1. Susceptibility to innate immune activation in genetically mediated myocarditis
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Selgrade, Daniel F., Fullenkamp, Dominic E., Chychula, Ivana A., Li, Binjie, Dellefave-Castillo, Lisa, Dubash, Adi D., Ohiri, Joyce, Monroe, Tanner O., Blancard, Malorie, Tomar, Garima, Holgren, Cory, Burridge, Paul W., George, Alfred L., Jr., Demonbreun, Alexis R., Puckelwartz, Megan J., George, Sharon A., Efimov, Igor R., Green, Kathleen J., and McNally, Elizabeth M.
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Myocarditis -- Diagnosis -- Care and treatment ,Disease susceptibility -- Analysis ,Health care industry ,Diagnosis ,Care and treatment ,Analysis - Abstract
Myocarditis is clinically characterized by chest pain, arrhythmias, and heart failure, and treatment is often supportive. Mutations in DSP, a gene encoding the desmosomal protein desmoplakin, have been increasingly implicated in myocarditis. To model DSP-associated myocarditis and assess the role of innate immunity, we generated engineered heart tissues (EHTs) using human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) from patients with heterozygous DSP truncating variants (DSPtvs) and a gene-edited homozygous deletion cell line ([DSP.sup.-/-]). At baseline, [DSP.sup.-/-] EHTs displayed a transcriptomic signature of innate immune activation, which was mirrored by cytokine release. Importantly, [DSP.sup.- /-] EHTs were hypersensitive to Toll-like receptor (TLR) stimulation, demonstrating more contractile dysfunction compared with isogenic controls. Relative to [DSP.sup.-/-] EHTs, heterozygous DSPtv EHTs had less functional impairment. DSPtv EHTs displayed heightened sensitivity to TLR stimulation, and when subjected to strain, DSPtv EHTs developed functional deficits, indicating reduced contractile reserve compared with healthy controls. Colchicine or NF-[kappa]B inhibitors improved straininduced force deficits in DSPtv EHTs. Genomic correction of DSP p.R1951X using adenine base editing reduced inflammatory biomarker release from EHTs. Thus, EHTs replicate electrical and contractile phenotypes seen in human myocarditis, implicating cytokine release as a key part of the myogenic susceptibility to inflammation. The heightened innate immune activation and sensitivity are targets for clinical intervention., Introduction Myocarditis is a life-threatening heart condition characterized by inflammation, cellular infiltrate, chest pain, reduced heart function, and arrhythmias (1). Myocarditis affects as many as 10-20 per 100,000 people, with [...]
- Published
- 2024
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