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Proteomics analyses reveal potential therapeutic strategies for HCM

ABSTRACT: Proteomics was performed to facilitate the understanding of the metabolic alterations in HCM patients from proteinlevel

INSTRUMENT(S): Q Exactive

ORGANISM(S): Homo Sapiens (human)

TISSUE(S): Heart

DISEASE(S): Cardiovascular System Disease

SUBMITTER: wang wenmin

LAB HEAD: Wenmin Wang, Zeping Hu

PROVIDER: PXD032097 | Pride | 2022-03-22

REPOSITORIES: Pride

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Project description:Background Hypertrophic cardiomyopathy (HCM) is defined clinically by pathological left ventricular hypertrophy (LVH). We have previously developed a plasma proteomics biomarker panel that correlates with clinical markers of disease severity and sudden cardiac death (SCD) risk in adult patients with HCM. The aim of this study was to validate the adult biomarkers and perform new discovery proteomics in childhood-onset HCM. Methods Fifty-nine protein biomarkers were identified from an exploratory plasma proteomics screen in children with HCM and augmented into our existing multiplexed targeted liquid chromatography-tandem/mass spectrometry-based assay. The association of these biomarkers with clinical phenotypes and outcomes was prospectively tested in plasma collected from 148 children with HCM and 50 healthy controls. Machine learning techniques were used to develop novel paediatric plasma proteomic biomarker panels.Results Four previously validated adult HCM markers (Aldolase Fructose-Bisphosphate A, Complement C3a, Talin-1 and Thrombospondin 1) and three new markers (Glycogen Phosphorylase B, Lipoprotein A and Profilin 1) were elevated in paediatric HCM. Using supervised machine learning applied to training (n=137) and validation cohorts (n=61), this 7-biomarker panel differentiated HCM from healthy controls with an area under the curve of 1.0 in the training dataset (sensitivity 100% [95% confidence interval: 95–100]; specificity 100% [96–100]) and 0.82 in the validation dataset (sensitivity 75% [59–86]; specificity 88% [75–94]). Reduced circulating levels of 4 other peptides (Apolipoprotein L1-, Complement 5b-, Immunoglobulin Heavy Constant Epsilon- and Serum Amyloid A4-peptide) found in children with high SCD risk provided complete separation from the low and intermediate risk groups, and predicted mortality and adverse cardiovascular outcomes (hazard ratio 1.53 [1.2 –2.0], p = 0.001). ConclusionIn children, a 7-biomarker proteomics panel can distinguish HCM from controls with high sensitivity and specificity, and a second 4-biomarker panel identifies those at high risk of adverse outcomes, including sudden cardiac death.

Project description:Rationale Hypertrophic cardiomyopathy (HCM) is the most common cardiac genetic disorder caused by sarcomeric gene variants and is associated with left ventricular hypertrophy and diastolic dysfunction. The role of the microtubule network has recently gained interest with findings that microtubule detyrosination (dTyr-MTs) is markedly elevated in heart failure. Acute reduction of dTyr-MTs by inhibition of the detyrosinase (VASH/SVBP complex) or activation of the tyrosinase (tubulin tyrosine ligase, TTL) markedly improved contractility and reduced stiffness in human failing cardiomyocytes, presenting a new perspective for HCM treatment. Objective In this study, we tested the impact of chronic tubulin tyrosination in a HCM mouse model (Mybpc3-knock-in; KI), in human HCM cardiomyocytes, and in SVBP-deficient human engineered heart tissues (EHTs). Methods and Results AAV9-mediated TTL transfer was applied in neonatal wild-type (WT) rodents, in 3-week-old KI mice, and in HCM human induced pluripotent stem cell (hiPSC)-derived cardiomyocytes. We show: i) TTL for 6 weeks dose-dependently reduced dTyr-MTs and improved contractility without affecting cytosolic calcium transients in WT cardiomyocytes. ii) TTL for 12 weeks reduced the abundance of dTyr-MTs in the myocardium, improved diastolic filling, compliance, cardiac output, and stroke volume in KI mice. iii) TTL for 10 days normalized cell area in HCM hiPSC-cardiomyocytes. iv) TTL overexpression activates transcription of several tubulin isoforms, and omics GO analysis revealed enrichment of components of the cytoskeleton, sarcomere Z-disc, mitochondria, and intercalated disc in KI mice. v) SVBP-deficient EHTs exhibited reduced dTyr-MT levels, higher force, and faster relaxation than TTL-deficient and WT EHTs. RNA-seq and mass spectrometry analysis revealed distinct enrichment of cardiomyocyte components and pathways in SVBP-KO vs. TTL-KO EHTs. Conclusion This study provides the first proof-of-concept that chronic activation of tubulin tyrosination in HCM mice and in human EHTs improves heart function and holds promise for targeting the non-sarcomeric cytoskeleton in heart disease.

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Proteomics analyses reveal potential therapeutic strategies for HCM

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