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Gasparini S, Balestrini S, Saccaro LF, Bacci G, Panichella G, Montomoli M, Cantalupo G, Bigoni S, Mancano G, Pellacani S, Leuzzi V, Volpi N, Mari F, Melani F, Cavallin M, Pisano T, Porcedda G, Vaglio A, Mei D, Barba C, Parrini E, Guerrini R. Multiorgan manifestations of COL4A1 and COL4A2 variants and proposal for a clinical management protocol. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2024:e32099. [PMID: 39016117 DOI: 10.1002/ajmg.c.32099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 06/23/2024] [Accepted: 06/28/2024] [Indexed: 07/18/2024]
Abstract
COL4A1/2 variants are associated with highly variable multiorgan manifestations. Depicting the whole clinical spectrum of COL4A1/2-related manifestations is challenging, and there is no consensus on management and preventative strategies. Based on a systematic review of current evidence on COL4A1/2-related disease, we developed a clinical questionnaire that we administered to 43 individuals from 23 distinct families carrying pathogenic variants. In this cohort, we extended ophthalmological and cardiological examinations to asymptomatic individuals and those with only limited or mild, often nonspecific, clinical signs commonly occurring in the general population (i.e., oligosymptomatic). The most frequent clinical findings emerging from both the literature review and the questionnaire included stroke (203/685, 29.6%), seizures or epilepsy (199/685, 29.0%), intellectual disability or developmental delay (168/685, 24.5%), porencephaly/schizencephaly (168/685, 24.5%), motor impairment (162/685, 23.6%), cataract (124/685, 18.1%), hematuria (63/685, 9.2%), and retinal arterial tortuosity (58/685, 8.5%). In oligosymptomatic and asymptomatic carriers, ophthalmological investigations detected retinal vascular tortuosity (5/13, 38.5%), dysgenesis of the anterior segment (4/13, 30.8%), and cataract (2/13, 15.4%), while cardiological investigations were unremarkable except for mild ascending aortic ectasia in 1/8 (12.5%). Our multimodal approach confirms highly variable penetrance and expressivity in COL4A1/2-related conditions, even at the intrafamilial level with neurological involvement being the most frequent and severe finding in both children and adults. We propose a protocol for prevention and management based on individualized risk estimation and periodic multiorgan evaluations.
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Affiliation(s)
- Simone Gasparini
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
- University of Florence, Florence, Italy
| | - Simona Balestrini
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
- University of Florence, Florence, Italy
| | - Luigi Francesco Saccaro
- Department of Psychiatry, Geneva University and Geneva University Hospitals, Geneva, Switzerland
| | - Giacomo Bacci
- Pediatric Ophthalmology Unit, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Giorgia Panichella
- University of Florence, Florence, Italy
- Department of Clinical and Experimental Medicine, University Hospital Careggi, Florence, Italy
| | - Martino Montomoli
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
| | - Gaetano Cantalupo
- Child Neuropsychiatry Unit, University Hospital of Verona (full member of the European Reference Network EpiCARE), Verona, Italy
- Department of Engineering for Innovation Medicine, Innovation Biomedicine Section, University of Verona, Verona, Italy
- Center for Research on Epilepsy in Pediatric Age (CREP), University Hospital of Verona, Verona, Italy
| | - Stefania Bigoni
- Medical Genetics Unit, Ferrara University Hospital, Ferrara, Italy
| | - Giorgia Mancano
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
| | - Simona Pellacani
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
- University of Florence, Florence, Italy
| | - Vincenzo Leuzzi
- Unit of Child Neurology and Psychiatry, Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Nila Volpi
- Neurology and Clinical Neurophysiology Unit, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Francesco Mari
- Child and Adolescent Epilepsy and Clinical Neurophysiology Departmental Unit, USL Centro Toscana, Prato, Italy
| | - Federico Melani
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
| | - Mara Cavallin
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
| | - Tiziana Pisano
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
| | - Giulio Porcedda
- Department of Paediatric Cardiology, Meyer Children's Hospital IRCCS, Florence, Italy
| | - Augusto Vaglio
- Nephrology and Dialysis Unit, Meyer Children's Hospital IRCCS, Florence, Italy
- Department of Biomedical, Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Davide Mei
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
| | - Carmen Barba
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
- University of Florence, Florence, Italy
| | - Elena Parrini
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
| | - Renzo Guerrini
- Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS (full member of the European Reference Network EpiCARE), Florence, Italy
- University of Florence, Florence, Italy
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Cozzitorto C, Peltz Z, Flores LM, Della Santina L, Mao M, Gould DB. Evaluating neural crest cell migration in a Col4a1 mutant mouse model of ocular anterior segment dysgenesis. Cells Dev 2024:203926. [PMID: 38729574 DOI: 10.1016/j.cdev.2024.203926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 05/02/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024]
Abstract
The periocular mesenchyme (POM) is a transient migratory embryonic tissue derived from neural crest cells (NCCs) and paraxial mesoderm that gives rise to most of the structures in front of the eye. Morphogenetic defects of these structures can impair aqueous humor outflow, leading to elevated intraocular pressure and glaucoma. Mutations in collagen type IV alpha 1 (COL4A1) and alpha 2 (COL4A2) cause Gould syndrome - a multisystem disorder often characterized by variable cerebrovascular, ocular, renal, and neuromuscular manifestations. Approximately one-third of individuals with COL4A1 and COL4A2 mutations have ocular anterior segment dysgenesis (ASD), including congenital glaucoma resulting from abnormalities of POM-derived structures. POM differentiation has been a major focus of ASD research, but the underlying cellular mechanisms are still unclear. Moreover, earlier events including NCC migration and survival defects have been implicated in ASD; however, their roles are not as well understood. Vascular defects are among the most common consequences of COL4A1 and COL4A2 mutations and can influence NCC survival and migration. We therefore hypothesized that NCC migration might be impaired by COL4A1 and COL4A2 mutations. In this study, we used 3D confocal microscopy, gross morphology, and quantitative analyses to test NCC migration in Col4a1 mutant mice. We show that homozygous Col4a1 mutant embryos have severe embryonic growth retardation and lethality, and we identified a potential maternal effect on embryo development. Cerebrovascular defects in heterozygous Col4a1 mutant embryos were present as early as E9.0, showing abnormal cerebral vasculature plexus remodeling compared to controls. We detected abnormal NCC migration within the diencephalic stream and the POM in heterozygous Col4a1 mutants whereby mutant NCCs formed smaller diencephalic migratory streams and POMs. In these settings, migratory NCCs within the diencephalic stream and POM localize farther away from the developing vasculature. Our results show for the first time that Col4a1 mutations lead to cranial NCCs migratory defects in the context of early onset defective angiogenesis without affecting cell numbers, possibly impacting the relation between NCCs and the blood vessels during ASD development.
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Affiliation(s)
- Corinna Cozzitorto
- Department of Ophthalmology, University of California, San Francisco, CA 94158, United States.
| | - Zoe Peltz
- Department of Ophthalmology, University of California, San Francisco, CA 94158, United States
| | - Lourdes M Flores
- Department of Ophthalmology, University of California, San Francisco, CA 94158, United States
| | - Luca Della Santina
- Department of Ophthalmology, University of California, San Francisco, CA 94158, United States.
| | - Mao Mao
- Department of Ophthalmology, University of California, San Francisco, CA 94158, United States
| | - Douglas B Gould
- Department of Ophthalmology, University of California, San Francisco, CA 94158, United States; Department of Anatomy, Cardiovascular Research Institute, Bakar Aging Research Institute, and Institute for Human Genetics, University of California, San Francisco, United States.
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3
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Wang H, Zhu Y, Zheng L, Chen M, Hao Z, Guo R, Feng L, Wang D. Association of the COL4A2 Gene Polymorphisms with Primary Intracerebral Hemorrhage Risk and Outcome in Chinese Han Population. Mol Neurobiol 2024:10.1007/s12035-024-04146-z. [PMID: 38565785 DOI: 10.1007/s12035-024-04146-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/23/2024] [Indexed: 04/04/2024]
Abstract
The relationship of single nucleotide polymorphisms (SNPs) in COL4A2 gene with risk and outcome of primary intracerebral hemorrhage (ICH) in the Chinese Han population remains unclear, which was investigated in this study. Primary ICH patients and non-stroke controls of Chinese Han ethnicity were enrolled. The genotypes of 8 tag-SNPs were determined using a custom-by-design 48-Plex SNPscan Kit. Poor 3-month outcome was defined as modified Rankin Scale score 4-6. Logistic regression was employed to examine association between COL4A2 variants and risk and poor outcome of primary ICH. 323 patients with primary ICH and 376 stroke-free controls were included. Compared to controls, the rs1049931 G and rs1049906 C alleles were associated with increased ICH risk (p = 0.027 and 0.033), and these two allele counts increased this risk after adjustments respectively (additive model: adjusted OR [aOR] 1.41, 95% CI 1.03-1.94, corrected p = 0.043; aOR 1.37, 95% CI 1.01-1.86, corrected p = 0.043). The rs1049931 AG/GG and rs1049906 CT/CC genotypes showed increased susceptibility to non-lobar hemorrhage (aOR 1.63, 95% CI 1.06-2.50, p = 0.025; aOR 1.63, 95% CI 1.07-2.47, p = 0.022). Haplotype analysis revealed an association between rs1049906-rs1049931 haplotype CG and ICH risk (OR 1.36, 95% CI 1.05-1.78, p = 0.021). Regarding clinical outcome, the rs3803230 C allele (dominant model: aOR 1.94, 95% CI 1.04-3.63, p = 0.037) and haplotype AC of rs7990214-rs3803230 (OR 1.98, 95% CI 1.13-3.46, p = 0.015) contributed to 3-month poor outcome. The COL4A2 polymorphisms are associated with an increased risk of primary ICH, mainly non-lobar hemorrhage, and with long-term poor outcome after ICH in Chinese Han population.
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Affiliation(s)
- Huan Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yuyi Zhu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Lukai Zheng
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, 81377, Munich, Germany
| | - Mingxi Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Zilong Hao
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China
- Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Rui Guo
- Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Ling Feng
- Department of Neurology, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, 610041, China.
| | - Deren Wang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, 610041, China.
- Center of Cerebrovascular Diseases, West China Hospital, Sichuan University, Chengdu, 610041, China.
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Tvaroška I. Glycosylation Modulates the Structure and Functions of Collagen: A Review. Molecules 2024; 29:1417. [PMID: 38611696 PMCID: PMC11012932 DOI: 10.3390/molecules29071417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/14/2024] Open
Abstract
Collagens are fundamental constituents of the extracellular matrix and are the most abundant proteins in mammals. Collagens belong to the family of fibrous or fiber-forming proteins that self-assemble into fibrils that define their mechanical properties and biological functions. Up to now, 28 members of the collagen superfamily have been recognized. Collagen biosynthesis occurs in the endoplasmic reticulum, where specific post-translational modification-glycosylation-is also carried out. The glycosylation of collagens is very specific and adds β-d-galactopyranose and β-d-Glcp-(1→2)-d-Galp disaccharide through β-O-linkage to hydroxylysine. Several glycosyltransferases, namely COLGALT1, COLGALT2, LH3, and PGGHG glucosidase, were associated the with glycosylation of collagens, and recently, the crystal structure of LH3 has been solved. Although not fully understood, it is clear that the glycosylation of collagens influences collagen secretion and the alignment of collagen fibrils. A growing body of evidence also associates the glycosylation of collagen with its functions and various human diseases. Recent progress in understanding collagen glycosylation allows for the exploitation of its therapeutic potential and the discovery of new agents. This review will discuss the relevant contributions to understanding the glycosylation of collagens. Then, glycosyltransferases involved in collagen glycosylation, their structure, and catalytic mechanism will be surveyed. Furthermore, the involvement of glycosylation in collagen functions and collagen glycosylation-related diseases will be discussed.
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Affiliation(s)
- Igor Tvaroška
- Institute of Chemistry, Slovak Academy of Sciences, 845 38 Bratislava, Slovakia
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5
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Markasz L, Mobini-Far H, Sindelar R. Collagen type IV alpha 1 chain (COL4A1) expression in the developing human lung. BMC Pulm Med 2024; 24:75. [PMID: 38331745 PMCID: PMC10851591 DOI: 10.1186/s12890-024-02875-4] [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: 10/11/2023] [Accepted: 01/22/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND Collagen type IV alpha 1 chain (COL4A1) in the basement membrane is an important component during lung development, as suggested from animal models where COL4A1 has been shown to regulate alveolarization and angiogenesis. Less is known about its role in human lung development. Our aim was to study COL4A1 expression in preterm infants with different lung maturational and clinical features. METHODS COL4A1 expression in 115 lung samples from newborn infants (21-41 weeks' gestational age; 0-228 days' postnatal age [PNA]) was studied by immunohistochemistry combined with digital image analysis. Cluster analysis was performed to find subgroups according to immunohistologic and clinical data. RESULTS Patients were automatically categorized into 4 Groups depending on their COL4A1 expression. Expression of COL4A1 was mainly extracellular in Group 1, low in Group 2, intracellular in Group 3, and both extra- and intracellular in Group 4. Intracellular/extracellular ratio of COL4A1 expression related to PNA showed a distinctive postnatal maturational pattern on days 1-7, where intracellular expression of COL4A1 was overrepresented in extremely preterm infants. CONCLUSIONS COL4A1 expression seems to be highly dynamic during the postnatal life due to a possible rapid remodeling of the basement membrane. Intracellular accumulation of COL4A1 in the lungs of extremely premature infants occurs more frequently between 1 and 7 postnatal days than during the first 24 hours. In view of the lung arrest described in extremely preterm infants, the pathological and/or developmental role of postnatally increased intracellular COL4A1 as marker for basement membrane turnover, needs to be further investigated.
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Affiliation(s)
- Laszlo Markasz
- Department of Women's and Children's Health, Uppsala University, Uppsala, SE-751 85, Sweden.
| | - Hamid Mobini-Far
- Department of Pathology, Uppsala University Hospital, Uppsala, Sweden
| | - Richard Sindelar
- Department of Women's and Children's Health, Uppsala University, Uppsala, SE-751 85, Sweden
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Dilliott AA, Berberian SA, Sunderland KM, Binns MA, Zimmer J, Ozzoude M, Scott CJM, Gao F, Lang AE, Breen DP, Tartaglia MC, Tan B, Swartz RH, Rogaeva E, Borrie M, Finger E, Fischer CE, Frank A, Freedman M, Kumar S, Pasternak S, Pollock BG, Rajji TK, Tang-Wai DF, Abrahao A, Turnbull J, Zinman L, Casaubon L, Dowlatshahi D, Hassan A, Mandzia J, Sahlas D, Saposnik G, Grimes D, Marras C, Steeves T, Masellis M, Farhan SMK, Bartha R, Symons S, Hegele RA, Black SE, Ramirez J. Rare neurovascular genetic and imaging markers across neurodegenerative diseases. Alzheimers Dement 2023; 19:5583-5595. [PMID: 37272523 DOI: 10.1002/alz.13316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/09/2023] [Accepted: 05/10/2023] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Cerebral small vessel disease (SVD) is common in patients with cognitive impairment and neurodegenerative diseases such as Alzheimer's and Parkinson's. This study investigated the burden of magnetic resonance imaging (MRI)-based markers of SVD in patients with neurodegenerative diseases as a function of rare genetic variant carrier status. METHODS The Ontario Neurodegenerative Disease Research Initiative study included 520 participants, recruited from 14 tertiary care centers, diagnosed with various neurodegenerative diseases and determined the carrier status of rare non-synonymous variants in five genes (ABCC6, COL4A1/COL4A2, NOTCH3/HTRA1). RESULTS NOTCH3/HTRA1 were found to significantly influence SVD neuroimaging outcomes; however, the mechanisms by which these variants contribute to disease progression or worsen clinical correlates are not yet understood. DISCUSSION Further studies are needed to develop genetic and imaging neurovascular markers to enhance our understanding of their potential contribution to neurodegenerative diseases.
