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Montani D, Eichstaedt CA, Belge C, Chung WK, Gräf S, Grünig E, Humbert M, Quarck R, Tenorio-Castano JA, Soubrier F, Trembath RC, Morrell NW. [Genetic counselling and testing in pulmonary arterial hypertension - A consensus statement on behalf of the International Consortium for Genetic Studies in PAH - French version]. Rev Mal Respir 2023; 40:838-852. [PMID: 37923650 DOI: 10.1016/j.rmr.2023.10.004] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 08/11/2023] [Indexed: 11/07/2023]
Abstract
Pulmonary arterial hypertension (PAH) is a rare disease that can be caused by (likely) pathogenic germline genomic variants. In addition to the most prevalent disease gene, BMPR2 (bone morphogenetic protein receptor 2), several genes, some belonging to distinct functional classes, are also now known to predispose to the development of PAH. As a consequence, specialist and non-specialist clinicians and healthcare professionals are increasingly faced with a range of questions regarding the need for, approaches to and benefits/risks of genetic testing for PAH patients and/or related family members. We provide a consensus-based approach to recommendations for genetic counselling and assessment of current best practice for disease gene testing. We provide a framework and the type of information to be provided to patients and relatives through the process of genetic counselling, and describe the presently known disease causal genes to be analysed. Benefits of including molecular genetic testing within the management protocol of patients with PAH include the identification of individuals misclassified by other diagnostic approaches, the optimisation of phenotypic characterisation for aggregation of outcome data, including in clinical trials, and importantly through cascade screening, the detection of healthy causal variant carriers, to whom regular assessment should be offered.
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Affiliation(s)
- D Montani
- French Referral Center for Pulmonary Hypertension, Pulmonary Department, hôpital de Bicêtre, AP-HP, université Paris-Saclay, Le Kremlin-Bicêtre, France; Inserm UMR_S999, hôpital Marie-Lannelongue, Le Plessis-Robinson, France.
| | - C A Eichstaedt
- Center for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Heidelberg, Allemagne; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Allemagne; Laboratory for Molecular Diagnostics, Institute of Human Genetics, Heidelberg University, Heidelberg, Allemagne
| | - C Belge
- Department of Chronic Diseases & Metabolism (CHROMETA), Clinical Department of Respiratory Diseases, University Hospitals, Laboratory of Respiratory Diseases & Thoracic Surgery (BREATHE), University of Leuven, 3000 Leuven, Belgique
| | - W K Chung
- Department of Pediatrics, Department of Medicine, Columbia University Irving Medical Center, New York, NY 10032, États-Unis
| | - S Gräf
- Department of Medicine, University of Cambridge, Heart and Lung Research Institute, Cambridge Biomedical Campus, Cambridge CB2 0BB, Royaume-Uni; Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0PT, Royaume-Uni; NIHR BioResource, for Translational Research - Rare Diseases, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0QQ, Royaume-Uni
| | - E Grünig
- Center for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Heidelberg, Allemagne; Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Allemagne
| | - M Humbert
- French Referral Center for Pulmonary Hypertension, Pulmonary Department, hôpital de Bicêtre, AP-HP, université Paris-Saclay, Le Kremlin-Bicêtre, France; Inserm UMR_S999, hôpital Marie-Lannelongue, Le Plessis-Robinson, France
| | - R Quarck
- Department of Chronic Diseases & Metabolism (CHROMETA), Clinical Department of Respiratory Diseases, University Hospitals, Laboratory of Respiratory Diseases & Thoracic Surgery (BREATHE), University of Leuven, 3000 Leuven, Belgique
| | - J A Tenorio-Castano
- INGEMM, Instituto de Genética Médica y Molecular, IdiPAZ, Hospital Universitario La Paz, Madrid, Espagne; CIBERER, Centro de Investigación Biomédica en Red de Enfermedades Raras, Madrid, Espagne; ITHACA, European Reference Network, Brussels, Belgique
| | - F Soubrier
- Département de génétique, Inserm UMR_S1166, AP-HP, hôpital Pitié-Salpêtrière, Institute for Cardio-metabolism and Nutrition (ICAN), Sorbonne université, Paris, France
| | - R C Trembath
- Department of Medical & Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London SE1 9RT, Royaume-Uni
| | - N W Morrell
- Department of Medicine, University of Cambridge, Heart and Lung Research Institute, Cambridge Biomedical Campus, Cambridge CB2 0BB, Royaume-Uni; Department of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge CB2 0PT, Royaume-Uni
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Soukarieh O, Tillet E, Proust C, Dupont C, Jaspard-Vinassa B, Soubrier F, Goyenvalle A, Eyries M, Trégouët DA. uAUG creating variants in the 5'UTR of ENG causing Hereditary Hemorrhagic Telangiectasia. NPJ Genom Med 2023; 8:32. [PMID: 37848456 PMCID: PMC10582052 DOI: 10.1038/s41525-023-00378-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 10/03/2023] [Indexed: 10/19/2023] Open
Abstract
Hereditary Hemorrhagic Telangiectasia (HHT) is a rare, autosomal dominant, vascular disorder. About 80% of cases are caused by pathogenic variants in ACVRL1 (also known as ALK1) and ENG, with the remaining cases being unexplained. We identified two variants, c.-79C>T and c.-68G>A, in the 5'UTR of ENG in two unrelated patients. They create upstream AUGs at the origin of upstream overlapping open reading frames (uoORFs) ending at the same stop codon. To assess the pathogenicity of these variants, we performed functional assays based on the expression of wild-type and mutant constructs in human cells and evaluated their effect on ALK1 activity in a BMP-response element assay. This assay is mandatory for molecular diagnosis and has been so far only applied to coding ENG variants. These variants were associated with a decrease of protein levels in HeLa and HUVEC cells and a decreased ability to activate ALK1. We applied the same experiments on three additional uoORF-creating variants (c.-142A>T, c.-127C>T and c.-10C>T) located in the 5'UTR of ENG and previously reported in HHT patients. We found that all the analyzed variants alter protein levels and function. Additional experiments relying on an artificial deletion in our mutated constructs show that identified uAUGs could initiate the translation indicating that the associated effect is translation-dependent. Overall, we have identified two 5'UTR ENG variations in HHT patients and shed new light on the role of upstream ORFs on ENG regulation. Our findings contribute to the amelioration of molecular diagnosis in HHT.
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Affiliation(s)
- Omar Soukarieh
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France.
- Univ. Bordeaux, INSERM, BMC, U1034, F-33600, Pessac, France.
| | - Emmanuelle Tillet
- INSERM UMR U1292, Laboratoire BIOSANTE, Université Grenoble Alpes, Inserm, CEA, Grenoble, France
| | - Carole Proust
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France
| | - Charlène Dupont
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France
| | | | - Florent Soubrier
- Département de Génétique, Hôpital Pitié-Salpêtrière, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France
- Sorbonne Université, INSERM, UMR_S 1166, Institute of Cardiometabolism And Nutrition (ICAN), Paris, France
| | | | - Mélanie Eyries
- Département de Génétique, Hôpital Pitié-Salpêtrière, Sorbonne Université, Assistance Publique-Hôpitaux de Paris, Paris, France
- Sorbonne Université, INSERM, UMR_S 1166, Institute of Cardiometabolism And Nutrition (ICAN), Paris, France
| | - David-Alexandre Trégouët
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, UMR 1219, F-33000, Bordeaux, France
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Santos-Ribeiro D, Lecocq M, de Beukelaer M, Verleden S, Bouzin C, Ambroise J, Dorfmuller P, Yakoub Y, Huaux F, Quarck R, Karmouty-Quintana H, Ghigna MR, Bignard J, Nadaud S, Soubrier F, Horman S, Perros F, Godinas L, Pilette C. Disruption of GCN2 Pathway Aggravates Vascular and Parenchymal Remodeling during Pulmonary Fibrosis. Am J Respir Cell Mol Biol 2023; 68:326-338. [PMID: 36476191 DOI: 10.1165/rcmb.2021-0541oc] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Pulmonary fibrosis (PF) and pulmonary hypertension (PH) are chronic diseases of the pulmonary parenchyma and circulation, respectively, which may coexist, but underlying mechanisms remain elusive. Mutations in the GCN2 (general control nonderepressible 2) gene (EIF2AK4 [eukaryotic translation initiation factor 2 alpha kinase 4]) were recently associated with pulmonary veno-occlusive disease. The aim of this study is to explore the involvement of the GCN2/eIF2α (eukaryotic initiation factor 2α) pathway in the development of PH during PF, in both human disease and in a laboratory animal model. Lung tissue from patients with PF with or without PH was collected at the time of lung transplantation, and control tissue was obtained from tumor resection surgery. Experimental lung disease was induced in either male wild-type or EIF2AK4-mutated Sprague-Dawley rats, randomly receiving a single intratracheal instillation of bleomycin or saline. Hemodynamic studies and organ collection were performed 3 weeks after instillation. Only significant results (P < 0.05) are presented. In PF lung tissue, GCN2 protein expression was decreased compared with control tissue. GCN2 expression was reduced in CD31+ endothelial cells. In line with human data, GCN2 protein expression was decreased in the lung of bleomycin rats compared with saline. EIF2AK4-mutated rats treated with bleomycin showed increased parenchymal fibrosis (hydroxyproline concentrations) and vascular remodeling (media wall thickness) as well as increased right ventricular systolic pressure compared with wild-type animals. Our data show that GCN2 is dysregulated in both humans and in an animal model of combined PF and PH. The possibility of a causative implication of GCN2 dysregulation in PF and/or PH development should be further studied.
