Functional studies on the mechanosensitive ion channel PIEZO1 in human induced pluripotent stem cell-derived cardiomyocytes

Der Herzmuskel muss sich einer dynamischen und sich mechanisch verändernden Umgebung anpassen. Die Mechanosignaltransduktion ermöglicht es Zellen mechanischen Kräfte zu erfassen und durch nachgeschaltete biochemische Signalkaskaden darauf zu reagieren. Obwohl verschiedene Gewebestrukturen und Proteine damit in Verbindung gebracht wurden, wie das Herz die mechanischen Kräfte wahrnimmt, ist unser Verständnis der kardialen Mechanosignaltransduktion unvollständig. Durch Dehnung aktivierte Ionenkanäle spielen eine wichtige Rolle bei der mechanosensitiven Autoregulation des Herzens. Um die funktionelle Rolle von PIEZO1 in Kardiomyozyten zu untersuchen, habe ich daher PIEZO1 in induzierten pluripotenten Stammzellen mittels Genomeditierung deletiert. Die PIEZO1-/- Zellen wurden dann in lebensfähige, herzähnlich schlagende Kardiomyozyten differenziert. In phänotypische Analysen der elektrophysiologischer Eigenschaften, Zellmorphologie und der herzähnlichen Schlagaktivität habe ich den Effekt der PIEZO1-deletion in genomeditierten Kardiomyozyten untersucht. Die Deletion von PIEZO1 zeigte zum ersten Mal, dass es PIEZO1-abhängige dehnungsaktivierte und Kalzium-Ströme in vom Menschen stammenden differenzierten Kardiomyozyten gibt. Dies legt nahe, dass PIEZO1 eine Rolle in der Mechanosignaltransduction in Herzzellen spielt. Darüber hinaus zeigte eine RNA-Sequenz Analyse, dass der Verlust von PIEZO1 in vom Menschen stammenden differenzierten Kardiomyozyten mit der Herunterregulation von Proteinen korreliert, die für die extrazellulärer Matrix von Bedeutung sind. Diese Daten unterstreichen die Rolle von PIEZO1 in Kardiomyozyten und legen seine Bedeutung für die Organisation und Struktur der extrazellulären Matrix nahe.The cardiac muscle has to adapt in a highly dynamic mechanical environment. Mechanotransduction is the process that allows cells to sense the mechanical forces and respond by downstream biochemical signaling cascades. Although different tissue structures and proteins have been implicated in how the heart senses the mechanical forces, yet our understanding in cardiac mechanotransduction is incomplete. Stretch-activated channels (SACs) have been suggested to play an important role in the mechanosensitive autoregulation of the heart. PIEZO1 is a stretch-activated channel and has been involved in vascularization, erythrocyte volume homeostasis and regulation of the baroreceptor reflex, yet its role in cardiac mechanotransduction has not been described. To study the functional role of PIEZO1 in cardiomyocytes I have generated a PIEZO1 knockout (KO) human induced pluripotent cell (hiPSC) line using genome editing technology. The genome edited cells were then differentiated into viable, beating cardiomyocytes. Different phenotypic analyses were conducted, including the evaluation of electrophysiological characteristics, observation of cell morphology and beating activity of the genome edited hiPSC-derived cardiomyocytes. With this approach the aim was to gain more insight into PIEZO1 function in cardiomyocytes using a reliable, efficient and reproducible human cellular model system. For the first time PIEZO1-dependent calcium transients and stretch-activated currents were observed in hiPSC-derived cardiomyocytes (hiPSC-CMs). This proposes a possible role of PIEZO1 as a cardiac mechanotransducer. Furthermore, RNA-seq analysis revealed that loss of PIEZO1 in hiPSC-CMs is associated with downregulation of the expression of extracellular matrix-associated proteins. These data highlight the role of PIEZO1 in cardiomyocytes and suggest its implication in extracellular matrix organization and structure

What makes cilia beat and how do different laterality mutations impact on heart morphology and physiology?

