Abstract

Spinal muscular atrophy (SMA) is a neurodegenerative disease characterized by loss of alpha motor neurons and skeletal muscle atrophy. The disease is caused by mutations of the SMN1 gene that result in reduced functional expression of survival motor neuron (SMN) protein. SMN is ubiquitously expressed, and there have been reports of cardiovascular dysfunction in the most severe SMA patients and animal models of the disease. In this study, we directly assessed the function of cardiomyocytes isolated from a severe SMA model mouse and cardiomyocytes generated from patient-derived IPSCs. Consistent with impaired cardiovascular function at the very early disease stages in mice, heart failure markers such as brain natriuretic peptide were significantly elevated. Functionally, cardiomyocyte relaxation kinetics were markedly slowed and the T50 for Ca2+ sequestration increased to 146 ± 4 ms in SMN-deficient cardiomyocytes from 126 ± 4 ms in wild type cells. Reducing SMN levels in cardiomyocytes from control patient IPSCs slowed calcium reuptake similar to SMA patent-derived cardiac cells. Importantly, restoring SMN increased calcium reuptake rate. Taken together, these results indicate that SMN deficiency impairs cardiomyocyte function at least partially through intracellular Ca2+ cycling dysregulation.

Highlights

  • Spinal muscle atrophy (SMA) is one of the leading genetic causes of infant mortality

  • Heart failure markers are elevated in survival motor neuron (SMN)-deficient mice There is growing evidence suggesting that peripheral tissues, including the heart, may be affected by the loss of SMN function in SMA patients

  • Heart failure is associated with the reactivation of fetal genes, including atrial natriuretic peptide (ANP; Nppa), brain natriuretic peptide (BNP; Nppb), and skeletal α-actin (Acta1), associated with structural and functional remodeling of the heart [30]

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Summary

Introduction

Spinal muscle atrophy (SMA) is one of the leading genetic causes of infant mortality. SMA is caused by survival motor neuron (SMN) protein deficiency due to deletions or mutations of the SMN1 gene. Individuals carry two or more copies of a paralog gene, SMN2, which produces suboptimal levels of the SMN protein. SMN is ubiquitously expressed in all tissues, where it is known to play a key role in snRNP biogenesis and spliceosome assembly [6,7,8]. It is unclear why reduced levels of the ubiquitously expressed SMN protein selectively target anterior horn cells of the spinal cord.

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