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Affiliation(s)
| | | | | | - Stijn Verleden
- Laboratory of Respiratory Diseases & Thoracic Surgery, Department of Chronic Diseases and Metabolism, and
| | | | | | - Peter Dorfmuller
- Department of Pathology, University of Giessen and Marburg Lung Center, Justus-Liebig University Giessen, German Center for Lung Research, Giessen, Germany
| | - Yousef Yakoub
- Louvain Center for Toxicology and Applied Pharmacology, and
| | - François Huaux
- Louvain Center for Toxicology and Applied Pharmacology, and
| | - Rozenn Quarck
- Clinical Department of Respiratory Diseases, University Hospitals - University of Leuven, Leuven, Belgium
| | - Harry Karmouty-Quintana
- Department of Biochemistry and Molecular Biology and.,Division of Critical Care and.,Division of Pulmonary and Sleep Medicine, Department of Internal Medicine, The University of Texas Health Science Center at Houston, Houston, Texas
| | - Maria-Rosa Ghigna
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Département de Pathologie and.,INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | | | - Sophie Nadaud
- UMR_S 1166-ICAN, INSERM, Sorbonne Université, Paris, France
| | | | - Sandrine Horman
- Cardiovascular Research Unit, Institute of Experimental and Clinical Research, Catholic University of Louvain, Brussels, Belgium
| | - Frederic Perros
- Faculté de Médecine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Assistance Publique-Hôpitaux de Paris, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,Laboratoire CarMeN, UMR INSERM U1060/INRA U1397, Université Claude Bernard Lyon1, Pierre-Bénite and Bron, France; and
| | - Laurent Godinas
- Clinical Department of Respiratory Diseases, University Hospitals - University of Leuven, Leuven, Belgium
| | - Charles Pilette
- Pneumology, ENT and Dermatology.,Département de Pneumologie, Cliniques Universitaires St-Luc, Brussels, Belgium
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Bignard J, Atassi F, Claude O, Ghigna MR, Mougenot N, Soilih Abdoulkarim B, Deknuydt F, Gestin A, Monceau V, Montani D, Nadaud S, Soubrier F, Perros F. T-cell dysregulation and inflammatory process in Gcn2 (Eif2ak4 -/-) deficient rats in basal and stress conditions. Am J Physiol Lung Cell Mol Physiol 2023; 324:L609-L624. [PMID: 36852942 DOI: 10.1152/ajplung.00460.2021] [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] [Indexed: 03/01/2023] Open
Abstract
Hereditary pulmonary veno-occlusive disease (hPVOD) is a severe form of autosomal recessive pulmonary hypertension due to biallelic loss-of-function of the EIF2AK4 gene (alias GCN2) coding for GCN2. GCN2 is a stress kinase that belongs to the integrated stress response pathway (ISR). Three rat lines carrying biallelic Gcn2 mutation were generated and found phenotypically normal and did not spontaneously develop a PVOD-related disease. We submitted these rats to amino acid deprivation to document the molecular and cellular response of the lungs and to identify phenotypic changes that could be involved in PVOD pathophysiology. Gcn2-/- rat lungs were analyzed under basal conditions and three days after a single administration of PEG-asparaginase (ASNase). Lung mRNAS were analyzed by RNASeq and single cell RNASeq (scRNA-seq), flow-cytometry, tissue imaging, and western-blots. The ISR was not activated after ASNase treatment in Gcn2-/- rat lungs, and apoptosis was increased. Several proinflammatory and innate immunity genes were overexpressed, and inflammatory cells infiltration was also observed in the perivascular area. Under basal conditions, scRNA-seq analysis of Gcn2-/- rat lungs revealed increases in two T cell populations, a LAG3+ T cell population and a proliferative T cell population. Following ASNase administration, we observed an increase in calprotectin expression involved in TLR pathway activation and neutrophil infiltration. In conclusion, under basal and asparagine and glutamine deprivation induced by asparaginase administration, Gcn2-/- rats display molecular and cellular signatures in the lungs that may indicate a role for Gcn2 in immune homeostasis and provide further clues to the mechanisms of hPVOD development.
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Affiliation(s)
| | - Fabrice Atassi
- UMR_S1166 ICAN INSERM, Sorbonne University, Paris, France
| | - Olivier Claude
- UMR_S1166 ICAN INSERM, Sorbonne University, Paris, France
| | - Maria-Rosa Ghigna
- Department of Pathology, Institut Gustave Roussy (Villejuif, France), Villejuif, France.,UMR_S 999 INSERM, University of Paris-Saclay, Le Plessis-Robinson, France
| | - Nathalie Mougenot
- UMS28, Plateforme d'Expérimentation Coeur, Muscles, Vaisseaux (PECMV), Sorbonne University, Paris, France
| | | | - Florence Deknuydt
- Flow cytometry core Cyto-ICAN, Institute of Cardiometabolism and Nutrition, Hôpital Pitié-Salpêtrière, Paris, France
| | - Aurélie Gestin
- Flow cytometry core Cyto-ICAN, Institute of Cardiometabolism and Nutrition, Hôpital Pitié-Salpêtrière, Paris, France
| | | | - David Montani
- UMR_S 999 INSERM, University of Paris-Saclay, Le Plessis-Robinson, France.,Service de Pneumologie et Soins Intensifs Respiratoires, Hôpital de Bicêtre, Assistance Publique Hôpitaux de paris, Le Kremlin Bicêtre, France
| | - Sophie Nadaud
- UMR_S1166 ICAN INSERM, Sorbonne University, Paris, France
| | | | - Frédéric Perros
- UMR_S 999 INSERM, University of Paris-Saclay, Le Plessis-Robinson, France.,Laboratoire CarMeN, UMR INSERM U1060/INRA U1397, Université Claude Bernard Lyon1, F-69310 Pierre-Bénite and F-69500 Bron, France
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5
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Eichstaedt CA, Belge C, Chung WK, Gräf S, Grünig E, Montani D, Quarck R, Tenorio-Castano JA, Soubrier F, Trembath RC, Morrell NW. Genetic counselling and testing in pulmonary arterial hypertension: a consensus statement on behalf of the International Consortium for Genetic Studies in PAH. Eur Respir J 2023; 61:2201471. [PMID: 36302552 PMCID: PMC9947314 DOI: 10.1183/13993003.01471-2022] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/07/2022] [Indexed: 11/05/2022]
Abstract
Pulmonary arterial hypertension (PAH) is a rare disease that can be caused by (likely) pathogenic germline genomic variants. In addition to the most prevalent disease gene, BMPR2 (bone morphogenetic protein receptor 2), several genes, some belonging to distinct functional classes, are also now known to predispose to the development of PAH. As a consequence, specialist and non-specialist clinicians and healthcare professionals are increasingly faced with a range of questions regarding the need for, approaches to and benefits/risks of genetic testing for PAH patients and/or related family members. We provide a consensus-based approach to recommendations for genetic counselling and assessment of current best practice for disease gene testing. We provide a framework and the type of information to be provided to patients and relatives through the process of genetic counselling, and describe the presently known disease causal genes to be analysed. Benefits of including molecular genetic testing within the management protocol of patients with PAH include the identification of individuals misclassified by other diagnostic approaches, the optimisation of phenotypic characterisation for aggregation of outcome data, including in clinical trials, and importantly through cascade screening, the detection of healthy causal variant carriers, to whom regular assessment should be offered.
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Affiliation(s)
- Christina A Eichstaedt
- Center for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
- Laboratory for Molecular Genetic Diagnostics, Institute of Human Genetics, Heidelberg University, Heidelberg, Germany
| | - Catharina Belge
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism (CHROMETA), Clinical Department of Respiratory Diseases, University Hospitals, University of Leuven, Leuven, Belgium
| | - Wendy K Chung
- Department of Pediatrics, Columbia University Irving Medical Center, New York, NY, USA
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Stefan Gräf
- Department of Medicine, Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
- NIHR BioResource for Translational Research - Rare Diseases, University of Cambridge, Cambridge, UK
| | - Ekkehard Grünig
- Center for Pulmonary Hypertension, Thoraxklinik Heidelberg gGmbH at Heidelberg University Hospital, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany
| | - David Montani
- Université Paris-Saclay, AP-HP, French Referral Center for Pulmonary Hypertension, Pulmonary Department, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France
- INSERM UMR_S999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Rozenn Quarck
- Laboratory of Respiratory Diseases and Thoracic Surgery (BREATHE), Department of Chronic Diseases and Metabolism (CHROMETA), Clinical Department of Respiratory Diseases, University Hospitals, University of Leuven, Leuven, Belgium
| | - Jair A Tenorio-Castano
- INGEMM, Instituto de Genética Médica y Molecular, IdiPAZ, Hospital Universitario La Paz, Madrid, Spain
- CIBERER (Centro de Investigación Biomédica en Red de Enfermedades Raras), Madrid, Spain
- ITHACA, European Reference Network, Brussels, Belgium
| | - Florent Soubrier
- Sorbonne Université, AP-HP, Département de Génétique, INSERM UMR_S1166, Sorbonne Université, Institute for Cardiometabolism and Nutrition (ICAN), Hôpital Pitié-Salpêtrière, Paris, France
| | - Richard C Trembath
- Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Nicholas W Morrell
- Department of Medicine, Heart and Lung Research Institute, University of Cambridge, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
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6
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Montani D, Lechartier B, Girerd B, Eyries M, Ghigna MR, Savale L, Jaïs X, Seferian A, Jevnikar M, Boucly A, Riou M, Traclet J, Chaouat A, Levy M, Le Pavec J, Fadel E, Perros F, Soubrier F, Remy-Jardin M, Sitbon O, Bonnet D, Humbert M. An emerging phenotype of pulmonary arterial hypertension patients carrying SOX17 variants. Eur Respir J 2022; 60:2200656. [PMID: 35618278 PMCID: PMC10436756 DOI: 10.1183/13993003.00656-2022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 05/17/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND The phenotype of pulmonary arterial hypertension (PAH) patients carrying SOX17 pathogenic variants remains mostly unknown. METHODS We report the genetic analysis findings, characteristics and outcomes of patients with heritable PAH carrying SOX17 variants from the French Pulmonary Hypertension Network. RESULTS 20 patients and eight unaffected relatives were identified. The median (range) age at diagnosis was 17 (2-53) years, with a female:male ratio of 1.5. At diagnosis, most of the patients (74%) were in New York Heart Association Functional Class III or IV with severe haemodynamic compromise, including a median pulmonary vascular resistance of 14.0 (4.2-31.5) WU. An associated congenital heart disease (CHD) was found in seven PAH patients (35%). Patients with CHD-associated PAH were significantly younger at diagnosis than PAH patients without CHD. Four patients (20%) suffered from recurrent haemoptysis requiring repeated arterial embolisations. 13 out of 16 patients (81%) for whom imaging was available displayed chest computed tomography abnormalities, including dilated, tortuous pulmonary vessels, ground-glass opacities as well as anomalies of the bronchial and nonbronchial arteries. After a median (range) follow-up of 47 (1-591) months, 10 patients underwent lung transplantation and one patient benefited from a heart-lung transplantation due to associated CHD. Histopathological analysis of lung explants showed a congested lung architecture with severe pulmonary arterial remodelling, subpleural vessel dilation and numerous haemorrhagic foci. CONCLUSIONS PAH due to SOX17 pathogenic variants is a severe phenotype, frequently associated with CHD, haemoptysis and radiological abnormalities. Pathological assessment reveals severe pulmonary arterial remodelling and malformations affecting pulmonary vessels and thoracic systemic arteries.