Tese de mestrado, Biologia Evolutiva e do Desenvolvimento, 2023, Universidade de Lisboa, Faculdade de CiênciasDespite their external bilateral symmetry, vertebrates are not as symmetrical as we think. Under their skin, several organs and corresponding vasculature display an asymmetric arrangement in the body cavity. This archetypal visceral patterning is the outcome of the left-right (LR) axis formation during embryonic development and is critical to ensure optimal organ functioning. For example, patients with laterality disorders tend to develop congenital cardiovascular malformations. In several species, in a transient organ known as LR organizer (LRO), directional fluid flow yielded by motile cilia beating has been reported to trigger asymmetric Nodal signaling expansion, which is critical for differentiating the left and right sides of the embryo. Zebrafish LRO comprises motile and immotile cilia and their balance is critical to develop an efficient fluid flow that promotes the correct positioning of visceral organs and, subsequently, healthy vertebrate development. Intriguingly, both types of cilia express cilia motilityrelated genes and are equipped with similar motility apparatus, and yet some beat and others do not. A previous study determined that the transcription repressor Her12 was a potential candidate to mediate this motility fate decision, and this hypothesis underpinned the beginning of this master thesis. We first aimed to ascertain the correlation between Her12 and cilia behavior by assessing her12 expression in the cilia population and identifying her12 targets. However, many pitfalls were encountered, and no conclusions could be drawn. Experiments must be repeated to solve this outstanding question. We also investigated how error-prone execution of asymmetric LR patterning in motile cilia and non-cilia mutants, ccdc40-/- and dand5-/- mutants, respectively, affected heart situs and morphogenesis. We characterized, for the first time, similar cardiovascular defects in both mutants. However, how the disrupted LR spatial-temporal signals impaired coordination between the heart situs and development remains to be enlightened and further studies should be conducted

Novel Cardiac Mapping Approaches and Multimodal Techniques to Unravel Multidomain Dynamics of Complex Arrhythmias Towards a Framework for Translational Mechanistic-Based Therapeutic Strategies

