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Stephens SB, Novy T, Spurzem GN, Jacob B, Beecroft T, Soludczyk E, Kozel BA, Weigand J, Morris SA. Genetic Testing for Supravalvar Aortic Stenosis: What to Do When It Is Not Williams Syndrome. J Am Heart Assoc 2024; 13:e034048. [PMID: 38591341 DOI: 10.1161/jaha.123.034048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 03/08/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND We aimed to describe the frequency and yield of genetic testing in supravalvar aortic stenosis (SVAS) following negative evaluation for Williams-Beuren syndrome (WS). METHODS AND RESULTS This retrospective cohort study included patients with SVAS at our institution who had a negative evaluation for WS from May 1991 to September 2021. SVAS was defined as (1) peak supravalvar velocity of ≥2 meters/second, (2) sinotubular junction or ascending aortic Z score <-2.0, or (3) sinotubular junction Z score <-1.5 with family history of SVAS. Patients with complex congenital heart disease, aortic valve disease as the primary condition, or only postoperative SVAS were excluded. Genetic testing and diagnoses were reported. Of 162 patients who were WS negative meeting inclusion criteria, 61 had genetic testing results available (38%). Chromosomal microarray had been performed in 44 of 61 and was nondiagnostic for non-WS causes of SVAS. Sequencing of 1 or more genes was performed in 47 of 61. Of these, 39 of 47 underwent ELN sequencing, 20 of 39 (51%) of whom had a diagnostic variant. Other diagnoses made by gene sequencing were Noonan syndrome (3 PTPN11, 1 RIT1), Alagille syndrome (3 JAG1), neurofibromatosis (1 NF1), and homozygous familial hypercholesterolemia (1 LDLR1). Overall, sequencing was diagnostic in 29 of 47 (62%). CONCLUSIONS When WS is excluded, gene sequencing for SVAS is high yield, with the highest yield for the ELN gene. Therefore, we recommend gene sequencing using a multigene panel or exome analysis. Hypercholesterolemia can also be considered in individuals bearing the stigmata of this disease.
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Affiliation(s)
- Sara B Stephens
- Section of Cardiology, Department of Pediatrics Baylor College of Medicine, Texas Children's Hospital Houston TX
- Department of Epidemiology, Human Genetics & Environmental Sciences, School of Public Health The University of Texas Health Science Center Houston TX
| | - Tyler Novy
- Division of Community and General Pediatrics, Department of Pediatrics, McGovern Medical School The University of Texas Health Science Center Houston TX
| | | | - Benjamin Jacob
- Section of Cardiology, Department of Pediatrics Baylor College of Medicine, Texas Children's Hospital Houston TX
| | - Taylor Beecroft
- Section of Cardiology, Department of Pediatrics Baylor College of Medicine, Texas Children's Hospital Houston TX
| | - Emily Soludczyk
- Section of Cardiology, Department of Pediatrics Baylor College of Medicine, Texas Children's Hospital Houston TX
| | - Beth A Kozel
- Translational Vascular Medicine Branch National Heart, Lung, and Blood Institute, National Institutes of Health Bethesda MD
| | - Justin Weigand
- Section of Cardiology, Department of Pediatrics Baylor College of Medicine, Texas Children's Hospital Houston TX
| | - Shaine A Morris
- Section of Cardiology, Department of Pediatrics Baylor College of Medicine, Texas Children's Hospital Houston TX
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Liu D, Billington CJ, Raja N, Wong ZC, Levin MD, Resch W, Alba C, Hupalo DN, Biamino E, Bedeschi MF, Digilio MC, Squeo GM, Villa R, Parrish PCR, Knutsen RH, Osgood S, Freeman JA, Dalgard CL, Merla G, Pober BR, Mervis CB, Roberts AE, Morris CA, Osborne LR, Kozel BA. Matrisome and Immune Pathways Contribute to Extreme Vascular Outcomes in Williams-Beuren Syndrome. J Am Heart Assoc 2024; 13:e031377. [PMID: 38293922 PMCID: PMC11056152 DOI: 10.1161/jaha.123.031377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/28/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Supravalvar aortic stenosis (SVAS) is a characteristic feature of Williams-Beuren syndrome (WBS). Its severity varies: ~20% of people with Williams-Beuren syndrome have SVAS requiring surgical intervention, whereas ~35% have no appreciable SVAS. The remaining individuals have SVAS of intermediate severity. Little is known about genetic modifiers that contribute to this variability. METHODS AND RESULTS We performed genome sequencing on 473 individuals with Williams-Beuren syndrome and developed strategies for modifier discovery in this rare disease population. Approaches include extreme phenotyping and nonsynonymous variant prioritization, followed by gene set enrichment and pathway-level association tests. We next used GTEx v8 and proteomic data sets to verify expression of candidate modifiers in relevant tissues. Finally, we evaluated overlap between the genes/pathways identified here and those ascertained through larger aortic disease/trait genome-wide association studies. We show that SVAS severity in Williams-Beuren syndrome is associated with increased frequency of common and rarer variants in matrisome and immune pathways. Two implicated matrisome genes (ACAN and LTBP4) were uniquely expressed in the aorta. Many genes in the identified pathways were previously reported in genome-wide association studies for aneurysm, bicuspid aortic valve, or aortic size. CONCLUSIONS Smaller sample sizes in rare disease studies necessitate new approaches to detect modifiers. Our strategies identified variation in matrisome and immune pathways that are associated with SVAS severity. These findings suggest that, like other aortopathies, SVAS may be influenced by the balance of synthesis and degradation of matrisome proteins. Leveraging multiomic data and results from larger aorta-focused genome-wide association studies may accelerate modifier discovery for rare aortopathies like SVAS.
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Affiliation(s)
- Delong Liu
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
| | - Charles J. Billington
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
- Department of PediatricsUniversity of MinnesotaMinneapolisMN
| | - Neelam Raja
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
| | - Zoe C. Wong
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
| | - Mark D. Levin
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
| | - Wulfgang Resch
- The High Performance Computing FacilityCenter for Information Technology, National Institutes of HealthBethesdaMD
| | - Camille Alba
- Henry M Jackson Foundation for the Advancement of Military MedicineBethesdaMD
| | - Daniel N. Hupalo
- Henry M Jackson Foundation for the Advancement of Military MedicineBethesdaMD
| | | | | | | | - Gabriella Maria Squeo
- Laboratory of Regulatory and Functional GenomicsFondazione IRCCS Casa Sollievo della SofferenzaSan Giovanni Rotondo (Foggia)Italy
| | - Roberta Villa
- Fondazione IRCCS Ca Granda Ospedale Maggiore Policlinico Medical Genetic UnitMilanItaly
| | - Pheobe C. R. Parrish
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
- Department of Genome SciencesUniversity of WashingtonSeattleWA
| | - Russell H. Knutsen
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
| | - Sharon Osgood
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
| | - Joy A. Freeman
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
| | - Clifton L. Dalgard
- Department of Anatomy, Physiology and Genetics, School of Medicinethe Uniformed Services University of the Health SciencesBethesdaMD
| | - Giuseppe Merla
- Laboratory of Regulatory and Functional GenomicsFondazione IRCCS Casa Sollievo della SofferenzaSan Giovanni Rotondo (Foggia)Italy
- Department of Molecular Medicine and Medical BiotechnologyUniversity of Naples Federico IINaplesItaly
| | - Barbara R. Pober
- Section of Genetics, Department of PediatricsMassachusetts General HospitalBostonMA
| | - Carolyn B. Mervis
- Department of Psychological and Brain SciencesUniversity of LouisvilleLouisvilleKY
| | - Amy E. Roberts
- Department of Cardiology and Division of Genetics and Genomics, Department of PediatricsBoston Children’s HospitalBostonMA
| | - Colleen A. Morris
- Department of PediatricsKirk Kerkorian School of Medicine at UNLVLas VegasNV
| | - Lucy R. Osborne
- Departments of Medicine and Molecular GeneticsUniversity of TorontoCanada
| | - Beth A. Kozel
- National Heart, Lung, and Blood InstituteNational Institutes of HealthBethesdaMD
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Romay MC, Knutsen RH, Ma F, Mompeón A, Hernandez GE, Salvador J, Mirkov S, Batra A, Sullivan DP, Procissi D, Buchanan S, Kronquist E, Ferrante EA, Muller WA, Walshon J, Steffens A, McCortney K, Horbinski C, Tournier‑Lasserve E, Sonabend AM, Sorond FA, Wang MM, Boehm M, Kozel BA, Iruela-Arispe ML. Age-related loss of Notch3 underlies brain vascular contractility deficiencies, glymphatic dysfunction, and neurodegeneration in mice. J Clin Invest 2024; 134:e166134. [PMID: 38015629 PMCID: PMC10786701 DOI: 10.1172/jci166134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/14/2023] [Indexed: 11/30/2023] Open
Abstract
Vascular aging affects multiple organ systems, including the brain, where it can lead to vascular dementia. However, a concrete understanding of how aging specifically affects the brain vasculature, along with molecular readouts, remains vastly incomplete. Here, we demonstrate that aging is associated with a marked decline in Notch3 signaling in both murine and human brain vessels. To clarify the consequences of Notch3 loss in the brain vasculature, we used single-cell transcriptomics and found that Notch3 inactivation alters regulation of calcium and contractile function and promotes a notable increase in extracellular matrix. These alterations adversely impact vascular reactivity, manifesting as dilation, tortuosity, microaneurysms, and decreased cerebral blood flow, as observed by MRI. Combined, these vascular impairments hinder glymphatic flow and result in buildup of glycosaminoglycans within the brain parenchyma. Remarkably, this phenomenon mirrors a key pathological feature found in brains of patients with CADASIL, a hereditary vascular dementia associated with NOTCH3 missense mutations. Additionally, single-cell RNA sequencing of the neuronal compartment in aging Notch3-null mice unveiled patterns reminiscent of those observed in neurodegenerative diseases. These findings offer direct evidence that age-related NOTCH3 deficiencies trigger a progressive decline in vascular function, subsequently affecting glymphatic flow and culminating in neurodegeneration.
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Affiliation(s)
- Milagros C. Romay
- Department of Cell and Development Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | | | - Feiyang Ma
- Department of Cell and Development Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ana Mompeón
- Department of Cell and Development Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Gloria E. Hernandez
- Department of Cell and Development Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Molecular Biology Institute, University of California, Los Angeles, Los Angeles, California, USA
| | - Jocelynda Salvador
- Department of Cell and Development Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Snezana Mirkov
- Department of Cell and Development Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Ayush Batra
- Department of Pathology
- Department of Neurology, and
| | | | - Daniele Procissi
- Department of Radiology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Department of Biomedical Engineering, Northwestern University, Evanston, Illinois, USA
| | - Samuel Buchanan
- Department of Cell and Development Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Elise Kronquist
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | - Elisa A. Ferrante
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
- Laboratory of Cardiovascular Regenerative Medicine, NIH, Bethesda, Maryland, USA
| | | | - Jordain Walshon
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Alicia Steffens
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Kathleen McCortney
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Craig Horbinski
- Department of Pathology
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Elisabeth Tournier‑Lasserve
- Inserm NeuroDiderot, Université Paris Cité, Paris, France
- Service de Génétique Neurovasculaire, Assistance Publique–Hôpitaux de Paris, Hôpital Saint-Louis, Paris, France
| | - Adam M. Sonabend
- Department of Neurological Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
- Northwestern Medicine Malnati Brain Tumor Institute of the Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Chicago, Illinois, USA
| | | | - Michael M. Wang
- Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA
- VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Manfred Boehm
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
- Laboratory of Cardiovascular Regenerative Medicine, NIH, Bethesda, Maryland, USA
| | - Beth A. Kozel
- National Heart, Lung, and Blood Institute, NIH, Bethesda, Maryland, USA
| | - M. Luisa Iruela-Arispe
- Department of Cell and Development Biology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Pai C, McIntosh BA, Knutsen RH, Levin MD, Tsang KM, Kozel BA, Heuckeroth RO. Loss of Baz1b in mice causes perinatal lethality, growth failure, and variable multi-system outcomes. Dev Biol 2024; 505:42-57. [PMID: 37827362 PMCID: PMC10872721 DOI: 10.1016/j.ydbio.2023.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 09/15/2023] [Accepted: 09/16/2023] [Indexed: 10/14/2023]
Abstract
BAZ1B is one of 25-27 coding genes deleted in canonical Williams syndrome, a multi-system disorder causing slow growth, vascular stenosis, and gastrointestinal complaints, including constipation. BAZ1B is involved in (among other processes) chromatin organization, DNA damage repair, and mitosis, suggesting reduced BAZ1B may contribute to Williams syndrome symptoms. In mice, loss of Baz1b causes early neonatal death. 89.6% of Baz1b-/- mice die within 24 h of birth without vascular anomalies or congenital heart disease (except for patent ductus arteriosus). Some (<50%) Baz1b-/- were noted to have prolonged neonatal cyanosis, patent ductus arteriosus, or reduced lung aeration, and none developed a milk spot. Meanwhile, 35.5% of Baz1b+/- mice die over the first three weeks after birth. Surviving Baz1b heterozygotes grow slowly (with variable severity). 66.7% of Baz1b+/- mice develop bowel dilation, compared to 37.8% of wild-type mice, but small bowel and colon transit studies were normal. Additionally, enteric neuron density appeared normal in Baz1b-/- mice except in distal colon myenteric plexus, where neuron density was modestly elevated. Combined with several rare phenotypes (agnathia, microphthalmia, bowel dilation) recovered, our work confirms the importance of BAZ1B in survival and growth and suggests that reduced copy number of BAZ1B may contribute to the variability in Williams syndrome phenotypes.
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Affiliation(s)
- Christopher Pai
- The Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, USA, 19104; The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA, 19104
| | - Basil A McIntosh
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA, 20892
| | - Russell H Knutsen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA, 20892
| | - Mark D Levin
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA, 20892
| | - Kit Man Tsang
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA, 20892
| | - Beth A Kozel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA, 20892.
| | - Robert O Heuckeroth
- The Children's Hospital of Philadelphia Research Institute, Philadelphia, PA, USA, 19104; The Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA, 19104.
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5
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Huryn LA, Flaherty T, Nolen R, Prasov L, Zein WM, Cukras CA, Osgood S, Raja N, Levin MD, Vitale S, Brooks BP, Hufnagel RB, Kozel BA. Novel ophthalmic findings and deep phenotyping in Williams-Beuren syndrome. Br J Ophthalmol 2023; 107:1554-1559. [PMID: 35760456 PMCID: PMC10074447 DOI: 10.1136/bjophthalmol-2022-321103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 05/26/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND/AIMS To characterise the ocular manifestations of Williams-Beuren syndrome (WBS) and compare these to patients with isolated elastin mediated supravalvular aortic stenosis (SVAS). METHODS Fifty-seven patients with a diagnosis of WBS and five with SVAS underwent comprehensive ophthalmic evaluation at the National Institutes of Health from 2017 to 2020, including best-corrected visual acuity, slit-lamp biomicroscopy, optical biometry, dilated fundus examination, optical coherence tomography and colour fundus imaging. RESULTS Mean age of the 57 WBS patients was 20.3 years (range 3-60 years). Best-corrected visual acuity ranged from 20/20 to 20/400 with mean spherical equivalent near plano OU. Twenty-four eyes (21.8%) had an axial length (AL) less than 20.5 mm and 38 eyes (34.5%) had an AL measuring 20.5-22.0 mm. Stellate iris and retinal arteriolar tortuosity were noted in 30 (52.6%) and 51 (89.5%) WBS patients, respectively. Novel retinal findings in WBS included small hypopigmented retinal deposits (OD 29/57, OS 27/57) and broad foveal pit contour (OD 44/55, OS 42/51). Of the five patients with SVAS, none had stellate iris or broad foveal pit contour while 2/5 had retinal arteriolar tortuosity. CONCLUSION WBS is a complex multisystem genetic disorder with diverse ophthalmic findings that differ from those seen in isolated elastin mediated SVAS. These results suggest other genes within the WBS critical region, aside from ELN, may be involved in observed ocular phenotypes and perhaps broader ocular development. Furthermore, retinal arteriolar tortuosity may provide future insight into systemic vascular findings in WBS.
