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Rypdal KB, Apte SS, Lunde IG. Emerging roles for the ADAMTS-like family of matricellular proteins in cardiovascular disease through regulation of the extracellular microenvironment. Mol Biol Rep 2024; 51:280. [PMID: 38324186 PMCID: PMC10850197 DOI: 10.1007/s11033-024-09255-5] [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: 12/05/2023] [Accepted: 01/12/2024] [Indexed: 02/08/2024]
Abstract
Dysregulation of the extracellular matrix (ECM) occurs widely across cardiovascular pathologies. Recent work has revealed important roles for the «a disintegrin-like and metalloprotease domain with thrombospondin-type 1 motifs like" (ADAMTSL) family of secreted glycoproteins in cardiovascular tissues during development and disease. Key insights in this regard have come from naturally occurring gene mutations in humans and animals that result in severe diseases with cardiovascular manifestations or aortopathies. Expression of ADAMTSL genes is greatly increased in the myocardium during heart failure. Genetically modified mice recapitulate phenotypes of patients with ADAMTSL mutations and demonstrate important functions in the ECM. The novel functions thus disclosed are intriguing because, while these proteins are neither structural, nor proteases like the related ADAMTS proteases, they appear to act as regulatory, i.e., matricellular proteins. Evidence from genetic variants, genetically engineered mouse mutants, and in vitro investigations have revealed regulatory functions of ADAMTSLs related to fibrillin microfibrils and growth factor signaling. Interestingly, the ability to regulate transforming growth factor (TGF)β signaling may be a shared characteristic of some ADAMTSLs. TGFβ signaling is important in cardiovascular development, health and disease and a central driver of ECM remodeling and cardiac fibrosis. New strategies to target dysregulated TGFβ signaling are warranted in aortopathies and cardiac fibrosis. With their emerging roles in cardiovascular tissues, the ADAMTSL proteins may provide causative genes, diagnostic biomarkers and novel treatment targets in cardiovascular disease. Here, we discuss the relevance of ADAMTSLs to cardiovascular medicine.
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Affiliation(s)
- Karoline Bjarnesdatter Rypdal
- KG Jebsen Center for Cardiac Biomarkers, Institute for Clinical Medicine, University of Oslo, Oslo, Norway.
- Oslo Center for Clinical Heart Research, Department of Cardiology Ullevaal, Oslo University Hospital, Oslo, Norway.
| | - Suneel S Apte
- Department of Biomedical Engineering, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA
| | - Ida G Lunde
- KG Jebsen Center for Cardiac Biomarkers, Institute for Clinical Medicine, University of Oslo, Oslo, Norway
- Oslo Center for Clinical Heart Research, Department of Cardiology Ullevaal, Oslo University Hospital, Oslo, Norway
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2
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Kumar M, Patel K, Chinnapparaj S, Sharma T, Aggarwal A, Singla N, Karthigeyan M, Singh A, Sahoo SK, Tripathi M, Takkar A, Gupta T, Pal A, Attri SV, Bansal YS, Ratho RK, Gupta SK, Khullar M, Vashishta RK, Mukherjee KK, Grover VK, Prasad R, Chatterjee A, Gowda H, Bhagat H. Dysregulated Genes and Signaling Pathways in the Formation and Rupture of Intracranial Aneurysm. Transl Stroke Res 2023:10.1007/s12975-023-01178-w. [PMID: 37644376 DOI: 10.1007/s12975-023-01178-w] [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: 09/19/2022] [Revised: 03/21/2023] [Accepted: 07/10/2023] [Indexed: 08/31/2023]
Abstract
Intracranial aneurysm (IA) has the potential to rupture. Despite scientific advances, we are still not in a position to screen patients for IA and identify those at risk of rupture. It is critical to comprehend the molecular basis of disease to facilitate the development of novel diagnostic strategies. We used transcriptomics to identify the dysregulated genes and understand their role in the disease biology. In particular, RNA-Seq was performed in tissue samples of controls, unruptured IA, and ruptured IA. Dysregulated genes (DGs) were identified and analyzed to understand the functional aspects of molecules. Subsequently, candidate genes were validated at both transcript and protein level. There were 314 DGs in patients with unruptured IA when compared to control samples. Out of these, SPARC and OSM were validated as candidate molecules in unruptured IA. PI3K-AKT signaling pathway was found to be an important pathway for the formation of IA. Similarly, 301 DGs were identified in the samples of ruptured IA when compared with unruptured IAs. CTSL was found to be a key candidate molecule which along with Hippo signaling pathway may be involved in the rupture of IA. We conclude that activation of PI3K-AKT signaling pathway by OSM along with up-regulation of SPARC is important for the formation of IA. Further, regulation of Hippo pathway through PI3K-AKT signaling results in the down-regulation of YAP1 gene. This along with up-regulation of CTSL leads to further weakening of aneurysm wall and its subsequent rupture.
