# Endoglin: A New Target of Therapy for Heart Failure

> **NIH NIH R01** · TUFTS MEDICAL CENTER · 2020 · $456,796

## Abstract

This new early stage investigator RO1 proposal explores new mechanisms regulating cardiac fibrosis, a major
cause of morbidity and mortality for patients with heart failure (HF) Based on exciting new data generated with
support from the NIH-KO8 program, we will explore a new mechanism for the role of endoglin, an auxiliary
receptor for the pro-fibrogenic cytokine transforming growth factor beta (TGFb1), as a mediator of maladaptive
cardiac remodeling. The PI is an advanced HF specialist, whose laboratory studies molecular mechanisms
regulating TGFb1 and endoglin activity using preclinical models of HF and human tissue. The Kapur laboratory
recently reported that endoglin facilitates TGFb1-mediated left and right ventricular (LV and RV) fibrosis, and
further, that reduced endoglin expression improves survival in models of LV and RV failure. More recent data
support that endoglin is required for signaling via bone morphogenetic protein 9 (BMP9) in endothelium,
however a role for BMP9 in HF has not been explored. The current proposal applies expertise in endoglin
biology, hemodynamics, and HF to the field of TGFb-mediated cardiac fibrosis, for which no specific therapy
currently exists. This proposal tests the novel hypothesis that endoglin promotes cardiac fibrosis by negatively
regulating BMP9, a new endogenous inhibitor of TGFb1-mediated collagen synthesis in cardiac fibroblasts,
and further that reducing endoglin activity selectively increases BMP9 abundance, thereby limiting cardiac
fibrosis and improving survival in HF. Preliminary data included in the proposal shows that 1) endoglin and
BMP9 are highly expressed by non-myocyte cell populations in the heart, 2) endoglin negatively regulates
BMP9 expression in human cardiac fibroblasts (hCF), 3) BMP9 inhibits TGFb1 mediated collagen synthesis in
hCF, 4) loss of BMP9 promotes LV fibrosis after TAC, 5) reduced endoglin activity increases BMP9 abundance
in the LV, and 6) neutralizing endoglin can reverse established cardiac fibrosis. Innovative aspects of the
proposal include: (a) the use of hCF for in vitro studies, (b) transgenic mice developed specifically to study
endoglin and BMP9 in HF, (c) pioneering techniques to study composition and mechanical properties of the
extracellular matrix, and d) studies to test the translational potential of targeting endoglin and BMP9 activity in
HF. To test this hypothesis three aims are proposed: (SA1) Determine the mechanisms underlying endoglin-
dependent regulation of BMP9 signaling in hCF; (SA2) Determine the mechanisms underlying endoglin-
dependent regulation of maladaptive remodeling in HF; (SA3) Test the utility of targeting endoglin/BMP9
activity to reverse established cardiac fibrosis in HF. This proposal explores a paradigm shifting hypothesis that
has tremendous potential to impact our basic understanding of cardiac fibroblast physiology, TGFb superfamily
signaling, and cardiac remodeling with important implications for the growing population of...

## Key facts

- **NIH application ID:** 9928486
- **Project number:** 5R01HL133215-05
- **Recipient organization:** TUFTS MEDICAL CENTER
- **Principal Investigator:** Navin Kumar Kapur
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $456,796
- **Award type:** 5
- **Project period:** 2016-06-15 → 2022-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9928486

## Citation

> US National Institutes of Health, RePORTER application 9928486, Endoglin: A New Target of Therapy for Heart Failure (5R01HL133215-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9928486. Licensed CC0.

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