基于腺相关病毒的基因治疗可预防和阻止磷酸葡萄糖变位酶 1 缺乏症(PGM1-CDG)小鼠模型中扩张型心肌病的进展。
AAV-based gene therapy prevents and halts the progression of dilated cardiomyopathy in a mouse model of phosphoglucomutase 1 deficiency (PGM1-CDG).
机构信息
Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
Department of Medical Genomics, Centre for Genomic Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
出版信息
Transl Res. 2023 Jul;257:1-14. doi: 10.1016/j.trsl.2023.01.004. Epub 2023 Jan 26.
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.
磷酸葡萄糖变位酶 1(PGM1)缺乏症被认为是人类中第三种最常见的 N 连接性先天性糖基化障碍(CDG)。受影响的个体表现出肝脏、肌肉骨骼、内分泌和凝血症状;然而,最危及生命的并发症是扩张型心肌病(DCM)的早期发作。最近,我们发现口服 D-半乳糖补充剂可改善肝脏疾病、内分泌和凝血异常,但不能缓解致命性心肌病和相关肌病。在这里,我们报告了 6 名 PGM1-CDG 个体的左心室射血分数(LVEF)。这些个体中的大多数 LVEF 明显较低,在 10%至 65%之间变化。为了研究 PGM1-CDG 中观察到的心脏疾病的病理生物学,我们构建了一种新型心肌细胞特异性条件性 Pgm2 基因(人类 PGM1 的小鼠同源物)敲除(Pgm2 cKO)小鼠模型。超声心动图研究证实了 DCM 表型,射血分数显著降低,左心室扩张与 PGM1-CDG 个体相似。组织学研究表明糖原积累过多和纤维化,而超微结构分析显示 Z 盘排列紊乱和肿胀/片段化的线粒体,与 PGM1-CDG 个体的心脏外植体的超微结构病理学相似。此外,我们发现 KO 小鼠心脏的线粒体功能下降。突变小鼠心脏的转录组分析显示出 DCM 的基因特征。尽管蛋白质组学仅揭示了突变小鼠左心室组织中整体蛋白质表达的轻度变化,但糖蛋白质组学分析揭示了广泛的糖基化变化,包括不同层粘连蛋白-211 亚基在内的质膜蛋白发生显著改变,免疫印迹分析证实了这一点。最后,通过 AAV9-PGM1 基因替代治疗在 KO 小鼠中增加 PGM1 可预防和阻止 DCM 表型的进展。
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