Skip to main content
Top
Published in: BMC Pulmonary Medicine 1/2019

Open Access 01-12-2019 | Bronchial Asthma | Research article

The role of secreted Hsp90α in HDM-induced asthmatic airway epithelial barrier dysfunction

Authors: Cuiping Ye, Chaowen Huang, Mengchen Zou, Yahui Hu, Lishan Luo, Yilan Wei, Xuan Wan, Haijin Zhao, Wei Li, Shaoxi Cai, Hangming Dong

Published in: BMC Pulmonary Medicine | Issue 1/2019

Login to get access

Abstract

Background

The dysfunction of airway epithelial barrier is closely related to the pathogenesis of asthma. Secreted Hsp90α participates in inflammation and Hsp90 inhibitor protects endothelial dysfunction. In the current study, we aimed to explore the role of secreted Hsp90α in asthmatic airway epithelial barrier function.

Methods

Male BALB/c mice were sensitized and challenged with HDM to generate asthma model. The 16HBE and Hsp90α-knockdown cells were cultured and treated according to the experiment requirements. Transepithelial Electric Resistance (TEER) and permeability of epithelial layer in vitro, distribution and expression of junction proteins both in vivo and in vitro were used to evaluate the epithelial barrier function. Western Blot was used to evaluate the expression of junction proteins and phosphorylated AKT in cells and lung tissues while ELISA were used to evaluate the Hsp90α expression and cytokines release in the lung homogenate.

Results

HDM resulted in a dysfunction of airway epithelial barrier both in vivo and in vitro, paralleled with the increased expression and release of Hsp90α. All of which were rescued in Hsp90α-knockdown cells or co-administration of 1G6-D7. Furthermore, either 1G6-D7 or PI3K inhibitor LY294002 suppressed the significant phosphorylation of AKT, which caused by secreted and recombinant Hsp90α, resulting in the restoration of epithelial barrier function.

