Pitx2c inhibition increases atrial fibroblast activity: Implications in atrial arrhythmogenesis

Eur J Clin Invest. 2019 Oct;49(10):e13160. doi: 10.1111/eci.13160. Epub 2019 Sep 19.

Abstract

Background: A Pitx2c deficiency increases the risk of atrial fibrillation (AF). Atrial structural remodelling with fibrosis blocks electrical conduction and leads to arrhythmogenesis. A Pitx2c deficiency enhances profibrotic transforming growth factor (TGF)-β expression and calcium dysregulation, suggesting that Pitx2c may play a role in atrial fibrosis. The purposes of this study were to evaluate whether a Pitx2c deficiency modulates cardiac fibroblast activity and study the underlying mechanisms.

Materials and methods: A migration assay, proliferation analysis, Western blot analysis and calcium fluorescence imaging were conducted in Pitx2c-knockdown human atrial fibroblasts (HAFs) using short hairpin (sh)RNA or small interfering (si)RNA.

Results: Compared to control HAFs, Pitx2c-knockdown HAFs had a greater migration but a similar proliferative ability. Pitx2c-knockdown HAFs had a higher calcium influx with enhanced phosphorylation of calmodulin kinase II (CaMKII), α-smooth muscle actin and matrix metalloproteinase-2. In the presence of a CaMKII inhibitor (KN-93, 0.5 μmol/L), control and Pitx2c-knockdown HAFs exhibited similar migratory abilities.

Conclusion: These findings suggest that downregulation of Pitx2c may regulate atrial fibrosis through modulating calcium homeostasis, which may contribute to its role in anti-atrial fibrosis, and Pitx2c downregulation may change the atrial electrophysiology and AF occurrence through modulating fibroblast activity.

Keywords: Pitx2c; atrial fibrillation; cardiac fibroblast; cell migration; intracellular calcium.

MeSH terms

  • Actins / metabolism
  • Arrhythmias, Cardiac / genetics
  • Arrhythmias, Cardiac / metabolism
  • Atrial Fibrillation / genetics*
  • Atrial Fibrillation / metabolism
  • Atrial Remodeling / genetics
  • Benzylamines / pharmacology
  • Calcium / metabolism
  • Calcium-Calmodulin-Dependent Protein Kinase Type 2 / antagonists & inhibitors
  • Calcium-Calmodulin-Dependent Protein Kinase Type 2 / metabolism
  • Cell Movement / drug effects
  • Cell Movement / genetics*
  • Cell Proliferation / genetics*
  • Down-Regulation
  • Fibroblasts / drug effects
  • Fibroblasts / metabolism*
  • Fibroblasts / physiology
  • Fibrosis / genetics
  • Gene Knockdown Techniques
  • Heart Atria / cytology*
  • Heart Atria / pathology
  • Homeobox Protein PITX2
  • Homeodomain Proteins / genetics*
  • Humans
  • In Vitro Techniques
  • Matrix Metalloproteinase 2 / metabolism
  • Optical Imaging
  • Phosphorylation
  • Protein Isoforms
  • Protein Kinase Inhibitors / pharmacology
  • RNA, Small Interfering
  • Sulfonamides / pharmacology
  • Transcription Factors / genetics*

Substances

  • ACTA2 protein, human
  • Actins
  • Benzylamines
  • Homeodomain Proteins
  • Protein Isoforms
  • Protein Kinase Inhibitors
  • RNA, Small Interfering
  • Sulfonamides
  • Transcription Factors
  • KN 93
  • Calcium-Calmodulin-Dependent Protein Kinase Type 2
  • MMP2 protein, human
  • Matrix Metalloproteinase 2
  • Calcium