Oxytocin Mediates Neuroendocrine Reprogramming Of The Epicardium In Heart Regeneration

Cardiovascular disease (CVD) is the leading cause of mortality both in the United States and worldwide. CVD often results in the massive loss of contractile cardiac cells and tissue. Critical work in the last two decades demonstrates that lost cells can be partially replenished by the epicardium, the outermost mesothelial layer of the heart. Upon cardiac injury, mature epicardial cells activate and undergo epithelial-mesenchymal transition (EMT) to form epicardium-derived progenitor cells (EPDCs), which are a type of multipotent stem cell that can differentiate into several important cardiac lineages, including cardiomyocytes and vascular cells. This process alone is insufficient for significant regeneration, but its efficiency can be improved by priming with specific factors (e.g., thymosin beta-4). Our group has recently discovered evidence that oxytocin (OT), a hypothalamic neuroendocrine peptide, induces a pro-regenerative phenotype in vitro in human induced pluripotent stem cell (iPSC) derived epicardial cells. We hypothesize that upon cardiac injury, oxytocin is released into the bloodstream, causing activation of the epicardium and mobilization of EPDCs to elicit regeneration of damaged tissue and restoration of function. Here, we show that we can differentiate mature, high-quality epicardial cells from iPSCs and that Ki67 levels and cell counts increase after three days of OT exposure. In addition, the peptide alters gene expression levels of several epithelial, mesenchymal, and EMT markers, indicating a transition to a dedifferentiated gene profile characteristic of EPDCs. Finally, when OT is administered intravenously to mice, it accelerates healing from cardiac injury by inducing epicardial activation. Future studies will aim to further reveal the physiological contribution of OT to heart regeneration in vivo and determine its molecular mechanism of action. Our findings have the potential to uncover a novel mechanism of neuroendocrine reprogramming of the injured heart and yield significant translational advances in the treatment of CVD.