stem cell therapy in Ebstein anomaly and other congenital cardiac malformations. TRIAL REGISTRATION clinicaltrials.gov identifier: NCT02914171.
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Affiliation(s)
- Patrick W O'Leary
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN; Wanek Family Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN.
| | - M Yasir Qureshi
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN; Wanek Family Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN
| | - Frank Cetta
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN; Wanek Family Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN
| | - Timothy J Nelson
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN; Wanek Family Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN
| | - Kimberly A Holst
- Wanek Family Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
| | - Joseph A Dearani
- Wanek Family Program for Hypoplastic Left Heart Syndrome, Mayo Clinic, Rochester, MN; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN
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12
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Klein Gunnewiek TM, Van Hugte EJH, Frega M, Guardia GS, Foreman K, Panneman D, Mossink B, Linda K, Keller JM, Schubert D, Cassiman D, Rodenburg R, Vidal Folch N, Oglesbee D, Perales-Clemente E, Nelson TJ, Morava E, Nadif Kasri N, Kozicz T. m.3243A > G-Induced Mitochondrial Dysfunction Impairs Human Neuronal Development and Reduces Neuronal Network Activity and Synchronicity. Cell Rep 2021; 31:107538. [PMID: 32320658 DOI: 10.1016/j.celrep.2020.107538] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [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: 07/08/2019] [Revised: 02/13/2020] [Accepted: 03/30/2020] [Indexed: 12/11/2022] Open
Abstract
Epilepsy, intellectual and cortical sensory deficits, and psychiatric manifestations are the most frequent manifestations of mitochondrial diseases. How mitochondrial dysfunction affects neural structure and function remains elusive, mostly because of a lack of proper in vitro neuronal model systems with mitochondrial dysfunction. Leveraging induced pluripotent stem cell technology, we differentiated excitatory cortical neurons (iNeurons) with normal (low heteroplasmy) and impaired (high heteroplasmy) mitochondrial function on an isogenic nuclear DNA background from patients with the common pathogenic m.3243A > G variant of mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes (MELAS). iNeurons with high heteroplasmy exhibited mitochondrial dysfunction, delayed neural maturation, reduced dendritic complexity, and fewer excitatory synapses. Micro-electrode array recordings of neuronal networks displayed reduced network activity and decreased synchronous network bursting. Impaired neuronal energy metabolism and compromised structural and functional integrity of neurons and neural networks could be the primary drivers of increased susceptibility to neuropsychiatric manifestations of mitochondrial disease.
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Affiliation(s)
- Teun M Klein Gunnewiek
- Department of Anatomy, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands; Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands
| | - Eline J H Van Hugte
- Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands
| | - Monica Frega
- Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands; Department of Clinical Neurophysiology, University of Twente, 7522 NB Enschede, the Netherlands
| | - Gemma Solé Guardia
- Department of Anatomy, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands; Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands
| | - Katharina Foreman
- Department of Cognitive Neuroscience, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands
| | - Daan Panneman
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Britt Mossink
- Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands
| | - Katrin Linda
- Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands
| | - Jason M Keller
- Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands
| | - Dirk Schubert
- Department of Cognitive Neuroscience, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands
| | - David Cassiman
- Department of Hepatology, UZ Leuven, 3000 Leuven, Belgium
| | - Richard Rodenburg
- Radboud Center for Mitochondrial Disorders, Radboudumc, 6500 HB Nijmegen, the Netherlands
| | - Noemi Vidal Folch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Devin Oglesbee
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Timothy J Nelson
- Division of General Internal Medicine, Division of Pediatric Cardiology, Departments of Medicine, Molecular Pharmacology, and Experimental Therapeutics, Mayo Clinic Center for Regenerative Medicine, Rochester, MN 55905, USA
| | - Eva Morava
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; Department of Clinical Genomics, Mayo Clinic, Rochester, MN 55905, USA
| | - Nael Nadif Kasri
- Department of Human Genetics, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands; Department of Cognitive Neuroscience, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands.
| | - Tamas Kozicz
- Department of Anatomy, Radboudumc, Donders Institute for Brain, Cognition, and Behaviour, 6500 HB Nijmegen, the Netherlands; Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA; Department of Clinical Genomics, Mayo Clinic, Rochester, MN 55905, USA; Department of Biochemistry and Molecular Biology, Mayo Clinic, 55905 Rochester, MN, USA.
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Brooks AF, Vajente G, Yamamoto H, Abbott R, Adams C, Adhikari RX, Ananyeva A, Appert S, Arai K, Areeda JS, Asali Y, Aston SM, Austin C, Baer AM, Ball M, Ballmer SW, Banagiri S, Barker D, Barsotti L, Bartlett J, Berger BK, Betzwieser J, Bhattacharjee D, Billingsley G, Biscans S, Blair CD, Blair RM, Bode N, Booker P, Bork R, Bramley A, Brown DD, Buikema A, Cahillane C, Cannon KC, Cao HT, Chen X, Ciobanu AA, Clara F, Compton C, Cooper SJ, Corley KR, Countryman ST, Covas PB, Coyne DC, Datrier LE, Davis D, Difronzo CD, Dooley KL, Driggers JC, Dupej P, Dwyer SE, Effler A, Etzel T, Evans M, Evans TM, Feicht J, Fernandez-Galiana A, Fritschel P, Frolov VV, Fulda P, Fyffe M, Giaime JA, Giardina DD, Godwin P, Goetz E, Gras S, Gray C, Gray R, Green AC, Gupta A, Gustafson EK, Gustafson D, Hall E, Hanks J, Hanson J, Hardwick T, Hasskew RK, Heintze MC, Helmling-Cornell AF, Holland NA, Izmui K, Jia W, Jones JD, Kandhasamy S, Karki S, Kasprzack M, Kawabe K, Kijbunchoo N, King PJ, Kissel JS, Kumar R, Landry M, Lane BB, Lantz B, Laxen M, Lecoeuche YK, Leviton J, Jian L, Lormand M, Lundgren AP, Macas R, Macinnis M, Macleod DM, Mansell GL, Marka S, Marka Z, Martynov DV, Mason K, Massinger TJ, Matichard F, Mavalvala N, McCarthy R, McClelland DE, McCormick S, McCuller L, McIver J, McRae T, Mendell G, Merfeld K, Merilh EL, Meylahn F, Mistry T, Mittleman R, Moreno G, Mow-Lowry CM, Mozzon S, Mullavey A, Nelson TJ, Nguyen P, Nuttall LK, Oberling J, Oram RJ, Osthelder C, Ottaway DJ, Overmier H, Palamos JR, Parker W, Payne E, Pele A, Penhorwood R, Perez CJ, Pirello M, Radkins H, Ramirez KE, Richardson JW, Riles K, Robertson NA, Rollins JG, Romel CL, Romie JH, Ross MP, Ryan K, Sadecki T, Sanchez EJ, Sanchez LE, Tiruppatturrajamanikkam SR, Savage RL, Schaetzl D, Schnabel R, Schofield RM, Schwartz E, Sellers D, Shaffer T, Sigg D, Slagmolen BJ, Smith JR, Soni S, Sorazu B, Spencer AP, Strain KA, Sun L, Szczepanczyk MJ, Thomas M, Thomas P, Thorne KA, Toland K, Torrie CI, Traylor G, Tse M, Urban AL, Valdes G, Vander-Hyde DC, Veitch PJ, Venkateswara K, Venugopalan G, Viets AD, Vo T, Vorvick C, Wade M, Ward RL, Warner J, Weaver B, Weiss R, Whittle C, Willke B, Wipf CC, Xiao L, Yu H, Yu H, Zhang L, Zucker ME, Zweizig J. Point absorbers in Advanced LIGO. Appl Opt 2021; 60:4047-4063. [PMID: 33983346 DOI: 10.1364/ao.419689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
Small, highly absorbing points are randomly present on the surfaces of the main interferometer optics in Advanced LIGO. The resulting nanometer scale thermo-elastic deformations and substrate lenses from these micron-scale absorbers significantly reduce the sensitivity of the interferometer directly though a reduction in the power-recycling gain and indirect interactions with the feedback control system. We review the expected surface deformation from point absorbers and provide a pedagogical description of the impact on power buildup in second generation gravitational wave detectors (dual-recycled Fabry-Perot Michelson interferometers). This analysis predicts that the power-dependent reduction in interferometer performance will significantly degrade maximum stored power by up to 50% and, hence, limit GW sensitivity, but it suggests system wide corrections that can be implemented in current and future GW detectors. This is particularly pressing given that future GW detectors call for an order of magnitude more stored power than currently used in Advanced LIGO in Observing Run 3. We briefly review strategies to mitigate the effects of point absorbers in current and future GW wave detectors to maximize the success of these enterprises.
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14
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Brandt EB, Li X, Nelson TJ. Activation of P53 Via Nutlin-3a Reveals Role for P53 In ROS Signaling During Cardiac Differentiation of hiPSCs. J Stem Cell Rep 2021; 3:101. [PMID: 34485982 PMCID: PMC8415805] [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] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Activation of the transcription factor P53 within cancer cells is a well-characterized pathway, whereas the effects of P53 activation during development remain largely unexplored. Previous research has indicated that increased levels of P53 protein during key murine developmental stages cause defects in multiple embryonic tissues, including the heart. These findings were confirmed in several different mouse models of congenital heart defects, but P53 activation in a human system of cardiovascular development is not available. Utilizing human induced pluripotent stem cells (hiPSCs), we characterized the normal levels of P53 during cardiac differentiation and showed that levels of P53 are high in hiPSCs and decrease upon cardiac lineage commitment. We also observed P53 localization changed from mainly cytoplasmic in iPS colonies to the nucleus in the Nkx2-5 + cardiac progenitor stage. Pharmacological-mediated increase of P53 protein levels with the Mdm2 inhibitor Nutlin-3a during early (mesoderm to cardiac mesoderm) stages of cardiogenesis resulted in a sizeable loss of cardiomyocytes due to increased apoptosis and cell cycle arrest. Interestingly, increasing P53 levels did not result in apoptosis at later (cardiac progenitor to beating cardiomyocytes) stages of the cardiac differentiation. These results illustrate the temporal sensitivity to increased P53 levels during cardiogenesis. We conducted RNA-Seq on these cells with or without Nutlin-3a to ascertain transcriptional differences due to increased P53 at the different stages during the differentiation. Our results from the RNA-Seq revealed up-regulation of Sestrins after Nutlin-3a treatment suggesting a new role for P53 in the metabolism of cardiac regeneration.
