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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 7

Gene-environment interaction model.

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Gene-environment interaction model.
(A) Schematic diagram representing t...
(A) Schematic diagram representing the normoglycemic condition and a proposed model in which HG results in increased ROS and reduced NO production by altering chromatin accessibility. Reduced NO is associated with increased expression of Jarid2 and its enrichment on the Notch1 locus with Setdb1. This results in repression of Notch1 and its downstream targets, culminating in congenital heart defects (highlighted by black circle). (B) Model showing gene-environment interaction between HG and Notch1 expression. In individuals without NOTCH1 mutations (red line), only severe HG crosses a threshold for congenital heart disease. Individuals with NOTCH1 mutations (blue) are a sensitized population that can cross the threshold with modest elevations in maternal blood glucose. HG, hyperglycemia; NG, normoglycemia.

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