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Affiliation(s)
- Munish Kumar
- Division of Neuro-anesthesia, Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Krishna Patel
- Institute of Bioinformatics, International Tech Park, Bangalore, India
| | - Shobia Chinnapparaj
- Division of Neuro-anesthesia, Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tanavi Sharma
- Division of Neuro-anesthesia, Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Aggarwal
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Navneet Singla
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhivanan Karthigeyan
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Apinderpreet Singh
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sushanta Kumar Sahoo
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manjul Tripathi
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aastha Takkar
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Tulika Gupta
- Department of Anatomy, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Arnab Pal
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Savita Verma Attri
- Pediatric Biochemistry, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Yogender Singh Bansal
- Department of Forensic Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Radha Kanta Ratho
- Department of Virology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sunil K Gupta
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Madhu Khullar
- Department of Experimental Medicine and Biotechnology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rakesh Kumar Vashishta
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kanchan Kumar Mukherjee
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vinod Kumar Grover
- Division of Neuro-anesthesia, Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rajendra Prasad
- Department of Biochemistry, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Aditi Chatterjee
- Institute of Bioinformatics, International Tech Park, Bangalore, India
| | - Harsha Gowda
- Institute of Bioinformatics, International Tech Park, Bangalore, India
| | - Hemant Bhagat
- Division of Neuro-anesthesia, Department of Anesthesia and Intensive Care, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
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3
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Sun Y, Cheng Z, Guo Z, Dai G, Li Y, Chen Y, Xie R, Wang X, Cui M, Lu G, Wang A, Gao C. Preliminary Study of Genome-Wide Association Identified Novel Susceptibility Genes for Hemorheological Indexes in a Chinese Population. Transfus Med Hemother 2022; 49:346-357. [PMID: 36654975 PMCID: PMC9768296 DOI: 10.1159/000524849] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 05/01/2022] [Indexed: 01/21/2023] Open
Abstract
Background Genome-wide association studies for various hemorheological characteristics have not been reported. We aimed to identify genetic loci associated with hemorheological indexes in a cohort of healthy Chinese Han individuals. Methods Genotyping was performed using Applied Biosystems Axiom™ Precision Medicine Diversity Array in 838 individuals, and 6,423,076 single nucleotide polymorphisms were available for genotyping. The relations were examined in an additive genetic model using mixed linear regression and combined with identical by descent matrix. Results We identified 38 genetic loci (p < 5 × 10-6) related to hemorheological traits. In which, LOC102724502-OLIG2 rs28371438 was related to the levels of nd30 (p = 8.58 × 10-07), nd300 (p = 1.89 × 10-06), erythrocyte rigidity (p = 1.29 × 10-06), assigned viscosity (p = 6.20 × 10-08) and whole blood high cut relative (p = 7.30 × 10-08). The association of STK32B rs4689231 for nd30 (p = 3.85 × 10-06) and nd300 (p = 2.94 × 10-06) and GTSCR1-LINC01541 rs11661911 for erythrocyte rigidity (p = 9.93 × 10-09) and whole blood high cut relative (p = 2.09 × 10-07) was found. USP25-MIR99AHG rs1297329 was associated with erythrocyte rigidity (p = 1.81 × 10-06) and erythrocyte deformation (p = 1.14 × 10-06). Moreover, the association of TMEM232-SLC25A46 rs3985087 and LINC00470-METTL4 rs9966987 for fibrinogen (p = 1.31 × 10-06 and p = 4.29 × 10-07) and plasma viscosity (p = 1.01 × 10-06 and p = 4.59 × 10-07) was found. Conclusion These findings may represent biological candidates for hemorheological indexes and contribute to hemorheological study.
