Key result
H19 gene therapy prevents and reverses pressure-overload heart failure in preclinical models.
Why the study?
Pathological cardiac remodelling and subsequent heart failure represent an unmet clinical need, and the therapeutic potential of the conserved lncRNA H19 remained to be defined.
Does H19 gene therapy prevent or reverse pathological cardiac hypertrophy in preclinical models?
Does H19 gene therapy prevent or reverse pathological cardiac hypertrophy in preclinical models?
H19 acts as an anti-hypertrophic lncRNA, and its targeted gene therapy represents a promising preclinical strategy to prevent and reverse pathological cardiac remodeling.
Answers are grounded in this paper and cite their sources.
H19 gene therapy reverses pressure-overload HF in mice; leaves open feasibility, efficacy, and safety in patients.
AIMS: Pathological cardiac remodelling and subsequent heart failure represents an unmet clinical need. Long non-coding RNAs (lncRNAs) are emerging as crucial molecular orchestrators of disease processes, including that of heart diseases. Here, we report on the powerful therapeutic potential of the conserved lncRNA H19 in the treatment of pathological cardiac hypertrophy. METHOD AND RESULTS: Pressure overload-induced left ventricular cardiac remodelling revealed an up-regulation of H19 in the early phase but strong sustained repression upon reaching the decompensated phase of heart failure. The translational potential of H19 is highlighted by its repression in a large animal (pig) model of left ventricular hypertrophy, in diseased human heart samples, in human stem cell-derived cardiomyocytes and in human engineered heart tissue in response to afterload enhancement. Pressure overload-induced cardiac hypertrophy in H19 knock-out mice was aggravated compared to wild-type mice. In contrast, vector-based, cardiomyocyte-directed gene therapy using murine and human H19 strongly attenuated heart failure even when cardiac hypertrophy was already established. Mechanistically, using microarray, gene set enrichment analyses and Chromatin ImmunoPrecipitation DNA-Sequencing, we identified a link between H19 and pro-hypertrophic nuclear factor of activated T cells (NFAT) signalling. H19 physically interacts with the polycomb repressive complex 2 to suppress H3K27 tri-methylation of the anti-hypertrophic Tescalcin locus which in turn leads to reduced NFAT expression and activity. CONCLUSION: H19 is highly conserved and down-regulated in failing hearts from mice, pigs and humans. H19 gene therapy prevents and reverses experimental pressure-overload-induced heart failure. H19 acts as an anti-hypertrophic lncRNA and represents a promising therapeutic target to combat pathological cardiac remodelling.
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Bührke et al. (2020) studied Pathological cardiac hypertrophy and heart failure. H19 gene therapy vs. Empty vector (AAV9-empty) or Sham operation was evaluated on Cardiac hypertrophy and heart failure progression (e.g., heart weight-to-tibia-length ratio, cardiomyocyte size, ejection fraction).
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