Uncovering cell type-specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathy

Abstract Background Transthyretin amyloid cardiomyopathy (ATTR-CM) is characterized by the misfolding of transthyretin (TTR), fibrillogenesis, and progressive amyloid fibril deposition in the myocardium, leading to cardiac dysfunction with dismal prognosis. In ATTR-CM, either destabilizing mutations...

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Main Authors: Jiabin Qin, Qiangbing Yang, Asier Ullate-Agote, Vasco Sampaio-Pinto, Laura Florit, Inge Dokter, Chrysoula Mathioudaki, Lotte Middelberg, Pilar Montero-Calle, Paula Aguirre-Ruiz, Joana de las Heras Rojo, Zhiyong Lei, Zeping Qiu, Jin Wei, Pim van der Harst, Felipe Prosper, Manuel M. Mazo, Olalla Iglesias-García, Monique C. Minnema, Joost P. G. Sluijter, Marish I.F.J. Oerlemans, Alain van Mil
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Stem Cell Research & Therapy
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Online Access:https://doi.org/10.1186/s13287-025-04464-6
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author Jiabin Qin
Qiangbing Yang
Asier Ullate-Agote
Vasco Sampaio-Pinto
Laura Florit
Inge Dokter
Chrysoula Mathioudaki
Lotte Middelberg
Pilar Montero-Calle
Paula Aguirre-Ruiz
Joana de las Heras Rojo
Zhiyong Lei
Zeping Qiu
Jin Wei
Pim van der Harst
Felipe Prosper
Manuel M. Mazo
Olalla Iglesias-García
Monique C. Minnema
Joost P. G. Sluijter
Marish I.F.J. Oerlemans
Alain van Mil
author_facet Jiabin Qin
Qiangbing Yang
Asier Ullate-Agote
Vasco Sampaio-Pinto
Laura Florit
Inge Dokter
Chrysoula Mathioudaki
Lotte Middelberg
Pilar Montero-Calle
Paula Aguirre-Ruiz
Joana de las Heras Rojo
Zhiyong Lei
Zeping Qiu
Jin Wei
Pim van der Harst
Felipe Prosper
Manuel M. Mazo
Olalla Iglesias-García
Monique C. Minnema
Joost P. G. Sluijter
Marish I.F.J. Oerlemans
Alain van Mil
author_sort Jiabin Qin
collection DOAJ
description Abstract Background Transthyretin amyloid cardiomyopathy (ATTR-CM) is characterized by the misfolding of transthyretin (TTR), fibrillogenesis, and progressive amyloid fibril deposition in the myocardium, leading to cardiac dysfunction with dismal prognosis. In ATTR-CM, either destabilizing mutations (variant TTR, ATTRv) or ageing-associated processes (wild-type TTR, ATTRwt) lead to the formation of TTR amyloid fibrils. Due to a lack of representative disease models, ATTR-CM disease mechanisms are largely unknown, thereby limiting disease understanding and therapeutic discovery. Methods and results Here, we report a novel in vitro ATTR-CM model which uncovers cell type-specific disease phenotypes by exposing the three major human cardiac cell types to TTR fibrils, thereby providing novel insights into the cellular mechanisms of ATTR-CM disease. Human recombinant TTR proteins (WT, V122I, V30M) and respective fibrils were generated and characterized using Thioflavin T, Amytracker, Congo red and dot blot analyses. Seeding human induced pluripotent stem cell-derived-cardiomyocytes (hiPSC-CMs) and endothelial cells (ECs) on TTR fibrils resulted in reduced cell viability. Confocal microscopy revealed extracellular localization of TTR fibrils to hiPSC-CMs, leading to sarcomere disruption, altered calcium handling and disrupted electromechanical coupling, while ECs showed a reduced migration capacity with aberrant cell morphology. hiPSC-fibroblasts (hiPSC-FBs) were largely unaffected by TTR fibrils, presenting normal viability, but showing enhanced localization with TTR fibrils. Conclusions Our model shows that WT and variant TTR fibrils lead to cell type-specific phenotypes, providing novel insights into the underlying cellular disease mechanisms of ATTR-CM, thereby facilitating the identification of novel therapeutic targets and biomarkers.
