The Lhx9-integrin pathway is essential for positioning of the proepicardial organ

The development of the vertebrate embryonic heart occurs by hyperplastic growth as well as the incorporation of cells from tissues outside of the initial heart field. Amongst these tissues is the epicardium, a cell structure that develops from the precursor proepicardial organ on the right side of the septum transversum caudal to the developing heart. During embryogenesis, cells of the proepicardial organ migrate, adhere and envelop the maturing heart, forming the epicardium. The cells of the epicardium then delaminate and incorporate into the heart giving rise to cardiac derivatives, including smooth muscle cells and cardiac fibroblasts. Here, we demonstrate that the LIM homeodomain protein Lhx9 is transiently expressed in Xenopus proepicardial cells and is essential for the position of the proepicardial organ on the septum transversum. Utilizing a small-molecule screen, we found that Lhx9 acts upstream of integrin-paxillin signaling and consistently demonstrate that either loss of Lhx9 or disruption of the integrin-paxillin pathway results in mis-positioning of the proepicardial organ and aberrant deposition of extracellular matrix proteins. This leads to a failure of proepicardial cell migration and adhesion to the heart, and eventual death of the embryo. Collectively, these studies establish a requirement for the Lhx9-integrin-paxillin pathway in proepicardial organ positioning and epicardial formation

The Cardiac TBX5 Interactome Reveals a Chromatin Remodeling Network Essential for Cardiac Septation

Human mutations in the cardiac transcription factor gene TBX5 cause Congenital Heart Disease (CHD), however the underlying mechanism is unknown. We report characterization of the endogenous TBX5 cardiac interactome and demonstrate that TBX5, long considered a transcriptional activator, interacts biochemically and genetically with the Nucleosome Remodeling and Deacetylase (NuRD) repressor complex. Incompatible gene programs are repressed by TBX5 in the developing heart. CHD missense mutations that disrupt the TBX5-NuRD interaction cause depression of a subset of repressed genes. Furthermore, the TBX5-NuRD interaction is required for heart development. Phylogenetic analysis showed that the TBX5-NuRD interaction domain evolved during early diversification of vertebrates, simultaneous with the evolution of cardiac septation. Collectively, this work defines a TBX5-NuRD interaction essential to cardiac development and the evolution of the mammalian heart, and when altered may contribute to human CHD

Use and Impact of Visual Aids on Communication Dynamics During Genetic Counseling Sessions

The integration of genetics and genomics in medical care has increased the need for skilled communicators who can facilitate patient understanding and utilization of this complex information. Genetic counselors (GCs) help bridge this gap by engaging patients to achieve aims of patient understanding, decision-making, coping and adaptation in relation to genetic risk and conditions. While visual aids have been used in genetic counseling sessions to illustrate and explain complex biomedical concepts inherent in these conversations, we lack an understanding of how frequently GCs use visual aids in practice and how their use affects interpersonal communication during these sessions. The purpose of this study is to examine the frequency and consequences of visual aid use on genetic counselor-client communication in genetic counseling sessions. To address this question, 137 video recorded and transcribed simulated prenatal and cancer genetic counseling sessions that were collected as part of the Genetic Counseling Video Project were observed for visual aid use and associations between use and communication behaviors, oral literacy demand, and client and provider satisfaction. Visual aids were widely used in prenatal and cancer sessions, although use differed between the specialties. Patient-centered communication was negatively associated with visual aid use, and an increase in genetic terminology was noted in cancer sessions with the highest visual aid use. Visual aid use was not clearly associated with differences in simulated client or genetic counselor satisfaction. Hand drawing and hand gesturing were also noted as modes of visual communication. This research suggests that visual aid use may affect certain aspects of patient-provider communication in previously unrecognized ways that providers should be aware of as they incorporate these educational tools into their practices

Conservation and divergence of protein pathways in the vertebrate heart.

Heart disease is the leading cause of death in the western world. Attaining a mechanistic understanding of human heart development and homeostasis and the molecular basis of associated disease states relies on the use of animal models. Here, we present the cardiac proteomes of 4 model vertebrates with dual circulatory systems: the pig (Sus scrofa), the mouse (Mus musculus), and 2 frogs (Xenopus laevis and Xenopus tropicalis). Determination of which proteins and protein pathways are conserved and which have diverged within these species will aid in our ability to choose the appropriate models for determining protein function and to model human disease. We uncover mammalian- and amphibian-specific, as well as species-specific, enriched proteins and protein pathways. Among these, we find and validate an enrichment in cell-cycle-associated proteins within Xenopus laevis. To further investigate functional units within cardiac proteomes, we develop a computational approach to profile the abundance of protein complexes across species. Finally, we demonstrate the utility of these data sets for predicting appropriate model systems for studying given cardiac conditions by testing the role of Kielin/chordin-like protein (Kcp), a protein found as enriched in frog hearts compared to mammals. We establish that germ-line mutations in Kcp in Xenopus lead to valve defects and, ultimately, cardiac failure and death. Thus, integrating these findings with data on proteins responsible for cardiac disease should lead to the development of refined, species-specific models for protein function and disease states