Related Experiment Video
Updated: Mar 20, 2026

Analysis of Congenital Heart Defects in Mouse Embryos Using Qualitative and Quantitative Histological Methods
Published on: March 10, 2020
Defects in PDIA4 increase individuals' susceptibility to congenital heart disease
Yuquan Lu1,2, Jiangjie Liu1,2, Siyu Sun1,2
1Pediatric Heart Center, Children's Hospital of Fudan University, Shanghai, China.
Insights
Protein disulfide isomerase family member 4 (PDIA4) is implicated in congenital heart disease (CHD). PDIA4 deficiency impairs cardiac development by affecting the WNT/β-catenin pathway.
Area of Science:
- Genetics
- Cardiology
- Molecular Biology
Background:
- Congenital heart disease (CHD) involves structural heart defects during fetal development.
- The role of Protein disulfide isomerase family member 4 (PDIA4) in CHD is unexplored.
- PDIA4 is known to facilitate protein folding.
Purpose of the Study:
- To investigate the potential involvement of PDIA4 in congenital heart disease.
- To identify PDIA4 as a candidate gene for CHD.
- To elucidate the functional role of PDIA4 in cardiac development.
Main Methods:
- Whole-exome and targeted sequencing identified PDIA4 as a candidate gene.
- PDIA4-knockdown human umbilical vein endothelial cells were generated.
- Cellular and transcriptomic analyses were performed.
Main Results:
- A de novo PDIA4 mutation was identified in a patient with complex CHD.
- Rare deleterious PDIA4 variants were significantly enriched in CHD patients.
- PDIA4 deficiency suppressed endothelial cell function and WNT/β-catenin signaling.
Conclusions:
- PDIA4 may serve as a susceptibility gene for CHD.
- PDIA4 deficiency can contribute to abnormal cardiac development.
- Modulation of WNT/β-catenin signaling by PDIA4 is crucial for cardiac development.
Introduction:
Congenital heart disease (CHD) comprises structural abnormalities of the heart and major blood vessels arising during fetal development. Protein disulfide isomerase family member 4 (PDIA4) facilitates protein folding processes. However, its potential involvement in CHD has not been investigated. In this study, we identified PDIA4 as a candidate gene potentially involved in cardiac development.
Methods:
Whole-exome sequencing and targeted sequencing were performed to identify PDIA4 as a candidate gene of CHD. To investigate the functional role of PDIA4, PDIA4-knockdown human umbilical vein endothelial cells were generated, followed by cellular and transcriptomic analyses.
Results:
A de novo PDIA4 mutation (NM004911: c.1249G>A: p.V417I) was found in a patient with complex CHD. Burden analysis demonstrated a significant enrichment of rare deleterious PDIA4 variants in patients with CHD compared with controls (Person's chi-squared test: OR: 4.08, 95% CI: 2.23-4.76, p = 7.46e-7). Deficiency of PDIA4 in human umbilical vein endothelial cells suppressed functionality and inhibited the protein levels of both total and nuclear β-catenin as well as the downstream activity of the WNT/β-catenin signaling pathway.
Conclusion:
Our study suggests that PDIA4 may act as a susceptibility gene for CHD, and its deficiency may contribute to abnormal cardiac development by modulating the WNT/β-catenin signaling pathway.
Related Concept Videos
Cardiomyopathy III: Hypertrophic Cardiomyopathy
Teratogenicity
Cardiomyopathy II: Dilated Cardiomyopathy
Rheumatic Heart Disease I: Introduction
Cardiomyopathy IV: Restrictive Cardiomyopathy
Coronary Artery Disease I: Introduction

