CAMK2D causes heart failure in mice with RBM20 cardiomyopathy.
CAMK2D causes heart failure in mice with RBM20 cardiomyopathy.
👥 作者
van den Hoogenhof Maarten M G
(Heidelberg University)
Duran Javier
(Medical Faculty Heidelberg)
Britto-Borges Thiago
(Institute of Experimental Cardiology)
Sequeira Vasco
(Heidelberg)
Kemmling Elena
(Germany. maarten.hoogenhof@cardioscience.uni-heidelberg.de.; Heidelberg University)
Konrad Laura
(Medical Faculty Heidelberg)
Schreiter Friederike
(Institute of Experimental Cardiology)
Lennermann David C
(Heidelberg)
Hartmann Joshua
(Germany.; German Center for Cardiovascular Research (DZHK))
Schraft Laura
(Partner Site Heidelberg/Mannheim)
Kornienko Julia
(Heidelberg)
Bock Theresa
(Germany.; Comprehensive Heart Failure Center)
Krüger Marcus
(Department of Translational Science)
Maack Christoph
(University Clinic Würzburg)
Dieterich Christoph
(Würzburg)
Steinmetz Lars M
(Germany.; Heidelberg University)
Dewenter Matthias
(Medical Faculty Heidelberg)
Backs Johannes
(Institute of Experimental Cardiology)
📝 摘要
Although heart disease arises from different etiologies, treatment remains largely one-size-fits-all, leaving many patients without optimal benefit, which highlights the need for cause-directed therapies. Pathogenic variants in RBM20, a cardiac splicing factor, lead to an aggressive form of dilated cardiomyopathy with high risk of ventricular arrhythmias. We hypothesized that the splicing target calcium/calmodulin-dependent kinase II delta (CAMK2D) is disease causing in RBM20 cardiomyopathy. Here we show that Rbm20/Camk2d double knockout mice are protected from heart failure and sudden cardiac death. In Rbm20-deficient hearts, phosphorylation of CAMK2D targets was increased, indicating that RBM20 loss results not only in mis-splicing of Camk2d transcripts but also in functional activation of CAMK2D signaling. Reexpression of individual CAMK2D splice variants in Rbm20/Camk2d double knockout mice reintroduced cardiac dysfunction, demonstrating that overactivation, rather than mis-splicing, drives disease. Treatment of Rbm20-p.Arg636Gln knockin mice with the ATP-competitive CAMK2 inhibitor hesperadin improved cardiac function. These findings identify CAMK2D overactivation as a central mechanism in RBM20 cardiomyopathy and support CAMK2D inhibition as a promising cause-directed therapy.