Pitx2, a member of the bicoid family of homeodomain transcription factors, plays crucial roles in multiple biological processes. It is essential in morphogenesis, regulating right-left differentiation of the embryonic heart, thorax, and aorta [1]. In the adult heart, it is expressed in the left atrium and is involved in maintaining atrial structure and function. Additionally, it has been linked to the regulation of skeletal-muscle development, satellite-cell differentiation in adult muscle, and has implications in cancer-related processes such as ferroptosis regulation in pancreatic cancer cells [3,6].

Pitx2 deficiency in mouse models and human induced pluripotent stem cell-derived atrial cardiomyocytes has provided insights into its function. In human induced pluripotent stem cell-derived atrial cardiomyocytes, PITX2 knockout recapitulates some electrical remodeling findings seen in persistent atrial fibrillation, including lower force, altered expression of genes like CACNA1C, and changes in action potential characteristics [4]. In human induced pluripotent stem cell-derived atrial cardiomyocytes, PITX2-deficient cells show mitochondrial dysfunction, with increased mononucleation, altered mitochondrial protein expression, and a shift to increased glycolysis [2]. Also, in a mouse model, Nrf3-mediated suppression of Pitx2 promotes cardiomyocyte apoptosis and impairs cardiac functions [5].

In conclusion, Pitx2 is a key transcription factor involved in embryonic development, especially in cardiac development and left-right asymmetry establishment. Its deficiency in models has revealed its role in atrial fibrillation and cardiac function impairment. Additionally, its role in muscle development and cancer-related processes further emphasizes its broad biological importance. Understanding Pitx2 through model-based research provides insights into disease mechanisms and potential therapeutic targets for conditions like atrial fibrillation and certain cancers.