After removal of the apex of their cardiac ventricle, zebrafish replace the resected myocardium
4,5. While these events involve cardiomyocyte hyperplasia, it is uncertain whether proliferating cardiomyocytes derive from existing myocytes or from non-myocyte sources like stem cells. Identifying cellular contributions to embryonic or regenerative organogenesis has typically involved genetic methods to irreversibly label different cell types and track their progeny
6–11.
While searching for molecular markers informative for regeneration, we identified a unique expression pattern driven by upstream regulatory sequences of
gata4, a transcription factor gene expressed in the developing embryonic heart and essential for normal cardiac patterning and vascularization
12–17. Through use of the
Tg(gata4:EGFP)ae1 reporter line
18, we found that EGFP fluorescence was largely absent in the uninjured adult ventricle. However, upon resection of the ventricular apex,
gata4-driven EGFP was induced in a high percentage of cells throughout the outer compact layer of ventricular myocardium during a period from 3 to 7 days post-amputation (dpa) ().
gata4:EGFP was expressed in many cells surrounding and within the injury site by 2 weeks after injury (), and was limited at all timepoints to cells positive for myocyte markers () and negative for markers of the epicardium, a vasculogenic mesothelial layer overlying the compact muscle (). BrdU labeling studies demonstrated that many
gata4:EGFP
+ cells at the lateral edges of the wound at 7 dpa, and within the wound at 14 dpa, had recently undergone DNA synthesis (). By 30 dpa, a substantial area of the regenerated ventricular wall remained labeled by
gata4:EGFP fluorescence (). At these stages,
gata4:EGFP expression predominantly labeled compact cardiomyocytes, which normally occupy a greater portion of the regenerate than inner trabecular cardiomyocytes
4. Quantification of fluorescent ventricular muscle at different stages of regeneration by histology indicated progressive redistribution of
gata4-driven EGFP expression from wound edges into the injury site (
Supplementary Fig. 2a, b).
To clarify the dynamics of these events, we generated new transgenic strains to facilitate inducible, Cre recombinase-based lineage-tracing from
gata4+ cells. We created a line with a tamoxifen-inducible Cre driven by
gata4 regulatory sequences,
Tg(gata4:ERCreER)pd39, as well as an indicator line that would permit visualization of cardiomyocyte EGFP fluorescence after excision of
loxp-flanked STOP sequences,
Tg(β-
actin2:loxP-DsRed-STOP-loxP-EGFP)s928 (β-
act2:RSG;
Supplementary Fig. 3). We injected 4-hydroxytamoxifen (4-HT) or vehicle once daily in
gata4:ERCreER; β-
act2:RSG animals from 5–7 dpa, a timepoint preceding detectable
gata4-driven EGFP fluorescence in the injury site. Injection of
gata4:ERCreER; β-
act2:RSG animals with 4-HT, but not vehicle, labeled what presumably represented a subset of myocytes that fluoresced in the
gata4:EGFP line, revealing a small number of EGFP
+ cardiomyocytes bordering the wound by 9 dpa. Moreover, contiguous regions of EGFP
+ cardiomyocytes could be detected in the injury site by 14 dpa (), representing a quantifiably significant expansion in labeled cardiac muscle at 20 dpa (
Supplementary Fig. 2a, c). These findings indicated a mechanism in which subepicardial cells throughout the ventricle respond to injury by inducing
gata4 expression, with cells near the injury site proliferating and contributing a high proportion of new cardiomyocytes.
Although confocal imaging colocalized
gata4-driven EGFP and muscle markers, it remained possible that non-myocytes induced
gata4 after injury and rapidly differentiated into proliferative cardiomyocytes. To test the extent to which existing cardiomyocytes contribute to regeneration, we created a strain in which tamoxifen-inducible Cre is driven by regulatory sequences of the contractile gene
cardiac myosin light chain 2 (
cmlc2),
Tg(cmlc2:CreER)pd10. Measurements of labeling efficiency indicated that our 4-HT injection protocol tagged ~95% of uninjured
cmlc2:CreER; β-
act2:RSG ventricular cardiomyocytes with EGFP fluorescence (
Supplementary Fig. 4). Based on analysis of several different indicator lines, labeling by
cmlc2-driven CreER was specific to cardiomyocytes (
Supplementary Fig. 5), and was not instigated by injury or vehicle injection (). Five days after labeling cardiomyocytes, we resected ventricular apices and allowed 30 days of regeneration. We found no significant difference in the proportion of EGFP
+ cardiomyocytes in regenerated
cmlc2:CreER; β-
act2:RSG tissue compared to uninjured ventricles collected 5 or 35 days after injection, a result indicating that the vast majority of new cardiomyocytes derives from cells expressing
cmlc2 prior to injury (;
Supplementary Fig. 4).