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Affiliation(s)
- Allison A Dilliott
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
| | - Stephanie A Berberian
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Kelly M Sunderland
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Malcolm A Binns
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Julia Zimmer
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
| | - Miracle Ozzoude
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Christopher J M Scott
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Fuqiang Gao
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - Anthony E Lang
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - David P Breen
- Centre for Clinical Brain Sciences, University of Edinburgh; Anne Rowling Regenerative Neurology Clinic, University of Edinburgh; Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Maria C Tartaglia
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
- Division of Neurology, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Brian Tan
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
| | - Richard H Swartz
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Ontario, Canada
| | - Michael Borrie
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- St. Joseph's Healthcare Centre, London, Ontario, Canada
| | - Elizabeth Finger
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Corinne E Fischer
- Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, Ontario, Canada
| | - Andrew Frank
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Bruyère Research Institute, Ottawa, Ontario, Canada
| | - Morris Freedman
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Baycrest Health Sciences, Mt. Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Sanjeev Kumar
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Stephen Pasternak
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Bruce G Pollock
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Tarek K Rajji
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Adult Neurodevelopment and Geriatric Psychiatry, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Toronto Dementia Research Alliance, University of Toronto, Toronto, Ontario, Canada
| | - David F Tang-Wai
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - Agessandro Abrahao
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - John Turnbull
- Division of Neurology, Department of Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - Lorne Zinman
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - Leanne Casaubon
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - Dar Dowlatshahi
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Ayman Hassan
- Thunder Bay Regional Health Research Institute, Thunder Bay, Ontario, Canada
| | - Jennifer Mandzia
- Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Demetrios Sahlas
- Division of Neurology, Department of Medicine, Hamilton Health Sciences, McMaster University, Hamilton, Canada
| | - Gustavo Saposnik
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - David Grimes
- Department of Medicine (Neurology), University of Ottawa Brain and Mind Research Institute and Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Connie Marras
- Edmond J. Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Thomas Steeves
- Division of Neurology, Department of Medicine, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Mario Masellis
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
| | - Sali M K Farhan
- Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
| | - Robert Bartha
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sean Symons
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Robert A Hegele
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sandra E Black
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
- Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
- Department of Medicine (Neurology), Sunnybrook Health Sciences and University of Toronto, Ontario, Canada
- Heart and Stroke Foundation Canadian Partnership for Stroke Recovery, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, Toronto, Ontario, Canada
| | - Joel Ramirez
- Dr. Sandra Black Centre for Brain Resilience and Recovery, LC Campbell Cognitive Neurology, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada
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7
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Branyan K, Labelle-Dumais C, Wang X, Hayashi G, Lee B, Peltz Z, Gorman S, Li BQ, Mao M, Gould DB. Elevated TGFβ signaling contributes to cerebral small vessel disease in mouse models of Gould syndrome. Matrix Biol 2023; 115:48-70. [PMID: 36435425 PMCID: PMC10393528 DOI: 10.1016/j.matbio.2022.11.007] [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: 06/26/2022] [Revised: 11/21/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022]
Abstract
Cerebral small vessel disease (CSVD) is a leading cause of stroke and vascular cognitive impairment and dementia. Studying monogenic CSVD can reveal pathways that are dysregulated in common sporadic forms of the disease and may represent therapeutic targets. Mutations in collagen type IV alpha 1 (COL4A1) and alpha 2 (COL4A2) cause highly penetrant CSVD as part of a multisystem disorder referred to as Gould syndrome. COL4A1 and COL4A2 form heterotrimers [a1α1α2(IV)] that are fundamental constituents of basement membranes. However, their functions are poorly understood and the mechanism(s) by which COL4A1 and COL4A2 mutations cause CSVD are unknown. We used histological, molecular, genetic, pharmacological, and in vivo imaging approaches to characterize central nervous system (CNS) vascular pathologies in Col4a1 mutant mouse models of monogenic CSVD to provide insight into underlying pathogenic mechanisms. We describe developmental CNS angiogenesis abnormalities characterized by impaired retinal vascular outgrowth and patterning, increased numbers of mural cells with abnormal morphologies, altered contractile protein expression in vascular smooth muscle cells (VSMCs) and age-related loss of arteriolar VSMCs in Col4a1 mutant mice. Importantly, we identified elevated TGFβ signaling as a pathogenic consequence of Col4a1 mutations and show that genetically suppressing TGFβ signaling ameliorated CNS vascular pathologies, including partial rescue of retinal vascular patterning defects, prevention of VSMC loss, and significant reduction of intracerebral hemorrhages in Col4a1 mutant mice aged up to 8 months. This study identifies a novel biological role for collagen α1α1α2(IV) as a regulator of TGFβ signaling and demonstrates that elevated TGFβ signaling contributes to CNS vascular pathologies caused by Col4a1 mutations. Our findings suggest that pharmacologically suppressing TGFβ signaling could reduce the severity of CSVD, and potentially other manifestations associated with Gould syndrome and have important translational implications that could extend to idiopathic forms of CSVD.
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Affiliation(s)
- Kayla Branyan
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Cassandre Labelle-Dumais
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Xiaowei Wang
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Genki Hayashi
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Bryson Lee
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Zoe Peltz
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Seán Gorman
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Bo Qiao Li
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Mao Mao
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States
| | - Douglas B Gould
- Department of Ophthalmology, University of California, 555 Mission Bay Boulevard South, San Francisco, CA 94158, United States; Department of Anatomy, Cardiovascular Research Institute, Bakar Aging Research Institute, and Institute for Human Genetics, University of California, San Francisco, United States.
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Ferguson AC, Thrippleton S, Henshall D, Whittaker E, Conway B, MacLeod M, Malik R, Rawlik K, Tenesa A, Sudlow C, Rannikmae K. Frequency and Phenotype Associations of Rare Variants in 5 Monogenic Cerebral Small Vessel Disease Genes in 200,000 UK Biobank Participants. Neurol Genet 2022; 8:e200015. [PMID: 36035235 PMCID: PMC9403885 DOI: 10.1212/nxg.0000000000200015] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 06/17/2022] [Indexed: 04/14/2023]
Abstract
Background and Objectives Based on previous case reports and disease-based cohorts, a minority of patients with cerebral small vessel disease (cSVD) have a monogenic cause, with many also manifesting extracerebral phenotypes. We investigated the frequency, penetrance, and phenotype associations of putative pathogenic variants in cSVD genes in the UK Biobank (UKB), a large population-based study. Methods We used a systematic review of previous literature and ClinVar to identify putative pathogenic rare variants in CTSA, TREX1, HTRA1, and COL4A1/2. We mapped phenotypes previously attributed to these variants (phenotypes-of-interest) to disease coding systems used in the UKB's linked health data from UK hospital admissions, death records, and primary care. Among 199,313 exome-sequenced UKB participants, we assessed the following: the proportion of participants carrying ≥1 variant(s); phenotype-of-interest penetrance; and the association between variant carrier status and phenotypes-of-interest using a binary (any phenotype present/absent) and phenotype burden (linear score of the number of phenotypes a participant possessed) approach. Results Among UKB participants, 0.5% had ≥1 variant(s) in studied genes. Using hospital admission and death records, 4%-20% of variant carriers per gene had an associated phenotype. This increased to 7%-55% when including primary care records. Only COL4A1 variant carrier status was significantly associated with having ≥1 phenotype-of-interest and a higher phenotype score (OR = 1.29, p = 0.006). Discussion While putative pathogenic rare variants in monogenic cSVD genes occur in 1:200 people in the UKB population, only approximately half of variant carriers have a relevant disease phenotype recorded in their linked health data. We could not replicate most previously reported gene-phenotype associations, suggesting lower penetrance rates, overestimated pathogenicity, and/or limited statistical power.
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Affiliation(s)
- Amy Christina Ferguson
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Sophie Thrippleton
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - David Henshall
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Ed Whittaker
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Bryan Conway
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Malcolm MacLeod
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Rainer Malik
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Konrad Rawlik
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Albert Tenesa
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Cathie Sudlow
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
| | - Kristiina Rannikmae
- From the Centre for Medical Informatics (A.C.F., D.H., A.T., K.Rannikmae), Usher Institute, University of Edinburgh; Edinburgh Medical School (S.T., E.W.), University of Edinburgh; Centre for Cardiovascular Science (B.C.), The Queen's Medical Research Institute, University of Edinburgh; Centre for Clinical Brain Sciences (M.M.), University of Edinburgh, United Kingdom; Institute for Stroke and Dementia Research (ISD) (R.M.), University Hospital, LMU Munich, Germany; The Roslin Institute (K. Rawlik, A.T.), University of Edinburgh; MRC Human Genetics Unit (A.T.), Institute of Genetics and Cancer, University of Edinburgh, Western General Hospital; and BHF Data Science Centre (C.S.), Health Death Research UK, London, United Kingdom
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Zhang W, Hu L, Huang X, Xie D, Wu J, Fu X, Liang D, Huang S. Whole-exome sequencing identified five novel de novo variants in patients with unexplained intellectual disability. J Clin Lab Anal 2022; 36:e24587. [PMID: 35837997 PMCID: PMC9459325 DOI: 10.1002/jcla.24587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 05/20/2022] [Accepted: 06/25/2022] [Indexed: 11/30/2022] Open
Abstract
Background Intellectual disability (ID) represents a neurodevelopmental disorder, which is characterized by marked defects in the intellectual function and adaptive behavior, with an onset during the developmental period. ID is mainly caused by genetic factors, and it is extremely genetically heterogeneous. This study aims to identify the genetic cause of ID using trio‐WES analysis. Methods We recruited four pediatric patients with unexplained ID from non‐consanguineous families, who presented at the Department of Pediatrics, Guizhou Provincial People's Hospital. Whole‐exome sequencing (WES) and Sanger sequencing validation were performed in the patients and their unaffected parents. Furthermore, conservative analysis and protein structural and functional prediction were performed on the identified pathogenic variants. Results We identified five novel de novo mutations from four known ID‐causing genes in the four included patients, namely COL4A1 (c.2786T>A, p.V929D and c.2797G>A, p.G933S), TBR1 (c.1639_1640insCCCGCAGTCC, p.Y553Sfs*124), CHD7 (c.7013A>T, p.Q2338L), and TUBA1A (c.1350del, p.E450Dfs*34). These mutations were all predicted to be deleterious and were located at highly conserved domains that might affect the structure and function of these proteins. Conclusion Our findings contribute to expanding the mutational spectrum of ID‐related genes and help to deepen the understanding of the genetic causes and heterogeneity of ID.
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Affiliation(s)
- Wenqiu Zhang
- School of Medicine, Guizhou University, Guiyang, China.,Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China
| | - Li Hu
- Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China
| | - Xinyi Huang
- School of Medical and Life Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Dan Xie
- School of Medicine, Guizhou University, Guiyang, China.,Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China
| | - Jiangfen Wu
- School of Medicine, Guizhou University, Guiyang, China.,Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China
| | - Xiaoling Fu
- Department of Pediatrics, Guizhou Provincial People's hospital, Guiyang, China
| | - Daiyi Liang
- Department of Neurology, Guizhou Provincial People's hospital, Guiyang, China
| | - Shengwen Huang
- School of Medicine, Guizhou University, Guiyang, China.,Prenatal Diagnosis Center, Guizhou Provincial People's hospital, Guiyang, China.,NHC Key Laboratory of Pulmonary Immunological Diseases, Guizhou Provincial People's Hospital, Guiyang, China
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10
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Liu X, Yang Q, Tang L, He J, Tian D, Wang B, Xie L, Li C, Fan D. Rare and Common Variants in COL4A1 in Chinese Patients With Intracerebral Hemorrhage. Front Neurol 2022; 13:827165. [PMID: 35711275 PMCID: PMC9196627 DOI: 10.3389/fneur.2022.827165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 05/06/2022] [Indexed: 11/28/2022] Open
Abstract
Here, we screened the COL4A1 variants in Chinese intracerebral hemorrhage (ICH) patients to summarize the relationship between the variants and clinical characteristics. Targeted sequencing of a 65-gene panel including COL4A1 was performed to detect all the coding regions and ±10-bp splicing sites. In total, 568 patients were included. Regarding rare nonsynonymous variants with a minor allele frequency (MAF) <0.5%, 6 missense variants and five suspicious splice site variants, absent in 573 healthy controls, were found in 11 patients. The subgroup carrying rare variants did not show specific phenotype compared with non-variant carriers. For the single nucleotide polymorphism (SNP) loci with an MAF> 5%, we did not find a significant association between the allele or genotype distribution of the SNP loci and the risk of ICH. Rs3742207 was nominally associated with death at 1-year follow-up (p = 0.02027, OR 1.857, 95% CI 1.101-3.133) after adjusted by age, hypertension history, hematoma volume and recurrent ICH history. Nevertheless, after the Bonferroni correction, the association was no longer significant. In conclusion, rare nonsynonymous variants in COL4A1 were identified in 1.94% (11/568) of Chinese ICH patients, while rs3742207 maybe indicate a worse prognosis of ICH.
