Cardiac Myofibroblasts Research Articles

Elevated PRELP expression in heart and liver fibrosis promotes collagen production

Fibrosis results from the excessive production of extracellular matrix proteins by myofibroblasts. It has recently been reported that in the heart, myofibroblasts develop chondrocyte-like properties following myocardial infarction as fibrosis progresses and tissues stiffen. However, the nature of these chondrocyte-like myofibroblasts remains unclear. In this study, we found that the expression of the proline- and arginine-rich end leucine-rich repeat protein (PRELP) was upregulated in hearts and livers stiffened by fibrosis with chronic inflammation. Moreover, we established that Prelp was specifically expressed in chondrocyte-like myofibroblasts. Prelp expression was found to be regulated by the transcription factor SOX9, and in cardiac and liver myofibroblasts, Prelp-knockdown was observed to reduce collagen expression. These findings reveal that PRELP is specifically expressed in chondrocyte-like myofibroblasts and that it promotes collagen production. PRELP could thus serve as a novel therapeutic target for treating fibrosis.

Platelet and Erythrocyte Membranes Coassembled Biomimetic Nanoparticles for Heart Failure Treatment.

Cardiac fibrosis is a prevalent pathological process observed in the progression of numerous cardiovascular diseases and is associated with an increased risk of sudden cardiac death. Although the BRD4 inhibitor JQ1 has powerful antifibrosis properties, its clinical application is extremely limited due to its side effects. There remains an unmet need for effective, safe, and low-cost treatments. Here, we present a multifunctional biomimetic nanoparticle drug delivery system (PM&EM nanoparticles) assembled by platelet membranes and erythrocyte membranes for targeted JQ1 delivery in treating cardiac fibrosis. The platelet membrane endows PM&EM nanoparticles with the ability to target cardiac myofibroblasts and collagen, while the participation of the erythrocyte membrane enhances the long-term circulation ability of the formulated nanoparticles. In addition, PM&EM nanoparticles can deliver sufficient JQ1 with controllable release, achieving excellent antifibrosis effects. Based on these advantages, it is demonstrated in both pressures overloaded induced mouse cardiac fibrosis model and MI-induced mouse cardiac fibrosis that injection of the fusion membrane biomimetic nanodrug carrier system effectively reduced fibroblast activation, collagen secretion, and improved cardiac fibrosis. Moreover, it significantly mitigated the toxic and side effects of long-term JQ1 treatment on the liver, kidney, and intestinal tract. Mechanically, bioinformatics prediction and experimental validation revealed that PM&EM/JQ1 NPs reduced liver and kidney damage via alleviated oxidative stress and mitigated cardiac fibrosis via the activation of oxidative phosphorylation activation. These results highlight the potential value of integrating native platelet and erythrocyte membranes as a multifunctional biomimetic drug delivery system for treating cardiac fibrosis and preventing drug side effects.

Abstract We020: Myh9 plays a vital role in cardiac myofibroblast differentiation and is indispensable for cardiac repair after myocardial infarction

After myocardial infarction (MI), quiescent cardiac fibroblasts (CFs) are activated and differentiate into myofibroblasts featured by elevated expression of smooth muscle alpha-actin (SMαA, encoded by Acta2 ), which form contractile stress fibers. However, compared to the matrix formation function of cardiac myofibroblasts, much less is known about the role of their contraction in post-MI cardiac repair. In our previous study using mice lacking Acta2 in CFs, all other 5 actin isoforms were activated to compensate for the loss of Acta2 , suggesting the low feasibility of abolishing cardiac myofibroblast contraction through deleting actin genes. An alternative strategy through targeting myosin was explored. Our transcriptomic study identified Myh9 and Myh10 [encoding non-muscle myosin IIA (NM IIA) and NM IIB, respectively] as the dominant myosin isoforms in cardiac myofibroblasts. In vitro studies found that Myh9 knockout (KO) but not Myh10 KO significantly affected cardiac myofibroblast morphology, completely abolished the stress fiber formation and contractility of these cells, and reduced their proliferation and ability to stabilize the surrounding matrix. Mice lacking Myh9 in CFs have an increased post-MI cardiac rupture rate compared to WT mice regardless of sexes ( p =0.004 and 0.02 for male and female mice, respectively). In vitro and in vivo transcriptomic and proteomics analysis revealed disrupted expression of stress fiber and mesenchymal identity genes/proteins caused by Myh9 KO. Mechanistically, Myh9 KO led to an increased globular to filamentous (G/F) actin ratio. The altered actin dynamics likely trigger multiple epigenetic events, which together lead to significantly altered cardiac myofibroblast gene expression and activities beyond contraction.

