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The Genetic Architecture of Vascular Anomalies: Current Data and Future Therapeutic Perspectives Correlated with Molecular Mechanisms. Int J Mol Sci 2022; 23:ijms232012199. [PMID: 36293054 PMCID: PMC9603778 DOI: 10.3390/ijms232012199] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Revised: 10/11/2022] [Accepted: 10/11/2022] [Indexed: 11/17/2022] Open
Abstract
Vascular anomalies (VAs) are morphogenesis defects of the vascular system (arteries, capillaries, veins, lymphatic vessels) singularly or in complex combinations, sometimes with a severe impact on the quality of life. The progress made in recent years with the identification of the key molecular pathways (PI3K/AKT/mTOR and RAS/BRAF/MAPK/ERK) and the gene mutations that lead to the appearance of VAs has allowed the deciphering of their complex genetic architecture. Understanding these mechanisms is critical both for the correct definition of the phenotype and classification of VAs, as well as for the initiation of an optimal therapy and the development of new targeted therapies. The purpose of this review is to present in synthesis the current data related to the genetic factors involved in the etiology of VAs, as well as the possible directions for future research. We analyzed the data from the literature related to VAs, using databases (Google Scholar, PubMed, MEDLINE, OMIM, MedGen, Orphanet) and ClinicalTrials.gov. The obtained results revealed that the phenotypic variability of VAs is correlated with genetic heterogeneity. The identification of new genetic factors and the molecular mechanisms in which they intervene, will allow the development of modern therapies that act targeted as a personalized therapy. We emphasize the importance of the geneticist in the diagnosis and treatment of VAs, as part of a multidisciplinary team involved in the management of VAs.
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Castillo-Rangel C, Marín G, Hernandez-Contreras KA, Zarate-Calderon C, Vichi-Ramirez MM, Cortez-Saldias W, Rodriguez-Florido MA, Riley-Moguel ÁE, Pichardo O, Torres-Pineda O, Vega-Quesada HG, Lopez-Elizalde R, Ordoñez-Granja J, Alvarado-Martinez HH, Vega-Quesada LA, Aranda-Abreu GE. Atlas of Nervous System Vascular Malformations: A Systematic Review. LIFE (BASEL, SWITZERLAND) 2022; 12:life12081199. [PMID: 36013378 PMCID: PMC9410064 DOI: 10.3390/life12081199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/27/2022] [Accepted: 08/04/2022] [Indexed: 11/24/2022]
Abstract
Vascular malformations are frequent in the head and neck region, affecting the nervous system. The wide range of therapeutic approaches demand the correct anatomical, morphological, and functional characterization of these lesions supported by imaging. Using a systematic search protocol in PubMed, Google Scholar, Ebsco, Redalyc, and SciELO, the authors extracted clinical studies, review articles, book chapters, and case reports that provided information about vascular cerebral malformations, in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 385,614 articles were grouped; using the inclusion and exclusion criteria, three of the authors independently selected 51 articles about five vascular cerebral malformations: venous malformation, brain capillary telangiectasia, brain cavernous angiomas, arteriovenous malformation, and leptomeningeal angiomatosis as part of Sturge–Weber syndrome. We described the next topics—“definition”, “etiology”, “pathophysiology”, and “treatment”—with a focus on the relationship with the imaging approach. We concluded that the correct anatomical, morphological, and functional characterization of cerebral vascular malformations by means of various imaging studies is highly relevant in determining the therapeutic approach, and that new lines of therapeutic approaches continue to depend on the imaging evaluation of these lesions.
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Affiliation(s)
- Carlos Castillo-Rangel
- Department of Neurosurgery, “Hospital Regional 1º de Octubre”, Institute of Social Security and Services for State Workers (ISSSTE), Mexico City 07300, Mexico
| | - Gerardo Marín
- Biophysics Department, Brain Research Institute, Xalapa 91192, Mexico
- Correspondence: ; Tel.: +52-296-102-5707
| | | | | | | | - Wilmar Cortez-Saldias
- Department of Neurosurgery, “Hospital Regional 1º de Octubre”, Institute of Social Security and Services for State Workers (ISSSTE), Mexico City 07300, Mexico
| | - Marco Antonio Rodriguez-Florido
- National Center of Medicine, “Siglo XXI: Dr. Bernardo Sepúlveda Gutiérrez”, Mexican Social Security Institute (IMSS), Mexico City 07300, Mexico
| | - Ámbar Elizabeth Riley-Moguel
- Department of Neurosurgery, “Hospital Regional 1º de Octubre”, Institute of Social Security and Services for State Workers (ISSSTE), Mexico City 07300, Mexico
| | - Omar Pichardo
- Department of Neurosurgery, “Hospital Regional 1º de Octubre”, Institute of Social Security and Services for State Workers (ISSSTE), Mexico City 07300, Mexico
| | | | - Helena G. Vega-Quesada
- Department of Internal Medicine, General Hospital of Zone No. 71 “Lic. Benito Coquet Lagunes”, Veracruz 91700, Mexico
| | - Ramiro Lopez-Elizalde
- Department of Neurosurgery, “Hospital Regional 1º de Octubre”, Institute of Social Security and Services for State Workers (ISSSTE), Mexico City 07300, Mexico
| | - Jaime Ordoñez-Granja
- Department of Neurosurgery, “Hospital Regional 1º de Octubre”, Institute of Social Security and Services for State Workers (ISSSTE), Mexico City 07300, Mexico
| | | | - Luis Andrés Vega-Quesada
- Department of Cardiology, Cardiology Hospital of Zone No. 34, Mexican Institute of Social Security (IMSS), Ciudad de México 06600, Mexico
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Lee JS, Chung HY. Classification, diagnosis, and treatment of vascular malformations. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2021. [DOI: 10.5124/jkma.2021.64.9.614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: In the 1980s, vascular anomalies were divided into two major subgroups—vascular tumors and vascular malformations—based on the functional framework. This concept has been fundamental to the management of vascular anomalies and expanded and refined by the International Society for the Study of Vascular Anomalies. Vascular malformations are further sub-divided into several types; however, there are many cases with insufficient information about the disease.Current Concepts: Several instances have shown that the diagnosis of vascular malformations can be achieved after a careful evaluation of patient history and examination. However, recently developed imaging technology has been of great help in the diagnosis. Doppler ultrasonography, magnetic resonance imaging, computed tomography scan, and angiography are valuable tools for diagnostic and therapeutic planning. Advanced diagnostic and therapeutic technologies have also provided more accurate and safer diagnoses and appropriate treatment. Recently, an improved method of managing vascular malformations has emerged, based on a multidisciplinary approach, which is very useful for increasing the treatment efficacy. The development of gene research has enabled the investigation of disease-related genes and the development of new medications.Discussion and Conclusion: Accurate diagnosis of vascular malformations is one of the most crucial factors in determining treatment plan and prognosis, based on which it would be possible to achieve effective results through appropriate management and a multidisciplinary team approach.
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