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Affiliation(s)
- Emma B Brandt
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
- Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Xing Li
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy J Nelson
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
- Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
- Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
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15
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Holst KA, Dearani JA, Qureshi MY, Wackel P, Cannon BC, O'Leary PW, Olson TM, Seisler DK, Nelson TJ. From Safety to Benefit in Cell Delivery During Surgical Repair of Ebstein Anomaly: Initial Results. Ann Thorac Surg 2021; 113:890-895. [PMID: 33539782 DOI: 10.1016/j.athoracsur.2020.11.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 10/26/2020] [Accepted: 11/09/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The objective of this study is to assess the safety and early impact of intramyocardial delivery of autologous bone marrow-derived mononuclear cells (BM-MNC) at time of surgical Ebstein repair. METHODS Patients with Ebstein anomaly (ages 6 months to 30 years) scheduled to undergo repair of the tricuspid valve were eligible to participate in this open-label, non-randomized phase I clinical trial. BM-MNC target dose was 1-3 million cells/kg. Ten patients have undergone surgical intervention and cell delivery to the right ventricle (RV) and completed 6-month follow-up. RESULTS All patients underwent surgical tricuspid valve repair and uneventful BM-MNC delivery; there were no ventricular arrhythmias and no adverse events related to study product or delivery. Echocardiographic RV myocardial performance index improved and RV fractional area change showed an initial decline and then through study follow-up. There was no evidence of delayed myocardial enhancement or regional wall motion abnormalities at injection sites on 6-month follow-up magnetic resonance imaging. CONCLUSIONS Intramyocardial delivery of BM-MNC after surgical repair in Ebstein anomaly can be performed safely. Echocardiography variables suggest a positive impact of cell delivery on the RV myocardium with improvements in both RV size and wall motion over time. Additional follow-up and comparison to control groups are required to better characterize the impact of cell therapy on the myopathic RV in Ebstein anomaly.
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Affiliation(s)
- Kimberly A Holst
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - Joseph A Dearani
- Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - M Yasir Qureshi
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota.
| | - Philip Wackel
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota
| | - Bryan C Cannon
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota
| | | | - Timothy M Olson
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota
| | - Drew K Seisler
- Wanek HLHS Consortium Clinical Pipeline, Mayo Clinic, Rochester, Minnesota
| | - Timothy J Nelson
- Wanek HLHS Consortium Clinical Pipeline, Mayo Clinic, Rochester, Minnesota
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16
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Vincenti M, O'Leary PW, Qureshi MY, Seisler DK, Burkhart HM, Cetta F, Nelson TJ. Clinical Impact of Autologous Cell Therapy on Hypoplastic Left Heart Syndrome After Bidirectional Cavopulmonary Anastomosis. Semin Thorac Cardiovasc Surg 2021; 33:791-801. [DOI: 10.1053/j.semtcvs.2020.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 11/05/2020] [Indexed: 01/29/2023]
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17
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Miao Y, Tian L, Martin M, Paige S, Galdos FX, Lee S, Grossfeld PD, Mital S, Wu JC, RABINOVITCH M, Nelson TJ, Nie S, Wu SM, Gu M. Abstract 12937: Single-cell Transcriptomic Analysis Reveals Developmentally Impaired Endocardial Population in Hypoplastic Left Heart Syndrome. Circulation 2020. [DOI: 10.1161/circ.142.suppl_3.12937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hypoplastic left heart syndrome (HLHS) is one of the most challenging forms of congenital heart diseases. Previous studies were mainly focused on intrinsic defects in myocardium. However, this does not sufficiently explain the abnormal development of the cardiac valve, septum, and vasculature, known to originate from the endocardium. Here, using single-cell transcriptomic profiling, induced pluripotent stem cells (iPSC) derived endocardial cells (iEECs), human fetal heart tissue with underdeveloped left ventricle, as well as a
Xenopus
model, we identified a developmentally impaired endocardial population in HLHS. The intrinsic endocardial deficits contributed to abnormal endothelial to mesenchymal transition, NOTCH signaling, and extracellular matrix organization, all of which are key factors in valve formation. Consequently, in an endocardium-myocardium co-culture system, we found that endocardial abnormalities conferred reduced proliferation and maturation of iPSC derived cardiomyocyte (iPSC-CMs) judged by Ki67 staining, contractility, sarcomere organization, and related gene expressions through a disrupted fibronectin (FN1)-integrin interaction. Several recently described HLHS
de novo
mutations such as
ETS1
and
CHD7
showed reduced binding to
FN1
promoter and enhancer in HLHS vs. control iEECs based on ChIP-qPCR analysis. Additionally, we found that suppression of the ETS1 in
Xenopus
caused reduced endocardial FN1 expression and impaired heart development. Supplementation of FN1 or ETS1 over-expression in HLHS iEECs could rescue dysfunctions in both endocardium and myocardium in HLHS. Our studies reveal a critical role of endocardial abnormality in causing HLHS, and provide a rationale for improving endocardial function in future regenerative strategies.
Schematic illustration of the endocardial and myocardial defects in HLHS.
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Affiliation(s)
- Yifei Miao
- Cincinnati Children's Hosp, Stanford, CA
| | - Lei Tian
- Stanford Cardiovascular Institute, Stanford, CA
| | | | | | | | | | | | | | | | | | | | - Shuyi Nie
- Georgia Institute of Technology, Atlanta, GA
| | | | - Mingxia Gu
- Cincinnati Children's Hosp, Cincinnati, OH
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18
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Paige SL, Galdos FX, Lee S, Chin ET, Ranjbarvaziri S, Feyen DAM, Darsha AK, Xu S, Ryan JA, Beck AL, Qureshi MY, Miao Y, Gu M, Bernstein D, Nelson TJ, Mercola M, Rabinovitch M, Ashley EA, Parikh VN, Wu SM. Patient-Specific Induced Pluripotent Stem Cells Implicate Intrinsic Impaired Contractility in Hypoplastic Left Heart Syndrome. Circulation 2020; 142:1605-1608. [PMID: 33074758 DOI: 10.1161/circulationaha.119.045317] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Sharon L Paige
- Department of Pediatrics, Division of Pediatric Cardiology (S.L.P., S.R., J.A.R., Y.M., M.G., D.B., M.R., S.M.W.), Stanford School of Medicine, CA.,Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA.,Institute for Stem Cell Biology and Regenerative Medicine (S.L.P., F.X.G., S.M.W.), Stanford School of Medicine, CA
| | - Francisco X Galdos
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA.,Institute for Stem Cell Biology and Regenerative Medicine (S.L.P., F.X.G., S.M.W.), Stanford School of Medicine, CA
| | - Soah Lee
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Elizabeth T Chin
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA.,Department of Medicine, Division of Cardiovascular Medicine (E.T.C., M.M., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA.,Department of Biomedical Data Science (E.T.C.), Stanford School of Medicine, CA
| | - Sara Ranjbarvaziri
- Department of Pediatrics, Division of Pediatric Cardiology (S.L.P., S.R., J.A.R., Y.M., M.G., D.B., M.R., S.M.W.), Stanford School of Medicine, CA.,Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Dries A M Feyen
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Adrija K Darsha
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Sidra Xu
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Julia A Ryan
- Department of Pediatrics, Division of Pediatric Cardiology (S.L.P., S.R., J.A.R., Y.M., M.G., D.B., M.R., S.M.W.), Stanford School of Medicine, CA.,Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Aimee L Beck
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - M Yasir Qureshi
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine (M.Y.Q., T.J.N.), Mayo Clinic, Rochester, MN
| | - Yifei Miao
- Department of Pediatrics, Division of Pediatric Cardiology (S.L.P., S.R., J.A.R., Y.M., M.G., D.B., M.R., S.M.W.), Stanford School of Medicine, CA.,Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Mingxia Gu
- Department of Pediatrics, Division of Pediatric Cardiology (S.L.P., S.R., J.A.R., Y.M., M.G., D.B., M.R., S.M.W.), Stanford School of Medicine, CA.,Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Daniel Bernstein
- Department of Pediatrics, Division of Pediatric Cardiology (S.L.P., S.R., J.A.R., Y.M., M.G., D.B., M.R., S.M.W.), Stanford School of Medicine, CA.,Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Timothy J Nelson
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine (M.Y.Q., T.J.N.), Mayo Clinic, Rochester, MN.,Department of Molecular Pharmacology & Experimental Therapeutics (T.J.N.), Mayo Clinic, Rochester, MN.,General Internal Medicine and Transplant Center, Department of Internal Medicine (T.J.N.), Mayo Clinic, Rochester, MN.,Center for Regenerative Medicine (T.J.N.), Mayo Clinic, Rochester, MN
| | - Mark Mercola
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA.,Department of Medicine, Division of Cardiovascular Medicine (E.T.C., M.M., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Marlene Rabinovitch
- Department of Pediatrics, Division of Pediatric Cardiology (S.L.P., S.R., J.A.R., Y.M., M.G., D.B., M.R., S.M.W.), Stanford School of Medicine, CA.,Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Euan A Ashley
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA.,Department of Medicine, Division of Cardiovascular Medicine (E.T.C., M.M., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Victoria N Parikh
- Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA.,Department of Medicine, Division of Cardiovascular Medicine (E.T.C., M.M., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
| | - Sean M Wu
- Department of Pediatrics, Division of Pediatric Cardiology (S.L.P., S.R., J.A.R., Y.M., M.G., D.B., M.R., S.M.W.), Stanford School of Medicine, CA.,Cardiovascular Institute (S.L.P., E.T.C., F.X.G., S.L., S.R., D.A.M.F., A.K.D., S.X., J.A.R., A.L.B., Y.M., M.G., D.B., M.M., M.R., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA.,Institute for Stem Cell Biology and Regenerative Medicine (S.L.P., F.X.G., S.M.W.), Stanford School of Medicine, CA.,Department of Medicine, Division of Cardiovascular Medicine (E.T.C., M.M., E.A.A., V.N.P., S.M.W.), Stanford School of Medicine, CA
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19
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Theis JL, Vogler G, Missinato MA, Li X, Nielsen T, Zeng XXI, Martinez-Fernandez A, Walls SM, Kervadec A, Kezos JN, Birker K, Evans JM, O'Byrne MM, Fogarty ZC, Terzic A, Grossfeld P, Ocorr K, Nelson TJ, Olson TM, Colas AR, Bodmer R. Patient-specific genomics and cross-species functional analysis implicate LRP2 in hypoplastic left heart syndrome. eLife 2020; 9:e59554. [PMID: 33006316 PMCID: PMC7581429 DOI: 10.7554/elife.59554] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 09/29/2020] [Indexed: 12/12/2022] Open
Abstract
Congenital heart diseases (CHDs), including hypoplastic left heart syndrome (HLHS), are genetically complex and poorly understood. Here, a multidisciplinary platform was established to functionally evaluate novel CHD gene candidates, based on whole-genome and iPSC RNA sequencing of a HLHS family-trio. Filtering for rare variants and altered expression in proband iPSCs prioritized 10 candidates. siRNA/RNAi-mediated knockdown in healthy human iPSC-derived cardiomyocytes (hiPSC-CM) and in developing Drosophila and zebrafish hearts revealed that LDL receptor-related protein LRP2 is required for cardiomyocyte proliferation and differentiation. Consistent with hypoplastic heart defects, compared to patents the proband's iPSC-CMs exhibited reduced proliferation. Interestingly, rare, predicted-damaging LRP2 variants were enriched in a HLHS cohort; however, understanding their contribution to HLHS requires further investigation. Collectively, we have established a multi-species high-throughput platform to rapidly evaluate candidate genes and their interactions during heart development, which are crucial first steps toward deciphering oligogenic underpinnings of CHDs, including hypoplastic left hearts.
