A Multiscale Modeling Approach to Hypoplastic Left Heart Syndrome

左心发育不良综合征的多尺度建模方法

• 批准号: 9766412
• 负责人: VISHAL NIGAM
• 金额: $ 36.43万
• 依托单位: SEATTLE CHILDREN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-04-15 至 2021-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9766412
• 关键词: 3-Dimensional; Animal Model; Biomechanics; Blood flow; Cardiac; Cardiac Myocytes; Cardiac development; Cell Proliferation; Cells; Child; Clinical; Computer Simulation; Congenital Abnormality; Congenital Heart Defects; Coupled; Couples; Critical Pathways; Data; Defect; Development; Diastole; Echocardiography; Elements; Embryo; Embryonic Heart; Evolution; Exposure to; Fetus; Future; Goals; Growth; Growth and Development function; Heart; Heart Transplantation; Histologic; Human; Hypertrophy; Hypoplastic Left Heart Syndrome; In Vitro; Intervention; Left; Left ventricular structure; Mathematics; Mechanics; Methods; MicroRNAs; Modeling; Molecular; Molecular Biology; Morbidity - disease rate; Morphology; Mus; Newborn Infant; Operative Surgical Procedures; Organ; Pathogenesis; Pathway interactions; Patients; Pattern; Pediatric cardiology; Periodicity; Pharmacological Treatment; Pharmacology; Physiological; Process; Reporting; Research; Role; Signal Pathway; Signal Transduction; Stress; Stretching; Testing; Time; Tissues; Transplantation; Ventricular; base; biomechanical model; computer framework; experimental study; fetal; hemodynamics; improved; in utero; in vitro testing; in vivo; in vivo evaluation; induced pluripotent stem cell; mechanotransduction; models and simulation; molecular modeling; mortality; multi-scale modeling; multidisciplinary; novel; novel therapeutics; palliation; prediction algorithm; predictive modeling; prenatal; public health relevance; response; simulation; standard of care; therapeutic target

 DESCRIPTION (provided by applicant): Hypoplastic Left Heart Syndrome (HLHS) is a congenital defect marked by an underdeveloped left ventricle (LV) that is unable to provide adequate blood flow to the body. Currently, the standard of care for HLHS patients is surgical palliation or cardiac transplantation, both of which have serious complications. Fetal echocardiograms demonstrate that decreased LV filling during development results in a hypoplastic LV, thereby indicating a biomechanical mechanism for HLHS. Our rationale for this project is that understanding the role of biomechanical responsive pathways in the pathogenesis of HLHS will shift the current management paradigm of HLHS patients by enabling pharmacological treatment of this defect. Our overarching goals are 1) to discover novel molecular modulators that increase LV size in HLHS patients, and 2) to build and validate multi-scale computational models to evaluate the efficacy of these modulators at the cellular and whole-organ level. We hypothesize that increasing the activity of stretch-activated growth pathways will improve the growth of hypoplastic LVs in utero. This hypothesis is based on our data that stretch stimulates cardiomyocyte proliferation, growth, and ventricular growth. Furthermore, utilizing miRNA-Seq, we have identified a microRNA, miR-486, that is 1) stretch responsive in vitro/HLHS patients and 2) promotes cardiac growth in vivo. To test our hypothesis and to achieve our overarching goals, we will perform two specific aims: Aim 1. Predict and validate the effects of miR-486 treatment on mouse and human embryonic hearts developing HLHS. We postulate that miR-486 increases embryonic cardiac growth. Thus this aim will examine miR-486 role in LV growth, both in murine and human HLHS embryos. miR-486 effects on cell proliferation, size, and contractile function will also be studied in mouse and human iPS cardiomyocytes. These in vitro data will be incorporated into a novel 3D finite element (FE) model of embryonic cardiac growth. Finally, treatment of HLHS mouse embryos with miR-486 in utero will be used to validate FE modeling simulations. Aim 2. Prioritization of candidate miRNAs for in vivo testing based upon computational modeling of the miRNAʼs potential to improve embryonic ventricular growth. We postulate that miRNA target predictions, mathematic molecular model of cardiomyocytes, and HLHS FE modeling can be coupled to test candidate stretch-responsive miRNAs for potential to increase LV size in HLHS hearts. The candidate miRNA that increases LV the most growth within simulations of mouse HLHS embryos will be tested in vivo. This miRNA will be tested in utero, to 1) examine the effects on LV growth and 2) validate the coupled model. The proposed studies using complementary in vitro (murine and human iPS cells), in vivo, and in silico methods will elucidate critical pathways by which biomechanical stress stimulates cardiac growth. Such a unique comprehensive approach is made possible by a multidisciplinary team that incorporates expertise in pediatric cardiology, cardiac biomechanics, molecular biology, and computational modeling.

