New Investigator Research Grant Program

2022-2023

Anja Karlstaedt, MD, PhD

Assistant Professor
Smidt Heart Institute, Department of Cardiology
Cedars-Sinai Medical Center

Research project

Cardiovascular Remodeling in Leukemia

Summary

Cardiovascular disease and cancer are the two leading causes of morbidity and mortality in the world. Patients and cancer survivors of acute myeloid leukemia are at an increased risk of dying from heart failure. Therefore, a mechanistic understanding of the fundamental biological processes that are central to driving remodeling in the heart are desperately needed. Metabolic alterations contribute to disease progression during leukemia. Our study seeks to characterize these metabolic alterations, understand how they compromise cardiac function, develop models of leukemia to study metabolism in vivo and design targeted therapies to prevent cardiac remodeling and restore normal cardiac contractile function. Our lab uses metabolic flux analysis and computational tools to study how leukemic cells impact cardiac energy substrate metabolism and protein synthesis. We will generate models of acute myeloid leukemia in mice targeting two common mutations that impair cellular energy provision and epigenetic regulation. Using this innovative model system we will mechanistically dissect how leukemic cells impair cardiac metabolism and promote structural remodeling. Our study offers the unique opportunity for cross-disciplinary interaction between a diverse team of cardiology and oncology experts and the application of cutting-edge technology to elucidate oncometabolic remodeling in the heart. Ultimately these findings will improve risk stratification and therapy for cancer patients.

Impact

Our studies have uncovered a novel concept: metabolic crosstalk between myeloid cancer cells and the heart drives heart failure.

Research on cancer-associated cardiomyopathies and heart failure has focused on the toxicities of chemotherapeutic agents, including during acute myeloid leukemia (AML). Our work uncovered that myeloid TET2 and IDH2 mutations disrupt cardiac metabolism and promote structural remodeling. We are now advancing these findings to elucidate links between metabolic and epigenetic regulation. Our goal is to reveal how TET2 and IDH2 mutations affect gene expression and impair activity of critical metabolic functions in the heart. These studies will expose more effective treatment options for cancer patients with heart failure.

Intriguingly, our studies revealed sexual dimorphism. Our understanding of cardiovascular risk in women stems from predominantly descriptive data despite decades-long efforts to improve preclinical and clinical information. Based on our findings we have now designed experiments that will uncover the role of sex as a biological variable in the context of heart failure during leukemia.

Publication

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Leukemia Research Foundation grant
$100K awarded in 2022

Disease focus
Acute myeloid leukemia (AML)

Research focus
Cancer cell biology (microenvironment)