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spelling doaj-art-37370a90c6084fda8ed0e1cea808cb5d2025-08-20T03:04:34ZengBMCStem Cell Research & Therapy1757-65122025-07-0116111710.1186/s13287-025-04464-6Uncovering cell type-specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathyJiabin Qin0Qiangbing Yang1Asier Ullate-Agote2Vasco Sampaio-Pinto3Laura Florit4Inge Dokter5Chrysoula Mathioudaki6Lotte Middelberg7Pilar Montero-Calle8Paula Aguirre-Ruiz9Joana de las Heras Rojo10Zhiyong Lei11Zeping Qiu12Jin Wei13Pim van der Harst14Felipe Prosper15Manuel M. Mazo16Olalla Iglesias-García17Monique C. Minnema18Joost P. G. Sluijter19Marish I.F.J. Oerlemans20Alain van Mil21Department of Cardiology, University Medical Center UtrechtCDL Research, University Medical Center UtrechtBiomedical Engineering Program, Technological Innovation Division, CIMA Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA)Department of Cardiology, University Medical Center UtrechtDepartment of Cardiology, University Medical Center UtrechtDepartment of Cardiology, University Medical Center UtrechtDepartment of Cardiology, University Medical Center UtrechtDepartment of Cardiology, University Medical Center UtrechtBiomedical Engineering Program, Technological Innovation Division, CIMA Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA)Hemato-Oncology Program, Cancer Division, CIMA Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA)Hematology and Cell Therapy, Clínica Universidad de NavarraCDL Research, University Medical Center UtrechtDepartment of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Cardiovascular Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Cardiology, University Medical Center UtrechtHematology and Cell Therapy, Clínica Universidad de NavarraBiomedical Engineering Program, Technological Innovation Division, CIMA Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA)Biomedical Engineering Program, Technological Innovation Division, CIMA Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA)Department of Hematology, University Medical Center UtrechtDepartment of Cardiology, University Medical Center UtrechtDepartment of Cardiology, University Medical Center UtrechtDepartment of Cardiology, University Medical Center UtrechtAbstract Background Transthyretin amyloid cardiomyopathy (ATTR-CM) is characterized by the misfolding of transthyretin (TTR), fibrillogenesis, and progressive amyloid fibril deposition in the myocardium, leading to cardiac dysfunction with dismal prognosis. In ATTR-CM, either destabilizing mutations (variant TTR, ATTRv) or ageing-associated processes (wild-type TTR, ATTRwt) lead to the formation of TTR amyloid fibrils. Due to a lack of representative disease models, ATTR-CM disease mechanisms are largely unknown, thereby limiting disease understanding and therapeutic discovery. Methods and results Here, we report a novel in vitro ATTR-CM model which uncovers cell type-specific disease phenotypes by exposing the three major human cardiac cell types to TTR fibrils, thereby providing novel insights into the cellular mechanisms of ATTR-CM disease. Human recombinant TTR proteins (WT, V122I, V30M) and respective fibrils were generated and characterized using Thioflavin T, Amytracker, Congo red and dot blot analyses. Seeding human induced pluripotent stem cell-derived-cardiomyocytes (hiPSC-CMs) and endothelial cells (ECs) on TTR fibrils resulted in reduced cell viability. Confocal microscopy revealed extracellular localization of TTR fibrils to hiPSC-CMs, leading to sarcomere disruption, altered calcium handling and disrupted electromechanical coupling, while ECs showed a reduced migration capacity with aberrant cell morphology. hiPSC-fibroblasts (hiPSC-FBs) were largely unaffected by TTR fibrils, presenting normal viability, but showing enhanced localization with TTR fibrils. Conclusions Our model shows that WT and variant TTR fibrils lead to cell type-specific phenotypes, providing novel insights into the underlying cellular disease mechanisms of ATTR-CM, thereby facilitating the identification of novel therapeutic targets and biomarkers.https://doi.org/10.1186/s13287-025-04464-6Transthyretin amyloid cardiomyopathyIn vitro disease modelTTR fibrilsVariant TTRiPSC
spellingShingle Jiabin Qin
Qiangbing Yang
Asier Ullate-Agote
Vasco Sampaio-Pinto
Laura Florit
Inge Dokter
Chrysoula Mathioudaki
Lotte Middelberg
Pilar Montero-Calle
Paula Aguirre-Ruiz
Joana de las Heras Rojo
Zhiyong Lei
Zeping Qiu
Jin Wei
Pim van der Harst
Felipe Prosper
Manuel M. Mazo
Olalla Iglesias-García
Monique C. Minnema
Joost P. G. Sluijter
Marish I.F.J. Oerlemans
Alain van Mil
Uncovering cell type-specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathy
Stem Cell Research & Therapy
Transthyretin amyloid cardiomyopathy
In vitro disease model
TTR fibrils
Variant TTR
iPSC
title Uncovering cell type-specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathy
title_full Uncovering cell type-specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathy
title_fullStr Uncovering cell type-specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathy
title_full_unstemmed Uncovering cell type-specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathy
title_short Uncovering cell type-specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathy
title_sort uncovering cell type specific phenotypes using a novel human in vitro model of transthyretin amyloid cardiomyopathy
topic Transthyretin amyloid cardiomyopathy
In vitro disease model
TTR fibrils
Variant TTR
iPSC
url https://doi.org/10.1186/s13287-025-04464-6
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