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Affiliation(s)
- Jeanne L Theis
- Cardiovascular Genetics Research LaboratoryRochesterUnited States
| | - Georg Vogler
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | - Maria A Missinato
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | - Xing Li
- Division of Biomedical Statistics and Informatics, Mayo ClinicRochesterUnited States
| | - Tanja Nielsen
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
- Doctoral Degrees and Habilitations, Department of Biology, Chemistry, and Pharmacy, Freie Universität BerlinBerlinGermany
| | - Xin-Xin I Zeng
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | | | - Stanley M Walls
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | - Anaïs Kervadec
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | - James N Kezos
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | - Katja Birker
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | - Jared M Evans
- Division of Biomedical Statistics and Informatics, Mayo ClinicRochesterUnited States
| | - Megan M O'Byrne
- Division of Biomedical Statistics and Informatics, Mayo ClinicRochesterUnited States
| | - Zachary C Fogarty
- Division of Biomedical Statistics and Informatics, Mayo ClinicRochesterUnited States
| | - André Terzic
- Department of Cardiovascular Medicine, Mayo ClinicRochesterUnited States
- Department of Molecular and Pharmacology and Experimental Therapeutics, Mayo ClinicLa JollaUnited States
- Center for Regenerative Medicine, Mayo ClinicRochesterUnited States
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo ClinicRochesterUnited States
| | - Paul Grossfeld
- University of California San Diego, Rady’s HospitalSan DiegoUnited States
- Division of General Internal Medicine, Mayo ClinicRochesterUnited States
| | - Karen Ocorr
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | - Timothy J Nelson
- Department of Molecular and Pharmacology and Experimental Therapeutics, Mayo ClinicLa JollaUnited States
- Center for Regenerative Medicine, Mayo ClinicRochesterUnited States
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo ClinicRochesterUnited States
| | - Timothy M Olson
- Department of Cardiovascular Medicine, Mayo ClinicRochesterUnited States
- Department of Molecular and Pharmacology and Experimental Therapeutics, Mayo ClinicLa JollaUnited States
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo ClinicRochesterUnited States
| | - Alexandre R Colas
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
| | - Rolf Bodmer
- Development, Aging and Regeneration, Sanford Burnham Prebys Medical Discovery InstituteLa JollaUnited States
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20
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Gold S, Edin KJ, Nelson TJ. Does Time with Dad in Childhood Pay Off in Adolescence? J Marriage Fam 2020; 82:1587-1605. [PMID: 34393267 PMCID: PMC8356204 DOI: 10.1111/jomf.12676] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 02/12/2020] [Indexed: 05/22/2023]
Abstract
OBJECTIVE We aim to understand the association between father involvement in middle childhood and adolescent behaviors and whether the relationship differs by father residence. BACKGROUND Internalizing and externalizing behaviors in adolescence can trigger a cascade of negative outcomes later in life, including lower educational attainment, criminal justice involvement, and future psychological distress. Evidence, largely focusing on nonresidential fathers and older cohort, suggests that father involvement-particularly closeness and engagement-may reduce adolescents' internalizing and externalizing behaviors. METHOD We use data six waves of the Fragile Families and Child Wellbeing Study, a birth cohort survey representative of births in large U.S. cities between 1998 and 2000, to estimate OLS regression models examining (a) whether father involvement in middle childhood is associated with fewer problem behaviors at Age 15, (b) if the salience of father involvement differs depending on whether the father was present in the home (i.e., was married to or living with his child's mother) in middle childhood, and (c) whether father involvement matters differently based on the child's sex. RESULTS We find protective associations between father involvement and adolescent behavioural outcomes that persist even among children who were not living with their fathers. In models stratified by the child's sex, father involvement matters for both boys and girls. In all models, father presence alone, apart from active involvement, is not significantly associated with behavioral outcomes. CONCLUSION Father involvement protects against negative adolescent behaviors even among children with nonresidential fathers and for both boys and girls. IMPLICATIONS These results suggest that policies that promote greater father involvement and father-child bonds, rather than other options such as promoting marriage, may be more effective in reducing behavioral problems among adolescents.
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Affiliation(s)
- Sarah Gold
- Princeton University, Woodrow Wilson School, Wallace Hall, Princeton, NJ 08544
| | - Kathryn J Edin
- Princeton University, Woodrow Wilson School, Wallace Hall, Princeton, NJ 08544
| | - Timothy J Nelson
- Princeton University, Woodrow Wilson School, Wallace Hall, Princeton, NJ 08544
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21
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Miao Y, Tian L, Martin M, Paige SL, Galdos FX, Li J, Klein A, Zhang H, Ma N, Wei Y, Stewart M, Lee S, Moonen JR, Zhang B, Grossfeld P, Mital S, Chitayat D, Wu JC, Rabinovitch M, Nelson TJ, Nie S, Wu SM, Gu M. Intrinsic Endocardial Defects Contribute to Hypoplastic Left Heart Syndrome. Cell Stem Cell 2020; 27:574-589.e8. [PMID: 32810435 PMCID: PMC7541479 DOI: 10.1016/j.stem.2020.07.015] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 05/21/2020] [Accepted: 07/15/2020] [Indexed: 01/03/2023]
Abstract
Hypoplastic left heart syndrome (HLHS) is a complex congenital heart disease characterized by abnormalities in the left ventricle, associated valves, and ascending aorta. Studies have shown intrinsic myocardial defects but do not sufficiently explain developmental defects in the endocardial-derived cardiac valve, septum, and vasculature. Here, we identify a developmentally impaired endocardial population in HLHS through single-cell RNA profiling of hiPSC-derived endocardium and human fetal heart tissue with an underdeveloped left ventricle. Intrinsic endocardial defects contribute to abnormal endothelial-to-mesenchymal transition, NOTCH signaling, and extracellular matrix organization, key factors in valve formation. Endocardial abnormalities cause reduced cardiomyocyte proliferation and maturation by disrupting fibronectin-integrin signaling, consistent with recently described de novo HLHS mutations associated with abnormal endocardial gene and fibronectin regulation. Together, these results reveal a critical role for endocardium in HLHS etiology and provide a rationale for considering endocardial function in regenerative strategies.
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Affiliation(s)
- Yifei Miao
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Lei Tian
- Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell and Regenerative Biology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Marcy Martin
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Sharon L Paige
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell and Regenerative Biology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Francisco X Galdos
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell and Regenerative Biology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Jibiao Li
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Alyssa Klein
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Hao Zhang
- Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell and Regenerative Biology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Ning Ma
- Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell and Regenerative Biology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Yuning Wei
- Center for Personal Dynamic Regulomes, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Maria Stewart
- Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Soah Lee
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell and Regenerative Biology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Jan-Renier Moonen
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Bing Zhang
- Key Laboratory of Systems Biomedicine, Shanghai Center for Systems Biomedicine, Xin Hua Hospital, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Paul Grossfeld
- Department of Pediatrics, UCSD School of Medicine, La Jolla, CA 92093, USA
| | - Seema Mital
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - David Chitayat
- Department of Pediatrics, Hospital for Sick Children, University of Toronto, Toronto, ON M5G 1X8, Canada; The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, ON M5G 1X5, Canada
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell and Regenerative Biology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Marlene Rabinovitch
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Timothy J Nelson
- Division of General Internal Medicine, Division of Pediatric Cardiology, and Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA
| | - Shuyi Nie
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Sean M Wu
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Institute of Stem Cell and Regenerative Biology, Stanford School of Medicine, Stanford, CA 94305, USA
| | - Mingxia Gu
- Department of Pediatrics, Division of Pediatric Cardiology, Stanford School of Medicine, Stanford, CA 94305, USA; Vera Moulton Wall Center for Pulmonary Vascular Disease, Stanford School of Medicine, Stanford, CA 94305, USA; Stanford Cardiovascular Institute, Stanford School of Medicine, Stanford, CA 94305, USA; Perinatal Institute, Division of Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA; Center for Stem Cell and Organoid Medicine, CuSTOM, Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
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22
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Gu M, Miao Y, Zhou X, Tian L, Martin M, Nelson TJ. Abstract 238: Single-Cell Transcriptomic Analysis and Patient-Specific IPSCs Reveal Dysregulated Cell Cycle in Coronary Endothelial Cell in Hypoplastic Left Heart Syndrome. Circ Res 2020. [DOI: 10.1161/res.127.suppl_1.238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Hypoplastic left heart syndrome (HLHS) is a single ventricle congenital heart disease that results in severe underdevelopment of the left ventricle, mitral valve, aortic valve, and ascending aorta. Early serial postmortem examinations also revealed a high rate of coronary anomalies in HLHS, which included multiple ventriculo-coronary arterial connections as well as thick-walled and kinked coronary arteries. A previous study showed that fetal hypoplastic left hearts had a reduced endothelial cell (EC) population and lower capillary density compared with normal hearts. However, the mechanism underlying coronary abnormalities associated with HLHS remains unknown. Thus, we generated induced pluripotent stem cells derived ECs (iPSC-ECs) from three HLHS patients and three age-matched controls. Single Cell RNA-Seq (scRNA-seq) profiling identified both endocardial (NPR3
+
/CDH5
+
) and coronary endothelial populations (APLN
+
/CDH5
+
) from the heterogeneous iPSC-ECs. Intriguingly, a subcluster of the coronary endothelial cells (CECs) with cell cycle arrest was specifically enriched in HLHS patients. Further cell cycle analysis showed that 30.6% of the HLHS cells were trapped in the G1 phase, while the majority of the control CECs entered cell cycle normally. Additionally, the cell cycle differences between control and HLHS was only seen in CECs, not in the endocardial population. To verify our transcriptomic analysis, we applied negative cell sorting (NPR3
-
/CDH5
+
) on iPSC-ECs to purify CECs (iCECs) and confirmed that HLHS iCECs showed profound reduction of cell cycle/proliferative genes (
KI67, PCNA, CCNA2, CCNB1
) and abnormal induction of
CCND2
, which is the hallmark of G1 phase. BrdU assays also indicated suppressed proliferation in HLHS iCECs. Furthermore, we profiled the transcriptome from a human heart with an underdevelopment left ventricle (ULV) at single cell resolution. When compared to the normal human heart, pathway enrichment analysis of differentially expressed genes in ULV hearts demonstrated reduced cell proliferation in the CEC subpopulation. Here, we identified that CECs from HLHS patients exerted proliferative defects that can potentially impede the development of vascular/capillary structure and cause related functional deficiencies. Reformation of the coronary defect provides a promising therapeutic strategy to prevent HLHS deterioration.
