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Procknow SS, Kozel BA. Emerging mechanisms of elastin transcriptional regulation. Am J Physiol Cell Physiol 2022; 323:C666-C677. [PMID: 35816641 PMCID: PMC9448287 DOI: 10.1152/ajpcell.00228.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/06/2022] [Accepted: 07/06/2022] [Indexed: 11/22/2022]
Abstract
Elastin provides recoil to tissues that stretch such as the lung, blood vessels, and skin. It is deposited in a brief window starting in the prenatal period and extending to adolescence in vertebrates, and then slowly turns over. Elastin insufficiency is seen in conditions such as Williams-Beuren syndrome and elastin-related supravalvar aortic stenosis, which are associated with a range of vascular and connective tissue manifestations. Regulation of the elastin (ELN) gene occurs at multiple levels including promoter activation/inhibition, mRNA stability, interaction with microRNAs, and alternative splicing. However, these mechanisms are incompletely understood. Better understanding of the processes controlling ELN gene expression may improve medicine's ability to intervene in these rare conditions, as well as to replace age-associated losses by re-initiating elastin production. This review describes what is known about the ELN gene promoter structure, transcriptional regulation by cytokines and transcription factors, and posttranscriptional regulation via mRNA stability and micro-RNA and highlights new approaches that may influence regenerative medicine.
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Affiliation(s)
- Sara S Procknow
- Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Beth A Kozel
- Translational Vascular Medicine Branch, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland
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Kronquist EK, Kaur M, Gober LM, Knutsen RH, Fu YP, Yu ZX, Donahue DR, Chen MY, Osgood S, Raja N, Levin MD, Barochia A, Kozel BA. Airflow Obstruction in Adults with Williams Syndrome and Mice with Elastin Insufficiency. Diagnostics (Basel) 2022; 12:diagnostics12061438. [PMID: 35741248 PMCID: PMC9221558 DOI: 10.3390/diagnostics12061438] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/05/2022] [Accepted: 06/07/2022] [Indexed: 11/23/2022] Open
Abstract
Williams−Beuren syndrome (WS) results from the deletion of 25−27 coding genes, including elastin (ELN), on human chromosome 7q11.23. Elastin provides recoil to tissues; emphysema and chronic obstructive pulmonary disease have been linked to its destruction. Consequently, we hypothesized that elastin insufficiency would predispose to obstructive features. Twenty-two adults with WS (aged 18−55) and controls underwent pulmonary function testing, 6 min walk, and chest computed tomography (CT). Lung and airspace dimensions were assessed in Eln+/− and control mice via microCT and histology. The forced expiratory volume in 1 s (FEV1) and the ratio of FEV1 to forced vital capacity (FVC) were lower in adults with WS (p < 0.0001 and p < 0.05, respectively). The FEV1/FVC ratio was more frequently below the lower limit of normal in cases (p < 0.01). The ratio of residual volume to total lung capacity (RV/TLC, percent predicted) was higher in cases (p < 0.01), suggesting air trapping. People with WS showed reduced exercise capacity (p < 0.0001). In Eln+/− mice, ex vivo lung volumes were increased (p < 0.0001), with larger airspaces (p < 0.001). Together these data show that elastin insufficiency impacts lung physiology in the form of increased air trapping and obstruction, suggesting a role for lung function monitoring in adults with WS.
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Affiliation(s)
- Elise K. Kronquist
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Maninder Kaur
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Leah M. Gober
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Russell H. Knutsen
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Yi-Ping Fu
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Zu-Xi Yu
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Danielle R. Donahue
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD 20824, USA;
| | - Marcus Y. Chen
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Sharon Osgood
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Neelam Raja
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Mark D. Levin
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Amisha Barochia
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
| | - Beth A. Kozel
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (E.K.K.); (M.K.); (L.M.G.); (R.H.K.); (Y.-P.F.); (Z.-X.Y.); (M.Y.C.); (S.O.); (N.R.); (M.D.L.); (A.B.)