A critical aspect of successful regeneration is the functional incorporation of newly created cells into existing tissue. We labeled whole explanted hearts with the transmembrane potential-sensitive dye di-4-ANEPPS, and performed optical voltage mapping of surface level cardiomyocytes that include the compact layer and regenerate. At 7 dpa, and less-so at 14 dpa, there was an increased density of isochrones near the apex of the ventricle as compared to uninjured controls, indicating a marked slowing of conduction (). In addition, electrical activity consistently failed to propagate into the regenerating apex at 7 dpa, while impulses again conducted throughout the ventricle by 14 dpa when substantial numbers of new
gata4+ cardiomyocytes appear (). By 30 dpa, isochrone densities at the apex appeared normal (). These observations were confirmed by direct estimation of conduction velocity, which revealed slowing of distal ventricular conduction at 7 and 14 dpa, and normal conduction at 30 dpa (). We also found evidence of a significant reduction in the maximum depolarization rate at 7 dpa, which was fully restored by 14 dpa, while action potential duration was the same in all groups (;
Supplementary Fig. 6). Thus, our imaging data indicate that electrical coupling of new apical cardiomyocytes begins to occur by ~2 weeks post-injury, with full coupling in the restored wall by 30 dpa.
The normal regenerative response of the zebrafish heart to injury is thought to deter or outcompete a secondary scarring response
4. To test whether regeneration can occur after a scar is established, we injured
Tg(hsp70:dn-fgfr1)pd1 ventricles and induced expression of a dominant-negative Fibroblast growth factor (Fgf) receptor by heat-shock for 30 days, causing regenerative arrest and scarring
19 (). Then, we enabled Fgf signaling by removal from heat-shocks for 14 or 60 days. Interestingly, 14 days of restored Fgf signaling increased myocardium in 73% of wounds (
Supplementary Fig. 7), with
hsp70:dn-fgfr1; gata4:EGFP apices containing areas of
gata4:EGFP
+ cardiomyocytes (). When we restored Fgf signaling to scarred hearts for an extended period of 60 days, fibrin was cleared from the wounds, although we did not observe loss of scar tissue. Notably, 90% of injury sites showed histological improvement after extended restoration of Fgf signaling, including 60% that had formed a contiguous wall of muscle enveloping the scar (). These findings suggest that regenerative signals are maintained in zebrafish hearts with established injury scars, an environment that in mammals presents a hurdle for cell-based MI therapies
20,21. Accordingly, mechanisms that underlie zebrafish heart regeneration might be pertinent to human MI survivors harboring mature scar tissue and compromised ventricular walls.
Earlier studies assessed fast- (EGFP) and slow-folding (nuclear DsRed2) reporters in double transgenic
Tg(cmlc2:EGFP)f1 or twu26; Tg(cmlc2nucDsRed2)f2 zebrafish to document evidence for fresh maturation of
cmlc2− progenitor cells into proliferative cardiomyocytes. Specifically, many EGFP
+nucDsRed2
− cardiomyocytes were observed in the developing embryonic heart and the regenerating adult ventricle
19,22. We re-explored this developmental timing assay by substituting a cytosolic DsRed2 reporter of
cmlc2 which removes the element of nuclear localization that might reduce reporter sensitivity during dynamic developmental events (
Tg(cmlc2:DsRed2)pd15). We observed EGFP
+DsRed2
− myocytes in embryos but not in 7 dpa adult regenerates, which instead contained EGFP
+DsRed2
+ myocytes with each cytosolic reporter fluorescing at lower intensities than in non-regenerating muscle (
Supplementary Fig. 8). Together with
cmlc2:CreER lineage-tracing data, these new results argue for modifying the previous interpretation, and indicate that cardiomyocytes participating in regeneration possess or acquire an immature phenotype with reduced
cmlc2 expression. Such a phenotype is possibly reflected by ultrastructural features of cardiomyocytes in 14 dpa regenerates that we did not observe in subepicardial cardiomyocytes of uninjured ventricles, including reduced sarcomeric structure, dysmorphic mitochondria, and low mitochondrial density (
Supplementary Fig. 9).
In conclusion, we have identified new mechanistic aspects of zebrafish heart regeneration germane to the origin, function, and capabilities of regenerated cardiomyocytes. Foremost, we found that a subpopulation of cardiomyocytes within the ventricular wall activates
gata4 regulatory sequences, proliferates, and contributes substantially to local muscle regeneration. The extent to which other cell populations possibly supply the regenerate awaits further direct lineage-tracing experiments. Interestingly, the activation of
gata4:EGFP expression in subepicardial cardiomyocytes parallels the rapid, chamber-wide injury response of the overlying epicardial cells before they also incorporate into the regenerating area
19. The similar spatiotemporal dynamics of these muscularizing and vascularizing tissues suggests important interactions as they each become activated, proliferate, and integrate into the injury site.
Our findings are intriguing in light of recent reports describing factors that when introduced can increase proliferation of differentiated cardiomyocytes and improve function in the injured adult mammalian heart
23–26. It is likely that the zebrafish heart provides an optimized injury environment that encourages activation and/or proliferation of cardiomyocyte subpopulations. Cre-based tools in zebrafish including those we have described here will enable precise experimental manipulation of gene expression or function in attempts to modify the injury environment or regenerative response. With knowledge of a key origin of new cardiomyocytes, the cellular and molecular regulatory interactions that mediate heart regeneration in zebrafish can now be more informatively pursued.