Focal and segmental glomerulosclerosis (FSGS) is a kidney disorder of unknown etiology, and up to 20% of patients on dialysis have been diagnosed with it. Here we show that a large family with hereditary FSGS carries a missense mutation in the TRPC6 gene on chromosome 11q, encoding the ion-channel protein transient receptor potential cation channel 6 (TRPC6). The proline-to-glutamine substitution at position 112, which occurs in a highly conserved region of the protein, enhances TRPC6-mediated calcium signals in response to agonists such as angiotensin II and appears to alter the intracellular distribution of TRPC6 protein. Previous work has emphasized the importance of cytoskeletal and structural proteins in proteinuric kidney diseases. Our findings suggest an alternative mechanism for the pathogenesis of glomerular disease.

Rationale Repopulation of the injured heart with new, functional cardiomyocytes remains a daunting challenge for cardiac regenerative medicine. An ideal therapeutic approach would involve an effective method at achieving direct conversion of injured areas to functional tissue in situ. Objective The aim of this study was to develop a strategy that identified and evaluated the potential of specific miRNAs capable of inducing reprogramming of cardiac fibroblasts directly to cardiomyocytes in vitro and in vivo. Methods and Results Using a combinatorial strategy, we identified a combination of microRNAs (miRNA) 1, 133, 208, and 499 capable of inducing direct cellular reprogramming of fibroblasts to cardiomyocyte-like cells in vitro. Detailed studies of the reprogrammed cells, demonstrated that a single transient transfection of the microRNAs can direct a switch in cell fate as documented by expression of mature cardiomyocyte markers, sarcomeric organization, and exhibition of spontaneous calcium flux characteristic of a cardiomyocyte-like phenotype. Interestingly, we also found that miRNA-mediated reprogramming was enhanced 10 fold upon JAK inhibitor I treatment. Importantly, administration of microRNAs into ischemic mouse myocardium resulted in evidence of direct conversion of cardiac fibroblasts to cardiomyocytes in situ. Genetic tracing analysis using Fsp1Cre-traced fibroblasts from both cardiac and non-cardiac cell sources strongly suggests that induced cells are most likely of fibroblastic origin. Conclusion The findings from this study provide the first proof-of-concept that miRNAs have the capability of directly converting fibroblasts to a cardiomyocyte-like phenotype in vitro. Also of significance is that this is the first report of direct cardiac reprogramming in vivo. Our approach may have broad and important implications for therapeutic tissue regeneration in general.

It is now well established that stromal interaction molecule 1 (STIM1) is the calcium sensor of endoplasmic reticulum stores required to activate store-operated calcium entry (SOC) channels at the surface of non-excitable cells. However, little is known about STIM1 in excitable cells, such as striated muscle, where the complement of calcium regulatory molecules is rather disparate from that of non-excitable cells. Here, we show that STIM1 is expressed in both myotubes and adult skeletal muscle. Myotubes lacking functional STIM1 fail to show SOC and fatigue rapidly. Moreover, mice lacking functional STIM1 die perinatally from a skeletal myopathy. In addition, STIM1 haploinsufficiency confers a contractile defect only under conditions where rapid refilling of stores would be needed. These findings provide insight into the role of STIM1 in skeletal muscle and suggest that STIM1 has a universal role as an ER/SR calcium sensor in both excitable and non-excitable cells.

Peroxisome proliferator-activated receptor ␥ co-activator 1␣ (PGC-1␣) promotes mitochondrial biogenesis and slow fiber formation in skeletal muscle. We hypothesized that activation of the p38 mitogen-activated protein kinase (MAPK) pathway in response to increased muscle activity stimulated Pgc-1␣ gene transcription as part of the mechanisms for skeletal muscle adaptation. Here we report that a single bout of voluntary running induced a transient increase of Pgc-1␣ mRNA expression in mouse plantaris muscle, concurrent with an activation of the p38 MAPK pathway. Activation of the p38 MAPK pathway in cultured C2C12 myocytes stimulated Pgc-1␣ promoter activity, which could be blocked by the specific inhibitors of p38, SB203580 and SB202190, or a dominant negative p38. Furthermore, the p38-mediated increase in Pgc-1␣ promoter activity was enhanced by increased expression of the downstream transcription factor ATF2 and completely blocked by ATF2⌬N, a dominant negative ATF2. Skeletal muscle-specific expression of a constitutively active activator of p38, MKK6E, in transgenic mice resulted in enhanced Pgc-1␣ and cytochrome oxidase IV protein expression in fast-twitch skeletal muscles. These findings suggest that contractile activity-induced activation of the p38 MAPK pathway promotes Pgc-1␣ gene expression and skeletal muscle adaptation.

