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Giusti B, Sticchi E, De Cario R, Magi A, Nistri S, Pepe G. Genetic Bases of Bicuspid Aortic Valve: The Contribution of Traditional and High-Throughput Sequencing Approaches on Research and Diagnosis. Front Physiol 2017; 8:612. [PMID: 28883797 PMCID: PMC5573733 DOI: 10.3389/fphys.2017.00612] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/09/2017] [Indexed: 12/20/2022] Open
Abstract
Bicuspid aortic valve (BAV) is a common (0.5-2.0% of general population) congenital heart defect with increased prevalence of aortic dilatation and dissection. BAV has an autosomal dominant inheritance with reduced penetrance and variable expressivity. BAV has been described as an isolated trait or associated with syndromic conditions [e.g., Marfan Marfan syndrome or Loeys-Dietz syndrome (MFS, LDS)]. Identification of a syndromic condition in a BAV patient is clinically relevant to personalize aortic surgery indication. A 4-fold increase in BAV prevalence in a large cohort of unrelated MFS patients with respect to general population was reported, as well as in LDS patients (8-fold). It is also known that BAV is more frequent in patients with thoracic aortic aneurysm (TAA) related to mutations in ACTA2, FBN1, and TGFBR2 genes. Moreover, in 8 patients with BAV and thoracic aortic dilation, not fulfilling the clinical criteria for MFS, FBN1 mutations in 2/8 patients were identified suggesting that FBN1 or other genes involved in syndromic conditions correlated to aortopathy could be involved in BAV. Beyond loci associated to syndromic disorders, studies in humans and animal models evidenced/suggested the role of further genes in non-syndromic BAV. The transcriptional regulator NOTCH1 has been associated with the development and acceleration of calcium deposition. Genome wide marker-based linkage analysis demonstrated a linkage of BAV to loci on chromosomes 18, 5, and 13q. Recently, a role for GATA4/5 in aortic valve morphogenesis and endocardial cell differentiation has been reported. BAV has also been associated with a reduced UFD1L gene expression or involvement of a locus containing AXIN1/PDIA2. Much remains to be understood about the genetics of BAV. In the last years, high-throughput sequencing technologies, allowing the analysis of large number of genes or entire exomes or genomes, progressively became available. The latter issue together with the development of "BigData" analysis methods improving their interpretation and integration with clinical data represents a promising opportunity to increase the disease knowledge and diagnosis in monogenic and multifactorial complex traits. This review summarized the main knowledge on the BAV genetic bases, the role of genetic diagnosis in BAV patient managements and the crucial challenges for the comprehension of genetics of BAV in research and diagnosis.
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Affiliation(s)
- Betti Giusti
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of FlorenceFlorence, Italy.,Marfan Syndrome and Related Disorders Regional (Tuscany) Referral Center, Careggi HospitalFlorence, Italy.,Advanced Molecular Genetics Laboratory, Atherothrombotic Diseases Center, Careggi HospitalFlorence, Italy.,Center of Excellence for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies (DENOTHE), University of FlorenceFlorence, Italy
| | - Elena Sticchi
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of FlorenceFlorence, Italy.,Marfan Syndrome and Related Disorders Regional (Tuscany) Referral Center, Careggi HospitalFlorence, Italy.,Advanced Molecular Genetics Laboratory, Atherothrombotic Diseases Center, Careggi HospitalFlorence, Italy.,Center of Excellence for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies (DENOTHE), University of FlorenceFlorence, Italy
| | - Rosina De Cario
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of FlorenceFlorence, Italy.,Marfan Syndrome and Related Disorders Regional (Tuscany) Referral Center, Careggi HospitalFlorence, Italy
| | - Alberto Magi
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of FlorenceFlorence, Italy.,Advanced Molecular Genetics Laboratory, Atherothrombotic Diseases Center, Careggi HospitalFlorence, Italy
| | - Stefano Nistri
- Center of Excellence for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies (DENOTHE), University of FlorenceFlorence, Italy.,Cardiology Service, Centro Medico Strumentale Riabilitativo (CMSR) Veneto MedicaAltavilla Vicentina, Italy
| | - Guglielmina Pepe
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of FlorenceFlorence, Italy.,Marfan Syndrome and Related Disorders Regional (Tuscany) Referral Center, Careggi HospitalFlorence, Italy.,Center of Excellence for the Study at Molecular and Clinical Level of Chronic, Degenerative and Neoplastic Diseases to Develop Novel Therapies (DENOTHE), University of FlorenceFlorence, Italy
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Aghajanian H, Cho YK, Rizer NW, Wang Q, Li L, Degenhardt K, Jain R. Pdgfrα functions in endothelial-derived cells to regulate neural crest cells and the development of the great arteries. Dis Model Mech 2017; 10:1101-1108. [PMID: 28714851 PMCID: PMC5611965 DOI: 10.1242/dmm.029710] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Accepted: 07/05/2017] [Indexed: 12/16/2022] Open
Abstract
Originating as a single vessel emerging from the embryonic heart, the truncus arteriosus must septate and remodel into the aorta and pulmonary artery to support postnatal life. Defective remodeling or septation leads to abnormalities collectively known as conotruncal defects, which are associated with significant mortality and morbidity. Multiple populations of cells must interact to coordinate outflow tract remodeling, and the cardiac neural crest has emerged as particularly important during this process. Abnormalities in the cardiac neural crest have been implicated in the pathogenesis of multiple conotruncal defects, including persistent truncus arteriosus, double outlet right ventricle and tetralogy of Fallot. However, the role of the neural crest in the pathogenesis of another conotruncal abnormality, transposition of the great arteries, is less well understood. In this report, we demonstrate an unexpected role of Pdgfra in endothelial cells and their derivatives during outflow tract development. Loss of Pdgfra in endothelium and endothelial-derived cells results in double outlet right ventricle and transposition of the great arteries. Our data suggest that loss of Pdgfra in endothelial-derived mesenchyme in the outflow tract endocardial cushions leads to a secondary defect in neural crest migration during development. Summary: Loss of Pdgfrα in endothelial-derived mesenchyme results in defective neural crest behavior and is associated with conotruncal defects including, surprisingly, transposition of the great arteries.
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Affiliation(s)
- Haig Aghajanian
- Departments of Medicine and Cell and Developmental Biology, Penn Cardiovascular Institute, Institute for Regenerative Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Young Kuk Cho
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, 61186, South Korea
| | - Nicholas W Rizer
- Departments of Medicine and Cell and Developmental Biology, Penn Cardiovascular Institute, Institute for Regenerative Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Qiaohong Wang
- Departments of Medicine and Cell and Developmental Biology, Penn Cardiovascular Institute, Institute for Regenerative Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Li Li
- Departments of Medicine and Cell and Developmental Biology, Penn Cardiovascular Institute, Institute for Regenerative Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Karl Degenhardt
- Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rajan Jain
- Departments of Medicine and Cell and Developmental Biology, Penn Cardiovascular Institute, Institute for Regenerative Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA 19104, USA
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53
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Poelmann RE, Gittenberger-de Groot AC, Biermans MWM, Dolfing AI, Jagessar A, van Hattum S, Hoogenboom A, Wisse LJ, Vicente-Steijn R, de Bakker MAG, Vonk FJ, Hirasawa T, Kuratani S, Richardson MK. Outflow tract septation and the aortic arch system in reptiles: lessons for understanding the mammalian heart. EvoDevo 2017; 8:9. [PMID: 28491275 PMCID: PMC5424407 DOI: 10.1186/s13227-017-0072-z] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 05/03/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiac outflow tract patterning and cell contribution are studied using an evo-devo approach to reveal insight into the development of aorto-pulmonary septation. RESULTS We studied embryonic stages of reptile hearts (lizard, turtle and crocodile) and compared these to avian and mammalian development. Immunohistochemistry allowed us to indicate where the essential cell components in the outflow tract and aortic sac were deployed, more specifically endocardial, neural crest and second heart field cells. The neural crest-derived aorto-pulmonary septum separates the pulmonary trunk from both aortae in reptiles, presenting with a left visceral and a right systemic aorta arising from the unseptated ventricle. Second heart field-derived cells function as flow dividers between both aortae and between the two pulmonary arteries. In birds, the left visceral aorta disappears early in development, while the right systemic aorta persists. This leads to a fusion of the aorto-pulmonary septum and the aortic flow divider (second heart field population) forming an avian aorto-pulmonary septal complex. In mammals, there is also a second heart field-derived aortic flow divider, albeit at a more distal site, while the aorto-pulmonary septum separates the aortic trunk from the pulmonary trunk. As in birds there is fusion with second heart field-derived cells albeit from the pulmonary flow divider as the right 6th pharyngeal arch artery disappears, resulting in a mammalian aorto-pulmonary septal complex. In crocodiles, birds and mammals, the main septal and parietal endocardial cushions receive neural crest cells that are functional in fusion and myocardialization of the outflow tract septum. Longer-lasting septation in crocodiles demonstrates a heterochrony in development. In other reptiles with no indication of incursion of neural crest cells, there is either no myocardialized outflow tract septum (lizard) or it is vestigial (turtle). Crocodiles are unique in bearing a central shunt, the foramen of Panizza, between the roots of both aortae. Finally, the soft-shell turtle investigated here exhibits a spongy histology of the developing carotid arteries supposedly related to regulation of blood flow during pharyngeal excretion in this species. CONCLUSIONS This is the first time that is shown that an interplay of second heart field-derived flow dividers with a neural crest-derived cell population is a variable but common, denominator across all species studied for vascular patterning and outflow tract septation. The observed differences in normal development of reptiles may have impact on the understanding of development of human congenital outflow tract malformations.
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Affiliation(s)
- Robert E Poelmann
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.,Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands
| | | | - Marcel W M Biermans
- Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands
| | - Anne I Dolfing
- Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands
| | - Armand Jagessar
- Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands
| | - Sam van Hattum
- Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands
| | - Amanda Hoogenboom
- Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands
| | - Lambertus J Wisse
- Department of Anatomy and Embryology, Leiden University Medical Center, Einthovenweg 20, Leiden, The Netherlands
| | - Rebecca Vicente-Steijn
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, Leiden, The Netherlands.,Department of Anatomy and Embryology, Leiden University Medical Center, Einthovenweg 20, Leiden, The Netherlands
| | - Merijn A G de Bakker
- Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands
| | - Freek J Vonk
- Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands.,Naturalis Biodiversity Center, Darwinweg 2, Leiden, The Netherlands
| | - Tatsuya Hirasawa
- Laboratory for Evolutionary Morphology, RIKEN, 2-2-3 Minatojima-minami, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Shigeru Kuratani
- Laboratory for Evolutionary Morphology, RIKEN, 2-2-3 Minatojima-minami, Chuo-ku, Kobe, Hyogo 650-0047 Japan
| | - Michael K Richardson
- Animal Sciences and Health, Sylvius Laboratories, University of Leiden, Sylviusweg 72, Leiden, The Netherlands
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54
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Martín M, Lorca R, Rozado J, Alvarez-Cabo R, Calvo J, Pascual I, Cigarrán H, Rodríguez I, Morís C. Bicuspid aortic valve syndrome: a multidisciplinary approach for a complex entity. J Thorac Dis 2017; 9:S454-S464. [PMID: 28616342 DOI: 10.21037/jtd.2017.05.11] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Bicuspid aortic valve (BAV) or bicuspid aortopathy is the most common congenital heart disease. It can be clinically silent and it is often identified as an incidental finding in otherwise healthy, asymptomatic patients. However, it can be dysfunctioning at birth, even requiring neonatal intervention, or, in time, lead to aortic stenosis, aortic insufficiency, and endocarditis, and also be associated with aortic aneurysm and aortic dissection. Given its prevalence and significant complications, it is estimated that BAV is responsible for more deaths and morbidity than the combined effects of all the other congenital heart defects. Pathology of BAV is still not well known and many questions are unresolved. In this manuscript we review some aspects on bicuspid aortopathy, a heterogeneous and frequent disease in which like some authors have previously described, complex gene environment are present. Further investigations and, what is more, multidisciplinary teams are needed to improve our knowledge on this really fascinating disease.
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Affiliation(s)
- María Martín
- Cardiology Department, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Rebeca Lorca
- Cardiology Department, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - José Rozado
- Cardiology Department, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Rubén Alvarez-Cabo
- Cardiac Surgery Department, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Juan Calvo
- Radiology Department, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Isaac Pascual
- Cardiology Department, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Helena Cigarrán
- Radiology Department, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - Isabel Rodríguez
- Bone and Mineral Research Unit, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - César Morís
- Cardiology Department, Instituto Reina Sofía de Investigación Nefrológica, REDinREN from ISCIII. Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
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55
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Yokoyama U, Ichikawa Y, Minamisawa S, Ishikawa Y. Pathology and molecular mechanisms of coarctation of the aorta and its association with the ductus arteriosus. J Physiol Sci 2017; 67:259-270. [PMID: 28000176 PMCID: PMC10717425 DOI: 10.1007/s12576-016-0512-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 12/06/2016] [Indexed: 01/18/2023]
Abstract
Coarctation of the aorta (CoA) is defined as a congenital stenosis of the thoracic aorta and is one of the most common congenital cardiovascular diseases. Despite successful surgical treatment for CoA, arterial abnormalities, including refractory hypertension, aortic aneurysm, and proatherogenic phenotypic changes, frequently affect patients' quality of life. Emerging evidence from morphological and molecular biological investigations suggest that the area of CoA is characterized by phenotypic modulation of smooth muscle cells, intimal thickening, and impaired elastic fiber formation. These changes extend to the pre-and post-stenotic aorta and impair arterial elasticity. The aim of this review is to present current findings on the pathology and molecular mechanisms of vascular remodeling due to CoA. In particular, we will discuss the association between CoA and the ductus arteriosus since the most common site for the stenosis is in the proximity of the ductus arteriosus.
