成纤维细胞
细胞外基质
肌成纤维细胞
纤维化
扩张型心肌病
心脏纤维化
心力衰竭
心肌纤维化
医学
表型
心肌病
人口
提丁
内科学
心脏病学
细胞生物学
生物
肌节
心肌细胞
体外
遗传学
基因
环境卫生
作者
Ross C. Bretherton,Isabella M. Reichardt,Kristin A. Zabrecky,Alex Goldstein,Logan R.J. Bailey,Darrian Bugg,Timothy S. McMillen,Kristina B. Kooiker,Galina V. Flint,Amy Martinson,Jagdambika Gunaje,Franziska Koser,Elizabeth Plaster,Wolfgang A. Linke,Michael Regnier,Farid Moussavi‐Harami,Nathan J. Sniadecki,Cole A. DeForest,Jennifer Davis
标识
DOI:10.1101/2023.01.23.523684
摘要
Inherited mutations in contractile and structural genes, which decrease cardiomyocyte tension generation, are principal drivers of dilated cardiomyopathy (DCM)- the leading cause of heart failure 1,2 . Progress towards developing precision therapeutics for and defining the underlying determinants of DCM has been cardiomyocyte centric with negligible attention directed towards fibroblasts despite their role in regulating the best predictor of DCM severity, cardiac fibrosis 3,4 . Given that failure to reverse fibrosis is a major limitation of both standard of care and first in class precision therapeutics for DCM, this study examined whether cardiac fibroblast-mediated regulation of the heart's material properties is essential for the DCM phenotype. Here we report in a mouse model of inherited DCM that prior to the onset of fibrosis and dilated myocardial remodeling both the myocardium and extracellular matrix (ECM) stiffen from switches in titin isoform expression, enhanced collagen fiber alignment, and expansion of the cardiac fibroblast population, which we blocked by genetically suppressing p38α in cardiac fibroblasts. This fibroblast-targeted intervention unexpectedly improved the primary cardiomyocyte defect in contractile function and reversed ECM and dilated myocardial remodeling. Together these findings challenge the long-standing paradigm that ECM remodeling is a secondary complication to inherited defects in cardiomyocyte contractile function and instead demonstrate cardiac fibroblasts are essential contributors to the DCM phenotype, thus suggesting DCM-specific therapeutics will require fibroblast-specific strategies.
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