Conclusions

Secreted Hsp90α medicates HDM-induced asthmatic airway epithelial barrier dysfunction via PI3K/AKT pathway, indicating that anti-secreted Hsp90α therapy might be a potential treatment to asthma in future.
Literature
1.
go back to reference Georas SN, Rezaee F. Epithelial barrier function: at the front line of asthma immunology and allergic airway inflammation. J Allergy Clin Immunol. 2014;134(3):509–20.PubMedPubMedCentralCrossRef Georas SN, Rezaee F. Epithelial barrier function: at the front line of asthma immunology and allergic airway inflammation. J Allergy Clin Immunol. 2014;134(3):509–20.PubMedPubMedCentralCrossRef
2.
go back to reference Lambrecht BN, Hammad H. Allergens and the airway epithelium response: gateway to allergic sensitization. J Allergy Clin Immunol. 2014;134(3):499–507.PubMedCrossRef Lambrecht BN, Hammad H. Allergens and the airway epithelium response: gateway to allergic sensitization. J Allergy Clin Immunol. 2014;134(3):499–507.PubMedCrossRef
3.
go back to reference Heijink IH, Brandenburg SM, Noordhoek JA, et al. Characterisation of cell adhesion in airway epithelial cell types using electric cell-substrate impedance sensing. Eur Respir J. 2010;35(4):894–903.PubMedCrossRef Heijink IH, Brandenburg SM, Noordhoek JA, et al. Characterisation of cell adhesion in airway epithelial cell types using electric cell-substrate impedance sensing. Eur Respir J. 2010;35(4):894–903.PubMedCrossRef
4.
go back to reference Bajpai S, Correia J, Feng Y, et al. {alpha}-Catenin mediates initial E-cadherin-dependent cell-cell recognition and subsequent bond strengthening. Proc Natl Acad Sci U S A. 2008;105(47):18331–6.PubMedPubMedCentralCrossRef Bajpai S, Correia J, Feng Y, et al. {alpha}-Catenin mediates initial E-cadherin-dependent cell-cell recognition and subsequent bond strengthening. Proc Natl Acad Sci U S A. 2008;105(47):18331–6.PubMedPubMedCentralCrossRef
5.
go back to reference Tunggal JA, Helfrich I, Schmitz A, et al. E-cadherin is essential for in vivo epidermal barrier function by regulating tight junctions. EMBO J. 2005;24(6):1146–56.PubMedPubMedCentralCrossRef Tunggal JA, Helfrich I, Schmitz A, et al. E-cadherin is essential for in vivo epidermal barrier function by regulating tight junctions. EMBO J. 2005;24(6):1146–56.PubMedPubMedCentralCrossRef
6.
go back to reference Zou W, Zou Y, Zhao Z, et al. Nicotine-induced epithelial-mesenchymal transition via Wnt/beta-catenin signaling in human airway epithelial cells. Am J Physiol Lung Cell Mol Physiol. 2013;304(4):L199–209.PubMedCrossRef Zou W, Zou Y, Zhao Z, et al. Nicotine-induced epithelial-mesenchymal transition via Wnt/beta-catenin signaling in human airway epithelial cells. Am J Physiol Lung Cell Mol Physiol. 2013;304(4):L199–209.PubMedCrossRef
7.
go back to reference Sreedhar AS, Kalmar E, Csermely P, et al. Hsp90 isoforms: functions, expression and clinical importance. FEBS Lett. 2004;562(1–3):11–5.PubMedCrossRef Sreedhar AS, Kalmar E, Csermely P, et al. Hsp90 isoforms: functions, expression and clinical importance. FEBS Lett. 2004;562(1–3):11–5.PubMedCrossRef
8.
go back to reference Eustace BK, Sakurai T, Stewart JK, et al. Functional proteomic screens reveal an essential extracellular role for hsp90 alpha in cancer cell invasiveness. Nat Cell Biol. 2004;6(6):507–14.PubMedCrossRef Eustace BK, Sakurai T, Stewart JK, et al. Functional proteomic screens reveal an essential extracellular role for hsp90 alpha in cancer cell invasiveness. Nat Cell Biol. 2004;6(6):507–14.PubMedCrossRef
9.
