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CHARLOTTESVILLE, VA (Dec. 17,
2007) New research from the University of Virginia Health System
shows that, in cases of Type 1 myotonic muscular dystrophy (DM1), a
well known heart protein does several surprising things. DM1 is the
most common form of muscular dystrophy in adults and affects
approximately 40,000 adults and children in the U.S.
The protein, NKX2-5, is a biomarker
for heart stem cells. It is also very important for the normal
development of the heart. Too little of it causes major cardiac
problems including slow and irregular heartbeats, observes Dr. Mani
Mahadevan, a human genetics researcher and Professor of Pathology at
UVa who led the study.
The researchers were surprised to find
that mice and individuals with DM1 actually overproduce NKX2-5, yet
experience the same kind of heart problems associated with too little
of it.
Excessive NKX2-5 may explain why as
many as 60 to 70 percent of individuals with DM1 develop heart problems
which cause their heartbeats to become slow and irregular, often
necessitating the need for pacemakers. If these irregular heartbeats
are not detected, sudden death can occur.
By using the mouse model of DM1 and
mice genetically engineered to produce less NKX2-5, Dr. Mahadevan and
his team showed that reducing the excessive levels of NKX2-5 seemed to
protect the mice from the heart problems.
Researchers were also surprised to
find NKX2-5 in the muscles of mice and individuals with DM1. Usually,
NKX2-5 is found only in the heart of adults, Dr. Mahadevan notes. It's
like the muscle is having some kind of identity crisis and starting to
make proteins that shouldn't be there normally.
This discovery could prove beneficial,
says Dr. Mahadevan, and lead to development of a simple diagnostic test
to follow a patient's response to potential therapies.
Myotonic muscular dystrophy is
recognized as the first example of a disease caused by a toxic RNA.
RNAs are intermediary molecules that convey the genetic code in the DNA
to the rest of the cell. RNAs are normally cut and pasted together by a
process called RNA splicing. It is currently thought that the toxic RNA
causes DM1 by disrupting normal RNA splicing.
"Much of the research on DM1 is
focused on factors that cause RNA splicing defects. Our work may
provide explanations for pathogenic effects not accounted for by RNA
mis-splicing, Mahadevan explained.
In this current study, Dr. Mahadevan
and his colleagues built upon their groundbreaking research from 2006
which showed that toxic RNA causes DM1 and that getting rid of it
actually reversed the disease process. Their latest findings
demonstrate a new effect of RNA toxicity and how this may cause cardiac
conduction abnormalities.
Entitled, RNA Toxicity in Myotonic
Muscular Dystrophy Induces NKX2-5 Expression, the study appears in the
December 16, 2007 online edition of Nature Genetics.
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