Relaxin independent cardio protection by cardiomyocyte-specific RXFP1-overexpression

https://doi.org/10.1007/s00392-025-02625-4

Julia Wingert (Heidelberg)1, E. Meinhardt (Heidelberg)1, N. Sasipong (Heidelberg)1, M. Pott (Heidelberg)1, P. Most (Heidelberg)2, H. A. Katus (Heidelberg)1, N. Frey (Heidelberg)1, P. Raake (Augsburg)3, P. Schlegel (Heidelberg)1

1Universitätsklinikum Heidelberg Klinik für Innere Med. III, Kardiologie, Angiologie u. Pneumologie Heidelberg, Deutschland; 2Universitätsklinikum Heidelberg Innere Medizin III, Inst. für Molekulare und Translationale Kardiologie Heidelberg, Deutschland; 3Universitätsklinikum Augsburg I. Medizinische Klinik Augsburg, Deutschland

 

Objective:
Cardiomyocyte (CM)-specific overexpression of Relaxin-receptor 1 (RXFP1), along with additional Relaxin (RLN) supplementation, significantly attenuates heart failure (HF) in a pressure-overload model induced by transverse aortic constriction (TAC).
Transgenic mice with high levels of CM-specific overexpression of human RXFP1 (hRXFP1tg) exhibit protection from TAC-induced HF even in the absence of exogenous RLN supplementation. This finding suggests a potential RXFP1 receptor activity that occurs even without its cognate ligand. To further investigate this hypothesis, a RLN knockout model was employed to examine the role of endogenous RLN in receptor activation and its effects on heart failure progression.

Methods and results:
Transgenic mice with a systemic RLN-knockout (RLNko) were generated. hRXFP1tg were cross bred with RLNko to generate transgenics with a CM-specific overexpression of human RXFP1 in the absence of systemic RLN (hRXtg/RLNko).
To evaluate cardioprotective RXFP1 effects in the absence of endogenous RLN, hRXtg/RLNko and RLNko controls were subjected to TAC. CM-specific RXFP1 overexpression protects from TAC-induced pressure overload even in the absence of systemic RLN, with TAC/hRXtg/RLNko presenting not only less decline in systolic left ventricular (LV) function but also abrogated LV dilation and cardiac hypertrophy compared to TAC/RLNko mice. Molecularly, TAC/hRXtg/RLNko hearts showed attenuated activation of the fetal gene program as well as less CM hypertrophy in histological sections compared to TAC/RLNko hearts.
Additionally, we observed attenuated activation of fetal genes in hRXtg/RLNko compared to RLNko. This aligns with previous findings that RLNko induces cardiac fibrosis, supporting the notion that the absence of endogenous RLN serves as a pathological stimulus that could be mitigated by hRXFP1 overexpression.

Conclusion:
CM-specific RXFP1 overexpression protects from TAC-induced HF even in the absence of systemic RLN, suggesting an alternative mechanism of receptor activation through intrinsic activity, alternative endogenous ligands or crosstalk with other receptors.

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