A systems genetics approach identifies roles for proteasome factors in heart development and congenital heart defects
Authors: Farr Gist H. , Reid Whitaker , Young Isabelle , Li Mona L. , Beier David R. , Maves Lisa 
Published: January 2025

Congenital heart defects (CHDs) occur in about 1% of live births and are the leading cause of infant death due to birth defects. While there have been remarkable efforts to pursue large-scale whole-exome and genome sequencing studies on CHD patient cohorts, it is estimated that these approaches have thus far accounted for only about 50% of the genetic contribution to CHDs. We sought to take a new approach to identify genetic causes of CHDs. By combining analyses of genes that are under strong selective constraint along with published embryonic heart transcriptomes, we identified over 200 new candidate genes for CHDs. We utilized protein-protein interaction (PPI) network analysis to identify a functionally-related subnetwork consisting of known CHD genes as well as genes encoding proteasome factors, in particularPOMP,PSMA6,PSMA7,PSMD3, andPSMD6. We used CRISPR screening in zebrafish embryos to preliminarily identify roles for the PPI subnetwork genes in heart development. We then used CRISPR to create new mutant zebrafish strains for two of the proteasome genes in the subnetwork:pompandpsmd6. Phenotypic analyses confirm critical roles forpompandpsmd6in heart development. In particular, we find defects in myocardial cell shapes and in outflow tract development inpompandpsmd6mutant zebrafish embryos, and these phenotypes have been observed in other zebrafish CHD-gene mutants. Our study provides a novel systems genetics approach to further our understanding of the genetic causes of human CHDs.

Author Summary

Congenital heart defects (CHDs) are birth defects resulting in the abnormal structure and function of the heart. Genetic mutations are a significant cause of CHDs. Many studies have used genome sequencing of CHD patients and their families to gain knowledge of the mutations that cause CHDs. However, these studies have only found about 50 percent of the genes involved in CHDs. Here, we take a new approach to identifying genes that are required for heart development and that may cause CHDs, generating a list of over 200 candidate genes. Using multiple data systems, including human exome sequences, mouse transcriptomes, and protein-protein interactions, we identify a small group of related potential CHD genes that includes multiple genes encoding proteasome factors. These factors are known to be important for assembling the proteasome, a large molecular machine that eliminates unneeded or damaged proteins from the cell, but which has not been shown to contribute to CHD. We use a CRISPR-based approach in zebrafish to specifically eliminate some of these candidate genes and reveal new roles for proteasome genes in heart development. We show that loss of proteasome gene functions leads to zebrafish heart defects that resemble those seen in other zebrafish CHD-gene mutants. This study shows that a proteasome gene family contributes to heart development, advancing our understanding of the causes of CHDs. By increasing our understanding of the genetic causes of CHDs, our work should lead to better screening, more accurate diagnoses, and, ultimately, better treatments for these disorders.