DMD Pluripotent Stem Cell Derived Cardiac Cells Recapitulate in vitro Human Cardiac Pathophysiology
Sarka Jelinkova1,2, Aleksandra Vilotic1, Jan Pribyl3
1Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia.
Insights
Duchenne muscular dystrophy (DMD) patient cells show impaired cardiac function and increased death rates in a new human model. This study provides a tool for understanding DMD cardiomyopathy and testing therapies.
Area of Science:
- Cardiovascular Research
- Genetics
- Stem Cell Biology
Background:
- Duchenne muscular dystrophy (DMD) causes progressive cardiomyopathy and heart failure, the primary cause of death in patients.
- Previous research relied on mouse models, lacking human relevance for studying DMD cardiomyocyte (DMD-CM) dysfunction.
- A human model was needed to accurately characterize DMD-CM phenotype and symptom onset.
Purpose of the Study:
- To create and validate a human Duchenne muscular dystrophy cardiac cell (DMD-CC) disease model.
- To investigate the functional and molecular consequences of dystrophin deficiency in human cardiac cells.
- To establish a platform for studying DMD cardiomyopathy progression and in vitro therapy testing.
Main Methods:
- Generation of dystrophin-deficient human pluripotent stem cell (hPSC) lines from DMD patients and via CRISPR/Cas9.
- Differentiation of DMD-hPSCs into cardiac cells (DMD-CCs).
- Assessment of differentiation efficiency, cell death rates, ion channel expression, calcium handling, mechanical function, and adrenergic response.
Main Results:
- DMD-hPSCs showed reduced differentiation into cardiac cells.
- DMD-CCs exhibited increased cell death, altered potassium and calcium handling (Kir2.1 and dihydropyridine receptor overexpression).
- DMD-CCs displayed impaired contractility, bradycardia, increased heart rate variability, and blunted beta-adrenergic response.
Conclusions:
- The developed human DMD-CC model accurately recapitulates key functional defects and cardiac wasting seen in Duchenne muscular dystrophy.
- Dystrophin deficiency directly impacts human cardiac cell function, leading to observable mechanical and electrophysiological impairments.
- This novel in vitro model serves as a valuable tool for advancing the study of DMD-associated cardiomyopathy and evaluating potential therapeutic interventions.
Abstract:
Duchenne muscular dystrophy (DMD) is a severe genetic disorder characterized by the lack of functional dystrophin. DMD is associated with progressive dilated cardiomyopathy, eventually leading to heart failure as the main cause of death in DMD patients. Although several molecular mechanisms leading to the DMD cardiomyocyte (DMD-CM) death were described, mostly in mouse model, no suitable human CM model was until recently available together with proper clarification of the DMD-CM phenotype and delay in cardiac symptoms manifestation. We obtained several independent dystrophin-deficient human pluripotent stem cell (hPSC) lines from DMD patients and CRISPR/Cas9-generated DMD gene mutation. We differentiated DMD-hPSC into cardiac cells (CC) creating a human DMD-CC disease model. We observed that mutation-carrying cells were less prone to differentiate into CCs. DMD-CCs demonstrated an enhanced cell death rate in time. Furthermore, ion channel expression was altered in terms of potassium (Kir2.1 overexpression) and calcium handling (dihydropyridine receptor overexpression). DMD-CCs exhibited increased time of calcium transient rising compared to aged-matched control, suggesting mishandling of calcium release. We observed mechanical impairment (hypocontractility), bradycardia, increased heart rate variability, and blunted β-adrenergic response connected with remodeling of β-adrenergic receptors expression in DMD-CCs. Overall, these results indicated that our DMD-CC models are functionally affected by dystrophin-deficiency associated and recapitulate functional defects and cardiac wasting observed in the disease. It offers an accurate tool to study human cardiomyopathy progression and test therapies in vitro.
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