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Affiliation(s)
- Utako Yokoyama
- Cardiovascular Research Institute, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
| | - Yasuhiro Ichikawa
- Cardiovascular Research Institute, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan
| | - Susumu Minamisawa
- The Jikei University School of Medicine, 3-25-8 Nishi-Shimbashi, Minato, Tokyo, Japan
| | - Yoshihiro Ishikawa
- Cardiovascular Research Institute, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
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56
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Wu B, Wang Y, Xiao F, Butcher JT, Yutzey KE, Zhou B. Developmental Mechanisms of Aortic Valve Malformation and Disease. Annu Rev Physiol 2017; 79:21-41. [DOI: 10.1146/annurev-physiol-022516-034001] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Bingruo Wu
- Departments of Genetics, Pediatrics, and Medicine (Cardiology), Wilf Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, New York 10461;
| | - Yidong Wang
- Departments of Genetics, Pediatrics, and Medicine (Cardiology), Wilf Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, New York 10461;
| | - Feng Xiao
- Departments of Genetics, Pediatrics, and Medicine (Cardiology), Wilf Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, New York 10461;
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029 China
| | - Jonathan T. Butcher
- Department of Biomedical Engineering, Cornell University, Ithaca, New York 14853;
| | - Katherine E. Yutzey
- Division of Molecular Cardiovascular Biology, Cincinnati Children's Medical Center, Cincinnati, Ohio 45229;
| | - Bin Zhou
- Departments of Genetics, Pediatrics, and Medicine (Cardiology), Wilf Cardiovascular Research Institute, Albert Einstein College of Medicine, Bronx, New York 10461;
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029 China
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57
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Bolar N, Verstraeten A, Van Laer L, Loeys B. Molecular Insights into Bicuspid Aortic Valve Development and the associated aortopathy. AIMS MOLECULAR SCIENCE 2017. [DOI: 10.3934/molsci.2017.4.478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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58
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Roux M, Laforest B, Eudes N, Bertrand N, Stefanovic S, Zaffran S. Hoxa1 and Hoxb1 are required for pharyngeal arch artery development. Mech Dev 2016; 143:1-8. [PMID: 27956219 DOI: 10.1016/j.mod.2016.11.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 11/30/2016] [Accepted: 11/30/2016] [Indexed: 01/15/2023]
Abstract
Hox transcription factors play critical roles during early vertebrate development. Previous studies have revealed an overlapping function of Hoxa1 and Hoxb1 during specification of the rhombomeres from which neural crest cells emerge. A recent study on Hoxa1 mutant mice documented its function during cardiovascular development, however, the role of Hoxb1 is still unclear. Here we show using single and compound Hoxa1;Hoxb1 mutant embryos that reduction of Hoxa1 gene dosage in Hoxb1-null genetic background is sufficient to result in abnormal pharyngeal aortic arch (PAA) development and subsequently in great artery defects. Endothelial cells in the 4th PAAs of compound mutant differentiate normally whereas vascular smooth muscle cells of the vessels are absent in the defective PAAs. The importance of Hoxa1 and Hoxb1, and their interaction during specification of cardiac NCCs is demonstrated. Together, our data reveal a critical role for anterior Hox genes during PAA development, providing new mechanistic insights into the etiology of congenital heart defects.
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Affiliation(s)
- Marine Roux
- Aix Marseille Univ, INSERM, GMGF, Marseille, France
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59
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Ploeg M, Saey V, van Loon G, Delesalle C. Thoracic aortic rupture in horses. Equine Vet J 2016; 49:269-274. [PMID: 27783422 DOI: 10.1111/evj.12641] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 10/05/2016] [Indexed: 02/06/2023]
Abstract
The aorta can rupture at the aortic root or aortic arch. In most breeds, the aortic root is the likely site and rupture leads to aortocardiac fistula with communication between the aorta and the right atrium, right ventricle and/or the interventricular septum. There is a high prevalence of aortic rupture in young Friesian horses and rupture occurs at the aortic arch with pseudoaneurysm and potentially aortopulmonary fistulation. Echocardiographic and post-mortem techniques must be adapted to identify aortic arch rupture that is not generally identified with standard approaches. Given the narrow genetic base of the Friesian breed and the significant differences found in extracellular matrix composition and metabolism between Friesians and Warmbloods, genetic factors are likely to contribute to the condition in the Friesian breed.
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Affiliation(s)
- M Ploeg
- Department of Pathobiology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - V Saey
- Department of Pathology, Bacteriology and Poultry Diseases, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - G van Loon
- Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
| | - C Delesalle
- Department of Comparative Physiology and Biometrics, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium
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60
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Ma P, Gu S, Karunamuni GH, Jenkins MW, Watanabe M, Rollins AM. Cardiac neural crest ablation results in early endocardial cushion and hemodynamic flow abnormalities. Am J Physiol Heart Circ Physiol 2016; 311:H1150-H1159. [PMID: 27542407 PMCID: PMC5130492 DOI: 10.1152/ajpheart.00188.2016] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Accepted: 08/17/2016] [Indexed: 12/22/2022]
Abstract
Cardiac neural crest cell (CNCC) ablation creates congenital heart defects (CHDs) that resemble those observed in many syndromes with craniofacial and cardiac consequences. The loss of CNCCs causes a variety of great vessel defects, including persistent truncus arteriosus and double-outlet right ventricle. However, because of the lack of quantitative volumetric measurements, less severe defects, such as great vessel size changes and valve defects, have not been assessed. Also poorly understood is the role of abnormal cardiac function in the progression of CNCC-related CHDs. CNCC ablation was previously reported to cause abnormal cardiac function in early cardiogenesis, before the CNCCs arrive in the outflow region of the heart. However, the affected functional parameters and how they correlate with the structural abnormalities were not fully characterized. In this study, using a CNCC-ablated quail model, we contribute quantitative phenotyping of CNCC ablation-related CHDs and investigate abnormal early cardiac function, which potentially contributes to late-stage CHDs. Optical coherence tomography was used to assay early- and late-stage embryos and hearts. In CNCC-ablated embryos at four-chambered heart stages, great vessel diameter and left atrioventricular valve leaflet volumes are reduced. Earlier, at cardiac looping stages, CNCC-ablated embryos exhibit abnormally twisted bodies, abnormal blood flow waveforms, increased retrograde flow percentage, and abnormal cardiac cushions. The phenotypes observed in this CNCC-ablation model were also strikingly similar to those found in an established avian fetal alcohol syndrome model, supporting the contribution of CNCC dysfunction to the development of alcohol-induced CHDs.
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Affiliation(s)
- Pei Ma
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio; and
| | - Shi Gu
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio; and
| | - Ganga H Karunamuni
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| | - Michael W Jenkins
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio; and
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| | - Michiko Watanabe
- Department of Pediatrics, Case Western Reserve University, Cleveland, Ohio
| | - Andrew M Rollins
- Department of Biomedical Engineering, Case Western Reserve University, Cleveland, Ohio; and
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61
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Ju ZR, Wang HJ, Ma XJ, Ma D, Huang GY. HIRA Gene is Lower Expressed in the Myocardium of Patients with Tetralogy of Fallot. Chin Med J (Engl) 2016; 129:2403-2408. [PMID: 27748330 PMCID: PMC5072250 DOI: 10.4103/0366-6999.191745] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background: The most typical cardiac abnormality is conotruncal defects (CTDs) in patients with 22q11 deletion syndrome (22q11DS). HIRA (histone cell cycle regulator) gene, as one of the candidate genes located at the critical region of 22q11DS, was reported as possibly relevant to CTD in animal models. This study aimed to analyze the level of expression of the HIRA gene in tetralogy of Fallot (TOF) patients and the potential DNA sequence variations in the promoter region. Methods: The messenger RNA (mRNA) expression was examined with quantitative real-time polymerase chain reaction in 39 myocardial tissues of the right ventricular outflow tract (RVOT) from TOF patients and 4 myocardial tissues of RVOT from noncardiac death children. The protein expression was detected using immunohistochemistry in 12 TOF patients and 4 controls. A total of 100 TOF cases and 200 healthy controls were recruited for DNA sequencing. Results: The mRNA and protein expressions of the HIRA gene in the myocardium of the TOF patients were both significantly lower as compared to the controls (P < 0.05). Five single nucleotide polymorphisms (SNPs), including g.4111A>G (rs1128399), g.4265C>A (rs4585115), g.4369T>G (rs2277837), g.4371C>A (rs148516780), and g.4543T>C (rs111802956), were found in the promoter region of the HIRA gene. There were no significant differences of frequencies in these SNPs between the TOF patients and the controls (P > 0.05). Conclusion: The abnormal lower expression of the HIRA gene in the myocardium may participate in the pathogenesis of TOF.
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Affiliation(s)
- Zhao-Ru Ju
- Pediatric Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102, China
| | - Hui-Jun Wang
- Pediatric Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102; Laboratory of Congenital Heart Disease, Shanghai Key Laboratory of Birth Defects, Shanghai 201102, China
| | - Xiao-Jing Ma
- Pediatric Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102; Laboratory of Congenital Heart Disease, Shanghai Key Laboratory of Birth Defects, Shanghai 201102, China
| | - Duan Ma
- Laboratory of Congenital Heart Disease, Shanghai Key Laboratory of Birth Defects, Shanghai 201102, China
| | - Guo-Ying Huang
- Pediatric Cardiovascular Center, Children's Hospital of Fudan University, Shanghai 201102; Laboratory of Congenital Heart Disease, Shanghai Key Laboratory of Birth Defects, Shanghai 201102, China
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62
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McKean DM, Homsy J, Wakimoto H, Patel N, Gorham J, DePalma SR, Ware JS, Zaidi S, Ma W, Patel N, Lifton RP, Chung WK, Kim R, Shen Y, Brueckner M, Goldmuntz E, Sharp AJ, Seidman CE, Gelb BD, Seidman JG. Loss of RNA expression and allele-specific expression associated with congenital heart disease. Nat Commun 2016; 7:12824. [PMID: 27670201 PMCID: PMC5052634 DOI: 10.1038/ncomms12824] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Accepted: 08/04/2016] [Indexed: 12/22/2022] Open
Abstract
Congenital heart disease (CHD), a prevalent birth defect occurring in 1% of newborns, likely results from aberrant expression of cardiac developmental genes. Mutations in a variety of cardiac transcription factors, developmental signalling molecules and molecules that modify chromatin cause at least 20% of disease, but most CHD remains unexplained. We employ RNAseq analyses to assess allele-specific expression (ASE) and biallelic loss-of-expression (LOE) in 172 tissue samples from 144 surgically repaired CHD subjects. Here we show that only 5% of known imprinted genes with paternal allele silencing are monoallelic versus 56% with paternal allele expression-this cardiac-specific phenomenon seems unrelated to CHD. Further, compared with control subjects, CHD subjects have a significant burden of both LOE genes and ASE events associated with altered gene expression. These studies identify FGFBP2, LBH, RBFOX2, SGSM1 and ZBTB16 as candidate CHD genes because of significantly altered transcriptional expression.
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Affiliation(s)
- David M McKean
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA.,Cardiovascular Division, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts 02115, USA
| | - Jason Homsy
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA.,Cardiovascular Division, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts 02115, USA.,Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
| | - Hiroko Wakimoto
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Neil Patel
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
| | - Joshua Gorham
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
| | - Steven R DePalma
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA.,Howard Hughes Medical Institute, Harvard University, Boston, Massachusetts 02115, USA
| | - James S Ware
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA.,National Institute for Health Research Cardiovascular Biomedical Research Unit at Royal Brompton and Harefield National Health Service Foundation Trust and Imperial College London, London SW3 6NP, UK.,National Heart and Lung Institute, Imperial College London, London SW3 6NP, UK
| | - Samir Zaidi
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut 06510, USA
| | - Wenji Ma
- Department of Systems Biology, Columbia University Medical Center, New York, New York 10032, USA
| | - Nihir Patel
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
| | - Richard P Lifton
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut 06510, USA.,Howard Hughes Medical Institute, Yale University, Connecticut 06510, USA
| | - Wendy K Chung
- Department of Pediatrics and Medicine, Columbia University Medical Center, New York, New York 10032, USA
| | - Richard Kim
- Section of Cardiothoracic Surgery, University of Southern California Keck School of Medicine, Los Angeles, California 90089, USA
| | - Yufeng Shen
- Department of Systems Biology, Columbia University Medical Center, New York, New York 10032, USA.,Department of Biomedical Informatics, Columbia University Medical Center, New York, New York 10032, USA
| | - Martina Brueckner
- Department of Genetics, Yale University School of Medicine, New Haven, Connecticut 06510, USA
| | - Elizabeth Goldmuntz
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
| | - Andrew J Sharp
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
| | - Christine E Seidman
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA.,Cardiovascular Division, Brigham and Women's Hospital, Harvard University, Boston, Massachusetts 02115, USA.,Howard Hughes Medical Institute, Harvard University, Boston, Massachusetts 02115, USA
| | - Bruce D Gelb
- The Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA.,Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA.,Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, New York 10029, USA
| | - J G Seidman
- Department of Genetics, Harvard Medical School, Boston, Massachusetts 02115, USA
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63
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Végh AMD, Duim SN, Smits AM, Poelmann RE, Ten Harkel ADJ, DeRuiter MC, Goumans MJ, Jongbloed MRM. Part and Parcel of the Cardiac Autonomic Nerve System: Unravelling Its Cellular Building Blocks during Development. J Cardiovasc Dev Dis 2016; 3:jcdd3030028. [PMID: 29367572 PMCID: PMC5715672 DOI: 10.3390/jcdd3030028] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2016] [Revised: 09/05/2016] [Accepted: 09/07/2016] [Indexed: 02/06/2023] Open
Abstract
The autonomic nervous system (cANS) is essential for proper heart function, and complications such as heart failure, arrhythmias and even sudden cardiac death are associated with an altered cANS function. A changed innervation state may underlie (part of) the atrial and ventricular arrhythmias observed after myocardial infarction. In other cardiac diseases, such as congenital heart disease, autonomic dysfunction may be related to disease outcome. This is also the case after heart transplantation, when the heart is denervated. Interest in the origin of the autonomic nerve system has renewed since the role of autonomic function in disease progression was recognized, and some plasticity in autonomic regeneration is evident. As with many pathological processes, autonomic dysfunction based on pathological innervation may be a partial recapitulation of the early development of innervation. As such, insight into the development of cardiac innervation and an understanding of the cellular background contributing to cardiac innervation during different phases of development is required. This review describes the development of the cANS and focuses on the cellular contributions, either directly by delivering cells or indirectly by secretion of necessary factors or cell-derivatives.
