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Balakrishnan B, Altassan R, Budhraja R, Liou W, Lupo A, Bryant S, Mankouski A, Radenkovic S, Preston G, Pandey A, Boudina S, Kozicz T, Morava E, Lai K. AAV-based gene therapy prevents and halts the progression of dilated cardiomyopathy in a mouse model of phosphoglucomutase 1 deficiency (PGM1-CDG). Transl Res 2023; 257:1-14. [PMID: 36709920 PMCID: PMC10192047 DOI: 10.1016/j.trsl.2023.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023]
Abstract
Phosphoglucomutase 1 (PGM1) deficiency is recognized as the third most common N-linked congenital disorders of glycosylation (CDG) in humans. Affected individuals present with liver, musculoskeletal, endocrine, and coagulation symptoms; however, the most life-threatening complication is the early onset of dilated cardiomyopathy (DCM). Recently, we discovered that oral D-galactose supplementation improved liver disease, endocrine, and coagulation abnormalities, but does not alleviate the fatal cardiomyopathy and the associated myopathy. Here we report on left ventricular ejection fraction (LVEF) in 6 individuals with PGM1-CDG. LVEF was pathologically low in most of these individuals and varied between 10% and 65%. To study the pathobiology of the cardiac disease observed in PGM1-CDG, we constructed a novel cardiomyocyte-specific conditional Pgm2 gene (mouse ortholog of human PGM1) knockout (Pgm2 cKO) mouse model. Echocardiography studies corroborated a DCM phenotype with significantly reduced ejection fraction and left ventricular dilation similar to those seen in individuals with PGM1-CDG. Histological studies demonstrated excess glycogen accumulation and fibrosis, while ultrastructural analysis revealed Z-disk disarray and swollen/fragmented mitochondria, which was similar to the ultrastructural pathology in the cardiac explant of an individual with PGM1-CDG. In addition, we found decreased mitochondrial function in the heart of KO mice. Transcriptomic analysis of hearts from mutant mice demonstrated a gene signature of DCM. Although proteomics revealed only mild changes in global protein expression in left ventricular tissue of mutant mice, a glycoproteomic analysis unveiled broad glycosylation changes with significant alterations in sarcolemmal proteins including different subunits of laminin-211, which was confirmed by immunoblot analyses. Finally, augmentation of PGM1 in KO mice via AAV9-PGM1 gene replacement therapy prevented and halted the progression of the DCM phenotype.
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Affiliation(s)
- B Balakrishnan
- Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, USA
| | - R Altassan
- Department of Medical Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - R Budhraja
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - W Liou
- Electron Microscopy Core Facility, University of Utah, Salt Lake City, USA
| | - A Lupo
- Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, USA
| | - S Bryant
- Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, USA
| | - A Mankouski
- Division of Neonatology, Department of Pediatrics, University of Utah, Salt Lake City, USA
| | - S Radenkovic
- Department of Clinical Genomics, Center of Individualized Medicine, Mayo Clinic, Rochester, USA
| | - G Preston
- Department of Clinical Genomics, Center of Individualized Medicine, Mayo Clinic, Rochester, USA
| | - A Pandey
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
- Manipal Academy of Higher Education (MAHE), Manipal 576104, Karnataka, India
| | - S Boudina
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, USA
| | - T Kozicz
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Clinical Genomics, Center of Individualized Medicine, Mayo Clinic, Rochester, USA
- Department of Anatomy, University of Pecs School of Medicine, Pecs, Hungary
| | - E Morava
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
- Department of Clinical Genomics, Center of Individualized Medicine, Mayo Clinic, Rochester, USA
- Department of Medical Genetics, University of Pecs, School of Medicine, Pecs, Hungary
| | - K Lai
- Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, USA
- Department of Nutrition and Integrative Physiology, College of Health, University of Utah, Salt Lake City, USA
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Mankouski A, Miller TA, Dodson RB, Yu B, Yang Y, Liu J, Machin DR, Donato AJ, McKnight RA, Zinkhan EK. Large artery stiffening and mortality in a rat model of early vascular remodeling induced by intrauterine growth restriction and a high-fat diet. Physiol Rep 2022; 10:e15518. [PMID: 36461654 PMCID: PMC9718947 DOI: 10.14814/phy2.15518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 11/02/2022] [Indexed: 05/31/2023] Open
Abstract
Intrauterine growth restriction (IUGR) and exposure to a high-fat diet (HFD) independently increase the risk of cardiovascular disease (CVD) and hyperlipidemia. In our previous studies, IUGR increased blood pressure and promoted vascular remodeling and stiffness in early life, a finding that persisted and was augmented by a maternal HFD through postnatal day (PND) 60. The impact of these findings with aging and the development of hyperlipidemia and atherosclerosis remain unknown. We hypothesized that the previously noted impact of IUGR on hypertension, vascular remodeling, and hyperlipidemia would persist. Adult female rats were fed either a regular diet (RD) or high fat diet (HFD) prior to conception through lactation. IUGR was induced by uterine artery ligation. Offspring were weaned to either RD or HFD through PND 365. For both control (C) and IUGR (I) and rats, this resulted in the following six groups per sex: offspring from RD dams weaned to an RD (CRR and IRR), or offspring from HFD dams weaned to either an RD (CHR and IHR) or to an HFD (CHH and IHH). IHH male and female rats had increased large artery stiffness, a suggestion of fatty streaks in the aorta, and persistent decreased elastin and increased collagen in the aorta and carotid arteries. Post-weaning HFD intake increased blood lipids regardless of IUGR status. IUGR increased HFD-induced mortality. We speculate that HFD-induced risk of CVD and mortality is potentiated by developmental programming of the ECM.