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Affiliation(s)
- Xiaolu Liu
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Qiong Yang
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Lu Tang
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Ji He
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Danyang Tian
- Department of Neurology, Peking University Third Hospital, Beijing, China
| | - Baojun Wang
- Department of Neurology, Central Hospital of Baotou, Baotou, China
| | - Lihong Xie
- Department of Neurology, Central Hospital of Baotou, Baotou, China
| | - Changbao Li
- Department of Neurosurgery, Beijing Pinggu Hospital, Beijing, China
| | - Dongsheng Fan
- Department of Neurology, Peking University Third Hospital, Beijing, China.,Beijing Municipal Key Laboratory of Biomarker and Translational Research in Neurodegenerative Diseases, Beijing, China.,Key Laboratory for Neuroscience, National Health Commission/Ministry of Education, Peking University, Beijing, China
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11
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Sun K, Wang H, Zhang D, Li Y, Ren L. Depleting circ_0088364 restrained cell growth and motility of human hepatocellular carcinoma via circ_0088364-miR-1270-COL4A1 ceRNA pathway. Cell Cycle 2022; 21:261-275. [PMID: 34951563 PMCID: PMC8855875 DOI: 10.1080/15384101.2021.2016196] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Circular RNA hsa_circ_0088364 (circ_0088364) is a contributory factor in the malignancy of hepatocellular carcinoma (HCC). We aimed to elaborate its role and competing endogenous RNA (ceRNA) mechanism in HCC cell growth and motility. Expression of circ_0088364, microRNA (miR)-1270 and Collagen type IV alpha 1 chain (COL4A1) was measured by real-time quantitative PCR and Western blotting, and their relationships were determined by dual-luciferase reporter assay, RNA immunoprecipitation, biotinylated RNA pull-down, and Spearman's rank correlation analysis. Cellular programs were measured by cell counting kit-8 assay, flow cytometry and transwell assays, Western blotting, and xenograft experiment. Expression of circ_0088364 and COL4A1 was upregulated, and miR-1270 was downregulated in HCC patients' tumors; moreover, there were linear correlations among circ_0088364, miR-1270, and COL4A1 expression. Essentially, circ_0088364 and COL4A1 were ceRNAs for miR-1270 via target binding. In function, silencing circ_0088364 or upregulating miR-1270 could suppress cell proliferation, cell cycle entrance, transwell migration and invasion in Huh7 and HCCLM3 cells, as well as promote apoptosis rate. Moreover, above-mentioned effects were accompanied with reduced B-cell lymphoma (Bcl)-2, N-cadherin and Vimentin levels, and elevated Bcl-2-associated X protein (Bax) and E-cadherin levels. Contrarily, exhausting miR-1270 and restoring COL4A1 could severally abrogate the tumor-suppressive roles of circ_0088364 knockdown and miR-1270 overexpression in HCC cells in vitro. In vivo, silencing circ_0088364 retarded xenograft tumor growth in nude mice induced by Huh7 cells by upregulating miR-1270 and downregulating COL4A1. Blocking circ_0088364 suppressed HCC by inhibiting cell growth and motility via targeting miR-1270-COL4A1 axis.
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Affiliation(s)
- Kai Sun
- Department of Hepatobiliary Surgery, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong, China
| | - Haochen Wang
- Department of Hepatobiliary Surgery, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong, China
| | - Dongyuan Zhang
- Department of Hepatobiliary Surgery, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong, China
| | - Yupeng Li
- Department of Hepatobiliary Surgery, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong, China
| | - Lei Ren
- Department of Hepatobiliary Surgery, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, Jinan, Shandong, China,CONTACT Lei Ren Department of Hepatobiliary Surgery, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, No. 16766, Jingshi Road, Lixia District, Jinan City, Shandong Province, China
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12
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Shao C, Wang R, Kong D, Gao Q, Xu C. Identification of potential core genes in gastric cancer using bioinformatics analysis. J Gastrointest Oncol 2021; 12:2109-2122. [PMID: 34790378 DOI: 10.21037/jgo-21-628] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Background Gastric cancer is the third leading cause of cancer-related mortality in China. Most patients with gastric cancer have no obvious early symptoms; thus, many of them are in the middle and late stages of gastric cancer at first diagnosis and miss the best treatment opportunity. Molecular targeted therapy is particularly important in changing this status quo. Methods Three microarray datasets (GSE29272, GSE33651, and GSE54129) were selected from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were screened using GEO2R. The Database for Annotation, Visualization and Integrated Discovery (DAVID) was used to analyze the functional features of these DEGs and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment. The protein-protein interaction (PPI) of these DEGs was visualized by Cytoscape software. The expressions of hub genes were evaluated based on Gene Expression Profiling Interactive Analysis (GEPIA). Moreover, we used the online Kaplan-Meier plotter survival analysis tool to evaluate the prognostic values of hub genes. The Target Scan database was used to predict microRNAs that could regulate the target gene, collagen type IV alpha 1 chain (COL4A1). The OncomiR database was used to analyze the expression levels of three microRNAs, as well as the relationships with tumor stage, grade, and prognosis. Results We identified 78 DEGs, including 53 upregulated genes and 25 downregulated genes. The DEGs were mainly enriched in extracellular matrix organization, extracellular structure organization, and response to wounding. Moreover, three KEGG pathways were markedly enriched, including focal adhesion, complement and coagulation cascades, and extracellular matrix (ECM)-receptor interaction. Among these 78 genes, we selected 10 hub genes. The overexpression levels of these hub genes were closely related to poor prognosis and the development of gastric cancer (except for COL3A1, LOX, and CXCL8). Moreover, we found that microRNA-29a-3p, miR-29b-3p, and miR-29c-3p were the potential microRNAs that could regulate the target gene, COL4A1. Conclusions Our results showed that FN1, COL1A1, TIMP1, COL1A2, SPARC, COL4A1, and SERPINE1 could contribute to the development of novel molecular targets and biomarker-driven treatments for gastric cancer.
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Affiliation(s)
- Changjiang Shao
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China.,Department of Gastroenterology, The Second People's Hospital of Lianyungang City, Lianyungang, China
| | - Rong Wang
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Dandan Kong
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Qian Gao
- Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China
| | - Chunfang Xu
- Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, China
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The role of basement membranes in cardiac biology and disease. Biosci Rep 2021; 41:229516. [PMID: 34382650 PMCID: PMC8390786 DOI: 10.1042/bsr20204185] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/26/2021] [Accepted: 08/11/2021] [Indexed: 11/17/2022] Open
Abstract
Basement membranes are highly specialised extracellular matrix structures that within the heart underlie endothelial cells and surround cardiomyocytes and vascular smooth muscle cells. They generate a dynamic and structurally supportive environment throughout cardiac development and maturation by providing physical anchorage to the underlying interstitium, structural support to the tissue, and by influencing cell behaviour and signalling. While this provides a strong link between basement membrane dysfunction and cardiac disease, the role of the basement membrane in cardiac biology remains under-researched and our understanding regarding the mechanistic interplay between basement membrane defects and their morphological and functional consequences remain important knowledge-gaps. In this review we bring together emerging understanding of basement membrane defects within the heart including in common cardiovascular pathologies such as contractile dysfunction and highlight some key questions that are now ready to be addressed.
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Chung J, Hamilton G, Kim M, Marini S, Montgomery B, Henry J, Cho AE, Brown DL, Worrall BB, Meschia JF, Silliman SL, Selim M, Tirschwell DL, Kidwell CS, Kissela B, Greenberg SM, Viswanathan A, Goldstein JN, Langefeld CD, Rannikmae K, Sudlow CLM, Samarasekera N, Rodrigues M, Al-Shahi Salman R, Prendergast JGD, Harris SE, Deary I, Woo D, Rosand J, Van Agtmael T, Anderson CD. Rare Missense Functional Variants at COL4A1 and COL4A2 in Sporadic Intracerebral Hemorrhage. Neurology 2021; 97:e236-e247. [PMID: 34031201 PMCID: PMC8302151 DOI: 10.1212/wnl.0000000000012227] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/19/2021] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE To test the genetic contribution of rare missense variants in COL4A1 and COL4A2 in which common variants are genetically associated with sporadic intracerebral hemorrhage (ICH), we performed rare variant analysis in multiple sequencing data for the risk for sporadic ICH. METHODS We performed sequencing across 559 Kbp at 13q34 including COL4A1 and COL4A2 among 2,133 individuals (1,055 ICH cases; 1,078 controls) in United States-based and 1,381 individuals (192 ICH cases; 1,189 controls) from Scotland-based cohorts, followed by sequence annotation, functional impact prediction, genetic association testing, and in silico thermodynamic modeling. RESULTS We identified 107 rare nonsynonymous variants in sporadic ICH, of which 2 missense variants, rs138269346 (COL4A1I110T) and rs201716258 (COL4A2H203L), were predicted to be highly functional and occurred in multiple ICH cases but not in controls from the United States-based cohort. The minor allele of rs201716258 was also present in Scottish patients with ICH, and rs138269346 was observed in 2 ICH-free controls with a history of hypertension and myocardial infarction. Rs138269346 was nominally associated with nonlobar ICH risk (p = 0.05), but not with lobar ICH (p = 0.08), while associations between rs201716258 and ICH subtypes were nonsignificant (p > 0.12). Both variants were considered pathogenic based on minor allele frequency (<0.00035 in European populations), predicted functional impact (deleterious or probably damaging), and in silico modeling studies (substantially altered physical length and thermal stability of collagen). CONCLUSIONS We identified rare missense variants in COL4A1/A2 in association with sporadic ICH. Our annotation and simulation studies suggest that these variants are highly functional and may represent targets for translational follow-up.
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Affiliation(s)
- Jaeyoon Chung
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Graham Hamilton
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Minsup Kim
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Sandro Marini
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Bailey Montgomery
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Jonathan Henry
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Art E Cho
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Devin L Brown
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Bradford B Worrall
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - James F Meschia
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Scott L Silliman
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Magdy Selim
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - David L Tirschwell
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Chelsea S Kidwell
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Brett Kissela
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Steven M Greenberg
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Anand Viswanathan
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Joshua N Goldstein
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Carl D Langefeld
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Kristiina Rannikmae
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Catherine L M Sudlow
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Neshika Samarasekera
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Mark Rodrigues
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Rustam Al-Shahi Salman
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - James G D Prendergast
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Sarah E Harris
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Ian Deary
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Daniel Woo
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Jonathan Rosand
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Tom Van Agtmael
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
| | - Christopher D Anderson
- From the Center for Genomic Medicine (J.C., S.M., B.M., J.H., J.R., C.D.A.), Department of Neurology (B.M., J.H., S.M.G., A.V., J.R., C.D.A.), McCance Center for Brain Health (J.H., J.R., C.D.A.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston; Program in Medical and Population Genetics (J.C., J.R., C.D.A.), Broad Institute, Boston, MA; Glasgow Polyomics, Wolfson Wohl Cancer Research Centre, Garscube Campus (G.H.), and Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences (G.H., T.V.A.), University of Glasgow, Bearsden, UK; Department of Bioinformatics (M.K., A.E.C.), Korea University, Sejong, South Korea; Stroke Program, Department of Neurology (D.L.B.), University of Michigan, Ann Arbor; Department of Neurology and Public Health Sciences (B.B.W.), University of Virginia Health System, Charlottesville; Department of Neurology (J.F.M.), Mayo Clinic Jacksonville; Department of Neurology (S.L.S.), University of Florida College of Medicine, Jacksonville; Department of Neurology, Stroke Division (M.S.), Beth Israel Deaconess Medical Center, Boston, MA; Department of Neurology, Harborview Medical Center (D.L.T.), University of Washington, Seattle; Department of Neurology (C.S.K.), The University of Arizona, Tucson; Department of Neurology and Rehabilitation Medicine (B.K., D.W.), University of Cincinnati, OH; Center for Public Health Genomics and Department of Biostatistical Sciences (C.D.L.), Wake Forest School of Medicine, Winston-Salem, NC; Centre for Medical Informatics, Usher Institute (K.R., C.L.M.S.), Centre for Clinical Brain Sciences (N.S., M.R., R.A.-S.S.), The Roslin Institute (J.G.D.P.), and Lothian Birth Cohorts Group, Department of Psychology (S.E.H., I.D.), University of Edinburgh; and British Heart Foundation Data Science Centre (K.R.), London, UK. Dr. Anderson is currently at the Department of Neurology, Brigham and Women's Hospital, Boston, MA
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15
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Ulivi L, Cosottini M, Migaleddu G, Orlandi G, Giannini N, Siciliano G, Mancuso M. Brain MRI in Monogenic Cerebral Small Vessel Diseases: A Practical Handbook. Curr Mol Med 2021; 22:300-311. [DOI: 10.2174/1566524021666210510164003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 01/28/2021] [Accepted: 02/09/2021] [Indexed: 11/22/2022]
Abstract
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Monogenic cerebral small vessel diseases are a topic of growing interest, as several genes responsible have been recently described and new sequencing techniques such as Next generation sequencing are available. Brain imaging is a key exam in these diseases. First, since it is often the first exam performed, an MRI is key in selecting patients for genetic testing and for interpreting Next generation sequencing reports. In addition, neuroimaging can be helpful in describing the underlying pathological mechanisms involved in cerebral small vessel disease. With this review, we aim to provide Neurologists and Stroke physicians with an up-to date overview of the current neuroimaging knowledge on monogenic small vessel diseases.
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Affiliation(s)
- Leonardo Ulivi
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Via Roma 67, Pisa, Italy
| | - Mirco Cosottini
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Gianmichele Migaleddu
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Giovanni Orlandi
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Via Roma 67, Pisa, Italy
| | - Nicola Giannini
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Via Roma 67, Pisa, Italy
| | - Gabriele Siciliano
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Via Roma 67, Pisa, Italy
| | - Michelangelo Mancuso
- Department of Experimental and Clinical Medicine, Neurological Clinic, Pisa University, Via Roma 67, Pisa, Italy
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16
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Genetic Profiling of Idiopathic Antenatal Intracranial Haemorrhage: What We Know? Genes (Basel) 2021; 12:genes12040573. [PMID: 33920939 PMCID: PMC8071218 DOI: 10.3390/genes12040573] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 03/26/2021] [Accepted: 04/12/2021] [Indexed: 11/16/2022] Open
Abstract
Intracranial hemorrhage (ICH) is reported in premature infants and rarely, in prenatal life. Fetal ICH can be accurately identified in utero and categorized by antenatal sonography and/or MRI. Infectious disease, maternal drug exposure, alloimmune thrombocytopenia, maternal trauma, coagulation disorders and twin-to-twin transfusion syndrome can cause fetal ICH. However, in many cases, the cause is not identified and a genetic disorder should be taken into consideration. We conducted a review of the literature to investigate what we know about genetic origins of fetal ICH. We conducted targeted research on the databases PubMed and EMBASE, ranging from 1980 to 2020. We found 311 studies and 290 articles were excluded because they did not meet the inclusion criteria, and finally, 21 articles were considered relevant for this review. Hemostatic, protrombotic, collagen and X-linked GATA 1 genes were reported in the literature as causes of fetal ICH. In cases of ICH classified as idiopathic, possible underlying genetic causes should be accounted for and investigated. The identification of ICH genetic causes can guide the counselling process with respect to the recurrence risk, in addition to producing relevant clinical data to the neonatologist for the optimal management and prompt treatment of the newborn.