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Affiliation(s)
- Anna M D Végh
- Department of Molecular Cell Biology, Leiden University Medical Center, Einthovenweg 20, 2333 ZC Leiden, The Netherlands.
| | - Sjoerd N Duim
- Department of Molecular Cell Biology, Leiden University Medical Center, Einthovenweg 20, 2333 ZC Leiden, The Netherlands.
| | - Anke M Smits
- Department of Molecular Cell Biology, Leiden University Medical Center, Einthovenweg 20, 2333 ZC Leiden, The Netherlands.
| | - Robert E Poelmann
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZC Leiden, The Netherlands.
- Institute of Biology Leiden, Leiden University, Sylviusweg 20, 2311 EZ Leiden, The Netherlands.
| | - Arend D J Ten Harkel
- Department of Pediatric Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZC Leiden, The Netherlands.
| | - Marco C DeRuiter
- Department of Anatomy & Embryology, Leiden University Medical Center, Einthovenweg 20, 2333 ZC Leiden, The Netherlands.
| | - Marie José Goumans
- Department of Molecular Cell Biology, Leiden University Medical Center, Einthovenweg 20, 2333 ZC Leiden, The Netherlands.
| | - Monique R M Jongbloed
- Department of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZC Leiden, The Netherlands.
- Department of Pediatric Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZC Leiden, The Netherlands.
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64
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Síndrome de deleción 22q11: bases embriológicas y algoritmo diagnóstico. REVISTA COLOMBIANA DE CARDIOLOGÍA 2016. [DOI: 10.1016/j.rccar.2016.05.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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65
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Koenig SN, Bosse K, Majumdar U, Bonachea EM, Radtke F, Garg V. Endothelial Notch1 Is Required for Proper Development of the Semilunar Valves and Cardiac Outflow Tract. J Am Heart Assoc 2016; 5:e003075. [PMID: 27107132 PMCID: PMC4843530 DOI: 10.1161/jaha.115.003075] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 03/16/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Congenital heart disease is the most common type of birth defect, affecting ≈2% of the population. Malformations involving the cardiac outflow tract and semilunar valves account for >50% of these cases predominantly because of a bicuspid aortic valve, which has an estimated prevalence of 1% in the population. We previously reported that mutations in NOTCH1 were a cause of bicuspid aortic valve in nonsyndromic autosomal-dominant human pedigrees. Subsequently, we described a highly penetrant mouse model of aortic valve disease, consisting of a bicuspid aortic valve with thickened cusps and associated stenosis and regurgitation, in Notch1-haploinsufficient adult mice backcrossed into a Nos3-null background. METHODS AND RESULTS Here, we described the congenital cardiac abnormalities in Notch1(+/-);Nos3(-/-) embryos that led to ≈65% lethality by postnatal day 10. Although expected Mendelian ratios of Notch1(+/-);Nos3(-/-) embryos were found at embryonic day 18.5, histological examination revealed thickened, malformed semilunar valve leaflets accompanied by additional anomalies of the cardiac outflow tract including ventricular septal defects and overriding aorta. The aortic valve leaflets of Notch1(+/-);Nos3(-/-) embryos at embryonic day 15.5 were significantly thicker than controls, consistent with a defect in remodeling of the semilunar valve cushions. In addition, we generated mice haploinsufficient for Notch1 specifically in endothelial and endothelial-derived cells in a Nos3-null background and found that Notch1(fl/+);Tie2-Cre(+/-);Nos3(-/-) mice recapitulate the congenital cardiac phenotype of Notch1(+/-);Nos3(-/-) embryos. CONCLUSIONS Our data demonstrate the role of endothelial Notch1 in the proper development of the semilunar valves and cardiac outflow tract.
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Affiliation(s)
- Sara N Koenig
- Center for Cardiovascular and Pulmonary Research and The Heart Center, Nationwide Children's Hospital, Columbus, OH
| | - Kevin Bosse
- Center for Cardiovascular and Pulmonary Research and The Heart Center, Nationwide Children's Hospital, Columbus, OH
| | - Uddalak Majumdar
- Center for Cardiovascular and Pulmonary Research and The Heart Center, Nationwide Children's Hospital, Columbus, OH
| | | | - Freddy Radtke
- Ecole Polytechnique Fédérale de Lausanne, Swiss Institute for Experimental Cancer Research, Lausanne, Switzerland
| | - Vidu Garg
- Center for Cardiovascular and Pulmonary Research and The Heart Center, Nationwide Children's Hospital, Columbus, OH Department of Pediatrics, The Ohio State University, Columbus, OH Department of Molecular Genetics, The Ohio State University, Columbus, OH
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66
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MacGrogan D, D'Amato G, Travisano S, Martinez-Poveda B, Luxán G, Del Monte-Nieto G, Papoutsi T, Sbroggio M, Bou V, Gomez-Del Arco P, Gómez MJ, Zhou B, Redondo JM, Jiménez-Borreguero LJ, de la Pompa JL. Sequential Ligand-Dependent Notch Signaling Activation Regulates Valve Primordium Formation and Morphogenesis. Circ Res 2016; 118:1480-97. [PMID: 27056911 DOI: 10.1161/circresaha.115.308077] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 04/07/2016] [Indexed: 01/01/2023]
Abstract
RATIONALE The Notch signaling pathway is crucial for primitive cardiac valve formation by epithelial-mesenchymal transition, and NOTCH1 mutations cause bicuspid aortic valve; however, the temporal requirement for the various Notch ligands and receptors during valve ontogeny is poorly understood. OBJECTIVE The aim of this study is to determine the functional specificity of Notch in valve development. METHODS AND RESULTS Using cardiac-specific conditional targeted mutant mice, we find that endothelial/endocardial deletion of Mib1-Dll4-Notch1 signaling, possibly favored by Manic-Fringe, is specifically required for cardiac epithelial-mesenchymal transition. Mice lacking endocardial Jag1, Notch1, or RBPJ displayed enlarged valve cusps, bicuspid aortic valve, and septal defects, indicating that endocardial Jag1 to Notch1 signaling is required for post-epithelial-mesenchymal transition valvulogenesis. Valve dysmorphology was associated with increased mesenchyme proliferation, indicating that Jag1-Notch1 signaling restricts mesenchyme cell proliferation non-cell autonomously. Gene profiling revealed upregulated Bmp signaling in Jag1-mutant valves, providing a molecular basis for the hyperproliferative phenotype. Significantly, the negative regulator of mesenchyme proliferation, Hbegf, was markedly reduced in Jag1-mutant valves. Hbegf expression in embryonic endocardial cells could be readily activated through a RBPJ-binding site, identifying Hbegf as an endocardial Notch target. Accordingly, addition of soluble heparin-binding EGF-like growth factor to Jag1-mutant outflow tract explant cultures rescued the hyperproliferative phenotype. CONCLUSIONS During cardiac valve formation, Dll4-Notch1 signaling leads to epithelial-mesenchymal transition and cushion formation. Jag1-Notch1 signaling subsequently restrains Bmp-mediated valve mesenchyme proliferation by sustaining Hbegf-EGF receptor signaling. Our studies identify a mechanism of signaling cross talk during valve morphogenesis involved in the origin of congenital heart defects associated with reduced NOTCH function.
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Affiliation(s)
- Donal MacGrogan
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Gaetano D'Amato
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Stanislao Travisano
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Beatriz Martinez-Poveda
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Guillermo Luxán
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Gonzalo Del Monte-Nieto
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Tania Papoutsi
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Mauro Sbroggio
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Vanesa Bou
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Pablo Gomez-Del Arco
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Manuel Jose Gómez
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Bin Zhou
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Juan Miguel Redondo
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - Luis J Jiménez-Borreguero
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.)
| | - José Luis de la Pompa
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory (D.M., G.D., S.T., B.M.-P., G.L., G.d.M.-N., T.P., M.S., V.B., J.L.d.l.P.), Regulation of Gene Expression in Vascular Endothelium Laboratory (P.G.-d. A., J.M.R.), Bioinformatics Unit (M.J.G.), and Cardiovascular Imaging Laboratory (L.J.J.-B.), Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Department of Molecular Biology, Universidad Autónoma de Madrid, Madrid, Spain (P.G.-d. A.); Department of Genetics, Pediatrics, and Medicine, Albert Einstein College of Medicine, New York, NY (B.Z.); and Instituto de Investigación Sanitaria Hospital, Universitario La Princesa, Madrid, Spain (L.J.J.-B.).
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Abstract
Cardiovascular malformations (CVMs) are the most common birth defect, occurring in 1% to 5% of all live births. Genetic, epigenetic, and environmental factors all influence the development of CVMs, and an improved understanding of the causation of CVMs is a prerequisite for prevention. Cardiac development is a complex, multistep process of morphogenesis that is under genetic regulation. Although the genetic contribution to CVMs is well recognized, the genetic causes of human CVMs are still identified infrequently. This article discusses the key genetic concepts characterizing human CVMs, their developmental basis, and the critical developmental and genetic concepts underlying their pathogenesis.
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Affiliation(s)
- Mohamad Azhar
- Department of Cell Biology & Anatomy, University of South Carolina School of Medicine, 6439 Garners Ferry Road, Columbia, SC 29208, USA.
| | - Stephanie M. Ware
- Department of Pediatrics, Herman B Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, IN,Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN,Corresponding authors: Mohamad Azhar, PhD, Indiana University School of Medicine, 1044 W. Walnut Street, Indianapolis, IN 46202, Phone: 317-278-8661, , Stephanie M. Ware, MD, PhD, Indiana University School of Medicine, 1044 W. Walnut Street, Indianapolis, IN 46202, Phone: 317-274-8938, Fax: 317-274-8679,
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68
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Baardman ME, Zwier MV, Wisse LJ, Gittenberger-de Groot AC, Kerstjens-Frederikse WS, Hofstra RMW, Jurdzinski A, Hierck BP, Jongbloed MRM, Berger RMF, Plösch T, DeRuiter MC. Common arterial trunk and ventricular non-compaction in Lrp2 knockout mice indicate a crucial role of LRP2 in cardiac development. Dis Model Mech 2016; 9:413-25. [PMID: 26822476 PMCID: PMC4852499 DOI: 10.1242/dmm.022053] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 01/20/2016] [Indexed: 01/22/2023] Open
Abstract
Lipoprotein-related receptor protein 2 (LRP2) is important for development of the embryonic neural crest and brain in both mice and humans. Although a role in cardiovascular development can be expected, the hearts of Lrp2 knockout (KO) mice have not yet been investigated. We studied the cardiovascular development of Lrp2 KO mice between embryonic day 10.5 (E10.5) and E15.5, applying morphometry and immunohistochemistry, using antibodies against Tfap2α (neural crest cells), Nkx2.5 (second heart field), WT1 (epicardium derived cells), tropomyosin (myocardium) and LRP2. The Lrp2 KO mice display a range of severe cardiovascular abnormalities, including aortic arch anomalies, common arterial trunk (persistent truncus arteriosus) with coronary artery anomalies, ventricular septal defects, overriding of the tricuspid valve and marked thinning of the ventricular myocardium. Both the neural crest cells and second heart field, which are essential for the lengthening and growth of the right ventricular outflow tract, are abnormally positioned in the Lrp2 KO. This explains the absence of the aorto-pulmonary septum, which leads to common arterial trunk and ventricular septal defects. Severe blebbing of the epicardial cells covering the ventricles is seen. Epithelial-mesenchymal transition does occur; however, there are fewer WT1-positive epicardium-derived cells in the ventricular wall as compared to normal, coinciding with the myocardial thinning and deep intertrabecular spaces. LRP2 plays a crucial role in cardiovascular development in mice. This corroborates findings of cardiac anomalies in humans with LRP2 mutations. Future studies should reveal the underlying signaling mechanisms in which LRP2 is involved during cardiogenesis. Summary: This paper sheds a new light on the role of the second heart field and neural crest cells in outflow tract formation in the mouse embryo. Depletion of the LPR2 results in a disturbed contribution pattern and subsequent common arterial trunk.