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Affiliation(s)
- David Montani
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- D. Montani and B. Lechartier contributed equally to this work
| | - Benoit Lechartier
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- D. Montani and B. Lechartier contributed equally to this work
| | - Barbara Girerd
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Mélanie Eyries
- Dépt de Génétique, Hôpital Pitié-Salpêtrière, AP-HP and UMR_S 1166 Sorbonne Université, Paris, France
| | - Maria-Rosa Ghigna
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Service d'Anatomopathologie, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Laurent Savale
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Xavier Jaïs
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Andrei Seferian
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Mitja Jevnikar
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Athénais Boucly
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Marianne Riou
- Dépt de Pneumologie, Nouvel Hôpital Civil, Strasbourg, France
| | - Julie Traclet
- Université Lyon 1, Hospices Civils de Lyon, Centre de Référence des Maladies Pulmonaires Rares, Centre de Compétences de l'Hypertension Pulmonaire, Hôpital Louis Pradel, Lyon, France
| | - Ari Chaouat
- Université de Lorraine, CHU de Nancy, Pôle des Spécialités Médicales, Dépt de Pneumologie, Vandoeuvre-lès-Nancy, France
| | - Maryline Levy
- Service de Cardiologie Congénitale et Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France
| | - Jerome Le Pavec
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Service de Pneumologie et Transplantation Pulmonaire, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Elie Fadel
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
- Service de Chirurgie Thoracique, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Frédéric Perros
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Florent Soubrier
- Dépt de Génétique, Hôpital Pitié-Salpêtrière, AP-HP and UMR_S 1166 Sorbonne Université, Paris, France
| | - Martine Remy-Jardin
- CHU de Lille, Service d'Imagerie Thoracique, Hôpital Albert Calmette, Lille, France
| | - Olivier Sitbon
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Damien Bonnet
- Service de Cardiologie Congénitale et Pédiatrique, Hôpital Necker Enfants Malades, AP-HP, Université de Paris, Paris, France
| | - Marc Humbert
- AP-HP, Dept of Respiratory and Intensive Care Medicine, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France
- INSERM UMR_S 999 "Pulmonary Hypertension: Pathophysiology and Novel Therapies", Hôpital Marie Lannelongue, Le Plessis-Robinson, France
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Soubrier F. Prédispositions héréditaires au cancer de l’endomètre1. Bulletin de l'Académie Nationale de Médecine 2022. [DOI: 10.1016/j.banm.2022.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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8
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Solinc J, Ribot J, Soubrier F, Pavoine C, Dierick F, Nadaud S. The Platelet-Derived Growth Factor Pathway in Pulmonary Arterial Hypertension: Still an Interesting Target? Life (Basel) 2022; 12:life12050658. [PMID: 35629326 PMCID: PMC9143262 DOI: 10.3390/life12050658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 04/14/2022] [Revised: 04/22/2022] [Accepted: 04/25/2022] [Indexed: 12/03/2022] Open
Abstract
The lack of curative options for pulmonary arterial hypertension drives important research to understand the mechanisms underlying this devastating disease. Among the main identified pathways, the platelet-derived growth factor (PDGF) pathway was established to control vascular remodeling and anti-PDGF receptor (PDGFR) drugs were shown to reverse the disease in experimental models. Four different isoforms of PDGF are produced by various cell types in the lung. PDGFs control vascular cells migration, proliferation and survival through binding to their receptors PDGFRα and β. They elicit multiple intracellular signaling pathways which have been particularly studied in pulmonary smooth muscle cells. Activation of the PDGF pathway has been demonstrated both in patients and in pulmonary hypertension (PH) experimental models. Tyrosine kinase inhibitors (TKI) are numerous but without real specificity and Imatinib, one of the most specific, resulted in beneficial effects. However, adverse events and treatment discontinuation discouraged to pursue this therapy. Novel therapeutic strategies are currently under experimental evaluation. For TKI, they include intratracheal drug administration, low dosage or nanoparticles delivery. Specific anti-PDGF and anti-PDGFR molecules can also be designed such as new TKI, soluble receptors, aptamers or oligonucleotides.
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Affiliation(s)
- Julien Solinc
- INSERM, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, UMR_S1166, F-75013 Paris, France; (J.S.); (J.R.); (F.S.); (C.P.)
| | - Jonathan Ribot
- INSERM, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, UMR_S1166, F-75013 Paris, France; (J.S.); (J.R.); (F.S.); (C.P.)
| | - Florent Soubrier
- INSERM, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, UMR_S1166, F-75013 Paris, France; (J.S.); (J.R.); (F.S.); (C.P.)
| | - Catherine Pavoine
- INSERM, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, UMR_S1166, F-75013 Paris, France; (J.S.); (J.R.); (F.S.); (C.P.)
| | - France Dierick
- Lady Davis Institute for Medical Research, McGill University, Montreal, QC H3T 1E2, Canada;
| | - Sophie Nadaud
- INSERM, Institute of Cardiometabolism and Nutrition (ICAN), Sorbonne Université, UMR_S1166, F-75013 Paris, France; (J.S.); (J.R.); (F.S.); (C.P.)
- Correspondence: ; Tel.: +33-14077-9681
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9
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Solinc J, Raimbault‐Machado J, Dierick F, El Bernoussi L, Tu L, Thuillet R, Mougenot N, Hoareau‐Coudert B, Monceau V, Pavoine C, Atassi F, Sassoon D, Marazzi G, Harvey RP, Schofield P, Christ D, Humbert M, Guignabert C, Soubrier F, Nadaud S. Platelet‐Derived Growth Factor Receptor Type α Activation Drives Pulmonary Vascular Remodeling Via Progenitor Cell Proliferation and Induces Pulmonary Hypertension. J Am Heart Assoc 2022; 11:e023021. [PMID: 35348002 PMCID: PMC9075467 DOI: 10.1161/jaha.121.023021] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Background Platelet‐derived growth factor is a major regulator of the vascular remodeling associated with pulmonary arterial hypertension. We previously showed that protein widely 1 (PW1+) vascular progenitor cells participate in early vessel neomuscularization during experimental pulmonary hypertension (PH) and we addressed the role of the platelet‐derived growth factor receptor type α (PDGFRα) pathway in progenitor cell‐dependent vascular remodeling and in PH development. Methods and Results Remodeled pulmonary arteries from patients with idiopathic pulmonary arterial hypertension showed an increased number of perivascular and vascular PW1+ cells expressing PDGFRα. PW1nLacZ reporter mice were used to follow the fate of pulmonary PW1+ progenitor cells in a model of chronic hypoxia–induced PH development. Under chronic hypoxia, PDGFRα inhibition prevented the increase in PW1+ progenitor cell proliferation and differentiation into vascular smooth muscle cells and reduced pulmonary vessel neomuscularization, but did not prevent an increased right ventricular systolic pressure or the development of right ventricular hypertrophy. Conversely, constitutive PDGFRα activation led to neomuscularization via PW1+ progenitor cell differentiation into new smooth muscle cells and to PH development in male mice without fibrosis. In vitro, PW1+ progenitor cell proliferation, but not differentiation, was dependent on PDGFRα activity. Conclusions These results demonstrate a major role of PDGFRα signaling in progenitor cell–dependent lung vessel neomuscularization and vascular remodeling contributing to PH development, including in idiopathic pulmonary arterial hypertension patients. Our findings suggest that PDGFRα blockers may offer a therapeutic add‐on strategy to combine with current pulmonary arterial hypertension treatments to reduce vascular remodeling. Furthermore, our study highlights constitutive PDGFRα activation as a novel experimental PH model.