Gene expression in skeletal muscles of adult vertebrates is altered profoundly by changing patterns of contractile work. Here we observed that the functional activity of MEF2 transcription factors is stimulated by sustained periods of endurance exercise or motor nerve pacing, as assessed by expression in transgenic mice of a MEF2-dependent reporter gene (desMEF2-lacZ). This response is accompanied by transformation of specialized myo®ber subtypes, and is blocked either by cyclosporin A, a speci®c chemical inhibitor of calcineurin, or by forced expression of the endogenous calcineurin inhibitory protein, myocyte-enriched calcineurin interacting protein 1. Calcineurin removes phosphate groups from MEF2, and augments the potency of the transcriptional activation domain of MEF2 fused to a heterologous DNA binding domain. Across a broad range, the enzymatic activity of calcineurin correlates directly with expression of endogenous genes that are transcriptionally activated by muscle contractions. These results delineate a molecular pathway in which calcineurin and MEF2 participate in the adaptive mechanisms by which skeletal myo®bers acquire specialized contractile and metabolic properties as a function of changing patterns of muscle contraction.

The G protein-coupled receptor kinases (GRKs) and ␤-arrestins, families of molecules essential to the desensitization of G proteindependent signaling via seven-transmembrane receptors (7TMRs), have been recently shown to also transduce G protein-independent signals from receptors. However, the physiologic consequences of this G protein-independent, GRK͞␤-arrestin-dependent signaling are largely unknown. Here, we establish that GRK͞␤-arrestin-mediated signal transduction via the angiotensin II (ANG) type 1A receptor (AT1AR) results in positive inotropic and lusitropic effects in isolated adult mouse cardiomyocytes. We used the ''biased'' AT1AR agonist [Sar 1 , Ile 4 , Ile 8 ]-angiotensin II (SII), which is unable to stimulate G␣q-mediated signaling, but which has previously been shown to promote ␤-arrestin interaction with the AT1AR. Cardiomyocytes from WT, but not AT 1A R-deficient knockout (KO) mice, exhibited positive inotropic and lusitropic responses to both ANG and SII. Responses of WT cardiomyocytes to ANG were dramatically reduced by protein kinase C (PKC) inhibition, whereas those to SII were unaffected. In contrast, cardiomyocytes from ␤-arrestin2 KO and GRK6 KO mice failed to respond to SII, but displayed preserved responses to ANG. Cardiomyocytes from GRK2 heterozygous knockout mice (GRK2 ؉/؊ ) exhibited augmented responses to SII in comparison to ANG, whereas those from GRK5 KO mice did not differ from those from WT mice. These findings indicate the existence of independent G␣q͞PKC-and GRK6͞␤-arrestin2-dependent mechanisms by which stimulation of the AT1AR can modulate cardiomyocyte function, and which can be differentially activated by selective receptor ligands. Such ligands may have potential as a novel class of therapeutic agents.seven-transmembrane receptors ͉ G protein-coupled receptor kinase ͉ mice V irtually all physiologic processes in higher organisms are critically regulated by signal transduction through seventransmembrane receptors (7TMRs), the largest and most diverse family of cell surface receptors (1). The biological effects of 7TMR signal transduction have conventionally been attributed to activation of 7TMR-associated heterotrimeric G proteins, and consequent activation of second messenger-generating enzymes, production of second messengers, and activation of second messenger-dependent effector molecules (2). This classical understanding has been supported by numerous physiologic studies, and forms the basis for the utilization of drugs (agonists and antagonists) targeting 7TMRs, as therapeutic strategies for a vast array of diseases (1).However, this simple paradigm has been altered by an increasing appreciation of the biochemical importance of both negative regulation of G protein-dependent signaling, and G protein-independent signal transduction by 7TMRs (3, 4). G protein activation and dependent downstream processes are predominantly antagonized by the sequential actions of two families of molecules, the G protein-coupled receptor kinases (GRKs) and the ␤-arrestins. Agonist bin...