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17
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Hausman-Kedem M, Malinger G, Modai S, Kushner SA, Shiran SI, Ben-Sira L, Roth J, Constantini S, Fattal-Valevski A, Ben-Shachar S. Monogenic Causes of Apparently Idiopathic Perinatal Intracranial Hemorrhage. Ann Neurol 2021; 89:813-822. [PMID: 33527515 DOI: 10.1002/ana.26033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/26/2021] [Accepted: 01/26/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Perinatal intracranial hemorrhage (pICH) is a rare event that occurs during the fetal/neonatal period with potentially devastating neurological outcome. However, the etiology of pICH is frequently hard to depict. We investigated the role of rare genetic variations in unexplained cases of pICH. METHODS We performed whole-exome sequencing (WES) in fetuses and term neonates with otherwise unexplained pICH and their parents. Variant causality was determined according to the American College of Medical Genetics and Genomics (ACMG) criteria, consistency between suggested genes and phenotypes, and mode of inheritance. RESULTS Twenty-six probands (25 families) were included in the study (9 with a prenatal diagnosis and 17 with a postnatal diagnosis). Intraventricular hemorrhage (IVH) was the most common type of hemorrhage (n = 16, 62%), followed by subpial (n = 4, 15%), subdural (n = 4, 15%), and parenchymal (n = 2, 8%) hemorrhage. Causative/likely causative variants were found in 4 subjects from 3 of the 25 families (12%) involving genes related to the brain microenvironment (COL4A1, COL4A2, and TREX-1). Additionally, potentially causative variants were detected in genes related to coagulation (GP1BA, F11, Von Willebrand factor [VWF], FGA, and F7; n = 4, 16%). A potential candidate gene for phenotypic expansion related to microtubular function (DNAH5) was identified in 1 case (4%). Fifty-five percent of the variants were inherited from an asymptomatic parent. Overall, these findings showed a monogenic cause for pICH in 12% to 32% of the families. INTERPRETATION Our findings reveal a clinically significant diagnostic yield of WES in apparently idiopathic pICH and support the use of WES in the evaluation of these cases. ANN NEUROL 2021;89:813-822.
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Affiliation(s)
- Moran Hausman-Kedem
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faulty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gustavo Malinger
- Sackler Faulty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Obstetrics and Gynecology Ultrasound, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | - Steven A Kushner
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Shelly I Shiran
- Sackler Faulty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Radiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Liat Ben-Sira
- Sackler Faulty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Radiology Department, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Jonathan Roth
- Sackler Faulty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Neurosurgery Department, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Shlomi Constantini
- Sackler Faulty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Neurosurgery Department, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Aviva Fattal-Valevski
- Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler Faulty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shay Ben-Shachar
- Sackler Faulty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Schneider Children's Medical Center, Petah Tikva, Israel.,Clalit Research Institute, Ramat Gan, Israel
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18
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Wang H, Liang P, Zheng L, Long C, Li H, Zuo Y. eHSCPr discriminating the cell identity involved in endothelial to hematopoietic transition. Bioinformatics 2021; 37:2157-2164. [PMID: 33532815 DOI: 10.1093/bioinformatics/btab071] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 01/15/2021] [Accepted: 01/28/2021] [Indexed: 12/11/2022] Open
Abstract
MOTIVATION Hematopoietic stem cells (HSCs) give rise to all blood cells and play a vital role throughout the whole lifespan through their pluripotency and self-renewal properties. Accurately identifying the stages of early HSCs is extremely important, as it may open up new prospects for extracorporeal blood research. Existing experimental techniques for identifying the early stages of HSCs development are time-consuming and expensive. Machine learning has shown its excellence in massive single-cell data processing and it is desirable to develop related computational models as good complements to experimental techniques. RESULTS In this study, we presented a novel predictor called eHSCPr specifically for predicting the early stages of HSCs development. To reveal the distinct genes at each developmental stage of HSCs, we compared F-score with three state-of-art differential gene selection methods (limma, DESeq2, edgeR) and evaluated their performance. F-score captured the more critical surface markers of endothelial cells and hematopoietic cells, and the area under receiver operating characteristic curve (ROC) value was 0.987. Based on SVM, the 10-fold cross-validation accuracy of eHSCpr in the independent dataset and the training dataset reached 94.84% and 94.19%, respectively. Importantly, we performed transcription analysis on the F-score gene set, which indeed further enriched the signal markers of HSCs development stages. eHSCPr can be a powerful tool for predicting early stages of HSCs development, facilitating hypothesis-driven experimental design and providing crucial clues for the in vitro blood regeneration studies. AVAILABILITY http://bioinfor.imu.edu.cn/ehscpr. SUPPLEMENTARY INFORMATION Supplementary data are available at Bioinformatics online.
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Affiliation(s)
- Hao Wang
- State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, College of Life Sciences, Inner Mongolia University, Hohhot, 010070, China
| | - Pengfei Liang
- State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, College of Life Sciences, Inner Mongolia University, Hohhot, 010070, China
| | - Lei Zheng
- State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, College of Life Sciences, Inner Mongolia University, Hohhot, 010070, China
| | - ChunShen Long
- State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, College of Life Sciences, Inner Mongolia University, Hohhot, 010070, China
| | - HanShuang Li
- State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, College of Life Sciences, Inner Mongolia University, Hohhot, 010070, China
| | - Yongchun Zuo
- State Key Laboratory of Reproductive Regulation and Breeding of Grassland Livestock, College of Life Sciences, Inner Mongolia University, Hohhot, 010070, China
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19
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Chen CP, Chen CY, Chern SR, Wu PS, Chen SW, Lee CC, Chen LF, Wang W. Prenatal diagnosis and molecular cytogenetic characterization of mosaicism for r(13), monosomy 13 and idic r(13) by amniocentesis. Taiwan J Obstet Gynecol 2020; 59:130-134. [PMID: 32039781 DOI: 10.1016/j.tjog.2019.11.021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2019] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE We present prenatal diagnosis and molecular cytogenetic characterization of mosaicism for ring chromosome 13 [r(13)], monosomy 13 and isodicentric ring chromosome 13 [idic r(13)] by amniocentesis. CASE REPORT A 24-year-old woman underwent amniocentesis at 23 weeks of gestation because of intrauterine growth restriction (IUGR) in the fetus. Amniocentesis revealed a karyotype of 46,XY,r(13)[23]/45,XY,-13[10]/46,XY,idic r(13)[2]. The parental karyotypes were normal. Array comparative genomic hybridization (aCGH) on cultured amniocytes revealed the result of arr 13q11q31.3 (19,436,286-92,284,309) × 1.85, arr 13q31.3q34 (92,288,514-115,107,733) × 1 [GRCh37 (hg19)], indicating a 22.82-Mb 13q31.3-q34 deletion and a 15-20% mosaicism for 13q11-q31.3 deletion. The pregnancy was subsequently terminated, and a malformed fetus was delivered with facial dysmorphism. The placental tissues had a karyotype of 46,XY,r(13)[18]/46,XY,-13,+mar[14]/45,XY,-13[8]. Polymorphic DNA marker analysis confirmed a maternal origin of the 13q deletion. CONCLUSION Fetus with mosaic r(13), monosomy 13 and idic r(13) may present IUGR on prenatal ultrasound, and fetoplacental cytogenetic discrepancy may exist under such a circumstance.
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Affiliation(s)
- Chih-Ping Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Biotechnology, Asia University, Taichung, Taiwan; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan; Institute of Clinical and Community Health Nursing, National Yang-Ming University, Taipei, Taiwan; Department of Obstetrics and Gynecology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Chen-Yu Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan; Department of Medicine, MacKay Medical College, New Taipei City, Taiwan; MacKay Junior College of Medicine, Nursing and Management, Taipei, Taiwan
| | - Schu-Rern Chern
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | | | - Shin-Wen Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Chen-Chi Lee
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Li-Feng Chen
- Department of Obstetrics and Gynecology, MacKay Memorial Hospital, Taipei, Taiwan
| | - Wayseen Wang
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan; Department of Bioengineering, Tatung University, Taipei, Taiwan
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20
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Russo A, Pinto AM, Lopergolo D, Renieri A, Battisti C. An Italian family carrying a new mutation in the COL4A1 gene. J Neurol Sci 2020; 414:116815. [PMID: 32335342 DOI: 10.1016/j.jns.2020.116815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/30/2020] [Indexed: 10/24/2022]
Affiliation(s)
- A Russo
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.
| | - A M Pinto
- Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - D Lopergolo
- Medical Genetics, University of Siena, Siena, Italy; Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - A Renieri
- Medical Genetics, University of Siena, Siena, Italy; Genetica Medica, Azienda Ospedaliera Universitaria Senese, Siena, Italy
| | - C Battisti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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21
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Chung J, Marini S, Pera J, Norrving B, Jimenez-Conde J, Roquer J, Fernandez-Cadenas I, Tirschwell DL, Selim M, Brown DL, Silliman SL, Worrall BB, Meschia JF, Demel S, Greenberg SM, Slowik A, Lindgren A, Schmidt R, Traylor M, Sargurupremraj M, Tiedt S, Malik R, Debette S, Dichgans M, Langefeld CD, Woo D, Rosand J, Anderson CD. Genome-wide association study of cerebral small vessel disease reveals established and novel loci. Brain 2020; 142:3176-3189. [PMID: 31430377 DOI: 10.1093/brain/awz233] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 05/30/2019] [Accepted: 06/04/2019] [Indexed: 01/08/2023] Open
Abstract
Intracerebral haemorrhage and small vessel ischaemic stroke (SVS) are the most acute manifestations of cerebral small vessel disease, with no established preventive approaches beyond hypertension management. Combined genome-wide association study (GWAS) of these two correlated diseases may improve statistical power to detect novel genetic factors for cerebral small vessel disease, elucidating underlying disease mechanisms that may form the basis for future treatments. Because intracerebral haemorrhage location is an adequate surrogate for distinct histopathological variants of cerebral small vessel disease (lobar for cerebral amyloid angiopathy and non-lobar for arteriolosclerosis), we performed GWAS of intracerebral haemorrhage by location in 1813 subjects (755 lobar and 1005 non-lobar) and 1711 stroke-free control subjects. Intracerebral haemorrhage GWAS results by location were meta-analysed with GWAS results for SVS from MEGASTROKE, using 'Multi-Trait Analysis of GWAS' (MTAG) to integrate summary data across traits and generate combined effect estimates. After combining intracerebral haemorrhage and SVS datasets, our sample size included 241 024 participants (6255 intracerebral haemorrhage or SVS cases and 233 058 control subjects). Genome-wide significant associations were observed for non-lobar intracerebral haemorrhage enhanced by SVS with rs2758605 [MTAG P-value (P) = 2.6 × 10-8] at 1q22; rs72932727 (P = 1.7 × 10-8) at 2q33; and rs9515201 (P = 5.3 × 10-10) at 13q34. In the GTEx gene expression library, rs2758605 (1q22), rs72932727 (2q33) and rs9515201 (13q34) are significant cis-eQTLs for PMF1 (P = 1 × 10-4 in tibial nerve), NBEAL1, FAM117B and CARF (P < 2.1 × 10-7 in arteries) and COL4A2 and COL4A1 (P < 0.01 in brain putamen), respectively. Leveraging S-PrediXcan for gene-based association testing with the predicted expression models in tissues related with nerve, artery, and non-lobar brain, we found that experiment-wide significant (P < 8.5 × 10-7) associations at three genes at 2q33 including NBEAL1, FAM117B and WDR12 and genome-wide significant associations at two genes including ICA1L at 2q33 and ZCCHC14 at 16q24. Brain cell-type specific expression profiling libraries reveal that SEMA4A, SLC25A44 and PMF1 at 1q22 and COL4A1 and COL4A2 at 13q34 were mainly expressed in endothelial cells, while the genes at 2q33 (FAM117B, CARF and NBEAL1) were expressed in various cell types including astrocytes, oligodendrocytes and neurons. Our cross-phenotype genetic study of intracerebral haemorrhage and SVS demonstrates novel genome-wide associations for non-lobar intracerebral haemorrhage at 2q33 and 13q34. Our replication of the 1q22 locus previous seen in traditional GWAS of intracerebral haemorrhage, as well as the rediscovery of 13q34, which had previously been reported in candidate gene studies with other cerebral small vessel disease-related traits strengthens the credibility of applying this novel genome-wide approach across intracerebral haemorrhage and SVS.
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Affiliation(s)
- Jaeyoon Chung
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Sandro Marini
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Joanna Pera
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Bo Norrving
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Jordi Jimenez-Conde
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Jaume Roquer
- Department of Neurology, Neurovascular Research Unit, Institut Hospital del Mar d'Investigacions Mèdiques, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Israel Fernandez-Cadenas
- Neurovascular Research Laboratory and Neurovascular Unit, Institut de Recerca, Hospital Vall d'Hebron, Universitat Autonoma de Barcelona, Barcelona, Spain.,Stroke Pharmacogenomics and Genetics, Sant Pau Institute of Research, Hospital de la Santa Creu I Sant Pau, Barcelona, Spain
| | - David L Tirschwell
- Stroke Center, Harborview Medical Center, University of Washington, Seattle, WA, USA
| | - Magdy Selim
- Department of Neurology, Stroke Division, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Devin L Brown
- Stroke Program, Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Scott L Silliman
- Department of Neurology, University of Florida College of Medicine, Jacksonville, FL, USA
| | - Bradford B Worrall
- Department of Neurology and Public Health Sciences, University of Virginia Health System, Charlottesville, VA, USA
| | | | - Stacie Demel
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Steven M Greenberg
- The J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA
| | - Agnieszka Slowik
- Department of Neurology, Jagiellonian University Medical College, Krakow, Poland
| | - Arne Lindgren
- Department of Clinical Sciences Lund, Neurology, Lund University, Lund, Sweden.,Department of Neurology and Rehabilitation Medicine, Skåne University Hospital, Lund, Sweden
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Graz, Austria
| | - Matthew Traylor
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | | | - Steffen Tiedt
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Rainer Malik
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Stéphanie Debette
- University of Bordeaux, INSERM U1219, Bordeaux Population Health Research Center, Bordeaux, France.,Department of Neurology, Memory Clinic, Bordeaux University Hospital, University of Bordeaux, Bordeaux, France
| | - Martin Dichgans
- Institute for Stroke and Dementia Research, University Hospital, LMU Munich, Munich, Germany.,Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.,German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
| | - Carl D Langefeld
- Center for Public Health Genomics and Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Daniel Woo
- Department of Neurology and Rehabilitation Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jonathan Rosand
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Christopher D Anderson
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA.,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
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22
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Aguiar RS, Pohl F, Morais GL, Nogueira FCS, Carvalho JB, Guida L, Arge LWP, Melo A, Moreira MEL, Cunha DP, Gomes L, Portari EA, Velasquez E, Melani RD, Pezzuto P, de Castro FL, Geddes VEV, Gerber AL, Azevedo GS, Schamber-Reis BL, Gonçalves AL, Junqueira-de-Azevedo I, Nishiyama MY, Ho PL, Schanoski AS, Schuch V, Tanuri A, Chimelli L, Vasconcelos ZFM, Domont GB, Vasconcelos ATR, Nakaya HI. Molecular alterations in the extracellular matrix in the brains of newborns with congenital Zika syndrome. Sci Signal 2020; 13:eaay6736. [PMID: 32518143 DOI: 10.1126/scisignal.aay6736] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Zika virus (ZIKV) infection during pregnancy can cause a set of severe abnormalities in the fetus known as congenital Zika syndrome (CZS). Experiments with animal models and in vitro systems have substantially contributed to our understanding of the pathophysiology of ZIKV infection. Here, to investigate the molecular basis of CZS in humans, we used a systems biology approach to integrate transcriptomic, proteomic, and genomic data from the postmortem brains of neonates with CZS. We observed that collagens were greatly reduced in expression in CZS brains at both the RNA and protein levels and that neonates with CZS had several single-nucleotide polymorphisms in collagen-encoding genes that are associated with osteogenesis imperfecta and arthrogryposis. These findings were validated by immunohistochemistry and comparative analysis of collagen abundance in ZIKV-infected and uninfected samples. In addition, we showed a ZIKV-dependent increase in the expression of cell adhesion factors that are essential for neurite outgrowth and axon guidance, findings that are consistent with the neuronal migration defects observed in CZS. Together, these findings provide insights into the underlying molecular alterations in the ZIKV-infected brain and reveal host genes associated with CZS susceptibility.
