LAUSR

The bromodomain and extraterminal (BET) family of epigenetic reader proteins are key regulators of inflammatory and hypertrophic gene expression in the heart. We previously identified the activation of pro-inflammatory gene networks as a key early driver of dilated cardiomyopathy (DCM) in transgenic mice expressing a mutant form of phospholamban (PLNR9C) - a genetic cause of DCM in humans. We hypothesized that BETs coactivate this inflammatory process, representing a critical node in the progression of DCM. To test this hypothesis, PLNR9C or age-matched wild type mice were treated longitudinally with the small molecule BET bromodomain inhibitor JQ1 or vehicle. BET inhibition abrogated adverse cardiac remodeling, reduced cardiac fibrosis, and prolonged survival in PLNR9C mice by inhibiting expression of pro-inflammatory gene networks at all stages of disease. Specifically, JQ1 had profound effects on pro-inflammatory gene network expression in cardiac fibroblasts, while having little effect on gene expression in cardiomyocytes. Cardiac fibroblast proliferation was also substantially reduced by JQ1. Mechanistically, we demonstrated that BRD4 serves as a direct and essential regulator of NFkB-mediated pro-inflammatory gene expression in cardiac fibroblasts. Interdicting pro-inflammatory gene expression via BET bromodomain inhibition could be a novel therapeutic strategy for chronic DCM in humans.