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Affiliation(s)
- Laryssa A Huryn
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - Taylor Flaherty
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - Rosalie Nolen
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - Lev Prasov
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
- Department of Ophthalmology and Visual Sciences, W K Kellogg Eye Center, Ann Arbor, Michigan, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | - Wadih M Zein
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - Catherine A Cukras
- Division of Epidemiology and Clinical Applications, National Eye Institute, NIH, Bethesda, Maryland, USA
| | - Sharon Osgood
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | - Neelam Raja
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | - Mark D Levin
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
| | - Susan Vitale
- Division of Epidemiology and Clinical Applications, National Eye Institute, NIH, Bethesda, Maryland, USA
| | - Brian P Brooks
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - Robert B Hufnagel
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, Bethesda, Maryland, USA
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, Bethesda, Maryland, USA
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6
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Dang DD, Chandrashekhar V, Chandrashekhar V, Ghabdanzanluqui N, Knutsen RH, Nazari MA, Nimmagadda L, Donahue DR, McGavern DB, Kozel BA, Heiss JD, Pacak K, Zhuang Z, Rosenblum JS. A protocol for visualization of murine in situ neurovascular interfaces. STAR Protoc 2023; 4:102367. [PMID: 37339049 PMCID: PMC10511866 DOI: 10.1016/j.xpro.2023.102367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/04/2023] [Accepted: 05/18/2023] [Indexed: 06/22/2023] Open
Abstract
Mapping cranial vasculature and adjacent neurovascular interfaces in their entirety will enhance our understanding of central nervous system function in any physiologic state. We present a workflow to visualize in situ murine vasculature and surrounding cranial structures using terminal polymer casting of vessels, iterative sample processing and image acquisition, and automated image registration and processing. While this method does not obtain dynamic imaging due to mouse sacrifice, these studies can be performed before sacrifice and processed with other acquired images. For complete details on the use and execution of this protocol, please refer to Rosenblum et al.1.
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Affiliation(s)
- Danielle D Dang
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA; Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | | | | | - Nagela Ghabdanzanluqui
- Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders, National Institutes of Health, Bethesda, MD 20892, USA
| | - Russell H Knutsen
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Matthew A Nazari
- Eunice Kennedy Shriver National Institute of Child Health, Bethesda, MD 20892, USA
| | - Likitha Nimmagadda
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Danielle R Donahue
- Mouse Imaging Facility, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Dorian B McGavern
- Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders, National Institutes of Health, Bethesda, MD 20892, USA
| | - Beth A Kozel
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - John D Heiss
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Karel Pacak
- Eunice Kennedy Shriver National Institute of Child Health, Bethesda, MD 20892, USA
| | - Zhengping Zhuang
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA.
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Levin MD, Cathey BM, Smith K, Osgood S, Raja N, Fu YP, Kozel BA. Heart Rate Variability Analysis May Identify Individuals With Williams-Beuren Syndrome at Risk of Sudden Death. JACC Clin Electrophysiol 2023; 9:359-370. [PMID: 36752464 PMCID: PMC10065881 DOI: 10.1016/j.jacep.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 09/28/2022] [Accepted: 10/03/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Williams-Beuren syndrome (WBS) (Online Mendelian Inheritance in Man #194050) is a rare genetic multisystem disorder resulting from a chromosomal microdeletion at 7q11.23. The condition is characterized by distinct facies, intellectual disability, and supravalvar aortic stenosis. Those with WBS have an increased risk of sudden death, but mechanisms underlying this phenotype are incompletely understood. OBJECTIVES The aim of this study was to quantify and compare autonomic activity as reflected by heart rate variability (HRV) measures in a cohort of individuals with WBS (n = 18) and age- and sex-matched control subjects (n = 18). METHODS We performed HRV analysis on 24-hour electrocardiography recordings using nonlinear, time and frequency domain analyses on a cohort of subjects with WBS and age- and sex-matched control subjects enrolled in a prospective cross-sectional study designed to characterize WBS disease natural history. RESULTS WBS subjects demonstrated diminished HRV (reflected by the SD of the NN intervals [P = 0.0001], SD of the average NN interval for 5-minute intervals over 24 hours [P < 0.0001], average of the 5-minute SDs of NN intervals for 24 hours [P = 0.0002], root mean square of successive differences of NN intervals [P = 0.0004], short axis of the Poincaré plot (SD1) [P < 0.0001], and long axis of the Poincaré plot [P < 0.0001]) and indirect markers of parasympathetic activity (reflected by the percent of NN intervals different from previous by 50% or more of local average [P < 0.0007], root mean square of successive differences of NN intervals [P = 0.0004], natural log high-frequency power [P = 0.0038], and SD1 [P < 0.0001]). Additional parameters were also significantly different, including natural log very low-frequency power (decreased; P = 0.0002), natural log low-frequency power (decreased; P = 0.0024), and SD1 divided by the long axis of the Poincaré plot (decreased; P < 0.0001). CONCLUSIONS Individuals with WBS demonstrate significant HRV abnormalities consistent with diminished autonomic reserve. Future studies will be needed to determine the relationship between autonomic dysregulation observed and sudden death risk seen in these patients. (Impact of Elastin Mediated Vascular Stiffness on End Organs; NCT02840448).
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Affiliation(s)
- Mark D Levin
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
| | - Brianna M Cathey
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA; School of Engineering Medicine, Texas A&M University, College Station, Texas, USA
| | - Kevin Smith
- Nursing Department, Clinical Center, National Institutes of Health, Bethesda, Maryland, USA
| | - Sharon Osgood
- Office of the Clinical Director, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Neelam Raja
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Yi-Ping Fu
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
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8
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Condy EE, Becker L, Farmer C, Kaat AJ, Chlebowski C, Kozel BA, Thurm A. NIH Toolbox Cognition Battery Feasibility in Individuals With Williams Syndrome. Am J Intellect Dev Disabil 2022; 127:473-484. [PMID: 36306408 DOI: 10.1352/1944-7558-127.6.473] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 01/25/2022] [Indexed: 06/16/2023]
Abstract
The NIH Toolbox Cognition Battery (NIHTB-CB) was developed for epidemiological and longitudinal studies across a wide age span. Such a tool may be useful for intervention trials in conditions characterized by intellectual disability (ID), such as Williams syndrome (WS). Three NIHTB-CB tasks, including two executive functioning (Flanker, Dimensional Change Card Sort) and one episodic memory (Picture Sequence Memory) task, were given to 47 individuals with WS, ages 4 to 50, to evaluate feasibility (i.e., proportion of valid administrations) in this population. Findings indicated that NIHTB-CB tests showed good feasibility. Flanker and DCCS age-corrected scores were negatively correlated with age and showed floor effects, indicating these scores may not be useful for quantifying performance on these NIHTB-CB tests in ID.
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Affiliation(s)
- Emma E Condy
- Emma E. Condy, National Institute of Mental Health
| | - Lindsey Becker
- Lindsey Becker, Eunice Kennedy Shriver National Institute of Child Health & Human Development
| | | | - Aaron J Kaat
- Aaron J. Kaat, Northwestern University Feinberg School of Medicine
| | | | - Beth A Kozel
- Beth A. Kozel, National Heart, Lung, and Blood Institute
| | - Audrey Thurm
- Audrey Thurm, National Institute of Mental Health
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9
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Luperchio TR, Kozel BA. Extending the spectrum in aortopathy: stenosis to aneurysm. Curr Opin Genet Dev 2022; 76:101962. [DOI: 10.1016/j.gde.2022.101962] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 06/21/2022] [Accepted: 06/25/2022] [Indexed: 11/03/2022]
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10
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Procknow SS, Kozel BA. Emerging mechanisms of elastin transcriptional regulation. Am J Physiol Cell Physiol 2022; 323:C666-C677. [PMID: 35816641 PMCID: PMC9448287 DOI: 10.1152/ajpcell.00228.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 11/22/2022]
Abstract
Elastin provides recoil to tissues that stretch such as the lung, blood vessels, and skin. It is deposited in a brief window starting in the prenatal period and extending to adolescence in vertebrates, and then slowly turns over. Elastin insufficiency is seen in conditions such as Williams-Beuren syndrome and elastin-related supravalvar aortic stenosis, which are associated with a range of vascular and connective tissue manifestations. Regulation of the elastin (ELN) gene occurs at multiple levels including promoter activation/inhibition, mRNA stability, interaction with microRNAs, and alternative splicing. However, these mechanisms are incompletely understood. Better understanding of the processes controlling ELN gene expression may improve medicine's ability to intervene in these rare conditions, as well as to replace age-associated losses by re-initiating elastin production. This review describes what is known about the ELN gene promoter structure, transcriptional regulation by cytokines and transcription factors, and posttranscriptional regulation via mRNA stability and micro-RNA and highlights new approaches that may influence regenerative medicine.
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Affiliation(s)
- Sara S Procknow
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
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11
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Muratoglu SC, Charette MF, Galis ZS, Greenstein AS, Daugherty A, Joutel A, Kozel BA, Wilcock DM, Collins EC, Sorond FA, Howell GR, Hyacinth HI, Lloyd KKC, Stenmark KR, Boehm M, Kahn ML, Corriveau R, Wells S, Bussey TJ, Sukoff Rizzo SJ, Iruela-Arispe ML. Perspectives on Cognitive Phenotypes and Models of Vascular Disease. Arterioscler Thromb Vasc Biol 2022; 42:831-838. [PMID: 35510549 PMCID: PMC9233038 DOI: 10.1161/atvbaha.122.317395] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Clinical investigations have established that vascular-associated medical conditions are significant risk factors for various kinds of dementia. And yet, we are unable to associate certain types of vascular deficiencies with specific cognitive impairments. The reasons for this are many, not the least of which are that most vascular disorders are multi-factorial and the development of vascular dementia in humans is often a multi-year or multi-decade progression. To better study vascular disease and its underlying causes, the National Heart, Lung, and Blood Institute of the National Institutes of Health has invested considerable resources in the development of animal models that recapitulate various aspects of human vascular disease. Many of these models, mainly in the mouse, are based on genetic mutations, frequently using single-gene mutations to examine the role of specific proteins in vascular function. These models could serve as useful tools for understanding the association of specific vascular signaling pathways with specific neurological and cognitive impairments related to dementia. To advance the state of the vascular dementia field and improve the information sharing between the vascular biology and neurobehavioral research communities, National Heart, Lung, and Blood Institute convened a workshop to bring in scientists from these knowledge domains to discuss the potential utility of establishing a comprehensive phenotypic cognitive assessment of a selected set of existing mouse models, representative of the spectrum of vascular disorders, with particular attention focused on age, sex, and rigor and reproducibility. The workshop highlighted the potential of associating well-characterized vascular disease models, with validated cognitive outcomes, that can be used to link specific vascular signaling pathways with specific cognitive and neurobehavioral deficits.
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Affiliation(s)
- Selen C Muratoglu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (S.C.M., M.F.C., Z.S.G.)
| | - Marc F Charette
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (S.C.M., M.F.C., Z.S.G.)
| | - Zorina S Galis
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (S.C.M., M.F.C., Z.S.G.)
| | - Adam S Greenstein
- Division of Cardiovascular Sciences, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom (A.S.G.)
| | - Alan Daugherty
- Saha Cardiovascular Research Center (A.D.), University of Kentucky, Lexington
| | - Anne Joutel
- Institute of Psychiatry and Neurosciences of Paris, INSERM U1266, Université Paris Descartes, France (A.J.)
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (B.A.K., M.B.)
| | - Donna M Wilcock
- Sanders-Brown Center on Aging, Department of Neuroscience (D.M.W.), University of Kentucky, Lexington
| | | | - Farzaneh A Sorond
- Division of Stroke and Neurocritical Care, Northwestern University Feinberg School of Medicine, Chicago, IL (F.A.S.)
| | - Gareth R Howell
- The Jackson Laboratory, Bar Harbor, ME (G.R.H.)
- Graduate Program of Genetics, Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA (G.R.H.)
| | - Hyacinth I Hyacinth
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH (H.I.H.)
| | - Kent K C Lloyd
- Mutant Mouse Resource and Research Center (MMRRC) at the University of California, Davis (K.K.C.L.)
| | - Kurt R Stenmark
- Developmental Lung Biology and Cardiovascular Pulmonary Research Laboratories, University of Colorado, Denver (K.R.S.)
| | - Manfred Boehm
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (B.A.K., M.B.)
| | - Mark L Kahn
- Department of Medicine and Cardiovascular Institute, University of Pennsylvania, Perelman School of Medicine, Philadelphia (M.L.K.)
| | - Roderick Corriveau
- National Institute for Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD (R.C.)
| | - Sara Wells
- Mary Lyon Centre, Harwell Campus, MRC Harwell Institute, Oxfordshire, United Kingdom (S.W.)
| | - Timothy J Bussey
- Translational Neuroscience Group, Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada (T.J.B.)
| | - Stacey J Sukoff Rizzo
- Department of Medicine-Aging Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA (S.J.S.R.)
| | - M Luisa Iruela-Arispe
- Department of Cell and Developmental Biology, Northwestern University, Feinberg School of Medicine, Chicago, IL (M.L.I.-A.)
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12
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Tsang KM, Knutsen RH, Billington CJ, Lindberg E, Steenbock H, Fu YP, Wardlaw-Pickett A, Liu D, Malide D, Yu ZX, Bleck CKE, Brinckmann J, Kozel BA. Copper-Binding Domain Variation in a Novel Murine Lysyl Oxidase Model Produces Structurally Inferior Aortic Elastic Fibers Whose Failure Is Modified by Age, Sex, and Blood Pressure. Int J Mol Sci 2022; 23:6749. [PMID: 35743192 PMCID: PMC9223555 DOI: 10.3390/ijms23126749] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 12/23/2022] Open
Abstract
Lysyl oxidase (LOX) is a copper-binding enzyme that cross-links elastin and collagen. The dominant LOX variation contributes to familial thoracic aortic aneurysm. Previously reported murine Lox mutants had a mild phenotype and did not dilate without drug-induced provocation. Here, we present a new, more severe mutant, Loxb2b370.2Clo (c.G854T; p.Cys285Phe), whose mutation falls just N-terminal to the copper-binding domain. Unlike the other mutants, the C285F Lox protein was stably produced/secreted, and male C57Bl/6J Lox+/C285F mice exhibit increased systolic blood pressure (BP; p < 0.05) and reduced caliber aortas (p < 0.01 at 100mmHg) at 3 months that independently dilate by 6 months (p < 0.0001). Multimodal imaging reveals markedly irregular elastic sheets in the mutant (p = 2.8 × 10−8 for breaks by histology) that become increasingly disrupted with age (p < 0.05) and breeding into a high BP background (p = 6.8 × 10−4). Aortic dilation was amplified in males vs. females (p < 0.0001 at 100mmHg) and ameliorated by castration. The transcriptome of young Lox mutants showed alteration in dexamethasone (p = 9.83 × 10−30) and TGFβ-responsive genes (p = 7.42 × 10−29), and aortas from older C57Bl/6J Lox+/C285F mice showed both enhanced susceptibility to elastase (p < 0.01 by ANOVA) and increased deposition of aggrecan (p < 0.05). These findings suggest that the secreted Lox+/C285F mutants produce dysfunctional elastic fibers that show increased susceptibility to proteolytic damage. Over time, the progressive weakening of the connective tissue, modified by sex and blood pressure, leads to worsening aortic disease.
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Affiliation(s)
- Kit Man Tsang
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
| | - Russell H. Knutsen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
| | - Charles J. Billington
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
- Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Eric Lindberg
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
| | - Heiko Steenbock
- Institute of Virology and Cell Biology, University of Lübeck, 23562 Lübeck, Germany; (H.S.); (J.B.)
| | - Yi-Ping Fu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
| | - Amanda Wardlaw-Pickett
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
- Johns Hopkins University Applied Physics Lab, Laurel, MD 20724, USA
| | - Delong Liu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
| | - Daniela Malide
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
| | - Zu-Xi Yu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
| | - Christopher K. E. Bleck
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
| | - Jürgen Brinckmann
- Institute of Virology and Cell Biology, University of Lübeck, 23562 Lübeck, Germany; (H.S.); (J.B.)
- Department of Dermatology, University of Lübeck, 23562 Lübeck, Germany
| | - Beth A. Kozel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (K.M.T.); (R.H.K.); (C.J.B.J.); (E.L.); (Y.-P.F.); (A.W.-P.); (D.L.); (D.M.); (Z.-X.Y.); (C.K.E.B.)
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13
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Kronquist EK, Kaur M, Gober LM, Knutsen RH, Fu YP, Yu ZX, Donahue DR, Chen MY, Osgood S, Raja N, Levin MD, Barochia A, Kozel BA. Airflow Obstruction in Adults with Williams Syndrome and Mice with Elastin Insufficiency. Diagnostics (Basel) 2022; 12:diagnostics12061438. [PMID: 35741248 PMCID: PMC9221558 DOI: 10.3390/diagnostics12061438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022] Open
Abstract
Williams−Beuren syndrome (WS) results from the deletion of 25−27 coding genes, including elastin (ELN), on human chromosome 7q11.23. Elastin provides recoil to tissues; emphysema and chronic obstructive pulmonary disease have been linked to its destruction. Consequently, we hypothesized that elastin insufficiency would predispose to obstructive features. Twenty-two adults with WS (aged 18−55) and controls underwent pulmonary function testing, 6 min walk, and chest computed tomography (CT). Lung and airspace dimensions were assessed in Eln+/− and control mice via microCT and histology. The forced expiratory volume in 1 s (FEV1) and the ratio of FEV1 to forced vital capacity (FVC) were lower in adults with WS (p < 0.0001 and p < 0.05, respectively). The FEV1/FVC ratio was more frequently below the lower limit of normal in cases (p < 0.01). The ratio of residual volume to total lung capacity (RV/TLC, percent predicted) was higher in cases (p < 0.01), suggesting air trapping. People with WS showed reduced exercise capacity (p < 0.0001). In Eln+/− mice, ex vivo lung volumes were increased (p < 0.0001), with larger airspaces (p < 0.001). Together these data show that elastin insufficiency impacts lung physiology in the form of increased air trapping and obstruction, suggesting a role for lung function monitoring in adults with WS.
