A novel practical test for the function of HDL, the carrier of “good” cholesterol

High-density lipoprotein cholesterol (HDL-C) is known as “good” cholesterol, because HDL particles removes excess cholesterol from arterial walls and transport them back to the liver. A research group has developed a practical test for the ability of HDL to accept cholesterol. This method could help to prevent and monitor cardiovascular disease, and it is simple enough to be used in everyday clinical situations.
The group members include Senior Researcher HARADA Amane (Central Research Laboratories, Sysmex Corporation), Project Associate Professor TOH Ryuji (Kobe University Graduate School of Medicine, Division of Evidence-Based Laboratory Medicine) in collaboration with a research team led by Professor HIRATA Ken-ichi (Kobe University Graduate School of Medicine, Division of Cardiovascular Medicine).
Standard health checks measure HDL-C, the amount of cholesterol collected by HDL – they do not look at HDL’s capacity to accept cholesterol. However, HDL’s ability to extract and accept excess cholesterol that has accumulated in cells is a more effective marker in preventing and monitoring cardiovascular disease.
In order to measure HDL’s ability to extract cholesterol (efflux capacity), standard methods use cultured cells that contain cholesterol marked by radioisotopes. This procedure is complicated and takes several days, so it cannot be used in everyday clinical situations. In this study, researchers invented a simpler and faster way to measure HDL capacity.
The team marked cholesterol with fluorescent dye instead of radioactive isotopes and added it to blood serum samples from test subjects. They supplemented the HDL in the blood serum and evaluated the amount of cholesterol accepted by HDL by measuring the strength of the fluorescence . The team called the marker for this method cholesterol “uptake capacity”, as opposed to the conventional method that measures cholesterol “extraction” (efflux) capacity.
The research team is currently using this marker on a larger population to confirm the effect of decreased HDL capacity on the prevention and control of cardiovascular disease. The results of this study could help in creating strong core technology to develop drugs that improve HDL’s function.


Kobe University
www.kobe-u.ac.jp/research_at_kobe_en/NEWS/news/2017_07_10_01.html

Inflammatory biomarkers indicating brain injury

Researchers at the University of Birmingham have identified inflammatory biomarkers which indicate whether the brain has suffered injury.
The team, led by Professor Antonio Belli, at the University’s College of Medical and Dental Sciences, now hopes to use these new biomarkers to develop a test which can be used on the side of a sports pitch or by paramedics to detect brain injury at the scene of an incident.
Dr Lisa Hill, of the Institute of Inflammation and Ageing at the University of Birmingham, said: “Traumatic brain injury (TBI) is the leading cause of death and disability among young adults and, according to the World Health Organization, by 2020 TBI will become the world’s leading cause of neurological disability across all age groups.
“Early and correct diagnosis of traumatic brain injury is one of the most challenging aspects facing clinicians.
“Being able to detect compounds in the blood which help to determine how severe a brain injury is would be of great benefit to patients and aid in their treatment.
“Currently, no reliable biomarkers exist to help diagnose the severity of TBI to identify patients who are at risk of developing secondary injuries that impair function, damage other brain structures and promote further cell death.
“Thus, the discovery of reliable biomarkers for the management of TBI would improve clinical interventions.”
Inflammatory markers are particularly suited for biomarker discovery as TBI leads to very early alterations in inflammatory proteins.
In this novel study blood samples were taken from 30 injured patients within the first hour of injury prior to the patient arriving at hospital.
Subsequent blood samples were taken at intervals of four hours, 12 hours and 72 hours after injury. These blood samples were then screened for inflammatory biomarkers which correlated with the severity of the injury using protein detection methods.
In the laboratory, the team used a panel of 92 inflammation-associated human proteins when analysing the blood samples, which were screened simultaneously.
The serum biomarkers were analysed from patients with mild TBI with extracranial injury, severe TBI with extracranial injury and extracranial injury only and all groups were compared to a control group of healthy volunteer patients.
The results identified three inflammatory biomarkers, known as CST5, AXIN1 and TRAIL, as novel early biomarkers of TBI.
CST5 identified patients with severe TBI from all other cohorts and, importantly, was able to do so within the first hour of injury.
AXIN1 and TRAIL were able to discriminate between TBI and uninjured patient controls in under an hour.
Dr Valentina Di Pietro, also of the Institute of Inflammation and Ageing at the University of Birmingham, said: “Early and objective pre-hospital detection of TBI would support clinical decision making and the correct triage of major trauma.
“Moreover, the correct diagnosis of TBI, which is one of hardest diagnosis to make in medicine, would allow clinicians to implement strategies to reduce secondary brain injury at early stage, for example, by optimising blood and oxygen delivery to the brain and avoiding manoeuvres that could potentially increase intracranial pressure.
“In addition, this has potential implications for drug development, as novel compounds could be given immediately after injury and potentially commenced at the roadside, if there was sufficient confidence in the diagnosis of TBI.
“We conclude that CST5, AXIN1 and TRAIL are worthy of further study in the context of a pre-hospital or pitch-side test to detect brain injury.”


