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Cardiovasc Res. 2018 Jun 20. doi: 10.1093/cvr/cvy154. [Epub ahead of print]

A gene therapeutic approach to inhibit CIB1 ameliorates maladaptive remodeling in pressure overload.

Author information

Klinik für Kardiologie und Angiologie, Germany.
Abteilung für Herz- und Kreislaufforschung, European Center for Angioscience (ECAS), Medizinische Fakultät Mannheim, Universität Heidelberg, 68167 Mannheim, Germany.
Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Germany.
Leibniz Forschungslaboratorien für Biotechnologie und künstliche Organe, Klinik für Herz-, Thorax-, Transplantations- und Gefäßchirurgie, Germany.
Cluster of Excellence-Rebirth, Medizinische Hochschule Hannover, 30625 Hannover, Germany.
Current Address: Klinik für Thorax-, Herz- und Gefäßmedizin, Universitätsmedizin Göttingen, 37075 Göttingen, Germany.
Institut für Pharmakologie und Toxikologie and Rudolf Virchow Zentrum für Experimentelle Biomedizin, Universität Würzburg, 97078 Würzburg, Germany.
Klinik für Kardiologie, Angiologie und Pneumologie, Universitätsklinikum Heidelberg, 69120 Heidelberg, Germany.
DZHK (German Center for Cardiovascular Research), partner site Heidelberg/Mannheim, Germany.
Klinik für Innere Medizin III, Universitätsklinikum Schleswig-Holstein, 24105 Kiel, Germany.



Chronic heart failure is becoming increasingly prevalent and is still associated with a high mortality rate. Myocardial hypertrophy and fibrosis drive cardiac remodeling and heart failure, but they are not sufficiently inhibited by current treatment strategies. Furthermore, despite increasing knowledge on cardiomyocyte intracellular signaling proteins inducing pathological hypertrophy, therapeutic approaches to target these molecules are currently unavailable. In this study, we aimed to establish and test a therapeutic tool to counteract the 22kDa calcium and integrin binding protein (CIB) 1, which we have previously identified as nodal regulator of pathological cardiac hypertrophy and as activator of the maladaptive calcineurin/NFAT axis.

Methods and Results:

Among three different sequences, we selected a shRNA construct (shCIB1) to specifically downregulate CIB1 by 50% upon adenoviral overexpression in neonatal rat cardiomyocytes (NRCM), and upon overexpression by an adeno-associated-virus (AAV) 9 vector in mouse hearts. Overexpression of shCIB1 in NRCM markedly reduced cellular growth, improved contractility of bioartificial cardiac tissue and reduced calcineurin/NFAT activation in response to hypertrophic stimulation. In mice, administration of AAV-shCIB1 strongly ameliorated eccentric cardiac hypertrophy and cardiac dysfunction during two weeks of pressure overload by transverse aortic constriction (TAC). Ultrastructural and molecular analyses revealed markedly reduced myocardial fibrosis, inhibition of hypertrophy associated gene expression and calcineurin/NFAT as well as ERK-MAP kinase activation after TAC in AAV-shCIB1 versus AAV-shControl treated mice. During long-term exposure to pressure overload for 10 weeks, AAV-shCIB1 treatment maintained its anti-hypertrophic and anti-fibrotic effects, but cardiac function was no longer improved versus AAV-shControl treatment, most likely resulting from a reduction in myocardial angiogenesis upon downregulation of CIB1.


Inhibition of CIB1 by a shRNA-mediated gene-therapy potently inhibits pathological cardiac hypertrophy and fibrosis during pressure overload. While cardiac function is initially improved by shCIB1, this cannot be kept up during persisting overload.


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