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Affiliation(s)
- Renato S Aguiar
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
- Departamento de Biologia Geral, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Fabio Pohl
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Guilherme L Morais
- National Laboratory of Scientific Computation, LNCC/MCTI, Petrópolis, Brazil
| | - Fabio C S Nogueira
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Laboratory of Proteomics, LADETEC, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Joseane B Carvalho
- National Laboratory of Scientific Computation, LNCC/MCTI, Petrópolis, Brazil
| | - Letícia Guida
- Fernandes Figueira Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Luis W P Arge
- National Laboratory of Scientific Computation, LNCC/MCTI, Petrópolis, Brazil
| | - Adriana Melo
- Instituto de Pesquisa Professor Amorim Neto, Campina Grande, Paraíba, Brazil
| | | | - Daniela P Cunha
- Fernandes Figueira Institute, Fiocruz, Rio de Janeiro, Brazil
| | - Leonardo Gomes
- Fernandes Figueira Institute, Fiocruz, Rio de Janeiro, Brazil
| | | | - Erika Velasquez
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Rafael D Melani
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Paula Pezzuto
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Fernanda L de Castro
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Victor E V Geddes
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Alexandra L Gerber
- National Laboratory of Scientific Computation, LNCC/MCTI, Petrópolis, Brazil
| | - Girlene S Azevedo
- Instituto de Pesquisa Professor Amorim Neto, Campina Grande, Paraíba, Brazil
| | - Bruno L Schamber-Reis
- Faculdade de Ciências Médicas de Campina Grande, Núcleo de Genética Médica, Centro Universitário UniFacisa, Campina Grande, Paraíba, Brazil
| | - Alessandro L Gonçalves
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | | | - Milton Y Nishiyama
- Special Laboratory for Applied Toxinology, Butantan Institute, São Paulo, Brazil
| | - Paulo L Ho
- Bacteriology Laboratory, Butantan Institute, São Paulo, Brazil
| | | | - Viviane Schuch
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Amilcar Tanuri
- Departamento de Genética, Instituto de Biologia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leila Chimelli
- Laboratório de Neuropatologia, Instituto Estadual do Cérebro, Rio de Janeiro, Brazil.
| | | | - Gilberto B Domont
- Proteomics Unit, Department of Biochemistry, Institute of Chemistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
| | - Ana T R Vasconcelos
- National Laboratory of Scientific Computation, LNCC/MCTI, Petrópolis, Brazil.
| | - Helder I Nakaya
- Department of Clinical and Toxicological Analyses, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.
- Scientific Platform Pasteur-USP, São Paulo, Brazil
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23
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Foddis M, Winek K, Bentele K, Mueller S, Blumenau S, Reichhart N N, Crespo-Garcia S, Harnett D, Ivanov A, Meisel A, Joussen A, Strauss O, Beule D, Dirnagl U, Sassi C. An exploratory investigation of brain collateral circulation plasticity after cerebral ischemia in two experimental C57BL/6 mouse models. J Cereb Blood Flow Metab 2020; 40:276-287. [PMID: 31549895 PMCID: PMC7370619 DOI: 10.1177/0271678x19827251] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Brain collateral circulation is an essential compensatory mechanism in response to acute brain ischemia. To study the temporal evolution of brain macro and microcollateral recruitment and their reciprocal interactions in response to different ischemic conditions, we applied a combination of complementary techniques (T2-weighted magnetic resonance imaging [MRI], time of flight [TOF] angiography [MRA], cerebral blood flow [CBF] imaging and histology) in two different mouse models. Hypoperfusion was either induced by permanent bilateral common carotid artery stenosis (BCCAS) or 60-min transient unilateral middle cerebral artery occlusion (MCAO). In both models, collateralization is a very dynamic phenomenon with a global effect affecting both hemispheres. Patency of ipsilateral posterior communicating artery (PcomA) represents the main variable survival mechanism and the main determinant of stroke lesion volume and recovery in MCAO, whereas the promptness of external carotid artery retrograde flow recruitment together with PcomA patency, critically influence survival, brain ischemic lesion volume and retinopathy in BCCAS mice. Finally, different ischemic gradients shape microcollateral density and size.
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Affiliation(s)
- Marco Foddis
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Katarzyna Winek
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Kajetan Bentele
- Berlin Institute of Health, BIH, Unit Bioinformatics, Berlin, Germany
| | - Susanne Mueller
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Charité - Universitätsmedizin Berlin, NeuroCure Cluster of Excellence and Charité Core Facility 7T Experimental MRIs, Berlin, Germany
| | - Sonja Blumenau
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nadine Reichhart N
- Department of Ophthalmology, Experimental Ophthalmology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Sergio Crespo-Garcia
- Department of Ophthalmology, Experimental Ophthalmology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Dermot Harnett
- Berlin Institute of Health, BIH, Unit Bioinformatics, Berlin, Germany
| | - Andranik Ivanov
- Berlin Institute of Health, BIH, Unit Bioinformatics, Berlin, Germany
| | - Andreas Meisel
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Antonia Joussen
- Department of Ophthalmology, Experimental Ophthalmology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Olaf Strauss
- Department of Ophthalmology, Experimental Ophthalmology, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Dieter Beule
- Berlin Institute of Health, BIH, Unit Bioinformatics, Berlin, Germany
| | - Ulrich Dirnagl
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,QUEST Center for Transforming Biomedical Research, Berlin Institute of Health (BIH), Berlin, Germany
| | - Celeste Sassi
- Department of Experimental Neurology, Center for Stroke Research Berlin (CSB), Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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24
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Kinoshita K, Ishizaki Y, Yamamoto H, Sonoda M, Yonemoto K, Kira R, Sanefuji M, Ueda A, Matsui H, Ando Y, Sakai Y, Ohga S. De novo p.G696S mutation in COL4A1 causes intracranial calcification and late-onset cerebral hemorrhage: A case report and review of the literature. Eur J Med Genet 2019; 63:103825. [PMID: 31857254 DOI: 10.1016/j.ejmg.2019.103825] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 11/16/2019] [Accepted: 12/14/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND The collagen type IV alpha 1 chain (COL4A1) is an essential component of the basement membrane in small vessels. Pathogenic variants in COL4A1 cause perinatal cerebral hemorrhages in an autosomal-dominant fashion. However, little is known about the long-term outcomes of patients with mildly affecting COL4A1 mutations. CASE REPORT We report a 17-year-old boy, who presented with recurrent intracranial hemorrhages in the periventricular white matter. He had been followed-up as a child with cerebral palsy bearing intracranial calcifications, developmental delay and epilepsy. Screening tests in infancy provided negative results for intrauterine infections. Severe motor and cognitive deficits persisted after admission. Carbazochrome was introduced on day 19 of admission, which appeared to prevent extension and reactivation of cerebral hemorrhages for over 6 months after discharge. RESULTS Targeted sequencing of NOTCH3 and TREX1 excluded causal mutations in these genes. The whole-exome sequencing revealed that he carried a de novo mutation in COL4A1 (p.Gly696Ser). An overview of the literature for 345 cases with COL4A1 mutations supported evidence that p.Gly696Ser is associated with the unique phenotype of late-onset hemorrhage among patients with COL4A1-associated cerebral angiopathy. CONCLUSIONS This case first demonstrates that infants with COL4A1-associated leukoencephalopathy and calcifications have a risk for developing the rupture of small vessels in the cerebral white matter after 10 years of age.
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Affiliation(s)
- Keishiro Kinoshita
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshito Ishizaki
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroyuki Yamamoto
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Motoshi Sonoda
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Kousuke Yonemoto
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | | | - Masafumi Sanefuji
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Akihiko Ueda
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Hirotaka Matsui
- Department of Molecular Laboratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yukio Ando
- Department of Neurology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Yasunari Sakai
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - Shouichi Ohga
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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25
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Nandeesh BN, Bindu PS, Narayanappa G, Chickabasaviah Yasha T, Mahadevan A, Kulanthaivelu K, Santosh V. Cerebral small vessel disease with hemorrhagic stroke related to COL4A1 mutation: A case report. Neuropathology 2019; 40:93-98. [DOI: 10.1111/neup.12607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 07/26/2019] [Accepted: 08/29/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Bevinahalli N. Nandeesh
- Department of NeuropathologyNational Institute of Mental Health and Neurosciences Bangalore India
| | - Parayil Sankaran Bindu
- Department of NeurologyNational Institute of Mental Health and Neurosciences Bangalore India
| | - Gayathri Narayanappa
- Department of NeuropathologyNational Institute of Mental Health and Neurosciences Bangalore India
| | - T. Chickabasaviah Yasha
- Department of NeuropathologyNational Institute of Mental Health and Neurosciences Bangalore India
| | - Anita Mahadevan
- Department of NeuropathologyNational Institute of Mental Health and Neurosciences Bangalore India
| | - Karthik Kulanthaivelu
- Neuroimaging and Interventional RadiologyNational Institute of Mental Health and Neurosciences Bangalore India
| | - Vani Santosh
- Department of NeuropathologyNational Institute of Mental Health and Neurosciences Bangalore India
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26
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Romero-Ortuno R, Kenny RA, McManus R. Collagens and elastin genetic variations and their potential role in aging-related diseases and longevity in humans. Exp Gerontol 2019; 129:110781. [PMID: 31740390 DOI: 10.1016/j.exger.2019.110781] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/11/2019] [Accepted: 11/12/2019] [Indexed: 12/17/2022]
Abstract
Collagens and elastin are 'building blocks' of tissues and extracellular matrix. Mutations in these proteins cause severe congenital syndromes. Adverse genetic variations may accelerate the aging process in adults contributing to premature morbidity, disability and/or mortality. Favorable variants may contribute to longevity and/or healthy aging, but this is much less studied. We reviewed the association between variation in the genes of collagens and elastin and premature aging, accelerated aging, age-related diseases and/or frailty; and the association between genetic variation in those and longevity and/or healthy aging in humans. A systematic search was conducted in MEDLINE and other online databases (OMIM, Genetics Home Reference, Orphanet, ClinVar). Results suggest that genetic variants lead to aging phenotypes of known congenital disease, but also to association with common age-related diseases in adults without known congenital disease. This may be due to the variable penetrance and expressivity of many variants. Some collagen variants have been associated with longevity or healthy aging. A limitation is that most studies had <1000 participants and their criterion for statistical significance was p < 0.05. Results highlight the importance of adopting a lifecourse approach to the study of the genomics of aging. Gerontology can help with new methodologies that operationalize biological aging.
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Affiliation(s)
- Roman Romero-Ortuno
- Trinity College Dublin, Discipline of Medical Gerontology, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland; The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland..
| | - Rose Anne Kenny
- Trinity College Dublin, Discipline of Medical Gerontology, Mercer's Institute for Successful Ageing, St James's Hospital, Dublin 8, Ireland; The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
| | - Ross McManus
- Trinity College Dublin, Trinity Translational Medicine Institute, Trinity Centre for Health Sciences, St James's Hospital, Dublin 8, Ireland
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27
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Tan RYY, Traylor M, Megy K, Duarte D, Deevi SVV, Shamardina O, Mapeta RP, Ouwehand WH, Gräf S, Downes K, Markus HS. How common are single gene mutations as a cause for lacunar stroke? A targeted gene panel study. Neurology 2019; 93:e2007-e2020. [PMID: 31719132 PMCID: PMC6913325 DOI: 10.1212/wnl.0000000000008544] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 06/10/2019] [Indexed: 11/29/2022] Open
Abstract
Objectives To determine the frequency of rare and pertinent disease-causing variants in small vessel disease (SVD)-associated genes (such as NOTCH3, HTRA1, COL4A1, COL4A2, FOXC1, TREX1, and GLA) in cerebral SVD, we performed targeted gene sequencing in 950 patients with younger-onset apparently sporadic SVD stroke using a targeted sequencing panel. Methods We designed a high-throughput sequencing panel to identify variants in 15 genes (7 known SVD genes, 8 SVD-related disorder genes). The panel was used to screen a population of 950 patients with younger-onset (≤70 years) MRI-confirmed SVD stroke, recruited from stroke centers across the United Kingdom. Variants were filtered according to their frequency in control databases, predicted effect, presence in curated variant lists, and combined annotation dependent depletion scores. Whole genome sequencing and genotyping were performed on a subset of patients to provide a direct comparison of techniques. The frequency of known disease-causing and pertinent variants of uncertain significance was calculated. Results We identified previously reported variants in 14 patients (8 cysteine-changing NOTCH3 variants in 11 patients, 2 HTRA1 variants in 2 patients, and 1 missense COL4A1 variant in 1 patient). In addition, we identified 29 variants of uncertain significance in 32 patients. Conclusion Rare monogenic variants account for about 1.5% of younger onset lacunar stroke. Most are cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy variants, but the second most common gene affected is HTRA1. A high-throughput sequencing technology platform is an efficient, reliable method to screen for such mutations.
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Affiliation(s)
- Rhea Y Y Tan
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK.
| | - Matthew Traylor
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | - Karyn Megy
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | - Daniel Duarte
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | - Sri V V Deevi
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | - Olga Shamardina
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | - Rutendo P Mapeta
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | | | - Willem H Ouwehand
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | - Stefan Gräf
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | - Kate Downes
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
| | - Hugh S Markus
- From the Stroke Research Group, Department of Clinical Neurosciences (R.Y.Y.T., M.T., H.S.M.), Department of Haematology (K.M., D.D., S.V.V.D., O.S., R.P.M., W.H.O., S.G., K.D.), and Division of Respiratory Medicine, Department of Medicine (S.G.), University of Cambridge; and NIHR BioResource: Rare Diseases (K.M., S.V.V.D., O.S., R.P.M., W.H.O., S.G., H.S.M.), Biomedical Campus, Cambridge, UK
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28
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Regenhardt RW, Das AS, Lo EH, Caplan LR. Advances in Understanding the Pathophysiology of Lacunar Stroke: A Review. JAMA Neurol 2019; 75:1273-1281. [PMID: 30167649 DOI: 10.1001/jamaneurol.2018.1073] [Citation(s) in RCA: 144] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Importance Stroke is the second leading cause of death in the world, and nearly one-third of ischemic strokes are lacunar strokes (LSs) or small subcortical infarcts. Although smaller in size, they create large problems, leaving many patients with intellectual and physical disabilities. Because there are limitations in understanding the underlying pathophysiology of LS, the development of novel therapies has been slow. Observations When the term lacune was described in the 1800s, its underlying pathophysiological basis was obscure. In the 1960s, C. Miller Fisher, MD, performed autopsy studies that showed that vessels supplying lacunes displayed segmental arteriolar disorganization, characterized by vessel enlargement, hemorrhage, and fibrinoid deposition. For these pathologic changes, he coined the term lipohyalinosis. Since that time, few attempts have been made to reconcile this pathologic description with modern mechanisms of cerebral small vessel disease (CSVD). During the past 6 years, progress has been made in understanding the clinical mechanisms, imaging characteristics, and genetic basis of LS. Conclusions and Relevance Questions persist regarding the order of events related to the initiation and progression of CSVD, how LS is related to other sequelae of CSVD, and whether LS is part of a systemic disease process. The relative roles of aging, oxidative stress, mechanical stress, genetic predisposition, and other vascular risk factors should be further studied, especially in the era of widespread antihypertensive use. Although understanding of endothelial dysfunction has increased, future work on the role of media and adventitial dysfunction should be explored. Recent advances in mapping the brain vasculome may generate new hypotheses. The investigation of new therapeutic targets, aimed at reversing CSVD processes and promoting neural repair after LS, depends upon further understanding these basic mechanisms.
