Key result
AAV9-TRAF2 gene therapy reduces mortality and preserves LV systolic function in proteotoxic cardiomyopathy.
Why the study?
It was hypothesized that mitochondrial uptake of cytosolic protein aggregates and their removal by mitophagy facilitates cytosolic protein quality control in cardiac myocytes.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Rawnsley et al proposed that mitochondria can segregate the aggregates and dispose of them by mitophagy, thereby maintaining the PQC in mitochondria. Unlike PARKIN (parkin RBR E3 ubiquitin-protein ligase)–mediated mitophagy, TRAF2-mediated mitophagy can eliminate polarized mitochondria in the unstressed heart. Thus, clearance of cytosolic protein aggregates through TRAF2-mediated mitophagy may result in the loss of otherwise functional mitochondria, in contrast to more selective degradation of misfolded proteins by mitochondrial proteases.”
“In conclusion, Rawnsley et al reported a novel observation that mitophagy-mediated disposal of cytosolic protein aggregates could be a critical mechanism maintaining both mitochondrial and cytosolic PQC during proteinopathy. Elucidating the specific underlying mechanisms of mitochondrial transfer of protein aggregates and the molecular mechanism of TRAF2-mediated mitophagy may lead to the development of novel interventions for proteinopathy in the heart.”
TRAF2-mediated mitophagy facilitates the removal of cytosolic protein aggregates and can be stimulated to ameliorate proteotoxic cardiomyopathy in preclinical models.
Background Protein quality control (PQC) is critical for maintaining sarcomere structure and function in cardiac myocytes, and mutations in PQC pathway proteins, such as CRYAB (arginine to glycine at position 120, R120G) and BAG3 (proline to lysine at position 209, P209L) induce protein aggregate pathology with cardiomyopathy in humans. Novel observations in yeast and mammalian cells demonstrate mitochondrial uptake of cytosolic protein aggregates. We hypothesized that mitochondrial uptake of cytosolic protein aggregates and their removal by mitophagy, a lysosomal degradative pathway essential for myocardial homeostasis, facilitates cytosolic protein quality control in cardiac myocytes. Methods Mice with inducible cardiac myocyte specific ablation of TRAF2 (TRAF2icKO), which impairs mitophagy, were assessed for protein aggregates with biochemical fractionation and super-resolution imaging in comparison to floxed controls. Induced pluripotent stem cell (iPSC)-derived cardiac myocytes with R120G knock-in to the CRYAB locus were assessed for localization of the CRYAB protein. Transgenic mice expressing R120G CRYAB protein (R120G-TG) were subjected to both TRAF2 gain-of-function (with AAV9-cardiac Troponin T promoter-driven TRAF2 transduction) and TRAF2 loss-of-function (with tamoxifen-inducible ablation of one Traf2 allele) in cardiac myocytes to determine the effect of mitophagy modulation on cardiac structure, function, and protein aggregate pathology. Results Cardiomyocyte-specific ablation of TRAF2 results accumulation of mitochondrial and cytosolic protein aggregates and DESMIN mis-localization to protein aggregates. Isolated mitochondria take up cardiomyopathy-associated aggregate-prone cytosolic chaperone proteins, namely arginine to glycine (R120G) CRYAB mutant and proline to lysine (P209L) BAG3 mutant. R120G-CRYAB mutant protein increasingly localizes to mitochondria in human and mouse cardiomyocytes. R120G-TG mice demonstrate upregulation of TRAF2 in the mitochondrial fraction with increased mitophagy as compared with wild type. Adult-onset inducible haplo-insufficiency of TRAF2 resulted in accelerated mortality, impaired left ventricular systolic function and increased protein aggregates in R120G-TG mice as compared with controls. Conversely, AAV9-mediated TRAF2 transduction in R120G-TG mice reduced mortality and attenuated left ventricular systolic dysfunction, with reduced protein aggregates and restoration of normal localization of DESMIN, a cytosolic scaffolding protein chaperoned by CRYAB, as compared with control AAV9-GFP group. Conclusions TRAF2-mediated mitophagy in cardiac myocytes facilitates removal of cytosolic protein aggregates and can be stimulated to ameliorate proteotoxic cardiomyopathy.
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Rawnsley et al. (2024) studied Proteotoxic cardiomyopathy. TRAF2 modulation (ablation or AAV9-mediated transduction) vs. Floxed controls, wild type, or AAV9-GFP controls was evaluated on Cardiac structure, function, protein aggregate pathology, and mortality.
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