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  • BET inhibition blocks infla...
    Mills, Richard J.; Humphrey, Sean J.; Fortuna, Patrick R.J.; Lor, Mary; Foster, Simon R.; Quaife-Ryan, Gregory A.; Johnston, Rebecca L.; Dumenil, Troy; Bishop, Cameron; Rudraraju, Rajeev; Rawle, Daniel J.; Le, Thuy; Zhao, Wei; Lee, Leo; Mackenzie-Kludas, Charley; Mehdiabadi, Neda R.; Halliday, Christopher; Gilham, Dean; Fu, Li; Nicholls, Stephen J.; Johansson, Jan; Sweeney, Michael; Wong, Norman C.W.; Kulikowski, Ewelina; Sokolowski, Kamil A.; Tse, Brian W.C.; Devilée, Lynn; Voges, Holly K.; Reynolds, Liam T.; Krumeich, Sophie; Mathieson, Ellen; Abu-Bonsrah, Dad; Karavendzas, Kathy; Griffen, Brendan; Titmarsh, Drew; Elliott, David A.; McMahon, James; Suhrbier, Andreas; Subbarao, Kanta; Porrello, Enzo R.; Smyth, Mark J.; Engwerda, Christian R.; MacDonald, Kelli P.A.; Bald, Tobias; James, David E.; Hudson, James E.

    Cell, 04/2021, Letnik: 184, Številka: 8
    Journal Article

    Cardiac injury and dysfunction occur in COVID-19 patients and increase the risk of mortality. Causes are ill defined but could be through direct cardiac infection and/or inflammation-induced dysfunction. To identify mechanisms and cardio-protective drugs, we use a state-of-the-art pipeline combining human cardiac organoids with phosphoproteomics and single nuclei RNA sequencing. We identify an inflammatory “cytokine-storm”, a cocktail of interferon gamma, interleukin 1β, and poly(I:C), induced diastolic dysfunction. Bromodomain-containing protein 4 is activated along with a viral response that is consistent in both human cardiac organoids (hCOs) and hearts of SARS-CoV-2-infected K18-hACE2 mice. Bromodomain and extraterminal family inhibitors (BETi) recover dysfunction in hCOs and completely prevent cardiac dysfunction and death in a mouse cytokine-storm model. Additionally, BETi decreases transcription of genes in the viral response, decreases ACE2 expression, and reduces SARS-CoV-2 infection of cardiomyocytes. Together, BETi, including the Food and Drug Administration (FDA) breakthrough designated drug, apabetalone, are promising candidates to prevent COVID-19 mediated cardiac damage. Display omitted •Pro-inflammatory factors drive systolic and diastolic cardiac dysfunction•BRD4 activation drives diastolic dysfunction and is blocked by clinically relevant drugs•BET inhibition decreases ACE2 expression and decreases SARS-CoV2 infection COVID-19 causes cardiac injury, although mechanisms and effective therapeutics are lacking. In this study, Mills et al., show that cytokines elevated in COVID-19 patients drive cardiac dysfunction. These responses are mapped using phosphoproteomics and single nuclei RNA sequencing, enabling a targeted drug screen to identify therapeutics for rapid repurposing. BET inhibitors were identified as leading candidates to block cardiac dysfunction and decrease SARS-CoV-2 cardiac infection.