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Affiliation(s)
| | - Thomas A. Miller
- Department of PediatricsUniversity of UtahSalt Lake CityUtahUSA
- Division of Pediatric CardiologyMaine Medical CenterPortlandMaineUSA
| | - R. Blair Dodson
- Departments of Surgery and BioengineeringThe Pediatric Heart Lung Center and the Laboratory for Fetal and Regenerative Biology and the University of Colorado at Denver Anschutz Medical CampusAuroraColoradoUSA
| | - Baifeng Yu
- Department of PediatricsUniversity of UtahSalt Lake CityUtahUSA
| | - Yueqin Yang
- Department of PediatricsUniversity of UtahSalt Lake CityUtahUSA
| | - Jingtong Liu
- Department of PediatricsUniversity of UtahSalt Lake CityUtahUSA
| | - Daniel R. Machin
- Internal MedicineUniversity of UtahSalt Lake CityUtahUSA
- GRECCVA Medical CenterSalt Lake CityUtahUSA
- Florida State UniversityDepartment of Nutrition and Integrative PhysiologyTallahasseeFloridaUSA
| | - Anthony J. Donato
- Internal MedicineUniversity of UtahSalt Lake CityUtahUSA
- GRECCVA Medical CenterSalt Lake CityUtahUSA
- Nutrition and Integrative PhysiologyUniversity of UtahSalt Lake CityUtahUSA
- BiochemistryUniversity of UtahSalt Lake CityUtahUSA
| | | | - Erin K. Zinkhan
- Department of PediatricsUniversity of UtahSalt Lake CityUtahUSA
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Miller TA, Dodson RB, Mankouski A, Powers KN, Yang Y, Yu B, Zinkhan EK. Impact of diet on the persistence of early vascular remodeling and stiffening induced by intrauterine growth restriction and a maternal high-fat diet. Am J Physiol Heart Circ Physiol 2019; 317:H424-H433. [PMID: 31225985 DOI: 10.1152/ajpheart.00127.2019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Intrauterine growth restriction (IUGR) and maternal high-fat diet (HFD) independently predispose offspring to hypertension. In a rat model, IUGR more so than maternal HFD increases arterial stiffness with vascular remodeling as early as postnatal day (PND) 21. The trajectory of such early vascular changes remains unknown. We hypothesized that IUGR would increase blood pressure (BP), arterial stiffness, and markers of ongoing detrimental vascular remodeling in adult rats exposed to a maternal HFD regardless of weaning diet. Adult female rats were fed either a regular diet (RD) or an HFD before mating through lactation. IUGR was induced by uterine artery ligation. Offspring were weaned to either a RD or HFD through PND 60. For both control and IUGR rats, this design resulted in the following three diet groups: offspring from RD dams weaned to a RD and offspring from HFD dams weaned to a RD or to an HFD (IHH). In both males and females, only IHH increased systolic BP, but IUGR and HFD both alone and in combination increased arterial stiffness. Aortas contained fewer but thicker elastin bands in IHH rats and IUGR offspring from dams fed an HFD and weaned to a regular diet. IHH increased aortic lysl oxidase protein. In summary, the PND 21 rat mediators of vascular remodeling from IUGR and maternal HFD normalize by PND 60 while changes in elastin and arterial stiffness persist. We speculate that the longer-term risk of hypertension from dietary mediators is augmented by underlying IUGR-induced structural changes to the extracellular matrix.NEW & NOTEWORTHY We report that a combined insult of intrauterine growth restriction and maternal high-fat diet increases the risk of early cardiovascular pathology both independently and in conjunction with a continued high-fat diet in offspring.
