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Peer-reviewedCC BYCell death & disease

Inhibition of lactate-histone lactylation mediated cardiomyocyte-fibroblast communication mitigates cardiac fibrosis in cardiomyopathy models with Hippo pathway activation.

5 more authors
12 affiliations
  1. 1School of Nursing and Rehabilitation, Xi'an Medical University, Xi'an, China.
  2. 2Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.
  3. 3Department of Cell Biology and Genetics, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.
  4. 4Department of Pathology, Xi'an Guangren Hospital, Affiliated to Xi'an Jiaotong University Health Science Center, Xi'an, China.
  5. 5Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
  6. 6Cardiovascular Research Centre, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.
  7. 7Department of Cell Biology and Molecular Medicine, Rutgers New Jersey Medical School, Newark, USA.
  8. 8Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China. [email protected].
  9. 9Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China. [email protected].
  10. 10Baker Heart and Diabetes Institute, Melbourne, Australia. [email protected].
  11. 11Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China. [email protected].
  12. 12Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China. [email protected].

Abstract

Metabolic remodeling is a fundamental mechanism that underlies cardiomyopathy and heart failure. Preclinical and clinical studies in diverse types of heart disease have provided evidence for the activation of the myocardial Hippo pathway and that cardiomyocyte-specific Hippo pathway activation or YAP-TEAD1 inactivation drives cardiomyocyte mitochondrial damage, metabolic abnormalities and fibrosis. Here we studied whether intervention of myocardial lactate metabolism have therapeutic effect on cardiac fibrosis in cardiomyopathy models. In a Hippo pathway-activated mouse model (Mst1-cTG), single-nucleus RNA-sequencing (snRNA-seq) revealed activated fibroblasts while cardiomyocytes displayed downregulation of gene sets of mitochondrial metabolism and augmented HIF-1 signaling. Seahorse assay in isolated cardiomyocytes from adult TG mice showed impaired oxidative respiratory capacity together with enhanced glycolysis and lactate production. In TG mouse myocardium, fibroblast histone H3 lysine 18 lactylation (H3K18la), regulated by p300, was elevated starting from young age. By CUT&Tag, H3K18la was found to be enriched in promoter regions of numerous fibrotic genes with enhanced transcription. Treatment of TG mice with inhibitors to suppress either glycolysis (PX-478 as HIF-1α inhibitor) or lactate production (FX-11 as LDHA inhibitor) reduced both myocardial lactate content and H3K18la level, and ameliorated cardiac fibrosis and dysfunction. Similar efficacy was achieved in vitro or in vivo by fibroblast p300 knockdown using siRNA or AAV9. Treatment with FX-11 was similarly effective in inhibiting histone lactylation and fibrosis in mice subjected to chronic ischemia-reperfusion. Finally, we integrated our snRNA-seq and CUT&Tag studies to identify RUNX2 as a crucial transcription factor that promotes fibrotic gene expression in concert with H3K18la levels. Treatment with RUNX2 inhibitor CADD522 in TG mice improved heart dysfunction and fibrosis. In the setting of myocardial Hippo pathway activation, inhibiting the lactate-histone lactylation-RUNX2 axis effectively attenuated cardiac fibrosis. Myocardial Hippo pathway activation promotes the production and release of lactate that acts in a paracrine signaling fashion to activate fibroblasts through upregulation of fibroblast H3K18la and enhancing the enrichment of RUNX2 to the promoter regions of fibrotic genes with enhanced gene transcription, ultimately leading to cardiac fibrosis. Suppressing the lactate-histone lactylation-RUNX2 axis is protective against cardiac fibrosis.

