Endocardial cushion tissue formation, the primordia of valves and septa, is a critical event in cardiac morphogenesis. Maternally administrated all-trans retinoic acid is known to induce complete transposition of the great arteries (TGA) in the mouse embryo. To address the mechanisms of TGA, the effect of retinoic acid on cushion tissue formation was examined.

Using a three-dimensional collagen gel culture model, we performed various types of endothelial-mesenchymal transformation assays of co-cultured endocardium with myocardium obtained from 9.5-day mouse embryonic hearts. In vivo immunohistochemical detections of extracellular matrices, fibronectin and type I collagen, were also performed.

Endothelial-to-mesenchymal transformation at the onset of cushion tissue formation was suppressed in the outflow tract of embryos exposed to retinoic acid in culture. This inhibitory effect of retinoic acid was spatially restricted to the outflow tract and reversed by treatment with embryonic myocardial conditioned medium enriched in extracellular inductive molecules. Mesenchyme formation in the outflow tract was inhibited at a lower concentration of retinoic acid (10⁻¹⁰ mol/l) than that which inhibited the atrio-ventricular canal (10⁻⁷ mol/1) in culture. The fibronectin and type I collagen depositions in pre-migratory outflow tract cardiac jelly in retinoic acid-treated embryonic heart were reduced compared to those in the control.

Exogenously applied retinoic acid inhibits outflow tract cushion mesenchyme formation in the embryonic heart with TGA. It is suggested that retinoic acid inhibits the expression of extracellular matrices and inductive molecules synthesized by myocardium in the outflow tract.