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Majumder S, Chattopadhyay A, Wright JM, Guan P, Buja LM, Kwartler CS, Milewicz DM. Pericentrin deficiency in smooth muscle cells augments atherosclerosis through HSF1-driven cholesterol biosynthesis and PERK activation. JCI Insight 2023; 8:e173247. [PMID: 37937642 PMCID: PMC10721278 DOI: 10.1172/jci.insight.173247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 09/27/2023] [Indexed: 11/09/2023] Open
Abstract
Microcephalic osteodysplastic primordial dwarfism type II (MOPDII) is caused by biallelic loss-of-function variants in pericentrin (PCNT), and premature coronary artery disease (CAD) is a complication of the syndrome. Histopathology of coronary arteries from patients with MOPDII who died of CAD in their 20s showed extensive atherosclerosis. Hyperlipidemic mice with smooth muscle cell-specific (SMC-specific) Pcnt deficiency (PcntSMC-/-) exhibited significantly greater atherosclerotic plaque burden compared with similarly treated littermate controls despite similar serum lipid levels. Loss of PCNT in SMCs induced activation of heat shock factor 1 (HSF1) and consequently upregulated the expression and activity of HMG-CoA reductase (HMGCR), the rate-limiting enzyme in cholesterol biosynthesis. The increased cholesterol biosynthesis in PcntSMC-/- SMCs augmented PERK signaling and phenotypic modulation compared with control SMCs. Treatment with the HMGCR inhibitor, pravastatin, blocked the augmented SMC modulation and reduced plaque burden in hyperlipidemic PcntSMC-/- mice to that of control mice. These data support the notion that Pcnt deficiency activates cellular stress to increase SMC modulation and plaque burden, and targeting this pathway with statins in patients with MOPDII has the potential to reduce CAD in these individuals. The molecular mechanism uncovered further emphasizes SMC cytosolic stress and HSF1 activation as a pathway driving atherosclerotic plaque formation independently of cholesterol levels.
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Affiliation(s)
- Suravi Majumder
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, and
| | - Abhijnan Chattopadhyay
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, and
| | - Jamie M. Wright
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, and
| | - Pujun Guan
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, and
| | - L. Maximilian Buja
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Callie S. Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, and
| | - Dianna M. Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, and
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2
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Kaw A, Wu T, Starosolski Z, Zhou Z, Pedroza AJ, Majumder S, Duan X, Kaw K, Pinelo JEE, Fischbein MP, Lorenzi PL, Tan L, Martinez SA, Mahmud I, Devkota L, Taegtmeyer H, Ghaghada KB, Marrelli SP, Kwartler CS, Milewicz DM. Augmenting Mitochondrial Respiration in Immature Smooth Muscle Cells with an ACTA2 Pathogenic Variant Mitigates Moyamoya-like Cerebrovascular Disease. Res Sq 2023:rs.3.rs-3304679. [PMID: 37886459 PMCID: PMC10602100 DOI: 10.21203/rs.3.rs-3304679/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2023]
Abstract
ACTA2 pathogenic variants altering arginine 179 cause childhood-onset strokes due to moyamoya disease (MMD)-like occlusion of the distal internal carotid arteries. A smooth muscle cell (SMC)-specific knock-in mouse model (Acta2SMC-R179C/+) inserted the mutation into 67% of aortic SMCs, whereas explanted SMCs were uniformly heterozygous. Acta2R179C/+ SMCs fail to fully differentiate and maintain stem cell-like features, including high glycolytic flux, and increasing oxidative respiration (OXPHOS) with nicotinamide riboside (NR) drives the mutant SMCs to differentiate and decreases migration. Acta2SMC-R179C/+ mice have intraluminal MMD-like occlusive lesions and strokes after carotid artery injury, whereas the similarly treated WT mice have no strokes and patent lumens. Treatment with NR prior to the carotid artery injury attenuates the strokes, MMD-like lumen occlusions, and aberrant vascular remodeling in the Acta2SMC-R179C/+ mice. These data highlight the role of immature SMCs in MMD-associated occlusive disease and demonstrate that altering SMC metabolism to drive quiescence of Acta2R179C/+ SMCs attenuates strokes and aberrant vascular remodeling in the Acta2SMC-R179C/+ mice.
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Affiliation(s)
- Anita Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Ting Wu
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street, Houston, TX 77030, USA
| | - Zbigniew Starosolski
- Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USA
| | - Zhen Zhou
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Albert J. Pedroza
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Suravi Majumder
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Xueyan Duan
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Kaveeta Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Jose E. E. Pinelo
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Michael P. Fischbein
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Philip L. Lorenzi
- Metabolomics Core Facility, Department of Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lin Tan
- Metabolomics Core Facility, Department of Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sara A. Martinez
- Metabolomics Core Facility, Department of Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Iqbal Mahmud
- Metabolomics Core Facility, Department of Bioinformatics & Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Laxman Devkota
- Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USA
| | - Heinrich Taegtmeyer
- Division of Cardiovascular Medicine, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Ketan B. Ghaghada
- Department of Radiology, Baylor College of Medicine, Texas Children’s Hospital, Houston, TX 77030, USA
| | - Sean P. Marrelli
- Department of Neurology, McGovern Medical School, The University of Texas Health Science Center at Houston, McGovern Medical School, 6431 Fannin Street, Houston, TX 77030, USA
| | - Callie S. Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
| | - Dianna M. Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, TX 77030, USA
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3
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Kaw K, Chattopadhyay A, Guan P, Chen J, Majumder S, Duan XY, Ma S, Zhang C, Kwartler CS, Milewicz DM. Smooth muscle α-actin missense variant promotes atherosclerosis through modulation of intracellular cholesterol in smooth muscle cells. Eur Heart J 2023:ehad373. [PMID: 37377039 PMCID: PMC10393072 DOI: 10.1093/eurheartj/ehad373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 03/15/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
AIMS The variant p.Arg149Cys in ACTA2, which encodes smooth muscle cell (SMC)-specific α-actin, predisposes to thoracic aortic disease and early onset coronary artery disease in individuals without cardiovascular risk factors. This study investigated how this variant drives increased atherosclerosis. METHODS AND RESULTS Apoe-/- mice with and without the variant were fed a high-fat diet for 12 weeks, followed by evaluation of atherosclerotic plaque formation and single-cell transcriptomics analysis. SMCs explanted from Acta2R149C/+ and wildtype (WT) ascending aortas were used to investigate atherosclerosis-associated SMC phenotypic modulation. Hyperlipidemic Acta2R149C/+Apoe-/- mice have a 2.5-fold increase in atherosclerotic plaque burden compared to Apoe-/- mice with no differences in serum lipid levels. At the cellular level, misfolding of the R149C α-actin activates heat shock factor 1, which increases endogenous cholesterol biosynthesis and intracellular cholesterol levels through increased HMG-CoA reductase (HMG-CoAR) expression and activity. The increased cellular cholesterol in Acta2R149C/+ SMCs induces endoplasmic reticulum stress and activates PERK-ATF4-KLF4 signaling to drive atherosclerosis-associated phenotypic modulation in the absence of exogenous cholesterol, while WT cells require higher levels of exogenous cholesterol to drive phenotypic modulation. Treatment with the HMG-CoAR inhibitor pravastatin successfully reverses the increased atherosclerotic plaque burden in Acta2R149C/+Apoe-/- mice. CONCLUSION These data establish a novel mechanism by which a pathogenic missense variant in a smooth muscle-specific contractile protein predisposes to atherosclerosis in individuals without hypercholesterolemia or other risk factors. The results emphasize the role of increased intracellular cholesterol levels in driving SMC phenotypic modulation and atherosclerotic plaque burden.
