Key result
Elevated plasma PKM2 concentrations served as an independent predictor for the occurrence of aortic dissection (OR 5.95) and correlated with a higher incidence of major adverse events.
Why the study?
Metabolic disturbances are hallmarks of vascular smooth muscle cell phenotypic transitions that play a critical role in the pathogenesis of aortic dissection.
Does GMRSP overexpression prevent aortic dissection and regulate VSMC metabolic reprogramming?
Observational (n=205)
Does GMRSP overexpression prevent aortic dissection and regulate VSMC metabolic reprogramming?
Odds Ratio: 5.95 (95% CI 2.3–15.4)
GMRSP, a microprotein encoded by lncRNA H19, protects against aortic dissection by inhibiting PKM2-mediated glycolysis, and plasma PKM2 serves as a potential biomarker for AD.
GMRSP delivery attenuates aortic dissection in preclinical models; leaves open human therapeutic translation.
Metabolic disturbances are hallmarks of vascular smooth muscle cell (VSMC) phenotypic transitions, which play a critical role in the pathogenesis of aortic dissection (AD). In this study, we identify and characterize glucose metabolism regulatory protein (GMRSP), a protein encoded by lncRNA H19. Using VSMC-specific GMRSP induction in knock-in mice, adeno-associated virus-mediated GMRSP overexpression, and exosomal GMRSP delivery, we demonstrate significant improvements in AD and mitochondrial dysfunction. Mechanistically, GMRSP inhibits heterogeneous nuclear ribonucleoprotein (hnRNP) A2B1-mediated alternative splicing of pyruvate kinase M (PKM) pre-mRNA, leading to reduced PKM2 production and glycolysis. This reprogramming preserves the contractile phenotype of VSMCs and prevents their transition to a proliferative state. Importantly, pharmacological activation of PKM2 via TEPP-46 abrogates the protective effects of GMRSP in vivo and in vitro. Clinical relevance is shown by elevated plasma PKM2 levels in AD patients, which correlate with poor prognosis. Collectively, these findings indicate GMRSP as a key regulator of VSMC metabolism and phenotypic stability, highlighting its potential as a therapeutic target for AD. Metabolic dysfunction is an important characteristic of vascular smooth muscle cells (VSMCs) phenotypic transition in aortic dissection. Here, the authors show lncRNA H19 could encode a peptide, GMRSP. GMRSP regulates the glycolysis by counteracting hnRNP A2B1-mediated pyruvate kinase M pre-mRNA alternative splicing and control the phenotypic transition of VSMCs.
No takes yet. Share an insight, caveat, or question.
Wang et al. (2025) conducted an observational in Aortic dissection (n=205). Elevated plasma PKM2 levels vs. Healthy controls / Low PKM2 levels was evaluated on Occurrence of aortic dissection (OR 5.95, 95% CI 2.30-15.40). Elevated plasma PKM2 concentrations served as an independent predictor for the occurrence of aortic dissection (OR 5.95) and correlated with a higher incidence of major adverse events.