University of Birmingham
www.birmingham.ac.uk/news/latest/2017/07/researchers-identify-inflammatory-biomarkers-indicating-brain-injury.aspx

Glioblastoma ‘ecosystem’ redefined for more effective immunotherapy trials

A research team has revealed the intrinsic gene expression patterns of glioblastoma (GBM) tumours, insights that could drive more effective treatments for GBM, the most common and deadly malignant primary brain tumours in adults.
Jackson Laboratory (JAX) Professor Roel Verhaak, Ph.D., is the senior author of a paper showing tumour gene expression patterns distinct from those of the surrounding immune cells, and characterizing the effects of chemotherapy and radiation treatments.
Verhaak was the first author of a 2010 paper that established four subclasses of GBM — proneural, mesenchymal, neural and classical — based on molecular markers found in patient tumours. That paper was widely influential in the glioblastoma research field, observes Verhaak. “However, these four subtypes have not translated into differential treatment strategies. Every glioblastoma patient receives essentially the same treatment. We hope that our latest work will improve understanding of how to optimally stratify patients, another step towards precision medicine and more targeted, effective treatments.”
The cells that surround a tumour are known as its microenvironment, usually consisting of immune cells, supporting cells and other normal cells. Tumours donated to tissue banks consist of a mixture of microenvironment cells and cancer cells.
In the new paper, the research team isolated the intrinsic gene expression of 364 GBM tumours and observed the impact of the standard cancer treatment regimens of temozolomide and radiation on that expression after subtracting out the effects of therapy on the tumour-associated non-cancer cells.
“By separating out the contributions of the microenvironment, we developed a much clearer picture of the ‘ecosystem’ of hundreds of tumours,” Verhaak says. “We determined what types of cells are in the microenvironment and what their contributions are, and also assessed how treatment affects the microenvironment as well as the tumour cells themselves.”
Through this approach, the researchers found that the molecular markers defining the neural subtype of GBM was actually ascribed by the presence of normal neural tissue in the tumour margin, thus not representing a true tumour subtype.
By studying gene expression patterns in glioblastomas after treatment, their analysis also revealed that the presence of macrophages correlates with poorer outcomes for GBM patients receiving radiation therapy, and that tumours with a relatively high number of point mutations have an increased number of positive T cells, indicating they could respond to a kind of immunotherapy known as checkpoint inhibitors.
The resulting gene expression datasets, which are publicly available to researchers, provide comprehensive profiles of glioblastoma characteristics to more accurately guide immunotherapy trials.


