# Cardiac Sarcomere Protein Quality Control in Health and Disease

> **NIH NIH R01** · LOYOLA UNIVERSITY CHICAGO · 2022 · $539,215

## Abstract

Cardiomyocytes are essentially non-renewing, so proteotoxicity from dysregulated Protein
Quality Control (PQC) is intimately associated with heart failure. The proteins that comprise the
cardiac sarcomere are responsible for force generation in the myocyte, and this constant mechanical
stress uniquely predisposes them to misfolding. Despite PQC’s central role in heart failure, and the
particular vulnerability of the sarcomere to misfolding, the PQC mechanisms that maintain the
cardiac sarcomere are almost entirely unknown. This is a critical knowledge gap that we will
address in this proposal. Our past work described a z-disc localized complex, anchored by the co-
chaperone Bcl2-associated athanogene-3 (BAG3), that was essential for sarcomere PQC. Z-disc
BAG3 levels were depressed in human heart failure (HF) and correlated with decreased sarcomeric
force-generating capacity (Fmax). Similarly, cardio-myocyte specific inducible BAG3 KO mice had
increased ubiquitination of sarcomeric proteins that remained integrated in the lattice, reducing force
generation. Importantly, BAG3 gene therapy in a mouse HF model reversed this phenotype,
indicating the potential of targeting sarcomere PQC to improve contractile function. In this renewal we
will address the central hypothesis that sarcomere PQC occurs via sarcomere-localized pathways
and depression of these systems in HF due to BAG3 instability results in accumulation of
ubiquitinated proteins that induce dysfunction. In Aim 1 we will Explore the spatiotemporal
organization of the key steps in sarcomere PQC. We will use super-resolution live cell imaging in
neonatal rat ventricular myocytes (NRVMs) and human iPSC-CMs to visualize the spatiotemporal
interplay between BAG3, autophagosomes, lysosomes, the z-disc, and BAG3-clients at baseline and
in response to various stress and stimuli, such as heat shock, localized laser damage, hypertrophic
signaling, and depressed BAG3 levels. In Aim 2 we will identify the functional consequences of
sarcomeric protein ubiquitination. We will use in vivo and in vitro approaches to modulate sarcomere
protein ubiquitination and assess the impact on sarcomere function with biophysical assays (force-
Ca2+ relationship, tension cost, in vitro motility assay, super-relaxed state, co-sedimentation). In Aim
3 we will discover the regulation of BAG3 in the cardiomyocyte and how it is altered in heart failure.
We will use several transgenic mouse lines and a myocardial infarction induced heart failure model,
to discover the interplay between HSP70, BAG3, heart failure, and sarcomere PQC. We expect to
identify new methods to stabilize BAG3 in the failing heart as a possible therapeutic strategy. These 3
aims establish a foundational understanding of sarcomere PQC, functional consequences of its
misregulation, and how it can be modulated in vivo.

## Key facts

- **NIH application ID:** 10445976
- **Project number:** 2R01HL136737-06
- **Recipient organization:** LOYOLA UNIVERSITY CHICAGO
- **Principal Investigator:** JONATHAN A KIRK
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $539,215
- **Award type:** 2
- **Project period:** 2017-04-01 → 2027-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10445976

## Citation

> US National Institutes of Health, RePORTER application 10445976, Cardiac Sarcomere Protein Quality Control in Health and Disease (2R01HL136737-06). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10445976. Licensed CC0.

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