While the role of mitochondria as the powerhouse of the cell is widely appreciated, mitochondria have other roles in cardiomyocytes (CMs) that are less widely known and understood. These energy-independent roles of mitochondria in both heart development and heart disease are highlighted by an X-linked mitochondrial car- diomyopathy known as Barth Syndrome (BTHS; OMIM #302060). In BTHS, mutation of the acyltransferase Tafazzin (TAZ) depletes the inner mitochondrial membrane (IMM) of its normal complement of cardiolipin (CL), its principle phospholipid.1,2 As a result, the IMM environment does not support normal function of the electron transport chain, the F1F0ATP synthase, and other key mitochondrial protein complexes. Abnormalities of cardi- olipin have been implicated in a range of more common cardiovascular conditions, including ischemia/reperfu- sion and diabetes. Studies of TAZ function and CL metabolism thus have ramifications for common cardiovascular diseases. We studied an induced pluripotent stem cell (iPSC)-derived CM (iPSC-CM) model of BTHS and found that BTHS iPSC-CMs do not mature normally. Sarcomeres did not assembly properly, and myocardial tissues assembled from the diseased iPSC-CMs contracted weakly. These defects were not res- cued by conditions that normalized ATP levels. Rather, BTHS iPSC-CM mitochondria generated excessive ROS, and ROS normalization rescued BTHS iPSC-CM structural and functional defects. This proposal builds on these findings, using Barth syndrome as a window into novel aspects of mitochondrial regulation of cardiac development and function. At the same time, we will work towards therapy for this disease. We propose the fol- lowing Specific Aims:
Aim 1. To define mechanisms through which mitochondrial abnormalities in BTHS impair CM function, focusing on ROS as a mechanism by which mitochondrial disease perturbs cardiomyocyte calci- um handling.
Aim 2. To evaluate mitochondrial regulation of cardiac morphogenesis and cardiomyocyte matu- ration. We will study normal LV compaction and cardiomyocyte maturation and how they are disrupted by mitochondrial dysfunction.
Aim 3. To perform preclinical proof-of-concept studies of targeted therapies for Barth syndrome. This study will provide fundamental information on cardiolipin and mitochondrial function in heart development and heart disease. The studies will have direct relevance to the pathogenesis of BTHS as well as more common cardiovascular diseases and will inform development of targeted therapy for BTHS.

Public Health Relevance

Heart muscle cells contain the highest concentration of mitochondria in the body. While it is well recognized that these mitochondria are required to produce ATP needed for the adult heart to sustain its pumping activity, other roles of mitochondria in the development and function of the heart are less well understood. Mitochondrial disorders, such as Barth syndrome, cause left ventricular non-compaction, a form of heart disease in which the wall of the heart is not properly formed. They also can cause heart muscle dysfunction without causing energy depletion. By studying the disease processes involved in Barth syndrome, this study will illuminate the function of mitochondria in heart development and function. The study will use our understanding of Barth syndrome pathogenesis to perform pre-clinical testing of new treatment strategies for this disease.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL128694-03
Application #
9250808
Study Section
Cardiovascular Differentiation and Development Study Section (CDD)
Program Officer
Burns, Kristin
Project Start
2015-07-01
Project End
2019-04-30
Budget Start
2017-05-01
Budget End
2018-04-30
Support Year
3
Fiscal Year
2017
Total Cost
Indirect Cost
Name
Boston Children's Hospital
Department
Type
DUNS #
076593722
City
Boston
State
MA
Country
United States
Zip Code
02115
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Bezzerides, Vassilios J; Zhang, Donghui; Pu, William T (2016) Modeling Inherited Arrhythmia Disorders Using Induced Pluripotent Stem Cell-Derived Cardiomyocytes. Circ J 81:12-21