Evidence map›Paper›PMID 40745475›Full record

ArticleCommunications medicine2025

Pantethine ameliorates dilated cardiomyopathy features in PPCS deficiency disorder in patients and cell line models.

Fangfang Zhang, Tatjana Dorn, Barbara Gnutti, Yair Anikster, Sarah Kuebler, Rebecca Ahrens-Nicklas, Rachel Gosselin, Shamima Rahman, Ronen Durst, Enrica Zanuttigh and 19 more

Abstract read
In one paragraph

Article in Communications medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

29 authors.

Fangfang Zhang *Regenerative Medicine in Cardiovascular Diseases, First Department of Medicine, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany.
Tatjana Dorn *Regenerative Medicine in Cardiovascular Diseases, First Department of Medicine, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany.
Barbara Gnutti *Institute of Neurogenomics, Helmholtz Zentrum München, Neuherberg, Germany.ORCID http://orcid.org/0000-0001-8583-2583
Yair AniksterMetabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Tel Aviv, Israel.
Sarah KueblerRegenerative Medicine in Cardiovascular Diseases, First Department of Medicine, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany.ORCID http://orcid.org/0009-0004-5749-9698
Rebecca Ahrens-NicklasThe Children's Hospital of Philadelphia, Division of Human Genetics, Philadelphia, PA, USA.
Rachel GosselinNationwide Children's Hospital, Division of Genetic and Genomic Medicine, Columbus, OH, USA.ORCID http://orcid.org/0000-0002-4811-7916
Shamima RahmanUCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.ORCID http://orcid.org/0000-0003-2088-730X
Ronen DurstFaculty of Medicine, The Hebrew University, Jerusalem, Israel.
Enrica ZanuttighInstitute of Neurogenomics, Helmholtz Zentrum München, Neuherberg, Germany.
Miriam A GüraInstitute of Neurogenomics, Helmholtz Zentrum München, Neuherberg, Germany.ORCID http://orcid.org/0000-0003-2485-2294
Christine M PochRegenerative Medicine in Cardiovascular Diseases, First Department of Medicine, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany.
Anna B MeierRegenerative Medicine in Cardiovascular Diseases, First Department of Medicine, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany.ORCID http://orcid.org/0000-0001-6307-3248
Karl-Ludwig LaugwitzRegenerative Medicine in Cardiovascular Diseases, First Department of Medicine, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany.ORCID http://orcid.org/0000-0003-4948-4846
Hans-Joachim SchüllerCenter for Functional Genomics of Microbes, Abteilung Molekulare Genetik, Greifswald, Germany.
Ana C MessiasInstitute of Structural Biology, Molecular Targets and Therapeutics Center, Helmholtz Zentrum München, Neuherberg, Germany.ORCID http://orcid.org/0000-0002-5449-9922
Ody C SibonDepartment of Biomedical Sciences of Cells and Systems, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.ORCID http://orcid.org/0000-0002-6836-6063
Dario FinazziDepartment of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.ORCID http://orcid.org/0000-0001-5176-2839
Alyssa RippertThe Children's Hospital of Philadelphia, Division of Human Genetics, Philadelphia, PA, USA.
Dong LiThe Children's Hospital of Philadelphia, Division of Human Genetics, Philadelphia, PA, USA.
Kristen TruxalNationwide Children's Hospital, Division of Genetic and Genomic Medicine, Columbus, OH, USA.
Deipanjan NandiNationwide Children's Hospital, Division of Cardiology, Columbus, OH, USA.
Brent C LampertDivision of Cardiology, Department of Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
Mildrid YeoUCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Alice GardhamUCL Great Ormond Street Institute of Child Health and Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Batel NissanFaculty of Medicine, The Hebrew University, Jerusalem, Israel.
Smadar Horowitz CederboimFaculty of Medicine, The Hebrew University, Jerusalem, Israel.ORCID http://orcid.org/0009-0005-1450-8299
Alessandra MorettiRegenerative Medicine in Cardiovascular Diseases, First Department of Medicine, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany. amoretti@tum.de.ORCID http://orcid.org/0000-0001-5782-7832
Arcangela IusoRegenerative Medicine in Cardiovascular Diseases, First Department of Medicine, TUM University Hospital, Klinikum Rechts der Isar, Technical University of Munich, School of Medicine and Health, Munich, Germany. arcangela.iuso@helmholtz-munich.de.ORCID http://orcid.org/0000-0003-4844-2513

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPPCS deficiency disorder (PPCS DD) is an ultra-rare, autosomal recessive form of dilated cardiomyopathy (DCM) caused by pathogenic variants in PPCS, which encodes the enzyme catalyzing the second step in the coenzyme A (CoA) biosynthesis pathway. To date, only six patients worldwide have been identified.

methodsWhole-exome sequencing was performed to identify pathogenic PPCS variants in affected individuals. Protein stability was assessed by Western blotting. CoA levels were quantified using a microplate-based assay in patient-derived fibroblasts, cardiac progenitor cells, and cardiomyocytes. Functional evaluation of cardiac cells and engineered heart patches was conducted to investigate contractile performance and arrhythmogenicity. Pantethine was tested as a potential therapeutic agent both in vitro and through long-term clinical follow-up in patients.

resultsCausative PPCS variants are identified in six individuals with DCM and variable associated features, including neuromuscular and neurological symptoms. Identified variants lead to reduced PPCS protein stability and decreased cellular CoA levels. Cardiac cells exhibit impaired contractility and arrhythmias, which are partially rescued by pantethine treatment. Clinically, patients receiving pantethine show sustained improvement over time.

conclusionsOur study expands the genetic and clinical spectrum of PPCS deficiency disorder, identifying six new cases with diverse phenotypes. Functional investigations reveal reduced CoA levels and dysfunction in patient-derived cardiac cells. Pantethine treatment shows promise in partially rescuing DCM phenotypes, both in vitro and in patients. However, complete reversal may require early intervention. These findings underscore the importance of timely diagnosis and treatment in PPCS DD. Future research should focus on optimizing pantethine supplementation and exploring additional therapies to enhance CoA levels and cardiac function in affected individuals.

Identifiers

PMID40745475
PMCPMC12313872

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.