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How the early heart develops

Our skin can detect even the slightest breeze. Its sensitivity is due to special ion channels. One of these, PIEZO2, doesn’t just convey touch stimuli. It also plays a key role in the development of coronary vessels, as a team from the Max Delbrück Centre reports in Nature Cardiovascular Research. The findings could improve our understanding of congenital heart defects.

Heart of a mouse in late embryonic stage with transparent tissue, visible developing coronary arteries in turquoise colour
Heart of a mouse in the late embryonic stage: the tissue was made transparent by tissue clearing. The developing coronary arteries can be seen in the image taken with a light sheet microscope. They are coloured turquoise with antibodies. © Mireia Pampols-Perez, Max Delbrück Center

Our skin has special ion channels embedded in cell membranes that respond to even the slightest mechanical stimuli. The PIEZO2 ion channel also plays a critical role in the formation of coronary vessels and the heart. This was demonstrated by a team led by Dr Annette Hammes, in collaboration with other research groups at the Max Delbrück Center headed by Holger Gerhardt and Norbert Hübner, who are both Principal Investigators at the DZHK.

The new findings of this collaboration could help identify the causes of congenital heart diseases – ultimately allowing earlier diagnosis and treatment. 

When coronary vessels malfunction

Lead author Dr Mireia Pampols-Perez used mouse models to demonstrate that coronary arteries do not develop properly without PIEZO2. In the absence of this ion channel, the small vessels either remain too narrow or branch in abnormal ways – reducing oxygen supply to the heart muscle. Similar malformations occurred in mice with an overactive PIEZO2 variant, which in humans causes the rare genetic disorder Marden-Walker syndrome. In both cases, the heart muscle tissue, especially in the left ventricle, becomes thickened – likely due to the aberrant growth of blood vessels.

“Genome-wide association studies suggest that mutations in the PIEZO2 gene may also be linked to cardiovascular conditions in humans, such as heart failure, high blood pressure, or aneurysms,” Hammes explains. “Malfunctions in this ion channel during embryonic development may initially lead to subtle yet unnoticeable vascular changes – only to trigger serious heart issues later in life or under physical stress.”

PIEZO2 is usually active only during the embryonic stage in endothelial cells that line coronary arteries. After birth, the channel typically shuts down. “However, there is evidence that it may be re-expressed in the adult heart under certain conditions, potentially aiding blood vessel regeneration,” says Hammes. “This is, of course, an exciting prospect–especially in cases of coronary artery disease or after a heart attack.”

New options for diagnostics and prevention

To explore whether the PIEZO2 findings from mice also apply to humans, Hammes’ team is now collaborating with colleagues from the Helmholtz Institute for Translational AngioCardioScience (HI-TAC) in Heidelberg and Mannheim, and the Max Delbrück Center’s Pluripotent Stem Cell Technology Platform. The researchers are using human endothelial cells derived from pluripotent stem cells. “With these models, we aim to determine how PIEZO2 expression and activity can be selectively influenced in humans,” says Hammes.

There are many potential medical applications of the research. “This study deepens our understanding of congenital heart defects and expands the list of genes that could be useful in diagnostics and prevention,” Hammes explains. “Ultimately, our results could help detect genetically caused cardiovascular diseases earlier – and perhaps even prevent them.”


Original publication : 
Pampols-Perez, M et al., Mechanosensitive PIEZO2 channels shape coronary artery development, Nature Cardiovascular Research, June 2025

Source: Max Delbrück Center