The sodium-dependent multivitamin transporter, encoded by SLC5A6, mediates
cellular uptake of biotin and pantothenic acid, essential cofactors for energy metabolism.
We identified two families with SLC5A6 mutations presenting with early-onset dilated
cardiomyopathy (DCM). To investigate the link between vitamin deficiency and
cardiomyopathy, we generated a cardiac-specific SLC5A6 knockout (Slc5a6cKO) mouse model
and evaluated the impact of vitamin supplementation.
Slc5a6cKO mice developed progressive cardiac dysfunction, culminating in cardiac
pathology and premature death at 26 weeks; earlier stages exhibited cardiomyocyte
hypertrophy, fibrosis, impaired Coenzyme A synthesis, and metabolic imbalance, indicating
progression toward cardiomyopathy. Cardiac magnetic resonance imaging and ECG
confirmed progressive functional decline. Proteomic analysis revealed early mitochondrial
metabolic disruption and extracellular matrix protein upregulation at 8 weeks, preceding
overt cardiac dysfunction. Strikingly, vitamin supplementation from preconception onwards
prevented the cardiac phenotype, preserving cardiac structure, function, morphology and
survival. This paralleled the clinical outcome in one patient who received early vitamin
treatment, compared to another who required a heart transplant without vitamin
treatment.
This study establishes a direct link between SLC5A6-mediated vitamin transport,
mitochondrial function, and cardiac health. It highlights how vitamin deficiency contributes
to cardiomyopathy pathogenesis and supports early vitamin supplementation as a potential
therapeutic strategy for metabolic cardiomyopathies.
Fullerton, M., Phillips, L., Redgrave, R., Spray, L., Haufroid, V., Merces, G., Kerridge, S., Richardson, G., Mercier, N., Roland, D., Crossley, R., Morgan, A., Dewulf, J., Burn, J., Bamforth, S., & Phillips, H. (2026). A Slc5a6-Deficient Mouse Model Reveals Metabolically Driven Cardiomyopathy with Therapeutic Potential for Vitamin-Based Intervention. JCI Insight, 1, /. https://doi.org/10.1172/jci.insight.200381 (Original work published 2026)