Key result
The PLN R14del+/- mutation resulted in hyperdynamic Ca2+ handling, including a 43% reduction in Ca2+ transient decay kinetics, indicating a loss of SERCA2a inhibition rather than superinhibition.
Why the study?
SERCA2a superinhibition is widely assumed to cause PLN-R14del-associated cardiomyopathy, but alternative mechanisms like abnormal energy metabolism are reported. This study evaluated Ca2+ dynamics and energy metabolism prior to cardiomyopathy development.
The PLN R14del+/- mutation causes hyperdynamic Ca2+ handling and depressed resting energy metabolism prior to cardiomyopathy development, challenging the prevailing SERCA2a superinhibition hypothesis.
Answers are grounded in this paper and cite their sources.
Challenges superinhibition hypothesis in young PLN R14del mice; leaves open ER stress or SR-mito uncoupling as early ACM drivers in patients.
Aims The heterozygous phospholamban (PLN) mutation R14del (PLN R14del +/- ) is associated with a severe arrhythmogenic cardiomyopathy (ACM) developing in the adult. “Superinhibition” of SERCA2a by PLN R14del is widely assumed to underlie the pathogenesis, but alternative mechanisms such abnormal energy metabolism have also been reported. This work aims to 1) to evaluate Ca 2+ dynamics and energy metabolism in a transgenic (TG) mouse model of the mutation prior to cardiomyopathy development; 2) to test whether they are causally connected. Methods and Results Ca 2+ dynamics, energy metabolism parameters, reporters of mitochondrial integrity, energy and redox homeostasis were measured in ventricular myocytes of 8-12 weeks-old, phenotypically silent, TG mice. Mutation effects were compared to pharmacological PLN antagonism and analysed during modulation of sarcoplasmic reticulum (SR) and cytosolic Ca 2+ compartments. Transcripts and proteins of relevant signalling pathways were evaluated. The mutation was characterized by hyperdynamic Ca 2+ handling, similar to that induced by PLN antagonism. Albeit all components of energy metabolism were depressed at rest, functional signs of mitochondrial damage or energy starvation were absent and cell energy charge was preserved. The response of mitochondrial O 2 consumption to SERCA2a blockade was lost in mutant myocytes (SR-mitochondrial uncoupling) and ER-stress signalling was activated. Conclusions 1) PLN R14del +/- loses its ability to inhibit SERCA2a, which argues against SERCA2a superinhibition as a mechanism of ACM; 2) depression of resting energy metabolism may at least partly reflect impairment of SR-mitochondrial coupling; 3) ER-stress may be an early factor in the pathogenesis.
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Maniezzi et al. (2023) studied Arrhythmogenic cardiomyopathy. PLN R14del+/- mutation vs. Wild-type (WT) littermates was evaluated on Ca2+ transient decay kinetics (τ decay) (43% reduction, p=<0.0001). The PLN R14del+/- mutation resulted in hyperdynamic Ca2+ handling, including a 43% reduction in Ca2+ transient decay kinetics, indicating a loss of SERCA2a inhibition rather than superinhibition.
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