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Affiliation(s)
- Maria E Baardman
- Department of Genetics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - Mathijs V Zwier
- Department of Pediatrics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - Lambertus J Wisse
- Department of Anatomy and Embryology, Leiden University Medical Center, PO-Box 9600, Leiden 2300 RC, The Netherlands
| | | | - Wilhelmina S Kerstjens-Frederikse
- Department of Genetics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - Robert M W Hofstra
- Department of Clinical Genetics, Erasmus Medical Center Rotterdam, PO-Box 2040, Rotterdam 3000 CA, The Netherlands Neural Development and Gastroenterology Units, UCL Institute of Child Health, London WC1 NEH, UK
| | - Angelika Jurdzinski
- Department of Pediatrics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - Beerend P Hierck
- Department of Anatomy and Embryology, Leiden University Medical Center, PO-Box 9600, Leiden 2300 RC, The Netherlands
| | - Monique R M Jongbloed
- Department of Cardiology and Department of Anatomy and Embryology, Leiden University Medical Center, PO-Box 9600, Leiden 2300 RC, The Netherlands
| | - Rolf M F Berger
- Center for Congenital Heart Diseases, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - Torsten Plösch
- Department of Obstetrics and Gynaecology, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9713 GZ, The Netherlands
| | - Marco C DeRuiter
- Department of Anatomy and Embryology, Leiden University Medical Center, PO-Box 9600, Leiden 2300 RC, The Netherlands
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69
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Leung C, Liu Y, Lu X, Kim M, Drysdale TA, Feng Q. Rac1 Signaling Is Required for Anterior Second Heart Field Cellular Organization and Cardiac Outflow Tract Development. J Am Heart Assoc 2015; 5:e002508. [PMID: 26722124 PMCID: PMC4859369 DOI: 10.1161/jaha.115.002508] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Accepted: 11/18/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The small GTPase Rac1 regulates diverse cellular functions, including both apicobasal and planar cell polarity pathways; however, its role in cardiac outflow tract (OFT) development remains unknown. In the present study, we aimed to examine the role of Rac1 in the anterior second heart field (SHF) splanchnic mesoderm and subsequent OFT development during heart morphogenesis. METHODS AND RESULTS Using the Cre/loxP system, mice with an anterior SHF-specific deletion of Rac1 (Rac1(SHF)) were generated. Embryos were collected at various developmental time points for immunostaining and histological analysis. Intrauterine echocardiography was also performed to assess aortic valve blood flow in embryos at embryonic day 18.5. The Rac1(SHF) splanchnic mesoderm exhibited disruptions in SHF progenitor cellular organization and proliferation. Consequently, this led to a spectrum of OFT defects along with aortic valve defects in Rac1(SHF) embryos. Mechanistically, it was found that the ability of the Rac1(SHF) OFT myocardial cells to migrate into the proximal OFT cushion was severely reduced. In addition, expression of the neural crest chemoattractant semaphorin 3c was decreased. Lineage tracing showed that anterior SHF contribution to the OFT myocardium and aortic valves was deficient in Rac1(SHF) hearts. Furthermore, functional analysis with intrauterine echocardiography at embryonic day 18.5 showed aortic valve regurgitation in Rac1(SHF) hearts, which was not seen in control hearts. CONCLUSIONS Disruptions of Rac1 signaling in the anterior SHF results in aberrant progenitor cellular organization and defects in OFT development. Our data show Rac1 signaling to be a critical regulator of cardiac OFT formation during embryonic heart development.
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Affiliation(s)
- Carmen Leung
- Departments of Physiology and Pharmacology, Medicine and PediatricsSchulich School of Medicine and DentistryCollaborative Program in Developmental BiologyChildren's Health Research InstituteUniversity of Western OntarioLondonOntarioCanada
| | - Yin Liu
- Departments of Physiology and Pharmacology, Medicine and PediatricsSchulich School of Medicine and DentistryCollaborative Program in Developmental BiologyChildren's Health Research InstituteUniversity of Western OntarioLondonOntarioCanada
| | - Xiangru Lu
- Departments of Physiology and Pharmacology, Medicine and PediatricsSchulich School of Medicine and DentistryCollaborative Program in Developmental BiologyChildren's Health Research InstituteUniversity of Western OntarioLondonOntarioCanada
| | - Mella Kim
- Departments of Physiology and Pharmacology, Medicine and PediatricsSchulich School of Medicine and DentistryCollaborative Program in Developmental BiologyChildren's Health Research InstituteUniversity of Western OntarioLondonOntarioCanada
| | - Thomas A. Drysdale
- Departments of Physiology and Pharmacology, Medicine and PediatricsSchulich School of Medicine and DentistryCollaborative Program in Developmental BiologyChildren's Health Research InstituteUniversity of Western OntarioLondonOntarioCanada
| | - Qingping Feng
- Departments of Physiology and Pharmacology, Medicine and PediatricsSchulich School of Medicine and DentistryCollaborative Program in Developmental BiologyChildren's Health Research InstituteUniversity of Western OntarioLondonOntarioCanada
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70
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Masjedi S, Amarnath A, Baily KM, Ferdous Z. Comparison of calcification potential of valvular interstitial cells isolated from individual aortic valve cusps. Cardiovasc Pathol 2015; 25:185-194. [PMID: 26874039 DOI: 10.1016/j.carpath.2015.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Revised: 11/26/2015] [Accepted: 12/23/2015] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Calcific aortic valve disease (CAVD) is one of the most prevalent disorders among the elderly in developed countries. CAVD develops via cell-mediated processes, and clinical data show that CAVD initiates mostly in the noncoronary cusp of the aortic valve. Valvular interstitial cells (VICs) populate the inside of heart valves and are a heterogeneous cell population. The goal of this study is to elucidate the difference in calcification potential among VICs isolated from the left, right, and noncoronary cusps of porcine aortic valves. METHODS AND RESULTS VICs were isolated from each of the aortic valve cusps and cultured in calcifying medium for 14days to induce calcification. The samples were assessed for calcium deposits, nodule formation, and calcific markers using alizarin red and Von Kossa staining, alkaline phosphatase (ALP) staining, ALP enzyme activity assay, and Western blot. Extracellular matrix production and degradation were measured using collagen and glycosaminoglycan (GAG) assay and gelatin zymography. We observed that VICs isolated from the noncoronary cusp expressed greatest amount of the above calcific markers as compared to the coronary cusps. Also, collagen and GAG content was the greatest in noncoronary VICs. However, our zymography results showed significant difference only for active matrix metalloproteinase-2 expression between right and noncoronary VICs. CONCLUSION Our results suggest that VICs among the three cusps within aortic valve might be inherently different, where a subpopulation of VICs might be predisposed to calcification.
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Affiliation(s)
- Shirin Masjedi
- Department of Mechanical, Aerospace, and Biomedical Engineering, The University of Tennessee, Knoxville, TN 37996
| | - Adithi Amarnath
- Department of Mechanical, Aerospace, and Biomedical Engineering, The University of Tennessee, Knoxville, TN 37996
| | - Katherine M Baily
- Department of Mechanical, Aerospace, and Biomedical Engineering, The University of Tennessee, Knoxville, TN 37996
| | - Zannatul Ferdous
- Department of Mechanical, Aerospace, and Biomedical Engineering, The University of Tennessee, Knoxville, TN 37996.
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71
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Luxán G, D'Amato G, MacGrogan D, de la Pompa JL. Endocardial Notch Signaling in Cardiac Development and Disease. Circ Res 2015; 118:e1-e18. [PMID: 26635389 DOI: 10.1161/circresaha.115.305350] [Citation(s) in RCA: 160] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Accepted: 10/22/2015] [Indexed: 01/03/2023]
Abstract
The Notch signaling pathway is an ancient and highly conserved signaling pathway that controls cell fate specification and tissue patterning in the embryo and in the adult. Region-specific endocardial Notch activity regulates heart morphogenesis through the interaction with multiple myocardial-, epicardial-, and neural crest-derived signals. Mutations in NOTCH signaling elements cause congenital heart disease in humans and mice, demonstrating its essential role in cardiac development. Studies in model systems have provided mechanistic understanding of Notch function in cardiac development, congenital heart disease, and heart regeneration. Notch patterns the embryonic endocardium into prospective territories for valve and chamber formation, and later regulates the signaling processes leading to outflow tract and valve morphogenesis and ventricular trabeculae compaction. Alterations in NOTCH signaling in the endocardium result in congenital structural malformations that can lead to disease in the neonate and adult heart.
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Affiliation(s)
- Guillermo Luxán
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory, Centro Nacional de Investigaciones Cardiovascular (CNIC), Melchor Fernández Almagro, Madrid, Spain (G.L., G.D'A., D.M., J.L.d.l.P.); and Department of Tissue Morphogenesis, Max Planck Institute for Molecular Biomedicine, Münster, Germany (G.L.)
| | - Gaetano D'Amato
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory, Centro Nacional de Investigaciones Cardiovascular (CNIC), Melchor Fernández Almagro, Madrid, Spain (G.L., G.D'A., D.M., J.L.d.l.P.); and Department of Tissue Morphogenesis, Max Planck Institute for Molecular Biomedicine, Münster, Germany (G.L.)
| | - Donal MacGrogan
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory, Centro Nacional de Investigaciones Cardiovascular (CNIC), Melchor Fernández Almagro, Madrid, Spain (G.L., G.D'A., D.M., J.L.d.l.P.); and Department of Tissue Morphogenesis, Max Planck Institute for Molecular Biomedicine, Münster, Germany (G.L.)
| | - José Luis de la Pompa
- From the Intercellular Signaling in Cardiovascular Development and Disease Laboratory, Centro Nacional de Investigaciones Cardiovascular (CNIC), Melchor Fernández Almagro, Madrid, Spain (G.L., G.D'A., D.M., J.L.d.l.P.); and Department of Tissue Morphogenesis, Max Planck Institute for Molecular Biomedicine, Münster, Germany (G.L.).
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72
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Martin PS, Kloesel B, Norris RA, Lindsay M, Milan D, Body SC. Embryonic Development of the Bicuspid Aortic Valve. J Cardiovasc Dev Dis 2015; 2:248-272. [PMID: 28529942 PMCID: PMC5438177 DOI: 10.3390/jcdd2040248] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Bicuspid aortic valve (BAV) is the most common congenital valvular heart defect with an overall frequency of 0.5%–1.2%. BAVs result from abnormal aortic cusp formation during valvulogenesis, whereby adjacent cusps fuse into a single large cusp resulting in two, instead of the normal three, aortic cusps. Individuals with BAV are at increased risk for ascending aortic disease, aortic stenosis and coarctation of the aorta. The frequent occurrence of BAV and its anatomically discrete but frequent co-existing diseases leads us to suspect a common cellular origin. Although autosomal-dominant transmission of BAV has been observed in a few pedigrees, notably involving the gene NOTCH1, no single-gene model clearly explains BAV inheritance, implying a complex genetic model involving interacting genes. Several sequencing studies in patients with BAV have identified rare and uncommon mutations in genes of cardiac embryogenesis. But the extensive cell-cell signaling and multiple cellular origins involved in cardiac embryogenesis preclude simplistic explanations of this disease. In this review, we examine the series of events from cellular and transcriptional embryogenesis of the heart, to development of the aortic valve.
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Affiliation(s)
- Peter S. Martin
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Th724, Boston, MA 02115, USA; E-Mails: (P.S.M.); (B.K.)
| | - Benjamin Kloesel
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Th724, Boston, MA 02115, USA; E-Mails: (P.S.M.); (B.K.)
| | - Russell A. Norris
- Department of Regenerative Medicine and Cell Biology, Children’s Research Institute, Medical University of South Carolina, 173 Ashley St, Charleston, SC 29403, USA; E-Mail:
| | - Mark Lindsay
- Cardiovascular Research Center, Richard B. Simches Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA; E-Mails: (M.L.); (D.M.)
| | - David Milan
- Cardiovascular Research Center, Richard B. Simches Research Center, Massachusetts General Hospital, 185 Cambridge Street, Boston, MA 02114, USA; E-Mails: (M.L.); (D.M.)
| | - Simon C. Body
- Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women’s Hospital, Harvard Medical School, 75 Francis St., Th724, Boston, MA 02115, USA; E-Mails: (P.S.M.); (B.K.)
- Author to whom correspondence should be addressed: E-Mail: ; Tel.: +1-617-732-7330; Fax: +1-617-730-2813
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73
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Michelena HI, Della Corte A, Prakash SK, Milewicz DM, Evangelista A, Enriquez-Sarano M. Bicuspid aortic valve aortopathy in adults: Incidence, etiology, and clinical significance. Int J Cardiol 2015; 201:400-7. [PMID: 26310986 DOI: 10.1016/j.ijcard.2015.08.106] [Citation(s) in RCA: 96] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 07/11/2015] [Accepted: 08/10/2015] [Indexed: 12/21/2022]
Abstract
Bicuspid aortic valve is the most common congenital heart defect and is associated with an aortopathy manifested by dilatation of the ascending thoracic aorta. The clinical consequences of this aortopathy are the need for periodic monitoring of aortic diameters, elective prophylactic surgical aortic repair, and the occurrence of aortic dissection or rupture. This review describes the current knowledge of BAV aortopathy in adults, including incidence, pathophysiologic insights into its etiology, contemporary hypothesis-generating observations into its complications, and recommendations for monitoring and intervention.
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Affiliation(s)
| | | | - Siddharth K Prakash
- Division of Medical Genetics, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dianna M Milewicz
- Division of Medical Genetics, Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Artur Evangelista
- Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
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Mathieu P, Bossé Y, Huggins GS, Della Corte A, Pibarot P, Michelena HI, Limongelli G, Boulanger MC, Evangelista A, Bédard E, Citro R, Body SC, Nemer M, Schoen FJ. The pathology and pathobiology of bicuspid aortic valve: State of the art and novel research perspectives. JOURNAL OF PATHOLOGY CLINICAL RESEARCH 2015; 1:195-206. [PMID: 27499904 PMCID: PMC4939890 DOI: 10.1002/cjp2.21] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/25/2015] [Indexed: 12/12/2022]
Abstract
Bicuspid aortic valve is the most prevalent cardiac valvular malformation. It is associated with a high rate of long‐term morbidity including development of calcific aortic valve disease, aortic regurgitation and concomitant thoracic aortic aneurysm and dissection. Recently, basic and translational studies have identified some key processes involved in the development of bicuspid aortic valve and its morbidity. The development of aortic valve disease and thoracic aortic aneurysm and dissection is the result of complex interactions between genotypes, environmental risk factors and specific haemodynamic conditions created by bicuspid aortic valve anatomy. Herein, we review the pathobiology of bicuspid aortic valve with a special emphasis on translational aspects of these basic findings. Important but unresolved problems in the pathology of bicuspid aortic valve and thoracic aortic aneurysm and dissection are discussed, along with the molecular processes involved.