Fibroblast Smad7 Induction Protects the Remodeling Pressure-Overloaded Heart.

Cardiac fibroblast activation contributes to adverse remodeling, fibrosis, and dysfunction in the pressure-overloaded heart. Although early fibroblast TGF-β (transforming growth factor-β)/Smad (small mother against decapentaplegic)-3 activation protects the pressure-overloaded heart by preserving the matrix, sustained TGF-β activation is deleterious, accentuating fibrosis and dysfunction. Thus, endogenous mechanisms that negatively regulate the TGF-β response in fibroblasts may be required to protect from progressive fibrosis and adverse remodeling. We hypothesized that Smad7, an inhibitory Smad that restrains TGF-β signaling, may be induced in the pressure-overloaded myocardium and may regulate fibrosis, remodeling, and dysfunction. The effects of myofibroblast-specific Smad7 loss were studied in a mouse model of transverse aortic constriction, using echocardiography, histological analysis, and molecular analysis. Proteomic studies in S7KO (Smad7 knockout) and overexpressing cells were used to identify fibroblast-derived mediators modulated by Smad7. In vitro experiments using cultured cardiac fibroblasts, fibroblasts populating collagen lattices, and isolated macrophages were used to dissect the molecular signals responsible for the effects of Smad7. Following pressure overload, Smad7 was upregulated in cardiac myofibroblasts. TGF-β and angiotensin II stimulated fibroblast Smad7 upregulation via Smad3, whereas GDF15 (growth differentiation factor 15) induced Smad7 through GFRAL (glial cell line-derived neurotrophic factor family receptor α-like). MFS7KO (myofibroblast-specific S7KO) mice had increased mortality, accentuated systolic dysfunction and dilative remodeling, and accelerated diastolic dysfunction in response to transverse aortic constriction. Increased dysfunction in MFS7KO hearts was associated with accentuated fibrosis and increased MMP (matrix metalloproteinase)-2 activity and collagen denaturation. Secretomic analysis showed that Smad7 loss accentuates secretion of structural collagens and matricellular proteins and markedly increases MMP2 secretion. In contrast, Smad7 overexpression reduced MMP2 levels. In fibroblasts populating collagen lattices, the effects of Smad7 on fibroblast-induced collagen denaturation and pad contraction were partly mediated via MMP2 downregulation. Surprisingly, MFS7KO mice also exhibited significant macrophage expansion caused by paracrine actions of Smad7 null fibroblasts that stimulate macrophage proliferation and fibrogenic activation. Macrophage activation involved the combined effects of the fibroblast-derived matricellular proteins CD5L (CD5 antigen-like), SPARC (secreted protein acidic and rich in cysteine), CTGF (connective tissue growth factor), ECM1 (extracellular matrix protein 1), and TGFBI (TGFB induced). The antifibrotic effects of Smad7 in the pressure-overloaded heart protect from dysfunction and involve not only reduction in collagen deposition but also suppression of MMP2-mediated matrix denaturation and paracrine effects that suppress macrophage activation through inhibition of matricellular proteins.

Novel Mouse Model for Selective Tagging, Purification, and Manipulation of Cardiac Myofibroblasts

Novel Mouse Model for Selective Tagging, Purification, and Manipulation of Cardiac Myofibroblasts

Diagnostic and Prognostic Value of Plasma lncRNA SRA1 in Chronic Heart Failure.