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Affiliation(s)
- Julien Solinc
- Sorbonne Université, INSERM, UMR_S 1166, Faculté de Médecine Pitié‐Salpêtrière Paris France
- ICAN Institute Paris France
| | - Jessica Raimbault‐Machado
- Sorbonne Université, INSERM, UMR_S 1166, Faculté de Médecine Pitié‐Salpêtrière Paris France
- ICAN Institute Paris France
| | - France Dierick
- Sorbonne Université, INSERM, UMR_S 1166, Faculté de Médecine Pitié‐Salpêtrière Paris France
- Lady Davis Institute for Medical Research, McGill University Montréal QC Canada
| | - Lamiaa El Bernoussi
- Sorbonne Université, INSERM, UMR_S 1166, Faculté de Médecine Pitié‐Salpêtrière Paris France
- ICAN Institute Paris France
| | - Ly Tu
- Université Paris‐Saclay, School of Medicine Le Kremlin‐Bicêtre France
- INSERM, Hôpital Marie Lannelongue, UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies Le Plessis‐Robinson France
| | - Raphaël Thuillet
- Université Paris‐Saclay, School of Medicine Le Kremlin‐Bicêtre France
- INSERM, Hôpital Marie Lannelongue, UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies Le Plessis‐Robinson France
| | - Nathalie Mougenot
- Sorbonne Universités, INSERM, UMS2, Faculté de Médecine Pitié‐Salpêtrière Paris France
| | | | | | - Catherine Pavoine
- Sorbonne Université, INSERM, UMR_S 1166, Faculté de Médecine Pitié‐Salpêtrière Paris France
- ICAN Institute Paris France
| | - Fabrice Atassi
- Sorbonne Université, INSERM, UMR_S 1166, Faculté de Médecine Pitié‐Salpêtrière Paris France
- ICAN Institute Paris France
| | - David Sassoon
- Université de Paris, INSERM, Paris Cardiovascular Research Center Paris France
| | - Giovanna Marazzi
- Université de Paris, INSERM, Paris Cardiovascular Research Center Paris France
| | - Richard P. Harvey
- Victor Chang Cardiac Research Institute Darlinghurst Australia
- St. Vincent’s Clinical School and School of Biotechnology and Biomolecular Science UNSW Sydney Sydney Australia
| | - Peter Schofield
- St. Vincent’s Clinical School and School of Biotechnology and Biomolecular Science UNSW Sydney Sydney Australia
- Immunology Division Garvan Institute of Medical Research Darlinghurst Australia
| | - Daniel Christ
- St. Vincent’s Clinical School and School of Biotechnology and Biomolecular Science UNSW Sydney Sydney Australia
- Immunology Division Garvan Institute of Medical Research Darlinghurst Australia
| | - Marc Humbert
- Université Paris‐Saclay, School of Medicine Le Kremlin‐Bicêtre France
- INSERM, Hôpital Marie Lannelongue, UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies Le Plessis‐Robinson France
- Department of Respiratory and Intensive Care Medicine Assistance Publique–Hôpitaux de Paris (AP‐HP)Pulmonary Hypertension National Referral CenterHôpital Bicêtre Le Kremlin‐Bicêtre France
| | - Christophe Guignabert
- Université Paris‐Saclay, School of Medicine Le Kremlin‐Bicêtre France
- INSERM, Hôpital Marie Lannelongue, UMR_S 999 «Pulmonary Hypertension: Pathophysiology and Novel Therapies Le Plessis‐Robinson France
| | - Florent Soubrier
- Sorbonne Université, INSERM, UMR_S 1166, Faculté de Médecine Pitié‐Salpêtrière Paris France
- ICAN Institute Paris France
| | - Sophie Nadaud
- Sorbonne Université, INSERM, UMR_S 1166, Faculté de Médecine Pitié‐Salpêtrière Paris France
- ICAN Institute Paris France
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10
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El Sissy FN, Wassef M, Faucon B, Salvan D, Nadaud S, Coulet F, Adle-Biassette H, Soubrier F, Bisdorff A, Eyries M. Somatic Mutational Landscape of Extracranial Arteriovenous Malformations and Phenotypic Correlations. J Eur Acad Dermatol Venereol 2022; 36:905-912. [PMID: 35238086 DOI: 10.1111/jdv.18046] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 11/29/2021] [Accepted: 02/15/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Somatic genetic variants may be the cause of extracranial arteriovenous malformations, but few studies have explored these genetic anomalies, and no genotype-phenotype correlations have been identified. OBJECTIVES To characterize the somatic genetic landscape of extracranial arteriovenous malformations and correlate these findings with the phenotypic characteristics of these lesions. METHODS This study included twenty-three patients with extracranial arteriovenous malformations that were confirmed clinically and treated by surgical resection, and for whom frozen tissue samples were available. Targeted next-generation sequencing analysis of tissues was performed using a gene panel that included vascular disease-related genes and tumor-related genes. RESULTS We identified a pathogenic variant in 18 out of 23 samples (78.3%). Pathogenic variants were mainly located in MAP2K1 (n=7) and KRAS (n=6), and more rarely in BRAF (n=2) and RASA1 (n=3). KRAS variants were significantly (p<0.005) associated with severe extended facial arteriovenous malformations, for which relapse after surgical resection is frequently observed, while MAP2K1 variants were significantly (p<0.005) associated with less severe, limited arteriovenous malformations located on the lips. CONCLUSIONS Our study highlights a high prevalence of pathogenic somatic variants, predominantly in MAP2K1 and KRAS, in extracranial arteriovenous malformations. In addition, our study identifies for the first time a correlation between the genotype, clinical severity and angiographic characteristics of extracranial arteriovenous malformations. The RAS/MAPK variants identified in this study are known to be associated with malignant tumors for which targeted therapies have already been developed. Thus, identification of these somatic variants could lead to new therapeutic options to improve the management of patients with extracranial arteriovenous malformations.
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Affiliation(s)
- F N El Sissy
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Department of Pathology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Faculty of Medicine, Paris, France
| | - M Wassef
- Department of Pathology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Faculty of Medicine, Paris, France
| | - B Faucon
- Department of Otorhinolaryngology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - D Salvan
- Department of Otorhinolaryngology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - S Nadaud
- Sorbonne Université, INSERM, UMR_S1166, Unité de recherche sur les maladies cardiovasculaires, ICAN, le métabolisme et la nutrition, Paris, France
| | - F Coulet
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France
| | - H Adle-Biassette
- Department of Pathology, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, University of Paris, Faculty of Medicine, Paris, France
| | - F Soubrier
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, UMR_S1166, Unité de recherche sur les maladies cardiovasculaires, ICAN, le métabolisme et la nutrition, Paris, France
| | - A Bisdorff
- Department of Neuroradiology, Lariboisère Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - M Eyries
- Sorbonne Université, Département de génétique, Assistance Publique-Hôpitaux de Paris, Hôpital Pitié-Salpêtrière, Paris, France.,Sorbonne Université, INSERM, UMR_S1166, Unité de recherche sur les maladies cardiovasculaires, ICAN, le métabolisme et la nutrition, Paris, France
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11
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Tas B, Starnoni D, Smajda S, Vivanti AJ, Adamsbaum C, Eyries M, Melki J, Tawk M, Ozanne A, Revencu N, Soubrier F, Siala S, Vikkula M, Deiva K, Saliou G. Arteriovenous Cerebral High Flow Shunts in Children: From Genotype to Phenotype. Front Pediatr 2022; 10:871565. [PMID: 35547535 PMCID: PMC9081809 DOI: 10.3389/fped.2022.871565] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To study the genotypes and phenotypes of cerebral arteriovenous fistulas that drain or do not drain through the vein of Galen, and true vein of Galen aneurysmal malformations, in order to determine whether genotyping could help improve classification of these malformations and their management. METHODS We carried out a retrospective review of genetic and phenotypic data in databases of four centers. All children with cerebral arteriovenous fistula or vein of Galen aneurysmal malformations aged below 18 years at onset were included. We recorded the nature of the genetic variant or absence of variant, age at onset, type of malformation, symptoms at onset (hemorrhage, neurological deficit, hydrocephalus, incidental, and heart failure), type of venous drainage and the long-term outcome. RESULTS One hundred and fifteen children were included. Autosomal dominant variants were identified in 39% of patients. The most frequent variant affected was the RASA1 gene (25%) followed by EPHB4 (8%) and the HHT-associated genes (5%). HHT gene variants were only observed in pial arteriovenous fistula not draining into the vein of Galen; on the contrary, EPHB4 variants were only seen in genuine vein of Galen aneurysmal malformation. RASA1 variants were identified in all types of shunts. CONCLUSIONS EPHB4 variants seem specific to the vein of Galen aneurysmal malformation, RASA1 variants are associated with either pial arteriovenous fistulas or with genuine VGAM and HHT gene variants seem specific to pial arteriovenous fistulas. The genetic data helps to classify these malformations and to guide treatment toward lowest risk of post-operative cerebral ischemic-hemorrhagic complications.
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Affiliation(s)
- Berivan Tas
- Department of Diagnostic Radiology and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Daniele Starnoni
- Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.,Department of Clinical Neurosciences, Lausanne University Hospital, Lausanne, Switzerland
| | - Stanislas Smajda
- de Duve Institute, Université Catholique de Louvain, Human Molecular Genetics, Brussels, Belgium
| | - Alexandre J Vivanti
- INSERM U1195 Petites Molécules de Neuroprotection, Neurogénération et Remyélinisation, Le Kremlin Bicêtre, France
| | - Catherine Adamsbaum
- Service de Radiologie Pédiatrique, Hôpital Bicêtre, Le Kremlin Bicêtre, France.,Laboratoire Traitement et Communication de l'Information, TELECOM ParisTech, Paris, France
| | - Mélanie Eyries
- Department of Genetics, Hôpital Pitié-Salpêtrière, Paris, France
| | - Judith Melki
