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Epigenetic mechanisms underlying maternal diabetes-associated risk of congenital heart disease
Madhumita Basu, … , Zhe Han, Vidu Garg
Madhumita Basu, … , Zhe Han, Vidu Garg
Published October 19, 2017
Citation Information: JCI Insight. 2017;2(20):e95085. https://doi.org/10.1172/jci.insight.95085.
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Research Article Cardiology Genetics

Epigenetic mechanisms underlying maternal diabetes-associated risk of congenital heart disease

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Abstract

Birth defects are the leading cause of infant mortality, and they are caused by a combination of genetic and environmental factors. Environmental risk factors may contribute to birth defects in genetically susceptible infants by altering critical molecular pathways during embryogenesis, but experimental evidence for gene-environment interactions is limited. Fetal hyperglycemia associated with maternal diabetes results in a 5-fold increased risk of congenital heart disease (CHD), but the molecular basis for this correlation is unknown. Here, we show that the effects of maternal hyperglycemia on cardiac development are sensitized by haploinsufficiency of Notch1, a key transcriptional regulator known to cause CHD. Using ATAC-seq, we found that hyperglycemia decreased chromatin accessibility at the endothelial NO synthase (Nos3) locus, resulting in reduced NO synthesis. Transcription of Jarid2, a regulator of histone methyltransferase complexes, was increased in response to reduced NO, and this upregulation directly resulted in inhibition of Notch1 expression to levels below a threshold necessary for normal heart development. We extended these findings using a Drosophila maternal diabetic model that revealed the evolutionary conservation of this interaction and the Jarid2-mediated mechanism. These findings identify a gene-environment interaction between maternal hyperglycemia and Notch signaling and support a model in which environmental factors cause birth defects in genetically susceptible infants.

Authors

Madhumita Basu, Jun-Yi Zhu, Stephanie LaHaye, Uddalak Majumdar, Kai Jiao, Zhe Han, Vidu Garg

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Figure 3

Hyperglycemia alters chromatin accessibility, TF occupancy, and NO production.

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Hyperglycemia alters chromatin accessibility, TF occupancy, and NO produ...
(A) Loss of ATAC-seq peaks in HG- (25 mM) compared with NG-treated (5.5 mM) atrioventricular mesenchymal (AVM) cells. Heatmap generated from HG normalized to NG input, with peaks centered, including 1.5 kb upstream and downstream of the transcriptional start site. Red and blue represent low and high signal intensity, respectively. (B) Distribution of 49,035 differential peaks. Pie chart highlights distribution of peaks within promoter (33%), inside gene (17%), upstream (31%), and downstream (19%) regions. Histogram displays frequency of peaks at a given distance from TSS. (C) Volcano plot highlights fold change and significance of identified peaks as plotted by –log10(P value) versus fold change. (D) Integrative genome viewer tracks of normalized merged data sets, highlighting peak loss at Nos3 loci in HG. Square boxes highlight 3 regions (R1–R3) with relative chromatin closure in HG. (E) ChIP-qPCR with H3K27ac showed significant downregulation of activation marks at Nos3R1–R3 (n = 4). (F and G) Decreased expression of Nos3 in HG at mRNA and protein levels (n ≥ 5) by IF respectively. Measurement of NO (H and I) and superoxide (J and K) production in AVM cells maintained in NG and HG for 48 hours, probed with diaminorhodamine (DAR-4M AM) and dihydroethidium (DHE), respectively. (L and M) DAR-4M AM and (N and O) DHE staining of E13.5 murine hearts exposed to nondiabetic and diabetic environments demonstrates increased ROS and reduced NO with diabetes (n = 3 per group). Nuclear DAPI stain, blue; atrioventricular cushions (yellow arrows); LV, left ventricle; RV, right ventricle; IVS, interventricular septum. Mean ± SEM; *P < 0.05, 2-tailed Student’s t test in F and G, with Holm-Bonferroni correction in E. Scale bars: 50 μm (G–K); 100 μm (L–O).

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