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Affiliation(s)
- Kaveeta Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
| | - Abhijnan Chattopadhyay
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
| | - Pujun Guan
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
| | - Jiyuan Chen
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
| | - Suravi Majumder
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
| | - Xue-Yan Duan
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
| | - Shuangtao Ma
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
- Current address: Department of Medicine, Michigan State University, 1355 Bogue St, B226B Life Sciences, East Lansing, MI 48824, USA
| | - Chen Zhang
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Cardiovascular Surgery, Texas Heart Institute, 6770 Bertner Avenue, Houston, TX 77030, USA
| | - Callie S Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
| | - Dianna M Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, 6431 Fannin Street, Houston, TX 77030, USA
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4
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Kwartler CS, Pedroza AJ, Kaw A, Guan P, Ma S, Duan XY, Kernell C, Wang C, Pinelo JEE, Borthwick MS, Chen J, Zhong Y, Sinha S, Shen X, Fischbein MP, Milewicz DM. Nuclear Smooth Muscle α-actin in Vascular Smooth Muscle Cell Differentiation. Res Sq 2023:rs.3.rs-1623114. [PMID: 36909460 PMCID: PMC10002808 DOI: 10.21203/rs.3.rs-1623114/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
Missense variants throughout ACTA2, encoding smooth muscle α-actin (αSMA), predispose to adult onset thoracic aortic disease, but variants disrupting arginine 179 (R179) lead to Smooth Muscle Dysfunction Syndrome (SMDS) characterized by childhood-onset diverse vascular diseases. Our data indicate that αSMA localizes to the nucleus in wildtype (WT) smooth muscle cells (SMCs), enriches in the nucleus with SMC differentiation, and associates with chromatin remodeling complexes and SMC contractile gene promotors, and the ACTA2 p.R179 variant decreases nuclear localization of αSMA. SMCs explanted from a SMC-specific conditional knockin mouse model, Acta2SMC-R179/+, are less differentiated than WT SMCs, both in vitro and in vivo, and have global changes in chromatin accessibility. Induced pluripotent stem cells from patients with ACTA2 p.R179 variants fail to fully differentiate from neural crest cells to SMCs, and single cell transcriptomic analyses of an ACTA2 p.R179H patient's aortic tissue shows increased SMC plasticity. Thus, nuclear αSMA participates in SMC differentiation and loss of this nuclear activity occurs with ACTA2 p.R179 pathogenic variants.
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Affiliation(s)
- Callie S. Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Albert J. Pedroza
- Department of Cardiothoracic Surgery, Stanford University, Stanford, CA 94305
| | - Anita Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Pujun Guan
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Shuangtao Ma
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
- Current address: Department Medicine, Michigan State University, East Lansing, MI 48824
| | - Xue-yan Duan
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Caroline Kernell
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Charis Wang
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Jose Emiliano Esparza Pinelo
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Mikayla S. Borthwick
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Jiyuan Chen
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
| | - Yuan Zhong
- Department of Epigenetics and Molecular Carcinogenesis, The University of Texas MD Anderson Cancer Center, Smithville, TX 78957
| | - Sanjay Sinha
- Wellcome-MRC Cambridge Stem Cell Institute, University of Cambridge, Cambridge, United Kingdom
| | - Xuetong Shen
- Institute of Cancer Research, Shenzhen Bay Laboratory, Shenzhen, China
| | | | - Dianna M. Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX 77030
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5
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Kaw A, Pedroza AJ, Chattopadhyay A, Pinard A, Guo D, Kaw K, Zhou Z, Shad R, Fischbein MP, Kwartler CS, Milewicz DM. Mosaicism for the smooth muscle cell (SMC)-specific knock-in of the Acta2 R179C pathogenic variant: Implications for gene editing therapies. J Mol Cell Cardiol 2022; 171:102-104. [PMID: 35878552 PMCID: PMC11027732 DOI: 10.1016/j.yjmcc.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 06/20/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022]
Affiliation(s)
- Anita Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, TX 77030, USA
| | - Albert J Pedroza
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305, United States of America
| | - Abhijnan Chattopadhyay
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, TX 77030, USA
| | - Amelie Pinard
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, TX 77030, USA
| | - Dongchuan Guo
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, TX 77030, USA
| | - Kaveeta Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, TX 77030, USA
| | - Zhen Zhou
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, TX 77030, USA
| | - Rohan Shad
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305, United States of America
| | - Michael P Fischbein
- Department of Cardiothoracic Surgery, Stanford University School of Medicine, Stanford, CA 94305, United States of America
| | - Callie S Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, TX 77030, USA
| | - Dianna M Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, TX 77030, USA.
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6
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Chattopadhyay A, Guan P, Majumder S, Kaw K, Zhou Z, Zhang C, Prakash SK, Kaw A, Buja LM, Kwartler CS, Milewicz DM. Preventing Cholesterol-Induced Perk (Protein Kinase RNA-Like Endoplasmic Reticulum Kinase) Signaling in Smooth Muscle Cells Blocks Atherosclerotic Plaque Formation. Arterioscler Thromb Vasc Biol 2022; 42:1005-1022. [PMID: 35708026 PMCID: PMC9311463 DOI: 10.1161/atvbaha.121.317451] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Vascular smooth muscle cells (SMCs) undergo complex phenotypic modulation with atherosclerotic plaque formation in hyperlipidemic mice, which is characterized by de-differentiation and heterogeneous increases in the expression of macrophage, fibroblast, osteogenic, and stem cell markers. An increase of cellular cholesterol in SMCs triggers similar phenotypic changes in vitro with exposure to free cholesterol due to cholesterol entering the endoplasmic reticulum, triggering endoplasmic reticulum stress and activating Perk (protein kinase RNA-like endoplasmic reticulum kinase) signaling.
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Affiliation(s)
- Abhijnan Chattopadhyay
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston (A.C., P.G., S.M., K.K., Z.Z., A.K., C.S.K., D.M.M.)
| | - Pujun Guan
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston (A.C., P.G., S.M., K.K., Z.Z., A.K., C.S.K., D.M.M.).,Graduate School of Biomedical Sciences, University of Texas MD Anderson Cancer Center and UTHealth, Houston (P.G.)
| | - Suravi Majumder
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston (A.C., P.G., S.M., K.K., Z.Z., A.K., C.S.K., D.M.M.)
| | - Kaveeta Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston (A.C., P.G., S.M., K.K., Z.Z., A.K., C.S.K., D.M.M.)
| | - Zhen Zhou
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston (A.C., P.G., S.M., K.K., Z.Z., A.K., C.S.K., D.M.M.)
| | - Chen Zhang
- Division of Cardiothoracic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX (C.Z.).,Department of Cardiovascular Surgery, Texas Heart Institute, Houston (C.Z.)
| | | | - Anita Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston (A.C., P.G., S.M., K.K., Z.Z., A.K., C.S.K., D.M.M.)
| | - L Maximillian Buja
- Department of Pathology and Laboratory Medicine, The University of Texas Health Science Center at Houston (L.M.B.)
| | - Callie S Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston (A.C., P.G., S.M., K.K., Z.Z., A.K., C.S.K., D.M.M.)
| | - Dianna M Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School The University of Texas Health Science Center at Houston (A.C., P.G., S.M., K.K., Z.Z., A.K., C.S.K., D.M.M.)
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7
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Kaw A, Kaw K, Hostetler EM, Beleza-Meireles A, Smith-Collins A, Armstrong C, Scurr I, Cotts T, Aatre R, Bamshad MJ, Earl D, Groner A, Agre K, Raveh Y, Kwartler CS, Milewicz DM. Expanding ACTA2 genotypes with corresponding phenotypes overlapping with smooth muscle dysfunction syndrome. Am J Med Genet A 2022; 188:2389-2396. [PMID: 35567597 PMCID: PMC9283281 DOI: 10.1002/ajmg.a.62775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 03/13/2022] [Accepted: 04/09/2022] [Indexed: 11/07/2022]
Abstract
Pathogenic variants in ACTA2, encoding smooth muscle α-actin, predispose to thoracic aortic aneurysms and dissections. ACTA2 variants altering arginine 179 predispose to a more severe, multisystemic disease termed smooth muscle dysfunction syndrome (SMDS; OMIM 613834). Vascular complications of SMDS include patent ductus arteriosus (PDA) or aortopulmonary window, early-onset thoracic aortic disease (TAD), moyamoya-like cerebrovascular disease, and primary pulmonary hypertension. Patients also have dysfunction of other smooth muscle-dependent systems, including congenital mydriasis, hypotonic bladder, and gut hypoperistalsis. Here, we describe five patients with novel heterozygous ACTA2 missense variants, p.Arg179Gly, p.Met46Arg, p.Thr204Ile, p.Arg39Cys, and p.Ile66Asn, who have clinical complications that align or overlap with SMDS. Patients with the ACTA2 p.Arg179Gly and p.Thr204Ile variants display classic features of SMDS. The patient with the ACTA2 p.Met46Arg variant exhibits exclusively vascular complications of SMDS, including early-onset TAD, PDA, and moyamoya-like cerebrovascular disease. The patient with the ACTA2 p.Ile66Asn variant has an unusual vascular complication, a large fusiform internal carotid artery aneurysm. The patient with the ACTA2 p.Arg39Cys variant has pulmonary, gastrointestinal, and genitourinary complications of SMDS but no vascular manifestations. Identifying pathogenic ACTA2 variants associated with features of SMDS is critical for aggressive surveillance and management of vascular and nonvascular complications and delineating the molecular pathogenesis of SMDS.