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Affiliation(s)
- Mingxia Gu
- Cincinnati Children's Hosp, Cincinnati, OH
| | | | | | - Lei Tian
- Stanford Cardiovascular Institute, Stanford, CA
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23
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Kargaran PK, Evans JM, Bodbin SE, Smith JGW, Nelson TJ, Denning C, Mosqueira D. Mitochondrial DNA: Hotspot for Potential Gene Modifiers Regulating Hypertrophic Cardiomyopathy. J Clin Med 2020; 9:E2349. [PMID: 32718021 PMCID: PMC7463557 DOI: 10.3390/jcm9082349] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 07/17/2020] [Accepted: 07/21/2020] [Indexed: 12/16/2022] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is a prevalent and untreatable cardiovascular disease with a highly complex clinical and genetic causation. HCM patients bearing similar sarcomeric mutations display variable clinical outcomes, implying the involvement of gene modifiers that regulate disease progression. As individuals exhibiting mutations in mitochondrial DNA (mtDNA) present cardiac phenotypes, the mitochondrial genome is a promising candidate to harbor gene modifiers of HCM. Herein, we sequenced the mtDNA of isogenic pluripotent stem cell-cardiomyocyte models of HCM focusing on two sarcomeric mutations. This approach was extended to unrelated patient families totaling 52 cell lines. By correlating cellular and clinical phenotypes with mtDNA sequencing, potentially HCM-protective or -aggravator mtDNA variants were identified. These novel mutations were mostly located in the non-coding control region of the mtDNA and did not overlap with those of other mitochondrial diseases. Analysis of unrelated patients highlighted family-specific mtDNA variants, while others were common in particular population haplogroups. Further validation of mtDNA variants as gene modifiers is warranted but limited by the technically challenging methods of editing the mitochondrial genome. Future molecular characterization of these mtDNA variants in the context of HCM may identify novel treatments and facilitate genetic screening in cardiomyopathy patients towards more efficient treatment options.
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Affiliation(s)
- Parisa K. Kargaran
- Department of Cardiovascular Medicine, Center for Regenerative Medicine, Mayo Clinic, Rochester, MN 55905, USA;
| | - Jared M. Evans
- Department of Health Science Research, Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN 55905, USA;
| | - Sara E. Bodbin
- Division of Cancer and Stem Cells, Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, UK;
| | - James G. W. Smith
- Faculty of Medicine and Health Sciences, Norwich Medical School, University of East Anglia, Norwich NR4 7UQ, UK;
| | - Timothy J. Nelson
- Division of General Internal Medicine, Division of Pediatric Cardiology, Departments of Medicine, Molecular Pharmacology, and Experimental Therapeutics, Mayo Clinic Center for Regenerative Medicine, Rochester, MN 55905, USA;
| | - Chris Denning
- Division of Cancer and Stem Cells, Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, UK;
| | - Diogo Mosqueira
- Division of Cancer and Stem Cells, Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, UK;
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24
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Schroeder AM, Allahyari M, Vogler G, Missinato MA, Nielsen T, Yu MS, Theis JL, Larsen LA, Goyal P, Rosenfeld JA, Nelson TJ, Olson TM, Colas AR, Grossfeld P, Bodmer R. Model system identification of novel congenital heart disease gene candidates: focus on RPL13. Hum Mol Genet 2020; 28:3954-3969. [PMID: 31625562 DOI: 10.1093/hmg/ddz213] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 05/28/2019] [Accepted: 06/21/2019] [Indexed: 12/12/2022] Open
Abstract
Genetics is a significant factor contributing to congenital heart disease (CHD), but our understanding of the genetic players and networks involved in CHD pathogenesis is limited. Here, we searched for de novo copy number variations (CNVs) in a cohort of 167 CHD patients to identify DNA segments containing potential pathogenic genes. Our search focused on new candidate disease genes within 19 deleted de novo CNVs, which did not cover known CHD genes. For this study, we developed an integrated high-throughput phenotypical platform to probe for defects in cardiogenesis and cardiac output in human induced pluripotent stem cell (iPSC)-derived multipotent cardiac progenitor (MCPs) cells and, in parallel, in the Drosophila in vivo heart model. Notably, knockdown (KD) in MCPs of RPL13, a ribosomal gene and SON, an RNA splicing cofactor, reduced proliferation and differentiation of cardiomyocytes, while increasing fibroblasts. In the fly, heart-specific RpL13 KD, predominantly at embryonic stages, resulted in a striking 'no heart' phenotype. KD of Son and Pdss2, among others, caused structural and functional defects, including reduced or abolished contractility, respectively. In summary, using a combination of human genetics and cardiac model systems, we identified new genes as candidates for causing human CHD, with particular emphasis on ribosomal genes, such as RPL13. This powerful, novel approach of combining cardiac phenotyping in human MCPs and in the in vivo Drosophila heart at high throughput will allow for testing large numbers of CHD candidates, based on patient genomic data, and for building upon existing genetic networks involved in heart development and disease.
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Affiliation(s)
- Analyne M Schroeder
- Development, Aging and Regeneration Program, Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Massoud Allahyari
- Department of Pediatrics, UCSD School of Medicine, La Jolla, CA, USA
| | - Georg Vogler
- Development, Aging and Regeneration Program, Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Maria A Missinato
- Development, Aging and Regeneration Program, Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Tanja Nielsen
- Development, Aging and Regeneration Program, Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Michael S Yu
- Development, Aging and Regeneration Program, Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Jeanne L Theis
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Lars A Larsen
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Preeya Goyal
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | | | - Timothy J Nelson
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Timothy M Olson
- Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Alexandre R Colas
- Development, Aging and Regeneration Program, Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Paul Grossfeld
- Department of Pediatrics, UCSD School of Medicine, La Jolla, CA, USA
| | - Rolf Bodmer
- Development, Aging and Regeneration Program, Sanford-Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
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25
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Panicker AJ, Gates KV, Biendarra-Tiegs SM, Vetr NG, Higuita ML, Nelson TJ, Pereira NL, Griffiths LG. Role of non-HLA antigens in cardiac transplant rejection. The Journal of Immunology 2020. [DOI: 10.4049/jimmunol.204.supp.161.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Although immunosuppressive drugs improve short term survival, rejection incidence and long term survival remain largely unchanged in heart transplant patients. While Human Leukocyte Antigen (HLA) is a common initiator of graft-specific immune responses, non-HLA antibody mediated rejection (AMR) also commonly occurs. Furthermore, non-HLA antibodies have been implicated in cell mediated rejection and cardiac allograft vasculopathy. Therefore, there is a need to identify the role of non-HLA antigens in heart transplant rejection.
Serum from heart transplant patients lacking donor specific anti-HLA antibodies was collected longitudinally; pre-transplantation, acute rejection, and post-rejection for patients with AMR and matched controls. Serum IgG was used to form anti-human heart affinity columns and antigenic proteins from donor heart extracts captured. Antigens were eluted from the columns and subjected to LC-MS/MS. Longitudinal graft-specific changes in immune response were calculated.
Response toward non-HLA antigens increased longitudinally, with 41 high prevalence antigens found in ≥50% of the cohort. Co-culturing cardiomyocyte and endothelial cells with patient IgG indicated cell function changes correlated with specific antigens (e.g., Prohibitin). Immunofluorescence staining of patient biopsies revealed that longitudinal increase in antigen expression correlated with non-HLA antibody response.
The non-HLA antigens identified in this study elicit acute and chronic graft-specific adaptive immune responses in heart transplant recipients. Antibodies against these non-HLA antigens induced cellular dysfunction by changing expression of their target protein in the donor heart.
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Affiliation(s)
- Anjali Jacob Panicker
- 1Department of Immunology, Mayo Clinic Graduate School of Biomedical Sciences, Rochester, MN
- 2Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| | - Katherine V Gates
- 2Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
- 3UC Davis Department of Veterinary Medicine and Epidemiology
| | | | | | | | - Timothy J Nelson
- 2Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
- 6Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN
- 7Center for Regenerative Medicine, Mayo Clinic, Rochester, MN
- 8Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN
- 9Department of Pediatric Cardiology, Mayo Clinic, Rochester, MN
- 10Division of General Internal Medicine, Mayo Clinic, Rochester, MN
| | - Naveen L Pereira
- 2Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
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26
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Smith C, Martin-Lillie C, Higano JD, Turner L, Phu S, Arthurs J, Nelson TJ, Shapiro S, Master Z. Challenging misinformation and engaging patients: characterizing a regenerative medicine consult service. Regen Med 2020; 15:1427-1440. [PMID: 32319855 PMCID: PMC7466910 DOI: 10.2217/rme-2020-0018] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/19/2020] [Indexed: 02/06/2023] Open
Abstract
Aim: To address the unmet needs of patients interested in regenerative medicine, Mayo Clinic created a Regenerative Medicine Consult Service (RMCS). We describe the service and patient satisfaction. Materials & methods: We analyzed RMCS databases through retrospective chart analysis and performed qualitative interviews with patients. Results: The average patient was older to elderly and seeking information about regenerative options for their condition. Patients reported various conditions with osteoarthritis being most common. Over a third of consults included discussions about unproven interventions. About a third of patients received a clinical or research referral. Patients reported the RMCS as useful and the consultant as knowledgeable. Conclusion: An institutional RMCS can meet patients' informational needs and support the responsible translation of regenerative medicine.
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Affiliation(s)
- Cambray Smith
- Biomedical Ethics Research Program, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Charlene Martin-Lillie
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Jennifer Dens Higano
- Mayo Clinic Alix School of Medicine, 200 First Street, SW, Rochester, MN 55905, USA
| | - Leigh Turner
- Center for Bioethics, School of Public Health & College of Pharmacy, University of Minnesota, N520 Boynton, 410 Church Street SE, Minneapolis, MN 55455, USA
| | - Sydney Phu
- School of History, Philosophy & Religion, Oregon State University, 322 Milam Hall, 2520 SW Campus Way, Corvallis, OR 97331, USA
| | - Jennifer Arthurs
- Center for Regenerative Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Timothy J Nelson
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
- Department of General Internal Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Shane Shapiro
- Center for Regenerative Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
- Department of Orthopedic Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA
| | - Zubin Master
- Biomedical Ethics Research Program, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
- Center for Regenerative Medicine, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
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27
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Qureshi MY, Taggart N, Cabalka AK, Hagler D, Khan S, Holst K, Olson T, O'Leary P, Cantero-Peral S, Nelson TJ. AUTOLOGOUS STEM CELL THERAPY FOR SINGLE RIGHT VENTRICULAR DYSFUNCTION AFTER FONTAN OPERATION: PHASE I SAFETY AND FEASIBILITY STUDY OF INTRACORONARY INFUSION OF BONE MARROW-DERIVED MONONUCLEAR CELLS. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)31190-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Biendarra-Tiegs SM, Clemens DJ, Secreto FJ, Nelson TJ. Human Induced Pluripotent Stem Cell-Derived Non-Cardiomyocytes Modulate Cardiac Electrophysiological Maturation Through Connexin 43-Mediated Cell-Cell Interactions. Stem Cells Dev 2019; 29:75-89. [PMID: 31744402 PMCID: PMC6978788 DOI: 10.1089/scd.2019.0098] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
The functional maturation status of human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) has a notable impact upon their use in pharmacological studies, disease modeling, and therapeutic applications. Non-cardiomyocytes (non-CMs) produced in the differentiation process have previously been identified as having an extrinsic influence upon hiPSC-CM development, yet the underlying mechanisms are not fully understood. Herein, we aimed to modulate electrophysiological properties of hiPSC-CMs within co-cultures containing varied proportions of non-CMs and investigate the nature of interactions between these different cell types. Therefore, we sorted cardiac differentiations on day 10 and subsequently replated the cells at ratios of 7:3, 1:1, 3:7, and 1:9 non-CMs to CMs. After a month of co-culture, we evaluated electrophysiological properties through the genetically encoded voltage indicator ArcLight. We ultimately identified that co-cultures with approximately 70%–90% CM purity demonstrated the highest action potential (AP) amplitude and maximum upstroke velocity by day 40 of differentiation, indicative of enhanced electrophysiological maturation, as well as more ventricular-like AP morphologies. Notably, these findings were distinct from those observed for co-cultures of hiPSC-CMs and dermal fibroblasts. We determined that the co-culture phenotypes could not be attributed to paracrine effects of non-CMs due to the inability of conditioned media to recapitulate the observed effects. This led to the further observation of a distinctive expression pattern of connexin 43 (Cx43) at cell-cell interfaces between both CMs and non-CMs. Depletion of Cx43 by short hairpin RNA (shRNA) specifically in the non-CM population within a co-culture environment was able to recapitulate electrophysiological phenotypes of a purer hiPSC-CM population. Collectively, our data demonstrate that abundant non-CM content exerts a significant negative influence upon the electrophysiological maturation of hiPSC-CMs through Cx43-mediated cell-cell-contacts, and thus should be considered regarding the future production of purpose-built hiPSC-CM systems.