go back to reference Sims JD, Mccready J, Jay DG. Extracellular heat shock protein (Hsp)70 and Hsp90alpha assist in matrix metalloproteinase-2 activation and breast cancer cell migration and invasion. PLoS One. 2011;6(4):e18848.PubMedPubMedCentralCrossRef Sims JD, Mccready J, Jay DG. Extracellular heat shock protein (Hsp)70 and Hsp90alpha assist in matrix metalloproteinase-2 activation and breast cancer cell migration and invasion. PLoS One. 2011;6(4):e18848.PubMedPubMedCentralCrossRef
10.
go back to reference Li W, Li Y, Guan S, et al. Extracellular heat shock protein-90alpha: linking hypoxia to skin cell motility and wound healing. EMBO J. 2007;26(5):1221–33.PubMedPubMedCentralCrossRef Li W, Li Y, Guan S, et al. Extracellular heat shock protein-90alpha: linking hypoxia to skin cell motility and wound healing. EMBO J. 2007;26(5):1221–33.PubMedPubMedCentralCrossRef
11.
go back to reference Zhang R, Zhao H, Dong H, et al. 1α,25-Dihydroxyvitamin D3 counteracts the effects of cigarette smoke in airway epithelial cells. Cell Immunol. 2015;295(2):137–43.PubMedCrossRef Zhang R, Zhao H, Dong H, et al. 1α,25-Dihydroxyvitamin D3 counteracts the effects of cigarette smoke in airway epithelial cells. Cell Immunol. 2015;295(2):137–43.PubMedCrossRef
12.
go back to reference Zhao H, Peng H, Cai SX, et al. Toluene diisocyanate enhances human bronchial epithelial cells’ permeability partly through the vascular endothelial growth factor pathway. Clin Exp Allergy. 2009;39(10):1532–9.PubMedCrossRef Zhao H, Peng H, Cai SX, et al. Toluene diisocyanate enhances human bronchial epithelial cells’ permeability partly through the vascular endothelial growth factor pathway. Clin Exp Allergy. 2009;39(10):1532–9.PubMedCrossRef
13.
go back to reference Yao L, Zhao H, Tang H, et al. Phosphatidylinositol 3-kinase mediates β-catenin dysfunction of airway epithelium in a toluene Diisocyanate-induced murine asthma model. Toxicol Sci. 2015;147(1):168–77.PubMedCrossRef Yao L, Zhao H, Tang H, et al. Phosphatidylinositol 3-kinase mediates β-catenin dysfunction of airway epithelium in a toluene Diisocyanate-induced murine asthma model. Toxicol Sci. 2015;147(1):168–77.PubMedCrossRef
14.
go back to reference Song J, Zhao H, Dong H, et al. Mechanism of E-cadherin redistribution in bronchial airway epithelial cells in a TDI-induced asthma model. Toxicol Lett. 2013;220(1):8–14.PubMedCrossRef Song J, Zhao H, Dong H, et al. Mechanism of E-cadherin redistribution in bronchial airway epithelial cells in a TDI-induced asthma model. Toxicol Lett. 2013;220(1):8–14.PubMedCrossRef
15.
go back to reference Dong H, Zou M, Bhatia A, et al. Breast Cancer MDA-MB-231 cells use secreted heat shock protein-90alpha (Hsp90 α ) to survive a hostile hypoxic environment. Sci Rep. 2016;6:20605.PubMedPubMedCentralCrossRef Dong H, Zou M, Bhatia A, et al. Breast Cancer MDA-MB-231 cells use secreted heat shock protein-90alpha (Hsp90 α ) to survive a hostile hypoxic environment. Sci Rep. 2016;6:20605.PubMedPubMedCentralCrossRef
16.
go back to reference Nagaraju GP, Wu C, Merchant N, et al. Epigenetic effects of inhibition of heat shock protein 90 (HSP90) in human pancreatic and colon cancer. Cancer Lett. 2017;402:110–6.PubMedCrossRef Nagaraju GP, Wu C, Merchant N, et al. Epigenetic effects of inhibition of heat shock protein 90 (HSP90) in human pancreatic and colon cancer. Cancer Lett. 2017;402:110–6.PubMedCrossRef
17.
go back to reference Sarkar AA, Zohn IE. Hectd1 regulates intracellular localization and secretion of Hsp90 to control cellular behavior of the cranial mesenchyme. J Cell Biol. 2012;196(6):789–800.PubMedPubMedCentralCrossRef Sarkar AA, Zohn IE. Hectd1 regulates intracellular localization and secretion of Hsp90 to control cellular behavior of the cranial mesenchyme. J Cell Biol. 2012;196(6):789–800.PubMedPubMedCentralCrossRef
18.
