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Toward transcriptional therapies for the failing heart: chemical screens to modulate genes
Timothy A. McKinsey, Eric N. Olson
Timothy A. McKinsey, Eric N. Olson
Published March 1, 2005
Citation Information: J Clin Invest. 2005;115(3):538-546. https://doi.org/10.1172/JCI24144.
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Toward transcriptional therapies for the failing heart: chemical screens to modulate genes

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Abstract

In response to acute and chronic stresses, the heart frequently undergoes a remodeling process that is accompanied by myocyte hypertrophy, impaired contractility, and pump failure, often culminating in sudden death. The existence of redundant signaling pathways that trigger heart failure poses challenges for therapeutic intervention. Cardiac remodeling is associated with the activation of a pathological gene program that weakens cardiac performance. Thus, targeting the disease process at the level of gene expression represents a potentially powerful therapeutic approach. In this review, we describe strategies for normalizing gene expression in the failing heart with small molecules that control signal transduction pathways directed at transcription factors and associated chromatin-modifying enzymes.

Authors

Timothy A. McKinsey, Eric N. Olson

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Figure 6

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Modulation of cardiac calcineurin signaling by MCIP expression. The uppe...
Modulation of cardiac calcineurin signaling by MCIP expression. The upper set of panels shows the effect of calcineurin signaling in MCIP1-knockout mice. In the absence of MCIP, the heart is sensitized to calcineurin signaling and rapidly undergoes fatal hypertrophy. Because of the heightened sensitivity of MCIP1-knockout mice to calcineurin, only a weak calcineurin transgene can be expressed in the absence of MCIP1. A stronger calcineurin transgene, as used in the lower panels, results in heart failure and death within the first few days after birth. The lower set of panels shows the effect of calcineurin signaling in mice that overexpress MCIP1 in the heart. Overexpression of MCIP1 prevents pathological hypertrophy. Adapted with permission from Proceedings of the National Academy of Sciences of the United States of America (58, 59).

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