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Affiliation(s)
- Sherri M Biendarra-Tiegs
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota.,Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Daniel J Clemens
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota
| | - Frank J Secreto
- Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota.,Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
| | - Timothy J Nelson
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota.,Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota.,Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.,Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.,Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
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29
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Abstract
Hypoplastic Left Heart Syndrome (HLHS) is a complex Congenital Heart Disease (CHD) that was almost universally fatal until the advent of the Norwood operation in 1981. Children with HLHS who largely succumbed to the disease within the first year of life, are now surviving to adulthood. However, this survival is associated with multiple comorbidities and HLHS infants have a higher mortality rate as compared to other non-HLHS single ventricle patients. In this review we (a) discuss current clinical challenges associated in the care of HLHS patients, (b) explore the use of systems biology in understanding the molecular framework of this disease, (c) evaluate induced pluripotent stem cells as a translational model to understand molecular mechanisms and manipulate them to improve outcomes, and (d) investigate cell therapy, gene therapy, and tissue engineering as a potential tool to regenerate hypoplastic cardiac structures and improve outcomes.
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Affiliation(s)
- Anita Saraf
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USA.
| | - Wendy M Book
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Timothy J Nelson
- Division of General Internal Medicine, Center for Regenerative Medicine, Pediatric Cardiothoracic Surgery, Division of Cardiovascular Diseases, Transplant Center, Division of Biomedical Statistics and Informatics, Division of Pediatric Cardiology, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA
| | - Chunhui Xu
- Division of Pediatric Cardiology, Department of Pediatrics, Emory University School of Medicine and Children's Healthcare of Atlanta, Atlanta, GA 30322, USA; Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA 30322, USA
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30
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Burkhart HM, Qureshi MY, Rossano JW, Cantero Peral S, O'Leary PW, Hathcock M, Kremers W, Nelson TJ. Autologous stem cell therapy for hypoplastic left heart syndrome: Safety and feasibility of intraoperative intramyocardial injections. J Thorac Cardiovasc Surg 2019; 158:1614-1623. [PMID: 31345560 DOI: 10.1016/j.jtcvs.2019.06.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 05/30/2019] [Accepted: 06/01/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Staged surgical palliation for hypoplastic left heart syndrome results in an increased workload on the right ventricle serving as the systemic ventricle. Concerns for cardiac dysfunction and long-term heart failure have generated interest in first-in-infant, cell-based therapies as an additional surgical treatment modality. METHODS A phase 1 clinical trial was conducted to evaluate the safety and feasibility of direct intramyocardial injection of autologous umbilical cord blood-derived mononuclear cells in 10 infants with hypoplastic left heart syndrome at the time of stage II palliation. RESULTS All 10 patients underwent successful stage II palliation and intramyocardial injection of umbilical cord blood-derived mononuclear cells. Operative mortality was 0%. There was a single adverse event related to cell delivery: An injection site epicardial bleed that required simple oversew. The cohort did not demonstrate any significant safety concerns over 6 months. Additionally, the treatment group did not demonstrate any reduction in cardiac function in the context of the study related intramyocardial injections of autologous cells. CONCLUSIONS This phase 1 clinical trial showed that delivering autologous umbilical cord blood-derived mononuclear cells directly into the right ventricular myocardium during planned stage II surgical palliation for hypoplastic left heart syndrome was safe and feasible. Secondary findings of preservation of baseline right ventricular function throughout follow-up and normalized growth rates support the design of a phase 2b follow-up trial.
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Affiliation(s)
- Harold M Burkhart
- Division of Cardiovascular and Thoracic Surgery, University of Oklahoma, Oklahoma City, Okla.
| | | | - Joseph W Rossano
- Cardiac Center, Children's Hospital of Philadelphia, Philadelphia, Pa
| | | | | | - Matthew Hathcock
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minn
| | - Walter Kremers
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minn
| | - Timothy J Nelson
- Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minn; Division of General Internal Medicine, Mayo Clinic, Rochester, Minn; Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minn; Center for Regenerative Medicine, Mayo Clinic, Rochester, Minn
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31
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Biendarra-Tiegs SM, Li X, Ye D, Brandt EB, Ackerman MJ, Nelson TJ. Single-Cell RNA-Sequencing and Optical Electrophysiology of Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes Reveal Discordance Between Cardiac Subtype-Associated Gene Expression Patterns and Electrophysiological Phenotypes. Stem Cells Dev 2019; 28:659-673. [PMID: 30892143 PMCID: PMC6534093 DOI: 10.1089/scd.2019.0030] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
The ability to accurately phenotype cells differentiated from human induced pluripotent stem cells (hiPSCs) is essential for their application in modeling developmental and disease processes, yet also poses a particular challenge without the context of anatomical location. Our specific objective was to determine if single-cell gene expression was sufficient to predict the electrophysiology of iPSC-derived cardiac lineages, to evaluate the concordance between molecular and functional surrogate markers. To this end, we used the genetically encoded voltage indicator ArcLight to profile hundreds of hiPSC-derived cardiomyocytes (hiPSC-CMs), thus identifying patterns of electrophysiological maturation and increased prevalence of cells with atrial-like action potentials (APs) between days 11 and 42 of differentiation. To profile expression patterns of cardiomyocyte subtype-associated genes, single-cell RNA-seq was performed at days 12 and 40 after the populations were fully characterized with the high-throughput ArcLight platform. Although we could detect global gene expression changes supporting progressive differentiation, individual cellular expression patterns alone were not able to delineate the individual cardiomyocytes into atrial, ventricular, or nodal subtypes as functionally documented by electrophysiology measurements. Furthermore, our efforts to understand the distinct electrophysiological properties associated with day 12 versus day 40 hiPSC-CMs revealed that ion channel regulators SLMAP, FGF12, and FHL1 were the most significantly increased genes at day 40, categorized by electrophysiology-related gene functions. Notably, FHL1 knockdown during differentiation was sufficient to significantly modulate APs toward ventricular-like electrophysiology. Thus, our results establish the inability of subtype-associated gene expression patterns to specifically categorize hiPSC-derived cells according to their functional electrophysiology, and yet, altered FHL1 expression is able to redirect electrophysiological maturation of these developing cells. Therefore, noncanonical gene expression patterns of cardiac maturation may be sufficient to direct functional maturation of cardiomyocytes, with canonical gene expression patterns being insufficient to temporally define cardiac subtypes of in vitro differentiation.
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Affiliation(s)
- Sherri M Biendarra-Tiegs
- 1 Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota.,2 Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Xing Li
- 2 Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota.,3 Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Dan Ye
- 4 Windland Smith Rice Sudden Death Genomics Laboratory, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota
| | - Emma B Brandt
- 1 Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota.,2 Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota
| | - Michael J Ackerman
- 4 Windland Smith Rice Sudden Death Genomics Laboratory, Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota.,5 Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.,6 Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota
| | - Timothy J Nelson
- 1 Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota.,2 Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota.,5 Division of Heart Rhythm Services, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota.,6 Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota.,7 Division of General Internal Medicine, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota
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Abstract
U.S. children are more likely to live apart from a biological parent than at any time in history. Although the Child Support Enforcement system has tremendous reach, its policies have not kept pace with significant economic, demographic, and cultural changes. Narrative analysis of in-depth interviews with 429 low-income noncustodial fathers suggests that the system faces a crisis of legitimacy. Visualization of language used to describe all forms child support show that the formal system is considered punitive and to lead to a loss of power and autonomy. Further, it is not associated with coparenting or the father-child bond-themes closely associated with informal and in-kind support. Rather than stoking men's identities as providers, the system becomes "just another bill to pay." Orders must be sustainable, all fathers should have coparenting agreements, and alternative forms of support should count toward fathers' obligations. Recovery of government welfare costs should be eliminated.
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Johnson AA, Andrews-Pfannkoch C, Nelson TJ, Pulido JS, Marmorstein AD. Disease modeling studies using induced pluripotent stem cells: are we using enough controls? Regen Med 2017; 12:899-903. [PMID: 29243553 DOI: 10.2217/rme-2017-0101] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The comparison of differentiated induced pluripotent stem cells (iPSCs) derived from patients with disease to differentiated iPSCs derived from healthy patients enables powerful disease modeling. By performing an informal retrospective survey of disease modeling studies published in high impact journals, we found that the median and average number of controls used in these studies were 1 and 1.6, respectively. The bulk of these studies did not control for age, gender and ethnicity. Since a large proportion of phenotypic differences observed between iPSC lines are due to genetic variation or variation between lines, this is an insufficient number of controls to confidently rule out standard variation. Future studies need to include more controls and ensure that these controls are appropriately matched for gender, age and ethnicity.
