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Disruption of spatiotemporal hypoxic signaling causes congenital heart disease in mice
Xuejun Yuan, … , Yonggang Zhou, Thomas Braun
Xuejun Yuan, … , Yonggang Zhou, Thomas Braun
Published April 24, 2017
Citation Information: J Clin Invest. 2017;127(6):2235-2248. https://doi.org/10.1172/JCI88725.
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Research Article Cardiology

Disruption of spatiotemporal hypoxic signaling causes congenital heart disease in mice

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Abstract

Congenital heart disease (CHD) represents the most prevalent inborn anomaly. Only a minority of CHD cases are attributed to genetic causes, suggesting a major role of environmental factors. Nonphysiological hypoxia during early pregnancy induces CHD, but the underlying reasons are unknown. Here, we have demonstrated that cells in the mouse heart tube are hypoxic, while cardiac progenitor cells (CPCs) expressing islet 1 (ISL1) in the secondary heart field (SHF) are normoxic. In ISL1+ CPCs, induction of hypoxic responses caused CHD by repressing Isl1 and activating NK2 homeobox 5 (Nkx2.5), resulting in decreased cell proliferation and enhanced cardiomyocyte specification. We found that HIF1α formed a complex with the Notch effector hes family bHLH transcription factor 1 (HES1) and the protein deacetylase sirtuin 1 (SIRT1) at the Isl1 gene. This complex repressed Isl1 in the hypoxic heart tube or following induction of ectopic hypoxic responses. Subsequently, reduced Isl1 expression abrogated ISL1-dependent recruitment of histone deacetylases HDAC1/5, inhibiting Nkx2.5 expression. Inactivation of Sirt1 in ISL1+ CPCs blocked Isl1 suppression via the HIF1α/HES1/SIRT1 complex and prevented CHDs induced by pathological hypoxia. Our results indicate that spatial differences in oxygenation of the developing heart serve as signals to control CPC expansion and cardiac morphogenesis. We propose that physiological hypoxia coordinates homeostasis of CPCs, providing mechanistic explanations for some nongenetic causes of CHD.

Authors

Xuejun Yuan, Hui Qi, Xiang Li, Fan Wu, Jian Fang, Eva Bober, Gergana Dobreva, Yonggang Zhou, Thomas Braun

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Figure 2

Experimental induction of hypoxia alters the expression of Isl1 and Nkx2.5.

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Experimental induction of hypoxia alters the expression of Isl1 and Nkx2...
(A) RT-qPCR analysis of Isl1 (n = 8), Nkx2.5 (n = 8), Flk1 (n = 7), Hand1 (n = 6), Hand2 (n = 6), and Tbx5 (n = 6) expression in E9.5 embryonic hearts and the adjacent mesoderm (20–21 somites) after chemical induction of hypoxia responses. PBS-injected mice were used as control. The m34b4 gene was used as a reference for normalization. **P < 0.01; ***P < 0.001, t test. (B) In situ hybridization of C57BL/6 E9.25 embryos (18 somites) for either Isl1 mRNA (upper panel) or Nkx2.5 mRNA (lower panel) after chemical induction of hypoxia responses (30 mg CoCl2/kg body weight). Arrows indicate the NKX2.5+ or ISL1+ cardiogenic region. Representative images from 2 independent experiments are shown. (C) Western blot analysis of ISL1, NKX2.5, and sarcomeric α-actinin levels in cardiac mesoderm containing adjacent outflow tract isolated from E9.5 embryos with or without CoCl2 treatment. α-Tubulin was used as protein-loading control. Two separate experiments (3 individual litters per experiments) were analyzed, yielding similar results. (D) Analysis of ISL1+ cell proliferation in mock (n = 4) or CoCl2-treated (n = 4) E9.5 embryos by immunostaining for ISL1 and phospho-histone H3 (Ser10) (pH3). The percentages of pH3/ISL1 double-positive cells in cardiac mesoderm are shown. At least 6 sections from each embryo were counted. **P < 0.01, ANOVA with Dunnett’s post hoc correction. (E) TUNEL assay of ISL1+ cells after CoCl2 treatment. The percentages of TUNEL-positive ISL1+ CPCs are shown. At least 12 sections from each embryo were counted. ANOVA with Dunnett’s post hoc test was used to calculate significance (n = 3). (F) Immunofluorescence-based quantification of ISL1+NKX2.5–, ISL1+NKX2.5+, and ISL1–NKX2.5+ cells after FACS-based cell sorting of ISL1+ cells from E8.0 ISL1nGFP/+ embryos and 2-day cultivation of isolated cells under either normoxic or hypoxic conditions. Quantification of different cell populations was achieved by counting all immunostained cells in a multiwell dish. *P < 0.05; ***P < 0.001, t test (n = 3). (G) Number of Isl1-Cre+ Rosa26Nkx2.5 embryos after breeding of heterozygous Isl1-Cre+ mice with Rosa26Nkx2.5 mice at different developmental stages. (H) Whole-mount views of E9.5 (left panels) and E10.5 embryos (right panels). Boxed areas are enlarged. Representative images are shown. Arrows indicate shortened outflow tract in Isl1-Cre+ Rosa26Nkx2.5 embryos. Scale bars: 100 μm. (I) H&E staining of E15.5 hearts isolated from either Isl1-Cre– Rosa26WT (upper panel) or Isl1-Cre+ Rosa26Nkx2.5 (lower panel) mice. Thirty embryos from 5 litters including 2 Isl1-Cre+ Rosa26Nkx2.5 embryos were analyzed. Arrows point to individual cardiac defects named in the figure. Scale bars: 200 μm.

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