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Affiliation(s)
- Patrick Mathieu
- Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Groupe de Recherche en Valvulopathies (GRV), Department of Surgery Quebec Heart and Lung Institute/Research Center, Laval University Quebec Canada
| | - Yohan Bossé
- Department of Molecular Medicine, Quebec Heart and Lung Institute/Research Center Laval University Québec Canada
| | - Gordon S Huggins
- Molecular Cardiology Research Institute Center for Translational Genomics, Tufts Medical Center Boston Massachussetts USA
| | - Alessandro Della Corte
- Department of Cardiothoracic Sciences, Cardiac Surgery Second University of Naples 80131 Naples Italy
| | - Philippe Pibarot
- Department of Molecular Medicine, Quebec Heart and Lung Institute/Research Center Laval University Québec Canada
| | - Hector I Michelena
- Division of Cardiovascular Diseases, Mayo Clinic Rochester Minnesota USA
| | - Giuseppe Limongelli
- Department of Cardiology and Cardiothoracic and Respiratory Sciences, Cardiologia SUN, Monaldi Hospital, AO Colli Naples Italy
| | - Marie-Chloé Boulanger
- Laboratoire d'Études Moléculaires des Valvulopathies (LEMV), Groupe de Recherche en Valvulopathies (GRV), Department of Surgery Quebec Heart and Lung Institute/Research Center, Laval University Quebec Canada
| | - Arturo Evangelista
- Department of Cardiology Hospital Universitary Vall d'Hebron Barcelona Spain
| | - Elisabeth Bédard
- Department of Molecular Medicine, Quebec Heart and Lung Institute/Research Center Laval University Québec Canada
| | - Rodolfo Citro
- Heart Department University Hospital "San Giovanni di Dio e Ruggi d'Aragona" Salerno Italy
| | - Simon C Body
- Department of Anesthesiology, Perioperative and Pain Medicine Center for Perioperative Genomics, Brigham and Women's Hospital Boston Massachusetts USA
| | - Mona Nemer
- Laboratory for Cardiac Development and Differentiation University of Ottawa Ontario Canada
| | - Frederick J Schoen
- Department of Pathology Brigham and Women's Hospital, Harvard Medical School USA
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Endocardial Brg1 disruption illustrates the developmental origins of semilunar valve disease. Dev Biol 2015; 407:158-72. [PMID: 26100917 DOI: 10.1016/j.ydbio.2015.06.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 06/12/2015] [Accepted: 06/13/2015] [Indexed: 11/24/2022]
Abstract
The formation of intricately organized aortic and pulmonic valves from primitive endocardial cushions of the outflow tract is a remarkable accomplishment of embryonic development. While not always initially pathologic, developmental semilunar valve (SLV) defects, including bicuspid aortic valve, frequently progress to a disease state in adults requiring valve replacement surgery. Disrupted embryonic growth, differentiation, and patterning events that "trigger" SLV disease are coordinated by gene expression changes in endocardial, myocardial, and cushion mesenchymal cells. We explored roles of chromatin regulation in valve gene regulatory networks by conditional inactivation of the Brg1-associated factor (BAF) chromatin remodeling complex in the endocardial lineage. Endocardial Brg1-deficient mouse embryos develop thickened and disorganized SLV cusps that frequently become bicuspid and myxomatous, including in surviving adults. These SLV disease-like phenotypes originate from deficient endocardial-to-mesenchymal transformation (EMT) in the proximal outflow tract (pOFT) cushions. The missing cells are replaced by compensating neural crest or other non-EMT-derived mesenchyme. However, these cells are incompetent to fully pattern the valve interstitium into distinct regions with specialized extracellular matrices. Transcriptomics reveal genes that may promote growth and patterning of SLVs and/or serve as disease-state biomarkers. Mechanistic studies of SLV disease genes should distinguish between disease origins and progression; the latter may reflect secondary responses to a disrupted developmental system.
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76
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Circadian control of bile acid synthesis by a KLF15-Fgf15 axis. Nat Commun 2015; 6:7231. [PMID: 26040986 PMCID: PMC4457302 DOI: 10.1038/ncomms8231] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Accepted: 04/21/2015] [Indexed: 12/18/2022] Open
Abstract
Circadian control of nutrient availability is critical to efficiently meet the energetic demands of an organism. Production of bile acids (BAs), which facilitate digestion and absorption of nutrients, is a major regulator of this process. Here we identify a KLF15-Fgf15 signalling axis that regulates circadian BA production. Systemic Klf15 deficiency disrupted circadian expression of key BA synthetic enzymes, tissue BA levels and triglyceride/cholesterol absorption. Studies in liver-specific Klf15-knockout mice suggested a non-hepatic basis for regulation of BA production. Ileal Fgf15 is a potent inhibitor of BA synthesis. Using a combination of biochemical, molecular and functional assays (including ileectomy and bile duct catheterization), we identify KLF15 as the first endogenous negative regulator of circadian Fgf15 expression. Elucidation of this novel pathway controlling circadian BA production has important implications for physiologic control of nutrient availability and metabolic homeostasis.
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Mommersteeg MTM, Yeh ML, Parnavelas JG, Andrews WD. Disrupted Slit-Robo signalling results in membranous ventricular septum defects and bicuspid aortic valves. Cardiovasc Res 2015; 106:55-66. [PMID: 25691540 PMCID: PMC4362403 DOI: 10.1093/cvr/cvv040] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 01/09/2015] [Accepted: 01/29/2015] [Indexed: 12/17/2022] Open
Abstract
AIMS The mesenchymal cushions lining the early embryonic heart undergo complex remodelling to form the membranous ventricular septum as well as the atrioventricular and semilunar valves in later life. Disruption of this process underlies the most common congenital heart defects. Here, we identified a novel role for Slit-Robo signalling in the development of the murine membranous ventricular septum and cardiac valves. METHODS AND RESULTS Expression of Robo1 and Robo2 receptors and their ligands, Slit2 and Slit3, was present in or adjacent to all cardiac cushions/valves. Loss of Robo1 or both Robo1 and Robo2 resulted in membranous ventricular septum defects at birth, a defect also found in Slit3, but not in Slit2 mutants. Additionally, Robo1;Robo2 double mutants showed thickened immature semilunar and atrioventricular valves as well as highly penetrant bicuspid aortic valves. Slit2 mutants recapitulated the semilunar phenotype, whereas Slit3 mutants displayed thickened atrioventricular valves. Bicuspid aortic cushions were already observed at E12.5 in the Robo1;Robo2 double mutants. Expression of Notch- and downstream Hey and Hes genes was down-regulated in Robo1 mutants, suggesting that reduced Notch signalling in mice lacking Robo might underlie the defects. Luciferase assays confirmed regulation of Notch signalling by Robo. CONCLUSION Cardiac defects in mutants for Robo or Slit range from membranous ventricular septum defects to bicuspid aortic valves. These ligands and receptors have unique functions during development of specific cardiac cushion derivatives, and the Slit-Robo signalling pathway likely enforces its role by regulating Notch signalling, making these mutants a valuable new model to study cardiac valve formation.
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MESH Headings
- Animals
- Aortic Valve/abnormalities
- Aortic Valve/physiopathology
- Basic Helix-Loop-Helix Transcription Factors/genetics
- Basic Helix-Loop-Helix Transcription Factors/physiology
- Bicuspid Aortic Valve Disease
- Cell Cycle Proteins/genetics
- Cell Cycle Proteins/physiology
- Disease Models, Animal
- Gene Expression Regulation, Developmental/genetics
- Gene Expression Regulation, Developmental/physiology
- Heart Defects, Congenital/genetics
- Heart Defects, Congenital/physiopathology
- Heart Valve Diseases/genetics
- Heart Valve Diseases/physiopathology
- Homeodomain Proteins/genetics
- Homeodomain Proteins/physiology
- Intercellular Signaling Peptides and Proteins/genetics
- Intercellular Signaling Peptides and Proteins/physiology
- Membrane Proteins/genetics
- Membrane Proteins/physiology
- Mice
- Mice, Transgenic
- Mutation/genetics
- Nerve Tissue Proteins/genetics
- Nerve Tissue Proteins/physiology
- Receptors, Immunologic/genetics
- Receptors, Immunologic/physiology
- Receptors, Notch/genetics
- Receptors, Notch/physiology
- Signal Transduction/genetics
- Signal Transduction/physiology
- Transcription Factor HES-1
- Ventricular Septum/pathology
- Roundabout Proteins
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Affiliation(s)
- Mathilda T M Mommersteeg
- Department of Cell and Developmental Biology, University College London, 21 University Street, London WC1E 6DE, UK
| | - Mason L Yeh
- Department of Cell and Developmental Biology, University College London, 21 University Street, London WC1E 6DE, UK
| | - John G Parnavelas
- Department of Cell and Developmental Biology, University College London, 21 University Street, London WC1E 6DE, UK
| | - William D Andrews
- Department of Cell and Developmental Biology, University College London, 21 University Street, London WC1E 6DE, UK
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Koenig SN, Bosse KM, Nadorlik HA, Lilly B, Garg V. Evidence of Aortopathy in Mice with Haploinsufficiency of Notch1 in Nos3-Null Background. J Cardiovasc Dev Dis 2015; 2:17-30. [PMID: 25914885 PMCID: PMC4407710 DOI: 10.3390/jcdd2010017] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Thoracic aortic aneurysms (TAA) are a significant cause of morbidity and mortality in humans. While the exact etiology is unknown, genetic factors play an important role. Mutations in NOTCH1 have been linked to bicuspid aortic valve (BAV) and aortopathy in humans. The aim of this study was to determine if haploinsufficiency of Notch1 contributes to aortopathy using Notch1+/−; Nos3−/− mice. Echocardiographic analysis of Notch1+/−; Nos3−/− mice reveals effacement of the sinotubular junction and a trend toward dilation of the aortic sinus. Furthermore, examination of the proximal aorta of Notch1+/−; Nos3−/− mice reveals elastic fiber degradation, a trend toward increased matrix metalloproteinase 2 expression, and increased smooth muscle cell apoptosis, features characteristic of aneurysmal disease. Although at a lower penetrance, we also found features consistent with aortopathic changes in Notch1 heterozygote mice and in Nos3-null mice. Our findings implicate a novel role for Notch1 in aortopathy of the proximal aorta.
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Affiliation(s)
- Sara N. Koenig
- The Center for Cardiovascular and Pulmonary Research and Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA; E-Mails: (S.N.K.); (K.M.B.); (H.A.N.); (B.L.)
- Department of Pediatrics, The Ohio State University, 700 Children’s Drive, Columbus, OH 43205, USA
| | - Kevin M. Bosse
- The Center for Cardiovascular and Pulmonary Research and Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA; E-Mails: (S.N.K.); (K.M.B.); (H.A.N.); (B.L.)
| | - Holly A. Nadorlik
- The Center for Cardiovascular and Pulmonary Research and Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA; E-Mails: (S.N.K.); (K.M.B.); (H.A.N.); (B.L.)
- Department of Pediatrics, The Ohio State University, 700 Children’s Drive, Columbus, OH 43205, USA
| | - Brenda Lilly
- The Center for Cardiovascular and Pulmonary Research and Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA; E-Mails: (S.N.K.); (K.M.B.); (H.A.N.); (B.L.)
- Department of Pediatrics, The Ohio State University, 700 Children’s Drive, Columbus, OH 43205, USA
| | - Vidu Garg
- The Center for Cardiovascular and Pulmonary Research and Heart Center, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA; E-Mails: (S.N.K.); (K.M.B.); (H.A.N.); (B.L.)
- Department of Pediatrics, The Ohio State University, 700 Children’s Drive, Columbus, OH 43205, USA
- Department of Molecular Genetics, The Ohio State University, 484 West 12th Avenue, Columbus, OH 43210, USA
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +1-614-355-5740; Fax: +1-614-355-5725
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Quintero-Rivera F, Xi QJ, Keppler-Noreuil KM, Lee JH, Higgins AW, Anchan RM, Roberts AE, Seong IS, Fan X, Lage K, Lu LY, Tao J, Hu X, Berezney R, Gelb BD, Kamp A, Moskowitz IP, Lacro RV, Lu W, Morton CC, Gusella JF, Maas RL. MATR3 disruption in human and mouse associated with bicuspid aortic valve, aortic coarctation and patent ductus arteriosus. Hum Mol Genet 2015; 24:2375-89. [PMID: 25574029 PMCID: PMC4380077 DOI: 10.1093/hmg/ddv004] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Cardiac left ventricular outflow tract (LVOT) defects represent a common but heterogeneous subset of congenital heart disease for which gene identification has been difficult. We describe a 46,XY,t(1;5)(p36.11;q31.2)dn translocation carrier with pervasive developmental delay who also exhibited LVOT defects, including bicuspid aortic valve (BAV), coarctation of the aorta (CoA) and patent ductus arteriosus (PDA). The 1p breakpoint disrupts the 5′ UTR of AHDC1, which encodes AT-hook DNA-binding motif containing-1 protein, and AHDC1-truncating mutations have recently been described in a syndrome that includes developmental delay, but not congenital heart disease [Xia, F., Bainbridge, M.N., Tan, T.Y., Wangler, M.F., Scheuerle, A.E., Zackai, E.H., Harr, M.H., Sutton, V.R., Nalam, R.L., Zhu, W. et al. (2014) De Novo truncating mutations in AHDC1 in individuals with syndromic expressive language delay, hypotonia, and sleep apnea. Am. J. Hum. Genet., 94, 784–789]. On the other hand, the 5q translocation breakpoint disrupts the 3′ UTR of MATR3, which encodes the nuclear matrix protein Matrin 3, and mouse Matr3 is strongly expressed in neural crest, developing heart and great vessels, whereas Ahdc1 is not. To further establish MATR3 3′ UTR disruption as the cause of the proband's LVOT defects, we prepared a mouse Matr3Gt-ex13 gene trap allele that disrupted the 3′ portion of the gene. Matr3Gt-ex13 homozygotes are early embryo lethal, but Matr3Gt-ex13 heterozygotes exhibit incompletely penetrant BAV, CoA and PDA phenotypes similar to those in the human proband, as well as ventricular septal defect (VSD) and double-outlet right ventricle (DORV). Both the human MATR3 translocation breakpoint and the mouse Matr3Gt-ex13 gene trap insertion disturb the polyadenylation of MATR3 transcripts and alter Matrin 3 protein expression, quantitatively or qualitatively. Thus, subtle perturbations in Matrin 3 expression appear to cause similar LVOT defects in human and mouse.
