Correction of human phospholamban R14del mutation associated with cardiomyopathy using targeted nucleases and combination therapy

使用靶向核酸酶和联合疗法纠正与心肌病相关的人类受磷蛋白 R14del 突变

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作者:Ioannis Karakikes, Francesca Stillitano, Mathieu Nonnenmacher, Christos Tzimas, Despina Sanoudou, Vittavat Termglinchan, Chi-Wing Kong, Stephanie Rushing, Jens Hansen, Delaine Ceholski, Fotis Kolokathis, Dimitrios Kremastinos, Alexandros Katoulis, Lihuan Ren, Ninette Cohen, Johannes M I H Gho, Dimit

Abstract

A number of genetic mutations is associated with cardiomyopathies. A mutation in the coding region of the phospholamban (PLN) gene (R14del) is identified in families with hereditary heart failure. Heterozygous patients exhibit left ventricular dilation and ventricular arrhythmias. Here we generate induced pluripotent stem cells (iPSCs) from a patient harbouring the PLN R14del mutation and differentiate them into cardiomyocytes (iPSC-CMs). We find that the PLN R14del mutation induces Ca(2+) handling abnormalities, electrical instability, abnormal cytoplasmic distribution of PLN protein and increases expression of molecular markers of cardiac hypertrophy in iPSC-CMs. Gene correction using transcription activator-like effector nucleases (TALENs) ameliorates the R14del-associated disease phenotypes in iPSC-CMs. In addition, we show that knocking down the endogenous PLN and simultaneously expressing a codon-optimized PLN gene reverses the disease phenotype in vitro. Our findings offer novel strategies for targeting the pathogenic mutations associated with cardiomyopathies.

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