Jackson Laboratory
www.jax.org/news-and-insights/2017/july/glioblastoma-ecosystem-redefined

Genomic cause for Carey-Fineman-Ziter syndrome identified

An international team of researchers has identified genomic mutations for Carey-Fineman-Ziter (CFZS) syndrome, a very rare congenital myopathy (inherited muscle disorder) characterized by facial weakness, a small or retracted chin, a cleft palate and curvature of the spine (scoliosis), among other symptoms. The researchers determined that CFZS is caused by mutations in the gene MYMK that encodes for the protein myomaker. This protein is necessary for the fusion of muscle cells (myoblasts) into muscle fibres (myotubes) during the development of an embryo and the regeneration of muscle cells after injury.
"Advances in genomics technology and the power of team science have enabled us to identify the cause of this very rare disease 35 years after it was first described by Dr. John Carey and colleagues from the University of Utah," said National Institutes of Health Director Francis S. Collins, M.D., Ph.D., a co-author of the study.
"This discovery will improve physicians’ ability to diagnose this disease and offer families accurate genetic counselling and treatment," said Irini Manoli, M.D., Ph.D., co-lead author and a physician scientist and staff clinician in the Medical Genomics and Metabolic Genetics Branch at the National Human Genome Research Institute (NHGRI), part of NIH. People affected with CFZS have sometimes been misdiagnosed with Moebius syndrome, another very rare disorder characterized by facial paralysis.
Dr. Manoli said that uncovering that cell-cell fusion deficits can lead to congenital myopathies (inherited muscle disease) opens a new path of exploration for therapies for CFZS and other muscular diseases and tools for regenerating muscle. "In addition," she said, "this rare genetic syndrome provides novel insights into the effects of muscle development on craniofacial and skeletal bone formation."
The goal of the study was to learn more about the genetics and clinical characteristics of Moebius syndrome and other congenital facial weakness disorders. Toward this end, the consortium brought 63 people to the NIH Clinical Center affected with Moebius syndrome and other inherited facial weakness disorders, and their families for detailed multi-system evaluations, including brain and muscle imaging studies and muscle biopsies. The researchers collaborated through the Opportunities for Collaborative Research at the NIH Clinical Center, a new funding mechanism that encourages intramural and extramural researchers to work together at the NIH Clinical Center.
Researchers performed detailed phenotyping (identifying physical traits that are the result of a DNA sequence). They also employed the most up-to-date genomic tools, including exome sequencing of blood DNA in affected siblings from three unrelated families, as well as a muscle biopsy in one of the affected individuals. To identify the genomic mutations associated with CFZS, three laboratories – led separately by Elizabeth Engle, M.D., at the Boston Children’s Hospital, Stephen Robertson, M.D., from the University of Otago and John Carey, M.D., at the University of Utah – analysed exome sequence data from each of the three families. Among the genes harbouring mutations identified in each family, only the gene MYMK was common to all three. A knockout mouse model (genomically altered mice that are bred to lack a specific gene) displayed a complete lack of muscle development, leading to early death of the newborn mice, making this gene a promising candidate for further studies.
Using CRISPR-Cas9 technology, a tool for editing DNA at precise locations, a team led by Silvio Alessandro Di Gioia, Ph.D., and Dr. Engle, generated zebrafish with a mutated mymk gene. Affected mutant zebrafish were smaller and had abnormal muscle development and jaw deformities, resembling the patient phenotype. The researchers then performed further functional studies to validate the severity of each of the genomic mutations.
The researchers were able to correct affected zebrafish’s muscles by injecting the normal human MYMK gene product into the mutant fish. This success lends hope for restoring MYMK function in muscles as a treatment for CFZS and for reducing any potentially progressive features of this disorder.
Only eight people in the world have been diagnosed with CFZS with MYMK mutations, in part, because it hasn’t been readily recognized. Now that researchers have identified the genomic cause underlying the syndrome, it can be added to the diagnostic gene panels for congenital myopathies. This will improve the speed and accuracy of diagnosis and add to the understanding of the spectrum of disease severity and outcome, Dr. Manoli said.


