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Reversible cardiac disease features in an inducible CUG repeat RNA–expressing mouse model of myotonic dystrophy
Ashish N. Rao, … , Zheng Xia, Thomas A. Cooper
Ashish N. Rao, … , Zheng Xia, Thomas A. Cooper
Published January 26, 2021
Citation Information: JCI Insight. 2021;6(5):e143465. https://doi.org/10.1172/jci.insight.143465.
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Research Article Cardiology Cell biology

Reversible cardiac disease features in an inducible CUG repeat RNA–expressing mouse model of myotonic dystrophy

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Abstract

Myotonic dystrophy type 1 (DM1) is caused by a CTG repeat expansion in the DMPK gene. Expression of pathogenic expanded CUG repeat (CUGexp) RNA causes multisystemic disease by perturbing the functions of RNA-binding proteins, resulting in expression of fetal protein isoforms in adult tissues. Cardiac involvement affects 50% of individuals with DM1 and causes 25% of disease-related deaths. We developed a transgenic mouse model for tetracycline-inducible and heart-specific expression of human DMPK mRNA containing 960 CUG repeats. CUGexp RNA is expressed in atria and ventricles and induced mice exhibit electrophysiological and molecular features of DM1 disease, including cardiac conduction delays, supraventricular arrhythmias, nuclear RNA foci with Muscleblind protein colocalization, and alternative splicing defects. Importantly, these phenotypes were rescued upon loss of CUGexp RNA expression. Transcriptome analysis revealed gene expression and alternative splicing changes in ion transport genes that are associated with inherited cardiac conduction diseases, including a subset of genes involved in calcium handling. Consistent with RNA-Seq results, calcium-handling defects were identified in atrial cardiomyocytes isolated from mice expressing CUGexp RNA. These results identify potential tissue-specific mechanisms contributing to cardiac pathogenesis in DM1 and demonstrate the utility of reversible phenotypes in our model to facilitate development of targeted therapeutic approaches.

Authors

Ashish N. Rao, Hannah M. Campbell, Xiangnan Guan, Tarah A. Word, Xander H.T. Wehrens, Zheng Xia, Thomas A. Cooper

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Figure 1

Bitransgenic mouse model for inducible and heart-specific expression of CUGexp RNA.

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Bitransgenic mouse model for inducible and heart-specific expression of ...
(A) The TREDT960I transgene consists of a minimal CMV promoter fused to a tetracycline response element regulating doxycycline induction of RNA containing 960 interrupted CUG repeats in the context of human DMPK exons 11–15. The expression of reverse tetracycline transactivator (rtTA) transgene is driven by a cardiomyocyte-specific α myosin heavy chain promoter. (B) Animals were given 2 g/kg dox food for induction of CUG repeat RNA expression beginning at PN1 and characterized for DM1-associated cardiac manifestations. Animals were switched to standard chow to evaluate reversal of disease features in response to cessation of CUGexp RNA expression. (C) RT-qPCR analysis of transgene mRNA expression in atria and ventricles of CUG960 mice in response to dox induction since PN1 for 2 months and withdrawal for 2 months in comparison with MHCrtTA +dox control mice. mRpl4 was used as an internal control for normalization. n = 4 animals per group. Data represent the mean ± SD and were analyzed using 1-way ANOVA followed by Tukey’s test for multiple comparisons. ***P < 0.001, ****P < 0.0001. CUGexp, expanded CUG repeat; DM1, myotonic dystrophy type 1; dox, doxycycline; PN1, postnatal day 1.

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