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Affiliation(s)
- Anita Kaw
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kaveeta Kaw
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ellen M Hostetler
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Ana Beleza-Meireles
- Bristol Regional Clinical Genetics Service, St Michael's Hospital, Bristol, UK
| | - Adam Smith-Collins
- Regional Neonatal Intensive Care Unit, St Michael's Hospital, Bristol, UK
| | | | - Ingrid Scurr
- Bristol Regional Clinical Genetics Service, St Michael's Hospital, Bristol, UK
| | - Timothy Cotts
- Division of Pediatric Cardiology, Department of Pediatrics, Michigan Medicine, University of Michigan at Ann Arbor, Ann Arbor, Michigan, USA
| | - Rajani Aatre
- Franklin Cardiovascular Center, Department of Internal Medicine, Michigan Medicine, University of Michigan at Ann Arbor, Ann Arbor, Michigan, USA
| | - Michael J Bamshad
- Division of Medical Genetics, Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Dawn Earl
- Division of Medical Genetics, Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Abraham Groner
- Division of Cardiology, Department of Pediatrics, The University of Chicago, Chicago, Illinois, USA
| | | | - Yehuda Raveh
- Department of Anesthesia, University of Miami/Jackson Memorial Hospital, Miami, Florida, USA
| | - Callie S Kwartler
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Dianna M Milewicz
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, Texas, USA
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8
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Cecchi AC, Haidar A, Marin I, Kwartler CS, Prakash SK, Milewicz DM. Aortic root dilatation and dilated cardiomyopathy in an adult with Tatton-Brown-Rahman syndrome. Am J Med Genet A 2022; 188:628-634. [PMID: 34644003 PMCID: PMC9175539 DOI: 10.1002/ajmg.a.62541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 02/03/2023]
Abstract
Tatton-Brown-Rahman syndrome is an autosomal dominant overgrowth syndrome caused by pathogenic DNMT3A variants in the germline. Clinical findings of tall stature due to postnatal overgrowth, intellectual disability, and characteristic facial features, are the most consistent findings observed in patients with Tatton-Brown-Rahman syndrome (TBRS). Since the syndrome was first described in 2014, an expanding spectrum of neuropsychiatric, musculoskeletal, neurological, and cardiovascular manifestations have been reported. However, most TBRS cases described in the literature are children with de novo DNMT3A variants, signaling a need to better characterize the phenotypes in adults. In this report, we describe a 34 year old referred to genetics for possible Marfan syndrome with aortic root dilatation, mitral valve prolapse, and dilated cardiomyopathy, who was diagnosed with TBRS due to a heterozygous de novo DNMT3A variant. This represents the third reported TBRS case with aortic root dilation and the second with cardiomyopathy. Collectively, these data provide evidence for an association with aortic disease and cardiomyopathy, highlight the clinical overlap with Marfan syndrome, and suggest that cardiovascular surveillance into adulthood is indicated.
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Affiliation(s)
- Alana C. Cecchi
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School University of Texas Health Science Center at Houston Texas USA
| | - Amier Haidar
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School University of Texas Health Science Center at Houston Texas USA
| | - Isabella Marin
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School University of Texas Health Science Center at Houston Texas USA
| | - Callie S. Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School University of Texas Health Science Center at Houston Texas USA
| | - Siddharth K. Prakash
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School University of Texas Health Science Center at Houston Texas USA
| | - Dianna M. Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School University of Texas Health Science Center at Houston Texas USA
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9
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Chen J, Kaw K, Lu H, Fagnant PM, Chattopadhyay A, Duan XY, Zhou Z, Ma S, Liu Z, Huang J, Kamm K, Stull JT, Kwartler CS, Trybus KM, Milewicz DM. Resistance of Acta2 R149C/+ mice to aortic disease is associated with defective release of mutant smooth muscle α-actin from the chaperonin-containing TCP1 folding complex. J Biol Chem 2021; 297:101228. [PMID: 34600884 PMCID: PMC8633019 DOI: 10.1016/j.jbc.2021.101228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/12/2021] [Accepted: 09/21/2021] [Indexed: 11/04/2022] Open
Abstract
Pathogenic variants of the gene for smooth muscle α-actin (ACTA2), which encodes smooth muscle (SM) α-actin, predispose to heritable thoracic aortic disease. The ACTA2 variant p.Arg149Cys (R149C) is the most common alteration; however, only 60% of carriers have a dissection or undergo repair of an aneurysm by 70 years of age. A mouse model of ACTA2 p.Arg149Cys was generated using CRISPR/Cas9 technology to determine the etiology of reduced penetrance. Acta2R149C/+ mice had significantly decreased aortic contraction compared with WT mice but did not form aortic aneurysms or dissections when followed to 24 months, even when hypertension was induced. In vitro motility assays found decreased interaction of mutant SM α-actin filaments with SM myosin. Polymerization studies using total internal reflection fluorescence microscopy showed enhanced nucleation of mutant SM α-actin by formin, which correlated with disorganized and reduced SM α-actin filaments in Acta2R149C/+ smooth muscle cells (SMCs). However, the most prominent molecular defect was the increased retention of mutant SM α-actin in the chaperonin-containing t-complex polypeptide folding complex, which was associated with reduced levels of mutant compared with WT SM α-actin in Acta2R149C/+ SMCs. These data indicate that Acta2R149C/+ mice do not develop thoracic aortic disease despite decreased contraction of aortic segments and disrupted SM α-actin filament formation and function in Acta2R149C/+ SMCs. Enhanced binding of mutant SM α-actin to chaperonin-containing t-complex polypeptide decreases the mutant actin versus WT monomer levels in Acta2R149C/+ SMCs, thus minimizing the effect of the mutation on SMC function and potentially preventing aortic disease in the Acta2R149C/+ mice.
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Affiliation(s)
- Jiyuan Chen
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA
| | - Kaveeta Kaw
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA
| | - Hailong Lu
- Department of Molecular Physiology and Biophysics, University of Vermont, Burlington, Vermont, USA
| | - Patricia M Fagnant
- Department of Molecular Physiology and Biophysics, University of Vermont, Burlington, Vermont, USA
| | - Abhijnan Chattopadhyay
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA
| | - Xue Yan Duan
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA
| | - Zhen Zhou
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA
| | - Shuangtao Ma
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA
| | - Zhenan Liu
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Jian Huang
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Kristine Kamm
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - James T Stull
- Department of Physiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Callie S Kwartler
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA
| | - Kathleen M Trybus
- Department of Molecular Physiology and Biophysics, University of Vermont, Burlington, Vermont, USA
| | - Dianna M Milewicz
- Division of Medical Genetic, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Texas, USA.
