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Modified mRNA Treatment Restores Cardiac Function in Desmocollin-2-Deficient Mouse Models of Arrhythmogenic Right Ventricular Cardiomyopathy.

Circulation2025-04-11PubMed
Total: 90.0Innovation: 9Impact: 9Rigor: 9Citation: 9

Summary

Using modified mRNA targeting desmocollin‑2 deficiency, the authors restored desmosomal function and improved cardiac performance in mouse models of ARVC, bridged by human genetic discovery. This provides first-in-class preclinical evidence that mRNA replacement can treat inherited cardiomyopathy by correcting structural protein deficits.

Key Findings

  • Genetic discovery of a novel DSC2 (desmocollin‑2) variant linked to ARVC and functional validation in models.
  • Modified mRNA delivery restored desmosomal protein expression and improved right ventricular function in Dsc2‑deficient mice.
  • Therapeutic mRNA replacement mitigated arrhythmogenic substrate and structural dysplasia, demonstrating disease-modifying potential.

Clinical Implications

While preclinical, this work supports clinical development of modified mRNA replacement for ARVC and potentially other desmosomal cardiomyopathies. It suggests a feasible delivery/efficacy path to correct structural protein deficits without permanent genome alteration.

Why It Matters

Introduces a translational RNA therapy paradigm for desmosomal cardiomyopathy with robust functional rescue in vivo. It opens a therapeutic class beyond gene editing and small molecules for structural cardiomyopathies.

Limitations

  • Preclinical mouse data; human safety, dosing, and delivery need evaluation
  • Durability of mRNA therapy and immune responses were not fully established

Future Directions

Optimize cardiac-targeted mRNA delivery, assess long-term efficacy/safety, and design early-phase trials for ARVC and broader desmosomal cardiomyopathies.

Study Information

Study Type
Basic/Mechanistic
Research Domain
Treatment/Pathophysiology
Evidence Level
V - Preclinical mechanistic study with human genetic discovery and mouse models
Study Design
OTHER