Molecular mechanisms of arrhythmogenic cardiomyopathy
Karyn M Austin1, Michael A Trembley1, Stephanie F Chandler1
1Basic and Translational Cardiovascular Research and Inherited Arrhythmias Programs, Department of Cardiology, Boston Children's Hospital, Boston, MA, USA.
Insights
Arrhythmogenic cardiomyopathy stems from desmosome gene mutations, leading to heart dysfunction. Research highlights WNT, Hippo-YAP, and TGF-β pathways in its pathogenesis, offering potential therapeutic targets.
Area of Science:
- Cardiovascular Genetics
- Molecular Cardiology
- Genetic Medicine
Background:
- Arrhythmogenic cardiomyopathy (ACM) is a genetic heart disorder causing arrhythmias and fibrofatty tissue replacement.
- Desmosome gene mutations are primary drivers, found in ~50% of ACM patients.
- Underlying mechanisms of myocardial damage and arrhythmia risk are not fully understood.
Purpose of the Study:
- To review and discuss molecular mechanisms in arrhythmogenic cardiomyopathy pathogenesis.
- To highlight key signaling pathways implicated in ACM development.
- To identify potential therapeutic targets for ACM.
Main Methods:
- Review of recent scientific literature on arrhythmogenic cardiomyopathy.
- Analysis of data from animal models, induced pluripotent stem cells, and other disease models.
- Focus on signaling pathways including WNT, Hippo-YAP, and TGF-β.
Main Results:
- Advances in disease models have illuminated pathogenic mechanisms.
- Several key signaling pathways (WNT, Hippo-YAP, TGF-β) are central to ACM.
- Preclinical studies show promise for modulating these pathways therapeutically.
Conclusions:
- Understanding ACM pathogenesis involves key signaling pathways.
- Targeting WNT, Hippo-YAP, and TGF-β pathways offers therapeutic potential.
- Further research is crucial for developing effective ACM treatments.
Abstract:
Arrhythmogenic cardiomyopathy is a genetic disorder characterized by the risk of life-threatening arrhythmias, myocardial dysfunction and fibrofatty replacement of myocardial tissue. Mutations in genes that encode components of desmosomes, the adhesive junctions that connect cardiomyocytes, are the predominant cause of arrhythmogenic cardiomyopathy and can be identified in about half of patients with the condition. However, the molecular mechanisms leading to myocardial destruction, remodelling and arrhythmic predisposition remain poorly understood. Through the development of animal, induced pluripotent stem cell and other models of disease, advances in our understanding of the pathogenic mechanisms of arrhythmogenic cardiomyopathy over the past decade have brought several signalling pathways into focus. These pathways include canonical and non-canonical WNT signalling, the Hippo-Yes-associated protein (YAP) pathway and transforming growth factor-β signalling. These studies have begun to identify potential therapeutic targets whose modulation has shown promise in preclinical models. In this Review, we summarize and discuss the reported molecular mechanisms underlying the pathogenesis of arrhythmogenic cardiomyopathy.
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