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Affiliation(s)
- Elise K. Kronquist
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Maninder Kaur
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Leah M. Gober
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Russell H. Knutsen
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Yi-Ping Fu
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Zu-Xi Yu
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Danielle R. Donahue
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20824, USA;
| | - Marcus Y. Chen
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Sharon Osgood
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Neelam Raja
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Mark D. Levin
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Amisha Barochia
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Beth A. Kozel
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
- Correspondence: ; Tel.: +1-301-451-2888
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14
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Knutsen RH, Gober LM, Kronquist EK, Kaur M, Donahue DR, Springer D, Yu ZX, Chen MY, Fu YP, Choobdar F, Nguyen ML, Osgood S, Freeman JL, Raja N, Levin MD, Kozel BA. Elastin Insufficiency Confers Proximal and Distal Pulmonary Vasculopathy in Mice, Partially Remedied by the KATP Channel Opener Minoxidil: Considerations and Cautions for the Treatment of People With Williams-Beuren Syndrome. Front Cardiovasc Med 2022; 9:886813. [PMID: 35665242 PMCID: PMC9160528 DOI: 10.3389/fcvm.2022.886813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Williams Beuren syndrome (WBS) is a recurrent microdeletion disorder that removes one copy of elastin (ELN), resulting in large artery vasculopathy. Early stenosis of the pulmonary vascular tree is common, but few data are available on longer-term implications of the condition. Methods Computed tomography (CT) angiogram (n = 11) and echocardiogram (n = 20) were performed in children with WBS aged 3.4–17.8 years. Controls (n = 11, aged 4.4–16.8 years) also underwent echocardiogram. Eln+/− mice were analyzed by invasive catheter, echocardiogram, micro-CT (μCT), histology, and pressure myography. We subsequently tested whether minoxidil resulted in improved pulmonary vascular endpoints. Results WBS participants with a history of main or branch pulmonary artery (PA) stenosis requiring intervention continued to exhibit increased right ventricular systolic pressure (RVSP, echocardiogram) relative to their peers without intervention (p < 0.01), with no clear difference in PA size. Untreated Eln+/− mice also show elevated RVSP by invasive catheterization (p < 0.0001), increased normalized right heart mass (p < 0.01) and reduced caliber branch PAs by pressure myography (p < 0.0001). Eln+/− main PA medias are thickened histologically relative to Eln+/+ (p < 0.0001). Most Eln+/− phenotypes are shared by both sexes, but PA medial thickness is substantially greater in Eln+/− males (p < 0.001). Eln+/− mice showed more acute proximal branching angles (p < 0.0001) and longer vascular segment lengths (p < 0.0001) (μCT), with genotype differences emerging by P7. Diminished PA acceleration time (p < 0.001) and systolic notching (p < 0.0001) were also observed in Eln+/− echocardiography. Vascular casting plus μCT revealed longer generation-specific PA arcade length (p < 0.0001), with increased PA branching detectable by P90 (p < 0.0001). Post-weaning minoxidil decreased RVSP (p < 0.01) and normalized PA caliber (p < 0.0001) but not early-onset proximal branching angle or segment length, nor later-developing peripheral branch number. Conclusions Vascular deficiencies beyond arterial caliber persist in individuals with WBS who have undergone PA stenosis intervention. Evaluation of Eln+/− mice reveals complex vascular changes that affect the proximal and distal vasculatures. Minoxidil, given post-weaning, decreases RVSP and improves lumen diameter, but does not alter other earlier-onset vascular patterns. Our data suggest additional therapies including minoxidil could be a useful adjunct to surgical therapy, and future trials should be considered.
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Affiliation(s)
- Russell H. Knutsen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Leah M. Gober
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Elise K. Kronquist
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Maninder Kaur
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Danielle R. Donahue
- Mouse Imaging Facility, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, United States
| | - Danielle Springer
- Murine Phenotyping Core, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Zu Xi Yu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Marcus Y. Chen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Yi-Ping Fu
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Feri Choobdar
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - My-Le Nguyen
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Sharon Osgood
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Joy L. Freeman
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Neelam Raja
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Mark D. Levin
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Beth A. Kozel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, United States
- *Correspondence: Beth A. Kozel
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15
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Rosenblum JS, Cappadona AJ, Lookian PP, Chandrashekhar V, Bryant JP, Chandrashekhar V, Zhao DY, Knutsen RH, Donahue DR, McGavern DB, Kozel BA, Heiss JD, Pacak K, Zhuang Z. Non-invasive in situ Visualization of the Murine Cranial Vasculature. Cell Rep Methods 2022; 2:100151. [PMID: 35373177 PMCID: PMC8967186 DOI: 10.1016/j.crmeth.2021.100151] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 09/29/2021] [Accepted: 12/20/2021] [Indexed: 11/16/2022]
Abstract
Understanding physiologic and pathologic central nervous system function depends on our ability to map the entire in situ cranial vasculature and neurovascular interfaces. To accomplish this, we developed a non-invasive workflow to visualize murine cranial vasculature via polymer casting of vessels, iterative sample processing and micro-computed tomography, and automatic deformable image registration, feature extraction, and visualization. This methodology is applicable to any tissue and allows rapid exploration of normal and altered pathologic states.
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Affiliation(s)
| | - Anthony J. Cappadona
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Pashayar P. Lookian
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - Jean-Paul Bryant
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | | | - David Y. Zhao
- Department of Neurosurgery, Medstar Georgetown University Hospital, Washington, DC 20007, USA
| | - Russell H. Knutsen
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Danielle R. Donahue
- Mouse Imaging Facility, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Dorian B. McGavern
- Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Beth A. Kozel
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - John D. Heiss
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20892, USA
| | - Karel Pacak
- Eunice Kennedy Shriver National Institute of Child Health, National Institutes of Health, Bethesda, MD 20892, USA
| | - Zhengping Zhuang
- Neuro-Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA
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16
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Lin M, Roth RA, Kozel BA, Mecham RP, Halabi CM. Loss of Angiotensin II Type 2 Receptor Improves Blood Pressure in Elastin Insufficiency. Front Cardiovasc Med 2021; 8:782138. [PMID: 34790711 PMCID: PMC8591102 DOI: 10.3389/fcvm.2021.782138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
There is ample evidence supporting a role for angiotensin II type 2 receptor (AT2R) in counterbalancing the effects of angiotensin II (ang II) through the angiotensin II type 1 receptor by promoting vasodilation and having anti-inflammatory effects. Elastin insufficiency in both humans and mice results in large artery stiffness and systolic hypertension. Unexpectedly, mesenteric arteries from elastin insufficient (Eln+/−) mice were shown to have significant vasoconstriction to AT2R agonism in vitro suggesting that AT2R may have vasoconstrictor effects in elastin insufficiency. Given the potential promise for the use of AT2R agonists clinically, the goal of this study was to determine whether AT2R has vasoconstrictive effects in elastin insufficiency in vivo. To avoid off-target effects of agonists and antagonists, mice lacking AT2R (Agtr2−/Y) were bred to Eln+/− mice and cardiovascular parameters were assessed in wild-type (WT), Agtr2−/Y, Eln+/−, and Agtr2−/Y;Eln+/− littermates. As previously published, Agtr2−/Y mice were normotensive at baseline and had no large artery stiffness, while Eln+/− mice exhibited systolic hypertension and large artery stiffness. Loss of AT2R in Eln+/− mice did not affect large artery stiffness or arterial structure but resulted in significant reduction of both systolic and diastolic blood pressure. These data support a potential vasocontractile role for AT2R in elastin insufficiency. Careful consideration and investigation are necessary to determine the patient population that might benefit from the use of AT2R agonists.
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Affiliation(s)
- Michelle Lin
- Division of Nephrology, Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, United States
| | - Robyn A Roth
- Department of Cell Biology and Physiology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Beth A Kozel
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, United States
| | - Robert P Mecham
- Department of Cell Biology and Physiology, Washington University School of Medicine, Saint Louis, MO, United States
| | - Carmen M Halabi
- Division of Nephrology, Department of Pediatrics, Washington University School of Medicine, Saint Louis, MO, United States
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17
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Biesecker LG, Adam MP, Alkuraya FS, Amemiya AR, Bamshad MJ, Beck AE, Bennett JT, Bird LM, Carey JC, Chung B, Clark RD, Cox TC, Curry C, Dinulos MBP, Dobyns WB, Giampietro PF, Girisha KM, Glass IA, Graham JM, Gripp KW, Haldeman-Englert CR, Hall BD, Innes AM, Kalish JM, Keppler-Noreuil KM, Kosaki K, Kozel BA, Mirzaa GM, Mulvihill JJ, Nowaczyk MJM, Pagon RA, Retterer K, Rope AF, Sanchez-Lara PA, Seaver LH, Shieh JT, Slavotinek AM, Sobering AK, Stevens CA, Stevenson DA, Tan TY, Tan WH, Tsai AC, Weaver DD, Williams MS, Zackai E, Zarate YA. Response to Hamosh et al. Am J Hum Genet 2021; 108:1809-1810. [PMID: 34478656 DOI: 10.1016/j.ajhg.2021.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Leslie G Biesecker
- Medical Genomics and Metabolic Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA.
| | - Margaret P Adam
- Division of Genetic Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA
| | - Fowzan S Alkuraya
- Department of Translational Genomics, King Faisal Specialist Hospital and Research Center, Riyadh 11211, Saudi Arabia
| | | | - Michael J Bamshad
- Department of Pediatrics and Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA; Brotman Baty Institute for Precision Medicine, Seattle, WA 98195, USA
| | - Anita E Beck
- Division of Genetic Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98195, USA; Seattle Children's Hospital, Seattle, WA 98015, USA
| | - James T Bennett
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute and Division Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98101, USA
| | - Lynne M Bird
- Department of Pediatrics, University of California San Diego, San Diego 92123, USA; Rady Children's Hospital, San Diego, CA 92123, USA
| | - John C Carey
- Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, UT 84108, USA
| | - Brian Chung
- Department of Paediatrics and Adolescent Medicine, Hong Kong Children's Hospital, Queen Mary Hospital, LKS Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Robin D Clark
- Loma Linda University School of Medicine, Department of Pediatrics, Division of Medical Genetics, Loma Linda, CA 92354, USA
| | - Timothy C Cox
- Department of Oral and Craniofacial Sciences, School of Dentistry and Department of Pediatrics, School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | - Cynthia Curry
- Genetic Medicine, Department of Pediatrics, University of California, Fresno, Fresno, CA 93701, USA
| | - Mary Beth Palko Dinulos
- The Geisel School of Medicine at Dartmouth, Department of Pediatrics, Section of Genetics and Child Development, Dartmouth-Hitchcock Medical Center, Lebanon, NH 03756, USA
| | - William B Dobyns
- Division of Genetics and Metabolism, Department of Pediatrics, University of Minnesota, Minneapolis, MN 55455, USA
| | | | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal 576104, India
| | - Ian A Glass
- Department of Pediatrics and Medicine, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - John M Graham
- Cedars-Sinai Medical Center and Harbor-UCLA Medical Center, David Geffen School of Medicine at UCLA, Los Angeles, CA 90048, USA
| | - Karen W Gripp
- Division of Medical Genetics, Department of Pediatrics, AI DuPont Hospital for Children/Nemours, Wilmington, DE 19803, USA
| | | | - Bryan D Hall
- Greenwood Genetic Center, Greenwood, SC 29646, USA
| | - A Micheil Innes
- Department of Medical Genetics and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, AB T3B 6A8, Canada
| | - Jennifer M Kalish
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA; Departments of Pediatrics and Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | | | - Kenjiro Kosaki
- Keio University School of Medicine, Tokyo 160-8582, Japan
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ghayda M Mirzaa
- Brotman Baty Institute for Precision Medicine, Seattle, WA 98195, USA; Center for Integrative Brain Research, Seattle Children's Research Institute, Department of Pediatrics, University of Washington, Seattle, WA 98101, USA
| | - John J Mulvihill
- University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA; National Human Genome Research Institute, Bethesda, MD 20892, USA
| | - Malgorzata J M Nowaczyk
- Molecular Medicine & Pathology and Pediatrics, McMaster University, Hamilton, ON L8S 3K9, Canada
| | - Roberta A Pagon
- Division of Genetic Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, WA 98105, USA
| | | | - Alan F Rope
- Genome Medical, South San Francisco, CA 94080, USA
| | - Pedro A Sanchez-Lara
- Department of Pediatrics, Cedars-Sinai Medical Center and David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90048, USA
| | - Laurie H Seaver
- Spectrum Health Medical Genetics and Genomics/Helen Devos Children's Hospital, Department of Pediatrics and Human Development, Michigan State University College of Human Medicine, Grand Rapids, MI 49503, USA
| | - Joseph T Shieh
- Institute for Human Genetics and Division of Medical Genetics, Department of Pediatrics Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Anne M Slavotinek
- Institute for Human Genetics and Division of Medical Genetics, Department of Pediatrics Benioff Children's Hospital, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Andrew K Sobering
- Augusta University/University of Georgia Athens, Medical Partnership, Athens, GA 30606, USA
| | - Cathy A Stevens
- Department of Pediatrics, University of Tennessee College of Medicine, Chattanooga, TN 37403, USA
| | - David A Stevenson
- Division of Medical Genetics, Department of Pediatrics, Stanford University, Palo Alto, CA 94305, USA
| | - Tiong Yang Tan
- Victorian Clinical Genetics Services, Murdoch Children's Research Institute and Department of Paediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Anne C Tsai
- Section of Genetics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - David D Weaver
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, 975 W. Walnut Street, Indianapolis, IN 46202, USA
| | - Marc S Williams
- Genomic Medicine Institute, Geisinger, Danville, PA 17822, USA
| | - Elaine Zackai
- Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, PA 19104, USA
| | - Yuri A Zarate
- Section of Genetics and Metabolism, Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA
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18
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Parrish PCR, Liu D, Knutsen RH, Billington CJ, Mecham RP, Fu YP, Kozel BA. Whole exome sequencing in patients with Williams-Beuren syndrome followed by disease modeling in mice points to four novel pathways that may modify stenosis risk. Hum Mol Genet 2021; 29:2035-2050. [PMID: 32412588 DOI: 10.1093/hmg/ddaa093] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 04/07/2020] [Accepted: 05/12/2020] [Indexed: 12/11/2022] Open
Abstract
Supravalvular aortic stenosis (SVAS) is a narrowing of the aorta caused by elastin (ELN) haploinsufficiency. SVAS severity varies among patients with Williams-Beuren syndrome (WBS), a rare disorder that removes one copy of ELN and 25-27 other genes. Twenty percent of children with WBS require one or more invasive and often risky procedures to correct the defect while 30% have no appreciable stenosis, despite sharing the same basic genetic lesion. There is no known medical therapy. Consequently, identifying genes that modify SVAS offers the potential for novel modifier-based therapeutics. To improve statistical power in our rare-disease cohort (N = 104 exomes), we utilized extreme-phenotype cohorting, functional variant filtration and pathway-based analysis. Gene set enrichment analysis of exome-wide association data identified increased adaptive immune system variant burden among genes associated with SVAS severity. Additional enrichment, using only potentially pathogenic variants known to differ in frequency between the extreme phenotype subsets, identified significant association of SVAS severity with not only immune pathway genes, but also genes involved with the extracellular matrix, G protein-coupled receptor signaling and lipid metabolism using both SKAT-O and RQTest. Complementary studies in Eln+/-; Rag1-/- mice, which lack a functional adaptive immune system, showed improvement in cardiovascular features of ELN insufficiency. Similarly, studies in mixed background Eln+/- mice confirmed that variations in genes that increase elastic fiber deposition also had positive impact on aortic caliber. By using tools to improve statistical power in combination with orthogonal analyses in mice, we detected four main pathways that contribute to SVAS risk.