- INSERM U1195 Petites Molécules de Neuroprotection, Neurogénération et Remyélinisation, Le Kremlin Bicêtre, France
| | - Marcel Tawk
- INSERM U1195 Petites Molécules de Neuroprotection, Neurogénération et Remyélinisation, Le Kremlin Bicêtre, France
| | - Augustin Ozanne
- Department of Neuroradiology, Bicêtre Hospital, Le Kremlin Bicêtre, France
| | - Nicole Revencu
- de Duve Institute, Université Catholique de Louvain, Human Molecular Genetics, Brussels, Belgium
| | - Florent Soubrier
- Department of Genetics, Hôpital Pitié-Salpêtrière, Paris, France
| | - Selima Siala
- Service de Radiologie Pédiatrique, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Miikka Vikkula
- de Duve Institute, Université Catholique de Louvain, Human Molecular Genetics, Brussels, Belgium
| | - Kumaran Deiva
- Service de Neuropédiatrie, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Guillaume Saliou
- Department of Diagnostic Radiology and Interventional Radiology, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,University of Lausanne, Lausanne, Switzerland
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12
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Toshner M, Church C, Harbaum L, Rhodes C, Villar Moreschi SS, Liley J, Jones R, Arora A, Batai K, Desai AA, Coghlan JG, Gibbs JSR, Gor D, Gräf S, Harlow L, Hernandez-Sanchez J, Howard LS, Humbert M, Karnes J, Kiely DG, Kittles R, Knightbridge E, Lam B, Lutz KA, Nichols WC, Pauciulo MW, Pepke-Zaba J, Suntharalingam J, Soubrier F, Trembath RC, Schwantes-An THL, Wort SJ, Wilkins M, Gaine S, Morrell NW, Corris PA. Mendelian randomisation and experimental medicine approaches to IL-6 as a drug target in PAH. Eur Respir J 2021; 59:13993003.02463-2020. [PMID: 34588193 PMCID: PMC8907935 DOI: 10.1183/13993003.02463-2020] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 06/23/2020] [Accepted: 07/15/2021] [Indexed: 11/21/2022]
Abstract
Background Inflammation and dysregulated immunity are important in the development of pulmonary arterial hypertension (PAH). Compelling preclinical data supports the therapeutic blockade of interleukin-6 (IL-6) signalling. Methods We conducted a phase 2 open-label study of intravenous tocilizumab (8 mg·kg−1) over 6 months in patients with group 1 PAH. Co-primary end-points were safety, defined by incidence and severity of adverse events, and change in pulmonary vascular resistance. Separately, a mendelian randomisation study was undertaken on 11 744 individuals with European ancestry including 2085 patients with idiopathic/heritable disease for the IL-6 receptor (IL6R) variant (rs7529229), known to associate with circulating IL-6R levels. Results We recruited 29 patients (male/female 10/19; mean±sd age 54.9±11.4 years). Of these, 19 had heritable/idiopathic PAH and 10 had connective tissue disease-associated PAH. Six were withdrawn prior to drug administration; 23 patients received at least one dose of tocilizumab. Tocilizumab was discontinued in four patients owing to serious adverse events. There were no deaths. Despite evidence of target engagement in plasma IL-6 and C-reactive protein levels, both intention-to-treat and modified intention-to-treat analyses demonstrated no change in pulmonary vascular resistance. Inflammatory markers did not predict treatment response. Mendelian randomisation did not support an effect of the lead IL6R variant on risk of PAH (OR 0.99, p=0.88). Conclusion Adverse events were consistent with the known safety profile of tocilizumab. Tocilizumab did not show any consistent treatment effect. Tocilizumab did not block IL-6 signalling in pulmonary arterial hypertension. Multicentre mendelian randomisation studies additionally did not demonstrate evidence for IL-6R in pulmonary arterial hypertension.https://bit.ly/3xkDxS5
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Affiliation(s)
- Mark Toshner
- Department of Medicine, University of Cambridge, Cambridge, UK .,Royal Papworth Hospital, Cambridge, UK.,Authors contributed equally to this work
| | - Colin Church
- Golden Jubilee Hospital, Glasgow, UK.,Authors contributed equally to this work
| | - Lars Harbaum
- Heart Lung Research Institute, Imperial College, London, UK
| | | | | | - James Liley
- Department of Medicine, University of Cambridge, Cambridge, UK.,MRC Biostatistical Unit, University of Cambridge, Cambridge, UK
| | - Rowena Jones
- Department of Medicine, University of Cambridge, Cambridge, UK
| | - Amit Arora
- Department of Epidemiology and Biostatistics, University of Arizona, Arizona, US
| | - Ken Batai
- Department of Urology, University of Arizona, Arizona, US
| | - Ankit A Desai
- Department of Medicine, Indiana University, Indiana, US
| | | | | | - Dee Gor
- Roche Products Limited, Welwyn Garden City, UK
| | - Stefan Gräf
- Department of Medicine, University of Cambridge, Cambridge, UK
| | | | | | - Luke S Howard
- Heart Lung Research Institute, Imperial College, London, UK
| | - Marc Humbert
- Université Paris-Sud, Le Kremlin-Bicêtre, Paris, France
| | - Jason Karnes
- Department of Epidemiology and Biostatistics, University of Arizona, Arizona, US
| | | | - Rick Kittles
- Department of Epidemiology and Biostatistics, University of Arizona, Arizona, US
| | | | - Brian Lam
- Institute of Metabolic Sciences, University of Cambridge, Cambridge, UK
| | - Katie A Lutz
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, US
| | - William C Nichols
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, US
| | - Michael W Pauciulo
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, US
| | | | | | | | | | | | - S John Wort
- Heart Lung Research Institute, Imperial College, London, UK
| | - Martin Wilkins
- Heart Lung Research Institute, Imperial College, London, UK
| | - Sean Gaine
- Mater Misericordiae University Hospital, Dublin, Ireland
| | - Nicholas W Morrell
- Department of Medicine, University of Cambridge, Cambridge, UK.,Authors contributed equally to this work
| | - Paul A Corris
- Department of Medicine, Newcastle University, Newcastle, UK.,Authors contributed equally to this work
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Eyries M, Girerd B, Savale L, Soubrier F, Humbert M, Montani D. A CELSR1 variant in a patient with pulmonary arterial hypertension. Clin Genet 2021; 100:771-772. [PMID: 34435352 DOI: 10.1111/cge.14046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Affiliation(s)
- Mélanie Eyries
- Sorbonne Université, AP-HP, Département de Génétique, INSERM UMR_S1166, Sorbonne Université, Institute for Cardiometabolism and Nutrition (ICAN), Hôpital Pitié-Salpêtrière, Paris, France
| | - Barbara Girerd
- Department of Respiratory and Intensive Care Medicine, Université Paris-Saclay, AP-HP, INSERM UMR_S 999, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Laurent Savale
- Department of Respiratory and Intensive Care Medicine, Université Paris-Saclay, AP-HP, INSERM UMR_S 999, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Florent Soubrier
- Sorbonne Université, AP-HP, Département de Génétique, INSERM UMR_S1166, Sorbonne Université, Institute for Cardiometabolism and Nutrition (ICAN), Hôpital Pitié-Salpêtrière, Paris, France
| | - Marc Humbert
- Department of Respiratory and Intensive Care Medicine, Université Paris-Saclay, AP-HP, INSERM UMR_S 999, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - David Montani
- Department of Respiratory and Intensive Care Medicine, Université Paris-Saclay, AP-HP, INSERM UMR_S 999, Pulmonary Hypertension National Referral Centre, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
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Ribeiro Guerra M, Coignard J, Eon-Marchais S, Dondon MG, Le Gal D, Beauvallet J, Mebirouk N, Belotti M, Caron O, Gauthier-Villars M, Coupier I, Buecher B, Lortholary A, Fricker JP, Gesta P, Noguès C, Faivre L, Berthet P, Luporsi E, Delnatte C, Bonadona V, Maugard CM, Pujol P, Lasset C, Longy M, Bignon YJ, Adenis-Lavignasse C, Venat-Bouvet L, Dreyfus H, Gladieff L, Mortemousque I, Audebert-Bellanger S, Soubrier F, Giraud S, Lejeune-Dumoulin S, Limacher JM, Chiesa J, Fajac A, Floquet A, Eisinger F, Tinat J, Fert-Ferrer S, Colas C, Frebourg T, Damiola F, Barjhoux L, Cavaciuti E, Mazoyer S, Tardivon A, Lesueur F, Stoppa-Lyonnet D, Andrieu N. Diagnostic chest X-rays and breast cancer risk among women with a hereditary predisposition to breast cancer unexplained by a BRCA1 or BRCA2 mutation. Breast Cancer Res 2021; 23:79. [PMID: 34344426 PMCID: PMC8336294 DOI: 10.1186/s13058-021-01456-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/01/2021] [Accepted: 07/16/2021] [Indexed: 12/03/2022] Open
Abstract
Background Diagnostic ionizing radiation is a risk factor for breast cancer (BC). BC risk increases with increased dose to the chest and decreases with increased age at exposure, with possible effect modification related to familial or genetic predisposition. While chest X-rays increase the BC risk of BRCA1/2 mutation carriers compared to non-carriers, little is known for women with a hereditary predisposition to BC but who tested negative for a BRCA1 or BRCA2 (BRCA1/2) mutation. Methods We evaluated the effect of chest X-rays from diagnostic medical procedures in a dataset composed of 1552 BC cases identified through French family cancer clinics and 1363 unrelated controls. Participants reported their history of X-ray exposures in a detailed questionnaire and were tested for 113 DNA repair genes. Logistic regression and multinomial logistic regression models were used to assess the association with BC. Results Chest X-ray exposure doubled BC risk. A 3% increased BC risk per additional exposure was observed. Being 20 years old or younger at first exposure or being exposed before first full-term pregnancy did not seem to modify this risk. Birth after 1960 or carrying a rare likely deleterious coding variant in a DNA repair gene other than BRCA1/2 modified the effect of chest X-ray exposure. Conclusion Ever/never chest X-ray exposure increases BC risk 2-fold regardless of age at first exposure and, by up to 5-fold when carrying 3 or more rare variants in a DNA repair gene. Further studies are needed to evaluate other DNA repair genes or variants to identify those which could modify radiation sensitivity. Identification of subpopulations that are more or less susceptible to ionizing radiation is important and potentially clinically relevant. Supplementary Information The online version contains supplementary material available at 10.1186/s13058-021-01456-1.
