# Targeting Mek/Erk Signaling in the Treatment of Mitral Valve Prolapse

> **NIH NIH F31** · MEDICAL UNIVERSITY OF SOUTH CAROLINA · 2022 · $45,618

## Abstract

ABSTRACT
Mitral valve prolapse (MVP) is one of the most common forms of cardiac valve disease, affecting 1 in 40
humans and ~70% of small breed dogs. There are no effective nonsurgical treatments for MVP and
therapeutic efforts have been hindered due to an incomplete understanding of its fundamental causes. Recent
studies by our group have described the genetic basis for non-syndromic MVP and have provided new insights
into molecular processes that underlie the disease. We have used this genetic information to identify druggable
targets that can provide a non-surgical option for humans. In particular, we have identified the Mek/Erk
pathway as the major disease initiating pathway and prolonged hyperactivation of Mek/Erk drives disease
progression and severity. Activation of the Mek/Erk pathway leads to increased proliferation, aberrant
differentiation, and production of matrix metallopeptidases (MMPs). Thus, we hypothesize that
pharmacological blockade of Mek/Erk activities will sufficiently arrest the disease pathway and
maintain the valves in a sub-clinical condition. This hypothesis will be tested by screening novel and FDA-
approved mitogen-activated protein kinase kinase (MEK1) inhibitors in vitro (Aim 1) and in vivo (Aim 2). Aim 1
of this proposal involves an in vitro screen of MEK1 inhibitors using canine MVP and human mitral valve
interstitial cells, as well as performing enzyme kinetics using non-activated MEK1 protein. MEK1 is an
attractive therapeutic target within the Mek/Erk signaling pathway. MEK1 inhibitors are well-tolerated and FDA-
approved for melanoma, non-small cell lung cancer (NSCLC), and colorectal cancer (CRC); however, every
single MEK1 inhibitor, both FDA-approved and in clinical trials, interacts with major cytochromes and/or suffers
from deleterious off-target side-effects. Our group has identified novel, highly selective, MEK1 inhibitors that
exhibit exceptional docking scores in silico and do not inhibit major cytochromes. Thus, in Aim 1 we will test the
hypothesis that superior MEK1 inhibitors can be developed using computer-aided drug design. In Aim 2, we
will assess the efficacy of MEK1 drug treatment in mouse and canine MVP patients. In experiment 1, we will
administer both novel and FDA-approved MEK1 inhibitors to Dzip1S24R/+ mice; a disease model that
phenocopies human MVP. Readouts will include: functional measurements obtained from mouse
echocardiography; quantification of valve volume; histopathology, and RNA-sequencing. In experiment 2, we
plan to test our hypothesis with a double-blinded, placebo-controlled clinical trial with 40 dogs with stage B1
MVP in each arm (placebo or trametinib). Readouts will include echocardiography, complete blood count,
serum chemistry, NT-proBNP, and high sensitivity cardiac troponin (hs-cTnI). Results from this study may
serve as a stepping stone towards developing the first non-surgical treatment for human patients with MVP. In
addition to developing a better understand of ...

## Key facts

- **NIH application ID:** 10450643
- **Project number:** 5F31HL158243-02
- **Recipient organization:** MEDICAL UNIVERSITY OF SOUTH CAROLINA
- **Principal Investigator:** Tyler Beck
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $45,618
- **Award type:** 5
- **Project period:** 2021-07-01 → 2024-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10450643

## Citation

> US National Institutes of Health, RePORTER application 10450643, Targeting Mek/Erk Signaling in the Treatment of Mitral Valve Prolapse (5F31HL158243-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10450643. Licensed CC0.

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