Mutant ANP induces mitochondrial and ion channel remodeling in a human iPSC-derived atrial fibrillation model

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JCI Insight. 2022 Apr 8;7(7):e155640. doi: 10.1172/jci.insight.155640.

Olivia T Ly 1 2Hanna Chen 1Grace E Brown 2Liang Hong 1Xinge Wang 1 2Yong Duk Han 2Mahmud Arif Pavel 1Arvind Sridhar 1 3Mark Maienschein-Cline 4Brandon Chalazan 1Sang-Ging Ong 1 5Khaled Abdelhady 6Malek Massad 6Lona Ernst Rizkallah 6Jalees Rehman 1 2 6Salman R Khetani 2Dawood Darbar 1 2 3 6

Free PMC article

Abstract

Human induced pluripotent stem cell-derived cardiomyocytes (iPSC-CMs) can model heritable arrhythmias to personalize therapies for individual patients. Although atrial fibrillation (AF) is a leading cause of cardiovascular morbidity and mortality, current platforms to generate iPSC-atrial (a) CMs are inadequate for modeling AF. We applied a combinatorial engineering approach, which integrated multiple physiological cues, including metabolic conditioning and electrical stimulation, to generate mature iPSC-aCMs. Using the patient’s own atrial tissue as a gold standard benchmark, we assessed the electrophysiological, structural, metabolic, and molecular maturation of iPSC-aCMs. Unbiased transcriptomic analysis and inference from gene regulatory networks identified key gene expression pathways and transcription factors mediating atrial development and maturation. Only mature iPSC-aCMs generated from patients with heritable AF carrying the non-ion channel gene (NPPA) mutation showed enhanced expression and function of a cardiac potassium channel and revealed mitochondrial electron transport chain dysfunction. Collectively, we propose that ion channel remodeling in conjunction with metabolic defects created an electrophysiological substrate for AF. Overall, our electro-metabolic approach generated mature human iPSC-aCMs that unmasked the underlying mechanism of the first non-ion channel gene, NPPA, that causes AF. Our maturation approach will allow for the investigation of the molecular underpinnings of heritable AF and the development of personalized therapies.

Keywords: Arrhythmias; Cardiology; Genetic diseases; Genetics; iPS cells.

Ly OT, Chen H, Brown GE, Hong L, Wang X, Han YD, Pavel MA, Sridhar A, Maienschein-Cline M, Chalazan B, Ong SG, Abdelhady K, Massad M, Rizkallah LE, Rehman J, Khetani SR, Darbar D. Mutant ANP induces mitochondrial and ion channel remodeling in a human iPSC-derived atrial fibrillation model. JCI Insight. 2022 Apr 8;7(7):e155640. doi: 10.1172/jci.insight.155640. PMID: 35393944; PMCID: PMC9057627.

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