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Affiliation(s)
- Maximiliano Ribeiro Guerra
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France.,Department of Public Health, Faculty of Medicine, Federal University of Juiz de Fora - UFJF, Minas Gerais, Brazil
| | - Juliette Coignard
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Séverine Eon-Marchais
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Marie-Gabrielle Dondon
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Dorothée Le Gal
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Juana Beauvallet
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Noura Mebirouk
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | | | - Olivier Caron
- Gustave Roussy, Département de Médecine Oncologique, Université Paris-Saclay, Villejuif, France
| | | | - Isabelle Coupier
- Hôpital Arnaud de Villeneuve, CHU Montpellier, Service de Génétique Médicale et Oncogénétique, Montpellier, France.,INSERM 896, CRCM Val d'Aurelle, Montpellier, France
| | | | - Alain Lortholary
- Centre Catherine de Sienne, Service d'Oncologie Médicale, Nantes, France
| | | | - Paul Gesta
- CH Georges Renon, Service d'Oncogénétique Régional Poitou-Charentes, Niort, France
| | - Catherine Noguès
- Département d'Anticipation et de Suivi des Cancers, Oncogénétique Clinique, Institut Paoli Calmettes, Marseille, France.,Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Laurence Faivre
- Institut GIMI, CHU de Dijon, Hôpital d'Enfants, Dijon, France.,Centre de Lutte contre le Cancer Georges François Leclerc, Dijon, France
| | - Pascaline Berthet
- Centre François Baclesse, Unité de pathologie gynécologique, Caen, France
| | - Elisabeth Luporsi
- Service de Génétique UF4128 CHR Metz-Thionville, Hôpital de Mercy, Metz, France
| | - Capucine Delnatte
- Centre René Gauducheau, Unité d'Oncogénétique, Nantes, Saint Herblain, France
| | - Valérie Bonadona
- Université Claude Bernard Lyon 1, Villeurbanne, France.,CNRS UMR 5558, Lyon, France.,Centre Léon Bérard, Unité de Prévention et Epidémiologie Génétique, Lyon, France
| | - Christine M Maugard
- Génétique Oncologique moléculaire, UF1422, Département d'Oncobiologie, LBBM, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.,UF6948 Génétique Oncologique Clinique, Evaluation familiale et suivi, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Pascal Pujol
- Hôpital Arnaud de Villeneuve, CHU Montpellier, Service de Génétique Médicale et Oncogénétique, Montpellier, France.,INSERM 896, CRCM Val d'Aurelle, Montpellier, France
| | - Christine Lasset
- Université Claude Bernard Lyon 1, Villeurbanne, France.,CNRS UMR 5558, Lyon, France.,Centre Léon Bérard, Unité de Prévention et Epidémiologie Génétique, Lyon, France
| | | | - Yves-Jean Bignon
- Département d'oncogénétique, Centre Jean Perrin, Université Clermont Auvergne, UMR INSERM 1240, Clermont Ferrand, France
| | | | | | - Hélène Dreyfus
- Clinique Sainte Catherine, Avignon, France.,Hôpital Couple-Enfant, Département de Génétique, CHU de Grenoble, Grenoble, France
| | - Laurence Gladieff
- Institut Claudius Regaud - IUCT-Oncopole, Service d'Oncologie Médicale, Toulouse, France
| | | | | | | | - Sophie Giraud
- Hospices Civils de Lyon, Service de Génétique, Groupement Hospitalier EST, Bron, France
| | | | | | - Jean Chiesa
- Service d'Oncologie Médicale, CHRU Hôpital Caremeau, Nîmes, France
| | - Anne Fajac
- Service d'Oncogénétique, Hôpital Tenon, Paris, France
| | | | - François Eisinger
- Département d'Anticipation et de Suivi des Cancers, Oncogénétique Clinique, Institut Paoli Calmettes, Marseille, France.,Aix Marseille Univ, INSERM, IRD, SESSTIM, Marseille, France
| | - Julie Tinat
- Groupe Hospitalier Pellegrin, Service de génétique médicale, CHU De Bordeaux, Bordeaux, France
| | | | - Chrystelle Colas
- Institut Curie, Service de Génétique, Paris, France.,Institut Curie, Hopital René Huguenin, Saint-Cloud, France
| | - Thierry Frebourg
- Département de Génétique, Hopital Universitaire de Rouen, Rouen, France
| | - Francesca Damiola
- Department of Biopathology, Pathology Research platform, Centre Léon Bérard, Lyon, France
| | - Laure Barjhoux
- GCS AURAGEN, Plateforme de Génétique, Hôpital Edouart Herriot, Lyon, France
| | - Eve Cavaciuti
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Sylvie Mazoyer
- Centre de Recherche en Neurosciences de Lyon, INSERM U1028, CNRS UMR5292, Université Lyon 1, Université Saint Etienne, Lyon, France
| | - Anne Tardivon
- Service de Radiologie, Institut Curie, Paris, France
| | - Fabienne Lesueur
- INSERM, U900, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Dominique Stoppa-Lyonnet
- Institut Curie, Service de Génétique, Paris, France.,INSERM, U830, Paris, France.,Université Paris-Descartes, Paris, France
| | - Nadine Andrieu
- INSERM, U900, Paris, France. .,Institut Curie, Paris, France. .,Mines ParisTech, Fontainebleau, France. .,PSL Research University, Paris, France.
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15
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Montani D, Girerd B, Jaïs X, Laveneziana P, Lau EMT, Bouchachi A, Hascoët S, Günther S, Godinas L, Parent F, Guignabert C, Beurnier A, Chemla D, Hervé P, Eyries M, Soubrier F, Simonneau G, Sitbon O, Savale L, Humbert M. Screening for pulmonary arterial hypertension in adults carrying a BMPR2 mutation. Eur Respir J 2021; 58:13993003.04229-2020. [PMID: 33380512 PMCID: PMC8295506 DOI: 10.1183/13993003.04229-2020] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [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: 11/18/2020] [Accepted: 12/17/2020] [Indexed: 11/17/2022]
Abstract
Background Heritable pulmonary arterial hypertension (PAH) is most commonly due to heterozygous mutations of the BMPR2 gene. Based on expert consensus, guidelines recommend annual screening echocardiography in asymptomatic BMPR2 mutation carriers. The main objectives of this study were to evaluate the characteristics of asymptomatic BMPR2 mutation carriers, assess their risk of occurrence of PAH and detect PAH at an early stage in this high-risk population. Methods Asymptomatic BMPR2 mutation carriers underwent screening at baseline and annually for a minimum of 2 years (DELPHI-2 study; ClinicalTrials.gov: NCT01600898). Annual screening included clinical assessment, ECG, pulmonary function tests, 6-min walk distance, cardiopulmonary exercise testing, chest radiography, echocardiography and brain natriuretic peptide (BNP) or N-terminal (NT)-proBNP level. Right heart catheterisation (RHC) was performed based on predefined criteria. An optional RHC at rest and exercise was proposed at baseline. Results 55 subjects (26 males; median age 37 years) were included. At baseline, no PAH was suspected based on echocardiography and NT-proBNP levels. All subjects accepted RHC at inclusion, which identified two mild PAH cases (3.6%) and 12 subjects with exercise pulmonary hypertension (21.8%). At long-term follow-up (118.8 patient-years of follow-up), three additional cases were diagnosed, yielding a PAH incidence of 2.3% per year (0.99% per year in males and 3.5% per year in females). All PAH cases remained at low-risk status on oral therapy at last follow-up. Conclusions Asymptomatic BMPR2 mutation carriers have a significant risk of developing incident PAH. International multicentre studies are needed to confirm that refined multimodal screening programmes with regular follow-up allow early detection of PAH. Asymptomatic BMPR2 mutation carriers have a 2.3% per year risk of developing PAH. DELPHI-2 provides the platform for future international multicentre studies to refine multimodal screening algorithms in BMPR2 mutation carriers.http://bit.ly/3oi2KJ1
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Affiliation(s)
- David Montani
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,These two authors contributed equally to this work
| | - Barbara Girerd
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,These two authors contributed equally to this work
| | - Xavier Jaïs
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Pierantonio Laveneziana
- INSERM UMRS 1158, Neurophysiologie Respiratoire Expérimentale et Clinique, Sorbonne Université, Paris, France.,Service des Explorations Fonctionnelles de la Respiration, de l'Exercice et de la Dyspnée, Département Médico-Universitaire "APPROCHES", Hôpitaux Universitaires Pitié-Salpêtrière, Tenon et Saint-Antoine, AP-HP, Sorbonne Université, Paris, France
| | - Edmund M T Lau
- Dept of Respiratory Medicine, Royal Prince Alfred Hospital, Camperdown, Australia
| | - Amir Bouchachi
- INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Service de Cardiologie, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Sébastien Hascoët
- INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Pôle de Cardiologie Pédiatrique et Congénitale, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Sven Günther
- Service de Physiologie, AP-HP, Georges Pompidou European Hospital, Paris, France
| | - Laurent Godinas
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Florence Parent
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Christophe Guignabert
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Antoine Beurnier
- INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Service de Physiologie, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Denis Chemla
- INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Service de Physiologie, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France
| | - Philippe Hervé
- INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France.,Service de Chirurgie Thoracique, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Mélanie Eyries
- Département de Génétique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.,INSERM UMRS 1166, Sorbonne Université and Institute for Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Florent Soubrier
- Département de Génétique, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.,INSERM UMRS 1166, Sorbonne Université and Institute for Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Gérald Simonneau
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Olivier Sitbon
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Laurent Savale
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | - Marc Humbert
- School of Medicine, Université Paris-Saclay, Le Kremlin-Bicêtre, France .,Service de Pneumologie et Soins Intensifs Respiratoires, AP-HP, Hôpital Bicêtre, Le Kremlin-Bicêtre, France.,INSERM UMRS 999, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
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16
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Dierick F, Solinc J, Bignard J, Soubrier F, Nadaud S. Progenitor/Stem Cells in Vascular Remodeling during Pulmonary Arterial Hypertension. Cells 2021; 10:cells10061338. [PMID: 34071347 PMCID: PMC8226806 DOI: 10.3390/cells10061338] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/12/2021] [Accepted: 05/21/2021] [Indexed: 12/18/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is characterized by an important occlusive vascular remodeling with the production of new endothelial cells, smooth muscle cells, myofibroblasts, and fibroblasts. Identifying the cellular processes leading to vascular proliferation and dysfunction is a major goal in order to decipher the mechanisms leading to PAH development. In addition to in situ proliferation of vascular cells, studies from the past 20 years have unveiled the role of circulating and resident vascular in pulmonary vascular remodeling. This review aims at summarizing the current knowledge on the different progenitor and stem cells that have been shown to participate in pulmonary vascular lesions and on the pathways regulating their recruitment during PAH. Finally, this review also addresses the therapeutic potential of circulating endothelial progenitor cells and mesenchymal stem cells.
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Affiliation(s)
- France Dierick
- Lady Davis Institute for Medical Research, McGill University, Montréal, QC H3T 1E2, Canada;
| | - Julien Solinc
- UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, INSERM, Sorbonne Université, 75013 Paris, France; (J.S.); (J.B.); (F.S.)
| | - Juliette Bignard
- UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, INSERM, Sorbonne Université, 75013 Paris, France; (J.S.); (J.B.); (F.S.)
| | - Florent Soubrier
- UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, INSERM, Sorbonne Université, 75013 Paris, France; (J.S.); (J.B.); (F.S.)
| | - Sophie Nadaud
- UMR_S 1166, Faculté de Médecine Pitié-Salpêtrière, INSERM, Sorbonne Université, 75013 Paris, France; (J.S.); (J.B.); (F.S.)
