TFEB Overexpression, Not mTOR Inhibition, Ameliorates RagCS75Y Cardiomyopathy

M Kim, L Lu, AV Dvornikov, X Ma, Y Ding… - International journal of …, 2021 - mdpi.com
M Kim, L Lu, AV Dvornikov, X Ma, Y Ding, P Zhu, TM Olson, X Lin, X Xu
International journal of molecular sciences, 2021mdpi.com
A de novo missense variant in Rag GTPase protein C (RagCS75Y) was recently identified in
a syndromic dilated cardiomyopathy (DCM) patient. However, its pathogenicity and the
related therapeutic strategy remain unclear. We generated a zebrafish RragcS56Y
(corresponding to human RagCS75Y) knock-in (KI) line via TALEN technology. The KI fish
manifested cardiomyopathy-like phenotypes and poor survival. Overexpression of
RagCS75Y via adenovirus infection also led to increased cell size and fetal gene …
A de novo missense variant in Rag GTPase protein C (RagCS75Y) was recently identified in a syndromic dilated cardiomyopathy (DCM) patient. However, its pathogenicity and the related therapeutic strategy remain unclear. We generated a zebrafish RragcS56Y (corresponding to human RagCS75Y) knock-in (KI) line via TALEN technology. The KI fish manifested cardiomyopathy-like phenotypes and poor survival. Overexpression of RagCS75Y via adenovirus infection also led to increased cell size and fetal gene reprogramming in neonatal rat ventricle cardiomyocytes (NRVCMs), indicating a conserved mechanism. Further characterization identified aberrant mammalian target of rapamycin complex 1 (mTORC1) and transcription factor EB (TFEB) signaling, as well as metabolic abnormalities including dysregulated autophagy. However, mTOR inhibition failed to ameliorate cardiac phenotypes in the RagCS75Y cardiomyopathy models, concomitant with a failure to promote TFEB nuclear translocation. This observation was at least partially explained by increased and mTOR-independent physical interaction between RagCS75Y and TFEB in the cytosol. Importantly, TFEB overexpression resulted in more nuclear TFEB and rescued cardiomyopathy phenotypes. These findings suggest that S75Y is a pathogenic gain-of-function mutation in RagC that leads to cardiomyopathy. A primary pathological step of RagCS75Y cardiomyopathy is defective mTOR–TFEB signaling, which can be corrected by TFEB overexpression, but not mTOR inhibition.
MDPI