tbuckley/cabot-search huggingface dataset:
Abstract We110: Novel allosteric ligand designed to prevent Autoantibody targeting the Angiotensin Type 1 Receptor (AT1R) in cardiovascular diseases (CVD)
Authors: Dhanachandra Singh Khuraijam, Triveni Pardhi, Terri Harford, Tarun Ravu, Russell Desnoyer, Maradumane Mohan, Chia-Feng Liu, Sathyamangla Naga Prasad, Wai Hong Tang, Sadashiva Karnik
Journal: Circulation Research (2024)

Background: The clinical data suggest an association of autoantibodies (AAb) targeting angiotensin II type1 receptor (AT1R) and outcomes in heart failure (HF) and preeclampsia. Notably, patient’s risk increases 2 to 4-fold for heart diseases and hypertension. Although AT1R blockers (ARBs) have emerged as a key component in the therapeutic arsenal against CVD, we believe that rather than completely blocking AT1R signaling, maintaining a balanced signaling is crucial for cardiovascular homeostasis. Therefore, we posit that reducing AT1R overactivation and blocking AAb-mediated activation could benefit cardiac health and attenuate the progression of CVD. In our previous study (PMID:36440576), we identified small molecules capable of inhibiting AAb-induced AT1R signaling. Leveraging these observations, we have developed a novel AT1R allosteric ligand that inhibits autoantibody binding to AT1R while still retaining normal AT1R signaling. Methods: Using computational and medicinal chemistry approaches, we designed a series of novel AT1R ligands and obtained compounds with &gt;98% purity through chemical synthesis. Monoclonal antibodies mimicking AT1R-AAb have been generated. Serum samples from dilated cardiomyopathy (DCM) and preeclampsia (PE) patient cohorts were collected and presence of AT1R-AAb was determined using ELISA and epitope-peptide competition studies. Pharmacological characterization of compounds was performed using calcium mobilization, 125I -AngII binding, ex vivo vasoconstriction, and ELISA assays. Results: We identified an AT1R allosteric compound that reduced AngII-mediated calcium signaling with a 5-fold shift in EC 50 . The IC 50 was determined to be 18 µM. It reduces the AngII-mediated vasoconstriction while blocking both monoclonal and patient-derived autoantibody binding with an IC 50 of 5 µM. Conclusion: We have identified a novel AT1R allosteric ligand with negative allosteric modulator (NAM) properties, which has the potential to block autoantibodies and could serve as a new generation of ARBs. Uniquely, it retains beneficial AT1R signaling without competing with AngII, and its allosteric ligand property can be tailored to achieve optimal AT1R signaling.
Abstract We107: Reduction of Six-Month Heart Failure Readmission Rates in Patients Undergoing MitraClip with Beta Receptor Blockade
Authors: Usman Najam, Joseph Iskander, Timothy Avino, Thomas Drago, Kristina Deonaraine, Arham Pasha
Journal: Circulation Research (2024)

Introduction: MitraClip has been shown to reduce heart failure readmissions in patients with moderate to severe mitral valve regurgitation. Likewise, beta-blocker (BB) therapy has been shown to reduce morbidity and mortality in select heart failure patients. At the cellular level, chronic myocardial insult from ongoing heart failure and mitral regurgitation leads to persistent overstimulation of myocardial beta-receptors, ultimately reducing cardiac inotropic reserve and contributing to myocardial injury. Thus, we hypothesized that patients on beta-blocker therapy before the MitraClip procedure would have fewer heart failure-related readmissions. Hypothesis: We assessed the hypothesis that beta-blocker therapy before the MitraClip procedure would lead to fewer heart failure-related readmissions by conducting a retrospective cohort study. This would help us better understand the pathogenesis of re-admissions in this patient population as well as help us decide whether prophylactic initiation of BB therapy before the procedure would reduce the risk of heart failure readmissions. Methods: We reviewed the records of patients who underwent the MitraClip procedure at our institution from January 2017 to July 2022. Patients without listed home medications, as well as non-heart failure-related readmissions and deaths, were excluded. Patients were split into those on BB therapy and those with no BB therapy. Of the 401 charts screened, 324 met the inclusion criteria. Results: From those who met the inclusion criteria, 226 patients were on beta-blocker therapy, while 98 patients were not. Of those who had at least one heart failure-related readmission within 6 months of the MitraClip procedure, 18 patients were on beta-blocker therapy and 16 patients were not. Meaning a 7.96% readmission rate for patients on beta-blocker therapy, and a 16.32% readmission rate for those who were not (OR 2.05, 95% CI: 1.004 to 4.186, p&lt;0.05), with the number needed to treat being 11.9. Conclusions: Our data shows that the use of beta-blocker therapy was associated with a statistically significant decrease in 6-month heart failure readmissions in those undergoing the MitraClip procedure. This suggests that at the cellular level, cardiac beta receptor dysfunction plays an integral part in future hospitalizations in this population. In conclusion, beta-blocker therapy should be considered in heart failure patients planning to undergo the MitraClip procedure to reduce heart failure-related readmissions.
Abstract We105: cBIN1 Gene Therapy Improves Left Ventricular Filling Pressure in a Canine Model of Ischemic Dilated Cardiomyopathy
Authors: Muhammad Khan, Kyoichiro Yazaki, Yuki Ishidoya, Emmanuel Offei, Sofia Ruizcastillo, Ankur Shah, Jing Li, Joseph palatinus, Tingting Hong, Robin Shaw, Derek Dosdall
Journal: Circulation Research (2024)

