Song Yongfei, Zheng Zequn, Lian Jiangfang
Department of Cardiovascular, Ningbo Institute of Innovation for Combined Medicine and Engineering, Ningbo, China.
Department of Cardiovascular, Medical College, Ningbo University, Ningbo, China.
Front Cardiovasc Med. 2022 May 13;9:889519. doi: 10.3389/fcvm.2022.889519. eCollection 2022.
From carrying potentially pathogenic genes to severe clinical phenotypes, the basic research in the inherited cardiac ion channel disease such as long QT syndrome (LQTS) has been a significant challenge in explaining gene-phenotype heterogeneity. These have opened up new pathways following the parallel development and successful application of stem cell and genome editing technologies. Stem cell-derived cardiomyocytes and subsequent genome editing have allowed researchers to introduce desired genes into cells in a dish to replicate the disease features of LQTS or replace causative genes to normalize the cellular phenotype. Importantly, this has made it possible to elucidate potential genetic modifiers contributing to clinical heterogeneity and hierarchically manage newly identified variants of uncertain significance (VUS) and more therapeutic options to be tested . In this paper, we focus on and summarize the recent advanced application of human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) combined with clustered regularly interspaced short palindromic repeats/CRISPR-associated system 9 (CRISPR/Cas9) in the interpretation for the gene-phenotype relationship of the common LQTS and presence challenges, increasing our understanding of the effects of mutations and the physiopathological mechanisms in the field of cardiac arrhythmias.
从携带潜在致病基因到出现严重临床表型,诸如长QT综合征(LQTS)等遗传性心脏离子通道疾病的基础研究在解释基因-表型异质性方面一直是一项重大挑战。随着干细胞和基因组编辑技术的并行发展与成功应用,这些挑战开辟了新的途径。源自干细胞的心肌细胞以及随后的基因组编辑使研究人员能够将所需基因导入培养皿中的细胞,以复制LQTS的疾病特征或替换致病基因来使细胞表型正常化。重要的是,这使得阐明导致临床异质性的潜在遗传修饰因子成为可能,并对新发现的意义未明变异(VUS)进行分级管理,以及测试更多治疗方案。在本文中,我们重点关注并总结了人诱导多能干细胞衍生心肌细胞(hiPSC-CMs)与成簇规律间隔短回文重复序列/CRISPR相关系统9(CRISPR/Cas9)相结合在解释常见LQTS基因-表型关系方面的最新进展应用以及存在的挑战,增进了我们对心律失常领域突变效应和生理病理机制的理解。