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Affiliation(s)
- Adiv A Johnson
- Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Timothy J Nelson
- Departments of Cardiovascular Diseases, Molecular Pharmacology & Experimental Therapeutics, Division of General Internal Medicine, Division of Pediatric Cardiology, & Transplant Center, & Center for Regenerative Medicine, Rochester, MN 55905, USA
| | - Jose S Pulido
- Department of Ophthalmology, Mayo Clinic, Rochester, MN 55905, USA
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Secreto FJ, Li X, Smith AJ, Bruinsma ES, Perales-Clemente E, Oommen S, Hawse G, Hrstka SCL, Arendt BK, Brandt EB, Wigle DA, Nelson TJ. Quantification of Etoposide Hypersensitivity: A Sensitive, Functional Method for Assessing Pluripotent Stem Cell Quality. Stem Cells Transl Med 2017; 6:1829-1839. [PMID: 28924979 PMCID: PMC6430057 DOI: 10.1002/sctm.17-0116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 07/19/2017] [Indexed: 12/15/2022] Open
Abstract
Human induced pluripotent stem cells (hiPSC) hold great promise in diagnostic and therapeutic applications. However, translation of hiPSC technology depends upon a means of assessing hiPSC quality that is quantitative, high‐throughput, and can decipher malignant teratocarcinoma clones from normal cell lines. These attributes are lacking in current approaches such as detection of cell surface makers, RNA profiling, and/or teratoma formation assays. The latter remains the gold standard for assessing clone quality in hiPSCs, but is expensive, time‐consuming, and incompatible with high‐throughput platforms. Herein, we describe a novel method for determining hiPSC quality that exploits pluripotent cells’ documented hypersensitivity to the topoisomerase inhibitor etoposide (CAS No. 33419‐42‐0). Based on a study of 115 unique hiPSC clones, we established that a half maximal effective concentration (EC50) value of <300 nM following 24 hours of exposure to etoposide demonstrated a positive correlation with RNA profiles and colony morphology metrics associated with high quality hiPSC clones. Moreover, our etoposide sensitivity assay (ESA) detected differences associated with culture maintenance, and successfully distinguished malignant from normal pluripotent clones independent of cellular morphology. Overall, the ESA provides a simple, straightforward method to establish hiPSC quality in a quantitative and functional assay capable of being incorporated into a generalized method for establishing a quality control standard for all types of pluripotent stem cells. Stem Cells Translational Medicine2017;6:1829–1839
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Affiliation(s)
- Frank J Secreto
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Xing Li
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA
| | - Alyson J Smith
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Elizabeth S Bruinsma
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Ester Perales-Clemente
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Saji Oommen
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Gresin Hawse
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Sybil C L Hrstka
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Bonnie K Arendt
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Emma B Brandt
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - Dennis A Wigle
- Division of Thoracic Surgery, Mayo Clinic, Rochester, Minnesota, USA.,Center for Regenerative Medicine BioTrust, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy J Nelson
- Program for Hypoplastic Left Heart Syndrome-Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Transplant Center, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA.,Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.,Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA
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Holst KA, Said SM, Nelson TJ, Cannon BC, Dearani JA. Current Interventional and Surgical Management of Congenital Heart Disease: Specific Focus on Valvular Disease and Cardiac Arrhythmias. Circ Res 2017; 120:1027-1044. [PMID: 28302746 DOI: 10.1161/circresaha.117.309186] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 02/20/2017] [Accepted: 02/20/2017] [Indexed: 01/15/2023]
Abstract
Successful outcome in the care of patients with congenital heart disease depends on a comprehensive multidisciplinary team. Surgery is offered for almost every heart defect, despite complexity. Early mortality for cardiac surgery in the neonatal period is ≈10% and beyond infancy is <5%, with 90% to 95% of patients surviving with a good quality of life into the adult years. Advances in imaging have facilitated accurate diagnosis and planning of interventions and surgical procedures. Similarly, advances in the perioperative medical management of patients, particularly with intensive care, has also contributed to improving outcomes. Arrhythmias and heart failure are the most common late complications for the majority of defects, and reoperation for valvar problems is common. Lifelong surveillance for monitoring of recurrent or residual structural heart defects, as well as periodic assessment of cardiac function and arrhythmia monitoring, is essential for all patients. The field of congenital heart surgery is poised to incorporate new innovations such as bioengineered cells and scaffolds that will iteratively move toward bioengineered patches, conduits, valves, and even whole organs.
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Affiliation(s)
- Kimberly A Holst
- From the Department of Cardiovascular Surgery (K.A.H., S.M.S., J.A.D.), Departments of Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics (T.J.N., B.C.C.), and Division of Pediatric Cardiology (T.J.N., B.C.C.), Mayo Clinic, Rochester, MN
| | - Sameh M Said
- From the Department of Cardiovascular Surgery (K.A.H., S.M.S., J.A.D.), Departments of Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics (T.J.N., B.C.C.), and Division of Pediatric Cardiology (T.J.N., B.C.C.), Mayo Clinic, Rochester, MN
| | - Timothy J Nelson
- From the Department of Cardiovascular Surgery (K.A.H., S.M.S., J.A.D.), Departments of Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics (T.J.N., B.C.C.), and Division of Pediatric Cardiology (T.J.N., B.C.C.), Mayo Clinic, Rochester, MN
| | - Bryan C Cannon
- From the Department of Cardiovascular Surgery (K.A.H., S.M.S., J.A.D.), Departments of Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics (T.J.N., B.C.C.), and Division of Pediatric Cardiology (T.J.N., B.C.C.), Mayo Clinic, Rochester, MN
| | - Joseph A Dearani
- From the Department of Cardiovascular Surgery (K.A.H., S.M.S., J.A.D.), Departments of Pediatric and Adolescent Medicine, and Molecular Pharmacology and Experimental Therapeutics (T.J.N., B.C.C.), and Division of Pediatric Cardiology (T.J.N., B.C.C.), Mayo Clinic, Rochester, MN.
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36
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Hrstka SCL, Li X, Nelson TJ. NOTCH1-Dependent Nitric Oxide Signaling Deficiency in Hypoplastic Left Heart Syndrome Revealed Through Patient-Specific Phenotypes Detected in Bioengineered Cardiogenesis. Stem Cells 2017; 35:1106-1119. [PMID: 28142228 DOI: 10.1002/stem.2582] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 01/26/2016] [Revised: 11/12/2016] [Accepted: 12/19/2016] [Indexed: 12/25/2022]
Abstract
Hypoplastic left heart syndrome (HLHS) is a severe congenital heart defect (CHD) attributable to multifactorial molecular underpinnings. Multiple genetic loci have been implicated to increase the risk of disease, yet genotype-phenotype relationships remain poorly defined. Whole genome sequencing complemented by cardiac phenotype from five individuals in an HLHS-affected family enabled the identification of NOTCH1 as a prioritized candidate gene linked to CHD in three individuals with mutant allele burden significantly impairing Notch signaling in the HLHS-affected proband. To better understand a mechanistic basis through which NOTCH1 contributes to heart development, human induced pluripotent stem cells (hiPSCs) were created from the HLHS-affected parent-proband triad and differentiated into cardiovascular cell lineages for molecular characterization. HLHS-affected hiPSCs exhibited a deficiency in Notch signaling pathway components and a diminished capacity to generate hiPSC-cardiomyocytes. Optimization of conditions to procure HLHS-hiPSC-cardiomyocytes led to an approach that compensated for dysregulated nitric oxide (NO)-dependent Notch signaling in the earliest specification stages. Augmentation of HLHS-hiPSCs with small molecules stimulating NO signaling in the first 4 days of differentiation provided a cardiomyocyte yield equivalent to the parental hiPSCs. No discernable differences in calcium dynamics were observed between the bioengineered cardiomyocytes derived from the proband and the parents. We conclude that in vitro modeling with HLHS-hiPSCs bearing NOTCH1 mutations facilitated the discovery of a NO-dependent signaling component essential for cardiovascular cell lineage specification. Potentiation of NO signaling with small therapeutic molecules restored cardiogenesis in vitro and may identify a potential therapeutic target for patients affected by functionally compromised NOTCH1 variants. Stem Cells 2017;35:1106-1119.
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Affiliation(s)
- Sybil C L Hrstka
- Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA
| | - Xing Li
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota, USA.,Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Timothy J Nelson
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.,General Internal Medicine and Transplant Center, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pediatric Cardiology, Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Davison KK, Charles JN, Khandpur N, Nelson TJ. Fathers' Perceived Reasons for Their Underrepresentation in Child Health Research and Strategies to Increase Their Involvement. Matern Child Health J 2017; 21:267-274. [PMID: 27473093 PMCID: PMC5500207 DOI: 10.1007/s10995-016-2157-z] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Purpose Examine fathers' perceived reasons for their lack of inclusion in pediatric research and strategies to increase their participation. Description We conducted expert interviews with researchers and practitioners (N = 13) working with fathers to inform the development of an online survey. The survey-which measured fathers' perceived reasons for their underrepresentation in pediatric research, recommended recruitment venues, and research personnel and study characteristics valued by fathers-was distributed online and in-person to fathers. Assessment Respondents included 303 fathers. Over 80 % of respondents reported that fathers are underrepresented in pediatric research because they have not been asked to participate. Frequently recommended recruitment venues included community sports events (52 %), social service programs (48 %) and the internet (60 %). Compared with white fathers, more non-white fathers recommended public transit (19 % vs. 10 %, p = .02), playgrounds (16 % vs. 6 %, p = .007) and barber shops (34 % vs. 14 %, p < .0001) and fewer recommended doctors' offices (31 % vs. 43 %, p = .046) as recruitment venues. Compared with residential fathers (100 % resident with the target child), more non-residential fathers recommended social services programs (45 % vs. 63 %, p = .03) and public transit (10 % vs. 27 %, p = .001) and fewer recommended the workplace (17 % vs. 40 %, p = .002) as recruitment venues. Study brevity, perceived benefits for fathers and their families, and the credibility of the lead organization were valued by fathers. Conclusion Fathers' participation in pediatric research may increase if researchers explicitly invite father to participate, target father-focused recruitment venues, clearly communicate the benefits of the research for fathers and their families and adopt streamlined study procedures.
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Affiliation(s)
- Kirsten K Davison
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA.
| | - Jo N Charles
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
| | - Neha Khandpur
- Department of Nutrition, Harvard T.H. Chan School of Public Health, 665 Huntington Ave, Boston, MA, 02115, USA
| | - Timothy J Nelson
- Department of Sociology, Johns Hopkins University, Baltimore, MD, USA
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Cantero Peral S, Bernstein D, Nelson TJ. Regenerative medicine - From stem cell biology to clinical trials for pediatric heart failure. Progress in Pediatric Cardiology 2016. [DOI: 10.1016/j.ppedcard.2016.07.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Perales-Clemente E, Cook AN, Evans JM, Roellinger S, Secreto F, Emmanuele V, Oglesbee D, Mootha VK, Hirano M, Schon EA, Terzic A, Nelson TJ. Natural underlying mtDNA heteroplasmy as a potential source of intra-person hiPSC variability. EMBO J 2016; 35:1979-90. [PMID: 27436875 PMCID: PMC5282833 DOI: 10.15252/embj.201694892] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [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: 05/27/2016] [Accepted: 06/24/2016] [Indexed: 01/19/2023] Open
Abstract
Functional variability among human clones of induced pluripotent stem cells (hiPSCs) remains a limitation in assembling high-quality biorepositories. Beyond inter-person variability, the root cause of intra-person variability remains unknown. Mitochondria guide the required transition from oxidative to glycolytic metabolism in nuclear reprogramming. Moreover, mitochondria have their own genome (mitochondrial DNA [mtDNA]). Herein, we performed mtDNA next-generation sequencing (NGS) on 84 hiPSC clones derived from a cohort of 19 individuals, including mitochondrial and non-mitochondrial patients. The analysis of mtDNA variants showed that low levels of potentially pathogenic mutations in the original fibroblasts are revealed through nuclear reprogramming, generating mutant hiPSCs with a detrimental effect in their differentiated progeny. Specifically, hiPSC-derived cardiomyocytes with expanded mtDNA mutations non-related with any described human disease, showed impaired mitochondrial respiration, being a potential cause of intra-person hiPSC variability. We propose mtDNA NGS as a new selection criterion to ensure hiPSC quality for drug discovery and regenerative medicine.
