Disease Modeling and Phenotypic Drug Screening for Diabetic Cardiomyopathy using Human Induced Pluripotent Stem Cells

Diabetic cardiomyopathy is a complication of type 2 diabetes, with known contributions of lifestyle and genetics. We develop environmentally and genetically driven in vitro models of the condition using human-induced-pluripotent-stem-cell-derived cardiomyocytes. First, we mimic diabetic clinical chemistry to induce a phenotypic surrogate of diabetic cardiomyopathy, observing structural and functional disarray. Next, we consider genetic effects by deriving cardiomyocytes from two diabetic patients with variable disease progression. The cardiomyopathic phenotype is recapitulated in the patient-specific cells basally, with a severity dependent on their original clinical status. These models are incorporated into successive levels of a screening platform, identifying drugs that preserve cardiomyocyte phenotype in vitro during diabetic stress. In this work, we present a patient-specific induced pluripotent stem cell (iPSC) model of a complex metabolic condition, showing the power of this technique for discovery and testing of therapeutic strategies for a disease with ever-increasing clinical significance. [Display omitted] •Diabetic cardiomyopathy can be induced in vitro by environmental or genetic means•Diabetic patient-specific cardiomyocytes show baseline cardiomyopathy•The extent of patient-specific cardiomyopathy is clinically correlated•Phenotypic screening identifies drugs that rescue the disease phenotype Diabetes causes pathological remodeling of cardiac muscle, which impairs heart function. Drawnel et al. use induced-pluripotent-stem-cell-derived cardiomyocytes to develop environmental and patient-specific in vitro models recapitulating the condition. These models are harnessed in a phenotypic screening assay that identifies candidate protective molecules.