The pathogenesis and development of chronic heart failure (CHF) may involve long non-coding ribonucleic acid (lncRNA) steroid receptor RNA activator 1 (SRA1), a known cardiomyopathy risk factor and regulator of cardiac myofibroblast activation. This study aimed to investigate the application of SRA1 in the early detection and prediction of CHF. SRA1 plasma expression was determined in CHF patients and healthy individuals/using real time-quantitative polymerase chain reaction (RT-qPCR). The diagnostic and prognostic value of SRA1 was assessed using receiver operating curve (ROC) and Cox regression analyses. Compared with the healthy controls, the patients with CHF had increased brain natriuretic peptide (BNP) levels, left atrial end-systolic diameter (LAD), left ventricular end-diastolic diameter (LVDd), and decreased left ventricular ejection fraction (LVEF). SRA1 was significantly upregulated in CHF patients as well as positively correlated with BNP level, LAD, and LVDd, and negatively correlated with LVEF. SRA1 could sensitively discriminate CHF patients from healthy individuals and was an independent predictor of adverse event-free survival in CHF patients. Upregulated plasma SRA1 can discriminate patients with CHF from healthy individuals and predict adverse outcomes in CHF patients. Thus, SRA1 is a potential molecular indicator for monitoring chronic heart failure development.

DCM-Spheroid Morphs Express PADs and Citrullinated Cytoskeletal Proteins.

During investigating the role of peptidylarginine deiminase (PAD) enzymes in dilated cardiomyopathy (DCM), we observed unique spheroid formation in DCM-myofibroblasts that distinguished them from normal cardiac myofibroblasts. The present study aimed to assess the presence of PADs, the extracellular matrix (ECM), and citrullination in DCM spheroids using immunofluorescence staining and imaging techniques. The results revealed that spheroids derived from DCM-myofibroblasts displayed a more distinctive, tightly packed structure compared with those derived from human cardiac fibroblasts. DCM spheroids showed abundant protein expression of the PAD 2, 3, and 4 enzymes. Notably, increased Ki67 protein expression was associated with increased proliferation in DCM spheroids. Cytoskeletal proteins such as Col-1A, vimentin, α-SMA, and F-actin were highly abundant in DCM spheroids. Furthermore, DCM spheroids contained citrullinated cytoskeletal proteins, mainly citrullinated vimentin and citrullinated fibronectin. These observations supported the occurrence of PAD-mediated citrullination of ECM proteins in DCM spheroids. Collectively, these findings describe the distinctive features of DCM spheroids, representing the cellular characteristics of DCM myofibroblasts. Therefore, DCM spheroids can serve as an in vitro model for further investigations of disease morphology and therapeutic efficacy.

ARGININE VASOPRESSIN DEFICIENCY INDUCES DECREASED CARDIAC FIBROSIS RATE AND MEAN ARTERIAL BLOOD PRESSURE IN RATS WITH EXPERIMENTAL ABDOMINAL AORTIC STENOSIS