[ES] Las arritmias cardíacas son un problema importante para los sistemas de salud en el mundo desarrollado debido a su alta incidencia y prevalencia a medida que la población envejece. La fibrilación auricular (FA) y la fibrilación ventricular (FV) se encuentran entre las arritmias más complejas observadas en la práctica clínica. Las consecuencias clínicas de tales alteraciones arrítmicas incluyen el desarrollo de eventos cardioembólicos complejos en la FA, y repercusiones dramáticas debido a procesos fibrilatorios sostenidos que amenazan la vida infringiendo daño neurológico tras paro cardíaco por FV, y que pueden provocar la muerte súbita cardíaca (MSC). Sin embargo, a pesar de los avances tecnológicos de las últimas décadas, sus mecanismos intrínsecos se comprenden de forma incompleta y, hasta la fecha, las estrategias terapéuticas carecen de una base mecanicista suficiente y poseen bajas tasas de éxito. Entre los mecanismos implicados en la inducción y perpetuación de arritmias cardíacas, como la FA, se cree que las dinámicas de las fuentes focales y reentrantes de alta frecuencia, en sus diferentes modalidades, son las fuentes primarias que mantienen la arritmia. Sin embargo, se sabe poco sobre los atractores, así como, de la dinámica espacio-temporal de tales fuentes fibrilatorias primarias, específicamente, las fuentes focales o rotacionales dominantes que mantienen la arritmia. Por ello, se ha desarrollado una plataforma computacional, para comprender los factores (activos, pasivos y estructurales) determinantes, y moduladores de dicha dinámica. Esto ha permitido establecer un marco para comprender la compleja dinámica de los rotores con énfasis en sus propiedades deterministas para desarrollar herramientas basadas en los mecanismos para ayuda diagnóstica y terapéutica. Comprender los procesos fibrilatorios es clave para desarrollar marcadores y herramientas fisiológica- y clínicamente relevantes para la ayuda de diagnóstico temprano. Específicamente, las propiedades espectrales y de tiempo-frecuencia de los procesos fibrilatorios han demostrado resaltar el comportamiento determinista principal de los mecanismos intrínsecos subyacentes a las arritmias y el impacto de tales eventos arrítmicos. Esto es especialmente relevante para determinar el pronóstico temprano de los supervivientes comatosos después de un paro cardíaco debido a fibrilación ventricular (FV). Las técnicas de mapeo electrofisiológico, el mapeo eléctrico y óptico cardíaco, han demostrado ser recursos muy valiosos para dar forma a nuevas hipótesis y desarrollar nuevos enfoques mecanicistas y estrategias terapéuticas mejoradas. Esta tecnología permite además el trabajo multidisciplinar entre clínicos y bioingenieros, para el desarrollo y validación de dispositivos y metodologías para identificar biomarcadores multi-dominio que permitan rastrear con precisión la dinámica de las arritmias identificando fuentes dominantes y atractores con alta precisión para ser dianas de estrategias terapeúticas innovadoras. Es por ello que uno de los objetivos fundamentales ha sido la implantación y validación de nuevos sistemas de mapeo en distintas configuraciones que sirvan de plataforma de desarrollo de nuevas estrategias terapeúticas. Aunque el mapeo panorámico es el método principal y más completo para rastrear simultáneamente biomarcadores electrofisiológicos, su adopción por la comunidad científica es limitada principalmente debido al coste elevado de la tecnología. Aprovechando los avances tecnológicos recientes, nos hemos enfocado en desarrollar, y validar, sistemas de mapeo óptico de alta resolución para registro panorámico cardíaco, utilizando modelos clínicamente relevantes para la investigación básica y la bioingeniería.[CA] Les arítmies cardíaques són un problema important per als sistemes de salut del món desenvolupat a causa de la seva alta incidència i prevalença a mesura que la població envelleix. La fibril·lació auricular (FA) i la fibril·lació ventricular (FV), es troben entre les arítmies més complexes observades a la pràctica clínica. Les conseqüències clíniques d'aquests trastorns arítmics inclouen el desenvolupament d'esdeveniments cardioembòlics complexos en FA i repercussions dramàtiques a causa de processos fibril·latoris sostinguts que posen en perill la vida amb danys neurològics posteriors a la FV, que condueixen a una aturada cardíaca i a la mort cardíaca sobtada (SCD). Tanmateix, malgrat els avanços tecnològics de les darreres dècades, els seus mecanismes intrínsecs s'entenen de forma incompleta i, fins a la data, les estratègies terapèutiques no tenen una base mecanicista suficient i tenen baixes taxes d'èxit. La majoria dels avenços en el desenvolupament de biomarcadors òptims i noves estratègies terapèutiques en aquest camp provenen de tècniques valuoses en la investigació de mecanismes d'arítmia. Entre els mecanismes implicats en la inducció i perpetuació de les arítmies cardíaques, es creu que les fonts primàries subjacents a l'arítmia són les fonts focals reingressants d'alta freqüència dinàmica i AF, en les seves diferents modalitats. Tot i això, se sap poc sobre els atractors i la dinàmica espaciotemporal d'aquestes fonts primàries fibril·ladores, específicament les fonts rotacionals o focals dominants que mantenen l'arítmia. Per tant, s'ha desenvolupat una plataforma computacional per entendre determinants