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5′RNA-Seq identifies Fhl1 as a genetic modifier in cardiomyopathy
Danos C. Christodoulou, Hiroko Wakimoto, Kenji Onoue, Seda Eminaga, Joshua M. Gorham, Steve R. DePalma, Daniel S. Herman, Polakit Teekakirikul, David A. Conner, David M. McKean, Andrea A. Domenighetti, Anton Aboukhalil, Stephen Chang, Gyan Srivastava, Barbara McDonough, Philip L. De Jager, Ju Chen, Martha L. Bulyk, Jochen D. Muehlschlegel, Christine E. Seidman, J.G. Seidman
Danos C. Christodoulou, Hiroko Wakimoto, Kenji Onoue, Seda Eminaga, Joshua M. Gorham, Steve R. DePalma, Daniel S. Herman, Polakit Teekakirikul, David A. Conner, David M. McKean, Andrea A. Domenighetti, Anton Aboukhalil, Stephen Chang, Gyan Srivastava, Barbara McDonough, Philip L. De Jager, Ju Chen, Martha L. Bulyk, Jochen D. Muehlschlegel, Christine E. Seidman, J.G. Seidman
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Technical Advance Cardiology

5′RNA-Seq identifies Fhl1 as a genetic modifier in cardiomyopathy

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Abstract

The transcriptome is subject to multiple changes during pathogenesis, including the use of alternate 5′ start-sites that can affect transcription levels and output. Current RNA sequencing techniques can assess mRNA levels, but do not robustly detect changes in 5′ start-site use. Here, we developed a transcriptome sequencing strategy that detects genome-wide changes in start-site usage (5′RNA-Seq) and applied this methodology to identify regulatory events that occur in hypertrophic cardiomyopathy (HCM). Compared with transcripts from WT mice, 92 genes had altered start-site usage in a mouse model of HCM, including four-and-a-half LIM domains protein 1 (Fhl1). HCM-induced altered transcriptional regulation of Fhl1 resulted in robust myocyte expression of a distinct protein isoform, a response that was conserved in humans with genetic or acquired cardiomyopathies. Genetic ablation of Fhl1 in HCM mice was deleterious, which suggests that Fhl1 transcriptional changes provide salutary effects on stressed myocytes in this disease. Because Fhl1 is a chromosome X–encoded gene, stress-induced changes in its transcription may contribute to gender differences in the clinical severity of HCM. Our findings indicate that 5′RNA-Seq has the potential to identify genome-wide changes in 5′ start-site usage that are associated with pathogenic phenotypes.

Authors

Danos C. Christodoulou, Hiroko Wakimoto, Kenji Onoue, Seda Eminaga, Joshua M. Gorham, Steve R. DePalma, Daniel S. Herman, Polakit Teekakirikul, David A. Conner, David M. McKean, Andrea A. Domenighetti, Anton Aboukhalil, Stephen Chang, Gyan Srivastava, Barbara McDonough, Philip L. De Jager, Ju Chen, Martha L. Bulyk, Jochen D. Muehlschlegel, Christine E. Seidman, J.G. Seidman

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Figure 3

Fhl1 expression in mouse and human cardiomyopathic hearts.

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Fhl1 expression in mouse and human cardiomyopathic hearts.
 
(A) Histol...
(A) Histologic assessment of fibrosis and Fhl1 expression in male WT (Fhl1hemi/–) and HCM (Fhl1hemi/–) mouse hearts, assessed by lacZ expression in mice carrying the Fhl1lacZ allele (blue staining from β-gal with X-gal). Sections were also stained with Sirius red, which stains collagen in fibrotic areas red. The WT mouse expressed no iFhl1 and had no fibrosis. The young MHC403/+ mouse heart (bottom left) exhibited focal fibrosis (red) and iFhl1 expression (blue) prior to hypertrophy onset. An adult hypertrophic MHC403/+ mouse heart (top right) exhibited markedly increased iFhl1 expression in myocytes (bottom right, magnified view of boxed region) juxtaposed to interstitial fibrosis. Scale bars: 0.5 mm (left and top right); 0.05 mm (bottom right). (B) iFhl1 upregulation in mouse and human cardiomyopathies. Mouse 5′RNA-Seq libraries were constructed from RNA pooled from a minimum of 3 mouse hearts; human 5′RNA-Seq libraries were constructed from LV RNA extracted from individual subject hearts. N, normal; DCM, dilated cardiomyopathy; LVH, pressure overload LV hypertrophy; CHF, congestive heart failure.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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