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10
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Chattopadhyay A, Kwartler CS, Kaw K, Li Y, Kaw A, Chen J, LeMaire SA, Shen YH, Milewicz DM. Cholesterol-Induced Phenotypic Modulation of Smooth Muscle Cells to Macrophage/Fibroblast-like Cells Is Driven by an Unfolded Protein Response. Arterioscler Thromb Vasc Biol 2021; 41:302-316. [PMID: 33028096 PMCID: PMC7752246 DOI: 10.1161/atvbaha.120.315164] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 09/21/2020] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Vascular smooth muscle cells (SMCs) dedifferentiate and initiate expression of macrophage markers with cholesterol exposure. This phenotypic switching is dependent on the transcription factor Klf4 (Krüppel-like factor 4). We investigated the molecular pathway by which cholesterol induces SMC phenotypic switching. Approach and Results: With exposure to free cholesterol, SMCs decrease expression of contractile markers, activate Klf4, and upregulate a subset of macrophage and fibroblast markers characteristic of modulated SMCs that appear with atherosclerotic plaque formation. These phenotypic changes are associated with activation of all 3 pathways of the endoplasmic reticulum unfolded protein response (UPR), Perk (protein kinase RNA-like endoplasmic reticulum kinase), Ire (inositol-requiring enzyme) 1α, and Atf (activating transcription factor) 6. Blocking the movement of cholesterol from the plasma membrane to the endoplasmic reticulum prevents free cholesterol-induced UPR, Klf4 activation, and upregulation of the majority of macrophage and fibroblast markers. Cholesterol-induced phenotypic switching is also prevented by global UPR inhibition or specific inhibition of Perk signaling. Exposure to chemical UPR inducers, tunicamycin and thapsigargin, is sufficient to induce these same phenotypic transitions. Finally, analysis of published single-cell RNA sequencing data during atherosclerotic plaque formation in hyperlipidemic mice provides preliminary in vivo evidence of a role of UPR activation in modulated SMCs. CONCLUSIONS Our data demonstrate that UPR is necessary and sufficient to drive phenotypic switching of SMCs to cells that resemble modulated SMCs found in atherosclerotic plaques. Preventing a UPR in hyperlipidemic mice diminishes atherosclerotic burden, and our data suggest that preventing SMC transition to dedifferentiated cells expressing macrophage and fibroblast markers contributes to this decreased plaque burden.
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MESH Headings
- Activating Transcription Factor 4/metabolism
- Animals
- Atherosclerosis/metabolism
- Atherosclerosis/pathology
- Cell Line
- Cell Transdifferentiation/drug effects
- Cholesterol/toxicity
- Endoplasmic Reticulum Stress/drug effects
- Eukaryotic Initiation Factor-2/metabolism
- Female
- Fibroblasts/drug effects
- Fibroblasts/metabolism
- Fibroblasts/pathology
- Kruppel-Like Factor 4
- Kruppel-Like Transcription Factors/metabolism
- Macrophages/drug effects
- Macrophages/metabolism
- Macrophages/pathology
- Male
- Mice, Inbred C57BL
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Muscle, Smooth, Vascular/pathology
- Myocytes, Smooth Muscle/drug effects
- Myocytes, Smooth Muscle/metabolism
- Myocytes, Smooth Muscle/pathology
- Phenotype
- Plaque, Atherosclerotic
- Unfolded Protein Response/drug effects
- eIF-2 Kinase/metabolism
- Mice
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Affiliation(s)
- Abhijnan Chattopadhyay
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (A.C., C.S.K., K.K., A.K., J.C., D.M.M.)
| | - Callie S. Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (A.C., C.S.K., K.K., A.K., J.C., D.M.M.)
| | - Kaveeta Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (A.C., C.S.K., K.K., A.K., J.C., D.M.M.)
| | - Yanming Li
- Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX (.L., S.A.L., Y.H.S.)
| | - Anita Kaw
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (A.C., C.S.K., K.K., A.K., J.C., D.M.M.)
| | - Jiyuan Chen
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (A.C., C.S.K., K.K., A.K., J.C., D.M.M.)
| | - Scott A. LeMaire
- Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX (.L., S.A.L., Y.H.S.)
| | - Ying H. Shen
- Division of Cardiothoracic Surgery, Baylor College of Medicine, Houston, TX (.L., S.A.L., Y.H.S.)
| | - Dianna M. Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX (A.C., C.S.K., K.K., A.K., J.C., D.M.M.)
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11
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Drake KA, Chaney CP, Das A, Roy P, Kwartler CS, Rakheja D, Carroll TJ. Stromal β-catenin activation impacts nephron progenitor differentiation in the developing kidney and may contribute to Wilms tumor. Development 2020; 147:dev189597. [PMID: 32541007 PMCID: PMC7406317 DOI: 10.1242/dev.189597] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 06/02/2020] [Indexed: 02/03/2023]
Abstract
Wilms' tumor (WT) morphologically resembles the embryonic kidney, consisting of blastema, epithelial and stromal components, suggesting tumors arise from the dysregulation of normal development. β-Catenin activation is observed in a significant proportion of WTs; however, much remains to be understood about how it contributes to tumorigenesis. Although activating β-catenin mutations are observed in both blastema and stromal components of WT, current models assume that activation in the blastemal lineage is causal. Paradoxically, studies performed in mice suggest that activation of β-catenin in the nephrogenic lineage results in loss of nephron progenitor cell (NPC) renewal, a phenotype opposite to WT. Here, we show that activation of β-catenin in the stromal lineage non-autonomously prevents the differentiation of NPCs. Comparisons of the transcriptomes of kidneys expressing an activated allele of β-catenin in the stromal or nephron progenitor cells reveals that human WT more closely resembles the stromal-lineage mutants. These findings suggest that stromal β-catenin activation results in histological and molecular features of human WT, providing insights into how alterations in the stromal microenvironment may play an active role in tumorigenesis.
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Affiliation(s)
- Keri A Drake
- Division of Pediatric Nephrology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Christopher P Chaney
- Department of Molecular Biology and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Amrita Das
- Amgen, Inc., San Francisco, CA 94080, USA
| | - Priti Roy
- Department of Ophthalmology and Visual Sciences, Chicago, IL 60612, USA
| | - Callie S Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Dinesh Rakheja
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Thomas J Carroll
- Department of Molecular Biology and Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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12
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Ciuffetelli Alamo IV, Kwartler CS, Regalado ER, Afifi RO, Parkash S, Rideout A, Guo DC, Milewicz DM. Grange syndrome due to homozygous YY1AP1 missense rare variants. Am J Med Genet A 2019; 179:2500-2505. [PMID: 31633303 DOI: 10.1002/ajmg.a.61379] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/22/2019] [Accepted: 09/18/2019] [Indexed: 11/05/2022]
Abstract
Grange syndrome (OMIM 602531) is an autosomal recessive condition characterized by severe early onset vascular occlusive disease and variable penetrance of brachydactyly, syndactyly, bone fragility, and learning disabilities. Grange syndrome is caused by homozygous or compound heterozygous loss-of-function variants in the YYA1P1 gene. We report on the case of a 53-year old female with novel homozygous missense variants in YYA1P1 (c.1079C>T, p.Pro360Leu), presenting with a history of brachysyndactyly, hypertension, and ischemic stroke. Imaging studies revealed stenosis of the bilateral internal carotid with extensive collateralization of cerebral vessels in a moyamoya-like pattern, along with stenosis in the splenic, common hepatic, celiac, left renal, and superior mesenteric arteries. Functional studies conducted with the patient's dermal fibroblasts suggest that the p.Pro360Leu variant decreases the stability of the YY1AP1 protein. This is the first report of a missense variant associated with Grange syndrome characterized by later onset of vascular disease and a lack of developmental delay and bone fragility.