actius, passius, estructurals i moduladors d'aquestes dinàmiques. Això va permetre establir un marc per entendre la complexa dinàmica multidomini dels rotors amb ènfasi en les seves propietats deterministes per desenvolupar enfocaments mecanicistes per a l'ajuda i la teràpia diagnòstiques. La comprensió dels processos fibril·latoris és clau per desenvolupar puntuacions i eines rellevants fisiològicament i clínicament per ajudar al diagnòstic precoç. Concretament, les propietats espectrals i de temps-freqüència dels processos fibril·latoris han demostrat destacar un comportament determinista important dels mecanismes intrínsecs subjacents a les arítmies i l'impacte d'aquests esdeveniments arítmics. Mitjançant coneixements previs, processament de senyals, tècniques d'aprenentatge automàtic i anàlisi de dades, es va desenvolupar una puntuació de risc mecanicista a la aturada cardíaca per FV. Les tècniques de cartografia òptica cardíaca i electrofisiològica han demostrat ser recursos inestimables per donar forma a noves hipòtesis i desenvolupar nous enfocaments mecanicistes i estratègies terapèutiques. Aquesta tecnologia ha permès durant molts anys provar noves estratègies terapèutiques farmacològiques o ablatives i desenvolupar mètodes multidominis per fer un seguiment precís de la dinàmica d'arrímies que identifica fonts i atractors dominants. Tot i que el mapatge panoràmic és el mètode principal per al seguiment simultani de paràmetres electrofisiològics, la seva adopció per part de la comunitat multidisciplinària d'investigació cardiovascular està limitada principalment pel cost de la tecnologia. Aprofitant els avenços tecnològics recents, ens centrem en el desenvolupament i la validació de sistemes de mapes òptics de baix cost per a imatges panoràmiques mitjançant models clínicament rellevants per a la investigació bàsica i la bioenginyeria.[EN] Cardiac arrhythmias are a major problem for health systems in the developed world due to their high incidence and prevalence as the population ages. Atrial fibrillation (AF) and ventricular fibrillation (VF), are amongst the most complex arrhythmias seen in the clinical practice. Clinical consequences of such arrhythmic disturbances include developing complex cardio-embolic events in AF, and dramatic repercussions due to sustained life-threatening fibrillatory processes with subsequent neurological damage under VF, leading to cardiac arrest and sudden cardiac death (SCD). However, despite the technological advances in the last decades, their intrinsic mechanisms are incompletely understood, and, to date, therapeutic strategies lack of sufficient mechanistic basis and have low success rates. Most of the progress for developing optimal biomarkers and novel therapeutic strategies in this field has come from valuable techniques in the research of arrhythmia mechanisms. Amongst the mechanisms involved in the induction and perpetuation of cardiac arrhythmias such AF, dynamic high-frequency re-entrant and focal sources, in its different modalities, are thought to be the primary sources underlying the arrhythmia. However, little is known about the attractors and spatiotemporal dynamics of such fibrillatory primary sources, specifically dominant rotational or focal sources maintaining the arrhythmia. Therefore, a computational platform for understanding active, passive and structural determinants, and modulators of such dynamics was developed. This allowed stablishing a framework for understanding the complex multidomain dynamics of rotors with enphasis in their deterministic properties to develop mechanistic approaches for diagnostic aid and therapy. Understanding fibrillatory processes is key to develop physiologically and clinically relevant scores and tools for early diagnostic aid. Specifically, spectral and time-frequency properties of fibrillatory processes have shown to highlight major deterministic behaviour of intrinsic mechanisms underlying the arrhythmias and the impact of such arrhythmic events. Using prior knowledge, signal processing, machine learning techniques and data analytics, we aimed at developing a reliable mechanistic risk-score for comatose survivors of cardiac arrest due to VF. Cardiac optical mapping and electrophysiological mapping techniques have shown to be unvaluable resources to shape new hypotheses and develop novel mechanistic approaches and therapeutic strategies. This technology has allowed for many years testing new pharmacological or ablative therapeutic strategies, and developing multidomain methods to accurately track arrhymia dynamics identigying dominant sources and attractors. Even though, panoramic mapping is the primary method for simultaneously tracking electrophysiological parameters, its adoption by the multidisciplinary cardiovascular research community is limited mainly due to the cost of the technology. Taking advantage of recent technological advances, we focus on developing and validating low-cost optical mapping systems for panoramic imaging using clinically relevant models for basic research and bioengineering.Calvo Saiz, CJ. (2022). Novel Cardiac Mapping Approaches and Multimodal Techniques to Unravel Multidomain Dynamics of Complex Arrhythmias Towards a Framework for Translational Mechanistic-Based Therapeutic Strategies [Tesis doctoral]. Universitat Politècnica de València. https://doi.org/10.4995/Thesis/10251/182329TESI