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Affiliation(s)
- Robert W Regenhardt
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Alvin S Das
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Eng H Lo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston.,Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston
| | - Louis R Caplan
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
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29
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Giau VV, Bagyinszky E, Youn YC, An SSA, Kim SY. Genetic Factors of Cerebral Small Vessel Disease and Their Potential Clinical Outcome. Int J Mol Sci 2019; 20:ijms20174298. [PMID: 31484286 PMCID: PMC6747336 DOI: 10.3390/ijms20174298] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 08/27/2019] [Accepted: 09/01/2019] [Indexed: 12/23/2022] Open
Abstract
Cerebral small vessel diseases (SVD) have been causally correlated with ischemic strokes, leading to cognitive decline and vascular dementia. Neuroimaging and molecular genetic tests could improve diagnostic accuracy in patients with potential SVD. Several types of monogenic, hereditary cerebral SVD have been identified: cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL), cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), cathepsin A-related arteriopathy with strokes and leukoencephalopathy (CARASAL), hereditary diffuse leukoencephalopathy with spheroids (HDLS), COL4A1/2-related disorders, and Fabry disease. These disorders can be distinguished based on their genetics, pathological and imaging findings, clinical manifestation, and diagnosis. Genetic studies of sporadic cerebral SVD have demonstrated a high degree of heritability, particularly among patients with young-onset stroke. Common genetic variants in monogenic disease may contribute to pathological progress in several cerebral SVD subtypes, revealing distinct genetic mechanisms in different subtype of SVD. Hence, genetic molecular analysis should be used as the final gold standard of diagnosis. The purpose of this review was to summarize the recent discoveries made surrounding the genetics of cerebral SVD and their clinical significance, to provide new insights into the pathogenesis of cerebral SVD, and to highlight the possible convergence of disease mechanisms in monogenic and sporadic cerebral SVD.
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Affiliation(s)
- Vo Van Giau
- Department of Bionano Technology & Gachon Bionano Research Institute, Gachon University, Seongnam-si, Gyeonggi-do 461-701, Korea
| | - Eva Bagyinszky
- Department of Bionano Technology & Gachon Bionano Research Institute, Gachon University, Seongnam-si, Gyeonggi-do 461-701, Korea
| | - Young Chul Youn
- Department of Neurology, Chung-Ang University College of Medicine, Seoul 06973, Korea.
| | - Seong Soo A An
- Department of Bionano Technology & Gachon Bionano Research Institute, Gachon University, Seongnam-si, Gyeonggi-do 461-701, Korea.
| | - Sang Yun Kim
- Department of Neurology, Seoul National University College of Medicine & Neurocognitive Behavior Center, Seoul National University Bundang Hospital, Seoul 06973, Korea
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30
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Zhao YY, Duan RN, Ji L, Liu QJ, Yan CZ. Cervical Spinal Involvement in a Chinese Pedigree With Pontine Autosomal Dominant Microangiopathy and Leukoencephalopathy Caused by a 3' Untranslated Region Mutation of COL4A1 Gene. Stroke 2019; 50:2307-2313. [PMID: 31366314 DOI: 10.1161/strokeaha.119.024875] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Background and Purpose- Pontine autosomal dominant microangiopathy and leukoencephalopathy, a recently defined subtype of cerebral small vessel disease, is associated with mutations in COL4A1 (collagen type IV alpha 1 chain) 3' untranslated region. We here describe a pontine autosomal dominant microangiopathy and leukoencephalopathy pedigree with COL4A1 mutation presenting both pontine and cervical spinal cord involvement. Methods- For the diagnostic purpose, brain and spinal magnetic resonance imaging scanning, skin biopsy, and whole-exome sequencing were performed on the patients in the pedigree. Suspected pathogenic variants were further confirmed by cosegregation analysis using Sanger sequencing in the family members. Results- We identified a mutation located at the binding site of miR-29 (microRNA-29) in 3' untranslated region of COL4A1(c.*32G>A). The pontine autosomal dominant microangiopathy and leukoencephalopathy patients in this pedigree carried this variant, whereas other healthy family members but one did not. Magnetic resonance imaging showed lesions in the pons, white matter, and cervical spinal cord. Skin biopsy revealed thickened basal lamina in vessels. Conclusions- For the first time, we reported cervical spinal involvement in pontine autosomal dominant microangiopathy and leukoencephalopathy and expanded the clinical spectrum of this disease.
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Affiliation(s)
- Yu-Ying Zhao
- From the Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology (Y.-Y.Z., R.-N.D., C.-Z.Y.), Qilu Hospital, Shandong University, Jinan, China
| | - Ruo-Nan Duan
- From the Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology (Y.-Y.Z., R.-N.D., C.-Z.Y.), Qilu Hospital, Shandong University, Jinan, China.,Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Shandong University School of Basic Medical Sciences, Jinan, China (R.-N.D., Q.-J.L.)
| | - Lin Ji
- Department of Neurology, The Second Affiliated Hospital of Shandong University of TCM, Jinan, China (L.J.)
| | - Qi-Ji Liu
- Key Laboratory for Experimental Teratology of the Ministry of Education and Department of Medical Genetics, Shandong University School of Basic Medical Sciences, Jinan, China (R.-N.D., Q.-J.L.)
| | - Chuan-Zhu Yan
- From the Research Institute of Neuromuscular and Neurodegenerative Diseases and Department of Neurology (Y.-Y.Z., R.-N.D., C.-Z.Y.), Qilu Hospital, Shandong University, Jinan, China.,Brain Science Research Institute (C.-Z.Y.), Qilu Hospital, Shandong University, Jinan, China.,Mitochondrial Medicine Laboratory, Qilu Hospital (Qingdao), Shandong University, China (C.-Z.Y.)
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31
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Geister KA, Lopez-Jimenez AJ, Houghtaling S, Ho TH, Vanacore R, Beier DR. Loss of function of Colgalt1 disrupts collagen post-translational modification and causes musculoskeletal defects. Dis Model Mech 2019; 12:dmm.037176. [PMID: 31101663 PMCID: PMC6602307 DOI: 10.1242/dmm.037176] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Accepted: 05/13/2019] [Indexed: 12/11/2022] Open
Abstract
In a screen for organogenesis defects in N-ethyl-N-nitrosourea (ENU)-induced mutant mice, we discovered a line carrying a mutation in Colgalt1 [collagen beta(1-O)galactosyltransferase type 1], which is required for proper galactosylation of hydroxylysine residues in a number of collagens. Colgalt1 mutant embryos have not been previously characterized; here, we show that they exhibit skeletal and muscular defects. Analysis of mutant-derived embryonic fibroblasts reveals that COLGALT1 acts on collagen IV and VI, and, while collagen VI appears stable and its secretion is not affected, collagen IV accumulates inside of cells and within the extracellular matrix, possibly due to instability and increased degradation. We also generated mutant zebrafish that do not express the duplicated orthologs of mammalian Colgalt1. The double-homozygote mutants have muscle defects; they are viable through the larvae stage but do not survive to 10 days post-fertilization. We hypothesize that the Colgalt1 mutant could serve as a model of a human connective tissue disorder and/or congenital muscular dystrophy or myopathy. Summary: The authors characterized a novel mouse mutant that has a defect in collagen glycosylation, which appears to affect muscle development. There is very little functional characterization of the affected gene, but this study provides analysis of its embryonic phenotype and the biochemistry of the null mutant, as well as the phenotype of null-mutant zebrafish.
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Affiliation(s)
- Krista A Geister
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98105, USA.,Department of Pediatrics, Division of Genetics, University of Washington School of Medicine, Seattle, WA 98195, USA
| | - Alberto Jose Lopez-Jimenez
- Center for Matrix Biology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Scott Houghtaling
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98105, USA
| | - Tzu-Hua Ho
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98105, USA
| | - Roberto Vanacore
- Center for Matrix Biology, Vanderbilt University Medical Center, Nashville, TN 37232, USA.,Department of Medicine, Division of Nephrology, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - David R Beier
- Center for Developmental Biology and Regenerative Medicine, Seattle Children's Research Institute, Seattle, WA 98105, USA .,Department of Pediatrics, Division of Genetics, University of Washington School of Medicine, Seattle, WA 98195, USA
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32
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Chen D, Teng JM, North PE, Lapinski PE, King PD. RASA1-dependent cellular export of collagen IV controls blood and lymphatic vascular development. J Clin Invest 2019; 129:3545-3561. [PMID: 31185000 DOI: 10.1172/jci124917] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Combined germline and somatic second hit inactivating mutations of the RASA1 gene, which encodes a negative regulator of the Ras signaling pathway, cause blood and lymphatic vascular lesions in the human autosomal dominant vascular disorder capillary malformation-arteriovenous malformation (CM-AVM). How RASA1 mutations in endothelial cells (EC) result in vascular lesions in CM-AVM is unknown. Here, using different murine models of RASA1-deficiency, we found that RASA1 was essential for the survival of EC during developmental angiogenesis in which primitive vascular plexuses are remodeled into hierarchical vascular networks. RASA1 was required for EC survival during developmental angiogenesis because it was necessary for export of collagen IV from EC and deposition in vascular basement membranes. In the absence of RASA1, dysregulated Ras mitogen-activated protein kinase (MAPK) signal transduction in EC resulted in impaired folding of collagen IV and its retention in the endoplasmic reticulum (ER) leading to EC death. Remarkably, the chemical chaperone, 4-phenylbutyric acid, and small molecule inhibitors of MAPK and 2-oxoglutarate dependent collagen IV modifying enzymes rescued ER retention of collagen IV and EC apoptosis and resulted in normal developmental angiogenesis. These findings have important implications with regards an understanding of the molecular pathogenesis of CM-AVM and possible means of treatment.
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Affiliation(s)
- Di Chen
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Joyce M Teng
- Department of Dermatology, Stanford University, Stanford, California, USA
| | - Paula E North
- Department of Pathology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, Wisconsin, USA
| | - Philip E Lapinski
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Philip D King
- Department of Microbiology and Immunology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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33
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Regenhardt RW, Das AS, Ohtomo R, Lo EH, Ayata C, Gurol ME. Pathophysiology of Lacunar Stroke: History's Mysteries and Modern Interpretations. J Stroke Cerebrovasc Dis 2019; 28:2079-2097. [PMID: 31151839 DOI: 10.1016/j.jstrokecerebrovasdis.2019.05.006] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 04/13/2019] [Accepted: 05/04/2019] [Indexed: 01/13/2023] Open
Abstract
Since the term "lacune" was adopted in the 1800s to describe infarctions from cerebral small vessels, their underlying pathophysiological basis remained obscure until the 1960s when Charles Miller Fisher performed several autopsy studies of stroke patients. He observed that the vessels displayed segmental arteriolar disorganization that was associated with vessel enlargement, hemorrhage, and fibrinoid deposition. He coined the term "lipohyalinosis" to describe the microvascular mechanism that engenders small subcortical infarcts in the absence of a compelling embolic source. Since Fisher's early descriptions of lipohyalinosis and lacunar stroke (LS), there have been many advancements in the understanding of this disease process. Herein, we review lipohyalinosis as it relates to modern concepts of cerebral small vessel disease (cSVD). We discuss clinical classifications of LS as well as radiographic definitions based on modern neuroimaging techniques. We provide a broad and comprehensive overview of LS pathophysiology both at the vessel and parenchymal levels. We also comment on the role of biomarkers, the possibility of systemic disease processes, and advancements in the genetics of cSVD. Lastly, we assess preclinical models that can aid in studying LS disease pathogenesis. Enhanced understanding of this highly prevalent disease will allow for the identification of novel therapeutic targets capable of mitigating disease sequelae.
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Affiliation(s)
- Robert W Regenhardt
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alvin S Das
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ryo Ohtomo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Eng H Lo
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Cenk Ayata
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Mahmut Edip Gurol
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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34
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Dichgans M, Pulit SL, Rosand J. Stroke genetics: discovery, biology, and clinical applications. Lancet Neurol 2019; 18:587-599. [PMID: 30975520 DOI: 10.1016/s1474-4422(19)30043-2] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/21/2019] [Accepted: 01/24/2019] [Indexed: 02/07/2023]
Abstract
Stroke, a leading cause of long-term disability and death worldwide, has a heritable component. Recent gene discovery efforts have expanded the number of known single-gene disorders associated with stroke and have linked common variants at approximately 35 genetic loci to stroke risk. These discoveries have highlighted novel mechanisms and pathways implicated in stroke related to large artery atherosclerosis, cardioembolism, and small vessel disease, and defined shared genetic influences with related vascular traits. Genetics has also successfully established causal relationships with risk factors and holds promise for prioritising targets for exploration in clinical trials. Genome-wide polygenic scores enable the identification of high-risk individuals before the emergence of vascular risk factors. Challenges ahead include a better understanding of rare variants and ancestral differences for integration of genetics into precision medicine, integration with other omics data, uncovering the genetic factors that govern stroke recurrence and stroke outcome, and the conversion of genetic discoveries to novel therapies.
