Restrictive cardiomyopathy: Troponin I R170G/W and the interplay of proteins in the sarcomereRestrictive cardiomyopathy (RCM) -a rare heart muscle disease defined by disturbed relaxation and increased myocardial stiffness -is often caused by mutations in the gene encoding for cardiac troponin I. The phenotype of these mutations is probably determined by alterations in Ca
2+-sensitivity of contraction activation. Protein interactions between different filaments of the sarcomere are pivotal for its function and the regulation of Ca
2+-sensitivity. Therefore this work focused on interactions of the giant protein titin, especially its A-band regions, as well as the N-terminal fragment of myosin binding protein C (MyBP-C C0-C2) with the thin filament. A direct interaction of titin's A-band fragment with tropomyosin was found in pull down assays. Actin-myosin S1 ATPase activity was generally inhibited by A-band titin, implying a Ca
2+-independent mechanism of contraction regulation. In contrast, the actin binding MyBP-C C0-C2 fragment increased Ca
2+-sensitivity of the actin-myosin S1 ATPase and showed a competitive behaviour with troponin when binding to reconstituted thin filaments in cosedimentation experiments. Additionally, a direct interaction of MyBP-C C0-C2 with troponin was found, suggesting an immediate interplay of MyBP-C and troponin in the regulation of Ca
2+-sensitivity, which could be involved in RCM development.Two RCM causing mutations within TnI were recently identified in infant patients who died within few months after diagnosis. The mutations lead to amino acid exchanges R170G and R170W in the C-terminus of TnI, known to modulate the function of its inhibitory region and to bind to the thin filament in a Ca 2+ -dependent manner. Both mutants showed altered interactions with proteins of the thin filament. For R170W, the binding of troponin to reconstituted thin filaments was significantly decreased in cosedimentation experiments, which is probably due to a disturbed interaction with actin, as measured via surface plasmon resonance spectroscopy. This might lead to an impaired incorporation of the troponin complex into sarcomeres in vivo. Interestingly, both R170G and R170W showed a highly increased affinity towards tropomyosin, which could affect Ca 2+ -sensitivity. In fact, both mutants caused a strong Ca
2+-desensitization of actin-myosin S1 ATPase -a very new finding for RCM causing mutants. In presence of MyBP-C C0-C2, however, actin-myosin S1 ATPase activity of both mutants was restored almost to wildtype levels. These results demonstrate a direct impact of protein interactions beyond the thin filament for the pathogenesis of TnI mutants. Other protein interactions within the sarcomere could as well be affected by these mutations. Thus, early childhood RCM could conceivably be defined rather by altered protein interactions and resulting structural perturbances within the sarcomere, than by changes in Ca
2+-sensitivity. In this context, A-band titin could also be involved in the pathome...