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Affiliation(s)
- Phoebe C R Parrish
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA.,Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Delong Liu
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Russell H Knutsen
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA.,Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Charles J Billington
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA.,National Human Genome Research Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Robert P Mecham
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - Yi-Ping Fu
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA
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19
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Park KS, Rahat B, Lee HC, Yu ZX, Noeker J, Mitra A, Kean CM, Knutsen RH, Springer D, Gebert CM, Kozel BA, Pfeifer K. Cardiac pathologies in mouse loss of imprinting models are due to misexpression of H19 long noncoding RNA. eLife 2021; 10:67250. [PMID: 34402430 PMCID: PMC8425947 DOI: 10.7554/elife.67250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 08/04/2021] [Indexed: 12/24/2022] Open
Abstract
Maternal loss of imprinting (LOI) at the H19/IGF2 locus results in biallelic IGF2 and reduced H19 expression and is associated with Beckwith–-Wiedemann syndrome (BWS). We use mouse models for LOI to understand the relative importance of Igf2 and H19 mis-expression in BWS phenotypes. Here we focus on cardiovascular phenotypes and show that neonatal cardiomegaly is exclusively dependent on increased Igf2. Circulating IGF2 binds cardiomyocyte receptors to hyperactivate mTOR signaling, resulting in cellular hyperplasia and hypertrophy. These Igf2-dependent phenotypes are transient: cardiac size returns to normal once Igf2 expression is suppressed postnatally. However, reduced H19 expression is sufficient to cause progressive heart pathologies including fibrosis and reduced ventricular function. In the heart, H19 expression is primarily in endothelial cells (ECs) and regulates EC differentiation both in vivo and in vitro. Finally, we establish novel mouse models to show that cardiac phenotypes depend on H19 lncRNA interactions with Mirlet7 microRNAs.
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Affiliation(s)
- Ki-Sun Park
- Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
| | - Beenish Rahat
- Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
| | - Hyung Chul Lee
- Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
| | - Zu-Xi Yu
- Pathology Core, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, United States
| | - Jacob Noeker
- Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
| | - Apratim Mitra
- Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
| | - Connor M Kean
- Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
| | - Russell H Knutsen
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, United States
| | - Danielle Springer
- Murine Phenotyping Core, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, United States
| | - Claudia M Gebert
- Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
| | - Beth A Kozel
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, United States
| | - Karl Pfeifer
- Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, United States
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20
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Abstract
Williams syndrome (WS) is a relatively rare microdeletion disorder that occurs in as many as 1:7,500 individuals. WS arises due to the mispairing of low-copy DNA repetitive elements at meiosis. The deletion size is similar across most individuals with WS and leads to the loss of one copy of 25-27 genes on chromosome 7q11.23. The resulting unique disorder affects multiple systems, with cardinal features including but not limited to cardiovascular disease (characteristically stenosis of the great arteries and most notably supravalvar aortic stenosis), a distinctive craniofacial appearance, and a specific cognitive and behavioural profile that includes intellectual disability and hypersociability. Genotype-phenotype evidence is strongest for ELN, the gene encoding elastin, which is responsible for the vascular and connective tissue features of WS, and for the transcription factor genes GTF2I and GTF2IRD1, which are known to affect intellectual ability, social functioning and anxiety. Mounting evidence also ascribes phenotypic consequences to the deletion of BAZ1B, LIMK1, STX1A and MLXIPL, but more work is needed to understand the mechanism by which these deletions contribute to clinical outcomes. The age of diagnosis has fallen in regions of the world where technological advances, such as chromosomal microarray, enable clinicians to make the diagnosis of WS without formally suspecting it, allowing earlier intervention by medical and developmental specialists. Phenotypic variability is considerable for all cardinal features of WS but the specific sources of this variability remain unknown. Further investigation to identify the factors responsible for these differences may lead to mechanism-based rather than symptom-based therapies and should therefore be a high research priority.
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Affiliation(s)
- Beth A. Kozel
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, USA
| | - Boaz Barak
- The Sagol School of Neuroscience and The School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Chong Ae Kim
- Department of Pediatrics, Universidade de São Paulo, São Paulo, Brazil
| | - Carolyn B. Mervis
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, USA
| | - Lucy R. Osborne
- Department of Medicine, University of Toronto, Ontario, Canada
| | - Melanie Porter
- Department of Psychology, Macquarie University, Sydney, Australia
| | - Barbara R. Pober
- Department of Pediatrics, Massachusetts General Hospital and Harvard Medical School, Boston, USA
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21
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Troia A, Knutsen RH, Halabi CM, Malide D, Yu ZX, Wardlaw-Pickett A, Kronquist EK, Tsang KM, Kovacs A, Mecham RP, Kozel BA. Inhibition of NOX1 Mitigates Blood Pressure Increases in Elastin Insufficiency. Function (Oxf) 2021; 2:zqab015. [PMID: 34223172 PMCID: PMC8248879 DOI: 10.1093/function/zqab015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 03/06/2021] [Accepted: 03/09/2021] [Indexed: 02/07/2023]
Abstract
Elastin (ELN) insufficiency leads to the cardiovascular hallmarks of the contiguous gene deletion disorder, Williams-Beuren syndrome, including hypertension and vascular stiffness. Previous studies showed that Williams-Beuren syndrome deletions, which extended to include the NCF1 gene, were associated with lower blood pressure (BP) and reduced vascular stiffness. NCF1 encodes for p47phox, the regulatory component of the NOX1 NADPH oxidase complex that generates reactive oxygen species (ROS) in the vascular wall. Dihydroethidium and 8-hydroxyguanosine staining of mouse aortas confirmed that Eln heterozygotes (Eln+/- ) had greater ROS levels than the wild-types (Eln+/+ ), a finding that was negated in vessels cultured without hemodynamic stressors. To analyze the Nox effect on ELN insufficiency, we used both genetic and chemical manipulations. Both Ncf1 haploinsufficiency (Ncf1+/- ) and Nox1 insufficiency (Nox1-/y ) decreased oxidative stress and systolic BP in Eln+/- without modifying vascular structure. Chronic treatment with apocynin, a p47phox inhibitor, lowered systolic BP in Eln+/- , but had no impact on Eln+/+ controls. In vivo dosing with phenylephrine (PE) produced an augmented BP response in Eln+/- relative to Eln+/+ , and genetic modifications or drug-based interventions that lower Nox1 expression reduced the hypercontractile response to PE in Eln+/- mice to Eln+/+ levels. These results indicate that the mechanical and structural differences caused by ELN insufficiency leading to oscillatory flow can perpetuate oxidative stress conditions, which are linked to hypertension, and that by lowering the Nox1-mediated capacity for vascular ROS production, BP differences can be normalized.
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Affiliation(s)
- Angela Troia
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Russell H Knutsen
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Carmen M Halabi
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Daniela Malide
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Zu Xi Yu
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Amanda Wardlaw-Pickett
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Elise K Kronquist
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kit Man Tsang
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Attila Kovacs
- Department of Internal Medicine, Cardiovascular Division, Washington University School of Medicine, St. Louis, MO, USA
| | - Robert P Mecham
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Beth A Kozel
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA,Address correspondence to B.A.K. (e-mail: )
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22
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Rosenblum JS, Wang H, Dmitriev PM, Cappadona AJ, Mastorakos P, Xu C, Jha A, Edwards N, Donahue DR, Munasinghe J, Nazari MA, Knutsen RH, Rosenblum BR, Smirniotopoulos JG, Pappo A, Spetzler RF, Vortmeyer A, Gilbert MR, McGavern DB, Chew E, Kozel BA, Heiss JD, Zhuang Z, Pacak K. Developmental vascular malformations in EPAS1 gain-of-function syndrome. JCI Insight 2021; 6:144368. [PMID: 33497361 PMCID: PMC8021124 DOI: 10.1172/jci.insight.144368] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 01/21/2021] [Indexed: 12/21/2022] Open
Abstract
Mutations in EPAS1, encoding hypoxia-inducible factor-2α (HIF-2α), were previously identified in a syndrome of multiple paragangliomas, somatostatinoma, and polycythemia. HIF-2α, when dimerized with HIF-1β, acts as an angiogenic transcription factor. Patients referred to the NIH for new, recurrent, and/or metastatic paraganglioma or pheochromocytoma were confirmed for EPAS1 gain-of-function mutation; imaging was evaluated for vascular malformations. We evaluated the Epas1A529V transgenic syndrome mouse model, corresponding to the mutation initially detected in the patients (EPAS1A530V), for vascular malformations via intravital 2-photon microscopy of meningeal vessels, terminal vascular perfusion with Microfil silicate polymer and subsequent intact ex vivo 14T MRI and micro-CT, and histologic sectioning and staining of the brain and identified pathologies. Further, we evaluated retinas from corresponding developmental time points (P7, P14, and P21) and the adult dura via immunofluorescent labeling of vessels and confocal imaging. We identified a spectrum of vascular malformations in all 9 syndromic patients and in all our tested mutant mice. Patient vessels had higher variant allele frequency than adjacent normal tissue. Veins of the murine retina and intracranial dura failed to regress normally at the expected developmental time points. These findings add vascular malformation as a new clinical feature of EPAS1 gain-of-function syndrome. We discovered vascular malformations due to failure of developmental vascular regression in patients with EPAS1 gain-of-function mutation syndrome and the corresponding transgenic mouse model.
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Affiliation(s)
- Jared S Rosenblum
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Herui Wang
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Pauline M Dmitriev
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Anthony J Cappadona
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Panagiotis Mastorakos
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA.,Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Chen Xu
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Abhishek Jha
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
| | - Nancy Edwards
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Danielle R Donahue
- Mouse Imaging Facility, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Jeeva Munasinghe
- Mouse Imaging Facility, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Matthew A Nazari
- Internal Medicine and Pediatrics, MedStar Georgetown University Hospital, Washington, DC, USA
| | - Russell H Knutsen
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, NIH, Bethesda, Maryland, USA
| | - Bruce R Rosenblum
- Department of Neurosurgery, Riverview Medical Center, Red Bank, New Jersey, USA
| | - James G Smirniotopoulos
- Department of Radiology, School of Medicine and Health Sciences, George Washington University, Washington, DC, USA.,National Library of Medicine, Bethesda, Maryland, USA
| | - Alberto Pappo
- Oncology Department, Developmental Biology and Solid Tumor Program, St. Jude Comprehensive Cancer Center, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Robert F Spetzler
- Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital, and Medical Center, Phoenix, Arizona, USA
| | - Alexander Vortmeyer
- Department of Pathology and Laboratory Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Mark R Gilbert
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Dorian B McGavern
- Viral Immunology and Intravital Imaging Section, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Emily Chew
- Division of Epidemiology and Clinical Applications, National Eye Institute, NIH, Bethesda, Maryland, USA
| | - Beth A Kozel
- Laboratory of Vascular and Matrix Genetics, National Heart Lung and Blood Institute, NIH, Bethesda, Maryland, USA
| | - John D Heiss
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, NIH, Bethesda, Maryland, USA
| | - Zhengping Zhuang
- Neuro-Oncology Branch, National Cancer Institute, NIH, Bethesda, Maryland, USA
| | - Karel Pacak
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver, National Institute of Child Health and Human Development, NIH, Bethesda, Maryland, USA
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23
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Nguyen DT, Larsen TC, Wang M, Knutsen RH, Yang Z, Bennett EE, Mazilu D, Yu ZX, Tao X, Donahue DR, Gharib AM, Bleck CKE, Moss J, Remaley AT, Kozel BA, Wen H. X-ray microtomosynthesis of unstained pathology tissue samples. J Microsc 2021; 283:9-20. [PMID: 33482682 PMCID: PMC8248055 DOI: 10.1111/jmi.13003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 12/14/2020] [Accepted: 01/17/2021] [Indexed: 12/15/2022]
Abstract
In pathology protocols, a tissue block, such as one containing a mouse brain or a biopsy sample from a patient, can produce several hundred thin sections. Substantial time may be required to analyse all sections. In cases of uncertainty regarding which sections to focus on, noninvasive scout imaging of intact blocks can help in guiding the pathology procedure. The scouting step is ideally done in a time window of minutes without special sample preparation that may interfere with the pathology procedures. The challenge is to obtain some visibility of unstained tissue structures at sub‐10 µm resolution. We explored a novel x‐ray tomosynthesis method as a way to maximise contrast‐to‐noise ratio, a determinant of tissue visibility. It provided a z‐stack of thousands of images at 7.3 μm resolution (10% contrast, half‐period of 68.5 line pairs/mm), in scans of 5‐15 minutes. When compared with micro‐CT scans, the straight‐line tomosynthesis scan did not need to rotate the sample, which allowed flat samples, such as paraffin blocks, to be kept as close as possible to the x‐ray source. Thus, given the same hardware, scan time and resolution, this mode maximised the photon flux density through the sample, which helped in maximising the contrast‐to‐noise ratio. The tradeoff of tomosynthesis is incomplete 3D information. The microtomosynthesis scanner has scanned 110 unstained human and animal tissue samples as part of their respective pathology protocols. In all cases, the z‐stack of images showed tissue structures that guided sectioning or provided correlative structural information. We describe six examples that presented different levels of visibility of soft tissue structures. Additionally, in a set of coronary artery samples from an HIV patient donor, microtomosynthesis made a new discovery of isolated focal calcification in the internal elastic lamina of coronary wall, which was the onset of medial calcific sclerosis in the arteries.
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Affiliation(s)
- David T Nguyen
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Muyang Wang
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Russel H Knutsen
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Zhihong Yang
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Eric E Bennett
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Dumitru Mazilu
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Zu-Xi Yu
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Xi Tao
- School of Biomedical Engineering, Southern Medical University, Guangzhou, Guangdong, China
| | - Danielle R Donahue
- Mouse Imaging Facility, National Institutes of Health, Bethesda, Maryland
| | - Ahmed M Gharib
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Christopher K E Bleck
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Joel Moss
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Alan T Remaley
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Beth A Kozel
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Han Wen
- National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
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24
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Dmitrieva NI, Walts AD, Nguyen DP, Grubb A, Zhang X, Wang X, Ping X, Jin H, Yu Z, Yu ZX, Yang D, Schwartzbeck R, Dalgard CL, Kozel BA, Levin MD, Knutsen RH, Liu D, Milner JD, López DB, O'Connell MP, Lee CCR, Myles IA, Hsu AP, Freeman AF, Holland SM, Chen G, Boehm M. Impaired angiogenesis and extracellular matrix metabolism in autosomal-dominant hyper-IgE syndrome. J Clin Invest 2021; 130:4167-4181. [PMID: 32369445 DOI: 10.1172/jci135490] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 04/29/2020] [Indexed: 12/21/2022] Open
Abstract
There are more than 7000 described rare diseases, most lacking specific treatment. Autosomal-dominant hyper-IgE syndrome (AD-HIES, also known as Job's syndrome) is caused by mutations in STAT3. These patients present with immunodeficiency accompanied by severe nonimmunological features, including skeletal, connective tissue, and vascular abnormalities, poor postinfection lung healing, and subsequent pulmonary failure. No specific therapies are available for these abnormalities. Here, we investigated underlying mechanisms in order to identify therapeutic targets. Histological analysis of skin wounds demonstrated delayed granulation tissue formation and vascularization during skin-wound healing in AD-HIES patients. Global gene expression analysis in AD-HIES patient skin fibroblasts identified deficiencies in a STAT3-controlled transcriptional network regulating extracellular matrix (ECM) remodeling and angiogenesis, with hypoxia-inducible factor 1α (HIF-1α) being a major contributor. Consistent with this, histological analysis of skin wounds and coronary arteries from AD-HIES patients showed decreased HIF-1α expression and revealed abnormal organization of the ECM and altered formation of the coronary vasa vasorum. Disease modeling using cell culture and mouse models of angiogenesis and wound healing confirmed these predicted deficiencies and demonstrated therapeutic benefit of HIF-1α-stabilizing drugs. The study provides mechanistic insights into AD-HIES pathophysiology and suggests potential treatment options for this rare disease.
