Tracheal cartilaginous sleeve in patients with Beare-Stevenson syndrome

New developments in the biology of fibroblast growth factors

The fibroblast growth factor (FGF) family is composed of 18 secreted signaling proteins consisting of canonical FGFs and endocrine FGFs that activate four receptor tyrosine kinases (FGFRs 1-4) and four intracellular proteins (intracellular FGFs or iFGFs) that primarily function to regulate the activity of voltage-gated sodium channels and other molecules. The canonical FGFs, endocrine FGFs, and iFGFs have been reviewed extensively by us and others. In this review, we briefly summarize past reviews and then focus on new developments in the FGF field since our last review in 2015. Some of the highlights in the past 6 years include the use of optogenetic tools, viral vectors, and inducible transgenes to experimentally modulate FGF signaling, the clinical use of small molecule FGFR inhibitors, an expanded understanding of endocrine FGF signaling, functions for FGF signaling in stem cell pluripotency and differentiation, roles for FGF signaling in tissue homeostasis and regeneration, a continuing elaboration of mechanisms of FGF signaling in development, and an expanding appreciation of roles for FGF signaling in neuropsychiatric diseases. This article is categorized under: Cardiovascular Diseases > Molecular and Cellular Physiology Neurological Diseases > Molecular and Cellular Physiology Congenital Diseases > Stem Cells and Development Cancer > Stem Cells and Development.

Genotype-Phenotype Correlation of Tracheal Cartilaginous Sleeves and Fgfr2 Mutations in Mice

OBJECTIVES

To characterize tracheal cartilage morphology in mouse models of fibroblast growth factor receptor (Fgfr2)-related craniosynostosis syndromes. To establish relationships between specific Fgfr2 mutations and tracheal cartilaginous sleeve (TCS) phenotypes in these mouse models.

METHODS

Postnatal day 0 knock-in mouse lines with disease-specific genetic variations in the Fgfr2 gene (Fgfr2^C342Y/C342Y , Fgfr2^C342Y/+ , Fgfr2^+/Y394C , Fgfr2^+/S252W , and Fgfr2^+/P253R ) as well as line-specific controls were utilized. Tracheal cartilage morphology as measured by gross analyses, microcomputed tomography (μCT), and histopathology were compared using Chi-squared and single-factor analysis of variance statistical tests.

RESULTS

A greater proportion of rings per trachea were abnormal in Fgfr2^C342Y/+ tracheas (63%) than Fgfr2^+/S252W (17%), Fgfr2^+/P253R (17%), Fgfr2^+/Y394C (12%), and controls (10%) (P < .001 for each vs. Fgfr2^C342Y/+ ). TCS segments were found only in Fgfr2^C342Y/C342Y (100%) and Fgfr2^C342Y/+ (72%) tracheas. Cricoid and first-tracheal ring fusion was noted in all Fgfr2^C342Y/C342Y and 94% of Fgfr2^C342Y/+ samples. The Fgfr2^C342Y/C342Y and Fgfr2^C342Y/+ groups were found to have greater areas and volumes of cartilage than other lines on gross analysis and μCT. Histologic analyses confirmed TCS among the Fgfr2^C342Y/C342Y and Fgfr2^C342Y/+ groups, without appreciable differences in cartilage morphology, cell size, or density; no histologic differences were observed among other Fgfr2 lines compared to controls.

CONCLUSION

This study found TCS phenotypes only in the Fgfr2^C342Y mouse lines. These lines also had increased tracheal cartilage compared to other mutant lines and controls. These data support further study of the Fgfr2 mouse lines and the investigation of other Fgfr2 variants to better understand their role in tracheal development and TCS formation.

LEVEL OF EVIDENCE

NA Laryngoscope, 131:E1349-E1356, 2021.