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Affiliation(s)
- Martin Dichgans
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Center for Neurodegenerative Diseases, Munich, Germany; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
| | - Sara L Pulit
- Department of Genetics, Centre for Molecular Medicine, University Medical Centre Utrecht, Utrecht, Netherlands; Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Oxford University, Oxford, UK; Program in Medical Population and Genetics, Broad Institute, Cambridge, MA, USA
| | - Jonathan Rosand
- Program in Medical Population and Genetics, Broad Institute, Cambridge, MA, USA; Henry and Allison McCance Center for Brain Health, and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
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35
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Li H, Xu H, Wen H, Liu T, Sun Y, Xiao N, Bai C, Ge J, Wang X, Song L, Song Y, Zhang Y, Chen J. Overexpression of LH3 reduces the incidence of hypertensive intracerebral hemorrhage in mice. J Cereb Blood Flow Metab 2019; 39:547-561. [PMID: 30516406 PMCID: PMC6421250 DOI: 10.1177/0271678x18815791] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Hypertensive intracerebral hemorrhage (ICH) is a devastating cerebrovascular disease with no effective treatment. Lysyl hydroxylase 3 (LH3) is essential for collagen IV intermolecular crosslinking and stabilization. Deficiency in LH3 affects the assembly and secretion of collagen IV and basement membrane (BM) integrity of vessels. Here, we investigated whether LH3 has significant implications for disease progression and therapeutic intervention. Spontaneous hypertensive ICH of mice was induced by angiotensin II and L-NAME treatment. The adeno-associated virus was delivered into brain by stereotactic injection to knockdown or overexpress LH3. We found LH3 levels were reduced in human patients with ICH and gradually decreased in mice before ICH. LH3 knockdown increased the incidence of hypertensive ICH in mice. The incidence, number, and size of ICHs in mice were markedly reduced by LH3 overexpression. RNA-seq revealed that LH3 overexpression significantly reversed the profound alterations in gene transcriptional profiles of cerebral vessels. LH3 overexpression was sufficient to enhance BM integrity, inhibit matrix metalloproteinase activity, attenuate microglial activation and leukocyte infiltration, and reduce VSMC apoptosis before ICH. These results indicate that LH3 overexpression attenuates susceptibility to hypertensive ICH. We emphasize that LH3 modulation may serve as a viable approach for future investigations of ICH prevention.
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Affiliation(s)
- Hao Li
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Haochen Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongyan Wen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Tianlong Liu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yingying Sun
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Ning Xiao
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Congxia Bai
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jing Ge
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xuliang Wang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Li Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yan Song
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yinhui Zhang
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jingzhou Chen
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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36
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Jones FE, Murray LS, McNeilly S, Dean A, Aman A, Lu Y, Nikolova N, Malomgré R, Horsburgh K, Holmes WM, Kadler KE, Van Agtmael T. 4-Sodium phenyl butyric acid has both efficacy and counter-indicative effects in the treatment of Col4a1 disease. Hum Mol Genet 2019; 28:628-638. [PMID: 30351356 PMCID: PMC6360271 DOI: 10.1093/hmg/ddy369] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 10/11/2018] [Indexed: 12/22/2022] Open
Abstract
Mutations in the collagen genes COL4A1 and COL4A2 cause Mendelian eye, kidney and cerebrovascular disease including intracerebral haemorrhage (ICH), and common collagen IV variants are a risk factor for sporadic ICH. COL4A1 and COL4A2 mutations cause endoplasmic reticulum (ER) stress and basement membrane (BM) defects, and recent data suggest an association of ER stress with ICH due to a COL4A2 mutation. However, the potential of ER stress as a therapeutic target for the multi-systemic COL4A1 pathologies remains unclear. We performed a preventative oral treatment of Col4a1 mutant mice with the chemical chaperone phenyl butyric acid (PBA), which reduced adult ICH. Importantly, treatment of adult mice with the established disease also reduced ICH. However, PBA treatment did not alter eye and kidney defects, establishing tissue-specific outcomes of targeting Col4a1-derived ER stress, and therefore this treatment may not be applicable for patients with eye and renal disease. While PBA treatment reduced ER stress and increased collagen IV incorporation into BMs, the persistence of defects in BM structure and reduced ability of the BM to withstand mechanical stress indicate that PBA may be counter-indicative for pathologies caused by matrix defects. These data establish that treatment for COL4A1 disease requires a multipronged treatment approach that restores both ER homeostasis and matrix defects. Alleviating ER stress is a valid therapeutic target for preventing and treating established adult ICH, but collagen IV patients will require stratification based on their clinical presentation and mechanism of their mutations.
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Affiliation(s)
- Frances E Jones
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Lydia S Murray
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Sarah McNeilly
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Afshan Dean
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Alisha Aman
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Yinhui Lu
- Wellcome Centre for Cell-Matrix Research, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Nija Nikolova
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Ruben Malomgré
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Karen Horsburgh
- Centre for Discovery Brain Sciences, Medical School, University of Edinburgh, Edinburgh, UK
| | - William M Holmes
- Institute of Neuroscience and Psychology, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Karl E Kadler
- Wellcome Centre for Cell-Matrix Research, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK
| | - Tom Van Agtmael
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
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37
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Abstract
Located at the interface of the circulation system and the CNS, the basement membrane (BM) is well positioned to regulate blood-brain barrier (BBB) integrity. Given the important roles of BBB in the development and progression of various neurological disorders, the BM has been hypothesized to contribute to the pathogenesis of these diseases. After stroke, a cerebrovascular disease caused by rupture (hemorrhagic) or occlusion (ischemic) of cerebral blood vessels, the BM undergoes constant remodeling to modulate disease progression. Although an association between BM dissolution and stroke is observed, how each individual BM component changes after stroke and how these components contribute to stroke pathogenesis are mostly unclear. In this review, I first briefly introduce the composition of the BM in the brain. Next, the functions of the BM and its major components in BBB maintenance under homeostatic conditions are summarized. Furthermore, the roles of the BM and its major components in the pathogenesis of hemorrhagic and ischemic stroke are discussed. Last, unsolved questions and potential future directions are described. This review aims to provide a comprehensive reference for future studies, stimulate the formation of new ideas, and promote the generation of new genetic tools in the field of BM/stroke research.
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Affiliation(s)
- Yao Yao
- Yao Yao, Department of Pharmaceutical and Biomedical Sciences, University of Georgia, 340 Pharmacy South Building, 250 West Green Street, Athens, GA 30602, USA.
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38
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Chen YC, Chang KH, Chen CM. Genetic Polymorphisms Associated with Spontaneous Intracerebral Hemorrhage. Int J Mol Sci 2018; 19:ijms19123879. [PMID: 30518145 PMCID: PMC6321144 DOI: 10.3390/ijms19123879] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 12/01/2018] [Accepted: 12/03/2018] [Indexed: 01/14/2023] Open
Abstract
Differences in the incidence of spontaneous intracerebral hemorrhage (ICH) between ethnicities exist, with an estimated 42% of the variance explained by ethnicity itself. Caucasians have a higher proportion of lobar ICH (LICH, 15.4% of all ICH) than do Asians (3.4%). Alterations in the causal factor exposure between countries justify part of the ethnic variance in ICH incidence. One third of ICH risk can be explained by genetic variation; therefore, genetic differences between populations can partly explain the difference in ICH incidence. In this paper, we review the current knowledge of genetic variants associated with ICH in multiple ethnicities. Candidate gene variants reportedly associated with ICH were involved in the potential pathways of hypertension, vessel wall integrity, lipid metabolism, endothelial dysfunction, inflammation, platelet function, and coagulopathy. Furthermore, variations in APOE (in multiple ethnicities), PMF1/SLC25A44 (in European), ACE (in Asian), MTHFR (in multiple ethnicities), TRHDE (in European), and COL4A2 (in European) were the most convincingly associated with ICH. The majority of the associated genes provide small contributions to ICH risk, with few of them being replicated in multiple ethnicities.
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Affiliation(s)
- Yi-Chun Chen
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, No.5, Fuxing St., Guishan Township, Taoyuan County 333, Taiwan.
| | - Kuo-Hsuan Chang
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, No.5, Fuxing St., Guishan Township, Taoyuan County 333, Taiwan.
| | - Chiung-Mei Chen
- Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang-Gung University, No.5, Fuxing St., Guishan Township, Taoyuan County 333, Taiwan.
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39
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Miyatake S, Schneeberger S, Koyama N, Yokochi K, Ohmura K, Shiina M, Mori H, Koshimizu E, Imagawa E, Uchiyama Y, Mitsuhashi S, Frith MC, Fujita A, Satoh M, Taguri M, Tomono Y, Takahashi K, Doi H, Takeuchi H, Nakashima M, Mizuguchi T, Takata A, Miyake N, Saitsu H, Tanaka F, Ogata K, Hennet T, Matsumoto N. Biallelic COLGALT1 variants are associated with cerebral small vessel disease. Ann Neurol 2018; 84:843-853. [PMID: 30412317 DOI: 10.1002/ana.25367] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 10/24/2018] [Accepted: 10/24/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Approximately 5% of cerebral small vessel diseases are hereditary, which include COL4A1/COL4A2-related disorders. COL4A1/COL4A2 encode type IV collagen α1/2 chains in the basement membranes of cerebral vessels. COL4A1/COL4A2 mutations impair the secretion of collagen to the extracellular matrix, thereby resulting in vessel fragility. The diagnostic yield for COL4A1/COL4A2 variants is around 20 to 30%, suggesting other mutated genes might be associated with this disease. This study aimed to identify novel genes that cause COL4A1/COL4A2-related disorders. METHODS Whole exome sequencing was performed in 2 families with suspected COL4A1/COL4A2-related disorders. We validated the role of COLGALT1 variants by constructing a 3-dimensional structural model, evaluating collagen β (1-O) galactosyltransferase 1 (ColGalT1) protein expression and ColGalT activity by Western blotting and collagen galactosyltransferase assays, and performing in vitro RNA interference and rescue experiments. RESULTS Exome sequencing demonstrated biallelic variants in COLGALT1 encoding ColGalT1, which was involved in the post-translational modification of type IV collagen in 2 unrelated patients: c.452 T > G (p.Leu151Arg) and c.1096delG (p.Glu366Argfs*15) in Patient 1, and c.460G > C (p.Ala154Pro) and c.1129G > C (p.Gly377Arg) in Patient 2. Three-dimensional model analysis suggested that p.Leu151Arg and p.Ala154Pro destabilized protein folding, which impaired enzymatic activity. ColGalT1 protein expression and ColGalT activity in Patient 1 were undetectable. RNA interference studies demonstrated that reduced ColGalT1 altered COL4A1 secretion, and rescue experiments showed that mutant COLGALT1 insufficiently restored COL4A1 production in cells compared with wild type. INTERPRETATION Biallelic COLGALT1 variants cause cerebral small vessel abnormalities through a common molecular pathogenesis with COL4A1/COL4A2-related disorders. Ann Neurol 2018;84:843-853.
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Affiliation(s)
- Satoko Miyatake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Clinical Genetics Department, Yokohama City University Hospital, Yokohama, Japan
| | | | - Norihisa Koyama
- Department of Pediatrics, Toyohashi Municipal Hospital, Toyohashi, Japan
| | - Kenji Yokochi
- Department of Pediatrics, Toyohashi Municipal Hospital, Toyohashi, Japan.,Department of Pediatrics, Seirei Mikatahara General Hospital, Shizuoka, Japan
| | - Kayo Ohmura
- Department of Pediatric Neurology, Morinomiya Hospital, Osaka, Japan
| | - Masaaki Shiina
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Harushi Mori
- Department of Radiology, Graduate School and Faculty of Medicine, University of Tokyo, Tokyo, Japan
| | - Eriko Koshimizu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Eri Imagawa
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yuri Uchiyama
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Satomi Mitsuhashi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Martin C Frith
- Artificial Intelligence Research Center, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan.,Graduate School of Frontier Sciences, University of Tokyo, Chiba, Japan.,Computational Bio Big-Data Open Innovation Laboratory, National Institute of Advanced Industrial Science and Technology, Tokyo, Japan
| | - Atsushi Fujita
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mai Satoh
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Masataka Taguri
- Department of Data Science, Yokohama City University School of Data Science, Yokohama, Japan
| | - Yasuko Tomono
- Division of Molecular and Cell Biology, Shigei Medical Research Institute, Okayama, Japan
| | - Keita Takahashi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hiroshi Doi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hideyuki Takeuchi
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Mitsuko Nakashima
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Biochemistry, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Takeshi Mizuguchi
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Atsushi Takata
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Noriko Miyake
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Hirotomo Saitsu
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan.,Department of Biochemistry, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Fumiaki Tanaka
- Department of Neurology and Stroke Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Kazuhiro Ogata
- Department of Biochemistry, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Thierry Hennet
- Institute of Physiology, University of Zurich, Zurich, Switzerland
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama, Japan
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40
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Ihara M, Tonomura S, Yamamoto Y, Saito S. Collagen-binding Streptococcus mutans tied to cerebral microbleeds and intracerebral hemorrhage. FUTURE NEUROLOGY 2018. [DOI: 10.2217/fnl-2018-0016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Genome-wide association and candidate gene studies have identified COL4A1 and COL4A2 as risk genes for intracerebral hemorrhage (ICH), suggesting that the disrupted collagen architecture could be a contributory factor in disease onset. Environmental factors that disrupt the vascular collagen architecture may therefore bring about gene–environmental interactions. Certain oral strains of Streptococcus mutans expressing Cnm, a collagen-binding protein, have been found to be responsible for ICH in a preclinical study. In support of this finding, a population-based study showed a close association between Cnm-positive Streptococcus mutans with cerebral microbleeds, a precursor of ICH, and a hospital-based study between such bacteria with cerebral microbleeds and ICH. Taken together, these findings suggest that Cnm-positive Streptococcus mutans serve as an important environmental factor in ICH.
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Affiliation(s)
- Masafumi Ihara
- Department of Neurology, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Shuichi Tonomura
- Department of Neurology, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Yumi Yamamoto
- Department of Regenerative Medicine & Tissue Engineering, National Cerebral & Cardiovascular Center, Osaka, Japan
| | - Satoshi Saito
- Department of Neurology, National Cerebral & Cardiovascular Center, Osaka, Japan
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41
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Hayashi G, Labelle-Dumais C, Gould DB. Use of sodium 4-phenylbutyrate to define therapeutic parameters for reducing intracerebral hemorrhage and myopathy in Col4a1 mutant mice. Dis Model Mech 2018; 11:dmm.034157. [PMID: 29895609 PMCID: PMC6078406 DOI: 10.1242/dmm.034157] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Accepted: 05/31/2018] [Indexed: 12/24/2022] Open
Abstract
Collagen type IV alpha 1 (COL4A1) and alpha 2 (COL4A2) form heterotrimers that constitute a major component of nearly all basement membranes. COL4A1 and COL4A2 mutations cause a multisystem disorder that includes variable cerebrovascular and skeletal muscle manifestations. The pathogenicity of COL4A1 and COL4A2 mutations is generally attributed to impaired secretion into basement membranes. Sodium 4-phenylbutyrate (4PBA) is a US Food and Drug Administration-approved drug that promotes mutant heterotrimer secretion in vitro and in vivo. Here, we use different 4PBA treatment paradigms to define therapeutic parameters for preventing cerebrovascular and muscular pathologies in Col4a1 mutant mice. We show the efficacy of long-term 4PBA treatment in reducing the severity of intracerebral hemorrhages (ICHs) in Col4a1 mutant mice aged up to 8 months. In addition, we demonstrate that maximal efficacy of 4PBA on ICH and myopathy was achieved when treatment was initiated prenatally, whereby even transient 4PBA administration had lasting benefits after being discontinued. Importantly, postnatal treatment with 4PBA also reduced ICH and skeletal myopathy severities in Col4a1 mutant mice, which has significant clinical implications for patients with COL4A1 and COL4A2 mutations. This article has an associated First Person interview with the first author of the paper. Summary:COL4A1 mutations cause a multisystem disorder by impairing secretion of COL4A1/A2 heterotrimers. We define parameters for reducing stroke and myopathy in Col4a1 mutant mice by pharmacologically promoting heterotrimer secretion.