- Correspondence:
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17
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Hong J, Arneson D, Umar S, Ruffenach G, Cunningham CM, Ahn IS, Diamante G, Bhetraratana M, Park JF, Said E, Huynh C, Le T, Medzikovic L, Humbert M, Soubrier F, Montani D, Girerd B, Trégouët DA, Channick R, Saggar R, Eghbali M, Yang X. Single-Cell Study of Two Rat Models of Pulmonary Arterial Hypertension Reveals Connections to Human Pathobiology and Drug Repositioning. Am J Respir Crit Care Med 2021; 203:1006-1022. [PMID: 33021809 PMCID: PMC8048757 DOI: 10.1164/rccm.202006-2169oc] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [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: 06/07/2020] [Accepted: 10/06/2020] [Indexed: 12/14/2022] Open
Abstract
Rationale: The cellular and molecular landscape and translational value of commonly used models of pulmonary arterial hypertension (PAH) are poorly understood. Single-cell transcriptomics can enhance molecular understanding of preclinical models and facilitate their rational use and interpretation.Objectives: To determine and prioritize dysregulated genes, pathways, and cell types in lungs of PAH rat models to assess relevance to human PAH and identify drug repositioning candidates.Methods: Single-cell RNA sequencing was performed on the lungs of monocrotaline (MCT), Sugen-hypoxia (SuHx), and control rats to identify altered genes and cell types, followed by validation using flow-sorted cells, RNA in situ hybridization, and immunofluorescence. Relevance to human PAH was assessed by histology of lungs from patients and via integration with human PAH genetic loci and known disease genes. Candidate drugs were predicted using Connectivity Map.Measurements and Main Results: Distinct changes in genes and pathways in numerous cell types were identified in SuHx and MCT lungs. Widespread upregulation of NF-κB signaling and downregulation of IFN signaling was observed across cell types. SuHx nonclassical monocytes and MCT conventional dendritic cells showed particularly strong NF-κB pathway activation. Genes altered in SuHx nonclassical monocytes were significantly enriched for PAH-associated genes and genetic variants, and candidate drugs predicted to reverse the changes were identified. An open-access online platform was developed to share single-cell data and drug candidates (http://mergeomics.research.idre.ucla.edu/PVDSingleCell/).Conclusions: Our study revealed the distinct and shared dysregulation of genes and pathways in two commonly used PAH models for the first time at single-cell resolution and demonstrated their relevance to human PAH and utility for drug repositioning.
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Affiliation(s)
- Jason Hong
- Division of Pulmonary and Critical Care Medicine
| | | | - Soban Umar
- Department of Anesthesiology and Perioperative Medicine, and
| | | | | | - In Sook Ahn
- Department of Integrative Biology and Physiology
| | | | - May Bhetraratana
- Division of Cardiology, University of California Los Angeles, Los Angeles, California
| | - John F. Park
- Department of Anesthesiology and Perioperative Medicine, and
| | - Emma Said
- Department of Anesthesiology and Perioperative Medicine, and
| | | | - Trixie Le
- Department of Anesthesiology and Perioperative Medicine, and
| | | | - Marc Humbert
- Department of Respiratory and Intensive Care Medicine, Bicêtre Hospital, University of Paris-Saclay, National Institute of Health and Medical Research Joint Research Unit S 999, Public Assistance Hospitals of Paris, Le Kremlin-Bicêtre, France
| | - Florent Soubrier
- Institut Hospitalo–Universitaire Cardiométabolisme et Nutrition, Paris, France; and
| | - David Montani
- Department of Respiratory and Intensive Care Medicine, Bicêtre Hospital, University of Paris-Saclay, National Institute of Health and Medical Research Joint Research Unit S 999, Public Assistance Hospitals of Paris, Le Kremlin-Bicêtre, France
| | - Barbara Girerd
- Department of Respiratory and Intensive Care Medicine, Bicêtre Hospital, University of Paris-Saclay, National Institute of Health and Medical Research Joint Research Unit S 999, Public Assistance Hospitals of Paris, Le Kremlin-Bicêtre, France
| | - David-Alexandre Trégouët
- Bordeaux Population Health Research Center, University of Bordeaux, National Institute of Health and Medical Research Joint Research Unit 1219, Bordeaux, France
| | | | - Rajan Saggar
- Division of Pulmonary and Critical Care Medicine
| | | | - Xia Yang
- Department of Integrative Biology and Physiology
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18
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Swietlik EM, Greene D, Zhu N, Megy K, Cogliano M, Rajaram S, Pandya D, Tilly T, Lutz KA, Welch CC, Pauciulo MW, Southgate L, Martin JM, Treacy CM, Penkett CJ, Stephens JC, Bogaard HJ, Church C, Coghlan G, Coleman AW, Condliffe R, Eichstaedt CA, Eyries M, Gall H, Ghio S, Girerd B, Grünig E, Holden S, Howard L, Humbert M, Kiely DG, Kovacs G, Lordan J, Machado RD, MacKenzie Ross RV, McCabe C, Moledina S, Montani D, Olschewski H, Pepke-Zaba J, Price L, Rhodes CJ, Seeger W, Soubrier F, Suntharalingam J, Toshner MR, Vonk Noordegraaf A, Wharton J, Wild JM, Wort SJ, Lawrie A, Wilkins MR, Trembath RC, Shen Y, Chung WK, Swift AJ, Nichols WC, Morrell NW, Gräf S. Bayesian Inference Associates Rare KDR Variants with Specific Phenotypes in Pulmonary Arterial Hypertension. Circ Genom Precis Med 2020; 14. [PMID: 33320693 PMCID: PMC7892262 DOI: 10.1161/circgen.120.003155] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 11/29/2020] [Indexed: 11/26/2022]
Abstract
Background - Approximately 25% of patients with pulmonary arterial hypertension (PAH) have been found to harbor rare mutations in disease-causing genes. To identify missing heritability in PAH we integrated deep phenotyping with whole-genome sequencing data using Bayesian statistics. Methods - We analyzed 13,037 participants enrolled in the NIHR BioResource - Rare Diseases (NBR) study, of which 1,148 were recruited to the PAH domain. To test for genetic associations between genes and selected phenotypes of pulmonary hypertension (PH), we used the Bayesian rare-variant association method BeviMed. Results - Heterozygous, high impact, likely loss-of-function variants in the Kinase Insert Domain Receptor (KDR) gene were strongly associated with significantly reduced transfer coefficient for carbon monoxide (KCO, posterior probability (PP)=0.989) and older age at diagnosis (PP=0.912). We also provide evidence for familial segregation of a rare nonsense KDR variant with these phenotypes. On computed tomographic imaging of the lungs, a range of parenchymal abnormalities were observed in the five patients harboring these predicted deleterious variants in KDR. Four additional PAH cases with rare likely loss-of-function variants in KDR were independently identified in the US PAH Biobank cohort with similar phenotypic characteristics. Conclusions - The Bayesian inference approach allowed us to independently validate KDR, which encodes for the Vascular Endothelial Growth Factor Receptor 2 (VEGFR2), as a novel PAH candidate gene. Furthermore, this approach specifically associated high impact likely loss-of-function variants in the genetically constrained gene with distinct phenotypes. These findings provide evidence for KDR being a clinically actionable PAH gene and further support the central role of the vascular endothelium in the pathobiology of PAH.
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Affiliation(s)
- Emilia M. Swietlik
- Department of Medicine (E.M.S., D.P., T.T., C.M.T., M.R.T., N.W.M., S. Gräf), University of Cambridge
| | - Daniel Greene
- Department of Haematology (D.G., K.M., C.J.P., J.C.S., S. Gräf), University of Cambridge
- NIHR BioResource for Translational Research, Cambridge, United Kingdom (D.G., K.M., J.M.M., C.J.P., J.C.S., N.W.M., S. Gräf)
| | - Na Zhu
- Department of Pediatrics (N.Z., C.C.L.W.), Columbia University, NY
- Department of Systems Biology (N.Z., Y.S.), Columbia University, NY
| | - Karyn Megy
- Department of Haematology (D.G., K.M., C.J.P., J.C.S., S. Gräf), University of Cambridge
- NIHR BioResource for Translational Research, Cambridge, United Kingdom (D.G., K.M., J.M.M., C.J.P., J.C.S., N.W.M., S. Gräf)
| | - Marcella Cogliano
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield (M.C., J.M.W., A.L., A.J.S.)
| | - Smitha Rajaram
- Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom (S.R.)
| | - Divya Pandya
- Department of Medicine (E.M.S., D.P., T.T., C.M.T., M.R.T., N.W.M., S. Gräf), University of Cambridge
| | - Tobias Tilly
- Department of Medicine (E.M.S., D.P., T.T., C.M.T., M.R.T., N.W.M., S. Gräf), University of Cambridge
| | - Katie A. Lutz
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center (K.A.L., M.W.P., A.W.C., W.C.N.)
| | | | - Michael W. Pauciulo
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center (K.A.L., M.W.P., A.W.C., W.C.N.)
- Department of Pediatrics, University of Cincinnati College of Medicine, OH (M.W.P., W.C.N.)
| | - Laura Southgate
- Molecular & Clinical Sciences Research Institute, St George’s, University of London, United Kingdom (L.S., R.D.M.)
| | - Jennifer M. Martin
- NIHR BioResource for Translational Research, Cambridge, United Kingdom (D.G., K.M., J.M.M., C.J.P., J.C.S., N.W.M., S. Gräf)
| | - Carmen M. Treacy
- Department of Medicine (E.M.S., D.P., T.T., C.M.T., M.R.T., N.W.M., S. Gräf), University of Cambridge
| | - Christopher J. Penkett
- Department of Haematology (D.G., K.M., C.J.P., J.C.S., S. Gräf), University of Cambridge
- NIHR BioResource for Translational Research, Cambridge, United Kingdom (D.G., K.M., J.M.M., C.J.P., J.C.S., N.W.M., S. Gräf)
| | - Jonathan C. Stephens
- Department of Haematology (D.G., K.M., C.J.P., J.C.S., S. Gräf), University of Cambridge
- NIHR BioResource for Translational Research, Cambridge, United Kingdom (D.G., K.M., J.M.M., C.J.P., J.C.S., N.W.M., S. Gräf)
| | - Harm J. Bogaard
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands (H.J.B., A.V.N.)
| | - Colin Church
- Golden Jubilee National Hospital, Glasgow (C.C.)
| | | | - Anna W. Coleman
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center (K.A.L., M.W.P., A.W.C., W.C.N.)
| | - Robin Condliffe
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, United Kingdom (R.C., D.G.K.)
| | - Christina A. Eichstaedt
- Laboratory for Molecular Genetic Diagnostics, Institute of Human Genetics, Heidelberg University (C.A.E.)
- Center for Pulmonary Hypertension, Thoraxklinik gGmbH Heidelberg at Heidelberg University Hospital (C.A.E., E.G.)
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany (C.A.E., E.G.)
| | - Mélanie Eyries
- Département de génétique, hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris & UMR_S 1166-ICAN, INSERM, UPMC Sorbonne Universités, Paris, France (M.E., F.S.)
| | - Henning Gall
- University of Giessen & Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL) and of the Excellence Cluster Cardio-Pulmonary Institute (CPI), Giessen, Germany (H.G., W.S.)
| | - Stefano Ghio
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy (S. Ghio)
| | - Barbara Girerd
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay (B.G., M.H., D.M.)
