Completed Heart, Stroke & Blood Cells, Biochemistry & Physiology

Defining therapeutic targets in hypertrophic cardiomyopathy (renewal)

In plain English

AI plain-English summary

A faulty gene makes heart muscle proteins stick too tightly to calcium, and this project aims to loosen that grip. Hypertrophic cardiomyopathy (HCM) is a common inherited heart condition where the heart muscle thickens and stiffens, often without symptoms for years. The underlying problem is that mutations in sarcomere proteins—the molecular motors that make heart cells contract—disrupt energy use and calcium handling. Some people’s hearts compensate for these defects, but when compensation fails, the disease progresses. Current drugs can help symptoms but do not correct the root cause. This research tests two new strategies in rodent models. First, it will redirect glucose metabolism toward aerobic glycolysis to improve the heart’s energy supply. Second, it will directly reduce the excessive calcium sensitivity of the mutant sarcomeres. The team will also explore whether gene-editing tools called TALENs can target and disable the faulty gene copy itself. If successful, this work could lead to entirely new classes of drugs that prevent or reverse HCM by restoring the heart’s compensated state—a fundamental shift from managing symptoms to repairing the molecular defect.

View original technical description
The delayed onset and incomplete penetrance that characterise hypertrophic cardiomyopathy indicate that the molecular defects arising from sarcomere mutations can sometimes be compensated. Thus, interventions to ameliorate the biophysical penalty incurred, or to improve compensatory reserve, may restore the compensated state and prevent or reverse the disease. Mechanistic insights in HCM have supported our hypotheses that abnormalities of energy metabolism and Ca2+ handling are central; both have potential as therapeutic targets and are being tested in clinical trials using existing drugs. Yet much uncertainty remains and further questions need to be addressed in order to define novel types of agents. Using predominantly rodent model studies, we will test new approaches to improve energetics by channelling glucose metabolism to aerobic glycolysis and to directly lessen the heightened Ca2+ affinity of mutant sarcomeres. We will also determine whether new approaches with TALENs make it feasible for the first time to directly target the mutant allele.

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Researchers

Hugh Watkins (EPMC Awardee)

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Original classification

Programme Grant

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