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Modeling of arrhythmogenic right ventricular cardiomyopathy with human induced pluripotent stem cells

  • Oren Caspi
  • , Irit Huber
  • , Amira Gepstein
  • , Gil Arbel
  • , Leonid Maizels
  • , Monther Boulos
  • , Lior Gepstein*
  • *Corresponding author for this work
  • Sohnis Family Research Laboratory for Cardiac Electrophysiology and Regenerative Medicine
  • Technion-Israel Institute of Technology
  • Department of Internal Medicine B
  • Rambam Health Care Campus Israel
  • Cardiology Department

Research output: Contribution to journal › Article › peer-review

162 Scopus citations

Abstract

Background-Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a primary heart muscle disorder resulting from desmosomal protein mutations. ARVC is characterized pathologically by fibrofatty infiltration and clinically by arrhythmias and sudden cardiac death. We aimed to establish a patient-/disease-specific human induced pluripotent stem cell (hiPSC) model of ARVC. Methods and Results-Dermal fibroblasts were obtained from 2 patients with ARVC with plakophilin-2 (PKP2) mutations, reprogrammed to generate hiPSCs, coaxed to differentiate into cardiomyocytes (CMs), and then compared with healthy control hiPSC-derived CMs (hiPSC-CMs). Real-time polymerase chain reaction showed a significant decrease in the expression of PKP2 in the ARVC-hiPSC-CMs. Immunostainings revealed reduced densities of PKP2, the associated desmosomal protein plakoglobin, and the gap-junction protein connexin-43. Electrophysiological assessment demonstrated prolonged field potential rise time in the ARVC-hiPSC-CMs. Transmission electron microscopy identified widened and distorted desmosomes in the ARVC-hiPSC-CMs. Clusters of lipid droplets were identified in the ARVC-CMs that displayed the more severe desmosomal pathology. This finding was associated with upregulation of the proadipogenic transcription factor peroxisome proliferator-activated receptor-γ. Exposure of the cells to apidogenic stimuli augmented desmosomal distortion and lipid accumulation. The latter phenomenon was prevented by application of a specific inhibitor of glycogen synthase kinase 3β (6-bromoindirubin-3'-oxime). Conclusions-This study highlights the unique potential of the hiPSC technology for modeling inherited cardiac disorders in general and ARVC specifically. The hiPSC-CMs were demonstrated to recapitulate the ARVC phenotype in the dish, provide mechanistic insights into early disease pathogenesis, and provide a unique platform for drug discovery and testing in this disorder.

Original languageEnglish
Pages (from-to)557-568
Number of pages12
JournalCirculation: Cardiovascular Genetics
Volume6
Issue number6
DOIs
StatePublished - Dec 2013
Externally publishedYes

Funding

FundersFunder number
European Commission
Seventh Framework Programme260830

    Keywords

    • Arrhythmogenic right ventricular dysplasia
    • Lipids
    • Myocytes cardiac
    • Stem cells

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