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Affiliation(s)
- Natalia I Dmitrieva
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Avram D Walts
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Dai Phuong Nguyen
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Alex Grubb
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Xue Zhang
- Bioinformatics and Systems Biology Core, and
| | - Xujing Wang
- Bioinformatics and Systems Biology Core, and
| | - Xianfeng Ping
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Hui Jin
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Zhen Yu
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Zu-Xi Yu
- Pathology Core, National Heart, Lung, and Blood Institute (NHLBI), NIH, Bethesda, Maryland, USA
| | - Dan Yang
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Robin Schwartzbeck
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Clifton L Dalgard
- Department of Anatomy, Physiology & Genetics.,The American Genome Center, and.,Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Beth A Kozel
- Laboratory of Vascular and Matrix Genetics, NHLBI
| | - Mark D Levin
- Laboratory of Vascular and Matrix Genetics, NHLBI
| | | | - Delong Liu
- Laboratory of Vascular and Matrix Genetics, NHLBI
| | - Joshua D Milner
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | - Diego B López
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | - Michael P O'Connell
- Laboratory of Allergic Diseases, National Institute of Allergy and Infectious Diseases (NIAID)
| | - Chyi-Chia Richard Lee
- Laboratory of Pathology, Center for Cancer Research, National Cancer Institute (NCI), and
| | - Ian A Myles
- Laboratory of Clinical Immunology and Microbiology, NIAID, NIH, Bethesda, Maryland, USA
| | - Amy P Hsu
- Laboratory of Clinical Immunology and Microbiology, NIAID, NIH, Bethesda, Maryland, USA
| | - Alexandra F Freeman
- Laboratory of Clinical Immunology and Microbiology, NIAID, NIH, Bethesda, Maryland, USA
| | - Steven M Holland
- Laboratory of Clinical Immunology and Microbiology, NIAID, NIH, Bethesda, Maryland, USA
| | - Guibin Chen
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
| | - Manfred Boehm
- Laboratory of Cardiovascular Regenerative Medicine, Translational Vascular Medicine Branch
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25
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Addissie YA, Troia A, Wong ZC, Everson JL, Kozel BA, Muenke M, Lipinski RJ, Malecki KMC, Kruszka P. Identifying environmental risk factors and gene-environment interactions in holoprosencephaly. Birth Defects Res 2020; 113:63-76. [PMID: 33111505 DOI: 10.1002/bdr2.1834] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 10/11/2020] [Accepted: 10/16/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Holoprosencephaly is the most common malformation of the forebrain (1 in 250 embryos) with severe consequences for fetal and child development. This study evaluates nongenetic factors associated with holoprosencephaly risk, severity, and gene-environment interactions. METHODS For this retrospective case control study, we developed an online questionnaire focusing on exposures to common and rare toxins/toxicants before and during pregnancy, nutritional factors, maternal health history, and demographic factors. Patients with holoprosencephaly were primarily ascertained from our ongoing genetic and clinical studies of holoprosencephaly. Controls included children with Williams-Beuren syndrome (WBS) ascertained through online advertisements in a WBD support group and fliers. RESULTS Difference in odds of exposures between cases and controls as well as within cases with varying holoprosencephaly severity were studied. Cases included children born with holoprosencephaly (n = 92) and the control group consisted of children with WBS (n = 56). Pregnancy associated risk associated with holoprosencephaly included maternal pregestational diabetes (9.2% of cases and 0 controls, p = .02), higher alcohol consumption (adjusted odds ratio [aOR], 1.73; 95% CI, 0.88-15.71), and exposure to consumer products such as aerosols or sprays including hair sprays (aOR, 2.46; 95% CI, 0.89-7.19). Significant gene-environment interactions were identified including for consumption of cheese (p < .05) and espresso drinks (p = .03). CONCLUSION The study identifies modifiable risk factors and gene-environment interactions that should be considered in future prevention of holoprosencephaly. Studies with larger HPE cohorts will be needed to confirm these findings.
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Affiliation(s)
- Yonit A Addissie
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland, USA
| | - Angela Troia
- Cardiovascular & Pulmonary Branch, National Heart, Lung, and Blood Institute, The National Institutes of Health, Bethesda, Maryland, USA
| | - Zoe C Wong
- Cardiovascular & Pulmonary Branch, National Heart, Lung, and Blood Institute, The National Institutes of Health, Bethesda, Maryland, USA
| | - Joshua L Everson
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Beth A Kozel
- Cardiovascular & Pulmonary Branch, National Heart, Lung, and Blood Institute, The National Institutes of Health, Bethesda, Maryland, USA
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland, USA
| | - Robert J Lipinski
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Kristen M C Malecki
- Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Paul Kruszka
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland, USA
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26
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Knutsen RH, Gober LM, Sukinik JR, Donahue DR, Kronquist EK, Levin MD, McLean SE, Kozel BA. Vascular Casting of Adult and Early Postnatal Mouse Lungs for Micro-CT Imaging. J Vis Exp 2020. [PMID: 32628170 DOI: 10.3791/61242] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Blood vessels form intricate networks in 3-dimensional space. Consequently, it is difficult to visually appreciate how vascular networks interact and behave by observing the surface of a tissue. This method provides a means to visualize the complex 3-dimensional vascular architecture of the lung. To accomplish this, a catheter is inserted into the pulmonary artery and the vasculature is simultaneously flushed of blood and chemically dilated to limit resistance. Lungs are then inflated through the trachea at a standard pressure and the polymer compound is infused into the vascular bed at a standard flow rate. Once the entire arterial network is filled and allowed to cure, the lung vasculature may be visualized directly or imaged on a micro-CT (µCT) scanner. When performed successfully, one can appreciate the pulmonary arterial network in mice ranging from early postnatal ages to adults. Additionally, while demonstrated in the pulmonary arterial bed, this method can be applied to any vascular bed with optimized catheter placement and endpoints.
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Affiliation(s)
- Russell H Knutsen
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Leah M Gober
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Joseph R Sukinik
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Danielle R Donahue
- Mouse Imaging Facility, National Institute of Neurological Disorders and Stroke, National Institutes of Health
| | - Elise K Kronquist
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Mark D Levin
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health
| | - Sean E McLean
- Division of Pediatric Surgery, Department of Surgery, University of North Carolina at Chapel Hill
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart Lung and Blood Institute, National Institutes of Health;
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27
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Addissie YA, Kruszka P, Troia A, Wong ZC, Everson JL, Kozel BA, Lipinski RJ, Malecki KMC, Muenke M. Prenatal exposure to pesticides and risk for holoprosencephaly: a case-control study. Environ Health 2020; 19:65. [PMID: 32513280 PMCID: PMC7278164 DOI: 10.1186/s12940-020-00611-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 05/19/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND Pesticide exposure during susceptible windows and at certain doses are linked to numerous birth defects. Early experimental evidence suggests an association between active ingredients in pesticides and holoprosencephaly (HPE), the most common malformation of the forebrain in humans (1 in 250 embryos). No human studies to date have examined the association. This study investigated pesticides during multiple windows of exposure and fetal risk for HPE. It is hypothesized that pre-conception and early pregnancy, the time of brain development in utero, are the most critical windows of exposure. METHODS A questionnaire was developed for this retrospective case-control study to estimate household, occupational, and environmental pesticide exposures. Four windows of exposure were considered: preconception, early, mid and late pregnancy. Cases were identified through the National Human Genome Research Institute's ongoing clinical studies of HPE. Similarly, controls were identified as children with Williams-Beuren syndrome, a genetic syndrome also characterized by congenital malformations, but etiologically unrelated to HPE. We assessed for differences in odds of exposures to pesticides between cases and controls. RESULTS Findings from 91 cases and 56 controls showed an increased risk for HPE with reports of maternal exposure during pregnancy to select pesticides including personal insect repellants (adjusted odds ratio (aOR) 2.89, confidence interval (CI): 0.96-9.50) and insecticides and acaricides for pets (aOR 3.84, CI:1.04-16.32). Exposure to household pest control products during the preconception period or during pregnancy was associated with increased risk for HPE (aOR 2.60, OR: 0.84-8.68). No associations were found for occupational exposures to pesticides during pregnancy (aOR: 1.15, CI: 0.11-11.42), although exposure rates were low. Higher likelihood for HPE was also observed with residency next to an agricultural field (aOR 3.24, CI: 0.94-12.31). CONCLUSIONS Observational findings are consistent with experimental evidence and suggest that exposure to personal, household, and agricultural pesticides during pregnancy may increase risk for HPE. Further investigations of gene by environment interactions are warranted.
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Affiliation(s)
- Yonit A Addissie
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, MD, USA
| | - Paul Kruszka
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, MD, USA.
| | - Angela Troia
- National Heart, Lung, and Blood Institute, The National Institutes of Health, Bethesda, MD, USA
| | - Zoë C Wong
- National Heart, Lung, and Blood Institute, The National Institutes of Health, Bethesda, MD, USA
| | - Joshua L Everson
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Beth A Kozel
- National Heart, Lung, and Blood Institute, The National Institutes of Health, Bethesda, MD, USA
| | - Robert J Lipinski
- Department of Comparative Biosciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Kristen M C Malecki
- Molecular and Environmental Toxicology Center, University of Wisconsin-Madison, Madison, WI, USA
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, MD, USA
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28
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Rosenblum JS, Cappadona AJ, Argersinger DP, Pang Y, Wang H, Nazari MA, Munasinghe JP, Donahue DR, Jha A, Smirniotopoulos JG, Miettinen MM, Knutsen RH, Kozel BA, Zhuang Z, Pacak K, Heiss JD. Neuraxial dysraphism in EPAS1-associated syndrome due to improper mesenchymal transition. Neurol Genet 2020; 6:e414. [PMID: 32337341 PMCID: PMC7164966 DOI: 10.1212/nxg.0000000000000414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 02/06/2020] [Indexed: 01/25/2023]
Abstract
Objective To investigate the effect of somatic, postzygotic, gain-of-function mutation of Endothelial Per-Arnt-Sim (PAS) domain protein 1 (EPAS1) encoding hypoxia-inducible factor-2α (HIF-2α) on posterior fossa development and spinal dysraphism in EPAS1 gain-of-function syndrome, which consists of multiple paragangliomas, somatostatinoma, and polycythemia. Methods Patients referred to our institution for evaluation of new, recurrent, and/or metastatic paragangliomas/pheochromocytoma were confirmed for EPAS1 gain-of-function syndrome by identification of the EPAS1 gain-of-function mutation in resected tumors and/or circulating leukocytes. The posterior fossa, its contents, and the spine were evaluated retrospectively on available MRI and CT images of the head and neck performed for tumor staging and restaging. The transgenic mouse model underwent Microfil vascular perfusion and subsequent intact ex vivo 14T MRI and micro-CT as well as gross dissection, histology, and immunohistochemistry to assess the role of EPAS1 in identified malformations. Results All 8 patients with EPAS1 gain-of-function syndrome demonstrated incidental posterior fossa malformations—one Dandy-Walker variant and 7 Chiari malformations without syringomyelia. These findings were not associated with a small posterior fossa; rather, the posterior fossa volume exceeded that of its neural contents. Seven of 8 patients demonstrated spinal dysraphism; 4 of 8 demonstrated abnormal vertebral segmentation. The mouse model similarly demonstrated features of neuraxial dysraphism, including cervical myelomeningocele and spinal dysraphism, and cerebellar tonsil displacement through the foramen magnum. Histology and immunohistochemistry demonstrated incomplete mesenchymal transition in the mutant but not the control mouse. Conclusions This study characterized posterior fossa and spinal malformations seen in EPAS1 gain-of-function syndrome and suggests that gain-of-function mutation in HIF-2α results in improper mesenchymal transition.
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Affiliation(s)
- Jared S Rosenblum
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Anthony J Cappadona
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Davis P Argersinger
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Ying Pang
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Herui Wang
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Matthew A Nazari
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Jeeva P Munasinghe
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Danielle R Donahue
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Abhishek Jha
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - James G Smirniotopoulos
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Markku M Miettinen
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Russell H Knutsen
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Beth A Kozel
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Zhengping Zhuang
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - Karel Pacak
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
| | - John D Heiss
- National Institutes of Health (J.S.R., A.J.C., H.W., Z.Z.), National Cancer Institute Neuro-Oncology Branch; National Institutes of Health (D.P.A., J.D.H.), National Institute of Neurological Disorders and Stroke, Surgical Neurology Branch; National Institutes of Health (Y.P., A.J., K.P.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, Section on Medical Neuroendocrinology; Georgetown Hospital (M.A.N.), Internal Medicine and Pediatrics, Washington DC; National Institutes of Health (J.P.M., D.R.D.), National Institute of Neurological Disorders and Stroke, Mouse Imaging Facility, Bethesda, MD; George Washington University (J.G.S.), Radiology, Washington DC; National Library of Medicine (J.G.S.), MedPix®; National Institutes of Health (M.M.M.), Center for Cancer Research, National Cancer Institute, Laboratory of Pathology; and National Institutes of Health (R.H.K., B.A.K.), National Heart Lung and Blood Institute, Translational Vascular Medicine Branch, Bethesda, MD
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29
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Lugo M, Wong ZC, Billington CJ, Parrish PCR, Muldoon G, Liu D, Pober BR, Kozel BA. Social, neurodevelopmental, endocrine, and head size differences associated with atypical deletions in Williams-Beuren syndrome. Am J Med Genet A 2020; 182:1008-1020. [PMID: 32077592 DOI: 10.1002/ajmg.a.61522] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 01/22/2020] [Accepted: 01/28/2020] [Indexed: 12/21/2022]
Abstract
Williams-Beuren syndrome (WBS) is a multisystem disorder caused by a hemizygous deletion on 7q11.23 encompassing 26-28 genes. An estimated 2-5% of patients have "atypical" deletions, which extend in the centromeric and/or telomeric direction from the WBS critical region. To elucidate clinical differentiators among these deletion types, we evaluated 10 individuals with atypical deletions in our cohort and 17 individuals with similarly classified deletions previously described in the literature. Larger deletions in either direction often led to more severe developmental delays, while deletions containing MAGI2 were associated with infantile spasms and seizures in patients. In addition, head size was notably smaller in those with centromeric deletions including AUTS2. Because children with atypical deletions were noted to be less socially engaged, we additionally sought to determine how atypical deletions relate to social phenotypes. Using the Social Responsiveness Scale-2, raters scored individuals with atypical deletions as having different social characteristics to those with typical WBS deletions (p = .001), with higher (more impaired) scores for social motivation (p = .005) in the atypical deletion group. In recognizing these distinctions, physicians can better identify patients, including those who may already carry a clinical or FISH WBS diagnosis, who may benefit from additional molecular evaluation, screening, and therapy. In addition to the clinical findings, we note mild endocrine findings distinct from those typically seen in WBS in several patients with telomeric deletions that included POR. Further study in additional telomeric deletion cases will be needed to confirm this observation.
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Affiliation(s)
- Michael Lugo
- Department of Pediatrics, Medical University of South Carolina, Charleston, South Carolina.,Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Zoë C Wong
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Charles J Billington
- Medical Genetics and Genomic Medicine Training Program, National Human Genetics Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Phoebe C R Parrish
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.,Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Glennis Muldoon
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Delong Liu
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Barbara R Pober
- Department of Pediatrics, Massachusetts General Hospital, Boston, Massachusetts
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.,Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
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30
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Abstract
Studies over the years have described a filamentous structure to mature elastin that suggests a complicated packing arrangement of tropoelastin subunits. The currently accepted mechanism for tropoelastin assembly requires microfibrils to serve as a physical extracellular scaffold for alignment of tropoelastin monomers during and before crosslinking. However, recent evidence suggests that the initial stages of tropoelastin assembly occur within the cell or at unique assembly sites on the plasma membrane where tropoelastin self assembles to form elastin aggregates. Outside the cell, elastin aggregates transfer to growing elastic fibers in the extracellular matrix where tensional forces on microfibrils generated through cell movement help shape the growing fiber. Overall, these observations challenge the widely held idea that interaction between monomeric tropoelastin and microfibrils is a requirement for elastin assembly, and point to self-assembly of tropoelastin as a driving force in elastin maturation.
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Affiliation(s)
- Beth A Kozel
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Robert P Mecham
- Department of Cell Biology and Physiology, Washington University School of Medicine, Campus Box 8228, 660 South Euclid Ave, St. Louis, MO, 63110, USA.
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31
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Kruszka P, Porras AR, de Souza DH, Moresco A, Huckstadt V, Gill AD, Boyle AP, Hu T, Addissie YA, Mok GTK, Tekendo-Ngongang C, Fieggen K, Prijoles EJ, Tanpaiboon P, Honey E, Luk HM, Lo IFM, Thong MK, Muthukumarasamy P, Jones KL, Belhassan K, Ouldim K, El Bouchikhi I, Bouguenouch L, Shukla A, Girisha KM, Sirisena ND, Dissanayake VHW, Paththinige CS, Mishra R, Kisling MS, Ferreira CR, de Herreros MB, Lee NC, Jamuar SS, Lai A, Tan ES, Ying Lim J, Wen-Min CB, Gupta N, Lotz-Esquivel S, Badilla-Porras R, Hussen DF, El Ruby MO, Ashaat EA, Patil SJ, Dowsett L, Eaton A, Innes AM, Shotelersuk V, Badoe Ë, Wonkam A, Obregon MG, Chung BHY, Trubnykova M, La Serna J, Gallardo Jugo BE, Chávez Pastor M, Abarca Barriga HH, Megarbane A, Kozel BA, van Haelst MM, Stevenson RE, Summar M, Adeyemo AA, Morris CA, Moretti-Ferreira D, Linguraru MG, Muenke M. Williams-Beuren syndrome in diverse populations. Am J Med Genet A 2019; 176:1128-1136. [PMID: 29681090 DOI: 10.1002/ajmg.a.38672] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 02/08/2018] [Accepted: 02/20/2018] [Indexed: 01/12/2023]
Abstract
Williams-Beuren syndrome (WBS) is a common microdeletion syndrome characterized by a 1.5Mb deletion in 7q11.23. The phenotype of WBS has been well described in populations of European descent with not as much attention given to other ethnicities. In this study, individuals with WBS from diverse populations were assessed clinically and by facial analysis technology. Clinical data and images from 137 individuals with WBS were found in 19 countries with an average age of 11 years and female gender of 45%. The most common clinical phenotype elements were periorbital fullness and intellectual disability which were present in greater than 90% of our cohort. Additionally, 75% or greater of all individuals with WBS had malar flattening, long philtrum, wide mouth, and small jaw. Using facial analysis technology, we compared 286 Asian, African, Caucasian, and Latin American individuals with WBS with 286 gender and age matched controls and found that the accuracy to discriminate between WBS and controls was 0.90 when the entire cohort was evaluated concurrently. The test accuracy of the facial recognition technology increased significantly when the cohort was analyzed by specific ethnic population (P-value < 0.001 for all comparisons), with accuracies for Caucasian, African, Asian, and Latin American groups of 0.92, 0.96, 0.92, and 0.93, respectively. In summary, we present consistent clinical findings from global populations with WBS and demonstrate how facial analysis technology can support clinicians in making accurate WBS diagnoses.
