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.

Frontiers in Genetics
|March 19, 2026
PubMed

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.
Abstract

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