Hypertrophic cardiomyopathy (HCM) is a relatively common disease affecting more than 1 in 500 individuals and the leading cause of sudden death in young individuals and athletes. HCM is an unmet medical need with no FDA-approved treatments. ~40% of all HCM cases are associated with mutations in the gene encoding cardiac myosin-binding protein C (MyBP-C). MyBP-C is a thick filament-associated protein that is critical for normal myocardial performance; it is centrally positioned in the sarcomere to regulate interactions between myosin cross-bridges and actin thin filaments that are responsible for force development. We have previously demonstrated that increased phosphorylation of MyBP-C enhances actin-myosin interactions leading to accelerated contraction kinetics in myocardium, whereas reduced phosphorylation led to reduced actin-myosin proximity and decelerated contraction. However, it is not understood how MyBP-C phosphorylation alters the structural dynamics of its interactions with actin and/or myosin to modulate force development in normal myocardium or how mutations alter functions that ultimately contribute to HCM pathogenesis. We have developed innovative biophysical tools that, for the first time, enable evaluation of: (1) the structural dynamics of MyBP-C, (2) how it interacts with actin and/or myosin in muscle, and (3) how these interactions are affected by phosphorylation and known pathologic mutations. We will test the central hypothesis that phosphorylation and HCM mutations of N-terminal MyBP-C alter functionally significant structural properties of MyBP-C and interactions with actin and myosin.
Aim 1 will evaluate the effects of phosphorylation, HCM mutations, and binding to actin or myosin on MyBP-C structural dynamics. Spectroscopic approaches will be employed to detect conformational changes (structure) within MyBP-C due to phosphorylation, HCM mutation, and actin/myosin binding (function). Molecular dynamics (MD) simulations will be applied as a complementary approach.
Aim 2 will determine how MyBP-C phosphorylation and HCM mutants affect proximities and dynamics of key myocardial proteins. We will utilize site-directed probe technologies in skinned (demembranated) cardiac fibers to determine how phosphorylation/mutants affect protein structure/interactions in situ to regulate contractility. The proposed studies capture structural dynamics in real time and resolve interactions in real myocardial space using novel high-resolution approaches.
These aims are a stepwise progression developing a new paradigm for studying normal and mutant MyBP-C during the contractile cycle. This paradigm involves monitoring distances between points on proteins and the order (or disorder) of those distances under physiological conditions, in interacting proteins and functioning myocardium. Not all HCM mutants impact the same functions of MyBP-C. Time-resolved fluorescence data components, thin/thick filament dynamics, mechanics, and simulations will be used to separate mutants into identifiable bins, setting the stage for identifying mechanistic-based therapies to specifically treat different classes of mutations.
We aim to determine the molecular requirements for healthy cardiac muscle function, in order to pave the way for discovery and design of more effective therapies for heart disease. Our work will answer crucial questions about how the protein myosin-binding protein C (MyBP-C), the leading cause of cardiomyopathy, functions in the heart, using reporter probes to visualize dynamic protein structures in healthy, stressed, and diseased heart cells. This research will greatly improve the human health prospects for understanding disease by determining effects of disease mutations and will develop tools that can be used to discover novel treatments.