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Nakamura T, Colbert M, Krenz M, Molkentin JD, Hahn HS, Dorn GW, Robbins J. Mediating ERK 1/2 signaling rescues congenital heart defects in a mouse model of Noonan syndrome. J Clin Invest 2007; 117:2123-32. [PMID: 17641779 PMCID: PMC1913487 DOI: 10.1172/jci30756] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2006] [Accepted: 05/08/2007] [Indexed: 01/20/2023] Open
Abstract
Noonan syndrome (NS) is an autosomal dominant disorder characterized by a wide spectrum of defects, which most frequently include proportionate short stature, craniofacial anomalies, and congenital heart disease (CHD). NS is the most common nonchromosomal cause of CHD, and 80%-90% of NS patients have cardiac involvement. Mutations within the protein tyrosine phosphatase Src homology region 2, phosphatase 2 (SHP2) are responsible for approximately 50% of the cases of NS with cardiac involvement. To understand the developmental stage- and cell type-specific consequences of the NS SHP2 gain-of-function mutation, Q79R, we generated transgenic mice in which the mutated protein was expressed during gestation or following birth in cardiomyocytes. Q79R SHP2 embryonic hearts showed altered cardiomyocyte cell cycling, ventricular noncompaction, and ventricular septal defects, while, in the postnatal cardiomyocyte, Q79R SHP2 expression was completely benign. Fetal expression of Q79R led to the specific activation of the ERK1/2 pathway, and breeding of the Q79R transgenics into ERK1/2-null backgrounds confirmed the pathway's necessity and sufficiency in mediating mutant SHP2's effects. Our data establish the developmental stage-specific effects of Q79R cardiac expression in NS; show that ablation of subsequent ERK1/2 activation prevents the development of cardiac abnormalities; and suggest that ERK1/2 modulation could have important implications for developing therapeutic strategies in CHD.
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MESH Headings
- Amino Acid Substitution
- Animals
- Chromosome Disorders/embryology
- Chromosome Disorders/enzymology
- Chromosome Disorders/genetics
- Chromosome Disorders/pathology
- Chromosome Disorders/therapy
- Disease Models, Animal
- Gene Expression Regulation, Developmental/genetics
- Gene Expression Regulation, Enzymologic/genetics
- Heart Septal Defects, Ventricular/embryology
- Heart Septal Defects, Ventricular/enzymology
- Heart Septal Defects, Ventricular/genetics
- Heart Septal Defects, Ventricular/pathology
- Heart Septal Defects, Ventricular/prevention & control
- Heart Ventricles/embryology
- Heart Ventricles/enzymology
- Heart Ventricles/pathology
- Humans
- Intracellular Signaling Peptides and Proteins/genetics
- MAP Kinase Signaling System/genetics
- Mice
- Mice, Transgenic
- Mitogen-Activated Protein Kinase 1/genetics
- Mitogen-Activated Protein Kinase 1/metabolism
- Mitogen-Activated Protein Kinase 3/genetics
- Mitogen-Activated Protein Kinase 3/metabolism
- Mutation, Missense
- Myocytes, Cardiac/enzymology
- Myocytes, Cardiac/pathology
- Noonan Syndrome/embryology
- Noonan Syndrome/enzymology
- Noonan Syndrome/genetics
- Noonan Syndrome/pathology
- Noonan Syndrome/therapy
- Protein Phosphatase 2
- Protein Tyrosine Phosphatase, Non-Receptor Type 11
- Protein Tyrosine Phosphatases/biosynthesis
- Protein Tyrosine Phosphatases/genetics
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Affiliation(s)
- Tomoki Nakamura
- Cincinnati Children’s Hospital Medical Center, The Children’s Hospital Research Foundation, Division of Molecular Cardiovascular Biology, Cincinnati, Ohio, USA.
Department of Internal Medicine and Department of Cardiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Melissa Colbert
- Cincinnati Children’s Hospital Medical Center, The Children’s Hospital Research Foundation, Division of Molecular Cardiovascular Biology, Cincinnati, Ohio, USA.
Department of Internal Medicine and Department of Cardiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Maike Krenz
- Cincinnati Children’s Hospital Medical Center, The Children’s Hospital Research Foundation, Division of Molecular Cardiovascular Biology, Cincinnati, Ohio, USA.
Department of Internal Medicine and Department of Cardiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Jeffery D. Molkentin
- Cincinnati Children’s Hospital Medical Center, The Children’s Hospital Research Foundation, Division of Molecular Cardiovascular Biology, Cincinnati, Ohio, USA.
Department of Internal Medicine and Department of Cardiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Harvey S. Hahn
- Cincinnati Children’s Hospital Medical Center, The Children’s Hospital Research Foundation, Division of Molecular Cardiovascular Biology, Cincinnati, Ohio, USA.
Department of Internal Medicine and Department of Cardiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Gerald W. Dorn
- Cincinnati Children’s Hospital Medical Center, The Children’s Hospital Research Foundation, Division of Molecular Cardiovascular Biology, Cincinnati, Ohio, USA.
Department of Internal Medicine and Department of Cardiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
| | - Jeffrey Robbins
- Cincinnati Children’s Hospital Medical Center, The Children’s Hospital Research Foundation, Division of Molecular Cardiovascular Biology, Cincinnati, Ohio, USA.
Department of Internal Medicine and Department of Cardiology, University of Cincinnati Medical Center, Cincinnati, Ohio, USA
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Piéchaud JF. Hypoxemia related to right-to-left shunting through a patent foramen ovale: successful percutaneous treatment with the CardioSeal device. J Interv Cardiol 2001; 14:57-60. [PMID: 12053328 DOI: 10.1111/j.1540-8183.2001.tb00712.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Hypoxemia related to right-to-left shunting through a patent foramen ovale (PFO) is not rare. It can be observed in correlation with a specific situation such as pneumonectomy and can occur even with normal pulmonary pressure. This article reports the experience of 12 patients in which a transcatheter closure with the CardioSeal device was done successfully. Clinical improvement is often obtained, despite incomplete occlusion of the defects. The author demonstrated that transcatheter closure of PFO can be performed safety and should be considered as an efficient alternative to surgery in cyanotic patients with PFO.
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Affiliation(s)
- J F Piéchaud
- Institut Cardiovasculaire Paris Sud, Massy, France.
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Wilmshurst PT, Katritsis D. Restrictive and hypertrophic cardiomyopathies in Noonan syndrome: the overlap syndromes. HEART (BRITISH CARDIAC SOCIETY) 1996; 75:94-7. [PMID: 8624883 PMCID: PMC484232 DOI: 10.1136/hrt.75.1.94] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
A woman with Noonan syndrome had clinical and haemodynamic features of restrictive cardiomyopathy. There was no ventricular hypertrophy on echocardiography but myocardial biopsies showed myocyte hypertrophy without pathological disarray. This case illustrates the overlap of the cardiac phenotypes of Noonan syndrome, restrictive cardiomyopathy, and hypertrophic cardiomyopathy.
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Affiliation(s)
- P T Wilmshurst
- Department of Cardiology, Onassis Cardiac Surgery Centre, Athens, Greece
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