The National Human Genome Research Institute (NHGRI)
www.genome.gov/27568961/2017-news-release-nih-and-collaborators-identify-the-genomic-cause-for-careyfinemanziter-syndrome/

Source of Alzheimer’s gene found

Researchers led by Arizona State University (ASU) and the Translational Genomics Research Institute (TGen) have identified altered expression of a gene called ANK1, which only recently has been associated with memory robbing Alzheimer’s disease, in specific cells in the brain.
Using an extremely precise method of isolating cells called "laser capture microdissection," researchers looked at three specific cell types – microglia, astrocytes and neurons – in the brain tissue of individuals with a pathological diagnosis of Alzheimer’s disease, and compared them to brain samples from healthy individuals and those with Parkinson’s disease.
Following sequencing of each of these cell types, the ASU-TGen led team found that altered ANK1 expression originates in microglia, a type of immune cell found in the brain and central nervous system.
"Although previous genetic and epigenetic-wide association studies had shown a significant association between ANK1 and AD, they were unable to identify the class of cells that may be responsible for such association because of the use of brain homogenates. Here, we provide evidence that microglia are the source of the previously observed differential expression patterns in the ANK1 gene in Alzheimer’s disease," said Dr. Diego Mastroeni, an Assistant Research Professor at Biodesign’s ASU-Banner Neurodegenerative Disease Research Center, and the study’s lead author.
All three of the cell types in this study were derived from the hippocampus, a small looping structure shaped like a seahorse (its name derives from the Greek words for horse and sea monster).  The hippocampus resides deep inside the human brain and plays important roles in the consolidation of both short-term and long-term memory, and in the spatial memory that enables the body to navigate.
In Alzheimer’s disease – and other forms of dementia – the hippocampus is one of the first regions of the brain to suffer damage, resulting in short-term memory loss and disorientation. Individuals with extensive damage to the hippocampus are unable to form and retain new memories.
"Using our unique data set, we show that in the hippocampus, ANK1 is significantly increased four-fold in Alzheimer’s disease microglia, but not in neurons or astrocytes from the same individuals," said Dr. Winnie Liang, an Assistant Professor, Director of TGen Scientific Operations and Director of TGen’s Collaborative Sequencing Center, and one of the study’s authors. "These findings emphasize that expression analysis of defined classes of cells is required to understand what genes and pathways are dysregulated in Alzheimer’s."
Alzheimer’s features many signs of chronic inflammation, and microglia are key regulators of the inflammatory cascade, proposed as an early event in the development of Alzheimer’s, the study said.
Because the study found that ANK1 also was increased two-fold in Parkinson’s disease, "these data suggest that alterations in ANK1, at lease in microglia, may not be disease specific, but rather a response, or phenotype associated with neurodegeneration … more specifically, neuroinflammation."


Translational Genomics Research Institute
tgen.org/home/news/2017-media-releases/asu-tgen-find-source-of-alzheimers-gene.aspx#.WWqRu_-GP5Y

Potential cause for lupus identified

Leading rheumatologist and Feinstein Institute for Medical Research Professor Betty Diamond, MD, may have identified a protein as a cause for the adverse reaction of the immune system in patients suffering from lupus. A better understanding of how the immune system becomes overactive will help lead to more effective treatments for lupus and potentially other autoimmune diseases.
Lupus is an autoimmune disease that causes the immune system to lose the ability to differentiate between foreign agents and healthy tissue. It becomes hyperactive and attacks healthy tissue, causing inflammation and damage to joints, skin, and internal organs. Previous studies have shown that a polymorphism or variation in the gene PRDM1 is a risk factor for lupus. PRDM1 enacts the production of a protein called Blimp-1. In this study, Dr. Diamond and her team were looking to examine how Blimp-1 regulates the immune system.
"A healthy immune system is able to identify organisms that are not normally in the body and activate cells like T-Cells to attack them," said Dr. Diamond. "In the case of patients with an autoimmune disease like lupus, the immune system has started to identify healthy cells as something to target. Our study found that a low level of or no Blimp-1 protein in a particular cell type led to an increase in the protein CTSS which caused the immune system to identify healthy cells as something to attack – particularly in females."
In an animal model, Dr. Diamond’s team was able to show that females with reduced production of Blimp-1 caused an increase in CTSS, a protein that helps the immune system see microbes, or a microorganisms that causes disease. This resulted in an immune system which attacked healthy cells. Male animals with the reduced production of Blimp-1 showed no change in their immune system. Though more study is required to confirm that the risk gene PRDM1 could lead to a hyperactive immune system in human females, this is a significant discovery to better understanding the causes and potential treatments for lupus.


