Intronic regulatory sequences regulate epicardial gene expression and EMT during heart development

Abstract Background During organogenesis, cells from the outer layer of the heart, the epicardium, undergo epithelial-to-mesenchymal transition (EMT), contributing essential paracrine signals and different cell types to the growing heart. Epicardial cells are integral to heart regeneration in lower vertebrates and neonatal mammalian injured hearts. That said, prospects to harness the epicardium for therapeutic applications to effect adult heart repair, heavily depend on improved insight into its intrinsic properties during heart development. Purpose Cell fate decisions underpinning EMT are directed by transcription factors such as Wilms’ tumour 1 (WT1). Whilst a requirement for Wt1 in heart development is widely accepted, the upstream regulatory mechanisms underpinning its activation remain elusive. Our previous research has led to the identification of two intronic evolutionary conserved regions (ECRs) shared between mouse and human, located within intron 1 of the Wt1 locus, i.e. +4.0kbECR and +5.8kbECR. We hypothesised these regulatory sequences direct locus activation and EMT to support normal heart development. Methods & Results Here, we used CRISPR/Cas9 gene-editing technology to generate mice carrying a sequence deletion containing one ECR (Wt1Δ+4.0kbECR and Wt1Δ+5.8kbECR mice) or a deletion comprising both ECRs (Wt1Δ+4-5.8kbECR mouse). Extensive survival analysis, high-resolution episcopic microscopy (HREM), qPCR, immunostaining, confocal microscopy and epicardial explants were used to characterise heart formation in these models. Mendelian ratios indicated an overall underrepresentation of Wt1ΔECR/ΔECR mutants recovered in the offspring arising from heterozygous inter-crosses. HREM revealed smaller hearts, incidence of myocardial non-compaction and spongy interventricular septum with muscular or membranous ventricular septum defects, tricuspid hypoplasia and enlarged aortic valves, as well as abnormal formation/patterning of coronary artery stems in ΔECR/ΔECR hearts. Expression of Wt1 was markedly reduced in ΔECR/ΔECR hearts, but not in the kidneys, suggesting intronic enhancers are cardiac-specific. Whole-mount and tissue-section immunostaining combined with confocal microscopy revealed abnormal coronary vessel and innervation extension and patterning along the subepicardial space, as well as reduced epicardial EMT and myocardial non-compaction/hyper-trabeculation in Wt1ΔECR/ΔECR hearts. Conclusions Together, we demonstrated a requirement for novel intronic enhancers regulating Wt1 locus activity and impacting on essential epicardial EMT and associated biological processes during normal heart development. Importantly, observation of septum and aortic valve defects in ΔECR mutants suggests an hitherto unrecognised role for WT1/epicardial EMT and opens new avenues of research to improve our understanding of congenital heart disease that affects at least 1:150 live births, with remarkably two thirds of cases having unknown aetiology.