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Vargas Aguilar et al. report that the PD-1–PD-L1 checkpoint-inhibitor pathway is highly active in heart-resident and circulating immune cells of newborn mice and disruption of this pathway led to increased inflammation and pathogenic T cell activity, impairing regeneration.
A multistate analysis of 341,159 adults from the UK Biobank shows that the development and mortality of cardiometabolic multimorbidity are associated with biological aging, as measured by the Klemera–Doubal Method Biological Age and PhenoAge algorithms.
Myocarditis, an inflammatory heart disease, causes cardiomyocyte loss leading to heart failure. Research now shows that BMP4 is crucial for cardiac tissue homeostasis, and targeted neutralization of BMP inhibitors GREM1 and GREM2 mitigates T cell-induced myocardial inflammation and maintains cardiomyocyte integrity.
By performing a genome-wide CRISPR screen in human induced pluripotent stem cells, Padmanabhan et al. identify the acetyl-lysine reader protein BRD4 as a regulator of cardiomyocyte differentiation, and they validate in vivo that BRD4 is required during development for the fate determination of a subset of secondary heart field cardiac progenitor cells.
Perez-Shibayama et al. report that BMP4 signaling is downregulated in autoimmune myocarditis. Restoring BMP4 levels with antibodies that neutralize the BMP inhibitors gremlin-1 and gremlin-2 can ameliorate cardiac inflammation and improve function in mouse models.
Based on the 19th Global Cardiovascular Clinical Trialists meeting, this Perspective discusses potential sources of evidence that may be used to complement explanatory phase 3 randomized clinical trials and accelerate the development of new cardiovascular medications.
The cellular microenvironment and interplay between cell types are essential for cardiac renewal. Combined single-cell and single-nucleus sequencing, spatial transcriptomics and loss-of-function experiments in constitutively YAP-expressing infarcted hearts reveal a cellular triad and complement signaling that evoke renewal of heart muscle.
Using single-cell RNA sequencing, spatial transcriptomics and genetic experiments, Li et al. report that the close interaction of a specific cardiomyocyte subtype (aCM2), fibroblasts expressing the complement C3 and macrophages expressing C3ar1 was observed in pro-renewal conditions, such as regenerative neonatal hearts and hearts of adult mice overexpressing an active form of YAP in cardiomyocytes.
In coronary artery disease, the transition from an apparently stable state to a life-threatening acute cardiac event is difficult to predict. As such, a recent study applied proteomic and metabolomic approaches to discover new biomarkers that signal imminent myocardial infarction.
Gustafsson, Lampa et al. used proteomics, metabolomics and clinical factors in a case–cohort study to identify biomarkers of imminent myocardial infarction and devise a prediction model for imminent myocardial infarction, which can be clinically used in the general population.
Defects in platelet adhesion at sites of injury can lead to excessive bleeding. A study by Gandhi et al. investigates a new bispecific antibody as a possible therapy to prevent bleeding in patients with inherited defects in platelet adhesion.
Gandhi, Zivkovic, Østergaard and colleagues describe a bispecific antibody, HMB-001, which could be used for the prophylactic treatment of patients with genetic bleeding disorders, currently treated acutely with recombinant coagulation factor VIIa. HMB-001 can bind and accumulate endogenous FVIIa and localize it to sites of vascular injury by targeting it to the TREM-like transcript-1 receptor selectively expressed on activated platelets.
Selvakumar, Clayton et al. use a porcine model of myocardial infarction and PSC-CM transplantation and identify atrial and pacemaker-like cardiomyocytes as the cause of engraftment arrhythmias and surface marker signatures to distinguish between arrhythmogenic and non-arrhythmogenic cardiomyocytes.
Myocardial infarction causes endoplasmic reticulum (ER) stress, thereby triggering the release of a set of poorly defined growth factors. A study shows that the growth factor CRELD2 is secreted in response to ER stress and is required for preserving heart function after myocardial infarction in mice.
Cerebrospinal fluid is now thought to drain through lymphatics instead of veins, but the routes the fluid takes from the subarachnoid space to cervical lymph nodes are unclear. Using advanced imaging, a recent study provides unprecedented anatomical details of lymphatic vessels draining cerebrospinal fluid along the nasopharynx.
Regulatory T cells are cardinal players in cardiovascular disease. Research now identifies a noncanonical chemokine signaling pathway that governs the responsiveness and effector functions of these cells in atherosclerosis.