Introduction: In heart failure patients, increased left ventricular end diastolic pressure (LVEDP) is pathognomonic of myocardial dysfunction. Previously, we presented that gene therapy with exogeneous cardiac bridging integrator 1 (cBIN1), a membrane scaffolding protein that organizes T-tubule microdomains and is decreased in failing hearts, recovers systolic function in a canine model of chronic ischemic dilated cardiomyopathy (IDCM). The effect of catheter-based delivery of cBIN1 gene therapy on increased LVEDP is unclear. Hypothesis: We tested the hypothesis that cBIN1 gene therapy improves LVEDP in a canine model of IDCM. Methods: Twelve healthy dogs (30±2 kg) underwent left anterior descending artery ligation and developed IDCM with LVEF &lt;40% and NT-proBNP &gt;900 pmol/L over 3–4 months. Animals received a single application at 20 subendocardial LV sites of either AAV9-GFP (control, n=6) or AAV9-cBIN1 (n=6) using a MyoStar catheter-based injection. Pressure-volume loops were acquired in vivo, including measurement of LVEDP, end-systolic pressure-volume relation (ESPVR), isovolumic relaxation time (IVRT) and isovolumetric contraction time (IVCT). Measurements were performed on the day prior to administering the therapy ( pre-therapy ) and 5–8 weeks post-intramyocardial injection ( post-therapy ). For statistics, student t-test was used, and p&lt;0.05 refers as significant. Results are reported as mean±SD. Results: In AAV9-GFP control-treated dogs, compared with pre-therapy, post-therapy LVEDP elevated significantly (13±1 vs. 17±1 mmHg, p=0.002, Figure A ), whereas in the cBIN1-treated cohort, elevated LVEDP improved significantly (13±4 vs. 11±3 mmHg, p=0.042). With control therapy, ESPVR exhibited a significant decrease in contractility (1.40±0.44 vs. 1.81±0.49 mmHg/mL, p=0.001, Figure B ), whereas cBIN1 therapy caused a substantial improvement in ESPVR (1.54±0.71 vs. 1.34±0.43 mmHg/mL, p=0.022, Figure B ). At the post-therapy time-point, compared with control therapy, cBIN1 therapy improved IVRT (96±10 vs. 72±8 ms, p&lt;0.001, Figure C ) and IVCT (49±4 vs. 40±3 ms, p=0.009, Figure D ). Conclusion: cBIN1 gene therapy reduces elevated LV filling pressure and improves overall hemodynamics in a canine model of chronic IDCM.
Abstract We118: Phosphoglycerate Dehydrogenase Gene Therapy for Dilated Cardiomyopathy
Authors: Maryam Kay, Anne-Maj Apel, Nike Bharucha, Rachel Baum, Xueyi Li, Aurelie Laguerre, Christian Metallo, Michael Kapiloff, Ioannis Karakikes
Journal: Circulation Research (2024)