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Affiliation(s)
- Yuxiao Sun
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China,Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou, China
| | - Zhaoyun Cheng
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Zhiping Guo
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China,Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou, China
| | - Guoyou Dai
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China,Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou, China
| | - Yongqiang Li
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Chen
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Ruigang Xie
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Xianqing Wang
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Mingxia Cui
- FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Guoqing Lu
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Aifeng Wang
- FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Chuanyu Gao
- Department of Cardiology, Henan Provincial People's Hospital, Zhengzhou, China,FuWai Central China Cardiovascular Hospital, Zhengzhou, China,People's Hospital of Zhengzhou University, Zhengzhou, China,Henan Provincial Key Lab for Control of Coronary Heart Disease, Zhengzhou, China,*Chuanyu Gao,
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Aitkulova A, Mukhtarova K, Zholdybayeva E, Medetov Y, Dzhamantayeva B, Kassymbek K, Utupov T, Akhmetollayev I, Akshulakov S, Kulmambetova G, Ramankulov Y. Activated leukocyte cell adhesion molecule/cluster of differentiation 166 rs10933819 (G>A) variant is associated with familial intracranial aneurysms. Biomed Rep 2022; 17:65. [PMID: 35815187 PMCID: PMC9260160 DOI: 10.3892/br.2022.1548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/01/2022] [Indexed: 11/06/2022] Open
Abstract
Rupture of intracranial aneurysms (IAs) is the most common cause of subarachnoid hemorrhage (SAH). Currently, there is sufficient evidence to indicate that inflammatory responses contribute to aneurysm rupture. Moreover, the familial occurrence of SAH suggests that genetic factors may be involved in disease susceptibility. In the present study, a clinically proven case of IA in a patient who is a heterozygous mutation carrier of the activated leukocyte cell adhesion molecule (ALCAM)/cluster of differentiation 166 (CD166) gene, is reported. Genomic DNA was extracted from two siblings diagnosed with SAH and other available family members. A variant prioritization strategy that focused on functional prediction, frequency, predicted pathogenicity, and segregation within the family was employed. Sanger sequencing was also performed on the unaffected relatives to assess the segregation of variants within the phenotype. The verified mutations were sequenced in 145 ethnicity-matched healthy individuals. Based on whole exome sequencing data obtained from three individuals, two of whom were diagnosed with IAs, the single-nucleotide variant rs10933819 was prioritized in the family. Only one variant, rs10933819 (G>A), in ALCAM co-segregated with the phenotype, and this mutation was absent in ethnicity-matched healthy individuals. Collectively, ALCAM c1382 G>A p.Gly229Val was identified, for the first time, as a pathogenic mutation in this IA pedigree.