Cardiac fibrosis (CF) involves the accumulation of extracellular matrix proteins in the interstitial space, often seen in various cardiac pathologies. Each year, cardiovascular diseases claim the lives of 17.9 million people worldwide. Cardiac fibroblasts and myofibroblasts, equipped with vasopressin receptors (AVP), play a crucial role in regulating cell signaling pathways associated with CF development. AVP, an immunomodulatory hormone, influences immune responses, and its deficiency results in a decrease in immune activity. Abdominal aortic stenosis (AS) serves as an experimental model for left cardiac overload hypertension and CF. Neurointermediate pituitary lobectomy (NIL) induces a permanent decrease in circulating AVP levels, showcasing regression of hepatic fibrosis in liver damage models. The quest for effective alternative treatments for cardiac fibrosis poses a substantial challenge for researchers. In this experiment, groups of male Wistar rats weighing approximately 250 g (8/group) were categorized into: 1) Intact Control (IC), 2) Abdominal Aortic Stenosis (AS), 3) Neurointermediate pituitary lobectomy (NIL), and 4) AS+NIL. The AS and AS+NIL groups underwent abdominal aortic stenosis surgery on day one of the experiment. By week 5, the NIL and NIL+AS groups underwent NIL surgery. Prior to sacrifice at week 10, intracarotid mean blood pressure (MBP) was assessed in all groups. Following sacrifice, the hearts were removed, fixed in neutral formalin, and processed in paraffn for histopathological examination using H-E, Masson's trichrome, and Sirius red staining. Results revealed an elevated MBP in the AS group (156 ± 27.1 vs. 114 ± 30 mmHg in the IC), normalized in the AS+NIL group (110 ± 40.9 mmHg), and a mild decrease in the NIL group (87 ± 7.6 mmHg). The evaluation of CF in histological slides concurred with the MBP findings; a significant increase in CF occurred in the AS group compared to the IC, NIL, and AS+NIL groups, with almost complete reversion of CF observed in the AS+NIL group. In summary, this study demonstrates that AVP deficiency induces arterial hypotension, and in the AS+NIL group, AVP deficiency led to: 1) a decrease in blood pressure to normal levels and 2) reversion of cardiac fibrosis. Further experiments are warranted to determine if the decrease in blood pressure and cardiac overload are suffcient to inhibit profibrogenic mechanisms and/or activate antifibrogenic mechanisms. Additionally, investigations are needed to explore whether AVP deficiency, beyond inhibiting the inflammatory process, promotes the activation of antifibrogenic mechanisms. The present results offer new avenues for a deeper understanding of the molecular and cellular mechanisms through which AVP deficiency or the use of AVP receptor antagonists significantly influences fibrosis regulation in organ fibrotic diseases. Funding by Autonomous University of Aguascalientes (PIFF22-1). This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

3D bioprinted aged human post-infarct myocardium tissue model.

Fibrotic tissue formed after myocardial infarction (MI) can be as detrimental as MI itself. However, current in vitro cardiac fibrosis models fail to recapitulate the complexities of post-MI tissue. Moreover, although MI and subsequent fibrosis is most prominent in the aged population, the field suffers from inadequate aged tissue models. Herein, an aged human post-MI tissue model, representing the native microenvironment weeks after initial infarction, is engineered using three-dimensional bioprinting via creation of individual bioinks to specifically mimic three distinct regions: remote, border, and scar. The aged post-MI tissue model is engineered through combination of gelatin methacryloyl, methacrylated hyaluronic acid, aged type I collagen, and photoinitiator at variable concentrations with different cell types, including aged human induced pluripotent stem cell-derived cardiomyocytes, endothelial cells, cardiac fibroblasts, and cardiac myofibroblasts, by introducing a methodology which utilizes three printheads of the bioprinter to model aged myocardium. Then, using cell-specific proteins, the cell types that comprised each region are confirmed using immunofluorescence. Next, the beating characteristics are analyzed. Finally, the engineered aged post-MI tissue model is used as a benchtop platform to assess the therapeutic effects of stem cell-derived extracellular vesicles on the scar region. As a result, high viability (>74%) was observedin each region of the printed model. Constructs demonstrated functional behavior, exhibiting a beating velocity of 6.7 μm/s and a frequency of 0.3 Hz. Finally, the effectiveness of hiPSC-EV and MSC-EV treatment was assessed. While hiPSC-EV treatment showed no significant changes, MSC-EV treatment notably increased cardiomyocyte beating velocity, frequency, and confluency, suggesting a regenerative potential. In conclusion, we envision that our approach of modeling post-MI aged myocardium utilizing three printheads of the bioprinter may be utilized for various applications in aged cardiac microenvironment modeling and testing novel therapeutics.

Microcurrent-Mediated Modulation of Myofibroblasts for Cardiac Repair and Regeneration.