go back to reference Jayaprakash P, Dong H, Zou M, et al. Hsp90α and Hsp90β together operate a hypoxia and nutrient paucity stress-response mechanism during wound healing. J Cell Sci. 2015;128(8):1475–80.PubMedPubMedCentralCrossRef Jayaprakash P, Dong H, Zou M, et al. Hsp90α and Hsp90β together operate a hypoxia and nutrient paucity stress-response mechanism during wound healing. J Cell Sci. 2015;128(8):1475–80.PubMedPubMedCentralCrossRef
19.
20.
go back to reference Dong H, Le Y, Wang Y, et al. Extracellular heat shock protein 90α mediates HDM-induced bronchial epithelial barrier dysfunction by activating RhoA/MLC signaling. Respir Res. 2017;18(1):111.PubMedPubMedCentralCrossRef Dong H, Le Y, Wang Y, et al. Extracellular heat shock protein 90α mediates HDM-induced bronchial epithelial barrier dysfunction by activating RhoA/MLC signaling. Respir Res. 2017;18(1):111.PubMedPubMedCentralCrossRef
21.
go back to reference Hackett TL, Singhera GK, Shaheen F, et al. Intrinsic phenotypic differences of asthmatic epithelium and its inflammatory responses to respiratory syncytial virus and air pollution. Am J Respir Cell Mol Biol. 2011;45(5):1090–100.PubMedCrossRef Hackett TL, Singhera GK, Shaheen F, et al. Intrinsic phenotypic differences of asthmatic epithelium and its inflammatory responses to respiratory syncytial virus and air pollution. Am J Respir Cell Mol Biol. 2011;45(5):1090–100.PubMedCrossRef
22.
go back to reference Schleimer RP, Kato A, Kern R, et al. Epithelium: at the interface of innate and adaptive immune responses. J Allergy Clin Immunol. 2007;120(6):1279–84.PubMedPubMedCentralCrossRef Schleimer RP, Kato A, Kern R, et al. Epithelium: at the interface of innate and adaptive immune responses. J Allergy Clin Immunol. 2007;120(6):1279–84.PubMedPubMedCentralCrossRef
23.
go back to reference Holgate ST. The sentinel role of the airway epithelium in asthma pathogenesis. Immunol Rev. 2011;242(1):205–19.PubMedCrossRef Holgate ST. The sentinel role of the airway epithelium in asthma pathogenesis. Immunol Rev. 2011;242(1):205–19.PubMedCrossRef
24.
go back to reference Hirota JA, Hackett TL, Inman MD, et al. Modeling asthma in mice: what have we learned about the airway epithelium? Am J Respir Cell Mol Biol. 2011;44(4):431–8.PubMedCrossRef Hirota JA, Hackett TL, Inman MD, et al. Modeling asthma in mice: what have we learned about the airway epithelium? Am J Respir Cell Mol Biol. 2011;44(4):431–8.PubMedCrossRef
25.
go back to reference Solanas G, Porta-De-La-Riva M, Agusti C, et al. E-cadherin controls beta-catenin and NF-kappaB transcriptional activity in mesenchymal gene expression. J Cell Sci. 2008;121(Pt 13):2224–34.PubMedCrossRef Solanas G, Porta-De-La-Riva M, Agusti C, et al. E-cadherin controls beta-catenin and NF-kappaB transcriptional activity in mesenchymal gene expression. J Cell Sci. 2008;121(Pt 13):2224–34.PubMedCrossRef
26.
go back to reference Heijink IH, Kies PM, Kauffman HF, et al. Down-regulation of E-cadherin in human bronchial epithelial cells leads to epidermal growth factor receptor-dependent Th2 cell-promoting activity. J Immunol. 2007;178(12):7678–85.PubMedCrossRef Heijink IH, Kies PM, Kauffman HF, et al. Down-regulation of E-cadherin in human bronchial epithelial cells leads to epidermal growth factor receptor-dependent Th2 cell-promoting activity. J Immunol. 2007;178(12):7678–85.PubMedCrossRef
27.
go back to reference Carayol N, Campbell A, Vachier I, et al. Modulation of cadherin and catenins expression by tumor necrosis factor-alpha and dexamethasone in human bronchial epithelial cells. Am J Respir Cell Mol Biol. 2002;26(3):341–7.PubMedCrossRef Carayol N, Campbell A, Vachier I, et al. Modulation of cadherin and catenins expression by tumor necrosis factor-alpha and dexamethasone in human bronchial epithelial cells. Am J Respir Cell Mol Biol. 2002;26(3):341–7.PubMedCrossRef
28.
