Extracellular vesicles from immortalized cardiosphere-derived cells attenuate arrhythmogenic cardiomyopathy in desmoglein-2 mutant mice
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Aims: Arrhythmogenic cardiomyopathy (ACM) is characterized by progressive loss of cardiomyocytes, and fibrofatty tissue replacement. Extracellular vesicles (EVs) secreted by cardiosphere-derived cells, immortalized, and engineered to express high levels of β-catenin, exert anti-inflammatory, and anti-fibrotic effects. The aim of the current study was to assess efficacy of EVs in an ACM murine model. Methods and results: Four-week-old homozygous knock-in mutant desmoglein-2 (Dsg2mt/mt) were randomized to receive weekly EVs or vehicle for 4 weeks. After 4 weeks, DSG2mt/mt mice receiving EVs showed improved biventricular function (left, P < 0.0001; right, P = 0.0037) and less left ventricular dilation (P < 0.0179). Electrocardiography revealed abbreviated QRS duration (P = 0.0003) and QTc interval (P = 0.0006) in EV-treated DSG2mt/mt mice. Further electrophysiology testing in the EV group showed decreased burden (P = 0.0042) and inducibility of ventricular arrhythmias (P = 0.0037). Optical mapping demonstrated accelerated repolarization (P = 0.0290) and faster conduction (P = 0.0274) in Dsg2mt/mt mice receiving EVs. DSG2mt/mt hearts exhibited reduced fibrosis, less cell death, and preserved connexin 43 expression after EV treatment. Hearts of Dsg2mt/mt mice expressed markedly increased levels of inflammatory cytokines that were, in part, attenuated by EV therapy. The pan-inflammatory transcription factor nuclear factor-κB (NF-κB), the inflammasome sensor NLRP3, and the macrophage marker CD68 were all reduced in EV-treated animals. Blocking EV hsa-miR-4488 in vitro and in vivo reactivates NF-κB and blunts the beneficial effects of EVs. Conclusions: Extracellular vesicle treatment improved cardiac function, reduced cardiac inflammation, and suppressed arrhythmogenesis in ACM. Further studies are needed prior to translating the present findings to human forms of this heterogenous disease.
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Extracellular vesicles engineered to deliver or augment β-catenin levels attenuate inflammation and fibrosis in Dsg2-mutant mice.
“In experimental models, extracellular vesicles engineered to deliver or augment β-catenin levels have been shown to attenuate inflammation and fibrosis in Dsg2-mutant mice [81].”
From A Paradigm Shift: Arrhythmogenic Cardiomyopathy Is an Inflammatory Disease (2026) · cites this paper as [81]
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- Authors
- Lin, Y.-N., Mesquita, T., Sanchez, L., Chen, Y.-H., Liu, W., Li, C., Rogers, R., Wang, Y., Li, X., Wu, D., Zhang, R., Ibrahim, A., Marbán, E., & Cingolani, E.
- Affiliations
- Cedars-Sinai Medical Center (US)
- Smidt Heart Institute, Cedars-Sinai Medical Center , 127 S. San Vicente Boulevard, Los Angeles, CA 90048, USA
- Corresponding author
- Cingolani, Eugenio
- ORCID
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 2021-07-29
- Volume
- 42
- Issue
- 35
- Pages
- 3558-3571
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- PMC
- PMC8442111
- OpenAlex
- W3192840844
- Cited by
- 83
- References
- 37
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 24 · 2023: 18 · 2022: 18 · 2021: 3
- FWCI
- 11.23
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- European Heart Journal (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- China Medical University and Hospital (CMU107-N-05)
- National Institutes of Health (R01 HL124074, R01 HL135866, R01 HL147570)
- Peer-Reviewed Medical Research Program
- U.S. Department of Defense (PR150620)
- Cedars-Sinai Board of Governors
- Mark S. Siegel Family Foundation Distinguished Chair of the Cedars-Sinai Medical Center
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Effects of Exercise
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Extracellular vesicles in disease
- Keywords
- arrhythmogenic cardiomyopathy, extracellular vesicles, cardiosphere-derived cells, desmoglein 2, cardiomyocyte loss, myocardial fibrosis, ventricular arrhythmias, cardiac inflammation, NF-κB, NLRP3 inflammasome, connexin 43
- MeSH terms
- Extracellular Vesicles, Animals, Arrhythmias, Cardiac, Cardiomyopathies, Myocytes, Cardiac, Desmogleins, Mice
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