{"title":"Antibody–siRNA conjugates enable macrophage-specific osteopontin inhibition to suppress atrial fibrillation","authors":"Na Li","doi":"10.1038/s44161-026-00808-4","DOIUrl":"10.1038/s44161-026-00808-4","url":null,"abstract":"Atrial fibrillation is linked to fibrosis and inflammatory macrophage recruitment in atria, with osteopontin (encoded by Spp1) increasing susceptibility by promoting atrial fibrosis and uneven conduction. Research shows that antibody-based silencing of Spp1 in some TREM2+ macrophages reduces fibrotic remodeling and atrial fibrillation risk.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 5","pages":"387-388"},"PeriodicalIF":10.8,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mechanisms and therapeutic potential of colchicine in atherosclerotic cardiovascular disease","authors":"Xinyi Xia, Fen Yang, Yuhan Liao, Jiyu Zhang, Junyi He, Miao Yu, Xiang Cheng","doi":"10.1038/s44161-026-00807-5","DOIUrl":"10.1038/s44161-026-00807-5","url":null,"abstract":"Over the past decade, colchicine has re-emerged as a promising therapeutic candidate for atherosclerotic cardiovascular disease. Here we review evidence from large randomized controlled trials together with advances in mechanistic research that have clarified how colchicine modulates vascular inflammation and plaque stability. Canonically, colchicine disrupts microtubule dynamics and suppresses NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome activation. Beyond these actions, it limits oxidative stress, modulates cytoskeletal cross-talk, attenuates cholesterol crystal formation and reprograms inflammatory and metabolic proteomic networks. Colchicine influences multiple vascular and immune cell types, including neutrophils, monocytes, macrophages, endothelial cells, smooth muscle cells and platelets, collectively reducing vascular inflammation and promoting plaque stability. Notably, while colchicine has demonstrated benefit in coronary artery disease, several recent trials in cerebrovascular disease have reported neutral outcomes, suggesting disease-specific inflammatory mechanisms and therapeutic responsiveness. Integrating mechanistic insights with clinical evidence will be critical to optimize colchicine use and advance precision anti-inflammatory strategies in atherosclerotic cardiovascular disease. In this Review, Xia et al. discuss the potential of colchicine as a therapy for atherosclerotic cardiovascular disease, highlighting evidence from clinical trials and mechanistic studies showing its effects on vascular inflammation, plaque stability, and immune and vascular cell function. They also emphasize that mixed results in recent cardiovascular and cerebrovascular trials highlight the need to integrate mechanistic insights with clinical evidence to refine colchicine use and guide precision anti-inflammatory strategies.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 5","pages":"404-422"},"PeriodicalIF":10.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Noor Momin, Steffen Pabel, Arnab Rudra, Nina Kumowski, I-Hsiu Lee, Hana Seung, Kyle I. Mentkowski, Aneesh Bapat, Masahiro Yamazoe, Laura Stengel, Charlotte G. Muse, Alexandre Paccalet, Farid F. Kadyrov, Cristina González-Correa, Emily Jacobs, Ellie Feng, Jisoo Park, Jana Grune, Maximilian J. Schloss, Samuel Sossalla, Gregory Wojtkiewicz, Yoshiko Iwamoto, Patrick McMullen, Richard N. Mitchell, Patrick T. Ellinor, Daniel G. Anderson, Kamila Naxerova, Matthias Nahrendorf, Maarten Hulsmans
{"title":"Therapeutic Spp1 silencing in TREM2+ cardiac macrophages suppresses atrial fibrillation","authors":"Noor Momin, Steffen Pabel, Arnab Rudra, Nina Kumowski, I-Hsiu Lee, Hana Seung, Kyle I. Mentkowski, Aneesh Bapat, Masahiro Yamazoe, Laura Stengel, Charlotte G. Muse, Alexandre Paccalet, Farid F. Kadyrov, Cristina González-Correa, Emily Jacobs, Ellie Feng, Jisoo Park, Jana Grune, Maximilian J. Schloss, Samuel Sossalla, Gregory Wojtkiewicz, Yoshiko Iwamoto, Patrick McMullen, Richard N. Mitchell, Patrick T. Ellinor, Daniel G. Anderson, Kamila Naxerova, Matthias Nahrendorf, Maarten Hulsmans","doi":"10.1038/s44161-026-00806-6","DOIUrl":"10.1038/s44161-026-00806-6","url":null,"abstract":"Atrial fibrillation and the risk of its lethal complications are propelled by fibrosis, which induces electrical heterogeneity and gives rise to reentry circuits. Atrial TREM2+ macrophages secrete osteopontin (encoded by Spp1), a matricellular signaling protein that engenders fibrosis, inflammation, and atrial fibrillation. Here we developed an antibody–siRNA conjugate (ARC) drug candidate to silence Spp1. The ARC relies on an anti-TREM2 antibody for delivering Spp1-targeted siRNA to a pathogenic macrophage