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Affiliation(s)
- Akbota Aitkulova
- National Center for Biotechnology, Nur Sultan 010000, Republic of Kazakhstan
| | - Kymbat Mukhtarova
- National Center for Biotechnology, Nur Sultan 010000, Republic of Kazakhstan
| | - Elena Zholdybayeva
- National Center for Biotechnology, Nur Sultan 010000, Republic of Kazakhstan
| | - Yerkin Medetov
- National Center of Neurosurgery, Nazarbayev University, Nur Sultan 010000, Republic of Kazakhstan
| | - Botagoz Dzhamantayeva
- National Center of Neurosurgery, Nazarbayev University, Nur Sultan 010000, Republic of Kazakhstan
| | - Kuat Kassymbek
- National Center for Biotechnology, Nur Sultan 010000, Republic of Kazakhstan
| | - Talgat Utupov
- National Center for Biotechnology, Nur Sultan 010000, Republic of Kazakhstan
| | - Ilyas Akhmetollayev
- National Center for Biotechnology, Nur Sultan 010000, Republic of Kazakhstan
| | - Serik Akshulakov
- National Center of Neurosurgery, Nazarbayev University, Nur Sultan 010000, Republic of Kazakhstan
| | | | - Yerlan Ramankulov
- National Center for Biotechnology, Nur Sultan 010000, Republic of Kazakhstan
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5
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Bogdał A, Badeński A, Pac M, Wójcicka A, Badeńska M, Didyk A, Trembecka-Dubel E, Dąbrowska-Leonik N, Walaszczyk M, Matysiak N, Morawiec-Knysak A, Szczepański T, Szczepańska M. Atypical Hemolytic Uremic Syndrome (aHUS) and Adenosine Deaminase (ADA)-Deficient Severe Combined Immunodeficiency (SCID)-Two Diseases That Exacerbate Each Other: Case Report. Int J Mol Sci 2021; 22:ijms22179479. [PMID: 34502390 PMCID: PMC8430959 DOI: 10.3390/ijms22179479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/21/2021] [Accepted: 08/27/2021] [Indexed: 11/16/2022] Open
Abstract
Hemolytic uremic syndrome (HUS) is defined by the triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury (AKI). Atypical HUS (aHUS), distinguished by its etiology, is caused by uncontrolled overactivation of the alternative complement pathway. The correct diagnosis of aHUS is complex and involves various gene mutations. Severe combined immunodeficiency (SCID), characterized by severe T-cell lymphocytopenia and a lack of antigen-specific T-cell and B-cell immune responses, is of seldom occurrence. In 10–15% of pediatric patients, SCID is caused by adenosine deaminase (ADA) deficiency. The authors describe the case of a boy who suffered from both aHUS and ADA-deficient SCID. At the age of 9 months, the patient presented acute kidney injury with anuria and coagulopathy. The diagnosis of aHUS was established on the basis of alternative complement pathway deregulation and disease-associated gene mutations. Further examination revealed immune system failure and, at the age of 13 months, the ADA deficiency was confirmed by genetic tests and the boy was diagnosed with ADA-SCID. ADA SCID has recently been described as a possible triggering factor of aHUS development and progression. However, more research is required in this field. Nevertheless, it is crucial in clinical practice to be aware of these two co-existing life-threatening diseases.
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Affiliation(s)
- Anna Bogdał
- District Hospital in Zawiercie, ul. Miodowa 14, 42-400 Zawiercie, Poland;
| | - Andrzej Badeński
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800 Zabrze, Poland; (A.B.); (M.B.)
| | - Małgorzata Pac
- Department of Immunology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (M.P.); (N.D.-L.)
| | | | - Marta Badeńska
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800 Zabrze, Poland; (A.B.); (M.B.)
| | - Agnieszka Didyk
- Department of Pediatric Nephrology with Dialysis Division for Children, Public Clinical Hospital No. 1 in Zabrze, 41-800 Zabrze, Poland; (A.D.); (E.T.-D.); (A.M.-K.)
| | - Elżbieta Trembecka-Dubel
- Department of Pediatric Nephrology with Dialysis Division for Children, Public Clinical Hospital No. 1 in Zabrze, 41-800 Zabrze, Poland; (A.D.); (E.T.-D.); (A.M.-K.)
| | - Nel Dąbrowska-Leonik
- Department of Immunology, The Children’s Memorial Health Institute, 04-730 Warsaw, Poland; (M.P.); (N.D.-L.)
| | - Małgorzata Walaszczyk
- Department of Anaesthesiology and Intensive Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800 Zabrze, Poland;
| | - Natalia Matysiak
- Department of Histology and Cell Pathology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800 Zabrze, Poland;
| | - Aurelia Morawiec-Knysak
- Department of Pediatric Nephrology with Dialysis Division for Children, Public Clinical Hospital No. 1 in Zabrze, 41-800 Zabrze, Poland; (A.D.); (E.T.-D.); (A.M.-K.)
| | - Tomasz Szczepański
- Department of Pediatric Hematology and Oncology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice ul. 3 Maja 13/15, 41-800 Zabrze, Poland;
| | - Maria Szczepańska
- Department of Pediatrics, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, ul. 3 Maja 13/15, 41-800 Zabrze, Poland; (A.B.); (M.B.)