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Affiliation(s)
- Fabiola Quintero-Rivera
- Molecular Neurogenetics Unit and Center for Human Genetic Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA, Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | | | - Kim M Keppler-Noreuil
- Division of Medical Genetics, University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - Ji Hyun Lee
- Molecular Neurogenetics Unit and Center for Human Genetic Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Anne W Higgins
- Department of Obstetrics, Gynecology and Reproductive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Raymond M Anchan
- Division of Genetics, Department of Medicine, Department of Obstetrics, Gynecology and Reproductive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Amy E Roberts
- Department of Cardiology, Division of Genetics, Department of Medicine, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA
| | - Ihn Sik Seong
- Molecular Neurogenetics Unit and Center for Human Genetic Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Xueping Fan
- Renal Section, Department of Medicine, Boston University Medical Center, Boston, MA, USA
| | - Kasper Lage
- Pediatric Surgical Research Laboratories, Department of Surgery, Massachusetts General Hospital for Children and Harvard Medical School, Boston, MA, USA
| | - Lily Y Lu
- Division of Genetics, Department of Medicine
| | - Joanna Tao
- Division of Genetics, Department of Medicine
| | - Xuchen Hu
- Division of Genetics, Department of Medicine
| | - Ronald Berezney
- Department of Biological Sciences, University at Buffalo, Buffalo, NY, USA
| | - Bruce D Gelb
- Mindich Child Health and Development Institute, Departments of Pediatrics and Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Anna Kamp
- Departments of Pediatrics and Pathology, University of Chicago, Chicago, IL, USA and
| | - Ivan P Moskowitz
- Departments of Pediatrics and Pathology, University of Chicago, Chicago, IL, USA and
| | | | - Weining Lu
- Renal Section, Department of Medicine, Boston University Medical Center, Boston, MA, USA
| | - Cynthia C Morton
- Department of Obstetrics, Gynecology and Reproductive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA, Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - James F Gusella
- Molecular Neurogenetics Unit and Center for Human Genetic Research, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,
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80
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Review of Molecular and Mechanical Interactions in the Aortic Valve and Aorta: Implications for the Shared Pathogenesis of Aortic Valve Disease and Aortopathy. J Cardiovasc Transl Res 2014; 7:823-46. [DOI: 10.1007/s12265-014-9602-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 10/30/2014] [Indexed: 01/08/2023]
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81
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MacGrogan D, Luxán G, Driessen-Mol A, Bouten C, Baaijens F, de la Pompa JL. How to make a heart valve: from embryonic development to bioengineering of living valve substitutes. Cold Spring Harb Perspect Med 2014; 4:a013912. [PMID: 25368013 DOI: 10.1101/cshperspect.a013912] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Cardiac valve disease is a significant cause of ill health and death worldwide, and valve replacement remains one of the most common cardiac interventions in high-income economies. Despite major advances in surgical treatment, long-term therapy remains inadequate because none of the current valve substitutes have the potential for remodeling, regeneration, and growth of native structures. Valve development is coordinated by a complex interplay of signaling pathways and environmental cues that cause disease when perturbed. Cardiac valves develop from endocardial cushions that become populated by valve precursor mesenchyme formed by an epithelial-mesenchymal transition (EMT). The mesenchymal precursors, subsequently, undergo directed growth, characterized by cellular compartmentalization and layering of a structured extracellular matrix (ECM). Knowledge gained from research into the development of cardiac valves is driving exploration into valve biomechanics and tissue engineering directed at creating novel valve substitutes endowed with native form and function.
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Affiliation(s)
- Donal MacGrogan
- Program of Cardiovascular Developmental Biology, Department of Cardiovascular Development and Repair, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
| | - Guillermo Luxán
- Program of Cardiovascular Developmental Biology, Department of Cardiovascular Development and Repair, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
| | - Anita Driessen-Mol
- Biomedical Engineering/Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands
| | - Carlijn Bouten
- Biomedical Engineering/Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands
| | - Frank Baaijens
- Biomedical Engineering/Eindhoven University of Technology, 5600 MB Eindhoven, The Netherlands
| | - José Luis de la Pompa
- Program of Cardiovascular Developmental Biology, Department of Cardiovascular Development and Repair, Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain
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82
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Odelin G, Faure E, Kober F, Maurel-Zaffran C, Théron A, Coulpier F, Guillet B, Bernard M, Avierinos JF, Charnay P, Topilko P, Zaffran S. Loss of Krox20 results in aortic valve regurgitation and impaired transcriptional activation of fibrillar collagen genes. Cardiovasc Res 2014; 104:443-55. [PMID: 25344368 DOI: 10.1093/cvr/cvu233] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS Heart valve maturation is achieved by the organization of extracellular matrix (ECM) and the distribution of valvular interstitial cells. However, the factors that regulate matrix components required for valvular structure and function are unknown. Based on the discovery of its specific expression in cardiac valves, we aimed to uncover the role of Krox20 (Egr-2) during valve development and disease. METHODS AND RESULTS Using series of mouse genetic tools, we demonstrated that loss of function of Krox20 caused significant hyperplasia of the semilunar valves, while atrioventricular valves appeared normal. This defect was associated with an increase in valvular interstitial cell number and ECM volume. Echo Doppler analysis revealed that adult mutant mice had aortic insufficiency. Defective aortic valves (AoVs) in Krox20(-/-) mice had features of human AoV disease, including excess of proteoglycan deposition and reduction of collagen fibres. Furthermore, examination of diseased human AoVs revealed decreased expression of KROX20. To identify downstream targets of Krox20, we examined expression of fibrillar collagens in the AoV leaflets at different stages in the mouse. We found significant down-regulation of Col1a1, Col1a2, and Col3a1 in the semilunar valves of Krox20 mutant mice. Utilizing in vitro and in vivo experiments, we demonstrated that Col1a1 and Col3a1 are direct targets of Krox20 activation in interstitial cells of the AoV. CONCLUSION This study identifies a previously unknown function of Krox20 during heart valve development. These results indicate that Krox20-mediated activation of fibrillar Col1a1 and Col3a1 genes is crucial to avoid postnatal degeneration of the AoV leaflets.
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Affiliation(s)
- Gaëlle Odelin
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France
| | - Emilie Faure
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France
| | - Frank Kober
- Faculté de Médecine, Aix Marseille Université, CNRS, CRMBM UMR7339, Marseille, France
| | | | - Alexis Théron
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France Département de Cardiologie, AP-HM, Hôpital de la Timone, Marseille, France
| | - Fanny Coulpier
- Inserm, U1024, IBENS, École Normale Supérieure, Paris, France CNRS, UMR8197, IBENS, École Normale Supérieure, Paris, France
| | - Benjamin Guillet
- Faculté de Médecine, Aix Marseille Université, CERIMED, Marseille, France
| | - Monique Bernard
- Faculté de Médecine, Aix Marseille Université, CNRS, CRMBM UMR7339, Marseille, France
| | - Jean-François Avierinos
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France Département de Cardiologie, AP-HM, Hôpital de la Timone, Marseille, France
| | - Patrick Charnay
- Inserm, U1024, IBENS, École Normale Supérieure, Paris, France CNRS, UMR8197, IBENS, École Normale Supérieure, Paris, France
| | - Piotr Topilko
- Inserm, U1024, IBENS, École Normale Supérieure, Paris, France CNRS, UMR8197, IBENS, École Normale Supérieure, Paris, France
| | - Stéphane Zaffran
- Aix Marseille Université, GMGF UMR_S910, Faculté de Médecine, 27 Bd Jean Moulin, 13385 Marseille, France Inserm, U910, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France
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83
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Shi Y, Li J, Chen C, Gong M, Chen Y, Liu Y, Chen J, Li T, Song W. 5-Mehtyltetrahydrofolate rescues alcohol-induced neural crest cell migration abnormalities. Mol Brain 2014; 7:67. [PMID: 25223405 PMCID: PMC4172781 DOI: 10.1186/s13041-014-0067-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Accepted: 08/29/2014] [Indexed: 11/16/2022] Open
Abstract
Background Alcohol is detrimental to early development. Fetal alcohol spectrum disorders (FASD) due to maternal alcohol abuse results in a series of developmental abnormalities including cranial facial dysmorphology, ocular anomalies, congenital heart defects, microcephaly and intellectual disabilities. Previous studies have been shown that ethanol exposure causes neural crest (NC) apoptosis and perturbation of neural crest migration. However, the underlying mechanism remains elusive. In this report we investigated the fetal effect of alcohol on the process of neural crest development in the Xenopus leavis. Results Pre-gastrulation exposure of 2-4% alcohol induces apoptosis in Xenopus embryo whereas 1% alcohol specifically impairs neural crest migration without observing discernible apoptosis. Additionally, 1% alcohol treatment considerably increased the phenotype of small head (43.4% ± 4.4%, total embryo n = 234), and 1.5% and 2.0% dramatically augment the deformation to 81.2% ± 6.5% (n = 205) and 91.6% ± 3.0% (n = 235), respectively (P < 0.05). Significant accumulation of Homocysteine was caused by alcohol treatment in embryos and 5-mehtyltetrahydrofolate restores neural crest migration and alleviates homocysteine accumulation, resulting in inhibition of the alcohol-induced neurocristopathies. Conclusions Our study demonstrates that prenatal alcohol exposure causes neural crest cell migration abnormality and 5-mehtyltetrahydrofolate could be beneficial for treating FASD.
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84
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Abstract
Dilation of the wall of the thoracic aorta can be found in patients with a tricuspid (TAV) as well as a bicuspid aortic valve (BAV) with and without a syndromic component. BAV is the most common congenital cardiovascular malformation, with a population prevalence of 0.5–2 %. The clinical course is often characterised by aneurysm formation and in some cases dissection. The non-dilated aortic wall is less well differentiated in all BAV as compared with TAV, thereby conferring inherent developmental susceptibility. Furthermore, a turbulent flow, caused by the inappropriate opening of the bicuspid valve, could accelerate the degenerative process in the aortic wall. However, not all patients with bicuspidy develop clinical complications during their life. We postulate that the increased vulnerability for aortic complications in a subset of patients with BAV is caused by a defect in the early development of the aorta and aortic valve. This review discusses histological and molecular genetic aspects of the normal and abnormal development of the aortic wall and semilunar valves. Aortopathy associated with BAV could be the result of a shared developmental defect during embryogenesis.
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Karunamuni GH, Ma P, Gu S, Rollins AM, Jenkins MW, Watanabe M. Connecting teratogen-induced congenital heart defects to neural crest cells and their effect on cardiac function. BIRTH DEFECTS RESEARCH. PART C, EMBRYO TODAY : REVIEWS 2014; 102:227-50. [PMID: 25220155 PMCID: PMC4238913 DOI: 10.1002/bdrc.21082] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 08/26/2014] [Indexed: 12/26/2022]
Abstract
Neural crest cells play many key roles in embryonic development, as demonstrated by the abnormalities that result from their specific absence or dysfunction. Unfortunately, these key cells are particularly sensitive to abnormalities in various intrinsic and extrinsic factors, such as genetic deletions or ethanol-exposure that lead to morbidity and mortality for organisms. This review discusses the role identified for a segment of neural crest in regulating the morphogenesis of the heart and associated great vessels. The paradox is that their derivatives constitute a small proportion of cells to the cardiovascular system. Findings supporting that these cells impact early cardiac function raises the interesting possibility that they indirectly control cardiovascular development at least partially through regulating function. Making connections between insults to the neural crest, cardiac function, and morphogenesis is more approachable with technological advances. Expanding our understanding of early functional consequences could be useful in improving diagnosis and testing therapies.