Cardiovascular diseases are a significant cause of illness and death worldwide, often resulting in myofibroblast differentiation, pathological remodeling, and fibrosis, characterized by excessive extracellular matrix protein deposition. Treatment options for cardiac fibrosis that can effectively target myofibroblast activation and ECM deposition are limited, necessitating an unmet need for new therapeutic approaches. In recent years, microcurrent therapy has demonstrated promising therapeutic effects, showcasing its translational potential in cardiac care. This study therefore sought to investigate the effects of microcurrent therapy on cardiac myofibroblasts, aiming to unravel its potential as a treatment for cardiac fibrosis and heart failure. The experimental design involved the differentiation of primary rat cardiac fibroblasts into myofibroblasts. Subsequently, these cells were subjected to microcurrent (MC) treatment at 1 and 2 µA/cm2 DC with and without polarity reversal. We then investigated the impact of microcurrent treatment on myofibroblast cell behavior, including protein and gene expression, by performing various assays and analyses comparing them to untreated myofibroblasts and cardiac fibroblasts. The application of microcurrents resulted in distinct transcriptional signatures and improved cellular processes. Gene expression analysis showed alterations in myofibroblast markers, extracellular matrix components, and pro-inflammatory cytokines. These observations show signs of microcurrent-mediated reversal of myofibroblast phenotype, possibly reducing cardiac fibrosis, and providing insights for cardiac tissue repair.

JAK/STAT3 signaling in cardiac fibrosis: a promising therapeutic target.

Cardiac fibrosis is a serious health problem because it is a common pathological change in almost all forms of cardiovascular diseases. Cardiac fibrosis is characterized by the transdifferentiation of cardiac fibroblasts (CFs) into cardiac myofibroblasts and the excessive deposition of extracellular matrix (ECM) components produced by activated myofibroblasts, which leads to fibrotic scar formation and subsequent cardiac dysfunction. However, there are currently few effective therapeutic strategies protecting against fibrogenesis. This lack is largely because the molecular mechanisms of cardiac fibrosis remain unclear despite extensive research. The Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling cascade is an extensively present intracellular signal transduction pathway and can regulate a wide range of biological processes, including cell proliferation, migration, differentiation, apoptosis, and immune response. Various upstream mediators such as cytokines, growth factors and hormones can initiate signal transmission via this pathway and play corresponding regulatory roles. STAT3 is a crucial player of the JAK/STAT pathway and its activation is related to inflammation, malignant tumors and autoimmune illnesses. Recently, the JAK/STAT3 signaling has been in the spotlight for its role in the occurrence and development of cardiac fibrosis and its activation can promote the proliferation and activation of CFs and the production of ECM proteins, thus leading to cardiac fibrosis. In this manuscript, we discuss the structure, transactivation and regulation of the JAK/STAT3 signaling pathway and review recent progress on the role of this pathway in cardiac fibrosis. Moreover, we summarize the current challenges and opportunities of targeting the JAK/STAT3 signaling for the treatment of fibrosis. In summary, the information presented in this article is critical for comprehending the role of the JAK/STAT3 pathway in cardiac fibrosis, and will also contribute to future research aimed at the development of effective anti-fibrotic therapeutic strategies targeting the JAK/STAT3 signaling.

Cardiac and perivascular myofibroblasts, matrifibrocytes, and immune fibrocytes in hypertension; commonalities and differences with other cardiovascular diseases.

Hypertension is a major cause of cardiovascular diseases such as myocardial infarction and stroke. Cardiovascular fibrosis occurs with hypertension and contributes to vascular resistance, aortic stiffness, and cardiac hypertrophy. However, the molecular mechanisms leading to fibroblast activation in hypertension remain largely unknown. There are two types of fibrosis: replacement fibrosis and reactive fibrosis. Replacement fibrosis occurs in response to the loss of viable tissue to form a scar. Reactive fibrosis occurs in response to an increase in mechanical and neurohormonal stress. Although both types of fibrosis are considered adaptive processes, they become maladaptive when the tissue loss is too large, or the stress persists. Myofibroblasts represent a subpopulation of activated fibroblasts that have gained contractile function to promote wound healing. Therefore, myofibroblasts are a critical cell type that promotes replacement fibrosis. Although myofibroblasts were recognized as the fibroblasts participating in reactive fibrosis, recent experimental evidence indicated there are distinct fibroblast populations in cardiovascular reactive fibrosis. Accordingly, we will discuss the updated definition of fibroblast subpopulations, the regulatory mechanisms, and their potential roles in cardiovascular pathophysiology utilizing new knowledge from various lineage tracing and single-cell RNA sequencing studies. Among the fibroblast subpopulations, we will highlight the novel roles of matrifibrocytes and immune fibrocytes in cardiovascular fibrosis including experimental models of hypertension, pressure overload, myocardial infarction, atherosclerosis, aortic aneurysm, and nephrosclerosis. Exploration into the molecular mechanisms involved in the differentiation and activation of those fibroblast subpopulations may lead to novel treatments for end-organ damage associated with hypertension and other cardiovascular diseases.

