Elife. 2017 Dec 12;6. pii: e29330. doi: 10.7554/eLife.29330.

Glucose inhibits cardiac muscle maturation through nucleotide biosynthesis.

Nakano H¹, Minami I², Braas D³, Pappoe H¹, Wu X⁴, Sagadevan A¹, Vergnes L⁵, Fu K¹, Morselli M¹, Dunham C⁶, Ding X⁶, Stieg AZ^7,8, Gimzewski JK^6,7,8,9, Pellegrini M^1,9,10, Clark PM^3,9,11, Reue K^5,10, Lusis AJ^4,5,10,12, Ribalet B¹³, Kurdistani SK^9,10,14,15, Christofk H^3,10,14,15, Nakatsuji N^2,16, Nakano A^1,9,10,15.

Abstract

The heart switches its energy substrate from glucose to fatty acids at birth, and maternal hyperglycemia is associated with congenital heart disease. However, little is known about how blood glucose impacts heart formation. Using a chemically defined human pluripotent stem-cell-derived cardiomyocyte differentiation system, we found that high glucose inhibits the maturation of cardiomyocytes at genetic, structural, metabolic, electrophysiological, and biomechanical levels by promoting nucleotide biosynthesis through the pentose phosphate pathway. Blood glucose level in embryos is stable in utero during normal pregnancy, but glucose uptake by fetal cardiac tissue is drastically reduced in late gestational stages. In a murine model of diabetic pregnancy, fetal hearts showed cardiomyopathy with increased mitotic activity and decreased maturity. These data suggest that high glucose suppresses cardiac maturation, providing a possible mechanistic basis for congenital heart disease in diabetic pregnancy.