EurekAlert
www.eurekalert.org/pub_releases/2017-07/nh-fii071417.php

New gene therapy treatment routes for motor neurone disease uncovered

Scientists investigating the genetic causes and altered functioning of nerve cells in motor neurone disease (MND) have discovered a new mechanism that could lead to fresh treatment approaches for one of the most common forms of the disease.
The team, based in the Sheffield Institute for Translational Neuroscience (SITraN), investigated a mutation in one particular gene, which causes sections of DNA to replicate themselves inexplicably within cells. They found a way to prevent RNA, carrying these replicated sequences, from leaving the cell’s nucleus and travelling into the surrounding cytoplasm where they cause cell death.
Patients with MND suffer progressive paralysis as the nerves supplying muscles degenerate. Although there are several different types of MND, this mutation, in a gene called C9ORF72, is responsible for the most common type of MND, called Amyotrophic Lateral Sclerosis (ALS). This accounts for about 40-50 per cent of inherited cases and 10 per cent of all MND cases. The mutations or environmental factors causing the vast majority of MND cases remain unknown.
DNA is produced in the cell’s nucleus and contains the instructions which cells use to carry out their functions. Messenger RNA, called mRNA, transcribes this information and carries it out of the cell to ‘protein factories’ in the cytoplasm surrounding the nucleus. It is quite common for some sections of repeated DNA stretches to replicate themselves for reasons that are poorly understood. These repetitions are ‘non-coding’ sections that are not responsible for building proteins and are edited out before they leave the nucleus to serve as templates for the production of proteins.
In this particular type of motor neurone disease, however, the RNA not only contains the unnecessary replicated sequences, it is able to take them out of nucleus and into the cell’s cytoplasm. Once in the cytoplasm, the RNA is used to make up repeated proteins that clump together and block the normal function of the cell, causing it to die.
In an early stage study the researchers have been able to pinpoint why the repeated RNA sequences are able to leave the cell’s nucleus to cause cell death. The team identified a particular protein called SRSF1 which binds to the pathological repeated RNA molecules and transports them out of the cell centre, effectively overriding the gatekeeping machinery within the nucleus by opening a back door.
Working in partnership with researchers at the MRC Mitochondrial Biology Unit at the University of Cambridge, the team have shown that by targeting the SRSF1 protein, it is possible to reduce the amount of rogue RNA escaping into the cell’s cytoplasm.
“This is a completely new approach to tackling the most common type of motor neurone disease. No one has yet attempted to prevent these repeated sequences of RNA from leaving the cell’s nucleus and it opens up new areas of investigation for gene therapy,” explains University of Sheffield’s Dr Guillaume Hautbergue, who conceived the study and led the research jointly with Dr Alexander Whitworth, of the University of Cambridge, and SITraN Director, Professor Dame Pamela Shaw.


The University of Sheffield
www.sheffield.ac.uk/news/nr/motor-neurone-disease-1.716303

