Mutations in the NOTCH pathway regulator MIB1 cause left ventricular noncompaction cardiomyopathy

Guillermo Luxan, Jesus Fernandez Casanova, Beatriz Martinez Poveda, Belen Prados Pinto, Gaetano D'Amato, Donal MacGrogan, Alvaro Gonzalez-Rajal, David Dobarro, Carlos Torroja, Fernando Martinez de Benito, Jose Luis Izquierdo-Garcia, Leticia America Fernandez-Friera, Maria Sabater Molina, Young-Y Kong, Gonzalo Pizarro, Borja Ibanez Cabeza, Constancio Medrano Lopez, Pablo Garcia-Pavia, Juan Ramon Gimeno, Lorenzo Monserrat IglesiasLuis J Jimenez-Borreguero, Jose Luis de la Pompa

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Left ventricular noncompaction (LVNC) causes prominent ventricular trabeculations and reduces cardiac systolic function. The clinical presentation of LVNC ranges from asymptomatic to heart failure. We show that germline mutations in human MIB1 (mindbomb homolog 1), which encodes an E3 ubiquitin ligase that promotes endocytosis of the NOTCH ligands DELTA and JAGGED, cause LVNC in autosomal-dominant pedigrees, with affected individuals showing reduced NOTCH1 activity and reduced expression of target genes. Functional studies in cells and zebrafish embryos and in silico modeling indicate that MIB1 functions as a dimer, which is disrupted by the human mutations. Targeted inactivation of Mib1 in mouse myocardium causes LVNC, a phenotype mimicked by inactivation of myocardial Jagged1 or endocardial Notch1. Myocardial Mib1 mutants show reduced ventricular Notch1 activity, expansion of compact myocardium to proliferative, immature trabeculae and abnormal expression of cardiac development and disease genes. These results implicate NOTCH signaling in LVNC and indicate that MIB1 mutations arrest chamber myocardium development, preventing trabecular maturation and compaction.
Original languageEnglish
Pages (from-to)193 - 201
Number of pages9
JournalNature Medicine
Issue number2
Publication statusPublished - 2013
Externally publishedYes

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