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Affiliation(s)
- Isabella V Ciuffetelli Alamo
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houstan, Texas
| | - Callie S Kwartler
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houstan, Texas
| | - Ellen R Regalado
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houstan, Texas
| | - Rana O Afifi
- Cardiothoracic and Vascular Surgery Department, McGovern Medical School at the University of Texas Health Science Center at Houston, Houstan, Texas
| | - Sandhya Parkash
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada.,Maritime Medical Genetic Service, IWK Health Service, Halifax, Nova Scotia, Canada
| | - Andrea Rideout
- Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Dong-Chuan Guo
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houstan, Texas
| | - Dianna M Milewicz
- Division of Medical Genetics, Department of Internal Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houstan, Texas
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13
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Zhou Z, Peters AM, Wang S, Janda A, Chen J, Zhou P, Arthur E, Kwartler CS, Milewicz DM. Reversal of Aortic Enlargement Induced by Increased Biomechanical Forces Requires AT1R Inhibition in Conjunction With AT2R Activation. Arterioscler Thromb Vasc Biol 2019; 39:459-466. [PMID: 30602301 PMCID: PMC6400319 DOI: 10.1161/atvbaha.118.312158] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Objective- Pharmacological inhibition of the AT1R (angiotensin II type 1 receptor) with losartan can attenuate ascending aortic remodeling induced by transverse aortic constriction (TAC). In this study, we investigated the role of the AT2R (angiotensin II type 2 receptor) and MasR (Mas receptor) in TAC-induced ascending aortic dilation and remodeling. Approach and Results- Wild-type C57BL/6J mice were subjected to sham or TAC surgeries in the presence and absence of various drugs. Aortic diameters were assessed by echocardiography, central blood pressure was measured in the ascending aorta 2 weeks post-operation, and histology and gene expression analyses completed. An angiotensin-converting enzyme inhibitor, captopril, decreased systolic blood pressure to the same level as losartan but did not attenuate aortic dilation, adventitial inflammation, medial collagen deposition, elastin breakage, or Mmp9 (matrix metalloproteinase-9) expression when compared with TAC mice. In contrast, co-administration of captopril with an AT2R agonist, compound 21, attenuated aortic dilation, medial collagen content, elastin breaks, and Mmp9 expression, whereas co-administration of captopril with a MasR agonist (AVE0991) did not reverse aortic dilation and led to aberrant aortic remodeling. An AT2R antagonist, PD123319, reversed the protective effects of losartan in TAC mice. Treatment with compound 21 alone showed no effect on TAC-induced aortic enlargement, blood pressure, elastin breakage, or Mmp9 expression. Conclusions- Our data indicate that when AT1R signaling is blocked, AT2R activation is a key modulator to prevent aortic dilation that occurs with TAC. These data suggest that angiotensin-converting enzyme inhibitor may not be as effective as losartan for slowing aneurysm growth because losartan requires intact AT2R signaling to prevent aortic enlargement.
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Affiliation(s)
- Zhen Zhou
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
- Department of Cardiovascular Surgery, Renmin Hospital of Wuhan University, Wuhan, Hubei, People's Republic of China (Z.Z.)
| | - Andrew M Peters
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
| | - Shanzhi Wang
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
| | - Alexandra Janda
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
| | - Jiyuan Chen
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
| | - Ping Zhou
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
| | - Erin Arthur
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
| | - Callie S Kwartler
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
| | - Dianna M Milewicz
- From the Division of Medical Genetics, Department of Internal Medicine, The University of Texas Health Science Center at Houston (Z.Z., A.M.P., S.W., A.J., J.C., P.Z., E.A., C.S.K., D.M.M.)
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14
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Tan KL, Haelterman NA, Kwartler CS, Regalado ES, Lee PT, Nagarkar-Jaiswal S, Guo DC, Duraine L, Wangler MF, Bamshad MJ, Nickerson DA, Lin G, Milewicz DM, Bellen HJ. Ari-1 Regulates Myonuclear Organization Together with Parkin and Is Associated with Aortic Aneurysms. Dev Cell 2018; 45:226-244.e8. [PMID: 29689197 PMCID: PMC5920516 DOI: 10.1016/j.devcel.2018.03.020] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 02/15/2018] [Accepted: 03/26/2018] [Indexed: 12/25/2022]
Abstract
Nuclei are actively positioned and anchored to the cytoskeleton via the LINC (Linker of Nucleoskeleton and Cytoskeleton) complex. We identified mutations in the Parkin-like E3 ubiquitin ligase Ariadne-1 (Ari-1) that affect the localization and distribution of LINC complex members in Drosophila. ari-1 mutants exhibit nuclear clustering and morphology defects in larval muscles. We show that Ari-1 mono-ubiquitinates the core LINC complex member Koi. Surprisingly, we discovered functional redundancy between Parkin and Ari-1: increasing Parkin expression rescues ari-1 mutant phenotypes and vice versa. We further show that rare variants in the human homolog of ari-1 (ARIH1) are associated with thoracic aortic aneurysms and dissections, conditions resulting from smooth muscle cell (SMC) dysfunction. Human ARIH1 rescues fly ari-1 mutant phenotypes, whereas human variants found in patients fail to do so. In addition, SMCs obtained from patients display aberrant nuclear morphology. Hence, ARIH1 is critical in anchoring myonuclei to the cytoskeleton.
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Affiliation(s)
- Kai Li Tan
- Program in Developmental Biology, Baylor College of Medicine (BCM), Houston, TX 77030, USA
| | - Nele A Haelterman
- Program in Developmental Biology, Baylor College of Medicine (BCM), Houston, TX 77030, USA; Department of Molecular and Human Genetics, BCM, Houston, TX 77030, USA
| | - Callie S Kwartler
- Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX 77030, USA
| | - Ellen S Regalado
- Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX 77030, USA
| | - Pei-Tseng Lee
- Department of Molecular and Human Genetics, BCM, Houston, TX 77030, USA
| | - Sonal Nagarkar-Jaiswal
- Department of Molecular and Human Genetics, BCM, Houston, TX 77030, USA; Howard Hughes Medical Institute, BCM, Houston, TX 77030, USA
| | - Dong-Chuan Guo
- Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX 77030, USA
| | - Lita Duraine
- Howard Hughes Medical Institute, BCM, Houston, TX 77030, USA
| | - Michael F Wangler
- Program in Developmental Biology, Baylor College of Medicine (BCM), Houston, TX 77030, USA; Department of Molecular and Human Genetics, BCM, Houston, TX 77030, USA
| | - Michael J Bamshad
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Deborah A Nickerson
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Guang Lin
- Department of Molecular and Human Genetics, BCM, Houston, TX 77030, USA
| | - Dianna M Milewicz
- Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX 77030, USA
| | - Hugo J Bellen
- Program in Developmental Biology, Baylor College of Medicine (BCM), Houston, TX 77030, USA; Department of Molecular and Human Genetics, BCM, Houston, TX 77030, USA; Howard Hughes Medical Institute, BCM, Houston, TX 77030, USA; Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital (TCH), Houston, TX 77030, USA; Department of Neuroscience, BCM, Houston, TX 77030, USA.
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15
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Chen J, Peters A, Papke CL, Villamizar C, Ringuette LJ, Cao J, Wang S, Ma S, Gong L, Byanova KL, Xiong J, Zhu MX, Madonna R, Kee P, Geng YJ, Brasier AR, Davis EC, Prakash S, Kwartler CS, Milewicz DM. Loss of Smooth Muscle α-Actin Leads to NF-κB-Dependent Increased Sensitivity to Angiotensin II in Smooth Muscle Cells and Aortic Enlargement. Circ Res 2017; 120:1903-1915. [PMID: 28461455 DOI: 10.1161/circresaha.117.310563] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 04/24/2017] [Accepted: 05/01/2017] [Indexed: 11/16/2022]
Abstract
RATIONALE Mutations in ACTA2, encoding the smooth muscle isoform of α-actin, cause thoracic aortic aneurysms, acute aortic dissections, and occlusive vascular diseases. OBJECTIVE We sought to identify the mechanism by which loss of smooth muscle α-actin causes aortic disease. METHODS AND RESULTS Acta2-/- mice have an increased number of elastic lamellae in the ascending aorta and progressive aortic root dilation as assessed by echocardiography that can be attenuated by treatment with losartan, an angiotensin II (AngII) type 1 receptor blocker. AngII levels are not increased in Acta2-/- aortas or kidneys. Aortic tissue and explanted smooth muscle cells from Acta2-/- aortas show increased production of reactive oxygen species and increased basal nuclear factor κB signaling, leading to an increase in the expression of the AngII receptor type I a and activation of signaling at 100-fold lower levels of AngII in the mutant compared with wild-type cells. Furthermore, disruption of smooth muscle α-actin filaments in wild-type smooth muscle cells by various mechanisms activates nuclear factor κB signaling and increases expression of AngII receptor type I a. CONCLUSIONS These findings reveal that disruption of smooth muscle α-actin filaments in smooth muscle cells increases reactive oxygen species levels, activates nuclear factor κB signaling, and increases AngII receptor type I a expression, thus potentiating AngII signaling in vascular smooth muscle cells without an increase in the exogenous levels of AngII.