Better juvenile arthritis diagnosis & treatment outcome prediction

They discovered a previously unknown group of regulatory T cells linked to the disease and DNA features that affect patients’ response to treatment
A team of scientists and doctors from the SingHealth Duke-NUS Academic Medical Centre (AMC) has uncovered a new group of regulatory T (Treg) cells and DNA features associated with juvenile idiopathic arthritis (JIA), the most common form of arthritis among children under the age of 16. Their findings could potentially enhance diagnosis of the disease and prediction of therapy outcomes for improved treatment successes.
JIA is a disease of the immune system that causes inflammation leading to pain, stiffness and swelling in patients’ joints. It affects around one in 1,000 children in the world.
Juvenile arthritis has no cure and young patients can only alleviate pain or prevent joint deterioration through use of medication or therapy. In advancing care for JIA, researchers are keen to identify the culprit cells or genetic signatures behind the disease in order to tackle it.
In its first discovery, the SingHealth Duke-NUS AMC research team identified a previously unknown group of Treg cells that is associated with inflammation in JIA. Treg cells are a subset of white blood cells that regulate the body’s immune system. When the body has an imbalanced number of Treg cells, its immune tolerance can fail and experience autoimmune disorders such as arthritis.
The team found that the identified Treg cells play a role in JIA progression. During the active disease stage of JIA, these cells expand, grow in number, re-circulate through inflamed areas of patients’ body, and migrate to the connective tissue of patients’ joints. Additionally, a larger quantity of these cells can be found in JIA patients who cannot control arthritis inflammation and are unresponsive to therapy as compared to those who are.
"Clinicians could potentially use this novel group of cells as a marker to diagnose JIA in patients, as well as to predict or monitor patients’ responsiveness to therapy. Importantly, these cells are readily detectable in patients’ bloodstream, allowing for any clinical tests to be minimally invasive and pain-free for patients," said Professor Salvatore Albani, Director, SingHealth Translational Immunology and Inflammation Centre (STIIC), Professor, Duke-NUS Medical School and Senior Clinician Scientist, KK Women’s and Children’s Hospital (KKH), who is the principal investigator of the study.
 
2nd discovery: Patients’ DNA affects JIA treatment outcomes
Currently, only about one-third of JIA patients get better after medication or therapy, while the rest continue to see their condition flare up even after treatment.
To accurately predict treatment outcomes, the research team studied JIA patients’ treatment responses and found that epigenetics – or individuals’ DNA and the way each body uses its genes – determined one’s clinical "fate". In other words, the key is not in individuals’ genetic make-up but rather, in how their bodies employ genes. Even patients with identical genetic backgrounds could experience different clinical outcomes based on their DNA features that activate genes differently.
One of the research paper’s co-author, Associate Professor Thaschawee Arkachaisri, Head & Senior Consultant, Rheumatology and Immunology Service, KKH and Associate Professor, Duke-NUS, said "These discoveries could enable doctors to predict treatment responses and personalise treatment for patients. This is especially relevant for difficult JIA cases which may require more complex therapies, and is important to help save time and money, prevent treatment complications and ultimately, improve care outcomes."
The team’s findings are also relevant for adult rheumatoid arthritis, a similar autoimmune condition that affects one in 100 adults in the world.


EurekAlert
www.eurekalert.org/pub_releases/2017-07/s-ssp071317.php

MMA Fighters, boxers may have signs of long-term brain injury in blood

Boxers and mixed martial arts fighters may have markers of long-term brain injury in their blood, according to a study.
“This study is part of a larger study to detect not just individual concussions but permanent brain injury overall at its earliest stages and to determine which fighters are at greatest risk of long-term complications,” said study author Charles Bernick, MD, of the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas and member of the American Academy of Neurology. “Our study looked at data over a five-year period and found elevated levels of two brain injury markers in the blood; now the question is whether they may signify permanent traumatic brain injury with long-term consequences.”
Researchers measured two biological markers of brain injury. One is a brain protein called neurofilament light chain, the other is called tau. Both are components of nerve fibres that can be detected in the blood when the fibres are injured.
For the study, researchers took blood samples from 291 active professional fighters with an average age of 30, 44 retired fighters with an average age of 45 and 103 non-fighters with an average age of 30. The blood samples were then tested for levels of both proteins.
Researchers found that active professional fighters had higher levels of both proteins compared to retired fighters or non-fighters. For example, they found that levels of neurofilament light chain were 40 percent higher in active boxers than in non-fighters. They also found that the more a fighter sparred in the two weeks before the blood samples were taken, the higher the levels of neurofilament light chain in their blood.
Neither age, ethnicity nor number of professional fights in active fighters were linked to levels of either protein.
Bernick said while neurofilament light chain protein was higher in active fighters at the start of the study, levels did not increase significantly during the study period. On the other hand, there was a group of fighters who showed increasing levels of tau over time.
When the researchers looked at brain size, they found that for fighters who had increasing levels of tau over time, there was a 7 percent decline in the volume of their thalamus, which is located in the centre of the brain and regulates sleep, consciousness, alertness, cognitive function and language while also sending sensory and movement signals to other portions of the brain.
Finally, the study found that fighters with higher levels of neurofilament light chain protein did not do as well on computerized tests that measure the brain’s processing speed as the retired fighters and non-fighters.
“Our study found that higher levels of both proteins may be associated with repetitive head trauma,” said Bernick. “However, neurofilament light may be more sensitive to acute traumatic brain injury whereas tau may be a better measurement of cumulative damage over time. More research needs to be done to see how these may be used to monitor traumatic brain injury and the neurological consequences over time.”
A limitation of the study was the difference in the average age of active and retired fighters.