Myocardial slices as an in vitro platform to study cardiac disease

In vitro models are the pillars of fundamental research and drug discovery, offering reductionist methods to better understand cellular responses in isolation. Often these methods are oversimplified, which makes their relevance to human biology and clinical translation ambiguous. Living myocardial slices (LMSLMSs) are viable thin (200-400μm) cardiac tissue slices, with preserved native multicellularity, architecture, mechanical and electrophysiological responses. Recent development in their culture, by us and others, paved the way for long-term preservation of adult mammalian heart tissue in vitro, without significant changes in its function and structure. This model has been extensively used in healthy tissue; however, to date, there are no established pathological models to study disease progression in vitro. Here we hypothesised that LMSLMSs can be used as an informative in vitro disease model to study temporal and spatial changes in cardiac function/structure in response to local cardiac damage. Before inducing cardiac damage, we further improved and characterised the cultured LMS model by designing robust tissue holders, optimising the oxygenation of the media, and establishing the best slice thickness (300μ) for oxygen diffusion and tissue stability in culture. We found that the LMSLMSs were adequately oxygenated in the inner layers and responded to mechanical stimuli with an increase in their contraction and hyperpolarisation of the mitochondrial membrane. We then developed a cryoinjury model, by applying a cooled probe on the LMSLMSs. We found that injury created a distinct necrotic area, surrounded by a border zone (BZ). The injury resulted in preserved force but electrical instability, with the presence of spontaneous contractions. Microscopic analysis of the BZ showed the presence of high numbers of spontaneous Ca2+ sparks, which could be affected by inhibiting the activation of Ca2+/calmodulin-dependent protein kinase II (CamKII). The inhibitory effect was more pronounced in endocardial LMSLMSs, showing transmural differences of CamKII under pathological conditions. Structural analysis of the BZ also showed an acute increase of the sarcomere length and loss of t-tubule density upon culture, that could also account for the arrhythmogenicity of the injured LMSLMSs. One application of therapeutic interventions on the model, by using extracellular vesicles (EVs), did not show any functional or molecular improvements. This thesis demonstrates the significance of using diseased LMSLMSs to study the way that local injury affects tissue stability, function, and structure. Further work is required to better understand the link between spontaneous Ca2+ and contraction events, as well as finding successful therapeutic interventions.Open Acces

Central and peripheral autonomic influences : analysis of cardio-pulmonary dynamics using novel wavelet statistical methods

The development and implementation of novel signal processing techniques, particularly with regard to applications in the clinical environment, is critical to bringing computer-aided diagnoses of disease to reality. One of the most confounding factors in the field of cardiac autonomic response (CAR) research is the influence of the coupling of respiratory oscillations with cardiac oscillations. This research had three objectives. The first was the assessment of central autonomic influence over heart rate oscillations when the pulmonary system is damaged. The second was to assess the link between peripheral and central autonomic control schema by evaluating the heart rate variability (HRV) of people who were able or unable to adapt to the use of integrated lenses for vision, specifically acconrrmodation, correction (adaptive and non-adaptive presbyopes). The third objective was the development of a wavelet-based toolset by which the first two objectives could be achieved. The first tool is a wavelet based entropy measure that quantifies the level of information by assessing not only the entropy levels, but also the distribution of the entropy across frequency bands. The second tool is a wavelet source separation (WayS) method used to separate the respiratory component from the cardiac component, thereby allowing for analysis of the dynamics of the cardiac signal without the confounding influence of the respiratory signal that occurs when the body is perturbed. With regard to hypothesis one, the entropy method was used to separate the COPD study populations with 93% classification accuracy at rest, and with 100% accuracy during exercise. Changes in COPD and control autonomic markers were evident after respiration is removed. Specifically, the LF/HF ratio slightly decreased on average from pre to post reconstruction for controls, increased on average for COPD. In healthy controls, respiration frequency is distributed across multiple bandwidths, causing large decreases in both LF and HF when removed. With respiration effect removed from COPD population, LE dominates autonomic response, indicating that the frequency is concentrated in the HF autonomic region. Decrease in variance of data set increases probability tat smaller changes can be detected in values. The theory set forth in hypothesis two was validated by the quantification of a correlation between peripheral and central autonomic influences, as evidenced by differences in oculomotor adaptability correlating with differences in HRV. Standard Deviation varies with grouping, not with age. Increasing controlled respiration frequencies resulted in adaptive presbyopes and controls displaying similar sympathetic responses, diverging from non-adaptive group. WayS reduced frequency content in ranges concurrent with breathing rate, indicating a robust analysis. The outcome of hypothesis three was the confirmation that wavelet statistical methods possess significant potential for applications in HRV. Entropy can be used in conjunction with cluster analysis to classify patient populations with high accuracy. Using the WayS analysis, the respiration effect can be removed from HRV data sets, providing new insights into autonomic alterations, both central and peripheral, in disease