go back to reference Nawijn MC, Hackett TL, Postma DS, et al. E-cadherin: gatekeeper of airway mucosa and allergic sensitization. Trends Immunol. 2011;32(6):248–55.PubMedCrossRef Nawijn MC, Hackett TL, Postma DS, et al. E-cadherin: gatekeeper of airway mucosa and allergic sensitization. Trends Immunol. 2011;32(6):248–55.PubMedCrossRef
29.
go back to reference Cohen ED, Ihida-Stansbury K, Lu MM, et al. Wnt signaling regulates smooth muscle precursor development in the mouse lung via a tenascin C/PDGFR pathway. J Clin Invest. 2009;119(9):2538–49.PubMedPubMedCentralCrossRef Cohen ED, Ihida-Stansbury K, Lu MM, et al. Wnt signaling regulates smooth muscle precursor development in the mouse lung via a tenascin C/PDGFR pathway. J Clin Invest. 2009;119(9):2538–49.PubMedPubMedCentralCrossRef
30.
go back to reference Flozak AS, Lam AP, Russell S, et al. Beta-catenin/T-cell factor signaling is activated during lung injury and promotes the survival and migration of alveolar epithelial cells. J Biol Chem. 2010;285(5):3157–67.PubMedCrossRef Flozak AS, Lam AP, Russell S, et al. Beta-catenin/T-cell factor signaling is activated during lung injury and promotes the survival and migration of alveolar epithelial cells. J Biol Chem. 2010;285(5):3157–67.PubMedCrossRef
31.
32.
go back to reference Kumar H, Kawai T, Akira S. Pathogen recognition by the innate immune system. Int Rev Immunol. 2011;30(1):16–34.PubMedCrossRef Kumar H, Kawai T, Akira S. Pathogen recognition by the innate immune system. Int Rev Immunol. 2011;30(1):16–34.PubMedCrossRef
34.
go back to reference Bohonowych JE, Hance MW, Nolan KD, et al. Extracellular Hsp90 mediates an NF-κB dependent inflammatory stromal program: Implications for the prostate tumor microenvironment. Prostate. 2014;74(4):395–407.PubMedCrossRef Bohonowych JE, Hance MW, Nolan KD, et al. Extracellular Hsp90 mediates an NF-κB dependent inflammatory stromal program: Implications for the prostate tumor microenvironment. Prostate. 2014;74(4):395–407.PubMedCrossRef
35.
go back to reference Broemer M, Krappmann D, Scheidereit C. Requirement of Hsp90 activity for IkappaB kinase (IKK) biosynthesis and for constitutive and inducible IKK and NF-kappaB activation. Oncogene. 2004;23(31):5378–86.PubMedCrossRef Broemer M, Krappmann D, Scheidereit C. Requirement of Hsp90 activity for IkappaB kinase (IKK) biosynthesis and for constitutive and inducible IKK and NF-kappaB activation. Oncogene. 2004;23(31):5378–86.PubMedCrossRef
36.
go back to reference Cheng CF, Sahu D, Tsen F, et al. A fragment of secreted Hsp90alpha carries properties that enable it to accelerate effectively both acute and diabetic wound healing in mice. J Clin Invest. 2011;121(11):4348–61.PubMedPubMedCentralCrossRef Cheng CF, Sahu D, Tsen F, et al. A fragment of secreted Hsp90alpha carries properties that enable it to accelerate effectively both acute and diabetic wound healing in mice. J Clin Invest. 2011;121(11):4348–61.PubMedPubMedCentralCrossRef
37.
go back to reference Schwarznau A, Hanson MS, Sperger JM, et al. IL-1beta receptor blockade protects islets against pro-inflammatory cytokine induced necrosis and apoptosis. J Cell Physiol. 2009;220(2):341–7.PubMedPubMedCentralCrossRef Schwarznau A, Hanson MS, Sperger JM, et al. IL-1beta receptor blockade protects islets against pro-inflammatory cytokine induced necrosis and apoptosis. J Cell Physiol. 2009;220(2):341–7.PubMedPubMedCentralCrossRef
39.
go back to reference Manka LA, Wechsler ME. Selecting the right biologic for your patients with severe asthma. Ann Allergy Asthma Immunol. 2018;121(4):406–13.PubMedCrossRef Manka LA, Wechsler ME. Selecting the right biologic for your patients with severe asthma. Ann Allergy Asthma Immunol. 2018;121(4):406–13.PubMedCrossRef