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Affiliation(s)
- Paul Kruszka
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
| | - Antonio R Porras
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Deise Helena de Souza
- Department of Genetics, Institute of Biosciences, Sao Paulo State University - UNESP, São Paulo, Brazil
| | - Angélica Moresco
- Servicio de Genética, Hospital de Pediatría Garrahan, Buenos Aires, Argentina
| | - Victoria Huckstadt
- Servicio de Genética, Hospital de Pediatría Garrahan, Buenos Aires, Argentina
| | - Ashleigh D Gill
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
| | - Alec P Boyle
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Tommy Hu
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
| | - Yonit A Addissie
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
| | - Gary T K Mok
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hongkong, China
| | | | - Karen Fieggen
- Division of Human Genetics, University of Cape Town, Cape Town, South Africa
| | | | - Pranoot Tanpaiboon
- Rare Disease Institute, Children's National Medical Center, Washington, District of Columbia
| | - Engela Honey
- Department of Genetics, University of Pretoria, Pretoria, South Africa
| | - Ho-Ming Luk
- Clinical Genetic Service, Department of Health, Hong Kong Special Administrative Region, Hongkong, China
| | - Ivan F M Lo
- Clinical Genetic Service, Department of Health, Hong Kong Special Administrative Region, Hongkong, China
| | - Meow-Keong Thong
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Premala Muthukumarasamy
- Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Kelly L Jones
- Division of Medical Genetics and Metabolism, Children's Hospital of The King's Daughters, Norfolk, Virginia
| | - Khadija Belhassan
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland.,Medical Genetics and Oncogenetics Unit, Hassan II University Hospital, Fez, Morocco
| | - Karim Ouldim
- Medical Genetics and Oncogenetics Unit, Hassan II University Hospital, Fez, Morocco
| | - Ihssane El Bouchikhi
- Medical Genetics and Oncogenetics Unit, Hassan II University Hospital, Fez, Morocco.,Laboratory of Microbial Biotechnology, Faculty of Sciences and Techniques, University of Sidi Mohammed Ben Abdellah, Fez, Morocco
| | - Laila Bouguenouch
- Medical Genetics and Oncogenetics Unit, Hassan II University Hospital, Fez, Morocco
| | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
| | - Nirmala D Sirisena
- Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | | | | | - Rupesh Mishra
- Human Genetics Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Monisha S Kisling
- Rare Disease Institute, Children's National Medical Center, Washington, District of Columbia
| | - Carlos R Ferreira
- Rare Disease Institute, Children's National Medical Center, Washington, District of Columbia
| | - María Beatriz de Herreros
- National Secretariat for the Rights of People with Disabilities (SENADIS), Fernando de la Mora, Paraguay
| | - Ni-Chung Lee
- Department of Pediatrics and Medical Genetics, National Taiwan University Hospital, Taipei, Taiwan
| | - Saumya S Jamuar
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Angeline Lai
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Ee Shien Tan
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Jiin Ying Lim
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Cham Breana Wen-Min
- Genetics Service, Department of Paediatrics, KK Women's and Children's Hospital, Singapore, Singapore
| | - Neerja Gupta
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | | | - Ramsés Badilla-Porras
- Medical Genetics and Metabolism Department, Hospital Nacional de Niños (CCSS), San José, Costa Rica
| | - Dalia Farouk Hussen
- Department of Human Cytogenetics, The National Research Centre, Cairo, Egypt
| | - Mona O El Ruby
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | - Engy A Ashaat
- Clinical Genetics Department, National Research Centre, Cairo, Egypt
| | | | - Leah Dowsett
- Kapi'olani Medical Center for Women and Children, Honolulu, Hawaii
| | - Alison Eaton
- Department of Medical Genetics and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - A Micheil Innes
- Department of Medical Genetics and Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta
| | - Vorasuk Shotelersuk
- Center of Excellence for Medical Genetics, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Ëben Badoe
- School of Medicine and Dentistry, College of Health Sciences, University of Ghana, Accra, Ghana
| | - Ambroise Wonkam
- Division of Human Genetics, University of Cape Town, Cape Town, South Africa
| | | | - Brian H Y Chung
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hongkong, China
| | | | | | | | | | | | | | - Beth A Kozel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Mieke M van Haelst
- Department of Genetics, University Medical Centre, Utrecht, Utrecht, The Netherlands
| | | | - Marshall Summar
- Rare Disease Institute, Children's National Medical Center, Washington, District of Columbia
| | - A Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
| | - Colleen A Morris
- Department of Pediatrics (Genetics Division), University of Nevada School of Medicine, Las Vegas, Nevada
| | - Danilo Moretti-Ferreira
- Department of Genetics, Institute of Biosciences, Sao Paulo State University - UNESP, São Paulo, Brazil
| | - Marius George Linguraru
- Sheikh Zayed Institute for Pediatric Surgical Innovation, Children's National Health System, Washington, District of Columbia
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research Institute, The National Institutes of Health, Bethesda, Maryland
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32
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Kopp ND, Parrish PCR, Lugo M, Dougherty JD, Kozel BA. Exome sequencing of 85 Williams-Beuren syndrome cases rules out coding variation as a major contributor to remaining variance in social behavior. Mol Genet Genomic Med 2018; 6:749-765. [PMID: 30008175 PMCID: PMC6160704 DOI: 10.1002/mgg3.429] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 05/03/2018] [Accepted: 06/11/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Large, multigenic deletions at chromosome 7q11.23 result in a highly penetrant constellation of physical and behavioral symptoms known as Williams-Beuren syndrome (WS). Of particular interest is the unusual social-cognitive profile evidenced by deficits in social cognition and communication reminiscent of autism spectrum disorders (ASD) that are juxtaposed with normal or even relatively enhanced social motivation. Interestingly, duplications in the same region also result in ASD-like phenotypes as well as social phobias. Thus, the region clearly regulates human social motivation and behavior, yet the relevant gene(s) have not been definitively identified. METHOD Here, we deeply phenotyped 85 individuals with WS and used exome sequencing to analyze common and rare variation for association with the remaining variance in social behavior as assessed by the Social Responsiveness Scale. RESULTS We replicated the previously reported unusual juxtaposition of behavioral symptoms in this new patient collection, but we did not find any new alleles of large effect in the targeted analysis of the remaining copy of genes in the Williams syndrome critical region. However, we report on two nominally significant SNPs in two genes that have been implicated in the cognitive and social phenotypes of Williams syndrome, BAZ1B and GTF2IRD1. Secondary discovery driven explorations focusing on known ASD genes and an exome wide scan do not highlight any variants of a large effect. CONCLUSIONS Whole exome sequencing of 85 individuals with WS did not support the hypothesis that there are variants of large effect within the remaining Williams syndrome critical region that contribute to the social phenotype. This deeply phenotyped and genotyped patient cohort with a defined mutation provides the opportunity for similar analyses focusing on noncoding variation and/or other phenotypic domains.
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Affiliation(s)
- Nathan D. Kopp
- Department of GeneticsWashington University School of MedicineSt. LouisMissouri
| | - Phoebe C. R. Parrish
- National Heart Lung and Blood InstituteNational Institutes of HealthBethesdaMaryland
| | - Michael Lugo
- National Heart Lung and Blood InstituteNational Institutes of HealthBethesdaMaryland
- Department of PediatricsWashington University School of MedicineSt. LouisMissouri
| | - Joseph D. Dougherty
- Department of GeneticsWashington University School of MedicineSt. LouisMissouri
- Department of PsychiatryWashington University School of MedicineSt. LouisMissouri
| | - Beth A. Kozel
- National Heart Lung and Blood InstituteNational Institutes of HealthBethesdaMaryland
- Department of PediatricsWashington University School of MedicineSt. LouisMissouri
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33
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Kruszka P, Porras AR, de Souza DH, Moresco A, Huckstadt V, Gill AD, Boyle AP, Hu T, Addissie YA, Mok GTK, Tekendo‐Ngongang C, Fieggen K, Prijoles EJ, Tanpaiboon P, Honey E, Luk H, Lo IFM, Thong M, Muthukumarasamy P, Jones KL, Belhassan K, Ouldim K, El Bouchikhi I, Bouguenouch L, Shukla A, Girisha KM, Sirisena ND, Dissanayake VHW, Paththinige CS, Mishra R, Kisling MS, Ferreira CR, de Herreros MB, Lee N, Jamuar SS, Lai A, Tan ES, Ying Lim J, Wen‐Min CB, Gupta N, Lotz‐Esquivel S, Badilla‐Porras R, Hussen DF, El Ruby MO, Ashaat EA, Patil SJ, Dowsett L, Eaton A, Innes AM, Shotelersuk V, Badoe Ë, Wonkam A, Obregon MG, Chung BHY, Trubnykova M, La Serna J, Gallardo Jugo BE, Chávez Pastor M, Abarca Barriga HH, Megarbane A, Kozel BA, van Haelst MM, Stevenson RE, Summar M, Adeyemo AA, Morris CA, Moretti‐Ferreira D, Linguraru MG, Muenke M. Cover Image, Volume 176A, Number 5, May 2018. Am J Med Genet A 2018. [DOI: 10.1002/ajmg.a.38714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Paul Kruszka
- Medical Genetics Branch, National Human Genome Research InstituteThe National Institutes of HealthBethesda Maryland
| | - Antonio R. Porras
- Sheikh Zayed Institute for Pediatric Surgical InnovationChildren's National Health SystemWashington District of Columbia
| | - Deise Helena de Souza
- Department of Genetics, Institute of BiosciencesSao Paulo State University – UNESPSão Paulo Brazil
| | - Angélica Moresco
- Servicio de GenéticaHospital de Pediatría GarrahanBuenos Aires Argentina
| | - Victoria Huckstadt
- Servicio de GenéticaHospital de Pediatría GarrahanBuenos Aires Argentina
| | - Ashleigh D. Gill
- Medical Genetics Branch, National Human Genome Research InstituteThe National Institutes of HealthBethesda Maryland
| | - Alec P. Boyle
- Sheikh Zayed Institute for Pediatric Surgical InnovationChildren's National Health SystemWashington District of Columbia
| | - Tommy Hu
- Medical Genetics Branch, National Human Genome Research InstituteThe National Institutes of HealthBethesda Maryland
| | - Yonit A. Addissie
- Medical Genetics Branch, National Human Genome Research InstituteThe National Institutes of HealthBethesda Maryland
| | - Gary T. K. Mok
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of MedicineThe University of Hong Kong, Hong Kong Special Administrative RegionHongkong China
| | | | - Karen Fieggen
- Division of Human GeneticsUniversity of Cape TownCape Town South Africa
| | | | - Pranoot Tanpaiboon
- Rare Disease InstituteChildren's National Medical CenterWashington District of Columbia
| | - Engela Honey
- Department of GeneticsUniversity of PretoriaPretoria South Africa
| | - Ho‐Ming Luk
- Clinical Genetic Service, Department of HealthHong Kong Special Administrative RegionHongkong China
| | - Ivan F. M. Lo
- Clinical Genetic Service, Department of HealthHong Kong Special Administrative RegionHongkong China
| | - Meow‐Keong Thong
- Department of Paediatrics, Faculty of MedicineUniversity of MalayaKuala Lumpur Malaysia
| | | | - Kelly L. Jones
- Division of Medical Genetics and MetabolismChildren's Hospital of The King's DaughtersNorfolk Virginia
| | - Khadija Belhassan
- Medical Genetics Branch, National Human Genome Research InstituteThe National Institutes of HealthBethesda Maryland
- Medical Genetics and Oncogenetics UnitHassan II University HospitalFez Morocco
| | - Karim Ouldim
- Medical Genetics and Oncogenetics UnitHassan II University HospitalFez Morocco
| | - Ihssane El Bouchikhi
- Medical Genetics and Oncogenetics UnitHassan II University HospitalFez Morocco
- Laboratory of Microbial Biotechnology, Faculty of Sciences and TechniquesUniversity of Sidi Mohammed Ben AbdellahFez Morocco
| | - Laila Bouguenouch
- Medical Genetics and Oncogenetics UnitHassan II University HospitalFez Morocco
| | - Anju Shukla
- Department of Medical Genetics, Kasturba Medical CollegeManipal UniversityManipal India
| | - Katta M. Girisha
- Department of Medical Genetics, Kasturba Medical CollegeManipal UniversityManipal India
| | - Nirmala D. Sirisena
- Human Genetics Unit, Faculty of MedicineUniversity of ColomboColombo Sri Lanka
| | | | | | - Rupesh Mishra
- Human Genetics Unit, Faculty of MedicineUniversity of ColomboColombo Sri Lanka
| | - Monisha S. Kisling
- Rare Disease InstituteChildren's National Medical CenterWashington District of Columbia
| | - Carlos R. Ferreira
- Rare Disease InstituteChildren's National Medical CenterWashington District of Columbia
| | - María Beatriz de Herreros
- National Secretariat for the Rights of People with Disabilities (SENADIS)Fernando de la Mora Paraguay
| | - Ni‐Chung Lee
- Department of Pediatrics and Medical GeneticsNational Taiwan University HospitalTaipei Taiwan
| | - Saumya S. Jamuar
- Genetics Service, Department of PaediatricsKK Women's and Children's HospitalSingapore Singapore
| | - Angeline Lai
- Genetics Service, Department of PaediatricsKK Women's and Children's HospitalSingapore Singapore
| | - Ee Shien Tan
- Genetics Service, Department of PaediatricsKK Women's and Children's HospitalSingapore Singapore
| | - Jiin Ying Lim
- Genetics Service, Department of PaediatricsKK Women's and Children's HospitalSingapore Singapore
| | - Cham Breana Wen‐Min
- Genetics Service, Department of PaediatricsKK Women's and Children's HospitalSingapore Singapore
| | - Neerja Gupta
- Division of Genetics, Department of PediatricsAll India Institute of Medical SciencesNew Delhi India
| | | | - Ramsés Badilla‐Porras
- Medical Genetics and Metabolism DepartmentHospital Nacional de Niños (CCSS)San José Costa Rica
| | | | - Mona O. El Ruby
- Clinical Genetics DepartmentNational Research CentreCairo Egypt
| | - Engy A. Ashaat
- Clinical Genetics DepartmentNational Research CentreCairo Egypt
| | | | - Leah Dowsett
- Kapi'olani Medical Center for Women and ChildrenHonolulu Hawaii
| | - Alison Eaton
- Department of Medical Genetics and Alberta Children's Hospital Research InstituteCumming School of Medicine, University of CalgaryCalgary Alberta
| | - A. Micheil Innes
- Department of Medical Genetics and Alberta Children's Hospital Research InstituteCumming School of Medicine, University of CalgaryCalgary Alberta
| | - Vorasuk Shotelersuk
- Center of Excellence for Medical Genetics, Department of Pediatrics, Faculty of MedicineChulalongkorn UniversityBangkok Thailand
| | - Ëben Badoe
- School of Medicine and Dentistry, College of Health SciencesUniversity of GhanaAccra Ghana
| | - Ambroise Wonkam
- Division of Human GeneticsUniversity of Cape TownCape Town South Africa
| | | | - Brian H. Y. Chung
- Department of Paediatrics and Adolescent Medicine, LKS Faculty of MedicineThe University of Hong Kong, Hong Kong Special Administrative RegionHongkong China
| | | | | | | | | | | | | | - Beth A. Kozel
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, Department of PediatricsWashington University School of MedicineSt. Louis Missouri
| | - Mieke M. van Haelst
- Department of GeneticsUniversity Medical CentreUtrecht, Utrecht The Netherlands
| | | | - Marshall Summar
- Rare Disease InstituteChildren's National Medical CenterWashington District of Columbia
| | - A. Adebowale Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, The National Institutes of HealthBethesda Maryland
| | - Colleen A. Morris
- Department of Pediatrics (Genetics Division)University of Nevada School of MedicineLas Vegas Nevada
| | - Danilo Moretti‐Ferreira
- Department of Genetics, Institute of BiosciencesSao Paulo State University – UNESPSão Paulo Brazil
| | - Marius George Linguraru
- Sheikh Zayed Institute for Pediatric Surgical InnovationChildren's National Health SystemWashington District of Columbia
| | - Maximilian Muenke
- Medical Genetics Branch, National Human Genome Research InstituteThe National Institutes of HealthBethesda Maryland
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Knutsen RH, Beeman SC, Broekelmann TJ, Liu D, Tsang KM, Kovacs A, Ye L, Danback JR, Watson A, Wardlaw A, Wagenseil JE, Garbow JR, Shoykhet M, Kozel BA. Minoxidil improves vascular compliance, restores cerebral blood flow, and alters extracellular matrix gene expression in a model of chronic vascular stiffness. Am J Physiol Heart Circ Physiol 2018; 315:H18-H32. [PMID: 29498532 DOI: 10.1152/ajpheart.00683.2017] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Increased vascular stiffness correlates with a higher risk of cardiovascular complications in aging adults. Elastin (ELN) insufficiency, as observed in patients with Williams-Beuren syndrome or with familial supravalvular aortic stenosis, also increases vascular stiffness and leads to arterial narrowing. We used Eln+/- mice to test the hypothesis that pathologically increased vascular stiffness with concomitant arterial narrowing leads to decreased blood flow to end organs such as the brain. We also hypothesized that drugs that remodel arteries and increase lumen diameter would improve flow. To test these hypotheses, we compared carotid blood flow using ultrasound and cerebral blood flow using MRI-based arterial spin labeling in wild-type (WT) and Eln+/- mice. We then studied how minoxidil, an ATP-sensitive K+ channel opener and vasodilator, affects vessel mechanics, blood flow, and gene expression. Both carotid and cerebral blood flows were lower in Eln+/- mice than in WT mice. Treatment of Eln+/- mice with minoxidil lowered blood pressure and reduced functional arterial stiffness to WT levels. Minoxidil also improved arterial diameter and restored carotid and cerebral blood flows in Eln+/- mice. The beneficial effects persisted for weeks after drug removal. RNA-Seq analysis revealed differential expression of 127 extracellular matrix-related genes among the treatment groups. These results indicate that ELN insufficiency impairs end-organ perfusion, which may contribute to the increased cardiovascular risk. Minoxidil, despite lowering blood pressure, improves end-organ perfusion. Changes in matrix gene expression and persistence of treatment effects after drug withdrawal suggest arterial remodeling. Such remodeling may benefit patients with genetic or age-dependent ELN insufficiency. NEW & NOTEWORTHY Our work with a model of chronic vascular stiffness, the elastin ( Eln)+/- mouse, shows reduced brain perfusion as measured by carotid ultrasound and MRI arterial spin labeling. Vessel caliber, functional stiffness, and blood flow improved with minoxidil. The ATP-sensitive K+ channel opener increased Eln gene expression and altered 126 other matrix-associated genes.
