Defective sumoylation pathway directs congenital heart disease

Birth Defects Res A Clin Mol Teratol. 2011 Jun;91(6):468-76. doi: 10.1002/bdra.20816. Epub 2011 May 11.


Congenital heart defects (CHDs) are the most common of all birth defects, yet molecular mechanism(s) underlying highly prevalent atrial septal defects (ASDs) and ventricular septal defects (VSDs) have remained elusive. We demonstrate the indispensability of "balanced" posttranslational small ubiquitin-like modifier (SUMO) conjugation-deconjugation pathway for normal cardiac development. Both hetero- and homozygous SUMO-1 knockout mice exhibited ASDs and VSDs with high mortality rates, which were rescued by cardiac reexpression of the SUMO-1 transgene. Because SUMO-1 was also involved in cleft lip/palate in human patients, the previous findings provided a powerful rationale to question whether SUMO-1 was mutated in infants born with cleft palates and ASDs. Sequence analysis of DNA from newborn screening blood spots revealed a single 16 bp substitution in the SUMO-1 regulatory promoter of a patient displaying both oral-facial clefts and ASDs. Diminished sumoylation activity whether by genetics, environmental toxins, and/or pharmaceuticals may significantly contribute to susceptibility to the induction of congenital heart disease worldwide. Birth Defects Research (Part A) 2011. © 2011 Wiley-Liss, Inc.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Base Sequence
  • Cell Proliferation
  • Cleft Lip / genetics
  • Cleft Lip / metabolism
  • Cleft Palate / genetics
  • Cleft Palate / metabolism
  • Heart Septal Defects, Atrial / genetics
  • Heart Septal Defects, Atrial / metabolism*
  • Heart Septal Defects, Ventricular / genetics
  • Heart Septal Defects, Ventricular / metabolism*
  • Humans
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • Promoter Regions, Genetic / genetics
  • Reverse Transcriptase Polymerase Chain Reaction
  • SUMO-1 Protein / genetics
  • SUMO-1 Protein / metabolism*
  • Sequence Analysis, DNA
  • Sumoylation
  • Ubiquitin


  • SUMO-1 Protein
  • Ubiquitin