subset that expands in human atrial fibrillation. The ARC preferentially targeted atrial TREM2+ macrophages with limited uptake by other immune or stromal cells of the heart. We observed efficient silencing of the target gene in human myocardium and in mice, where it reduced pro-fibrotic fibroblast activation and atrial fibrosis. Four weeks of systemic ARC treatment suppressed inducible atrial fibrillation in mice exposed to clinically prevalent risk factors. These results suggest that macrophage subset targeting offers a viable immunomodulatory strategy for atrial fibrillation. Momin et al. develop an antibody–siRNA conjugate to inhibit the secretion of osteopontin by the TREM2+ macrophages that expand during human atrial fibrillation. In mice, this approach reduced fibrosis and atrial fibrillation vulnerability.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 5","pages":"423-438"},"PeriodicalIF":10.8,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yao Wei Lu, Zhuomin Liang, Kerry Dorr, Samantha Ruiz, Xiaoran Huang, Denise Fangnibo Hanvi, Sheri M. Juntilla, Gisela Beutner, Shuhan Lyu, Haipeng Guo, Tiago Fernandes, Ramon A. Espinoza-Lewis, Tingting Wang, Kathryn Li, Xue Li, Gurinder Bir Singh, Yi Wang, Rui Deng, Douglas Cowan, John D. Mably, William T. Pu, Jessie Huang, George A. Porter Jr., Frank Conlon, Hong Chen, Da-Zhi Wang
{"title":"PCBP1 regulates alternative splicing of AARS2 in congenital cardiomyopathy","authors":"Yao Wei Lu, Zhuomin Liang, Kerry Dorr, Samantha Ruiz, Xiaoran Huang, Denise Fangnibo Hanvi, Sheri M. Juntilla, Gisela Beutner, Shuhan Lyu, Haipeng Guo, Tiago Fernandes, Ramon A. Espinoza-Lewis, Tingting Wang, Kathryn Li, Xue Li, Gurinder Bir Singh, Yi Wang, Rui Deng, Douglas Cowan, John D. Mably, William T. Pu, Jessie Huang, George A. Porter Jr., Frank Conlon, Hong Chen, Da-Zhi Wang","doi":"10.1038/s44161-026-00798-3","DOIUrl":"10.1038/s44161-026-00798-3","url":null,"abstract":"Mutations in the AARS2 gene are linked to infantile cardiomyopathy; however, the underlying molecular mechanism remains unknown. Here we report that PCBP1, a poly(rC) binding protein, interacts with the AARS2 transcript to mediate its alternative splicing. Cardiomyocyte-specific deletion of Pcbp1 in mice impairs normal splicing and causes premature termination of Aars2, leading to defects in heart development and postnatal lethality. Similarly, mice with a deletion in Aars2 that mimics a disease-causing splicing lesion display heart developmental abnormalities, reminiscent of those in patients with infantile mitochondrial cardiomyopathy. Mechanistically, loss of Pcbp1 or Aars2 in the heart reduces oxidative phosphorylation, a hallmark of patients with AARS2 mutations. This reduction in mitochondrial-encoded proteome activates mitonuclear communication and the unfolded protein response pathway, thereby inducing a compensatory nuclear-encoded mitochondrial gene program. Our findings provide insights into the PCBP1−AARS2 regulatory axis in mitochondrial cardiomyopathy. Lu et al. report that PCBP1 safeguards AARS2 alternative splicing in the heart, and that loss of PCBP1 disrupts AARS2 splicing, leading to infantile mitochondrial cardiomyopathy. Loss of cardiac PCBP1 or AARS2 impairs oxidative phosphorylation and activates mitonuclear signaling and the unfolded protein response pathway.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 4","pages":"328-350"},"PeriodicalIF":10.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s44161-026-00798-3.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lea Melki, Uma Mahesh R. Avula, Pavithran Guttipatti, Ruiping Ji, Najla Saadallah, Muhammad Shaher Yar, Jonah A. Majumder, Albert Fang, Amar Desai, Naoko Yamaguchi, David S. Park, Ashwin Viswanathan, Karen Conboy, Brian Gill, Christine P. Hendon, Elaine Y. Wan
{"title":"Three-dimensional visualization of arrhythmogenic substrate in mouse hearts using panoramic optical mapping and micro-computed tomography","authors":"Lea Melki, Uma Mahesh R. Avula, Pavithran Guttipatti, Ruiping Ji, Najla Saadallah, Muhammad Shaher Yar, Jonah A. Majumder, Albert Fang, Amar Desai, Naoko Yamaguchi, David S. Park, Ashwin Viswanathan, Karen Conboy, Brian Gill, Christine P. Hendon, Elaine Y. Wan","doi":"10.1038/s44161-026-00803-9","DOIUrl":"10.1038/s44161-026-00803-9","url":null,"abstract":"Electrical and structural remodeling of the heart can contribute to the development of cardiac arrhythmias. Ex vivo optical mapping has been used to visualize cardiac electrophysiological properties, activation and phase maps to further elucidate the mechanisms of atrial fibrillation and ventricular fibrillation initiation and persistence. Here we show an epicardial