Cardiomyopathies are disorders of the heart muscle, resulting in improper contraction and/or relaxation of the heart. This can lead to cardiac arrhythmias, heart failure and even sudden cardiac death, sometimes in young individuals. Often these cardiomyopathies are inherited and research already enabled identification of more than 60 genes associated with these disorders. But in more than half of the patients no mutations are detected in any of the known genes and the genetic cause remains elusive. Through study of these disease genes new insight has already been gained in the pathophysiological mechanisms causing cardiomyopathies, but the picture remains far from complete. At present, there are some therapeutic options to reduce disease symptoms, but therapies that are capable of completely stopping or even reversing the disease are not yet available.
Goal
We
aim to further investigate the genetic causes and disease mechanisms
underlying cardiomyopathies. This will lead to a significantly
improved understanding of the disorders and provide the possibility
to develop novel therapies. With our research team we aim to improve
genetic diagnosis, risk prediction, optimize counseling and deliver
true personalized management of patients to increase their quality of
life.
Strategy
Using modern DNA sequencing techniques (including whole-exome and whole-genome sequencing) in patients without a genetic diagnosis, we will identify novel genes involved in cardiomyopathies. We are also focusing on the identification of genetic modifiers that play a role in the development of these disorders and can explain the phenotypic variability observed within families. The functional effect of mutations in these genes and modifiers are studied in patient samples, induced pluripotent stem cell (iPSC)-derived cardiac cells and transgenic zebrafish or mice. Hereto we are using state-of-the-art techniques such as CRISPR/Cas genome editing, transcriptomics, interactomics, proteomics, high-tech microscopy and micro-electrode arrays. Based on these novel insights, new therapeutic targets can be identified for which novel drugs can be tested in the pre-clinical disease models that we generated.
Disorders under investigation:
Hypertrophic
cardiomyopathy, dilated cardiomyopathy, arrhythmogenic
cardiomyopathy, non-compaction cardiomyopathy.
Team members:
Bart
Loeys, Maaike Alaerts, Ewa Sieliwonczyk, Hanne Boen, Laura Rabaut,
Maaike Bastiaansen, Jarl Bastianen, Jolien Schippers, Sofie Daemen,
Charlotte Claes
Discovering the role of titin (TTN) in anthracycline-induced cardiotoxicity in breast cancer.
Anthracyclines are the mainstay of chemotherapeutic treatment in a
wide range of malignancies, including breast cancer. Cardiotoxicity
is a well-known and feared adverse effect of anthracyclin therapy and
due to the growing population of cancer survivors, cardiovascular
disease in these patients is expected to escalate. Unless we can
identify high-risk patients for anthracycline therapy, today’s
breast cancer patients may become tomorrow ’s heart failure
patients.
However, there is an important inter individual
susceptibility for the development of cardiotoxicity and at present,
it is not possible to predict which patients will develop
cardiotoxicity. It was recently shown that genetic variants in
titin, an import anchoring protein in the cardiomyocytes, can cause a
predisposition to dilated cardiomyopathies and are also more
prevalent in chemotherapy-induced cardiotoxicity. In this research
project we investigate if mutations in titin increase the
susceptibility for cardiotoxicity to anthracyclines, in order to
identify high-risk patients. If this can be confirmed, the
impact on both the individual patient (morbidity, mortality) and on
society will be huge. The development of an hiPSC-CM model harbouring different TTN-truncating variants will allow us to test different possible
therapeutic and preventive measures for this high risk population.
PhD student: Hanne Boen
Promotors: Emeline Van Craenenbroeck, Hein Heidbuchel, Bart Loeys & Maaike Alaerts