Introduction: Dilated cardiomyopathy (DCM) is a multifaceted cardiac disorder affecting approximately 1 in 250 to 2000 individuals and stands as a predominant cause of heart failure. Despite advancements in identifying genetic mutations associated with DCM, the precise mechanisms driving its pathogenesis are unknown, translating to the lack of disease-modifying interventions. Hypothesis: Modulating serine biosynthesis and one-carbon metabolism in cardiomyocytes by forced expression of Phosphoglycerate Dehydrogenase ( PHGDH) will ameliorate cardiac dysfunction in DCM and halt the disease progression. Methods: We developed a gene therapy vector expressing the PHGDH gene, controlled by a chicken cardiac-specific promoter (cardiac troponin T, cTnT) (AAV9.cTnT.hPHGDH). We delivered this construct via an AAV-based gene transfer approach using the cardiotropic adeno-associated virus serotype-9 in the TM54 DCM mouse – a well-established transgenic mouse that expresses a mutant tropomyosin cDNA (Tpm1 p. E54K; Tm54) under the control of the cardiac αMHC promoter. At 6 weeks old, when the animals exhibit DCM, they were treated with AAV9.cTnT.hPHGDH or control (AAV9.cTnT.GFP). Serial echocardiography was employed to assess heart function for 10 weeks. Morphometric data including heart weight, body weight, and tibia length were recorded. Subsequently, WGA and picrosirius red staining were performed to evaluate cardiomyocyte size and fibrosis, respectively. Finally, metabolic changes were assessed by untargeted metabolomics. Results: AAV9.cTnT.hPHGDH treatment of DCM TM54 mice improved the systolic function and halted the progression of DCM compared to the control mice. Furthermore, PHGDH treatment prevented the development of interstitial fibrosis and cardiomyocyte hypertrophy. Finally, these functional and structural improvements correlate with metabolic rewiring of the glucose metabolism in the DCM heart. Conclusion: These findings suggest that metabolic rewiring of the glucose metabolism by enhancing serine biosynthesis and one-carbon metabolism in the DCM heart may be cardioprotective. Thus, PHGDH gene therapy may be a novel therapeutic approach for DCM and heart failure.
Individualized decision making in on-scene resuscitation time for out-of-hospital cardiac arrest using reinforcement learning
Authors: Dong Hyun Choi, Min Hyuk Lim, Ki Jeong Hong, Young Gyun Kim, Jeong Ho Park, Kyoung Jun Song, Sang Do Shin, Sungwan Kim
Journal: npj Digital Medicine (2024)

On-scene resuscitation time is associated with out-of-hospital cardiac arrest (OHCA) outcomes. We developed and validated reinforcement learning models for individualized on-scene resuscitation times, leveraging nationwide Korean data. Adult OHCA patients with a medical cause of arrest were included (N = 73,905). The optimal policy was derived from conservative Q-learning to maximize survival. The on-scene return of spontaneous circulation hazard rates estimated from the Random Survival Forest were used as intermediate rewards to handle sparse rewards, while patients' historical survival was reflected in the terminal rewards. The optimal policy increased the survival to hospital discharge rate from 9.6% to 12.5% (95% CI: 12.2-12.8) and the good neurological recovery rate from 5.4% to 7.5% (95% CI: 7.3-7.7). The recommended maximum on-scene resuscitation times for patients demonstrated a bimodal distribution, varying with patient, emergency medical services, and OHCA characteristics. Our survival analysis-based approach generates explainable rewards, reducing subjectivity in reinforcement learning.
Abstract We103: Integration of deep learning assisted high-content screening and deep tissue-phenotyping to identify cardioprotective compounds in dilated cardiomyopathy
Authors: Nicolas Wiest-Daessle, Krasimira Sharkova, Amelie Weiss, Peter Sommer, Wolfram Zimmermann, Konstantinos Gkatzis
Journal: Circulation Research (2024)