 描述（由申请人提供）：左心发育不良综合征（HLHS）是一种先天性缺陷，其特征是左心室（LV）发育不全，无法向身体提供充足的血流。目前，HLHS患者的护理标准是手术姑息或心脏移植，这两种方法都有严重的并发症。胎儿超声心动图显示，在发育过程中左心室充盈减少导致左心室发育不全，从而表明HLHS的生物力学机制。我们这个项目的基本原理是，了解生物力学反应途径在HLHS发病机制中的作用，将改变HLHS患者目前的管理模式，使药物治疗这一缺陷。我们的首要目标是1）发现增加HLHS患者LV大小的新型分子调节剂，2）建立和验证多尺度计算模型，以评估这些调节剂在细胞和整个器官水平上的疗效。我们假设增加牵张激活生长途径的活性将改善子宫内发育不良LV的生长。这一假设是基于我们的数据，拉伸刺激心肌细胞增殖，生长和心室生长。此外，利用miRNA-Seq，我们已经鉴定了一种microRNA，miR-486，其1）在体外/HLHS患者中具有牵拉响应性，2）在体内促进心脏生长。为了验证我们的假设并实现我们的总体目标，我们将执行两个具体目标：目标1。预测并验证miR-486治疗对发生HLHS的小鼠和人胚胎心脏的影响。我们推测miR-486促进胚胎心脏生长。因此，该目的将检查miR-486在小鼠和人HLHS胚胎中在LV生长中的作用。miR-486对细胞增殖、大小和收缩功能的影响也将在小鼠和小鼠中进行研究。 人iPS心肌细胞。这些体外数据将被纳入一个新的三维有限元（FE）模型的胚胎心脏生长。最后，在子宫内用miR-486处理HLHS小鼠胚胎将用于验证FE建模模拟。目标2.基于miRNA促进胚胎心室生长潜力的计算建模，对用于体内测试的候选miRNA进行优先排序。我们假设，miRNA靶预测，心肌细胞的数学分子模型，HLHS FE建模可以耦合到测试候选牵张响应miRNA的潜力，以增加HLHS心脏的LV大小。将在体内测试在小鼠HLHS胚胎的模拟中增加LV最多生长的候选miRNA。该miRNA将在子宫内进行测试，以1）检查对LV生长的影响和2）验证耦合模型。使用互补的体外（鼠和人iPS细胞）、体内和计算机模拟方法的拟定研究将阐明关键途径 生物力学应力刺激心脏生长的机制这种独特的综合方法是由一个多学科的团队，结合儿科心脏病学，心脏生物力学，分子生物学和计算建模的专业知识。

项目成果

Shear stress associated with cardiopulmonary bypass induces expression of inflammatory cytokines and necroptosis in monocytes.

与体外循环相关的剪切应力诱导单核细胞炎症细胞因子的表达和坏死性凋亡。

• DOI: 10.1172/jci.insight.141341
• 发表时间: 2021
• 期刊: JCI insight
• 影响因子: 8
• 作者: Tu,LanN;Hsieh,Lance;Kajimoto,Masaki;Charette,Kevin;Kibiryeva,Nataliya;Forero,Adriana;Hampson,Sarah;Marshall,JenniferA;O'Brien,James;Scatena,Marta;Portman,MichaelA;Savan,Ram;Benner,Chris;Aliseda,Alberto;Nuri,Muhammad;Bittel
• 通讯作者: Bittel