HAND transcription factors cooperatively specify the aorta and pulmonary trunk

Dev Biol. 2021 Aug;476:1-10. doi: 10.1016/j.ydbio.2021.03.011. Epub 2021 Mar 20.


Congenital heart defects (CHDs) affecting the cardiac outflow tract (OFT) constitute a significant cause of morbidity and mortality. The OFT develops from migratory cell populations which include the cardiac neural crest cells (cNCCs) and secondary heart field (SHF) derived myocardium and endocardium. The related transcription factors HAND1 and HAND2 have been implicated in human CHDs involving the OFT. Although Hand1 is expressed within the OFT, Hand1 NCC-specific conditional knockout mice (H1CKOs) are viable. Here we show that these H1CKOs present a low penetrance of OFT phenotypes, whereas SHF-specific Hand1 ablation does not reveal any cardiac phenotypes. Further, HAND1 and HAND2 appear functionally redundant within the cNCCs, as a reduction/ablation of Hand2 on an NCC-specific H1CKO background causes pronounced OFT defects. Double conditional Hand1 and Hand2 NCC knockouts exhibit persistent truncus arteriosus (PTA) with 100% penetrance. NCC lineage-tracing and Sema3c in situ mRNA expression reveal that Sema3c-expressing cells are mis-localized, resulting in a malformed septal bridge within the OFTs of H1CKO;H2CKO embryos. Interestingly, Hand1 and Hand2 also genetically interact within the SHF, as SHF H1CKOs on a heterozygous Hand2 background exhibit Ventricular Septal Defects (VSDs) with incomplete penetrance. Previously, we identified a BMP, HAND2, and GATA-dependent Hand1 OFT enhancer sufficient to drive reporter gene expression within the nascent OFT and aorta. Using these transcription inputs as a probe, we identify a novel Hand2 OFT enhancer, suggesting that a conserved BMP-GATA dependent mechanism transcriptionally regulates both HAND factors. These findings support the hypothesis that HAND factors interpret BMP signaling within the cNCCs to cooperatively coordinate OFT morphogenesis.

Keywords: Cardiac neural crest; Cardiac outflow track; Congenital heart defects; HAND1; HAND2; Second heart field; Transcription; bHLH transcription factors.

Publication types

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

MeSH terms

  • Animals
  • Aorta / embryology
  • Basic Helix-Loop-Helix Transcription Factors / genetics*
  • Basic Helix-Loop-Helix Transcription Factors / metabolism
  • Cardiac Output / physiology
  • Cell Movement / genetics
  • Gene Expression Regulation, Developmental / genetics
  • Heart / embryology*
  • Heart Defects, Congenital / genetics*
  • Heart Defects, Congenital / metabolism
  • Homeodomain Proteins / metabolism
  • Mice
  • Mice, Knockout
  • Myocardium / metabolism
  • Myocytes, Cardiac / metabolism
  • Neural Crest / metabolism
  • Phenotype
  • Signal Transduction / genetics
  • Transcription Factors / genetics


  • Basic Helix-Loop-Helix Transcription Factors
  • Hand1 protein, mouse
  • Hand2 protein, mouse
  • Homeodomain Proteins
  • Transcription Factors
  • helix-loop-helix protein, eHAND

Supplementary concepts

  • Conotruncal cardiac defects