- Correspondence: ; Tel.: +1-301-451-2888
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Cockbain B, Morris-Rosendahl D, Corrigan A, Hind MD. COPD in the chromosomes. Thorax 2022; 77:thoraxjnl-2022-218782. [PMID: 35552249 DOI: 10.1136/thoraxjnl-2022-218782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 04/20/2022] [Indexed: 11/04/2022]
Affiliation(s)
- Beatrice Cockbain
- Department of Infectious Diseases, Imperial College London, London, UK
- Genitourinary Medicine and HIV, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | | | - Adele Corrigan
- Viapath Genetics Laboratories, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Matthew David Hind
- Respiratory Medicine, Royal Brompton Hospital, London, UK
- National Heart and Lung Institute, Imperial College London, London, UK
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Salley JR, Kukkar V, Felde L. Vanishing lung syndrome: a consequence of mixed tobacco and marijuana use. BMJ Case Rep 2021; 14:e239255. [PMID: 34016626 PMCID: PMC8141430 DOI: 10.1136/bcr-2020-239255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 11/03/2022] Open
Abstract
Idiopathic giant bullous emphysema or vanishing lung syndrome (VLS) is a rare, chronic radiological diagnosis characterised by giant emphysematous bullae located primarily in the upper lobes of the lungs. This highly morbid phenotype of chronic obstructive pulmonary disease leads to severe progressive dyspnoea and significant disability. Here, we describe a 48-year-old man with a history significant for long-term tobacco and cannabis smoking, who is found to have VLS. We present a review of recent findings on the association between VLS and the additive effect of marijuana and tobacco.
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Affiliation(s)
- Jordan R Salley
- Internal Medicine, University of Texas Southwestern Medical School, Dallas, Texas, USA
| | - Vishal Kukkar
- Radiology, The University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Lanna Felde
- Internal Medicine, University of Texas Southwestern Medical School, Dallas, Texas, USA
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Pangallo E, Cianci P, Favuzza F, Milani D, Vimercati C, Moretti A, Picchi R, De Paoli A, Agosti M, Selicorni A. Pulmonary function in Williams-Beuren syndrome: Spirometric data of 22 Italian patients. Am J Med Genet A 2020; 185:390-396. [PMID: 33174385 DOI: 10.1002/ajmg.a.61966] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 08/21/2020] [Accepted: 10/24/2020] [Indexed: 11/12/2022]
Abstract
Williams-Beuren syndrome (WBS) is caused by an haploinsufficiency of the 7q11.2 region which involves the elastin gene (ELN). A deficiency of elastin is a known pathophysiological mechanism of emphysema/chronic obstructive pulmonary disease (COPD). A previous study hypothesized a higher risk of COPD in WBS patients. Herein, this phenomenon was further investigated looking for a possible correlation between COPD and WBS. Dynamic lung volumes (forced vital capacity [FVC], FEV1, FEV1/FVC) were measured in 22 patients (age range 18.9 ± 7.4 years) affected with WBS, genetically confirmed, correlating these parameters to respiratory risk factors. Dyspnea, cough and wheezing were detected in 6/22 (27%) patients. Obstructive and restrictive patterns were identified in 6/22 (27%) and 2/22 (9%) cases, respectively with no evidence of irreversible obstruction. CVF, FEV1 and FEV1/CVF mean values were all normal, with values of 91.3% (n.v. > 80%), 84.2% (n.v. > 80%) and 0.82 (n.v. > 0.7), respectively. The severity of the comorbidities did not show a cause-effect relation with the respiratory patterns, nevertheless patients treated with anti-hypertensive drugs had poorer pulmonary function. Our findings are in accordance with previous observations, showing that emphysema/COPD is not a typical finding in young patients with WBS. However, a respiratory function assessment should be included in the follow-up of WBS patients, especially in adolescents/young adults under treatment with anti-hypertensive drugs.
