BIN1 overexpression rescues cardiac but not skeletal muscle defects in a mouse model of caveolinopathy

ABSTRACT Background Mutations in CAV3 , encoding caveolin-3, cause caveolinopathies, rare genetic disorders affecting both skeletal and cardiac muscle. Caveolin-3 contributes to T-tubule formation and excitation-contraction coupling. BIN1 (amphiphysin 2), a membrane-shaping protein critical for T-tubule integrity, has shown therapeutic promise in congenital myopathies and heart dysfunction. To date, there are no therapy for caveolinopathies. Methods We evaluated the therapeutic impact of BIN1 overexpression in Cav-3 knockout mice, a model recapitulating key features of human caveolinopathy. We assessed skeletal and cardiac function, T-tubule morphology, mitochondria, and gene expression using histological, physiological, and molecular approaches. Results We found Cav-3 -/- mice displayed skeletal muscle weakness, T-tubule disorganization, and mitochondrial abnormalities, alongside cardiac diastolic dysfunction and myofibrillar disarray. While BIN1 overexpression failed to improve skeletal muscle strength, T-tubule structure, or fiber atrophy, it corrected nuclear positioning and partially restored mitochondrial markers. In contrast, BIN1 robustly rescued cardiac performance, restoring end-diastolic volume, cardiac output, and sarcomeric integrity. Expression profiling revealed greater dysregulation of excitation-contraction coupling and atrogene pathways in skeletal than in cardiac muscle. Cavin-4, a BIN1-interacting protein, was selectively dysregulated in Cav3-/- muscle, suggesting a mechanistic barrier to BIN1-mediated rescue in this tissue. Conclusions These findings identify tissue-specific differences in the molecular consequences of caveolin-3 loss and demonstrate that BIN1 overexpression effectively rescues cardiac, but not skeletal, manifestations of caveolinopathy. Our results support BIN1 as a promising gene therapy target for inherited cardiomyopathies, while highlighting the need for alternative strategies in skeletal muscle.