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Affiliation(s)
- Ganga H. Karunamuni
- Department of Pediatrics, Case Western Reserve University School of Medicine, Case Medical Center Division of Pediatric Cardiology, Rainbow Babies and Children’s Hospital, Cleveland OH 44106
| | - Pei Ma
- Department of Biomedical Engineering, Case Western Reserve University School of Engineering, Cleveland OH 44106
| | - Shi Gu
- Department of Biomedical Engineering, Case Western Reserve University School of Engineering, Cleveland OH 44106
| | - Andrew M. Rollins
- Department of Biomedical Engineering, Case Western Reserve University School of Engineering, Cleveland OH 44106
| | - Michael W. Jenkins
- Department of Pediatrics, Case Western Reserve University School of Medicine, Case Medical Center Division of Pediatric Cardiology, Rainbow Babies and Children’s Hospital, Cleveland OH 44106
- Department of Biomedical Engineering, Case Western Reserve University School of Engineering, Cleveland OH 44106
| | - Michiko Watanabe
- Department of Pediatrics, Case Western Reserve University School of Medicine, Case Medical Center Division of Pediatric Cardiology, Rainbow Babies and Children’s Hospital, Cleveland OH 44106
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86
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Stingone JA, Luben TJ, Daniels JL, Fuentes M, Richardson DB, Aylsworth AS, Herring AH, Anderka M, Botto L, Correa A, Gilboa SM, Langlois PH, Mosley B, Shaw GM, Siffel C, Olshan AF. Maternal exposure to criteria air pollutants and congenital heart defects in offspring: results from the national birth defects prevention study. ENVIRONMENTAL HEALTH PERSPECTIVES 2014; 122:863-72. [PMID: 24727555 PMCID: PMC4123026 DOI: 10.1289/ehp.1307289] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Accepted: 04/09/2014] [Indexed: 05/19/2023]
Abstract
BACKGROUND Epidemiologic literature suggests that exposure to air pollutants is associated with fetal development. OBJECTIVES We investigated maternal exposures to air pollutants during weeks 2-8 of pregnancy and their associations with congenital heart defects. METHODS Mothers from the National Birth Defects Prevention Study, a nine-state case-control study, were assigned 1-week and 7-week averages of daily maximum concentrations of carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide and 24-hr measurements of fine and coarse particulate matter using the closest air monitor within 50 km to their residence during early pregnancy. Depending on the pollutant, a maximum of 4,632 live-birth controls and 3,328 live-birth, fetal-death, or electively terminated cases had exposure data. Hierarchical regression models, adjusted for maternal demographics and tobacco and alcohol use, were constructed. Principal component analysis was used to assess these relationships in a multipollutant context. RESULTS Positive associations were observed between exposure to nitrogen dioxide and coarctation of the aorta and pulmonary valve stenosis. Exposure to fine particulate matter was positively associated with hypoplastic left heart syndrome but inversely associated with atrial septal defects. Examining individual exposure-weeks suggested associations between pollutants and defects that were not observed using the 7-week average. Associations between left ventricular outflow tract obstructions and nitrogen dioxide and between hypoplastic left heart syndrome and particulate matter were supported by findings from the multipollutant analyses, although estimates were attenuated at the highest exposure levels. CONCLUSIONS Using daily maximum pollutant levels and exploring individual exposure-weeks revealed some positive associations between certain pollutants and defects and suggested potential windows of susceptibility during pregnancy.
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Affiliation(s)
- Jeanette A Stingone
- Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
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Michelena HI, Prakash SK, Della Corte A, Bissell MM, Anavekar N, Mathieu P, Bossé Y, Limongelli G, Bossone E, Benson DW, Lancellotti P, Isselbacher EM, Enriquez-Sarano M, Sundt TM, Pibarot P, Evangelista A, Milewicz DM, Body SC. Bicuspid aortic valve: identifying knowledge gaps and rising to the challenge from the International Bicuspid Aortic Valve Consortium (BAVCon). Circulation 2014; 129:2691-704. [PMID: 24958752 PMCID: PMC4145814 DOI: 10.1161/circulationaha.113.007851] [Citation(s) in RCA: 300] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Hector I Michelena
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.).
| | - Siddharth K Prakash
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Alessandro Della Corte
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Malenka M Bissell
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Nandan Anavekar
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Patrick Mathieu
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Yohan Bossé
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Giuseppe Limongelli
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Eduardo Bossone
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - D Woodrow Benson
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Patrizio Lancellotti
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Eric M Isselbacher
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Maurice Enriquez-Sarano
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Thoralf M Sundt
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Philippe Pibarot
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Artur Evangelista
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Dianna M Milewicz
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
| | - Simon C Body
- From the Division of Cardiovascular Diseases, Mayo Clinic, Rochester, MN (H.I.M., N.A., M.E.-S.); Division of Medical Genetics; Department of Internal Medicine, University of Texas Health Science Center at Houston, Houston, TX (S.K.P., D.M.M.); Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy (A.D.C.); Department of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, United Kingdom (M.M.B.); Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Québec, Canada (P.M., Y.B., P.P.); Cardiologia SUN, Monaldi Hospital, Naples, Italy (G.L.); Cardiology Division, "Cava de' Tirreni and Amalfi Coast" Hospital, Heart Department, University of Salerno, Italy (E.B.); Children's Hospital of Wisconsin, Medical College of Wisconsin, Milwaukee, WI (D.W.B.); University Hospital of Liège, GIGA Cardiovascular Sciences, CHU Sart Tilman, Liège, Belgium (P.L.); Heart Center and Thoracic Aortic Center, Massachusetts General Hospital, Boston, MA (E.M.I.); Division of Cardiac Surgery and Corrigan Minehan Heart Center, Massachusetts General Hospital, Boston, MA (T.M.S.); Servei de Cardiologia, Hospital Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain (A.E.); and Dept of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA (S.C.B.)
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Abstract
The Notch signalling pathway is evolutionarily conserved and is crucial for the development and homeostasis of most tissues. Deregulated Notch signalling leads to various diseases, such as T cell leukaemia, Alagille syndrome and a stroke and dementia syndrome known as CADASIL, and so strategies to therapeutically modulate Notch signalling are of interest. Clinical trials of Notch pathway inhibitors in patients with solid tumours have been reported, and several approaches are under preclinical evaluation. In this Review, we focus on aspects of the pathway that are amenable to therapeutic intervention, diseases that could be targeted and the various Notch pathway modulation strategies that are currently being explored.
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89
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Chester AH, El-Hamamsy I, Butcher JT, Latif N, Bertazzo S, Yacoub MH. The living aortic valve: From molecules to function. Glob Cardiol Sci Pract 2014; 2014:52-77. [PMID: 25054122 PMCID: PMC4104380 DOI: 10.5339/gcsp.2014.11] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 04/28/2014] [Indexed: 12/12/2022] Open
Abstract
The aortic valve lies in a unique hemodynamic environment, one characterized by a range of stresses (shear stress, bending forces, loading forces and strain) that vary in intensity and direction throughout the cardiac cycle. Yet, despite its changing environment, the aortic valve opens and closes over 100,000 times a day and, in the majority of human beings, will function normally over a lifespan of 70–90 years. Until relatively recently heart valves were considered passive structures that play no active role in the functioning of a valve, or in the maintenance of its integrity and durability. However, through clinical experience and basic research the aortic valve can now be characterized as a living, dynamic organ with the capacity to adapt to its complex mechanical and biomechanical environment through active and passive communication between its constituent parts. The clinical relevance of a living valve substitute in patients requiring aortic valve replacement has been confirmed. This highlights the importance of using tissue engineering to develop heart valve substitutes containing living cells which have the ability to assume the complex functioning of the native valve.
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90
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Grunert M, Dorn C, Schueler M, Dunkel I, Schlesinger J, Mebus S, Alexi-Meskishvili V, Perrot A, Wassilew K, Timmermann B, Hetzer R, Berger F, Sperling SR. Rare and private variations in neural crest, apoptosis and sarcomere genes define the polygenic background of isolated Tetralogy of Fallot. Hum Mol Genet 2014; 23:3115-28. [PMID: 24459294 DOI: 10.1093/hmg/ddu021] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
Tetralogy of Fallot (TOF) is the most common cyanotic congenital heart disease. Its genetic basis is demonstrated by an increased recurrence risk in siblings and familial cases. However, the majority of TOF are sporadic, isolated cases of undefined origin and it had been postulated that rare and private autosomal variations in concert define its genetic basis. To elucidate this hypothesis, we performed a multilevel study using targeted re-sequencing and whole-transcriptome profiling. We developed a novel concept based on a gene's mutation frequency to unravel the polygenic origin of TOF. We show that isolated TOF is caused by a combination of deleterious private and rare mutations in genes essential for apoptosis and cell growth, the assembly of the sarcomere as well as for the neural crest and secondary heart field, the cellular basis of the right ventricle and its outflow tract. Affected genes coincide in an interaction network with significant disturbances in expression shared by cases with a mutually affected TOF gene. The majority of genes show continuous expression during adulthood, which opens a new route to understand the diversity in the long-term clinical outcome of TOF cases. Our findings demonstrate that TOF has a polygenic origin and that understanding the genetic basis can lead to novel diagnostic and therapeutic routes. Moreover, the novel concept of the gene mutation frequency is a versatile measure and can be applied to other open genetic disorders.
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Affiliation(s)
- Marcel Grunert
- Group of Cardiovascular Genetics, Department of Vertebrate Genomics and Cardiovascular Genetics, Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max Delbrück Center (MDC) for Molecular Medicine, Berlin 13125, Germany
| | - Cornelia Dorn
- Group of Cardiovascular Genetics, Department of Vertebrate Genomics and Cardiovascular Genetics, Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max Delbrück Center (MDC) for Molecular Medicine, Berlin 13125, Germany Department of Biology, Chemistry and Pharmacy, Free University of Berlin, Berlin 14195, Germany
| | - Markus Schueler
- Group of Cardiovascular Genetics, Department of Vertebrate Genomics and Cardiovascular Genetics, Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max Delbrück Center (MDC) for Molecular Medicine, Berlin 13125, Germany
| | - Ilona Dunkel
- Group of Cardiovascular Genetics, Department of Vertebrate Genomics and
| | - Jenny Schlesinger
- Group of Cardiovascular Genetics, Department of Vertebrate Genomics and Cardiovascular Genetics, Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max Delbrück Center (MDC) for Molecular Medicine, Berlin 13125, Germany
| | - Siegrun Mebus
- Department of Pediatric Cardiology, German Heart Institute Berlin and Department of Pediatric Cardiology, Charité-Universitätsmedizin Berlin, Berlin 13353, Germany
| | | | - Andreas Perrot
- Cardiovascular Genetics, Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max Delbrück Center (MDC) for Molecular Medicine, Berlin 13125, Germany
| | | | - Bernd Timmermann
- Next Generation Service Group, Max Planck Institute for Molecular Genetics, Berlin 14195, Germany
| | | | - Felix Berger
- Department of Pediatric Cardiology, German Heart Institute Berlin and Department of Pediatric Cardiology, Charité-Universitätsmedizin Berlin, Berlin 13353, Germany
| | - Silke R Sperling
- Group of Cardiovascular Genetics, Department of Vertebrate Genomics and Cardiovascular Genetics, Experimental and Clinical Research Center, Charité-Universitätsmedizin Berlin and Max Delbrück Center (MDC) for Molecular Medicine, Berlin 13125, Germany Department of Biology, Chemistry and Pharmacy, Free University of Berlin, Berlin 14195, Germany
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91
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Jamis-Dow CA, Barbier GH, Watkins MP, Lanza GM, Caruthers SD, Wickline SA. Bicuspid Pulmonic Valve and Pulmonary Artery Aneurysm. Cardiol Res 2014; 5:83-84. [PMID: 26191115 PMCID: PMC4505617 DOI: 10.14740/cr321w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Bicuspid pulmonary valves and pulmonary artery aneurysms are two rare entities, reported in association, and usually attributed to hemodynamic alterations caused by the bicuspid pulmonary valve. We present magnetic resonance images of a patient with a bicuspid pulmonary valve and pulmonary artery aneurysm, and propose an alternative mechanism for this association, based on recent embryologic studies that link anomalies of the semilunar valves and great vessels with derangement of the cardiac neural crest cell development.
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Affiliation(s)
- Carlos A Jamis-Dow
- Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pennsylvania, USA
| | - George H Barbier
- Cardiology Section, Bay Pines VA Healthcare System, Bay Pines, Florida, USA
| | - Mary P Watkins
- Consortium for Translational Research in Advanced Imaging and Nanomedicine (C-TRAIN), Washington University of Saint Louis, St Louis, Missouri, USA
| | - Gregory M Lanza
- Consortium for Translational Research in Advanced Imaging and Nanomedicine (C-TRAIN), Washington University of Saint Louis, St Louis, Missouri, USA
| | - Shelton D Caruthers
- Consortium for Translational Research in Advanced Imaging and Nanomedicine (C-TRAIN), Washington University of Saint Louis, St Louis, Missouri, USA
| | - Samuel A Wickline
- Consortium for Translational Research in Advanced Imaging and Nanomedicine (C-TRAIN), Washington University of Saint Louis, St Louis, Missouri, USA
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92
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Green SA, Bronner ME. The lamprey: a jawless vertebrate model system for examining origin of the neural crest and other vertebrate traits. Differentiation 2014; 87:44-51. [PMID: 24560767 PMCID: PMC3995830 DOI: 10.1016/j.diff.2014.02.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 01/26/2014] [Accepted: 02/04/2014] [Indexed: 11/15/2022]
Abstract
Lampreys are a group of jawless fishes that serve as an important point of comparison for studies of vertebrate evolution. Lampreys and hagfishes are agnathan fishes, the cyclostomes, which sit at a crucial phylogenetic position as the only living sister group of the jawed vertebrates. Comparisons between cyclostomes and jawed vertebrates can help identify shared derived (i.e. synapomorphic) traits that might have been inherited from ancestral early vertebrates, if unlikely to have arisen convergently by chance. One example of a uniquely vertebrate trait is the neural crest, an embryonic tissue that produces many cell types crucial to vertebrate features, such as the craniofacial skeleton, pigmentation of the skin, and much of the peripheral nervous system (Gans and Northcutt, 1983). Invertebrate chordates arguably lack unambiguous neural crest homologs, yet have cells with some similarities, making comparisons with lampreys and jawed vertebrates essential for inferring characteristics of development in early vertebrates, and how they may have evolved from nonvertebrate chordates. Here we review recent research on cyclostome neural crest development, including research on lamprey gene regulatory networks and differentiated neural crest fates.
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Affiliation(s)
- Stephen A Green
- California Institute of Technology, 1200 E. California Ave., Pasadena, CA 91125, USA
| | - Marianne E Bronner
- California Institute of Technology, 1200 E. California Ave., Pasadena, CA 91125, USA.
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93
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Gokhale SG, Gokhale S. High prevalence of 'mitral valve prolapse syndrome' (MVPS) among older children and adolescents in a contained population. Int J Cardiol 2013; 168:4307-8. [PMID: 23684344 DOI: 10.1016/j.ijcard.2013.04.187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Accepted: 04/20/2013] [Indexed: 10/26/2022]
Affiliation(s)
- Sanjay G Gokhale
- Department of Pediatrics and Neonatology, Rajhans Hospital, Saphale 401102, India.