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Affiliation(s)
- Jiyuan Chen
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Andrew Peters
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Christina L Papke
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Carlos Villamizar
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Lea-Jeanne Ringuette
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Jiumei Cao
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Shanzhi Wang
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Shuangtao Ma
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Limin Gong
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Katerina L Byanova
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Jian Xiong
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Michael X Zhu
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Rosalinda Madonna
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Patrick Kee
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Yong-Jian Geng
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Allan R Brasier
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Elaine C Davis
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Siddharth Prakash
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Callie S Kwartler
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.)
| | - Dianna M Milewicz
- From the Departments of Internal Medicine (J.C., A.P., C.L.P., C.V., J.C., S.W., S.M., L.G., K.L.B., R.M., P.K., Y.-J.G., S.P., C.S.K., D.M.M.) and Integrative Biology and Pharmacology (J.X., M.X.Z.), The University of Texas Health Science Center at Houston; Anatomy and Cell Biology, Strathcona Anatomy and Dentistry Building, 3640 Rue University, Montreal, Quebec, Canada; and Internal Medicine, Institute for Translational Sciences, and Sealy Center for Molecular Medicine, University of Texas Medical Branch, Galveston (A.R.B.).
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16
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Guo DC, Duan XY, Regalado ES, Mellor-Crummey L, Kwartler CS, Kim D, Lieberman K, de Vries BB, Pfundt R, Schinzel A, Kotzot D, Shen X, Yang ML, Bamshad MJ, Nickerson DA, Gornik HL, Ganesh SK, Braverman AC, Grange DK, Milewicz DM, Milewicz DM. Loss-of-Function Mutations in YY1AP1 Lead to Grange Syndrome and a Fibromuscular Dysplasia-Like Vascular Disease. Am J Hum Genet 2017; 100:21-30. [PMID: 27939641 DOI: 10.1016/j.ajhg.2016.11.008] [Citation(s) in RCA: 69] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Accepted: 11/04/2016] [Indexed: 12/27/2022] Open
Abstract
Fibromuscular dysplasia (FMD) is a heterogeneous group of non-atherosclerotic and non-inflammatory arterial diseases that primarily involves the renal and cerebrovascular arteries. Grange syndrome is an autosomal-recessive condition characterized by severe and early-onset vascular disease similar to FMD and variable penetrance of brachydactyly, syndactyly, bone fragility, and learning disabilities. Exome-sequencing analysis of DNA from three affected siblings with Grange syndrome identified compound heterozygous nonsense variants in YY1AP1, and homozygous nonsense or frameshift YY1AP1 variants were subsequently identified in additional unrelated probands with Grange syndrome. YY1AP1 encodes yin yang 1 (YY1)-associated protein 1 and is an activator of the YY1 transcription factor. We determined that YY1AP1 localizes to the nucleus and is a component of the INO80 chromatin remodeling complex, which is responsible for transcriptional regulation, DNA repair, and replication. Molecular studies revealed that loss of YY1AP1 in vascular smooth muscle cells leads to cell cycle arrest with decreased proliferation and increased levels of the cell cycle regulator p21/WAF/CDKN1A and disrupts TGF-β-driven differentiation of smooth muscle cells. Identification of YY1AP1 mutations as a cause of FMD indicates that this condition can result from underlying genetic variants that significantly alter the phenotype of vascular smooth muscle cells.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Dianna M Milewicz
- Department of Internal Medicine, The University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX 77030, USA.
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17
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Kuang SQ, Medina-Martinez O, Guo DC, Gong L, Regalado ES, Reynolds CL, Boileau C, Jondeau G, Prakash SK, Kwartler CS, Zhu LY, Peters AM, Duan XY, Bamshad MJ, Shendure J, Nickerson DA, Santos-Cortez RL, Dong X, Leal SM, Majesky MW, Swindell EC, Jamrich M, Milewicz DM. FOXE3 mutations predispose to thoracic aortic aneurysms and dissections. J Clin Invest 2016; 126:948-61. [PMID: 26854927 DOI: 10.1172/jci83778] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 12/10/2015] [Indexed: 12/11/2022] Open
Abstract
The ascending thoracic aorta is designed to withstand biomechanical forces from pulsatile blood. Thoracic aortic aneurysms and acute aortic dissections (TAADs) occur as a result of genetically triggered defects in aortic structure and a dysfunctional response to these forces. Here, we describe mutations in the forkhead transcription factor FOXE3 that predispose mutation-bearing individuals to TAAD. We performed exome sequencing of a large family with multiple members with TAADs and identified a rare variant in FOXE3 with an altered amino acid in the DNA-binding domain (p.Asp153His) that segregated with disease in this family. Additional pathogenic FOXE3 variants were identified in unrelated TAAD families. In mice, Foxe3 deficiency reduced smooth muscle cell (SMC) density and impaired SMC differentiation in the ascending aorta. Foxe3 expression was induced in aortic SMCs after transverse aortic constriction, and Foxe3 deficiency increased SMC apoptosis and ascending aortic rupture with increased aortic pressure. These phenotypes were rescued by inhibiting p53 activity, either by administration of a p53 inhibitor (pifithrin-α), or by crossing Foxe3-/- mice with p53-/- mice. Our data demonstrate that FOXE3 mutations lead to a reduced number of aortic SMCs during development and increased SMC apoptosis in the ascending aorta in response to increased biomechanical forces, thus defining an additional molecular pathway that leads to familial thoracic aortic disease.
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MESH Headings
- Adult
- Aortic Dissection/genetics
- Aortic Dissection/metabolism
- Aortic Dissection/pathology
- Animals
- Aorta/metabolism
- Aorta/pathology
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/metabolism
- Aortic Aneurysm, Thoracic/pathology
- Apoptosis
- Cells, Cultured
- Cyclin-Dependent Kinase Inhibitor p21/metabolism
- Female
- Forkhead Transcription Factors/genetics
- Gene Expression
- Genetic Association Studies
- Genetic Predisposition to Disease
- Humans
- Male
- Mice, Inbred C57BL
- Mice, Knockout
- Middle Aged
- Muscle, Smooth, Vascular/pathology
- Mutation, Missense
- Myocytes, Smooth Muscle/physiology
- Pedigree
- Tumor Suppressor Protein p53/genetics
- Vascular Remodeling
- Zebrafish
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18
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Kwartler CS, Chen J, Thakur D, Li S, Baskin K, Wang S, Wang ZV, Walker L, Hill JA, Epstein HF, Taegtmeyer H, Milewicz DM. Overexpression of smooth muscle myosin heavy chain leads to activation of the unfolded protein response and autophagic turnover of thick filament-associated proteins in vascular smooth muscle cells. J Biol Chem 2014; 289:14075-88. [PMID: 24711452 DOI: 10.1074/jbc.m113.499277] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Duplications spanning nine genes at the genomic locus 16p13.1 predispose individuals to acute aortic dissections. The most likely candidate gene in this region leading to the predisposition for dissection is MYH11, which encodes smooth muscle myosin heavy chain (SM-MHC). The effects of increased expression of MYH11 on smooth muscle cell (SMC) phenotypes were explored using mouse aortic SMCs with transgenic overexpression of one isoform of SM-MHC. We found that these cells show increased expression of Myh11 and myosin filament-associated contractile genes at the message level when compared with control SMCs, but not at the protein level due to increased protein degradation. Increased expression of Myh11 resulted in endoplasmic reticulum (ER) stress in SMCs, which led to a paradoxical decrease of protein levels through increased autophagic degradation. An additional consequence of ER stress in SMCs was increased intracellular calcium ion concentration, resulting in increased contractile signaling and contraction. The increased signals for contraction further promote transcription of contractile genes, leading to a feedback loop of metabolic abnormalities in these SMCs. We suggest that overexpression of MYH11 can lead to increased ER stress and autophagy, findings that may be globally implicated in disease processes associated with genomic duplications.