Rationale Fibroblast growth factor homologous factors (FHFs), a subfamily of fibroblast growth factors (FGFs) that are incapable of functioning as growth factors, are intracellular modulators of Na+ channels and have been linked to neurodegenerative diseases. Although certain FHFs have been found in embryonic heart, they have not been reported in adult heart, and they have not been shown to regulate endogenous cardiac Na+ channels nor participate in cardiac pathophysiology. Objective We tested whether FHFs regulate Na+ channels in murine heart. Methods and Results We demonstrated that isoforms of FGF13 are the predominant FHFs in adult mouse ventricular myocytes. FGF13 binds directly to, and co-localizes with the Na 1.5 Na+ V channel in the sarcolemma of adult mouse ventricular myocytes. Knockdown of FGF13 in adult mouse ventricular myocytes revealed a loss-of-function of NaV1.5: reduced Na+ current (INa) density, decreased Na+ channel availability, and slowed INa recovery from inactivation. Cell surface biotinylation experiments showed a ~45% reduction in NaV1.5 protein at the sarcolemma after FGF13 knockdown, whereas no changes in whole-cell NaV1.5 protein nor mRNA level were observed. Optical imaging in neonatal rat ventricular myocyte monolayers demonstrated slowed conduction velocity and a reduced maximum capture rate after FGF13 knockdown. Conclusion These findings show that FHFs are potent regulators of Na+ channels in adult ventricular myocytes and suggest that loss-of-function mutations in FHFs may underlie a similar set of cardiac arrhythmias and cardiomyopathies that result from NaV1.5 loss-of-function mutations.

Rationale: Cardiac muscle adapts to increase workload by altering cardiomyocyte size and function resulting in cardiac hypertrophy. G protein-coupled receptor signaling is known to govern the hypertrophic response through the regulation of ion channel activity and downstream signaling in failing cardiomyocytes. Objective: Transient receptor potential canonical (TRPC) channels are G protein-coupled receptor operated channels previously implicated in cardiac hypertrophy. Our objective of this study is to better understand how TRPC channels influence cardiomyocyte calcium signaling. Methods and Results: Here, we used whole cell patch clamp of adult cardiomyocytes to show upregulation of a nonselective cation current reminiscent of TRPC channels subjected to pressure overload. This TRPC current corresponds to the increased TRPC channel expression noted in hearts of mice subjected to pressure overload. Importantly, we show that mice lacking TRPC1 channels are missing this putative TRPC current. Moreover, Trpc1 ؊/؊ mice fail to manifest evidence of maladaptive cardiac hypertrophy and maintain preserved cardiac function when subjected to hemodynamic stress and neurohormonal excess. In addition, we provide a mechanistic basis for the protection conferred to Trpc1 ؊/؊ mice as mechanosensitive signaling through calcineurin/NFAT, mTOR and Akt is altered in Trpc1 ؊/؊ mice. Conclusions: From these studies, we suggest that TRPC1 channels are critical for the adaptation to biomechanical stress and TRPC dysregulation leads to maladaptive cardiac hypertrophy and failure. (Circ Res. 2009;105:1023-1030.)Key Words: transient receptor potential channels Ⅲ G protein receptor signaling Ⅲ cardiac hypertrophy C ardiac myocytes respond to changing mechanical workloads by altering the frequency and amplitude of their calcium transients. 1,2 Encoded in these calcium transients are signals that alter not only the immediate contractile response but also initiate and maintain a remodeling response that adjusts cellular mass, ionic currents, kinetic properties of contractile proteins, and metabolic capacity. 3 It is likely that persistence of these signals modulate the calcium signaling events resulting in a hypertrophic response and adverse remodeling. To identify the proximal signals that regulate cardiac hypertrophy, attention has begun to focus on ion channels because they may link mechanical activity to cell signaling. 4 Recent work has raised the possibility that hypertrophic agonists linked to G-protein coupled receptors activate calcium entry through transient receptor potential canonical (TRPC) channels. [5][6][7][8][9][10] TRPC channels encompass a large family of nonselective cation channels found in many different cell types. 11 TRPC channels are activated downstream of G-protein receptor through the phospholipase C signaling by inositol trisphosphate (TRPC1/4/5) or by diacyl glycerol (TRPC3/6/7). 5,12 More recently TRPC1/6 channels were found to be mechanosensitive channels that mediate nonselective cation entry in response to i...