AKAP2-anchored extracellular signal-regulated kinase 1 (ERK1) regulates cardiac myofibroblast migration

Cardiac fibrosis is a major cause of dysfunctions and arrhythmias in failing hearts. At the cellular level fibrosis is mediated by cardiac myofibroblasts, which display an increased migratory capacity and secrete large amounts of extracellular matrix. These properties allow myofibroblasts to invade, remodel and stiffen the myocardium and eventually alter cardiac function. While the enhanced ability of cardiac myofibroblasts to migrate has been proposed to contribute to the initiation of the fibrotic process, the molecular mechanisms controlling their motile function have been poorly defined. In this context, our current findings indicate that A-kinase anchoring protein 2 (AKAP2) associates with actin at the leading edge of migrating cardiac myofibroblasts. Proteomic analysis of the AKAP2 interactome revealed that this anchoring protein assembles a signaling complex composed of the extracellular regulated kinase 1 (ERK1) and its upstream activator Grb2 that mediates the activation of ERK in cardiac myofibroblasts. Silencing AKAP2 expression results in a significant reduction in the phosphorylation of ERK1 and its downstream effector WAVE2, a protein involved in actin polymerization, and impairs the ability of cardiac myofibroblasts to migrate. Importantly, disruption of the interaction between AKAP2 and F-actin using cell-permeant competitor peptides, inhibits the activation of the ERK-WAVE2 signaling axis, resulting in a reduction of the translocation of Arp2 to the leading-edge membrane and in inhibition of cardiac myofibroblast migration. Collectively, these findings suggest that AKAP2 functions as an F-actin bound molecular scaffold mediating the activation of an ERK1-dependent promigratory transduction pathway in cardiac myofibroblasts.

Identification of Periostin as a critical niche for myofibroblast dynamics and fibrosis during tendon healing

Tendon injuries are a major clinical problem, with poor patient outcomes caused by abundant scar tissue deposition during healing. Myofibroblasts play a critical role in the initial restoration of structural integrity after injury. However, persistent myofibroblast activity drives the transition to fibrotic scar tissue formation. As such, disrupting myofibroblast persistence is a key therapeutic target. While myofibroblasts are typically defined by the presence of αSMA+ stress fibers, αSMA is expressed in other cell types including the vasculature. As such, modulation of myofibroblast dynamics via disruption of αSMA expression is not a translationally tenable approach. Recent work has demonstrated that Periostin-lineage (PostnLin) cells are a precursor for cardiac fibrosis-associated myofibroblasts. In contrast to this, here we show that PostnLin cells contribute to a transient αSMA+ myofibroblast population that is required for functional tendon healing, and that Periostin forms a supportive matrix niche that facilitates myofibroblast differentiation and persistence. Collectively, these data identify the Periostin matrix niche as a critical regulator of myofibroblast fate and persistence that could be targeted for therapeutic manipulation to facilitate regenerative tendon healing.

Improved Factor Combination for In Vivo Reprogramming of Cardiac Myofibroblast to Cardiomyocyte-Like Cell With Dual Recombinase Tracing.

Improved Factor Combination for In Vivo Reprogramming of Cardiac Myofibroblast to Cardiomyocyte-Like Cell With Dual Recombinase Tracing.

