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<p>Atrial fibrillation and the risk of its lethal complications are propelled by fibrosis, which induces electrical heterogeneity and gives rise to reentry circuits. Atrial TREM2<sup>+</sup> macrophages secrete osteopontin (encoded by <i>Spp1</i>), a matricellular signaling protein that engenders fibrosis, inflammation, and atrial fibrillation. Here we developed an antibody–siRNA conjugate (ARC) drug candidate to silence <i>Spp1</i>. The ARC relies on an anti-TREM2 antibody for delivering <i>Spp1</i>-targeted siRNA to a pathogenic macrophage subset that expands in human atrial fibrillation. The ARC preferentially targeted atrial TREM2<sup>+</sup> macrophages with limited uptake by other immune or stromal cells of the heart. We observed efficient silencing of the target gene in human myocardium and in mice, where it reduced pro-fibrotic fibroblast activation and atrial fibrosis. Four weeks of systemic ARC treatment suppressed inducible atrial fibrillation in mice exposed to clinically prevalent risk factors. These results suggest that macrophage subset targeting offers a viable immunomodulatory strategy for atrial fibrillation.</p>

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Therapeutic Spp1 silencing in TREM2+ cardiac macrophages suppresses atrial fibrillation

  • 期刊论文

  • 发表日期：

    2026年4月23日

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  • Noor Momin,
  • Steffen Pabel,
  • Arnab Rudra,
  • Nina Kumowski,
  • I-Hsiu Lee,
  • Hana Seung,
  • Kyle I. Mentkowski,
  • Aneesh Bapat,
  • Masahiro Yamazoe,
  • Laura Stengel,
  • Charlotte G. Muse,
  • Alexandre Paccalet,
  • Farid F. Kadyrov,
  • Cristina González-Correa,
  • Emily Jacobs,
  • Ellie Feng,
  • Jisoo Park,
  • Jana Grune,
  • Maximilian J. Schloss,
  • Samuel Sossalla,
  • Gregory Wojtkiewicz,
  • Yoshiko Iwamoto,
  • Patrick McMullen,
  • Richard N. Mitchell,
  • Patrick T. Ellinor,
  • Daniel G. Anderson,
  • Kamila Naxerova,
  • Matthias Nahrendorf,
  • Maarten Hulsmans

摘要

Atrial fibrillation and the risk of its lethal complications are propelled by fibrosis, which induces electrical heterogeneity and gives rise to reentry circuits. Atrial TREM2+ macrophages secrete osteopontin (encoded by Spp1), a matricellular signaling protein that engenders fibrosis, inflammation, and atrial fibrillation. Here we developed an antibody–siRNA conjugate (ARC) drug candidate to silence Spp1. The ARC relies on an anti-TREM2 antibody for delivering Spp1-targeted siRNA to a pathogenic macrophage subset that expands in human atrial fibrillation. The ARC preferentially targeted atrial TREM2+ macrophages with limited uptake by other immune or stromal cells of the heart. We observed efficient silencing of the target gene in human myocardium and in mice, where it reduced pro-fibrotic fibroblast activation and atrial fibrosis. Four weeks of systemic ARC treatment suppressed inducible atrial fibrillation in mice exposed to clinically prevalent risk factors. These results suggest that macrophage subset targeting offers a viable immunomodulatory strategy for atrial fibrillation.