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Affiliation(s)
- Elisabetta Pangallo
- Pediatric and Neonatology Department, Hospital "F. Del Ponte", University of Insubria, Varese, Italy
| | - Paola Cianci
- Pediatric Department, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy
| | - Filippo Favuzza
- Pediatric Department, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy
| | - Donatella Milani
- Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Chiara Vimercati
- Pediatric Department, Fondazione MBMM San Gerardo Hospital, Monza, Italy
| | - Alex Moretti
- Pediatric and Neonatology Department, Hospital "F. Del Ponte", University of Insubria, Varese, Italy
| | - Raffaella Picchi
- Pediatric Department, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy
| | - Anita De Paoli
- Pediatric Department, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy
| | - Massimo Agosti
- Pediatric and Neonatology Department, Hospital "F. Del Ponte", University of Insubria, Varese, Italy
| | - Angelo Selicorni
- Pediatric Department, ASST-Lariana, Sant'Anna Hospital, San Fermo della Battaglia, Como, Italy
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Hawley MH, Moschovis PP, Lu M, Kinane TB, Yonker LM. The future is here: Integrating genetics into the pediatric pulmonary clinic. Pediatr Pulmonol 2020; 55:1810-1818. [PMID: 32533912 PMCID: PMC7384239 DOI: 10.1002/ppul.24723] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/28/2020] [Indexed: 02/02/2023]
Abstract
Recognition of underlying genetic etiologies of disease is increasing at an exponential rate, likely due to greater access to and lower cost of genetic testing. Monogenic causes of disease, or conditions resulting from a mutation or mutations in a single gene, are now well recognized in every subspecialty, including pediatric pulmonary medicine; thus, it is important to consider genetic conditions when evaluating children with respiratory disease. In the pediatric pulmonary clinic, genetic testing should be considered when multiple family members present with similar or related clinical features and when individuals have unusual clinical presentations, such as early-onset disease or complex, syndromic features. This review provides a practical guide for genetic diagnosis in the pediatric pulmonary setting, including a review of genetic concepts, considerations for test selection and results in interpretation, as well as an overview of genetic differential diagnoses for common pediatric pulmonary phenotypes. Genetic conditions that commonly present to the pediatric pulmonary clinic are reviewed in a companion article by Yonker et al.
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Affiliation(s)
- Megan H Hawley
- Pulmonary Division, Massachusetts General Hospital for Children, Boston, Massachusetts.,Laboratory for Molecular Medicine, Partners HealthCare Personalized Medicine, Cambridge, Massachusetts
| | - Peter P Moschovis
- Pulmonary Division, Massachusetts General Hospital for Children, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Mengdi Lu
- Pulmonary Division, Massachusetts General Hospital for Children, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - T Bernard Kinane
- Pulmonary Division, Massachusetts General Hospital for Children, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Lael M Yonker
- Pulmonary Division, Massachusetts General Hospital for Children, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Duque Lasio ML, Kozel BA. Elastin-driven genetic diseases. Matrix Biol 2018; 71-72:144-160. [PMID: 29501665 DOI: 10.1016/j.matbio.2018.02.021] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 02/23/2018] [Accepted: 02/23/2018] [Indexed: 02/08/2023]
Abstract
Elastic fibers provide recoil to tissues that undergo repeated deformation, such as blood vessels, lungs and skin. Composed of elastin and its accessory proteins, the fibers are produced within a restricted developmental window and are stable for decades. Their eventual breakdown is associated with a loss of tissue resiliency and aging. Rare alteration of the elastin (ELN) gene produces disease by impacting protein dosage (supravalvar aortic stenosis, Williams Beuren syndrome and Williams Beuren region duplication syndrome) and protein function (autosomal dominant cutis laxa). This review highlights aspects of the elastin molecule and its assembly process that contribute to human disease and also discusses potential therapies aimed at treating diseases of elastin insufficiency.
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Affiliation(s)
| | - Beth A Kozel
- National Institutes of Health, National Heart Lung and Blood Institute, Bethesda, MD, USA.
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