Nature Communications (Jan 2024)

DNMT3A clonal hematopoiesis-driver mutations induce cardiac fibrosis by paracrine activation of fibroblasts

  • Mariana Shumliakivska,
  • Guillermo Luxán,
  • Inga Hemmerling,
  • Marina Scheller,
  • Xue Li,
  • Carsten Müller-Tidow,
  • Bianca Schuhmacher,
  • Zhengwu Sun,
  • Andreas Dendorfer,
  • Alisa Debes,
  • Simone-Franziska Glaser,
  • Marion Muhly-Reinholz,
  • Klara Kirschbaum,
  • Jedrzej Hoffmann,
  • Eike Nagel,
  • Valentina O. Puntmann,
  • Sebastian Cremer,
  • Florian Leuschner,
  • Wesley Tyler Abplanalp,
  • David John,
  • Andreas M. Zeiher,
  • Stefanie Dimmeler

DOI
https://doi.org/10.1038/s41467-023-43003-w
Journal volume & issue
Vol. 15, no. 1
pp. 1 – 20

Abstract

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Abstract Hematopoietic mutations in epigenetic regulators like DNA methyltransferase 3 alpha (DNMT3A), play a pivotal role in driving clonal hematopoiesis of indeterminate potential (CHIP), and are associated with unfavorable outcomes in patients suffering from heart failure (HF). However, the precise interactions between CHIP-mutated cells and other cardiac cell types remain unknown. Here, we identify fibroblasts as potential partners in interactions with CHIP-mutated monocytes. We used combined transcriptomic data derived from peripheral blood mononuclear cells of HF patients, both with and without CHIP, and cardiac tissue. We demonstrate that inactivation of DNMT3A in macrophages intensifies interactions with cardiac fibroblasts and increases cardiac fibrosis. DNMT3A inactivation amplifies the release of heparin-binding epidermal growth factor-like growth factor, thereby facilitating activation of cardiac fibroblasts. These findings identify a potential pathway of DNMT3A CHIP-driver mutations to the initiation and progression of HF and may also provide a compelling basis for the development of innovative anti-fibrotic strategies.