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Reversal of Heart Failure: Role of Vascular Recovery

逆转心力衰竭：血管恢复的作用

基本信息

批准号：
10397100
负责人：
JOHN P COOKE
金额：
$ 71.09万
依托单位：
METHODIST HOSPITAL RESEARCH INSTITUTE
依托单位国家：
美国
项目类别：
财政年份：
2020
资助国家：
美国
起止时间：
2020-07-15 至 2024-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10397100
关键词：
Adult Affect Animal Model Area Bioinformatics Biological Biological Assay Blood Vessels Blood capillaries Candidate Disease Gene Cardiac Cell Lineage Cell Nucleus Cell physiology Cells Cicatrix Citrates Clinical Clinical Data Collagen Complement Computer Models Coupled DNA Data Device Removal Diastolic blood pressure Direct Costs Echocardiography Endothelial Cells Endothelium Enhancers Epigenetic Process Fibroblasts Fibrosis Gene Expression Profiling Genes Genetic Determinism Health Care Costs Heart Heart failure Histologic Histone Acetylation Human Impairment In Vitro Intercellular Fluid International Knock-out Lead Left Ventricular Mass Libraries Lung Mediating Mesenchymal Metabolic Metabolic Pathway Metabolism Methods Microspheres Mitochondria Modeling Modification Molecular Morbidity - disease rate Mus Muscle Cells Myocardial Natural regeneration Pathologic Pathway interactions Patients Pattern Perfusion Perivascular Fibrosis Physiological Population Process Recovery Research Reverse Transcriptase Polymerase Chain Reaction Role Sampling Services Specimen System Time Tissues Transgenic Mice Transplantation Vascular regeneration Ventricular Ventricular Function Work Workload base coronary fibrosis density epigenetic regulation heart function hemodynamics human tissue implantation improved in vivo insight interstitial knock-down left ventricular assist device loss of function mortality mouse model novel novel therapeutic intervention novel therapeutics pre-clinical promoter public database single-cell RNA sequencing small hairpin RNA small molecule inhibitor transcriptome sequencing transdifferentiation

项目摘要

PROJECT SUMMARY Heart failure is a major cause of morbidity and mortality worldwide, currently affecting an estimated 6.5 million adults in the US alone and contributing to $21 billion in health care costs. The aim of this proposal is to understand the mechanisms of heart failure recovery. We have clinical evidence that heart failure recovery involves a reduction in interstitial myocardial fibrosis and an increase in microvascular density. Our library of human samples from Left Ventricular Assist Device (LVAD) implantation/explantation represent a convenience sample to examine the mechanisms of recovery. In these patients, the LVAD implantation (and unloading of the heart from hemodynamic forces) promotes some improvement in ventricular function (as assessed by echocardiography) that is associated with decreased interstitial fibrosis and increased vascular density. Based on clinical and pre-clinical data, we hypothesize that recovery from heart failure is (at least in part) a vascular recovery. The vascular recovery may involve mesenchymal-to-endothelial transition (MEndoT), that is, the transdifferentiation of cardiac fibroblasts (or other mesenchymal cells) into endothelial cells. Furthermore, we have evidence that MEndoT may require a glycolytic switch that directly affects DNA accessibility and cellular plasticity. In our first aim, we will characterize the physiological, cellular, and molecular hallmarks of heart failure recovery in a unique mouse model. In the second aim, transcriptional profiling of disaggregated mouse hearts as well as human cardiac tissue obtained pre- and post-LVAD implantation will be combined with bioinformatics analyses to predict novel genes in heart failure recovery. In our third aim, we will confirm the genetic determinants discovered in the first aim using gain- or loss-of-function studies in vitro and in vivo. In addition, we will explore the role of the glycolytic switch in cell fate transitions and vascular recovery using bioinformatics analyses of our RNAseq data, confirmed with cell-specific and conditional gain- or loss-of-function studies of target genes (e.g. in metabolic pathways) in vitro and in vivo. The intent of this proposal is to generate fundamental insights regarding heart failure recovery that may lead to a new therapeutic strategy.

项目概要心力衰竭是全世界发病和死亡的主要原因，目前估计有 650 万人受到影响仅美国成年人就承担了 210 亿美元的医疗保健费用。该提案的目的是了解心力衰竭恢复机制。我们有临床证据表明心力衰竭的恢复涉及减少间质性心肌纤维化并增加微血管密度。我们的人类图书馆来自左心室辅助装置 (LVAD) 植入/取出的样本代表方便样本检查恢复机制。在这些患者中，LVAD 植入（以及心脏卸载）来自血流动力学）促进心室功能的一些改善（通过评估超声心动图）与间质纤维化减少和血管密度增加有关。基于根据临床和临床前数据，我们假设心力衰竭的恢复（至少部分）是血管性的恢复。血管恢复可能涉及间充质到内皮细胞的转变（MEndoT），即心脏成纤维细胞（或其他间充质细胞）转分化为内皮细胞。此外，我们有证据表明 MEndoT 可能需要糖酵解开关，直接影响 DNA 可及性和细胞可塑性。在我们的第一个目标中，我们将描述心力衰竭的生理、细胞和分子特征在独特的小鼠模型中恢复。在第二个目标中，将分解的小鼠心脏的转录谱分析为以及 LVAD 植入前后获得的人体心脏组织将与生物信息学相结合分析预测心力衰竭恢复中的新基因。我们的第三个目标是确认基因第一个目标是通过体外和体内功能获得或丧失研究发现的决定因素。此外，我们将利用生物信息学探讨糖酵解开关在细胞命运转变和血管恢复中的作用对我们的 RNAseq 数据进行分析，并通过细胞特异性和条件性功能获得或丧失研究得到证实体外和体内的靶基因（例如代谢途径中的）。该提案的目的是产生关于心力衰竭恢复的基本见解可能会导致新的治疗策略。