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94
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MacGrogan D, Luxán G, de la Pompa JL. Genetic and functional genomics approaches targeting the Notch pathway in cardiac development and congenital heart disease. Brief Funct Genomics 2013; 13:15-27. [PMID: 24106100 DOI: 10.1093/bfgp/elt036] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
The Notch signalling pathway plays crucial roles in cardiac development and postnatal cardiac homoeostasis. Gain- and loss-of-function approaches indicate that Notch promotes or inhibits cardiogenesis in a stage-dependent manner. However, the molecular mechanisms are poorly defined because many downstream effectors remain to be identified. Genome-scale analyses are shedding light on the genes that are regulated by Notch signalling and the mechanisms underlying this regulation. We review the functional data that implicates Notch in cardiac morphogenetic processes and expression profiling studies that enlighten the regulatory networks behind them. A recurring theme is that Notch cross-talks reiteratively with other key signalling pathways including Wnt and Bmp to coordinate cell and tissue interactions during cardiogenesis.
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Affiliation(s)
- Donal MacGrogan
- Program of Cardiovascular Developmental Biology, Department of Cardiovascular Development and Repair, Centro Nacional de Investigaciones Cardiovasculares (CNIC), Melchor Fernández Almagro 3, 28029 Madrid, Spain. Tel.: +34-620-936633; Fax: +34-91-4531304;
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95
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Abstract
Calcific aortic valve disease (CAVD) increasingly afflicts our aging population. One third of our elderly have echocardiographic or radiological evidence of calcific aortic valve sclerosis, an early and subclinical form of CAVD. Age, sex, tobacco use, hypercholesterolemia, hypertension, and type II diabetes mellitus all contribute to the risk of disease that has worldwide distribution. On progression to its most severe form, calcific aortic stenosis, CAVD becomes debilitating and devastating, and 2% of individuals >60 years are affected by calcific aortic stenosis to the extent that surgical intervention is required. No effective pharmacotherapies exist for treating those at risk for clinical progression. It is becoming increasingly apparent that a diverse spectrum of cellular and molecular mechanisms converge to regulate valvular calcium load; this is evidenced not only in histopathologic heterogeneity of CAVD, but also from the multiplicity of cell types that can participate in valve biomineralization. In this review, we highlight our current understanding of CAVD disease biology, emphasizing molecular and cellular aspects of its regulation. We end by pointing to important biological and clinical questions that must be answered to enable sophisticated disease staging and the development of new strategies to treat CAVD medically.
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Affiliation(s)
- Dwight A Towler
- Diabetes and Obesity Research Center, Sanford-Burnham Medical Research Institute at Lake Nona, Orlando, FL 32827, USA.
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96
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Kelsey L, Flenniken AM, Qu D, Funnell APW, Pearson R, Zhou YQ, Voronina I, Berberovic Z, Wood G, Newbigging S, Weiss ES, Wong M, Quach I, Yeh SYS, Deshwar AR, Scott IC, McKerlie C, Henkelman M, Backx P, Simpson J, Osborne L, Rossant J, Crossley M, Bruneau B, Adamson SL. ENU-induced mutation in the DNA-binding domain of KLF3 reveals important roles for KLF3 in cardiovascular development and function in mice. PLoS Genet 2013; 9:e1003612. [PMID: 23874215 PMCID: PMC3708807 DOI: 10.1371/journal.pgen.1003612] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2012] [Accepted: 05/22/2013] [Indexed: 12/23/2022] Open
Abstract
KLF3 is a Krüppel family zinc finger transcription factor with widespread tissue expression and no previously known role in heart development. In a screen for dominant mutations affecting cardiovascular function in N-ethyl-N-nitrosourea (ENU) mutagenized mice, we identified a missense mutation in the Klf3 gene that caused aortic valvular stenosis and partially penetrant perinatal lethality in heterozygotes. All homozygotes died as embryos. In the first of three zinc fingers, a point mutation changed a highly conserved histidine at amino acid 275 to arginine (Klf3H275R). This change impaired binding of the mutant protein to KLF3's canonical DNA binding sequence. Heterozygous Klf3H275R mutants that died as neonates had marked biventricular cardiac hypertrophy with diminished cardiac chambers. Adult survivors exhibited hypotension, cardiac hypertrophy with enlarged cardiac chambers, and aortic valvular stenosis. A dominant negative effect on protein function was inferred by the similarity in phenotype between heterozygous Klf3H275R mutants and homozygous Klf3 null mice. However, the existence of divergent traits suggested the involvement of additional interactions. We conclude that KLF3 plays diverse and important roles in cardiovascular development and function in mice, and that amino acid 275 is critical for normal KLF3 protein function. Future exploration of the KLF3 pathway provides a new avenue for investigating causative factors contributing to cardiovascular disorders in humans. Cardiac defects are among the most common malformations in humans. Most causative genetic mutations remain unknown. To discover new causative genes important in cardiovascular development and function, we examined 1770 mice with randomly mutated genes and found a mutant with aortic valvular stenosis, and increased risk of fetal and neonatal death. Using linkage analysis and sequencing, we identified a protein-altering point mutation in the gene regulatory protein KLF3. Mice that survived into adulthood with one mutant copy of the Klf3 gene had low arterial blood pressure, enlarged hearts, and increased mortality due to heart failure. When both copies of the Klf3 gene was mutant, then embryos had heart defects, and all died before birth. KLF3 had no previously known role in heart development so to confirm these findings, we (1) knocked down klf3 expression in zebrafish embryos and (2) examined mice with a mutation that effectively eliminated the KLF3 protein. In both cases, cardiovascular dysfunction was observed. In conclusion, we have discovered that KLF3 plays diverse and important roles in cardiovascular development and function in mice. Future exploration of the KLF3 pathway provides a new avenue for investigating causative factors contributing to cardiovascular disorders in humans.
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Affiliation(s)
- Lois Kelsey
- Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
| | - Ann M. Flenniken
- Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
| | - Dawei Qu
- Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
| | - Alister P. W. Funnell
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard Pearson
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Yu-Qing Zhou
- Mouse Imaging Centre, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Irina Voronina
- Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
| | - Zorana Berberovic
- Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
| | - Geoffrey Wood
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Susan Newbigging
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Edward S. Weiss
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
| | - Michael Wong
- Mouse Imaging Centre, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Ivan Quach
- Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | - S. Y. Sandy Yeh
- Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Ashish R. Deshwar
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - Ian C. Scott
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Heart and Stroke Richard Lewar Centre of Excellence, Toronto, Ontario, Canada
| | - Colin McKerlie
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Mark Henkelman
- Mouse Imaging Centre, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Peter Backx
- Heart and Stroke Richard Lewar Centre of Excellence, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Jeremy Simpson
- Heart and Stroke Richard Lewar Centre of Excellence, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Lucy Osborne
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Janet Rossant
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- The Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
| | - Merlin Crossley
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Benoit Bruneau
- Gladstone Institute of Cardiovascular Disease, Department of Pediatrics, and Cardiovascular Research Institute, University of California, San Francisco, California, United States of America
| | - S. Lee Adamson
- Samuel Lunenfeld Research Institute of Mount Sinai Hospital, Toronto, Ontario, Canada
- Centre for Modeling Human Disease, Toronto Centre for Phenogenomics, Toronto, Ontario, Canada
- Heart and Stroke Richard Lewar Centre of Excellence, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, Ontario, Canada
- * E-mail:
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97
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Cai X, Zhang W, Hu J, Zhang L, Sultana N, Wu B, Cai W, Zhou B, Cai CL. Tbx20 acts upstream of Wnt signaling to regulate endocardial cushion formation and valve remodeling during mouse cardiogenesis. Development 2013; 140:3176-87. [PMID: 23824573 DOI: 10.1242/dev.092502] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Cardiac valves are essential to direct forward blood flow through the cardiac chambers efficiently. Congenital valvular defects are prevalent among newborns and can cause an immediate threat to survival as well as long-term morbidity. Valve leaflet formation is a rigorously programmed process consisting of endocardial epithelial-mesenchymal transformation (EMT), mesenchymal cell proliferation, valve elongation and remodeling. Currently, little is known about the coordination of the diverse signals that regulate endocardial cushion development and valve elongation. Here, we report that the T-box transcription factor Tbx20 is expressed in the developing endocardial cushions and valves throughout heart development. Ablation of Tbx20 in endocardial cells causes severe valve elongation defects and impaired cardiac function in mice. Our study reveals that endocardial Tbx20 is crucial for valve endocardial cell proliferation and extracellular matrix development, but is not required for initiation of EMT. Elimination of Tbx20 also causes aberrant Wnt/β-catenin signaling in the endocardial cushions. In addition, Tbx20 regulates Lef1, a key transcriptional mediator for Wnt/β-catenin signaling, in this developmental process. Our study suggests a model in which Tbx20 regulates the Wnt pathway to direct endocardial cushion maturation and valve elongation, and provides new insights into the etiology of valve defects in humans.
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Affiliation(s)
- Xiaoqiang Cai
- Department of Developmental and Regenerative Biology, The Mindich Child Health and Development Institute, and The Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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98
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Phillips HM, Mahendran P, Singh E, Anderson RH, Chaudhry B, Henderson DJ. Neural crest cells are required for correct positioning of the developing outflow cushions and pattern the arterial valve leaflets. Cardiovasc Res 2013; 99:452-60. [PMID: 23723064 PMCID: PMC3718324 DOI: 10.1093/cvr/cvt132] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Aims Anomalies of the arterial valves, principally bicuspid aortic valve (BAV), are the most common congenital anomalies. The cellular mechanisms that underlie arterial valve development are poorly understood. While it is known that the valve leaflets derive from the outflow cushions, which are populated by cells derived from the endothelium and neural crest cells (NCCs), the mechanism by which these cushions are sculpted to form the leaflets of the arterial valves remains unresolved. We set out to investigate how NCCs participate in arterial valve formation, reasoning that disrupting NCC within the developing outflow cushions would result in arterial valve anomalies, in the process elucidating the normal mechanism of arterial valve leaflet formation. Methods and results By disrupting Rho kinase signalling specifically in NCC using transgenic mice and primary cultures, we show that NCC condensation within the cardiac jelly is required for correct positioning of the outflow cushions. Moreover, we show that this process is essential for normal patterning of the arterial valve leaflets with disruption leading to a spectrum of valve leaflet patterning anomalies, abnormal positioning of the orifices of the coronary arteries, and abnormalities of the arterial wall. Conclusion NCCs are required at earlier stages of arterial valve development than previously recognized, playing essential roles in positioning the cushions, and patterning the valve leaflets. Abnormalities in the process of NCC condensation at early stages of outflow cushion formation may provide a common mechanism underlying BAV, and also explain the link with arterial wall anomalies and outflow malalignment defects.
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Affiliation(s)
- Helen M Phillips
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne NE1 3BZ, UK
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99
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Wu B, Baldwin HS, Zhou B. Nfatc1 directs the endocardial progenitor cells to make heart valve primordium. Trends Cardiovasc Med 2013; 23:294-300. [PMID: 23669445 DOI: 10.1016/j.tcm.2013.04.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2013] [Revised: 04/09/2013] [Accepted: 04/10/2013] [Indexed: 11/26/2022]
Abstract
Heart valves arise from the cardiac endocardial cushions located at the atrioventricular canal (AVC) and cardiac outflow tract (OFT) during development. A subpopulation of cushion endocardial cells undergoes endocardial to mesenchymal transformation (EMT) and generates the cushion mesenchyme, which is then remodeled into the interstitial tissue of the mature valves. The cushion endocardial cells that do not undertake EMT proliferate to elongate valve leaflets. During EMT and the post-EMT valve remodeling, endocardial cells at the cushions highly express nuclear factor in activated T cell, cytoplasmic 1 (Nfatc1), a transcription factor required for valve formation in mice. In this review, we present the current knowledge of Nfatc1 roles in the ontogeny of heart valves with a focus on the fate decision of the endocardial cells in the processes of EMT and valve remodeling.
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Affiliation(s)
- Bingruo Wu
- Department of Genetics, Division of Cardiology, Wilf Cardiovascular Institute, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA; Department of Pediatrics, Division of Cardiology, Wilf Cardiovascular Institute, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA; Department of Medicine, Division of Cardiology, Wilf Cardiovascular Institute, Albert Einstein College of Medicine of Yeshiva University, Bronx, NY 10461, USA
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100
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Singh N, Gupta M, Trivedi CM, Singh MK, Li L, Epstein JA. Murine craniofacial development requires Hdac3-mediated repression of Msx gene expression. Dev Biol 2013; 377:333-44. [PMID: 23506836 DOI: 10.1016/j.ydbio.2013.03.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2012] [Revised: 03/04/2013] [Accepted: 03/09/2013] [Indexed: 01/11/2023]
Abstract
Craniofacial development is characterized by reciprocal interactions between neural crest cells and neighboring cell populations of ectodermal, endodermal and mesodermal origin. Various genetic pathways play critical roles in coordinating the development of cranial structures by modulating the growth, survival and differentiation of neural crest cells. However, the regulation of these pathways, particularly at the epigenomic level, remains poorly understood. Using murine genetics, we show that neural crest cells exhibit a requirement for the class I histone deacetylase Hdac3 during craniofacial development. Mice in which Hdac3 has been conditionally deleted in neural crest demonstrate fully penetrant craniofacial abnormalities, including microcephaly, cleft secondary palate and dental hypoplasia. Consistent with these abnormalities, we observe dysregulation of cell cycle genes and increased apoptosis in neural crest structures in mutant embryos. Known regulators of cell cycle progression and apoptosis in neural crest, including Msx1, Msx2 and Bmp4, are upregulated in Hdac3-deficient cranial mesenchyme. These results suggest that Hdac3 serves as a critical regulator of craniofacial morphogenesis, in part by repressing core apoptotic pathways in cranial neural crest cells.
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Affiliation(s)
- Nikhil Singh
- Department of Cell and Developmental Biology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
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