With a prevalence of 4:10,000, dilated cardiomyopathy (DCM) is the most common hereditary heart disease, characterized by dilatation of one or both ventricles and impaired systolic and diastolic function. Numerous mutations have been identified to cause DCM. TITIN-truncating variants (TTNtv) are commonly observed in 20% of the genetic DCM cases. Progress in drug discovery for DCM has been hampered by the lack of robust high-throughput/high-content analysis pipelines of disease-specific cell and tissue platforms for deep structural and functional phenotyping. To address this challenge, we have developed a two-tiered human induced pluripotent stem cell (iPSC)-based screening approach, comprised of high-content cardiomyocyte imaging with artificial intelligence (AI)-driven image and data analyses as well as deep tissue phenotyping in engineered heart muscle (EHM) models. As a DCM use case, we have developed several isogenic human iPSC-lines with and without a previously reported and pathologically relevant A-band-TTNtv mutation (c.70692_70693insAT; p.T23565SfsX5; Gerull et al. 11788824, Gramlich et al. 25759365, Fomin et al. 34731013) Using fixed weights from a convolutional deep neural network trained on ImageNet, we generated unbiased deep embeddings from each 2D cell model and applied these to train machine learning (ML) models to detect morphological disease phenotypes. Our ML model is able to confidently separate healthy controls from TTNtv cells with high accuracy (&gt;93%), specificity (WT &gt;79%) across different batches/plate layouts and generate concentration-response curves, demonstrating platform robustness and sensitivity. Building upon this work, we will present our latest efforts applying the platform technology for a chemogenomic screening campaign to identify novel cardioprotective drugs using a library of 7,100 bioactive compounds and validation assays, including measuring functional changes in EHMs. The phenotypic profiling platform, as presented here, can be readily adapted to other disease-relevant cell types and pathologies. Our results demonstrate the power of combining iPSC-CMs with cytological profiling and deep learning as well as tissue-level phenotyping to accelerate drug discovery for patients with DCM.
Abstract We104: A New Small-Molecule ErbB4 Agonist Attenuates Adverse Ventricular Remodeling After Myocardial Infarction In a Sex-Specific Manner
Authors: Bo Goovaerts, Celine Civati, Eline Feyen, Gilles De Keulenaer, Vincent Segers
Journal: Circulation Research (2024)

Background: The beneficial effects of the neuregulin/ErbB pathway on the diseased heart have been well-established. The cardioprotective aspects of neuregulin are largely attributable to the activation of the ErbB4 receptor. We recently developed a small-molecule selective ErbB4 agonist, which reduced collagen production in fibroblasts and prevented oxidative-stress induced cardiomyocyte death in vitro . Hypothesis: We hypothesized that the ErbB4 agonist (referred to as compound, Cpd), would attenuate left ventricular remodeling, reduce interstitial cardiac fibrosis and preserve cardiac function in a murine model of myocardial infarction (MI). Since there is a potential interaction between the ErbB4 receptor and the estrogen receptor, we further hypothesized these effects would be sex-dependent. Methods: Mice were divided by sex and then further divided into three experimental groups: a sham group, an MI group receiving Cpd (MI/Cpd), and a control MI group receiving vehicle only (MI/Veh). Mice started treatment with either Cpd (2mg/kg/d) or its vehicle through subcutaneous osmotic minipumps seven days after MI. Cardiac ultrasound was performed weekly until mice were sacrificed after four weeks of treatment. Hearts were excised and stained with Masson’s trichrome to assess interstitial cardiac fibrosis in myocardium remote from the infarction scar. Results: In females (n=25), Cpd significantly decreased left ventricular end-diastolic volume compared to vehicle (Fig.1A, 80±23 µl vs.108±29µl, p=0.045) and induced a slightly increased left ventricular ejection fraction (Fig.2A, 32±12% vs. 22±9%, p=0.086). In addition, Cpd significantly reduced reactive interstitial fibrosis (fibrotic area, Fig.3A, 1.4±1.0% vs. vehicle: 3.8±3.1%, p=0.036) in females. In males (n=30), Cpd had no significant effects on either of the parameters mentioned above (Fig.1B, 2B, 3B). Conclusion: Treatment with the novel small-molecule ErbB4 agonist attenuates left ventricular dilation and reactive interstitial fibrosis after MI in female mice, but not in males. These data support the premise that small molecule-induced ErbB4 activation is a potential new therapy for heart failure, especially in female patients. The mechanisms underlying the sex-dependent effects warrant further exploration.
Abstract We102: Synthetic N-Acylurea Derivative Reduces Angiogenesis in Human Endothelial Cells by Talin Modulation
Authors: Soon Jun Hong, Hun Park
Journal: Circulation Research (2024)