The American Academy of Neurology
www.aan.com/PressRoom/Home/PressRelease/1568

Study examines altered gene expression in heart failure

Heart failure refers to a condition in which heart muscle becomes weakened over time, making it increasingly difficult for the heart to pump blood through the body like it should.
It’s a progressive disease that begins when the heart adapts to stressors—high blood pressure, coronary artery disease, or diabetes, for example—in order to work properly. These stressors can lead to dilated cardiomyopathy, in which the heart’s left ventricle (pumping chamber) stretches, enlarges, and becomes thinner. Eventually, the heart cannot return to its normal shape, thus worsening its ability to pump blood and potentially leading to irregular heartbeats, blood clots, or even sudden death.
Researchers know that changes in gene expression occur during cardiomyopathy, but it remains unclear whether these changes are due to declining heart function or whether these changes are part of the progression to heart failure. A better understanding of the role transcription co-factors—proteins that are key to the regulation and expression of genes—could provide important clues into how heart failure develops.
Duane HallIn a new study, University of Iowa Health Care researchers report on the role of a protein—part of a large group of transcription co-factors called the Mediator complex—in regulating gene expression in heart muscle cells.
“A key question is how does the heart go from a normal state to a failing one after undergoing stress in some manner?” says Duane Hall, PhD, research assistant professor of internal medicine in the UI Carver College of Medicine and lead author of the study.
“It’s known that many genes are expressed during heart failure that are representative of a developing heart, so in these instances the heart may be trying to re-install developmental programs in order to adapt to those pressures,” adds Chad Grueter, PhD, assistant professor of internal medicine in the UI Carver College of Medicine and senior author of the study. “But we don’t fully understand how that transcriptional gene regulation happens, so we looked at how gene expression occurs through this Mediator complex.”
Grueter, Hall, and colleagues examined heart tissue samples from patients with heart failure and saw that levels of the protein Cdk8 in heart muscle cells were elevated. Knowing that Cdk8 is part of the Mediator complex and is involved in regulating the expression of thousands of genes, the researchers then over-expressed the protein in mouse heart cells. The increase in Cdk8 levels resulted in declining heart function and heart failure in these mice.
When the researchers examined the heart cells of the mice before a decrease in heart function was detectable, they found that more than 3,400 genes already were expressed with a profile similar to that of human heart muscle cells with dilated cardiomyopathy and heart failure.
Chad Greuter“Other studies have looked at tweaking the contraction and metabolism in heart cells as a possible cure for heart failure,” Hall says. “Our study is one of the first to show that something in the cell nucleus is capable by itself of inducing the structural changes that occur in heart failure.”
The study results suggest that modifying gene expression may provide a path to preventive treatments for heart failure.
“In terms of disease progression, heart failure is the end stage. Our study suggests that the transition, or ‘switch,’ from a stressed, enlarged heart to a failing heart is key,” Grueter says. “Looking ahead, hopefully we’ll be able to test whether a drug can block that switch from occurring.”

Carver College of Medicine
medicine.uiowa.edu/content/ui-study-examines-altered-gene-expression-heart-failure