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BibTeX
@article{jia2026inhibition,
  title = {{Inhibition of lactate-histone lactylation mediated cardiomyocyte-fibroblast communication mitigates cardiac fibrosis in cardiomyopathy models with Hippo pathway activation.}},
  author = {Li-Ye Jia and Xia-Xia Hai and Zhi-Qiang Wu and Jing-Jing Li and Yi-Yi Yang and Meng-Chen Hou and Lin-Hong Wu and Meng-Zhuan Han and Yi Zhang and Yungang Xu and Jie Deng and Bao-Chang Lai and Junichi Sadoshima and Xiu-Ling Deng and Zheng-Da Pang and Xiao-Jun Du and Gang She},
  journal = {Cell death \& disease},
  year = {2026},
  month = aug,
  doi = {10.1038/s41419-026-09137-7},
  url = {https://europepmc.org/article/MED/42957636},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Inhibition of lactate-histone lactylation mediated cardiomyocyte-fibroblast communication mitigates cardiac fibrosis in cardiomyopathy models with Hippo pathway activation.
AU  - Li-Ye Jia
AU  - Xia-Xia Hai
AU  - Zhi-Qiang Wu
AU  - Jing-Jing Li
AU  - Yi-Yi Yang
AU  - Meng-Chen Hou
AU  - Lin-Hong Wu
AU  - Meng-Zhuan Han
AU  - Yi Zhang
AU  - Yungang Xu
AU  - Jie Deng
AU  - Bao-Chang Lai
AU  - Junichi Sadoshima
AU  - Xiu-Ling Deng
AU  - Zheng-Da Pang
AU  - Xiao-Jun Du
AU  - Gang She
PY  - 2026
DA  - 2026/08/01
JO  - Cell death & disease
DO  - 10.1038/s41419-026-09137-7
UR  - https://europepmc.org/article/MED/42957636
AB  - Metabolic remodeling is a fundamental mechanism that underlies cardiomyopathy and heart failure. Preclinical and clinical studies in diverse types of heart disease have provided evidence for the activation of the myocardial Hippo pathway and that cardiomyocyte-specific Hippo pathway activation or YAP-TEAD1 inactivation drives cardiomyocyte mitochondrial damage, metabolic abnormalities and fibrosis. Here we studied whether intervention of myocardial lactate metabolism have therapeutic effect on cardiac fibrosis in cardiomyopathy models. In a Hippo pathway-activated mouse model (Mst1-cTG), single-nucleus RNA-sequencing (snRNA-seq) revealed activated fibroblasts while cardiomyocytes displayed downregulation of gene sets of mitochondrial metabolism and augmented HIF-1 signaling. Seahorse assay in isolated cardiomyocytes from adult TG mice showed impaired oxidative respiratory capacity together with enhanced glycolysis and lactate production. In TG mouse myocardium, fibroblast histone H3 lysine 18 lactylation (H3K18la), regulated by p300, was elevated starting from young age. By CUT&Tag, H3K18la was found to be enriched in promoter regions of numerous fibrotic genes with enhanced transcription. Treatment of TG mice with inhibitors to suppress either glycolysis (PX-478 as HIF-1α inhibitor) or lactate production (FX-11 as LDHA inhibitor) reduced both myocardial lactate content and H3K18la level, and ameliorated cardiac fibrosis and dysfunction. Similar efficacy was achieved in vitro or in vivo by fibroblast p300 knockdown using siRNA or AAV9. Treatment with FX-11 was similarly effective in inhibiting histone lactylation and fibrosis in mice subjected to chronic ischemia-reperfusion. Finally, we integrated our snRNA-seq and CUT&Tag studies to identify RUNX2 as a crucial transcription factor that promotes fibrotic gene expression in concert with H3K18la levels. Treatment with RUNX2 inhibitor CADD522 in TG mice improved heart dysfunction and fibrosis. In the setting of myocardial Hippo pathway activation, inhibiting the lactate-histone lactylation-RUNX2 axis effectively attenuated cardiac fibrosis. Myocardial Hippo pathway activation promotes the production and release of lactate that acts in a paracrine signaling fashion to activate fibroblasts through upregulation of fibroblast H3K18la and enhancing the enrichment of RUNX2 to the promoter regions of fibrotic genes with enhanced gene transcription, ultimately leading to cardiac fibrosis. Suppressing the lactate-histone lactylation-RUNX2 axis is protective against cardiac fibrosis.
SN  - 2041-4889
ER  -