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Affiliation(s)
| | - Jiyuan Chen
- From the Departments of Internal Medicine and
| | - Dhananjay Thakur
- Integrative Biology and Pharmacology, University of Texas Health Science Center, Houston, Texas 77030
| | - Shumin Li
- the Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas 77555
| | | | | | - Zhao V Wang
- the Departments of Internal Medicine (Cardiology) and Molecular Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, and
| | - Lori Walker
- the Department of Medicine, University of Colorado, Denver, Colorado 80217
| | - Joseph A Hill
- the Departments of Internal Medicine (Cardiology) and Molecular Biology, University of Texas Southwestern Medical Center, Dallas, Texas 75390, and
| | - Henry F Epstein
- the Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, Texas 77555
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19
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Kuang SQ, Geng L, Prakash SK, Cao JM, Guo S, Villamizar C, Kwartler CS, Peters AM, Brasier AR, Milewicz DM. Aortic remodeling after transverse aortic constriction in mice is attenuated with AT1 receptor blockade. Arterioscler Thromb Vasc Biol 2013; 33:2172-9. [PMID: 23868934 DOI: 10.1161/atvbaha.113.301624] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE Although hypertension is the most common risk factor for thoracic aortic diseases, it is not understood how increased pressures on the ascending aorta lead to aortic aneurysms. We investigated the role of angiotensin II type 1 receptor activation in ascending aortic remodeling in response to increased biomechanical forces using a transverse aortic constriction (TAC) mouse model. APPROACH AND RESULTS Two weeks after TAC, the increased biomechanical pressures led to ascending aortic dilatation and thickening of the medial and adventitial layers of the aorta. There was significant adventitial hyperplasia and inflammatory responses in TAC ascending aortas were accompanied by increased adventitial collagen, elevated inflammatory and proliferative markers, and increased cell density attributable to accumulation of myofibroblasts and macrophages. Treatment with losartan significantly blocked TAC-induced vascular inflammation and macrophage accumulation. However, losartan only partially prevented TAC-induced adventitial hyperplasia, collagen accumulation, and ascending aortic dilatation. Increased Tgfb2 expression and phosphorylated-Smad2 staining in the medial layer of TAC ascending aortas were effectively blocked with losartan. In contrast, the increased Tgfb1 expression and adventitial phospho-Smad2 staining were only partially attenuated by losartan. In addition, losartan significantly blocked extracellular signal-regulated kinase activation and reactive oxygen species production in the TAC ascending aorta. CONCLUSIONS Inhibition of the angiotensin II type 1 receptor using losartan significantly attenuated the vascular remodeling associated with TAC but did not completely block the increased transforming growth factor-β1 expression, adventitial Smad2 signaling, and collagen accumulation. These results help to delineate the aortic transforming growth factor-β signaling that is dependent and independent of the angiotensin II type 1 receptor after TAC.
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Affiliation(s)
- Shao-Qing Kuang
- Department of Internal Medicine, University of Texas Health Science Center at Houston, University of Texas Medical Branch, Houston, TX 77030, USA
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20
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Papke CL, Cao J, Kwartler CS, Villamizar C, Byanova KL, Lim SM, Sreenivasappa H, Fischer G, Pham J, Rees M, Wang M, Chaponnier C, Gabbiani G, Khakoo AY, Chandra J, Trache A, Zimmer W, Milewicz DM. Smooth muscle hyperplasia due to loss of smooth muscle α-actin is driven by activation of focal adhesion kinase, altered p53 localization and increased levels of platelet-derived growth factor receptor-β. Hum Mol Genet 2013; 22:3123-37. [PMID: 23591991 DOI: 10.1093/hmg/ddt167] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Mutations in ACTA2, encoding the smooth muscle cell (SMC)-specific isoform of α-actin (α-SMA), cause thoracic aortic aneurysms and dissections and occlusive vascular diseases, including early onset coronary artery disease and stroke. We have shown that occlusive arterial lesions in patients with heterozygous ACTA2 missense mutations show increased numbers of medial or neointimal SMCs. The contribution of SMC hyperplasia to these vascular diseases and the pathways responsible for linking disruption of α-SMA filaments to hyperplasia are unknown. Here, we show that the loss of Acta2 in mice recapitulates the SMC hyperplasia observed in ACTA2 mutant SMCs and determine the cellular pathways responsible for SMC hyperplasia. Acta2(-/-) mice showed increased neointimal formation following vascular injury in vivo, and SMCs explanted from these mice demonstrated increased proliferation and migration. Loss of α-SMA induced hyperplasia through focal adhesion (FA) rearrangement, FA kinase activation, re-localization of p53 from the nucleus to the cytoplasm and increased expression and ligand-independent activation of platelet-derived growth factor receptor beta (Pdgfr-β). Disruption of α-SMA in wild-type SMCs also induced similar cellular changes. Imatinib mesylate inhibited Pdgfr-β activation and Acta2(-/-) SMC proliferation in vitro and neointimal formation with vascular injury in vivo. Loss of α-SMA leads to SMC hyperplasia in vivo and in vitro through a mechanism involving FAK, p53 and Pdgfr-β, supporting the hypothesis that SMC hyperplasia contributes to occlusive lesions in patients with ACTA2 missense mutations.
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Affiliation(s)
- Christina L Papke
- Department of Internal Medicine, University of Texas Health Science Center at Houston, 6431 Fannin, MSB 6.100, Houston, TX 77030, USA
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21
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Boileau C, Guo DC, Hanna N, Regalado ES, Detaint D, Gong L, Varret M, Prakash SK, Li AH, d'Indy H, Braverman AC, Grandchamp B, Kwartler CS, Gouya L, Santos-Cortez RLP, Abifadel M, Leal SM, Muti C, Shendure J, Gross MS, Rieder MJ, Vahanian A, Nickerson DA, Michel JB, Jondeau G, Milewicz DM. TGFB2 mutations cause familial thoracic aortic aneurysms and dissections associated with mild systemic features of Marfan syndrome. Nat Genet 2012; 44:916-21. [PMID: 22772371 PMCID: PMC4033668 DOI: 10.1038/ng.2348] [Citation(s) in RCA: 267] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 06/15/2012] [Indexed: 12/20/2022]
Abstract
A predisposition for thoracic aortic aneurysms leading to acute aortic dissections can be inherited in families in an autosomal dominant manner. Genome-wide linkage analysis of two large unrelated families with thoracic aortic disease, followed by whole exome sequencing of affected relatives, identified causative mutations in TGFB2. These mutations, a frameshift mutation in exon 6 and a nonsense mutation in exon 4, segregated with disease with a combined LOD score of 7.7. Sanger sequencing of 276 probands from families with inherited thoracic aortic disease identified two additional TGFB2 mutations. TGFB2 encodes the transforming growth factor beta-2 (TGF-β2) and the mutations are predicted to cause haploinsufficiency for TGFB2, but aortic tissue from cases paradoxically shows increased TGF-β2 expression and immunostaining. Thus, haploinsufficiency of TGFB2 predisposes to thoracic aortic disease, suggesting the initial pathway driving disease is decreased cellular TGF-β2 levels leading to a secondary increase in TGF-β2 production in the diseased aorta.
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Affiliation(s)
- Catherine Boileau
- Institut National de la Santé et de la Recherche Médicale (INSERM) U698, Hôpital Bichat, Paris, France.