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Affiliation(s)
- Genki Hayashi
- Department of Ophthalmology, Department of Anatomy, Institute for Human Genetics, University of California, San Francisco, CA 94143-0730, USA
| | - Cassandre Labelle-Dumais
- Department of Ophthalmology, Department of Anatomy, Institute for Human Genetics, University of California, San Francisco, CA 94143-0730, USA
| | - Douglas B Gould
- Department of Ophthalmology, Department of Anatomy, Institute for Human Genetics, University of California, San Francisco, CA 94143-0730, USA
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42
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Giocanti-Auregan A, Gaudric A, Buffon F, Mine M, Delahaye-Mazza C, Cohen SY, Erginay A, Chabriat H, Lasserve ET, Krivosic V. Optical Coherence Tomography Angiography of Familial Retinal Arteriolar Tortuosity. Ophthalmic Surg Lasers Imaging Retina 2018; 49:397-401. [DOI: 10.3928/23258160-20180601-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/01/2017] [Indexed: 01/03/2023]
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43
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Noumbissi ME, Galasso B, Stins MF. Brain vascular heterogeneity: implications for disease pathogenesis and design of in vitro blood-brain barrier models. Fluids Barriers CNS 2018; 15:12. [PMID: 29688865 PMCID: PMC5911972 DOI: 10.1186/s12987-018-0097-2] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 04/13/2018] [Indexed: 12/22/2022] Open
Abstract
The vertebrate blood–brain barrier (BBB) is composed of cerebral microvascular endothelial cells (CEC). The BBB acts as a semi-permeable cellular interface that tightly regulates bidirectional molecular transport between blood and the brain parenchyma in order to maintain cerebral homeostasis. The CEC phenotype is regulated by a variety of factors, including cells in its immediate environment and within functional neurovascular units. The cellular composition of the brain parenchyma surrounding the CEC varies between different brain regions; this difference is clearly visible in grey versus white matter. In this review, we discuss evidence for the existence of brain vascular heterogeneity, focusing on differences between the vessels of the grey and white matter. The region-specific differences in the vasculature of the brain are reflective of specific functions of those particular brain areas. This BBB-endothelial heterogeneity may have implications for the course of pathogenesis of cerebrovascular diseases and neurological disorders involving vascular activation and dysfunction. This heterogeneity should be taken into account when developing BBB-neuro-disease models representative of specific brain areas.
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Affiliation(s)
- Midrelle E Noumbissi
- Malaria Research Institute, Dept. Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, SPH East 4135, Baltimore, MD, 21205, USA
| | - Bianca Galasso
- Malaria Research Institute, Dept. Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, SPH East 4135, Baltimore, MD, 21205, USA
| | - Monique F Stins
- Malaria Research Institute, Dept. Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, SPH East 4135, Baltimore, MD, 21205, USA.
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44
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Fidler AL, Boudko SP, Rokas A, Hudson BG. The triple helix of collagens - an ancient protein structure that enabled animal multicellularity and tissue evolution. J Cell Sci 2018; 131:jcs203950. [PMID: 29632050 PMCID: PMC5963836 DOI: 10.1242/jcs.203950] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The cellular microenvironment, characterized by an extracellular matrix (ECM), played an essential role in the transition from unicellularity to multicellularity in animals (metazoans), and in the subsequent evolution of diverse animal tissues and organs. A major ECM component are members of the collagen superfamily -comprising 28 types in vertebrates - that exist in diverse supramolecular assemblies ranging from networks to fibrils. Each assembly is characterized by a hallmark feature, a protein structure called a triple helix. A current gap in knowledge is understanding the mechanisms of how the triple helix encodes and utilizes information in building scaffolds on the outside of cells. Type IV collagen, recently revealed as the evolutionarily most ancient member of the collagen superfamily, serves as an archetype for a fresh view of fundamental structural features of a triple helix that underlie the diversity of biological activities of collagens. In this Opinion, we argue that the triple helix is a protein structure of fundamental importance in building the extracellular matrix, which enabled animal multicellularity and tissue evolution.
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Affiliation(s)
- Aaron L Fidler
- Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Center for Matrix Biology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Sergei P Boudko
- Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Center for Matrix Biology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Antonis Rokas
- Department of Biological Sciences, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Billy G Hudson
- Department of Medicine, Division of Nephrology and Hypertension, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Center for Matrix Biology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Medical Education and Administration, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Department of Biochemistry, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
- Vanderbilt Institute of Chemical Biology, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
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45
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Gotenstein JR, Koo CC, Ho TW, Chisholm AD. Genetic Suppression of Basement Membrane Defects in Caenorhabditis elegans by Gain of Function in Extracellular Matrix and Cell-Matrix Attachment Genes. Genetics 2018; 208:1499-1512. [PMID: 29440357 PMCID: PMC5887144 DOI: 10.1534/genetics.118.300731] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 02/05/2018] [Indexed: 11/18/2022] Open
Abstract
Basement membranes are extracellular matrices essential for embryonic development in animals. Peroxidasins are extracellular peroxidases implicated in the unique sulfilimine cross-links between type IV basement membrane collagens. Loss of function in the Caenorhabditis elegans peroxidasin PXN-2 results in fully penetrant embryonic or larval lethality. Using genetic suppressor screening, we find that the requirement for PXN-2 in development can be bypassed by gain of function in multiple genes encoding other basement membrane components, or proteins implicated in cell-matrix attachment. We identify multiple alleles of let-805, encoding the transmembrane protein myotactin, which suppress phenotypes of pxn-2 null mutants and of other basement membrane mutants such as F-spondin/spon-1 These let-805 suppressor alleles cause missense alterations in two pairs of FNIII repeats in the extracellular domain; they act dominantly and have no detectable phenotypes alone, suggesting they cause gain of function. We also identify suppressor missense mutations affecting basement membrane components type IV collagen (emb-9, let-2) and perlecan (unc-52), as well as a mutation affecting spectraplakin (vab-10), a component of the epidermal cytoskeleton. These suppressor alleles do not bypass the developmental requirement for core structural proteins of the basement membrane such as laminin or type IV collagen. In conclusion, putative gain-of-function alterations in matrix proteins or in cell-matrix receptors can overcome the requirement for certain basement membrane proteins in embryonic development, revealing previously unknown plasticity in the genetic requirements for the extracellular matrix.
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Affiliation(s)
- Jennifer R Gotenstein
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, California 92093
| | - Cassidy C Koo
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, California 92093
| | - Tiffany W Ho
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, California 92093
| | - Andrew D Chisholm
- Section of Cell and Developmental Biology, Division of Biological Sciences, University of California, San Diego, La Jolla, California 92093
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46
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Xia C, Lin S, Yang J, He S, Li H, Liu M, You C. Genetic Variations of COL4A1 Gene and Intracerebral Hemorrhage Outcome: A Cohort Study in a Chinese Han Population. World Neurosurg 2018; 113:e521-e528. [PMID: 29477007 DOI: 10.1016/j.wneu.2018.02.074] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Revised: 02/10/2018] [Accepted: 02/12/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the relationship between single nucleotide polymorphisms or haplotypes of COL4A1 gene and the outcome of intracerebral hemorrhage (ICH). METHODS In our study, 181 patients with hypertensive ICH were enrolled and followed up at 3 and 6 months. Outcome data included any cause of death and disability. Genomic DNA was extracted by DNA extraction kit, and the 6 single nucleotide polymorphism genotyping of the COL4A1 gene was detected through MassARRAY Analyzer. Unphased 3.1.4 and SPSS 19.0 were used to analyze the association between alleles, genotypes, and haplotypes of the COL4A1 gene and the outcomes of ICH. RESULTS Of the 181 patients with hypertensive ICH, 12 were lost in follow-up, which accounted for 6.6%. Our association analysis showed that the rs532625 AA genotype of the COL4A1 gene may increase risk of disability at 3 months; the rs532625 A allele and AA genotype were association factors of the risk of disability at 6 months; the rs532625 AA genotype was an association factor of the risk of death/disability at 6 months. After adjusting for gender, age, coma, and severe neurologic deficits, only the rs532625 AA genotype was independently associated with the risk of disability at 3 and 6 months and the risk of death/disability at 6 months. CONCLUSIONS Our study found that the rs532625 AA genotype in the COL4A1 gene was independently associated with the risk of disability at 3 and 6 months and death/disability at 6 months in a Chinese Han population. These conclusions need to be verified in future studies with larger samples.
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Affiliation(s)
- Chao Xia
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Sen Lin
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jie Yang
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Sha He
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hao Li
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ming Liu
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Chao You
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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47
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Lin S, Xia C, He S, Yang J, Li H, Zheng J, Liu M, You C. Genetic Variations of the COL4A1 Gene and Intracerebral Hemorrhage Risk: A Case-Control Study in a Chinese Han Population. World Neurosurg 2018; 112:e527-e533. [PMID: 29360590 DOI: 10.1016/j.wneu.2018.01.072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 01/08/2018] [Accepted: 01/11/2018] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To investigate the association between single nucleotide polymorphisms or haplotypes of the COL4A1 gene and the risk of intracerebral hemorrhage (ICH). METHODS We conducted a case-control study that included 181 patients from the Chinese Han population with hypertensive ICH and 197 hypertension patients without ICH. Genomic DNA was extracted by DNA extraction kit, and the 6 single nucleotide polymorphism genotypes of the COL4A1 gene were detected with a MassARRAY Analyzer. Unphased 3.1.4 and SPSS 19.0 were used to analyze the association between alleles, genotypes, and haplotypes of the COL4A1 gene and the risk of ICH. RESULTS Compared with the control group, patients in the ICH group were significantly younger. There were no differences in gender, diabetes, hyperlipidemia, current smoking, and alcohol consumption between the 2 groups. Our association analysis showed that the rs3742207 A, rs11069830 A, and rs679505 A alleles were association factors of the risks of ICH; rs11069830 AA, rs544012 AC, and rs679505 AA genotypes were association factors of the risk of ICH; AA haplotype (rs3742207-rs11069830) was an association factor of the risk of ICH. After adjusting age and gender by multivariate logistic regression, the rs544012 AC and rs679505 AA genotypes were independently associated with the risk of ICH. CONCLUSIONS Our study showed that the rs544012 AC and rs679505 AA genotypes were independently associated with the risk of ICH in the Chinese Han population and that the AA haplotype (rs3742207-rs11069830) in the COL4A1 gene may be related to the risk of ICH in the Chinese Han population; these conclusions need further confirmation in future studies with larger samples.
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Affiliation(s)
- Sen Lin
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Chao Xia
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Sha He
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jie Yang
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Hao Li
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jun Zheng
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Ming Liu
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Stroke Clinical Research Unit, Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
| | - Chao You
- Center of Cerebrovascular Diseases, Sichuan University, Chengdu, Sichuan, China; Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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48
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Falcone GJ, Woo D. Genetics of Spontaneous Intracerebral Hemorrhage. Stroke 2017; 48:3420-3424. [PMID: 29114093 PMCID: PMC5777521 DOI: 10.1161/strokeaha.117.017072] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 09/22/2017] [Accepted: 09/28/2017] [Indexed: 12/23/2022]
Affiliation(s)
- Guido J Falcone
- From the Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT (G.J.F.); and Department of Neurology and Rehabilitation Medicine (D.W.) and Comprehensive Stroke Center (D.W.), University of Cincinnati, OH.
| | - Daniel Woo
- From the Division of Neurocritical Care and Emergency Neurology, Department of Neurology, Yale School of Medicine, New Haven, CT (G.J.F.); and Department of Neurology and Rehabilitation Medicine (D.W.) and Comprehensive Stroke Center (D.W.), University of Cincinnati, OH.
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49
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Abstract
Understanding the genetic risk factors for stroke is an essential step to decipher the underlying mechanisms, facilitate the identification of novel therapeutic targets, and optimize the design of prevention strategies. A very small proportion of strokes are attributable to monogenic conditions, the vast majority being multifactorial, with multiple genetic and environmental risk factors of small effect size. Genome-wide association studies and large international consortia have been instrumental in finding genetic risk factors for stroke. While initial studies identified risk loci for specific stroke subtypes, more recent studies also revealed loci associated with all stroke and all ischemic stroke. Risk loci for ischemic stroke and its subtypes have been implicated in atrial fibrillation (PITX2 and ZFHX3), coronary artery disease (ABO, chr9p21, HDAC9, and ALDH2), blood pressure (ALDH2 and HDAC9), pericyte and smooth muscle cell development (FOXF2), coagulation (HABP2), carotid plaque formation (MMP12), and neuro-inflammation (TSPAN2). For hemorrhagic stroke, two loci (APOE and PMF1) have been identified.
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Affiliation(s)
- Ganesh Chauhan
- Inserm U1219 Bordeaux Population Health Research Center, 146, rue Léo Saignat, 33000, Bordeaux, France.,University of Bordeaux, Bordeaux, France.,Centre for Brain Research, Indian Institute of Science, Bangalore, India
| | - Stéphanie Debette
- Inserm U1219 Bordeaux Population Health Research Center, 146, rue Léo Saignat, 33000, Bordeaux, France. .,University of Bordeaux, Bordeaux, France. .,Department of Neurology, Bordeaux University Hospital, Bordeaux, France.
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50
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Staffaroni AM, Elahi FM, McDermott D, Marton K, Karageorgiou E, Sacco S, Paoletti M, Caverzasi E, Hess CP, Rosen HJ, Geschwind MD. Neuroimaging in Dementia. Semin Neurol 2017; 37:510-537. [PMID: 29207412 PMCID: PMC5823524 DOI: 10.1055/s-0037-1608808] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Although the diagnosis of dementia still is primarily based on clinical criteria, neuroimaging is playing an increasingly important role. This is in large part due to advances in techniques that can assist with discriminating between different syndromes. Magnetic resonance imaging remains at the core of differential diagnosis, with specific patterns of cortical and subcortical changes having diagnostic significance. Recent developments in molecular PET imaging techniques have opened the door for not only antemortem but early, even preclinical, diagnosis of underlying pathology. This is vital, as treatment trials are underway for pharmacological agents with specific molecular targets, and numerous failed trials suggest that earlier treatment is needed. This article provides an overview of classic neuroimaging findings as well as new and cutting-edge research techniques that assist with clinical diagnosis of a range of dementia syndromes, with an emphasis on studies using pathologically proven cases.
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Affiliation(s)
- Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Fanny M. Elahi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Dana McDermott
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Kacey Marton
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Elissaios Karageorgiou
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
- Neurological Institute of Athens, Athens, Greece
| | - Simone Sacco
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
- Institute of Radiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Matteo Paoletti
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
- Institute of Radiology, Department of Clinical Surgical Diagnostic and Pediatric Sciences, University of Pavia, Pavia, Italy
| | - Eduardo Caverzasi
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Christopher P. Hess
- Division of Neuroradiology, Department of Radiology, University of California, San Francisco (UCSF), California
| | - Howard J. Rosen
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
| | - Michael D. Geschwind
- Department of Neurology, Memory and Aging Center, University of California, San Francisco (UCSF), San Francisco, California
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