three-dimensional panoramic optical mapping tool integrated with micro-computed tomography automatically segmented with a deep learning model relying on a convolutional neural network to provide structural and electrical activation information in a single three-dimensional volume of a mouse heart. This technique allows for the acquisition and analysis of electrical activity of the entire epicardial surface with submillimeter spatial resolution and a temporal resolution of 1 ms. We establish the use of this method in transgenic mouse hearts with spontaneous atrial fibrillation and ventricular fibrillation, and mouse surgical models of myocardial infarction and left ventricular hypertrophy. Melki, Avula and colleagues combine three-dimensional panoramic optical mapping with micro-computed tomography and deep learning to generate structural and electrical activation data of the heart and elucidate mechanisms of conduction abnormalities.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 5","pages":"492-503"},"PeriodicalIF":10.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147730874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rachel L. DeLancey, Sunil K. Verma, Muge N. Kuyumcu-Martinez
{"title":"How RNA splicing decisions shape and break the developing heart","authors":"Rachel L. DeLancey, Sunil K. Verma, Muge N. Kuyumcu-Martinez","doi":"10.1038/s44161-026-00801-x","DOIUrl":"10.1038/s44161-026-00801-x","url":null,"abstract":"Splice-altering genetic variants are found in individuals with infantile cardiomyopathy, but the consequences are unclear. A study now shows that aberrant splicing of only one exon in the AARS2 gene can cause devastating heart development defects, phenocopying patient congenital cardiomyopathy.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 4","pages":"284-285"},"PeriodicalIF":10.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147721057","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"50 years of apheresis for homozygous familial hypercholesterolemia","authors":"Gilbert R. Thompson, Jaimini Cegla","doi":"10.1038/s44161-026-00805-7","DOIUrl":"10.1038/s44161-026-00805-7","url":null,"abstract":"Apheresis, introduced 50 years ago, remains a crucial therapy for homozygous familial hypercholesterolemia, a rare gene disorder that causes extreme LDL-cholesterol levels and early cardiovascular death. This Comment also honors the late professor Thompson, a pioneer of apheresis, whose work helped to shape the field.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 5","pages":"383-384"},"PeriodicalIF":10.8,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147719020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zhuoming Zhou, Wei Chen, Haojie Yu, Ira Tabas, Roger SY Foo, Wei Tao
{"title":"mRNA medicine for cardiovascular disease","authors":"Zhuoming Zhou, Wei Chen, Haojie Yu, Ira Tabas, Roger SY Foo, Wei Tao","doi":"10.1038/s44161-026-00804-8","DOIUrl":"10.1038/s44161-026-00804-8","url":null,"abstract":"Cardiovascular disease (CVD) remains the leading cause of global mortality, prompting urgent efforts to explore novel therapeutic approaches. The remarkable success of mRNA technology brings new possibilities for CVD treatment, with numerous preclinical studies establishing proof-of-concept, and several have advanced into clinical trials. Leveraging cumulative experience in mRNA therapeutics, improved understanding of cardiovascular pathophysiology and developments in nanotechnology, genome editing and RNA synthetic biology, mRNA medicine presents promising opportunities for addressing CVDs. Here, we provide an overview of the advancements of mRNA-based biotechnologies for CVDs, including mRNA modifications, mRNA delivery platforms, mRNA-encoded genomic and epigenomic editing, and mRNA-based chimeric antigen receptors for immune cell engineering. We also summarize preclinical and clinical applications of mRNA medicine in various CVDs, including hypercholesterolemia, atherosclerosis, ischemic cardiac injury, cardiac fibrosis and cardiac amyloidosis. Finally, we discuss the challenges and highlight the future directions for bench-to-bedside translation of mRNA technology in the field of CVDs. Zhou et al. review recent technological advances in mRNA-based biotechnologies for cardiovascular disease, examining preclinical applications, clinical trial outcomes, and the key challenges and future directions of these approaches.","PeriodicalId":74245,"journal":{"name":"Nature cardiovascular research","volume":"5 4","pages":"291-307"},"PeriodicalIF":10.8,"publicationDate":"2026-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147693738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}