Opto-SICM framework combines optogenetics with scanning ion conductance microscopy for probing cell-to-cell contacts

We present a novel framework, Opto-SICM, for studies of cellular interactions in live cells with high spatiotemporal resolution. The approach combines scanning ion conductance microscopy, SICM, and cell-type-specific optogenetic interrogation. Light-excitable cardiac fibroblasts (FB) and myofibroblasts (myoFB) were plated together with non-modified cardiomyocytes (CM) and then paced with periodic illumination. Opto-SICM reveals the extent of FB/myoFB-CM cell-cell contacts and the dynamic changes over time not visible by optical microscopy. FB-CM pairs have lower gap junctional expression of connexin-43 and higher contact dynamism compared to myoFB-CM pairs. The responsiveness of CM to pacing via FB/myoFB depends on the dynamics of the contact but not on the area. The non-responding pairs have higher net cell-cell movement at the contact. These findings are relevant to cardiac disease states, where adverse remodeling leads to abnormal electrical excitation of CM. The Opto-SICM framework can be deployed to offer new insights on cellular and subcellular interactions in various cell types, in real-time.

Abstract 15760: A Critical Contribution of Cardiac Myofibroblasts and a Predictive Role of UCP2 SNPs in the RV Decompensation in Pulmonary Hypertension

Introduction/hypothesis: The mechanism driving the transition from compensated (cRVH) to decompensated right ventricular hypertrophy (dRVH) in pulmonary hypertension (PHT) is unknown. We hypothesized that a transition from cardiac fibroblasts (cFB) to cardiac myofibroblasts (cMFB) underlies this mechanism. Decreased mitochondrial calcium (mCa ++ ) promotes cMFB differentiation (from cFB). Methylation of mCa ++ uptake 1 (MICU1) and lack of UCP2 (uncoupling protein 2, a component of the mCa ++ uniporter complex) decrease mCa ++ , and therefore, activity of Krebs enzymes that produce diffusible metabolites, regulating epigenetic mechanisms that drive change in cell identity. Methods/Results: In the monocrotaline-rat PHT model, we separated cRVH from dRVH based on strict hemodynamics (canulating the main pulmonary artery through the jugular vein) and Echo: dRVH had decreased cardiac output, increased right atrium pressure, decreased TAPSE and increased RV end diastolic diameter compared to cRVH. In isolated hearts, RV systolic pressure was lower in dRVH but in isolated cardiomyocytes (CM), contractility (sarcomere shortening) was not, pointing to a non-cardiomyocyte difference. The number of cMFB was not different between cRVH and Control, but dramatically increased in dRVH. Mitochondrial respiration was lower in dRVH cMFB than cRVH cFB. mCa ++ was progressively decreased from Control to cRVH to dRVH c(M)FB, while it was not different in CM. The MICU1 methyltransferase (PRMT1) levels and methylation of immunoprecipitated MICU1 were increased but the expression of UCP2 was decreased from Control to cRVH to dRVH c(M)FB (but not CM). In human RV tissues (from autopsy or biopsy, n=15), dRVH had increased number of cMFB compared to Control and cRVH. Cytoplasmic PRMT1 was increased and UCP2 was decreased from Control to cRVH to dRVH c(M)FB. In a cohort of 25 patients with PHT that had Echo and right heart Cath within 48 hours, carriers of the loss-of-function UCP2 SNP (rs659366) had decreased TAPSE compared to non-carriers that had similar mean PA pressure. Conclusion: A change of cell identity (cFB to cMFB) in the RV may be the basis of cRVH to dRVH transition, rather than contractile failure of CM. UCP2 SNP may predict early dRVH, if confirmed in larger cohorts.