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22
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Kuang SQ, Kwartler CS, Byanova KL, Pham J, Gong L, Prakash SK, Huang J, Kamm KE, Stull JT, Sweeney HL, Milewicz DM. Rare, nonsynonymous variant in the smooth muscle-specific isoform of myosin heavy chain, MYH11, R247C, alters force generation in the aorta and phenotype of smooth muscle cells. Circ Res 2012; 110:1411-22. [PMID: 22511748 DOI: 10.1161/circresaha.111.261743] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
RATIONALE Mutations in myosin heavy chain (MYH11) cause autosomal dominant inheritance of thoracic aortic aneurysms and dissections. At the same time, rare, nonsynonymous variants in MYH11 that are predicted to disrupt protein function but do not cause inherited aortic disease are common in the general population and the vascular disease risk associated with these variants is unknown. OBJECTIVE To determine the consequences of the recurrent MYH11 rare variant, R247C, through functional studies in vitro and analysis of a knock-in mouse model with this specific variant, including assessment of aortic contraction, response to vascular injury, and phenotype of primary aortic smooth muscle cells (SMCs). METHODS AND RESULTS The steady state ATPase activity (actin-activated) and the rates of phosphate and ADP release were lower for the R247C mutant myosin than for the wild-type, as was the rate of actin filament sliding in an in vitro motility assay. Myh11(R247C/R247C) mice exhibited normal growth, reproduction, and aortic histology but decreased aortic contraction. In response to vascular injury, Myh11(R247C/R247C) mice showed significantly increased neointimal formation due to increased SMC proliferation when compared with the wild-type mice. Primary aortic SMCs explanted from the Myh11(R247C/R247C) mice were dedifferentiated compared with wild-type SMCs based on increased proliferation and reduced expression of SMC contractile proteins. The mutant SMCs also displayed altered focal adhesions and decreased Rho activation, associated with decreased nuclear localization of myocardin-related transcription factor-A. Exposure of the Myh11(R247C/R247C) SMCs to a Rho activator rescued the dedifferentiated phenotype of the SMCs. CONCLUSIONS These results indicate that a rare variant in MYH11, R247C, alters myosin contractile function and SMC phenotype, leading to increased proliferation in vitro and in response to vascular injury.
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Affiliation(s)
- Shao-Qing Kuang
- Department of Internal Medicine, The University of Texas Medical School at Houston, Houston, TX 77030, USA
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Inamoto S, Kwartler CS, Lafont AL, Liang YY, Fadulu VT, Duraisamy S, Willing M, Estrera A, Safi H, Hannibal MC, Carey J, Wiktorowicz J, Tan FK, Feng XH, Pannu H, Milewicz DM. TGFBR2 mutations alter smooth muscle cell phenotype and predispose to thoracic aortic aneurysms and dissections. Cardiovasc Res 2010; 88:520-9. [PMID: 20628007 PMCID: PMC2972687 DOI: 10.1093/cvr/cvq230] [Citation(s) in RCA: 93] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2010] [Revised: 06/29/2010] [Accepted: 07/06/2010] [Indexed: 12/31/2022] Open
Abstract
AIMS Transforming growth factor-β (TGF-β) signaling is critical for the differentiation of smooth muscle cells (SMCs) into quiescent cells expressing a full repertoire of contractile proteins. Heterozygous mutations in TGF-β receptor type II (TGFBR2) disrupt TGF-β signaling and lead to genetic conditions that predispose to thoracic aortic aneurysms and dissections (TAADs). The aim of this study is to determine the molecular mechanism by which TGFBR2 mutations cause TAADs. METHODS AND RESULTS Using aortic SMCs explanted from patients with TGFBR2 mutations, we show decreased expression of SMC contractile proteins compared with controls. Exposure to TGF-β1 fails to increase expression of contractile genes in mutant SMCs, whereas control cells further increase expression of these genes. Analysis of fixed and frozen aortas from patients with TGFBR2 mutations confirms decreased in vivo expression of contractile proteins relative to unaffected aortas. Fibroblasts explanted from patients with TGFBR2 mutations fail to transform into mature myofibroblasts with TGF-β1 stimulation as assessed by expression of contractile proteins. CONCLUSIONS These data support the conclusion that heterozygous TGFBR2 mutations lead to decreased expression of SMC contractile protein in both SMCs and myofibroblasts. The failure of TGFBR2-mutant SMCs to fully express SMC contractile proteins predicts defective contractile function in these cells and aligns with a hypothesis that defective SMC contractile function contributes to the pathogenesis of TAAD.
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MESH Headings
- Actins/metabolism
- Aortic Dissection/genetics
- Aortic Dissection/metabolism
- Animals
- Aortic Aneurysm, Thoracic/genetics
- Aortic Aneurysm, Thoracic/metabolism
- Calcium-Binding Proteins/metabolism
- Calmodulin-Binding Proteins/metabolism
- Case-Control Studies
- Cell Differentiation/drug effects
- Cell Differentiation/genetics
- Cell Differentiation/physiology
- Cell Line
- Cell Proliferation
- Cells, Cultured
- Genetic Predisposition to Disease/genetics
- Humans
- Mice
- Microfilament Proteins/metabolism
- Muscle, Smooth, Vascular/cytology
- Muscle, Smooth, Vascular/drug effects
- Muscle, Smooth, Vascular/metabolism
- Myofibroblasts/cytology
- Myofibroblasts/metabolism
- Phenotype
- Protein Serine-Threonine Kinases/genetics
- Protein Serine-Threonine Kinases/metabolism
- Receptor, Transforming Growth Factor-beta Type II
- Receptors, Transforming Growth Factor beta/genetics
- Receptors, Transforming Growth Factor beta/metabolism
- Signal Transduction/physiology
- Transfection
- Transforming Growth Factor beta1/pharmacology
- Calponins
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Affiliation(s)
- Sakiko Inamoto
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Callie S. Kwartler
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Andrea L. Lafont
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Yao Yun Liang
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Van Tran Fadulu
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Senthil Duraisamy
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Marcia Willing
- Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Anthony Estrera
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Hazim Safi
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Mark C. Hannibal
- Department of Pediatrics, University of Washington School of Medicine, Seattle, WA, USA
| | - John Carey
- Department of Pediatrics, University of Utah College of Medicine, Salt Lake City, UT, USA
| | - John Wiktorowicz
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, USA
| | - Filemon K. Tan
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Xin-Hua Feng
- Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, TX 77030, USA
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX 77030, USA
| | - Hariyadarshi Pannu
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
| | - Dianna M. Milewicz
- Department of Internal Medicine and Cardiothoracic and Vascular Surgery, University of Texas Medical School at Houston, MSB 6.100, 6431, Fannin St, Houston, TX 77030, USA
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Cao J, Gong L, Guo DC, Mietzsch U, Kuang SQ, Kwartler CS, Safi H, Estrera A, Gambello MJ, Milewicz DM. Thoracic aortic disease in tuberous sclerosis complex: molecular pathogenesis and potential therapies in Tsc2+/- mice. Hum Mol Genet 2010; 19:1908-20. [PMID: 20159776 DOI: 10.1093/hmg/ddq066] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Tuberous sclerosis complex (TSC) is a genetic disorder with pleiotropic manifestations caused by heterozygous mutations in either TSC1 or TSC2. One of the less investigated complications of TSC is the formation of aneurysms of the descending aorta, which are characterized on pathologic examination by smooth muscle cell (SMC) proliferation in the aortic media. SMCs were explanted from Tsc2(+/-) mice to investigate the pathogenesis of aortic aneurysms caused by TSC2 mutations. Tsc2(+/-) SMCs demonstrated increased phosphorylation of mammalian target of rapamycin (mTOR), S6 and p70S6K and increased proliferation rates compared with wild-type (WT) SMCs. Tsc2(+/-) SMCs also had reduced expression of SMC contractile proteins compared with WT SMCs. An inhibitor of mTOR signaling, rapamycin, decreased SMC proliferation and increased contractile protein expression in the Tsc2(+/-) SMCs to levels similar to WT SMCs. Exposure to alpha-elastin fragments also decreased proliferation of Tsc2(+/-) SMCs and increased levels of p27(kip1), but failed to increase expression of contractile proteins. In response to artery injury using a carotid artery ligation model, Tsc2(+/-) mice significantly increased neointima formation compared with the control mice, and the neointima formation was inhibited by treatment with rapamycin. These results demonstrate that Tsc2 haploinsufficiency in SMCs increases proliferation and decreases contractile protein expression and suggest that the increased proliferative potential of the mutant cells may be suppressed in vivo by interaction with elastin. These findings provide insights into the molecular pathogenesis of aortic disease in TSC patients and identify a potential therapeutic target for treatment of this complication of the disease.
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Affiliation(s)
- Jiumei Cao
- Department of Internal Medicine, University of Texas Medical School at Houston, Houston, TX 77030, USA
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