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Affiliation(s)
- Ester Perales-Clemente
- Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics, Division of Cardiovascular Diseases, Mayo Clinic Center for Regenerative Medicine, Rochester, MN, USA
| | - Alexandra N Cook
- Departments of Cardiovascular Diseases, Molecular Pharmacology and Experimental Therapeutics, Division of General Internal Medicine, Division of Pediatric Cardiology, and Transplant Center, Mayo Clinic Center for Regenerative Medicine, Rochester, MN, USA
| | - Jared M Evans
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Samantha Roellinger
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Frank Secreto
- Departments of Cardiovascular Diseases, Molecular Pharmacology and Experimental Therapeutics, Division of General Internal Medicine, Division of Pediatric Cardiology, and Transplant Center, Mayo Clinic Center for Regenerative Medicine, Rochester, MN, USA
| | - Valentina Emmanuele
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Devin Oglesbee
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Vamsi K Mootha
- Department of Molecular Biology, Howard Hughes Medical Institute Massachusetts General Hospital, Boston, MA, USA
| | - Michio Hirano
- Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Eric A Schon
- Department of Neurology, Columbia University Medical Center, New York, NY, USA Department of Genetics and Development, Columbia University Medical Center, New York, NY, USA
| | - Andre Terzic
- Departments of Medicine, Molecular Pharmacology and Experimental Therapeutics, and Medical Genetics, Division of Cardiovascular Diseases, Mayo Clinic Center for Regenerative Medicine, Rochester, MN, USA
| | - Timothy J Nelson
- Departments of Cardiovascular Diseases, Molecular Pharmacology and Experimental Therapeutics, Division of General Internal Medicine, Division of Pediatric Cardiology, and Transplant Center, Mayo Clinic Center for Regenerative Medicine, Rochester, MN, USA
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Nelson TJ, Cantero Peral S. Stem Cell Therapy and Congenital Heart Disease. J Cardiovasc Dev Dis 2016; 3:jcdd3030024. [PMID: 29367570 PMCID: PMC5715673 DOI: 10.3390/jcdd3030024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 06/07/2016] [Accepted: 06/28/2016] [Indexed: 12/18/2022] Open
Abstract
For more than a decade, stem cell therapy has been the focus of intensive efforts for the treatment of adult heart disease, and now has promise for treating the pediatric population. On the basis of encouraging results in the adult field, the application of stem cell-based strategies in children with congenital heart disease (CHD) opens a new therapy paradigm. To date, the safety and efficacy of stem cell-based products to promote cardiac repair and recovery in dilated cardiomyopathy and structural heart disease in infants have been primarily demonstrated in scattered clinical case reports, and supported by a few relevant pre-clinical models. Recently the TICAP trial has shown the safety and feasibility of intracoronary infusion of autologous cardiosphere-derived cells in children with hypoplastic left heart syndrome. A focus on preemptive cardiac regeneration in the pediatric setting may offer new insights as to the timing of surgery, location of cell-based delivery, and type of cell-based regeneration that could further inform acquired cardiac disease applications. Here, we review the current knowledge on the field of stem cell therapy and tissue engineering in children with CHD, and discuss the gaps and future perspectives on cell-based strategies to treat patients with CHD.
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Affiliation(s)
- Timothy J Nelson
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA.
- Transplant Center, Mayo Clinic, Rochester, MN 55905, USA.
- Center for Regenerative Medicine, Mayo Clinic, Rochester, MN 55905, USA.
| | - Susana Cantero Peral
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN 55905, USA.
- Center for Regenerative Medicine, Mayo Clinic, Rochester, MN 55905, USA.
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Wyles SP, Hrstka SC, Reyes S, Terzic A, Olson TM, Nelson TJ. Pharmacological Modulation of Calcium Homeostasis in Familial Dilated Cardiomyopathy: An In Vitro Analysis From an RBM20 Patient-Derived iPSC Model. Clin Transl Sci 2016; 9:158-67. [PMID: 27105042 PMCID: PMC4902766 DOI: 10.1111/cts.12393] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 03/22/2016] [Indexed: 12/16/2022] Open
Abstract
For inherited cardiomyopathies, abnormal sensitivity to intracellular calcium (Ca(2+) ), incurred from genetic mutations, initiates subsequent molecular events leading to pathological remodeling. Here, we characterized the effect of β-adrenergic stress in familial dilated cardiomyopathy (DCM) using human-induced pluripotent stem cell (hiPSC)-derived cardiomyocytes (CMs) from a patient with RBM20 DCM. Our findings suggest that β-adrenergic stimulation accelerated defective Ca(2+) homeostasis, apoptotic changes, and sarcomeric disarray in familial DCM hiPSC-CMs. Furthermore, pharmacological modulation of abnormal Ca(2+) handling by pretreatment with β-blocker, carvedilol, or Ca(2+) -channel blocker, verapamil, significantly decreased the area under curve, reduced percentage of disorganized cells, and decreased terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick-end labeling (TUNEL)-positive apoptotic loci in familial DCM hiPSC-CMs after β-adrenergic stimulation. These translational data provide patient-based in vitro analysis of β-adrenergic stress in RBM20-deficient familial DCM hiPSC-CMs and evaluation of therapeutic interventions to modify heart disease progression, which may be personalized, but more importantly generalized in the clinic.
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Affiliation(s)
- S P Wyles
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, Minnesota, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - S C Hrstka
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - S Reyes
- Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
| | - A Terzic
- Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA.,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.,Department of Medical Genetics, Mayo Clinic, Rochester, Minnesota, USA
| | - T M Olson
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.,Division of Pediatric Cardiology, Mayo Clinic, Rochester, Minnesota, USA.,Cardiovascular Genetics Research Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - T J Nelson
- Center for Clinical and Translational Sciences, Mayo Clinic, Rochester, Minnesota, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA.,Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA.,Transplant Center, Mayo Clinic, Rochester, Minnesota, USA
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42
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Burkhart HM, Thompson JL, Nelson TJ. Hypoplastic left heart syndrome: What's next? J Thorac Cardiovasc Surg 2016; 151:909-10. [DOI: 10.1016/j.jtcvs.2015.12.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Accepted: 12/14/2015] [Indexed: 12/17/2022]
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43
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Li X, Campbell KA, Biendarra SM, Terzic A, Nelson TJ. Mapping transcriptome profiles of in vitro iPSC-derived cardiac differentiation to in utero heart development. Genom Data 2016; 7:129-30. [PMID: 26981387 PMCID: PMC4778660 DOI: 10.1016/j.gdata.2015.12.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 12/28/2015] [Indexed: 11/22/2022]
Abstract
The dataset includes microarray data (Affymetrix Mouse Genome 430 2.0 Array) from WT and Nos3−/− mouse embryonic heart ventricular tissues at 14.5 days post coitum (E14.5), induced pluripotent stem cells (iPSCs) derived from WT and Nos3−/− mouse tail tip fibroblasts, iPSC-differentiated cardiomyocytes at Day 11, and mouse embryonic stem cells (mESCs) and differentiated cardiomyocytes as positive controls for mouse iPSC differentiation. Both in utero (using embryonic heart tissues) and in vitro (using iPSCs and differentiated cells) microarray datasets were deposited to the NCBI Gene Expression Omnibus (GEO) database. The deposited data in GEO include raw microarray data, metadata for sample source information, experimental design, sample and data processing, and gene expression matrix. The data are available under GEO Access Number GSE69317 (GSE69315 for tissue sample microarray data, GSE69316 for iPSCs microarray data, http://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc= GSE69317).
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Affiliation(s)
- Xing Li
- Department of Health Sciences Research, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Division of Biomedical Statistics and Informatics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
| | - Katherine A. Campbell
- Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Center for Regenerative Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Division of General Internal Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
| | - Sherri M. Biendarra
- Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
| | - Andre Terzic
- Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Center for Regenerative Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Division of Cardiovascular Diseases, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Department of Medical Genetics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
| | - Timothy J. Nelson
- Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Center for Regenerative Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Division of Cardiovascular Diseases, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Division of General Internal Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Center for Transplantation and Clinical Regeneration, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Division of Pediatric Cardiology, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
- Corresponding author at: Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA.Department of Molecular Pharmacology and Experimental Therapeutics200 First Street SW, Mayo ClinicRochesterMN55905USA
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Wyles SP, Faustino RS, Li X, Terzic A, Nelson TJ. Systems-based technologies in profiling the stem cell molecular framework for cardioregenerative medicine. Stem Cell Rev Rep 2016; 11:501-10. [PMID: 25218144 DOI: 10.1007/s12015-014-9557-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Over the last decade, advancements in stem cell biology have yielded a variety of sources for stem cell-based cardiovascular investigation. Stem cell behavior, whether to maintain its stable state of pluripotency or to prime toward the cardiovascular lineage is governed by a set of coordinated interactions between epigenetic, transcriptional, and translational mechanisms. The science of incorporating genes (genomics), RNA (transcriptomics), proteins (proteomics), and metabolites (metabolomics) data in a specific biological sample is known as systems biology. Integrating systems biology in progression with stem cell biologics can contribute to our knowledge of mechanisms that underlie pluripotency maintenance and guarantee fidelity of cardiac lineage specification. This review provides a brief summarization of OMICS-based strategies including transcriptomics, proteomics, and metabolomics used to understand stem cell fate and to outline molecular processes involved in heart development. Additionally, current efforts in cardioregeneration based on the "one-size-fits-all" principle limit the potential of individualized therapy in regenerative medicine. Here, we summarize recent studies that introduced systems biology into cardiovascular clinical outcomes analysis, allowing for predictive assessment for disease recurrence and patient-specific therapeutic response.
