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iPSC-derived cardiomyocytes from patients with myotonic dystrophy type 1 have abnormal ion channel functions and
Hugo Poulin1, Aurélie Mercier1, Mohammed Djemai1
1CERVO Brain Research Centre, Quebec, QC, Canada.
Insights
Myotonic Dystrophy type 1 (DM1) cardiac dysfunction involves abnormal sodium and calcium channels in heart cells. This study models DM1 using patient-derived cells, revealing ion channel defects impacting heart electrical activity and conduction.
Area of Science:
- Cardiovascular Biology
- Genetics
- Stem Cell Biology
Background:
- Cardiac complications, including arrhythmias, are a primary cause of mortality in Myotonic Dystrophy type 1 (DM1).
- DM1 is characterized by CTG repeat expansions, leading to toxic RNA foci and MBNL1/2 mis-splicing, impacting cellular function.
Purpose of the Study:
- To develop and characterize an induced pluripotent stem cell-derived cardiomyocyte (iPSC-CM) model of DM1.
- To investigate the ion channel dysfunctions underlying cardiac electrical abnormalities in DM1 patients.
Main Methods:
- Generation of iPSC-CMs from healthy individuals and DM1 patients with varying CTG repeat lengths.
- Confirmation of toxic RNA foci and MBNL1/2 mis-splicing in DM1 iPSC-CMs.
- Electrophysiological assessments (e.g., optical mapping, ion current measurements) and molecular analyses (e.g., transcript/protein expression).
Main Results:
- DM1 iPSC-CMs exhibited toxic RNA foci and MBNL1/2 mis-splicing.
- A switch from adult to neonatal SCN5A isoforms and increased L-type calcium current (ICaL) density were observed in DM1-1300 iPSC-CMs.
- Ion channel dysfunctions (INa and ICaL) led to prolonged action potential duration, slower conduction velocities, and decreased action potential upstrokes.
Conclusions:
- DM1 iPSC-CMs recapitulate key cardiac electrical abnormalities seen in patients.
- Distinct perturbations in sodium (Na+) and calcium (Ca2+) channels contribute to cardiac dysfunction in DM1.
- These ion channel defects significantly impact cardiac action potentials and overall heart conduction.
Abstract:
Cardiac complications such as electrical abnormalities including conduction delays and arrhythmias are the main cause of death in individuals with Myotonic Dystrophy type 1 (DM1). We developed a disease model using iPSC-derived cardiomyocytes (iPSC-CMs) from a healthy individual and two DM1 patients with different CTG repeats lengths and clinical history (DM1-1300 and DM1-300). We confirmed the presence of toxic RNA foci and mis-spliced MBNL1/2 transcripts in DM1 iPSC-CMs. In DM1-1300, we identified a switch in the cardiac sodium channel SCN5A from the adult to the neonatal isoform. The down-regulation of adult SCN5A isoforms is consistent with a shift in the sodium current activation to depolarized potentials observed in DM1-1300. L-type calcium current density was higher in iPSC-CMs from DM1-1300, which is correlated with the overexpression of the CaV1.2 transcript and proteins. Importantly, INa and ICaL dysfunctions resulted in prolonged action potentials duration, slower velocities, and decreased overshoots. Optical mapping analysis revealed a slower conduction velocity in DM1-1300 iPSC-CM monolayers. In conclusion, our data revealed two distinct ions channels perturbations in DM1 iPSC-CM from the patient with cardiac dysfunction, one affecting Na+ channels and one affecting Ca2+ channels. Both have an impact on cardiac APs and ultimately on heart conduction.
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