Abstract 14150: Glycolysis and Cardial Fibrosis

Introduction: Cardiac fibrosis is a significant global issue, which however has limited therapeutic options. 6 - phosphofructo - 2 - kinase/fructose - 2,6 - biphosphatase 3 (PFKFB3) is established to play a critical role in the process of glycolysis. However, its specific role in the pathogenesis of cardiac fibrosis is still not well understood. Hypothesis: PFKFB3 plays a critical role in cardial fibrosis. Methods: To determine the role of PFKFB3 in cardiac fibroblast (CF) activation and fibrosis, single - cell RNA sequencing analysis was applied to identify the metabolic changes of fibroblast subclusters in cardiomyopathy. PFKFB3 inhibition with genetic ( Pfkfb3 +/- ) mice or pharmacological (3PO) approach was used to demonstrate the role of PFKFB3 in cardiac fibrosis with animal models, induced by isoproterenol (ISO) or left coronary ligation. The role of PFKFB3 in primary CFs activation was confirmed by gene inhibition or overexpression. Recombinant PFKFB3 was used to test its extracellular role in CFs activation and inflammation. Serum PFKFB3 level was also tested from patients with cardiomyopathy. Results: We found that glycolysis changes most in cardiac myofibroblasts (myoCFs) in cardiomyopathy. PFKFB3 increased significantly in both cardiac fibrotic regions and myoCFs induced by TGF-β1. Inhibition of glycolysis, via several approaches, blunted TGF-β1-induced activation, proliferation and migration ability of myofibroblasts and demonstrated therapeutic benefit in cardiac fibrosis in mice. PFKFB3 released from myoCFs facilitated the activation of CFs and promoted the inflammatory response. Mechanistically, HIF-1α is required in TGF-β1 induced glycolysis. Plasm PFKFB3 was also found to be a biomarker for cardiac fibrosis in patients with cardiomyopathy. Conclusions: PFKFB3 is a candidate target for cardiac fibrosis.

Human left ventricular cardiac fibroblasts undergo a dynamic shift in secretome and gene expression toward a cardiac myofibroblast phenotype during early passage in typical culture expansion conditions

Cardiac fibroblasts (CFs) are critical components of the cardiac niche and primarily responsible for assembly and maintenance of the cardiac extracellular matrix (ECM). CFs are increasingly of interest for tissue engineering and drug development applications, as they provide synergistic support to cardiomyocytes through direct cell-to-cell signaling and cell-to-ECM interactions via soluble factors, including cytokines, growth factors and extracellular vesicles. CFs can be activated to a cardiac myofibroblast (CMF) phenotype upon injury or stimulation with transforming growth factor beta 1. Once activated, CMFs assemble collagen-rich ECM, which is vitally important to stabilize scar formation following myocardial infarction, for example. Although there is greater experience with culture expansion of CFs among non-human strains, very little is known about human CF-to-CMF transitions and expression patterns during culture expansion. In this study, we evaluated for shifts in inflammatory and angiogenic expression profiles of human CFs in typical culture expansion conditions. Understanding shifts in cellular expression patterns during CF culture expansion is critically important to establish quality benchmarks and optimize large-scale manufacturing for future clinical applications.

Circular RNA circSMAD4 regulates cardiac fibrosis by targeting miR-671-5p and FGFR2 in cardiac fibroblasts

Heart failure is a leading cause of death and is often accompanied by activation of quiescent cardiac myofibroblasts, which results in cardiac fibrosis. In this study, we aimed to identify novel circular RNAs that regulate cardiac fibrosis. We applied transverse aortic constriction (TAC) for 1, 4, and 8weeks in mice. RNA sequencing datasets were obtained from cardiac fibroblasts isolated by use of a Langendorff apparatus and then further processed by use of selection criteria such as differential expression and conservation in species. CircSMAD4 was upregulated by TAC in mice or by transforming growth factor (TGF)-β1 in primarily cultured human cardiac fibroblasts. Delivery of si-circSMAD4 attenuated myofibroblast activation and cardiac fibrosis in mice treated with isoproterenol (ISP). si-circSmad4 significantly reduced cardiac fibrosis and remodeling at 8weeks. Mechanistically, circSMAD4 acted as a sponge against the microRNA miR-671-5p in a sequence-specific manner. miR-671-5p was downregulated during myofibroblast activation and its mimic form attenuated cardiac fibrosis. miR-671-5p mimic destabilized fibroblast growth factor receptor 2 (FGFR2) mRNA in a sequence-specific manner and interfered with the fibrotic action of FGFR2. The circSMAD4-miR-671-5p-FGFR2 pathway is involved in the differentiation of cardiac myofibroblasts and thereby the development of cardiac fibrosis.