Talin is a focal adhesion protein that activates integrins and recruits other focal adhesion proteins. Talin regulates the interactions between integrins and the extracellular matrix, which are critical for endothelial cells during angiogenesis. In this study, we successfully synthesized a novel talin modulator, N-((2-(1H-indol-3-yl)ethyl)carbamoyl)-2-(benzo[d][1,3]dioxol-5-yloxy)acetamide, referred to as KCH-1521. KCH-1521 was determined to bind talin and modulate downstream signaling molecules of talin. After 24 hrs of treatment, KCH-1521 changed the cell morphology of HUVECs and reduced focal adhesion protein expression including vinculin and paxillin. Talin downstream signaling is regulated via FAK, AKT, and ERK pathways, however, treatment with KCH-1521 decreased phosphorylation of FAK, AKT, and ERK, leading to a reduction of cell proliferation, survival, and angiogenesis. Interestingly, the expression of various angiogenic genes was significantly decreased after treatment with KCH-1521. Also, in vitro tube forming assay revealed that KCH-1521 reduced angiogenic networks in a time-dependent manner. To investigate the reversibility of its effects, KCH-1521 was removed after treatment. HUVECs recovered their morphology through rearrangement of the cytoskeleton and the expression of angiogenic genes was also recovered. By further optimization and in vivo studies of KCH-1521, a novel drug of talin modulation could be used to achieve therapeutic anti-angiogenesis for vascular diseases and cancers.
Abstract We117: Preclinical Evidence of Long-term Efficacy and Safety of LX2020, an AAV based Plakophilin-2 Gene Therapy, for the Treatment of Arrhythmogenic Cardiomyopathy
Authors: Jing Zhang, Erika Joana Gutierrez Lara, Aryanne Do, Lena Nguyen, Anju Nair, Nithya Selvan, Tim Fenn, Eric Adler, Richie Khanna, Farah Sheikh
Journal: Circulation Research (2024)

Arrhythmogenic cardiomyopathy (ACM) is a fatal inherited cardiac disease caused by mutations in desmosomal anchoring genes, with plakophilin-2 (PKP2) being the most frequently mutated gene (70%). While AAV9-PKP2 gene therapy shows promise in mitigating ACM-related deficits in mice, high dose toxicity and organ failure of AAV9 in human clinical trials raises safety concerns. Prior studies showed AAVrh.10 exhibiting preferential cardiac gene expression at lower doses that could potentially be safer. We hypothesized that AAVrh.10.PKP2 (LX2020) could restore PKP2 to scaffold the desmosomal complex and ameliorate cardiac deficits with long-term efficacy at relatively lower doses and safety in non-human primates (NHP). We employed LX2020 to assess its efficacy in severe (PKP2 homozygous (Hom)) and mild (PKP2 heterozygous (Het)) adult ACM diseased mice, as well as safety in NHP at doses from 2E13 to 1E14 vg/kg and up to 12 weeks post-administration. A dose-dependent increase in hPKP2 expression was seen in all models, with rescue of desmosomal/gap junction protein deficits at 2E13 and 6E13 vg/kg doses in PKP2-Het and PKP2-Hom mouse hearts. Long term LX2020 efficacy was observed at the same doses in PKP2-Hom mice with dose-dependent improvements in cardiac function, arrhythmia reduction and histological improvements, such that LX2020 treated PKP2-Hom hearts resembled wild-type hearts, indicating a potential for reversal of late-stage pathology. The extended lifespan was striking with 100% of PKP2-Hom mice surviving using 2E13 vg/kg, completely averting premature death. Safety assessments in NHP also revealed no adverse events up to the highest dose of 1E14 vg/kg. These data support advancing LX2020 as a potentially viable treatment for PKP2 ACM patients, based on safety and long-term efficacy in rescuing desmosomal and cardiac deficits in ACM models at lower doses reported in the field.
Abstract We101: Targeted gene silencing with small interfering RNA-loaded lipid nanoparticles to treat cardiac fibrosis
Authors: Mengrui Liu
Journal: Circulation Research (2024)

Bromodomain-containing protein 4 (BRD4) is an effector of transforming growth factor-β (TGF-β) signaling. Upon injury, BRD4 stimulates the differentiation of quiescent cardiac fibroblasts into activated fibroblasts. These activated fibroblasts unfavorably remodel the myocardium by depositing excess extracellular matrix. Here, we reported lipid nanoparticles (LNPs) loaded with small interference RNA against BRD4 (siBRD4) to deactivate fibroblasts after cardiac injury. Because fibroblast activation protein (FAP) is a biomarker of activated fibroblasts, we conjugated anti-FAP antibodies on the LNPs for targeted delivery to activated fibroblasts. Systemic administration of these targeted siBRD4-loaded LNPs inhibited fibroblast activation, reduced fibrosis, and improved cardiac functions in rodent models of myocardial infarction and cardiac fibrosis. Single-nucleus RNA sequencing and cytokine analysis revealed that this therapy further converted the pro-fibrotic and pro-inflammatory microenvironment to a pro-resolution and pro-regeneration one. The safety and toxicity of this nanomedicine were tested in nonhuman primates.