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Affiliation(s)
- Russell H Knutsen
- National Heart, Lung, and Blood Institute, National Institutes of Health , Bethesda, Maryland.,Department of Cell Biology and Physiology, Washington University School of Medicine , St. Louis, Missouri
| | - Scott C Beeman
- Department of Radiology, Washington University School of Medicine , St. Louis, Missouri
| | - Thomas J Broekelmann
- Department of Cell Biology and Physiology, Washington University School of Medicine , St. Louis, Missouri
| | - Delong Liu
- National Heart, Lung, and Blood Institute, National Institutes of Health , Bethesda, Maryland
| | - Kit Man Tsang
- National Heart, Lung, and Blood Institute, National Institutes of Health , Bethesda, Maryland
| | - Attila Kovacs
- Department of Internal Medicine, Washington University School of Medicine , St. Louis, Missouri
| | - Li Ye
- Department of Pediatrics, Washington University School of Medicine , St. Louis, Missouri
| | - Joshua R Danback
- Department of Pediatrics, Washington University School of Medicine , St. Louis, Missouri
| | - Anderson Watson
- National Heart, Lung, and Blood Institute, National Institutes of Health , Bethesda, Maryland
| | - Amanda Wardlaw
- National Heart, Lung, and Blood Institute, National Institutes of Health , Bethesda, Maryland
| | - Jessica E Wagenseil
- Department of Biomedical Engineering, Washington University in St. Louis , St. Louis, Missouri; Department of Pediatrics, Children's National Medical Center, Washington, D.C
| | - Joel R Garbow
- Department of Radiology, Washington University School of Medicine , St. Louis, Missouri
| | - Michael Shoykhet
- Department of Pediatrics, Washington University School of Medicine , St. Louis, Missouri.,Department of Biomedical Engineering, Washington University in St. Louis , St. Louis, Missouri; Department of Pediatrics, Children's National Medical Center, Washington, D.C
| | - Beth A Kozel
- National Heart, Lung, and Blood Institute, National Institutes of Health , Bethesda, Maryland.,Department of Pediatrics, Washington University School of Medicine , St. Louis, Missouri
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Abstract
Elastic fibers provide recoil to tissues that undergo repeated deformation, such as blood vessels, lungs and skin. Composed of elastin and its accessory proteins, the fibers are produced within a restricted developmental window and are stable for decades. Their eventual breakdown is associated with a loss of tissue resiliency and aging. Rare alteration of the elastin (ELN) gene produces disease by impacting protein dosage (supravalvar aortic stenosis, Williams Beuren syndrome and Williams Beuren region duplication syndrome) and protein function (autosomal dominant cutis laxa). This review highlights aspects of the elastin molecule and its assembly process that contribute to human disease and also discusses potential therapies aimed at treating diseases of elastin insufficiency.
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Affiliation(s)
| | - Beth A Kozel
- National Institutes of Health, National Heart Lung and Blood Institute, Bethesda, MD, USA.
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Abstract
Peroxisomal biogenesis disorders are caused by disruption of long chain fatty acid metabolism due to mutations in PEX genes. Individuals with these disorders often have vision loss due to optic atrophy and pigmentary retinopathy. We report an unusual retinal manifestation of peroxisomal biogenesis disorder.
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Affiliation(s)
- B E O'Bryhim
- a Department of Ophthalmology and Visual Sciences , Washington University in St. Louis , St. Louis , MO , USA
| | - B A Kozel
- b Department of Pediatrics , Washington University School of Medicine , St. Louis , MO , USA.,c National Institutes of Health , National Heart, Lung, and Blood Institute , Bethesda , MD , USA
| | - G T Lueder
- a Department of Ophthalmology and Visual Sciences , Washington University in St. Louis , St. Louis , MO , USA.,d Department of Pediatrics , St. Louis Children's Hospital , St. Louis , MO , USA
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Baldridge D, Heeley J, Vineyard M, Manwaring L, Toler TL, Fassi E, Fiala E, Brown S, Goss CW, Willing M, Grange DK, Kozel BA, Shinawi M. The Exome Clinic and the role of medical genetics expertise in the interpretation of exome sequencing results. Genet Med 2017; 19:1040-1048. [PMID: 28252636 PMCID: PMC5581723 DOI: 10.1038/gim.2016.224] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2016] [Accepted: 12/13/2016] [Indexed: 02/03/2023] Open
Abstract
Purpose Evaluation of the clinician’s role in optimal interpretation of clinical exome sequencing (ES) results. Methods Retrospective chart review of the first 155 patients who underwent clinical ES in our Exome Clinic and direct interaction with the ordering geneticist to evaluate the process of interpretation of results. Results The most common primary indication was neurodevelopmental problems (~66%), followed by multiple congenital anomalies (~10%). The overall diagnostic yield was 36% based on sequencing data. After assessment by the medical geneticist, incorporation of detailed phenotypic and molecular data, and utilization of additional diagnostic modalities, the final diagnostic yield was increased to 43%. Seven patients of our cohort were included in initial case series that described novel genetic syndromes, and 23% of patients were involved in subsequent research studies directly related to their results or involved in efforts to move beyond clinical ES for diagnosis. The clinical management was directly altered due to the ES findings in 12% of definitively diagnosed cases. Conclusions Our results emphasize the usefulness of ES, demonstrate the significant role of the medical geneticist in the diagnostic process of patients undergoing ES, and illustrate the benefits of post-analytical diagnostic work-up in solving the “diagnostic odyssey.”
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Affiliation(s)
- Dustin Baldridge
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Jennifer Heeley
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,Current affiliation: Mercy Clinic-Kids Genetics, Mercy Children's Hospital St. Louis, St. Louis, Missouri, USA
| | - Marisa Vineyard
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Linda Manwaring
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Tomi L Toler
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Emily Fassi
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Elise Fiala
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Sarah Brown
- Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Charles W Goss
- Division of Biostatistics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Marcia Willing
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Dorothy K Grange
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Beth A Kozel
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA.,Current affiliation: National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Marwan Shinawi
- Division of Genetics and Genomic Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri, USA
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Sindhar S, Lugo M, Levin MD, Danback JR, Brink BD, Yu E, Dietzen DJ, Clark AL, Purgert CA, Waxler JL, Elder RW, Pober BR, Kozel BA. Hypercalcemia in Patients with Williams-Beuren Syndrome. J Pediatr 2016; 178:254-260.e4. [PMID: 27574996 PMCID: PMC5085847 DOI: 10.1016/j.jpeds.2016.08.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Revised: 07/11/2016] [Accepted: 08/08/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVE To evaluate the timing, trajectory, and implications of hypercalcemia in Williams-Beuren syndrome (WBS) through a multicenter retrospective study. STUDY DESIGN Data on plasma calcium levels from 232 subjects with WBS aged 0-67.1 years were compared with that in controls and also with available normative data. Association testing was used to identify relevant comorbidities. RESULTS On average, individuals with WBS had higher plasma calcium levels than controls, but 86.7% of values were normal. Nonpediatric laboratories overreport hypercalcemia in small children. When pediatric reference intervals were applied, the occurrence of hypercalcemia dropped by 51% in infants and by 38% in toddlers. Across all ages, 6.1% of the subjects had actionable hypercalcemia. In children, actionable hypercalcemia was seen in those aged 5-25 months. In older individuals, actionable hypercalcemia was often secondary to another disease process. Evidence of dehydration, hypercalciuria, and nephrocalcinosis were common in both groups. Future hypercalcemia could not be reliably predicted by screening calcium levels. A subgroup analysis of 91 subjects found no associations between hypercalcemia and cardiovascular disease, gastrointestinal complaints, or renal anomalies. Analyses of electrogradiography data showed an inverse correlation of calcium concentration with corrected QT interval, but no acute life-threatening events were reported. CONCLUSIONS Actionable hypercalcemia in patients with WBS occurs infrequently. Although irritability and lethargy were commonly reported, no mortality or acute life-threatening events were associated with hypercalcemia and the only statistically associated morbidities were dehydration, hypercalciuria, and nephrocalcinosis.
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Affiliation(s)
- Sampat Sindhar
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Michael Lugo
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Mark D. Levin
- National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Joshua R. Danback
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Benjamin D. Brink
- Frank H. Netter School of Medicine, Quinnipiac University, North Haven, CT
| | - Eric Yu
- Frank H. Netter School of Medicine, Quinnipiac University, North Haven, CT
| | - Dennis J. Dietzen
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Amy L. Clark
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Carolyn A. Purgert
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | | | - Robert W. Elder
- Section of Cardiology, Departments of Pediatrics and Internal Medicine, Yale University School of Medicine, New Haven, CT
| | - Barbara R. Pober
- Frank H. Netter School of Medicine, Quinnipiac University, North Haven, CT,Massachusetts General Hospital, Boston, MA,Harvard Medical School, Boston, MA
| | - Beth A. Kozel
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO,National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, MD
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Kulsum-Mecci N, Goss C, Kozel BA, Garbutt JM, Schechtman KB, Dharnidharka VR. Effects of Obesity and Hypertension on Pulse Wave Velocity in Children. J Clin Hypertens (Greenwich) 2016; 19:221-226. [PMID: 27511880 DOI: 10.1111/jch.12892] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/28/2016] [Accepted: 07/03/2016] [Indexed: 01/05/2023]
Abstract
Pulse wave velocity (PWV) is a biomarker of arterial stiffness. Findings from prior studies are conflicting regarding the impact of obesity on PWV in children. The authors measured carotid-femoral PWV in 159 children aged 4 to 18 years, of whom 95 were healthy, 25 were obese, 15 had hypertension (HTN), and 24 were both obese and hypertensive. Mean PWV increased with age but did not differ by race or sex. In adjusted analyses in children 10 years and older (n=102), PWV was significantly higher in children with hypertension (PWV±standard deviation, 4.9±0.7 m/s), obesity (5.0±0.9 m/s), and combined obesity-hypertension (5.2±0.6 m/s) vs healthy children (4.3±0.7 m/s) (each group, P<.001 vs control). In our study, obesity and HTN both significantly and independently increased PWV, while African American children did not have a higher PWV than Caucasian children.
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Affiliation(s)
- Nazia Kulsum-Mecci
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Charles Goss
- Department of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - Beth A Kozel
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Jane M Garbutt
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
| | - Kenneth B Schechtman
- Department of Biostatistics, Washington University School of Medicine, St. Louis, MO
| | - Vikas R Dharnidharka
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO
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40
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Halabi CM, Broekelmann TJ, Knutsen RH, Ye L, Mecham RP, Kozel BA. Chronic antihypertensive treatment improves pulse pressure but not large artery mechanics in a mouse model of congenital vascular stiffness. Am J Physiol Heart Circ Physiol 2015; 309:H1008-16. [PMID: 26232234 DOI: 10.1152/ajpheart.00288.2015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 07/27/2015] [Indexed: 01/08/2023]
Abstract
Increased arterial stiffness is a common characteristic of humans with Williams-Beuren syndrome and mouse models of elastin insufficiency. Arterial stiffness is associated with multiple negative cardiovascular outcomes, including myocardial infarction, stroke, and sudden death. Therefore, identifying therapeutic interventions that improve arterial stiffness in response to changes in elastin levels is of vital importance. The goal of this study was to determine the effect of chronic pharmacologic therapy with different classes of antihypertensive medications on arterial stiffness in elastin insufficiency. Elastin-insufficient mice 4-6 wk of age and wild-type littermates were subcutaneously implanted with osmotic micropumps delivering a continuous dose of one of the following: vehicle, losartan, nicardipine, or propranolol for 8 wk. At the end of treatment period, arterial blood pressure and large artery compliance and remodeling were assessed. Our results show that losartan and nicardipine treatment lowered blood pressure and pulse pressure in elastin-insufficient mice. Elastin and collagen content of abdominal aortas as well as ascending aorta and carotid artery biomechanics were not affected by any of the drug treatments in either genotype. By reducing pulse pressure and shifting the working pressure range of an artery to a more compliant region of the pressure-diameter curve, antihypertensive medications may mitigate the consequences of arterial stiffness, an effect that is drug class independent. These data emphasize the importance of early recognition and long-term management of hypertension in Williams-Beuren syndrome and elastin insufficiency.
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Affiliation(s)
- Carmen M Halabi
- Departments of Pediatrics Washington University School of Medicine, St. Louis, Missouri; and
| | - Thomas J Broekelmann
- Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri
| | - Russell H Knutsen
- Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri
| | - Li Ye
- Departments of Pediatrics Washington University School of Medicine, St. Louis, Missouri; and
| | - Robert P Mecham
- Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri
| | - Beth A Kozel
- Departments of Pediatrics Washington University School of Medicine, St. Louis, Missouri; and
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Kozel BA, Bayliss SJ, Berk DR, Waxler JL, Knutsen RH, Danback JR, Pober BR. Skin findings in Williams syndrome. Am J Med Genet A 2014; 164A:2217-25. [PMID: 24920525 DOI: 10.1002/ajmg.a.36628] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 05/05/2014] [Indexed: 01/30/2023]
Abstract
Previous examination in a small number of individuals with Williams syndrome (also referred to as Williams-Beuren syndrome) has shown subtly softer skin and reduced deposition of elastin, an elastic matrix protein important in tissue recoil. No quantitative information about skin elasticity in individuals with Williams syndrome is available; nor has there been a complete report of dermatologic findings in this population. To fill this knowledge gap, 94 patients with Williams syndrome aged 7-50 years were recruited as part of the skin and vascular elasticity (WS-SAVE) study. They underwent either a clinical dermatologic assessment by trained dermatologists (2010 WSA family meeting) or measurement of biomechanical properties of the skin with the DermaLab™ suction cup (2012 WSA family meeting). Clinical assessment confirmed that soft skin is common in this population (83%), as is premature graying of the hair (80% of those 20 years or older), while wrinkles (92%), and abnormal scarring (33%) were detected in larger than expected proportions. Biomechanical studies detected statistically significant differences in dP (the pressure required to lift the skin), dT (the time required to raise the skin through a prescribed gradient), VE (viscoelasticity), and E (Young's modulus) relative to matched controls. The RT (retraction time) also trended longer but was not significant. The biomechanical differences noted in these patients did not correlate with the presence of vascular defects also attributable to elastin insufficiency (vascular stiffness, hypertension, and arterial stenosis) suggesting the presence of tissue specific modifiers that modulate the impact of elastin insufficiency in each tissue.
