The intercalated disc (ICD) is a highly specialized cell-cell interface that ensures mechanical and electrical coupling between cardiomyocytes through interconnected junctional complexes (gap junctions, adherens junctions, and desmosomes). Disruption of desmosomal integrity is a hallmark of Arrhythmogenic Cardiomyopathy (ACM), a hereditary heart disease in which impaired cell-cell adhesion represents an early pathogenic event. ACM is initially characterized by life-threatening ventricular arrhythmias and later progresses to fibrosis and cardiac dysfunction. Here, the mechanisms linking defective mechanical adhesion to impaired electrical conduction and arrhythmogenesis remain poorly understood.
We hypothesize that disruption of mechanical junctional microdomains and their respective crosstalk with electrical and signaling components contributes to the development of an early arrhythmogenic phenotype. Therefore, the functional interplay and signalling network of the ICD microdomains will be characterized, especially in early phases of the disease prior to structural changes, with a focus on gap junctions and cAMP/PKA signaling.