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Updated: Jun 21, 2026

Investigating the Pathogenesis of MYH7 Mutation Gly823Glu in Familial Hypertrophic Cardiomyopathy using a Mouse Model
Published on: August 8, 2022
The ubiquitin-proteasome system and nonsense-mediated mRNA decay in hypertrophic cardiomyopathy
Lucie Carrier1, Saskia Schlossarek, Monte S Willis
1Institute of Experimental and Clinical Pharmacology and Toxicology, Cardiovascular Research Center, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany. l.carrier@uke.uni-hamburg.de
Insights
Hypertrophic cardiomyopathy (HCM) involves genetic mutations affecting sarcomeric proteins. Quality control systems like nonsense-mediated mRNA decay (NMD) and ubiquitin-proteasome system (UPS) regulate mutant proteins, offering therapeutic targets.
Area of Science:
- Cardiology
- Genetics
- Molecular Biology
Background:
- Cardiomyopathies, particularly hypertrophic cardiomyopathy (HCM), are significant causes of heart failure, arrhythmias, and sudden death.
- Most HCM cases are familial, inherited in an autosomal-dominant pattern, with genetics largely elucidated over the past two decades.
- HCM is classified as a sarcomeropathy, typically caused by mutations in sarcomeric proteins like beta-myosin heavy chain and cardiac myosin-binding protein C.
Purpose of the Study:
- To review the clinical and genetic aspects of hypertrophic cardiomyopathy (HCM).
- To explore the roles of nonsense-mediated mRNA decay (NMD) and the ubiquitin-proteasome system (UPS) in regulating mutant proteins in HCM.
- To discuss evidence implicating UPS impairment in pathogenesis and to consider potential therapeutic strategies for HCM.
Main Methods:
- Review of existing literature on the genetic basis and pathophysiology of HCM.
- Analysis of the mechanisms of nonsense-mediated mRNA decay (NMD) and ubiquitin-proteasome system (UPS) in relation to sarcomeric protein mutations.
- Examination of evidence linking UPS dysfunction to HCM pathogenesis.
Main Results:
- Missense mutations in beta-myosin heavy chain lead to dysfunctional sarcomeric proteins.
- Nonsense and frameshift mutations in cardiac myosin-binding protein C result in haploinsufficiency via NMD and UPS.
- Impairment of the ubiquitin-proteasome system (UPS) is suggested as a pathogenic factor in HCM.
Conclusions:
- Understanding the genetic underpinnings and protein quality control mechanisms in HCM is crucial.
- Nonsense-mediated mRNA decay (NMD) and ubiquitin-proteasome system (UPS) play key roles in HCM pathogenesis by managing mutant sarcomeric proteins.
- Targeting NMD and UPS pathways presents potential therapeutic avenues for hypertrophic cardiomyopathy.
Abstract:
Cardiomyopathies represent an important cause of cardiovascular morbidity and mortality due to heart failure, arrhythmias, and sudden death. Most forms of hypertrophic cardiomyopathy (HCM) are familial with an autosomal-dominant mode of inheritance. Over the last 20 years, the genetic basis of the disease has been largely unravelled. HCM is considered as a sarcomeropathy involving mutations in sarcomeric proteins, most often beta-myosin heavy chain and cardiac myosin-binding protein C. 'Missense' mutations, more common in the former, are associated with dysfunctional proteins stably integrated into the sarcomere. 'Nonsense' and frameshift mutations, more common in the latter, are associated with low mRNA and protein levels derived from the diseased allele, leading to haploinsufficiency of the remaining healthy allele. The two quality control systems responsible for the removal of the affected mRNAs and proteins are the nonsense-mediated mRNA decay (NMD) and the ubiquitin-proteasome system (UPS), respectively. This review discusses clinical and genetic aspects of HCM and the role of NMD and UPS in the regulation of mutant proteins, evidence for impairment of UPS as a pathogenic factor, as well as potential therapies for HCM.
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