- Correspondence: ; Tel.: +48-32-3704305; Fax: +48-32-3704292
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Rustenhoven J, Tanumihardja C, Kipnis J. Cerebrovascular Anomalies: Perspectives From Immunology and Cerebrospinal Fluid Flow. Circ Res 2021; 129:174-194. [PMID: 34166075 DOI: 10.1161/circresaha.121.318173] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Appropriate vascular function is essential for the maintenance of central nervous system homeostasis and is achieved through virtue of the blood-brain barrier; a specialized structure consisting of endothelial, mural, and astrocytic interactions. While appropriate blood-brain barrier function is typically achieved, the central nervous system vasculature is not infallible and cerebrovascular anomalies, a collective terminology for diverse vascular lesions, are present in meningeal and cerebral vasculature supplying and draining the brain. These conditions, including aneurysmal formation and rupture, arteriovenous malformations, dural arteriovenous fistulas, and cerebral cavernous malformations, and their associated neurological sequelae, are typically managed with neurosurgical or pharmacological approaches. However, increasing evidence implicates interacting roles for inflammatory responses and disrupted central nervous system fluid flow with respect to vascular perturbations. Here, we discuss cerebrovascular anomalies from an immunologic angle and fluid flow perspective. We describe immune contributions, both common and distinct, to the formation and progression of diverse cerebrovascular anomalies. Next, we summarize how cerebrovascular anomalies precipitate diverse neurological sequelae, including seizures, hydrocephalus, and cognitive effects and possible contributions through the recently identified lymphatic and glymphatic systems. Finally, we speculate on and provide testable hypotheses for novel nonsurgical therapeutic approaches for alleviating neurological impairments arising from cerebrovascular anomalies, with a particular emphasis on the normalization of fluid flow and alleviation of inflammation through manipulations of the lymphatic and glymphatic central nervous system clearance pathways.
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Affiliation(s)
- Justin Rustenhoven
- Center for Brain Immunology and Glia (J.R., J.K.), Washington University in St. Louis, St Louis, MO.,Department of Pathology and Immunology, School of Medicine (J.R., J.K.), Washington University in St. Louis, St Louis, MO
| | | | - Jonathan Kipnis
- Center for Brain Immunology and Glia (J.R., J.K.), Washington University in St. Louis, St Louis, MO.,Department of Pathology and Immunology, School of Medicine (J.R., J.K.), Washington University in St. Louis, St Louis, MO
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Sun N, Yang XY, Zhao Y, Zhang QJ, Ma X, Wei ZN, Li MQ. Treatment of pediatric intracranial dissecting aneurysm with clipping and angioplasty, and next-generation sequencing analysis: A case report and literature review. World J Clin Cases 2021; 9:1103-1110. [PMID: 33644173 PMCID: PMC7896649 DOI: 10.12998/wjcc.v9.i5.1103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 12/11/2020] [Accepted: 12/23/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Large intracranial dissecting aneurysm (IDA) in the anterior cerebral circulation is rare in children. There has been no consensus on the diagnosis and treatment for IDA in children.
CASE SUMMARY We report a 3-year-old boy with a large ruptured IDA in the right middle cerebral artery (16 mm × 14 mm). The IDA was successfully managed with clipping and angioplasty. Next-generation sequencing of the blood sample followed by bioinformatics analysis suggested that the rs78977446 variant of the ADAMTS13 gene is a risk for pediatric IDA. Three years after surgery, the boy was develop-mentally normal.
CONCLUSION Clipping and angioplasty are effective treatments for ruptured IDA in the anterior cerebral circulation. ADAMTS13 rs78977446 is a risk factor for pediatric IDA.
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Affiliation(s)
- Ning Sun
- Department of Neurosurgery, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin 300134, China
| | - Xin-Yu Yang
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Yan Zhao
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Qing-Jiang Zhang
- Department of Neurosurgery, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin 300134, China
| | - Xiao Ma
- Department of Neurosurgery, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin 300134, China
| | - Zhong-Nan Wei
- Department of Neurosurgery, Tianjin Children's Hospital/Tianjin University Children's Hospital, Tianjin 300134, China
| | - Meng-Qi Li
- Department of Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China
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