Desmosomal dysfunction due to mutations in desmoplakin causes arrhythmogenic right ventricular dysplasia/cardiomyopathy

Zhao Yang, Neil E. Bowles, Steven E. Scherer, Michael D. Taylor, Debra L. Kearney, Shuping Ge, Vyacheslav V. Nadvoretskiy, Gilberto DeFreitas, Blasé Carabello, Lois I. Brandon, Lisa M. Godsel, Kathleen J. Green, Jeffrey E. Saffitz, Hua Li, Gian Antonio Danieli, Hugh Calkins, Frank Marcus, Jeffrey A. Towbin*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

217 Scopus citations


Arrhythmogenic right ventricular dysplasia/cardiomyopathy (ARVD/C) is characterized by progressive degeneration of the right ventricular myocardium, ventricular arrhythmias, fibrous-fatty replacement, and increased risk of sudden death. Mutations in 6 genes, including 4 encoding desmosomal proteins (Junctional plakoglobin (JUP), Desmoplakin (DSP), Plakophilin 2, and Desmoglein 2), have been identified in patients with ARVD/C. Mutation analysis of 66 probands identified 4 variants in DSP; V30M, Q90R, W233X, and R2834H. To establish a cause and effect relationship between those DSP missense mutations and ARVD/C, we performed in vitro and in vivo analyses of the mutated proteins. Unlike wild-type (WT) DSP, the N-terminal mutants (V30M and Q90R) failed to localize to the cell membrane in desomosome-forming cell line and failed to bind to and coimmunoprecipitate JUP. Multiple attempts to generate N-terminal DSP (V30M and Q90R) cardiac-specific transgenes have failed: analysis of embryos revealed evidence of profound ventricular dilation, which likely resulted in embryonic lethality. We were able to develop transgenic (Tg) mice with cardiac-restricted overexpression of the C-terminal mutant (R2834H) or WT DSP. Whereas mice overexpressing WT DSP had no detectable histologic, morphological, or functional cardiac changes, the R2834H-Tg mice had increased cardiomyocyte apoptosis, cardiac fibrosis, and lipid accumulation, along with ventricular enlargement and cardiac dysfunction in both ventricles. These mice also displayed interruption of DSP-desmin interaction at intercalated discs (IDs) and marked ultra-structural changes of IDs. These data suggest DSP expression in cardiomyocytes is crucial for maintaining cardiac tissue integrity, and DSP abnormalities result in ARVD/C by cardiomyocyte death, changes in lipid metabolism, and defects in cardiac development.

Original languageEnglish (US)
Pages (from-to)646-655
Number of pages10
JournalCirculation research
Issue number6
StatePublished - Sep 2006


  • Arrhythmogenic right ventricular dysplasia/cardiomyopathy
  • Gene mutations
  • Mechanical junctions

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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