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Balboa-Beltran E, Fernández-Seara MJ, Pérez-Muñuzuri A, Lago R, García-Magán C, Couce ML, Sobrino B, Amigo J, Carracedo A, Barros F. A novel stop mutation in the vascular endothelial growth factor-C gene (VEGFC) results in Milroy-like disease. J Med Genet 2014; 51:475-8. [PMID: 24744435 DOI: 10.1136/jmedgenet-2013-102020] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND Milroy and Milroy-like disease are rare disorders characterised by congenital lymphoedema caused by dysfunctional lymphatic vessel formation. Loss of extracellular response mediated by vascular endothelial growth factor receptor 3 (VEGFR-3) is associated with Milroy disease, and VEGFR-3 gene is mutated in around 70% of the cases diagnosed. The only genetic alteration known to be associated with Milroy-like disease was recently identified in a family with a frameshift mutation in vascular endothelial growth factor C (VEGFC) gene, which encodes a VEGFR3 ligand. METHODS AND RESULTS We report a newborn patient with an external phenotype consistent with Milroy disease and a truncating mutation (p.R210X) in the VEGFC gene detected by exome sequence analysis. Subsequent analysis, by lymphoscintigraphic scan, performed for research purposes, allowed us to correct the diagnosis, confirming patient's disease as Milroy-like. The mutation segregates with the phenotype in the family according to a dominant model with full penetrance. CONCLUSIONS The clinical presentation, similar to Milroy disease, indicates an overlapping of the external phenotype of both diseases, suggesting that genetic analysis of VEGFC would be useful in diagnosing patients that present with Milroy features but have no mutation in VEGFR-3. Establishing a well-defined genetic pattern would help with differential diagnosis.
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Affiliation(s)
- Emilia Balboa-Beltran
- Fundación Pública Galega de Medicina Xenómica, SERGAS, Santiago de Compostela, Spain
| | - María J Fernández-Seara
- Servicio de Neonatología, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Alejandro Pérez-Muñuzuri
- Servicio de Neonatología, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Ramón Lago
- Fundación Pública Galega de Medicina Xenómica, SERGAS, Santiago de Compostela, Spain
| | - Carlos García-Magán
- Servicio de Neonatología, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - María L Couce
- Servicio de Neonatología, Departamento de Pediatría, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Beatriz Sobrino
- Grupo de Medicina Xenómica-USC, CIBERER, Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain
| | - Jorge Amigo
- Grupo de Medicina Xenómica-USC, CIBERER, Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain
| | - Angel Carracedo
- Fundación Pública Galega de Medicina Xenómica, SERGAS, Santiago de Compostela, Spain Grupo de Medicina Xenómica-USC, CIBERER, Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain King Abdulaziz University, Center of Excellence in Genomic Medicine Research, Jeddah, Saudi Arabia
| | - Francisco Barros
- Fundación Pública Galega de Medicina Xenómica, SERGAS, Santiago de Compostela, Spain Grupo de Medicina Xenómica-USC, CIBERER, Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela, Spain
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111
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Dellinger MT, Meadows SM, Wynne K, Cleaver O, Brekken RA. Vascular endothelial growth factor receptor-2 promotes the development of the lymphatic vasculature. PLoS One 2013; 8:e74686. [PMID: 24023956 PMCID: PMC3759473 DOI: 10.1371/journal.pone.0074686] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 08/08/2013] [Indexed: 01/01/2023] Open
Abstract
Vascular endothelial growth factor receptor 2 (VEGFR2) is highly expressed by lymphatic endothelial cells and has been shown to stimulate lymphangiogenesis in adult mice. However, the role VEGFR2 serves in the development of the lymphatic vascular system has not been defined. Here we use the Cre-lox system to show that the proper development of the lymphatic vasculature requires VEGFR2 expression by lymphatic endothelium. We show that Lyve-1wt/Cre;Vegfr2flox/flox mice possess significantly fewer dermal lymphatic vessels than Vegfr2flox/flox mice. Although Lyve-1wt/Cre;Vegfr2flox/flox mice exhibit lymphatic hypoplasia, the lymphatic network is functional and contains all of the key features of a normal lymphatic network (initial lymphatic vessels and valved collecting vessels surrounded by smooth muscle cells (SMCs)). We also show that Lyve-1Cre mice display robust Cre activity in macrophages and in blood vessels in the yolk sac, liver and lung. This activity dramatically impairs the development of blood vessels in these tissues in Lyve-1wt/Cre;Vegfr2flox/flox embryos, most of which die after embryonic day14.5. Lastly, we show that inactivation of Vegfr2 in the myeloid lineage does not affect the development of the lymphatic vasculature. Therefore, the abnormal lymphatic phenotype of Lyve-1wt/Cre;Vegfr2flox/flox mice is due to the deletion of Vegfr2 in the lymphatic vasculature not macrophages. Together, this work demonstrates that VEGFR2 directly promotes the expansion of the lymphatic network and further defines the molecular mechanisms controlling the development of the lymphatic vascular system.
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Affiliation(s)
- Michael T. Dellinger
- Division of Surgical Oncology, Department of Surgery, Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- * E-mail:
| | - Stryder M. Meadows
- Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Katherine Wynne
- Division of Surgical Oncology, Department of Surgery, Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Ondine Cleaver
- Department of Molecular Biology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
| | - Rolf A. Brekken
- Division of Surgical Oncology, Department of Surgery, Hamon Center for Therapeutic Oncology Research, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
- Department of Pharmacology, University of Texas Southwestern Medical Center, Dallas, Texas, United States of America
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115
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Cermenati S, Moleri S, Neyt C, Bresciani E, Carra S, Grassini DR, Omini A, Goi M, Cotelli F, François M, Hogan BM, Beltrame M. Sox18 Genetically Interacts With VegfC to Regulate Lymphangiogenesis in Zebrafish. Arterioscler Thromb Vasc Biol 2013; 33:1238-47. [DOI: 10.1161/atvbaha.112.300254] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
- Solei Cermenati
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Silvia Moleri
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Christine Neyt
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Erica Bresciani
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Silvia Carra
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Daniela R. Grassini
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Alice Omini
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Michela Goi
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Franco Cotelli
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Mathias François
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Benjamin M. Hogan
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
| | - Monica Beltrame
- From the Dipartimento di Scienze Biomolecolari e Biotecnologie (S. Cermenati, S.M., D.R.G., M.G., M.B.), Dipartimento di Bioscienze (S. Cermenati, S.M., S. Carra, A.O., F.C., M.B.), and Dipartimento di Biologia (E.B., S. Carra, F.C.), Universita’ degli Studi di Milano, Milan, Italy; and Institute for Molecular Bioscience, The University of Queensland, Brisbane, Australia (C.N., M.F., B.M.H.)
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