Cardiac Reprogramming Factors Synergistically Activate Genome-wide Cardiogenic Stage-Specific Enhancers

Hisayuki Hashimoto, Zhaoning Wang, Glynnis A. Garry, Venkat S. Malladi, Giovanni A. Botten, Wenduo Ye, Huanyu Zhou, Marco Osterwalder, Diane E. Dickel, Axel Visel, Ning Liu, Rhonda Bassel-Duby, Eric N. Olson

Research output: Contribution to journalArticlepeer-review

57 Citations (Scopus)


The cardiogenic transcription factors (TFs) Mef2c, Gata4, and Tbx5 can directly reprogram fibroblasts to induced cardiac-like myocytes (iCLMs), presenting a potential source of cells for cardiac repair. While activity of these TFs is enhanced by Hand2 and Akt1, their genomic targets and interactions during reprogramming are not well studied. We performed genome-wide analyses of cardiogenic TF binding and enhancer profiling during cardiac reprogramming. We found that these TFs synergistically activate enhancers highlighted by Mef2c binding sites and that Hand2 and Akt1 coordinately recruit other TFs to enhancer elements. Intriguingly, these enhancer landscapes collectively resemble patterns of enhancer activation during embryonic cardiogenesis. We further constructed a cardiac reprogramming gene regulatory network and found repression of EGFR signaling pathway genes. Consistently, chemical inhibition of EGFR signaling augmented reprogramming. Thus, by defining epigenetic landscapes these findings reveal synergistic transcriptional activation across a broad landscape of cardiac enhancers and key signaling pathways that govern iCLM reprogramming. Hashimoto and colleagues show that reprogramming factors act in concert at cardiac regulatory elements to directly reprogram mouse fibroblasts into induced cardiac-like myocytes (iCLMs). Moreover, cardiac reprogramming is achieved by activation of endogenous cardiac enhancers that initiate a cardiogenic gene regulatory network.

Original languageEnglish
Pages (from-to)69-86.e5
JournalCell stem cell
Issue number1
Publication statusPublished - 2019 Jul 3


  • Akt1
  • Gata4
  • Hand2
  • Mef2c
  • Tbx5
  • cardiomyocytes
  • direct reprogramming
  • heart regeneration
  • induced cardiac-like myocytes

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Cell Biology


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