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Affiliation(s)
- Thomas A Miller
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - R Blair Dodson
- Departments of Surgery and Bioengineering, The Pediatric Heart Lung Center and the Laboratory for Fetal and Regenerative Biology, and the University of Colorado at Denver Anschutz Medical Campus, Aurora, Colorado
| | | | - Kyle N Powers
- Departments of Surgery and Bioengineering, The Pediatric Heart Lung Center and the Laboratory for Fetal and Regenerative Biology, and the University of Colorado at Denver Anschutz Medical Campus, Aurora, Colorado
| | - Yueqin Yang
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Baifeng Yu
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
| | - Erin K Zinkhan
- Department of Pediatrics, University of Utah, Salt Lake City, Utah
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Mankouski A, Kantores C, Wong MJ, Ivanovska J, Jain A, Benner EJ, Mason SN, Tanswell AK, Auten RL, Jankov RP. Intermittent hypoxia during recovery from neonatal hyperoxic lung injury causes long-term impairment of alveolar development: A new rat model of BPD. Am J Physiol Lung Cell Mol Physiol 2016; 312:L208-L216. [PMID: 27913427 PMCID: PMC5336579 DOI: 10.1152/ajplung.00463.2016] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2016] [Revised: 11/28/2016] [Accepted: 11/30/2016] [Indexed: 01/02/2023] Open
Abstract
Bronchopulmonary dysplasia (BPD) is a chronic lung injury characterized by impaired alveologenesis that may persist into adulthood. Rat models of BPD using varying degrees of hyperoxia to produce injury either cause early mortality or spontaneously recover following removal of the inciting stimulus, thus limiting clinical relevance. We sought to refine an established rat model induced by exposure to 60% O2 from birth by following hyperoxia with intermittent hypoxia (IH). Rats exposed from birth to air or 60% O2 until day 14 were recovered in air with or without IH (FIO2 = 0.10 for 10 min every 6 h) until day 28 Animals exposed to 60% O2 and recovered in air had no evidence of abnormal lung morphology on day 28 or at 10-12 wk. In contrast, 60% O2-exposed animals recovered in IH had persistently increased mean chord length, more dysmorphic septal crests, and fewer peripheral arteries. Recovery in IH also increased pulmonary vascular resistance, Fulton index, and arterial wall thickness. IH-mediated abnormalities in lung structure (but not pulmonary hypertension) persisted when reexamined at 10-12 wk, accompanied by increased pulmonary vascular reactivity and decreased exercise tolerance. Increased mean chord length secondary to IH was prevented by treatment with a peroxynitrite decomposition catalyst [5,10,15,20-Tetrakis(4-sulfonatophenyl)-21H,23H-porphyrin iron (III) chloride, 30 mg/kg/day, days 14-28], an effect accompanied by fewer inflammatory cells. We conclude that IH during recovery from hyperoxia-induced injury prevents recovery of alveologenesis and leads to changes in lung and pulmonary vascular function lasting into adulthood, thus more closely mimicking contemporary BPD.
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Affiliation(s)
- Anastasiya Mankouski
- Division of Neonatology, Department of Pediatrics, Neonatal-Perinatal Research Institute, Duke University Medical Center, Durham, North Carolina.,Physiology & Experimental Medicine Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Crystal Kantores
- Physiology & Experimental Medicine Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Mathew J Wong
- Physiology & Experimental Medicine Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Faculty of Medicine, Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Julijana Ivanovska
- Physiology & Experimental Medicine Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Amish Jain
- Faculty of Medicine, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; and.,Faculty of Medicine, Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Eric J Benner
- Division of Neonatology, Department of Pediatrics, Neonatal-Perinatal Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Stanley N Mason
- Division of Neonatology, Department of Pediatrics, Neonatal-Perinatal Research Institute, Duke University Medical Center, Durham, North Carolina
| | - A Keith Tanswell
- Physiology & Experimental Medicine Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada.,Faculty of Medicine, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; and.,Faculty of Medicine, Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Richard L Auten
- Division of Neonatology, Department of Pediatrics, Neonatal-Perinatal Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Robert P Jankov
- Physiology & Experimental Medicine Program, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada; .,Faculty of Medicine, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada; and.,Faculty of Medicine, Department of Physiology, University of Toronto, Toronto, Ontario, Canada
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