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Affiliation(s)
- Saranya P Wyles
- Center for Clinical and Translational Sciences, Rochester, MN, USA
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Hartjes KA, Li X, Martinez-Fernandez A, Roemmich AJ, Larsen BT, Terzic A, Nelson TJ. Selection via pluripotency-related transcriptional screen minimizes the influence of somatic origin on iPSC differentiation propensity. Stem Cells 2015; 32:2350-9. [PMID: 24802033 DOI: 10.1002/stem.1734] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 09/20/2013] [Revised: 03/26/2014] [Accepted: 04/17/2014] [Indexed: 01/25/2023]
Abstract
The value of induced pluripotent stem cells (iPSCs) within regenerative medicine is contingent on predictable and consistent iPSC differentiation. However, residual influence of the somatic origin or reprogramming technique may variegate differentiation propensity and confound comparative genotype/phenotype analyses. The objective of this study was to define quality control measures to select iPSC clones that minimize the influence of somatic origin on differentiation propensity independent of the reprogramming strategy. More than 60 murine iPSC lines were derived from different fibroblast origins (embryonic, cardiac, and tail tip) via lentiviral integration and doxycycline-induced transgene expression. Despite apparent equivalency according to established iPSC histologic and cytomorphologic criteria, clustering of clonal variability in pluripotency-related gene expression identified transcriptional outliers that highlighted cell lines with unpredictable cardiogenic propensity. Following selection according to a standardized gene expression profile calibrated by embryonic stem cells, the influence of somatic origin on iPSC methylation and transcriptional patterns was negated. Furthermore, doxycycline-induced iPSCs consistently demonstrated earlier differentiation than lentiviral-reprogrammed lines using contractile cardiac tissue as a measure of functional differentiation. Moreover, delayed cardiac differentiation was predominately associated with upregulation in pluripotency-related gene expression upon differentiation. Starting from a standardized pool of iPSCs, relative expression levels of two pluripotency genes, Oct4 and Zfp42, statistically correlated with enhanced cardiogenicity independent of somatic origin or reprogramming strategy (R(2) = 0.85). These studies demonstrate that predictable iPSC differentiation is independent of somatic origin with standardized gene expression selection criteria, while the residual impact of reprogramming strategy greatly influences predictable output of tissue-specification required for comparative genotype/phenotype analyses.
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Affiliation(s)
- Katherine A Hartjes
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, Minnesota, USA; Center for Regenerative Medicine, Mayo Clinic, Rochester, Minnesota, USA
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Li X, Wyles S, Hrstka SC, Kocher JPA, Terzic A, Olson TM, Nelson TJ. Time course transcriptome data analysis for in vitro modeling of dilated cardiomyopathy using patient-derived induced pluripotent stem cells. BMC Bioinformatics 2015. [PMCID: PMC4625215 DOI: 10.1186/1471-2105-16-s15-p8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wyles SP, Li X, Hrstka SC, Reyes S, Oommen S, Beraldi R, Edwards J, Terzic A, Olson TM, Nelson TJ. Modeling structural and functional deficiencies of RBM20 familial dilated cardiomyopathy using human induced pluripotent stem cells. Hum Mol Genet 2015; 25:254-65. [PMID: 26604136 DOI: 10.1093/hmg/ddv468] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Accepted: 11/09/2015] [Indexed: 12/16/2022] Open
Abstract
Dilated cardiomyopathy (DCM) is a leading cause of heart failure. In families with autosomal-dominant DCM, heterozygous missense mutations were identified in RNA-binding motif protein 20 (RBM20), a spliceosome protein induced during early cardiogenesis. Dermal fibroblasts from two unrelated patients harboring an RBM20 R636S missense mutation were reprogrammed to human induced pluripotent stem cells (hiPSCs) and differentiated to beating cardiomyocytes (CMs). Stage-specific transcriptome profiling identified differentially expressed genes ranging from angiogenesis regulator to embryonic heart transcription factor as initial molecular aberrations. Furthermore, gene expression analysis for RBM20-dependent splice variants affected sarcomeric (TTN and LDB3) and calcium (Ca(2+)) handling (CAMK2D and CACNA1C) genes. Indeed, RBM20 hiPSC-CMs exhibited increased sarcomeric length (RBM20: 1.747 ± 0.238 µm versus control: 1.404 ± 0.194 µm; P < 0.0001) and decreased sarcomeric width (RBM20: 0.791 ± 0.609 µm versus control: 0.943 ± 0.166 µm; P < 0.0001). Additionally, CMs showed defective Ca(2+) handling machinery with prolonged Ca(2+) levels in the cytoplasm as measured by greater area under the curve (RBM20: 814.718 ± 94.343 AU versus control: 206.941 ± 22.417 AU; P < 0.05) and higher Ca(2+) spike amplitude (RBM20: 35.281 ± 4.060 AU versus control:18.484 ± 1.518 AU; P < 0.05). β-adrenergic stress induced with 10 µm norepinephrine demonstrated increased susceptibility to sarcomeric disorganization (RBM20: 86 ± 10.5% versus control: 40 ± 7%; P < 0.001). This study features the first hiPSC model of RBM20 familial DCM. By monitoring human cardiac disease according to stage-specific cardiogenesis, this study demonstrates RBM20 familial DCM is a developmental disorder initiated by molecular defects that pattern maladaptive cellular mechanisms of pathological cardiac remodeling. Indeed, hiPSC-CMs recapitulate RBM20 familial DCM phenotype in a dish and establish a tool to dissect disease-relevant defects in RBM20 splicing as a global regulator of heart function.
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Affiliation(s)
- Saranya P Wyles
- Center for Clinical and Translational Sciences, Center for Regenerative Medicine
| | - Xing Li
- Department of Health Sciences Research, Division of Biomedical Statistics and Informatics
| | | | | | - Saji Oommen
- Division of General Internal Medicine, Department of Molecular Pharmacology and Experimental Therapeutics
| | - Rosanna Beraldi
- Children's Hospital Research Center, Sanford Research, Sioux Falls, SD 57104, USA
| | | | - Andre Terzic
- Center for Regenerative Medicine, Division of Cardiovascular Diseases, Department of Molecular Pharmacology and Experimental Therapeutics, Department of Medical Genetics
| | - Timothy M Olson
- Department of Molecular Pharmacology and Experimental Therapeutics, Division of Pediatric Cardiology, Cardiovascular Genetics Research Laboratory and
| | - Timothy J Nelson
- Center for Regenerative Medicine, Division of General Internal Medicine, Department of Molecular Pharmacology and Experimental Therapeutics, Division of Pediatric Cardiology, Transplant Center, Mayo Clinic, Rochester, MN 55905, USA and
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Campbell KA, Terzic A, Nelson TJ. Induced pluripotent stem cells for cardiovascular disease: from product-focused disease modeling to process-focused disease discovery. Regen Med 2015; 10:773-83. [PMID: 26439809 DOI: 10.2217/rme.15.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Induced pluripotent stem (iPS) cell technology offers an unprecedented opportunity to study patient-specific disease. This biotechnology platform enables recapitulation of individualized disease signatures in a dish through differentiation of patient-derived iPS cells. Beyond disease modeling, the in vitro process of differentiation toward genuine patient tissue offers a blueprint to inform disease etiology and molecular pathogenesis. Here, we highlight recent advances in patient-specific cardiac disease modeling and outline the future promise of iPS cell-based disease discovery applications.
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Affiliation(s)
- Katherine A Campbell
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Andre Terzic
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.,Department of Medical Genetics, Mayo Clinic, Rochester, MN, USA
| | - Timothy J Nelson
- Department of Molecular Pharmacology & Experimental Therapeutics, Mayo Clinic, Rochester, MN, USA.,Center for Regenerative Medicine, Mayo Clinic, Rochester, MN, USA.,Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA.,Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN, USA.,Center for Transplantation & Clinical Regeneration, Mayo Clinic, Rochester, MN, USA.,Division of Pediatric Cardiology, Mayo Clinic, Rochester, MN, USA
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Abstract
Ebstein anomaly accounts for 1% of all congenital heart disease. It is a right ventricular myopathy with failure of tricuspid valve delamination and highly variable tricuspid valve morphology that usually results in severe regurgitation. It is the only congenital heart lesion that has a range of clinical presentations, from the severely symptomatic neonate to an asymptomatic adult. Neonatal operation has high operative mortality, whereas operation performed beyond infancy and into adulthood has low operative mortality. Late survival and quality of life for hospital survivors are excellent for the majority of patients in all age brackets. Atrial tachyarrhythmias are the most common late complication. There have been more techniques of tricuspid repair reported in the literature than any other congenital or acquired cardiac lesion. This is largely due to the infinite anatomic variability encountered with this anomaly. The cone reconstruction of Ebstein anomaly can achieve near anatomic restoration of the tricuspid valve anatomy. Early and intermediate results with these repairs are promising. Reduced right ventricular function continues to be a challenge for some patients, as is the need for reoperation for recurrent tricuspid regurgitation. The purpose of this article is to outline the current standard of care for diagnosis and treatment of Ebstein anomaly and describe innovative strategies to address poor right ventricular function and associated right-sided heart failure.
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Affiliation(s)
| | - Bassem N Mora
- a Divisions of Cardiovascular Surgery, Pediatric Cardiology and Cardiovascular Diseases, and Anesthesiology and Critical Care, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Timothy J Nelson
- a Divisions of Cardiovascular Surgery, Pediatric Cardiology and Cardiovascular Diseases, and Anesthesiology and Critical Care, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Dawit T Haile
- a Divisions of Cardiovascular Surgery, Pediatric Cardiology and Cardiovascular Diseases, and Anesthesiology and Critical Care, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
| | - Patrick W O'Leary
- a Divisions of Cardiovascular Surgery, Pediatric Cardiology and Cardiovascular Diseases, and Anesthesiology and Critical Care, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA
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Campbell KA, Li X, Biendarra SM, Terzic A, Nelson TJ. Nos3-/- iPSCs model concordant signatures of in utero cardiac pathogenesis. J Mol Cell Cardiol 2015; 87:228-36. [PMID: 26344701 DOI: 10.1016/j.yjmcc.2015.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 08/28/2015] [Accepted: 08/29/2015] [Indexed: 01/17/2023]
Abstract
BACKGROUND Through genome-wide transcriptional comparisons, this study interrogates the capacity of in vitro differentiation of induced pluripotent stem cells (iPSCs) to accurately model pathogenic signatures of developmental cardiac defects. METHODS AND RESULTS Herein, we studied the molecular etiology of cardiac defects in Nos3(-/-) mice via transcriptional analysis of stage-matched embryonic tissues and iPSC-derived cells. In vitro comparisons of differentiated cells were calibrated to in utero benchmarks of health and disease. Integrated systems biology analysis of WT and Nos3(-/-) transcriptional profiles revealed 50% concordant expression patterns between in utero embryonic tissues and ex vivo iPSC-derived cells. In particular, up-regulation of glucose metabolism (p-value=3.95×10(-12)) and down-regulation of fatty acid metabolism (p-value=6.71×10(-12)) highlight a bioenergetic signature of early Nos3 deficiency during cardiogenesis that can be recapitulated in iPSC-derived differentiated cells. CONCLUSIONS The in vitro concordance of early Nos3(-/-) disease signatures supports the utility of iPSCs as a cellular model of developmental heart defects. Moreover, this study supports the use of iPSCs as a platform to pinpoint initial stages of congenital cardiac pathogenesis.
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Affiliation(s)
- Katherine A Campbell
- Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Center for Regenerative Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Division of General Internal Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
| | - Xing Li
- Department of Health Sciences Research, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Division of Biomedical Statistics and Informatics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
| | - Sherri M Biendarra
- Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
| | - Andre Terzic
- Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Center for Regenerative Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Division of Cardiovascular Diseases, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Department of Medical Genetics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA
| | - Timothy J Nelson
- Department of Molecular Pharmacology and Experimental Therapeutics, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Center for Regenerative Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Division of Cardiovascular Diseases, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Division of General Internal Medicine, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Center for Transplantation and Clinical Regeneration, 200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA; Division of Pediatric Cardiology,200 First Street SW, Mayo Clinic, Rochester, MN 55905, USA.
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