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Affiliation(s)
- Beth A Kozel
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri
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42
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Kozel BA, Su CT, Danback JR, Minster RL, Madan-Khetarpal S, McConnell JS, Mac Neal MK, Levine KL, Wilson RC, Sciurba FC, Urban Z. Biomechanical properties of the skin in cutis laxa. J Invest Dermatol 2014; 134:2836-2838. [PMID: 24844858 PMCID: PMC4199921 DOI: 10.1038/jid.2014.224] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- Beth A Kozel
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Chi-Ting Su
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Joshua R Danback
- Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
| | - Ryan L Minster
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Suneeta Madan-Khetarpal
- Division of Medical Genetics, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Juliann S McConnell
- Division of Medical Genetics, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Meghan K Mac Neal
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Kara L Levine
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Robert C Wilson
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Frank C Sciurba
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Zsolt Urban
- Department of Human Genetics, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania, USA.
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43
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Osei-Owusu P, Knutsen RH, Kozel BA, Dietrich HH, Blumer KJ, Mecham RP. Altered reactivity of resistance vasculature contributes to hypertension in elastin insufficiency. Am J Physiol Heart Circ Physiol 2014; 306:H654-66. [PMID: 24414067 DOI: 10.1152/ajpheart.00601.2013] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Elastin (Eln) insufficiency in mice and humans is associated with hypertension and altered structure and mechanical properties of large arteries. However, it is not known to what extent functional or structural changes in resistance arteries contribute to the elevated blood pressure that is characteristic of Eln insufficiency. Here, we investigated how Eln insufficiency affects the structure and function of the resistance vasculature. A functional profile of resistance vasculature in Eln(+/-) mice was generated by assessing small mesenteric artery (MA) contractile and vasodilatory responses to vasoactive agents. We found that Eln haploinsufficiency had a modest effect on phenylephrine-induced vasoconstriction, whereas ANG II-evoked vasoconstriction was markedly increased. Blockade of ANG II type 2 receptors with PD-123319 or modulation of Rho kinase activity with the inhibitor Y-27632 attenuated the augmented vasoconstriction, whereas acute Y-27632 administration normalized blood pressure in Eln(+/-) mice. Sodium nitroprusside- and isoproterenol-induced vasodilatation were normal, whereas ACh-induced vasodilatation was severely impaired in Eln(+/-) MAs. Histologically, the number of smooth muscle layers did not change in Eln(+/-) MAs; however, an additional discontinuous layer of Eln appeared between the smooth muscle layers that was absent in wild-type arteries. We conclude that high blood pressure arising from Eln insufficiency is due partly to permanent changes in vascular tone as a result of increased sensitivity of the resistance vasculature to circulating ANG II and to impaired vasodilatory mechanisms arising from endothelial dysfunction characterized by impaired endothelium-dependent vasodilatation. Eln insufficiency causes augmented ANG II-induced vasoconstriction in part through a novel mechanism that facilitates contraction evoked by ANG II type 2 receptors and altered G protein signaling.
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Affiliation(s)
- Patrick Osei-Owusu
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri
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DeMarsilis AJ, Walji TA, Maedeker JA, Stoka KV, Kozel BA, Mecham RP, Wagenseil JE, Craft CS. Elastin Insufficiency Predisposes Mice to Impaired Glucose Metabolism. J Mol Genet Med 2014; 8. [PMID: 26167199 PMCID: PMC4497575 DOI: 10.4172/1747-0862.1000129] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Williams-Beuren syndrome is the consequence of a large contiguous-gene deletion on the seventh human chromosome that includes the elastin gene. Elastin is an extracellular matrix protein responsible for the cardiovascular abnormalities associated with Williams’s syndrome, including hypertension and aortic stenosis. A high percentage of individuals with Williams’s syndrome also have impaired glucose tolerance, independent of traditional risk factors for diabetes. Here, we show that murine adipose tissue does assemble elastic fibers; however, isolated elastin insufficiency (Eln+/−) in mice does not independently influence glucose metabolism or tissue lipid accumulation. Similarly, isolated ApoE deficiency (ApoE−/−), a model of hyperlipidemia and atherosclerosis, does not impair insulin sensitivity. However, Eln+/−; ApoE−/− double mutant mice exhibit notable hyperglycemia, adipocyte hypertrophy, inflammation of adipose tissue, and ectopic lipid accumulation in liver tissue. Further, Eln+/−; ApoE−/− mutants have significant impairment of insulin sensitivity by insulin tolerance testing, independent of body weight or diet, suggesting that elastin insufficiency predisposes to metabolic disease in susceptible individuals.
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Affiliation(s)
- Antea J DeMarsilis
- Department of Cell Biology & Physiology, Washington University in St. Louis, MO, USA
| | - Tezin A Walji
- Department of Cell Biology & Physiology, Washington University in St. Louis, MO, USA
| | - Justine A Maedeker
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, MO, USA
| | - Kellie V Stoka
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, MO, USA
| | - Beth A Kozel
- Department of Pediatrics,, Washington University in St. Louis, MO, USA
| | - Robert P Mecham
- Department of Cell Biology & Physiology, Washington University in St. Louis, MO, USA
| | - Jessica E Wagenseil
- Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, MO, USA
| | - Clarissa S Craft
- Department of Cell Biology & Physiology, Washington University in St. Louis, MO, USA
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Cheng YW, Tan CA, Minor A, Arndt K, Wysinger L, Grange DK, Kozel BA, Robin NH, Waggoner D, Fitzpatrick C, Das S, Del Gaudio D. Copy number analysis of NIPBL in a cohort of 510 patients reveals rare copy number variants and a mosaic deletion. Mol Genet Genomic Med 2013; 2:115-23. [PMID: 24689074 PMCID: PMC3960053 DOI: 10.1002/mgg3.48] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 10/11/2013] [Indexed: 12/24/2022] Open
Abstract
Cornelia de Lange syndrome (CdLS) is a genetically heterogeneous disorder characterized by growth retardation, intellectual disability, upper limb abnormalities, hirsutism, and characteristic facial features. In this study we explored the occurrence of intragenic NIPBL copy number variations (CNVs) in a cohort of 510 NIPBL sequence-negative patients with suspected CdLS. Copy number analysis was performed by custom exon-targeted oligonucleotide array-comparative genomic hybridization and/or MLPA. Whole-genome SNP array was used to further characterize rearrangements extending beyond the NIPBL gene. We identified NIPBL CNVs in 13 patients (2.5%) including one intragenic duplication and a deletion in mosaic state. Breakpoint sequences in two patients provided further evidence of a microhomology-mediated replicative mechanism as a potential predominant contributor to CNVs in NIPBL. Patients for whom clinical information was available share classical CdLS features including craniofacial and limb defects. Our experience in studying the frequency of NIBPL CNVs in the largest series of patients to date widens the mutational spectrum of NIPBL and emphasizes the clinical utility of performing NIPBL deletion/duplication analysis in patients with CdLS.
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Affiliation(s)
- Yu-Wei Cheng
- Department of Human Genetics, University of Chicago Chicago, Illinois
| | - Christopher A Tan
- Department of Human Genetics, University of Chicago Chicago, Illinois
| | - Agata Minor
- Department of Pathology, University of Chicago Chicago, Illinois
| | - Kelly Arndt
- Department of Human Genetics, University of Chicago Chicago, Illinois
| | - Latrice Wysinger
- Department of Human Genetics, University of Chicago Chicago, Illinois
| | - Dorothy K Grange
- Department of Pediatrics, Division of Genetics and Genomic Medicine, Washington University School of Medicine St. Louis, Missouri
| | - Beth A Kozel
- Department of Pediatrics, Division of Genetics and Genomic Medicine, Washington University School of Medicine St. Louis, Missouri
| | - Nathaniel H Robin
- Department of Genetics, University of Alabama at Birmingham Birmingham, Alabama
| | - Darrel Waggoner
- Department of Human Genetics, University of Chicago Chicago, Illinois
| | | | - Soma Das
- Department of Human Genetics, University of Chicago Chicago, Illinois
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Kozel BA, Danback JR, Waxler JL, Knutsen RH, de Las Fuentes L, Reusz GS, Kis E, Bhatt AB, Pober BR. Williams syndrome predisposes to vascular stiffness modified by antihypertensive use and copy number changes in NCF1. Hypertension 2013; 63:74-9. [PMID: 24126171 DOI: 10.1161/hypertensionaha.113.02087] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Williams syndrome is caused by the deletion of 26 to 28 genes, including elastin, on human chromosome 7. Elastin insufficiency leads to the cardiovascular hallmarks of this condition, namely focal stenosis and hypertension. Extrapolation from the Eln(+/-) mouse suggests that affected people may also have stiff vasculature, a risk factor for stroke, myocardial infarction, and cardiac death. NCF1, one of the variably deleted Williams genes, is a component of the nicotinamide adenine dinucleotide phosphate (NADPH) oxidase complex and is involved in the generation of oxidative stress, making it an interesting candidate modifier for vascular stiffness. Using a case-control design, vascular stiffness was evaluated by pulse wave velocity in 77 Williams cases and matched controls. Cases had stiffer conducting vessels than controls (P<0.001), with increased stiffness observed in even the youngest children with Williams syndrome. Pulse wave velocity increased with age at comparable rates in cases and controls, and although the degree of vascular stiffness varied, it was seen in both hypertensive and normotensive Williams participants. Use of antihypertensive medication and extension of the Williams deletion to include NCF1 were associated with protection from vascular stiffness. These findings demonstrate that vascular stiffness is a primary vascular phenotype in Williams syndrome and that treatment with antihypertensives or agents inhibiting oxidative stress may be important in managing patients with this condition, potentially even those who are not overtly hypertensive.
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Affiliation(s)
- Beth A Kozel
- Washington University School of Medicine, 660 S Euclid, Campus Box 8208, St. Louis, MO 63110.
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Schilter KF, Reis LM, Schneider A, Bardakjian TM, Abdul-Rahman O, Kozel BA, Zimmerman HH, Broeckel U, Semina EV. Whole-genome copy number variation analysis in anophthalmia and microphthalmia. Clin Genet 2013; 84:473-81. [PMID: 23701296 DOI: 10.1111/cge.12202] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2013] [Revised: 05/17/2013] [Accepted: 05/17/2013] [Indexed: 01/19/2023]
Abstract
Anophthalmia/microphthalmia (A/M) represent severe developmental ocular malformations. Currently, mutations in known genes explain less than 40% of A/M cases. We performed whole-genome copy number variation analysis in 60 patients affected with isolated or syndromic A/M. Pathogenic deletions of 3q26 (SOX2) were identified in four independent patients with syndromic microphthalmia. Other variants of interest included regions with a known role in human disease (likely pathogenic) as well as novel rearrangements (uncertain significance). A 2.2-Mb duplication of 3q29 in a patient with non-syndromic anophthalmia and an 877-kb duplication of 11p13 (PAX6) and a 1.4-Mb deletion of 17q11.2 (NF1) in two independent probands with syndromic microphthalmia and other ocular defects were identified; while ocular anomalies have been previously associated with 3q29 duplications, PAX6 duplications, and NF1 mutations in some cases, the ocular phenotypes observed here are more severe than previously reported. Three novel regions of possible interest included a 2q14.2 duplication which cosegregated with microphthalmia/microcornea and congenital cataracts in one family, and 2q21 and 15q26 duplications in two additional cases; each of these regions contains genes that are active during vertebrate ocular development. Overall, this study identified causative copy number mutations and regions with a possible role in ocular disease in 17% of A/M cases.
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Affiliation(s)
- K F Schilter
- Department of Pediatrics and Children's Research Institute, Medical College of Wisconsin and Children's Hospital of Wisconsin, Milwaukee, WI, USA; Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI, USA
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Sugitani H, Hirano E, Knutsen RH, Shifren A, Wagenseil JE, Ciliberto C, Kozel BA, Urban Z, Davis EC, Broekelmann TJ, Mecham RP. Alternative splicing and tissue-specific elastin misassembly act as biological modifiers of human elastin gene frameshift mutations associated with dominant cutis laxa. J Biol Chem 2012; 287:22055-67. [PMID: 22573328 DOI: 10.1074/jbc.m111.327940] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Elastin is the extracellular matrix protein in vertebrates that provides elastic recoil to blood vessels, the lung, and skin. Because the elastin gene has undergone significant changes in the primate lineage, modeling elastin diseases in non-human animals can be problematic. To investigate the pathophysiology underlying a class of elastin gene mutations leading to autosomal dominant cutis laxa, we engineered a cutis laxa mutation (single base deletion) into the human elastin gene contained in a bacterial artificial chromosome. When expressed as a transgene in mice, mutant elastin was incorporated into elastic fibers in the skin and lung with adverse effects on tissue function. In contrast, only low levels of mutant protein incorporated into aortic elastin, which explains why the vasculature is relatively unaffected in this disease. RNA stability studies found that alternative exon splicing acts as a modifier of disease severity by influencing the spectrum of mutant transcripts that survive nonsense-mediated decay. Our results confirm the critical role of the C-terminal region of tropoelastin in elastic fiber assembly and suggest tissue-specific differences in the elastin assembly pathway.
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Affiliation(s)
- Hideki Sugitani
- Department of Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA
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Kozel BA, Knutsen RH, Ye L, Ciliberto CH, Broekelmann TJ, Mecham RP. Genetic modifiers of cardiovascular phenotype caused by elastin haploinsufficiency act by extrinsic noncomplementation. J Biol Chem 2011; 286:44926-36. [PMID: 22049077 PMCID: PMC3248007 DOI: 10.1074/jbc.m111.274779] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Revised: 10/15/2011] [Indexed: 12/21/2022] Open
Abstract
Elastin haploinsufficiency causes the cardiovascular complications associated with Williams-Beuren syndrome and isolated supravalvular aortic stenosis. Significant variability exists in the vascular pathology in these individuals. Using the Eln(+/-) mouse, we sought to identify the source of this variability. Following outcrossing of C57Bl/6J Eln(+/-), two backgrounds were identified whose cardiovascular parameters deviated significantly from the parental strain. F1 progeny of the C57Bl/6J; Eln(+/-)x129X1/SvJ were more hypertensive and their arteries less compliant. In contrast, Eln(+/-) animals crossed to DBA/2J were protected from the pathologic changes associated with elastin insufficiency. Among the crosses, aortic elastin and collagen content did not correlate with quantitative vasculopathy traits. Quantitative trait locus analysis performed on F2 C57; Eln(+/-)x129 intercrosses identified highly significant peaks on chromosome 1 (LOD 9.7) for systolic blood pressure and on chromosome 9 (LOD 8.7) for aortic diameter. Additional peaks were identified that affect only Eln(+/-), including a region upstream of Eln on chromosome 5 (LOD 4.5). Bioinformatic analysis of the quantitative trait locus peaks revealed several interesting candidates, including Ren1, Ncf1, and Nos1; genes whose functions are unrelated to elastic fiber assembly, but whose effects may synergize with elastin insufficiency to predispose to hypertension and stiffer blood vessels. Real time RT-PCR studies show background-specific increased expression of Ncf1 (a subunit of the NOX2 NAPDH oxidase) that parallel the presence of increased oxidative stress in Eln(+/-) aortas. This finding raises the possibility that polymorphisms in genes affecting the generation of reactive oxygen species alter cardiovascular function in individuals with elastin haploinsufficiency through extrinsic noncomplementation.
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Affiliation(s)
| | - Russell H. Knutsen
- Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Li Ye
- From the Departments of Pediatrics and
| | - Christopher H. Ciliberto
- Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Thomas J. Broekelmann
- Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri 63110
| | - Robert P. Mecham
- Cell Biology and Physiology, Washington University School of Medicine, St. Louis, Missouri 63110
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Toib A, Grange DK, Kozel BA, Ewald GA, White FV, Canter CE. Distinct clinical and histopathological presentations of Danon cardiomyopathy in young women. J Am Coll Cardiol 2010; 55:408-10. [PMID: 20117447 DOI: 10.1016/j.jacc.2009.11.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2009] [Revised: 11/09/2009] [Accepted: 11/18/2009] [Indexed: 11/30/2022]
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