40.
go back to reference Oura J, Tamura Y, Kamiguchi K, et al. Extracellular heat shock protein 90 plays a role in translocating chaperoned antigen from endosome to proteasome for generating antigenic peptide to be cross-presented by dendritic cells. Int Immunol. 2011;23(4):223–37.PubMedCrossRef Oura J, Tamura Y, Kamiguchi K, et al. Extracellular heat shock protein 90 plays a role in translocating chaperoned antigen from endosome to proteasome for generating antigenic peptide to be cross-presented by dendritic cells. Int Immunol. 2011;23(4):223–37.PubMedCrossRef
41.
go back to reference Cecchini P, Tavano R, Polverino DLP, et al. The soluble recombinant Neisseria meningitidis adhesin NadA (Delta351-405) stimulates human monocytes by binding to extracellular Hsp90. PLoS One. 2011;6(9):e25089.PubMedPubMedCentralCrossRef Cecchini P, Tavano R, Polverino DLP, et al. The soluble recombinant Neisseria meningitidis adhesin NadA (Delta351-405) stimulates human monocytes by binding to extracellular Hsp90. PLoS One. 2011;6(9):e25089.PubMedPubMedCentralCrossRef
42.
go back to reference Liang J, Zhao H, Yao L, et al. Phosphatidylinositol 3-kinases pathway mediates lung caspase-1 activation and high mobility group box 1 production in a toluene-diisocyanate induced murine asthma model. Toxicol Lett. 2015;236(1):25–33.PubMedCrossRef Liang J, Zhao H, Yao L, et al. Phosphatidylinositol 3-kinases pathway mediates lung caspase-1 activation and high mobility group box 1 production in a toluene-diisocyanate induced murine asthma model. Toxicol Lett. 2015;236(1):25–33.PubMedCrossRef
43.
go back to reference Hance MW, Dole K, Gopal U, et al. Secreted Hsp90 is a novel regulator of the epithelial to mesenchymal transition (EMT) in prostate cancer. J Biol Chem. 2012;287(45):37732–44.PubMedPubMedCentralCrossRef Hance MW, Dole K, Gopal U, et al. Secreted Hsp90 is a novel regulator of the epithelial to mesenchymal transition (EMT) in prostate cancer. J Biol Chem. 2012;287(45):37732–44.PubMedPubMedCentralCrossRef
44.
go back to reference van der Velden JL, Hoffman SM, Alcorn JF, et al. Absence of c-Jun NH2-terminal kinase 1 protects against house dust mite-induced pulmonary remodeling but not airway hyperresponsiveness and inflammation. Am J Physiol Lung Cell Mol Physiol. 2014;306(9):L866–75.PubMedPubMedCentralCrossRef van der Velden JL, Hoffman SM, Alcorn JF, et al. Absence of c-Jun NH2-terminal kinase 1 protects against house dust mite-induced pulmonary remodeling but not airway hyperresponsiveness and inflammation. Am J Physiol Lung Cell Mol Physiol. 2014;306(9):L866–75.PubMedPubMedCentralCrossRef
45.
go back to reference Tsen F, Bhatia A, O'Brien K, et al. Extracellular heat shock protein 90 signals through subdomain II and the NPVY motif of LRP-1 receptor to Akt1 and Akt2: a circuit essential for promoting skin cell migration in vitro and wound healing in vivo. Mol Cell Biol. 2013;33(24):4947–59.PubMedPubMedCentralCrossRef Tsen F, Bhatia A, O'Brien K, et al. Extracellular heat shock protein 90 signals through subdomain II and the NPVY motif of LRP-1 receptor to Akt1 and Akt2: a circuit essential for promoting skin cell migration in vitro and wound healing in vivo. Mol Cell Biol. 2013;33(24):4947–59.PubMedPubMedCentralCrossRef
Metadata
Title
The role of secreted Hsp90α in HDM-induced asthmatic airway epithelial barrier dysfunction
Authors
Cuiping Ye
Chaowen Huang
Mengchen Zou
Yahui Hu
Lishan Luo
Yilan Wei
Xuan Wan
Haijin Zhao
Wei Li
Shaoxi Cai
Hangming Dong
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2019
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-019-0938-z

Other articles of this Issue 1/2019

BMC Pulmonary Medicine 1/2019 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.