- AP-HP, Service de Pneumologie, Centre de référence de l’hypertension pulmonaire (B.G., M.H., D.M.)
- INSERM UMR_S 999, Hôpital Bicêtre, Le Kremlin-Bicêtre, Paris, France (B.G., M.H., D.M.)
| | - Ekkehard Grünig
- Center for Pulmonary Hypertension, Thoraxklinik gGmbH Heidelberg at Heidelberg University Hospital (C.A.E., E.G.)
- Translational Lung Research Center Heidelberg (TLRC), German Center for Lung Research (DZL), Heidelberg, Germany (C.A.E., E.G.)
| | - Simon Holden
- Addenbrooke’s Hospital NHS Foundation Trust, Cambridge (S.H., N.W.M.)
| | - Luke Howard
- National Heart & Lung Institute, Imperial College London, United Kingdom (L.H., C.M., L.P., C.J.R., J.W., S.J.W., M.R.W.)
| | - Marc Humbert
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay (B.G., M.H., D.M.)
- AP-HP, Service de Pneumologie, Centre de référence de l’hypertension pulmonaire (B.G., M.H., D.M.)
- INSERM UMR_S 999, Hôpital Bicêtre, Le Kremlin-Bicêtre, Paris, France (B.G., M.H., D.M.)
| | - David G. Kiely
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, United Kingdom (R.C., D.G.K.)
| | - Gabor Kovacs
- Ludwig Boltzmann Institute for Lung Vascular Research (G.K., H.O.)
- Medical University of Graz, Austria (G.K., H.O.)
| | - Jim Lordan
- Freeman Hospital, Newcastle upon Tyne (J.L.)
| | - Rajiv D. Machado
- Molecular & Clinical Sciences Research Institute, St George’s, University of London, United Kingdom (L.S., R.D.M.)
| | | | - Colm McCabe
- National Heart & Lung Institute, Imperial College London, United Kingdom (L.H., C.M., L.P., C.J.R., J.W., S.J.W., M.R.W.)
- Royal Brompton & Harefield NHS Foundation Trust (C.M., L.P., S.J.W.)
| | | | - David Montani
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay (B.G., M.H., D.M.)
- AP-HP, Service de Pneumologie, Centre de référence de l’hypertension pulmonaire (B.G., M.H., D.M.)
- INSERM UMR_S 999, Hôpital Bicêtre, Le Kremlin-Bicêtre, Paris, France (B.G., M.H., D.M.)
| | - Horst Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research (G.K., H.O.)
- Medical University of Graz, Austria (G.K., H.O.)
| | - Joanna Pepke-Zaba
- Royal Papworth Hospital NHS Foundation Trust (J.P.-Z., M.R.T., N.W.M.)
| | - Laura Price
- National Heart & Lung Institute, Imperial College London, United Kingdom (L.H., C.M., L.P., C.J.R., J.W., S.J.W., M.R.W.)
- Royal Brompton & Harefield NHS Foundation Trust (C.M., L.P., S.J.W.)
| | - Christopher J. Rhodes
- National Heart & Lung Institute, Imperial College London, United Kingdom (L.H., C.M., L.P., C.J.R., J.W., S.J.W., M.R.W.)
| | - Werner Seeger
- University of Giessen & Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL) and of the Excellence Cluster Cardio-Pulmonary Institute (CPI), Giessen, Germany (H.G., W.S.)
| | - Florent Soubrier
- Département de génétique, hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris & UMR_S 1166-ICAN, INSERM, UPMC Sorbonne Universités, Paris, France (M.E., F.S.)
| | | | - Mark R. Toshner
- Department of Medicine (E.M.S., D.P., T.T., C.M.T., M.R.T., N.W.M., S. Gräf), University of Cambridge
- Royal Papworth Hospital NHS Foundation Trust (J.P.-Z., M.R.T., N.W.M.)
| | - Anton Vonk Noordegraaf
- Department of Clinical Genetics, Amsterdam UMC, Vrije Universiteit Amsterdam, the Netherlands (H.J.B., A.V.N.)
| | - John Wharton
- National Heart & Lung Institute, Imperial College London, United Kingdom (L.H., C.M., L.P., C.J.R., J.W., S.J.W., M.R.W.)
| | - James M. Wild
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield (M.C., J.M.W., A.L., A.J.S.)
| | - Stephen John Wort
- National Heart & Lung Institute, Imperial College London, United Kingdom (L.H., C.M., L.P., C.J.R., J.W., S.J.W., M.R.W.)
- Royal Brompton & Harefield NHS Foundation Trust (C.M., L.P., S.J.W.)
| | | | | | | | - Allan Lawrie
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield (M.C., J.M.W., A.L., A.J.S.)
| | - Martin R. Wilkins
- National Heart & Lung Institute, Imperial College London, United Kingdom (L.H., C.M., L.P., C.J.R., J.W., S.J.W., M.R.W.)
| | - Richard C. Trembath
- Department of Medical & Molecular Genetics, King’s College London, United Kingdom (R.C.T.)
| | - Yufeng Shen
- Department of Systems Biology (N.Z., Y.S.), Columbia University, NY
- Department of Biomedical Informatics (Y.S.), Columbia University, NY
| | | | - Andrew J. Swift
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield (M.C., J.M.W., A.L., A.J.S.)
| | - William C. Nichols
- Division of Human Genetics, Cincinnati Children’s Hospital Medical Center (K.A.L., M.W.P., A.W.C., W.C.N.)
- Department of Pediatrics, University of Cincinnati College of Medicine, OH (M.W.P., W.C.N.)
| | - Nicholas W. Morrell
- Department of Medicine (E.M.S., D.P., T.T., C.M.T., M.R.T., N.W.M., S. Gräf), University of Cambridge
- NIHR BioResource for Translational Research, Cambridge, United Kingdom (D.G., K.M., J.M.M., C.J.P., J.C.S., N.W.M., S. Gräf)
- Addenbrooke’s Hospital NHS Foundation Trust, Cambridge (S.H., N.W.M.)
- Royal Papworth Hospital NHS Foundation Trust (J.P.-Z., M.R.T., N.W.M.)
| | - Stefan Gräf
- Department of Medicine (E.M.S., D.P., T.T., C.M.T., M.R.T., N.W.M., S. Gräf), University of Cambridge
- Department of Haematology (D.G., K.M., C.J.P., J.C.S., S. Gräf), University of Cambridge
- NIHR BioResource for Translational Research, Cambridge, United Kingdom (D.G., K.M., J.M.M., C.J.P., J.C.S., N.W.M., S. Gräf)
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19
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Manaud G, Nossent EJ, Lambert M, Ghigna MR, Boët A, Vinhas MC, Ranchoux B, Dumas SJ, Courboulin A, Girerd B, Soubrier F, Bignard J, Claude O, Lecerf F, Hautefort A, Florio M, Sun B, Nadaud S, Verleden SE, Remy S, Anegon I, Bogaard HJ, Mercier O, Fadel E, Simonneau G, Vonk Noordegraaf A, Grünberg K, Humbert M, Montani D, Dorfmüller P, Antigny F, Perros F. Comparison of Human and Experimental Pulmonary Veno-Occlusive Disease. Am J Respir Cell Mol Biol 2020; 63:118-131. [PMID: 32209028 DOI: 10.1165/rcmb.2019-0015oc] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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
Pulmonary veno-occlusive disease (PVOD) occurs in humans either as a heritable form (hPVOD) due to biallelic inactivating mutations of EIF2AK4 (encoding GCN2) or as a sporadic form in older age (sPVOD). The chemotherapeutic agent mitomycin C (MMC) is a potent inducer of PVOD in humans and in rats (MMC-PVOD). Here, we compared human hPVOD and sPVOD, and MMC-PVOD pathophysiology at the histological, cellular, and molecular levels to unravel common altered pathomechanisms. MMC exposure in rats was associated primarily with arterial and microvessel remodeling, and secondarily by venous remodeling, when PVOD became symptomatic. In all forms of PVOD tested, there was convergent GCN2-dependent but eIF2α-independent pulmonary protein overexpression of HO-1 (heme oxygenase 1) and CHOP (CCAAT-enhancer-binding protein [C/EBP] homologous protein), two downstream effectors of GCN2 signaling and endoplasmic reticulum stress. In human PVOD samples, CHOP immunohistochemical staining mainly labeled endothelial cells in remodeled veins and arteries. Strong HO-1 staining was observed only within capillary hemangiomatosis foci, where intense microvascular proliferation occurs. HO-1 and CHOP stainings were not observed in control and pulmonary arterial hypertension lung tissues, supporting the specificity for CHOP and HO-1 involvement in PVOD pathobiology. In vivo loss of GCN2 (EIF2AK4 mutations carriers and Eif2ak4-/- rats) or in vitro GCN2 inhibition in cultured pulmonary artery endothelial cells using pharmacological and siRNA approaches demonstrated that GCN2 loss of function negatively regulates BMP (bone morphogenetic protein)-dependent SMAD1/5/9 signaling. Exogenous BMP9 was still able to reverse GCN2 inhibition-induced proliferation of pulmonary artery endothelial cells. In conclusion, we identified CHOP and HO-1 inhibition, and BMP9, as potential therapeutic options for PVOD.
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Affiliation(s)
- Grégoire Manaud
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Esther J Nossent
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Mélanie Lambert
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | | | - Angèle Boët
- Department of Research, Hôpital Marie Lannelongue, Le Plessis-Robinson, France
| | | | - Benoit Ranchoux
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Sébastien J Dumas
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Audrey Courboulin
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Barbara Girerd
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Florent Soubrier
- INSERM UMR_S 956, Pierre and Marie Curie Université (Paris 06), Paris, France
| | - Juliette Bignard
- INSERM UMR_S 956, Pierre and Marie Curie Université (Paris 06), Paris, France
| | - Olivier Claude
- INSERM UMR_S 956, Pierre and Marie Curie Université (Paris 06), Paris, France
| | - Florence Lecerf
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Aurélie Hautefort
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Monica Florio
- Cardio-Metabolic Disorders, Amgen Research, Amgen Inc., Thousand Oaks, California
| | - Banghua Sun
- Cardio-Metabolic Disorders, Amgen Research, Amgen Inc., Thousand Oaks, California
| | - Sophie Nadaud
- INSERM UMR_S 956, Pierre and Marie Curie Université (Paris 06), Paris, France
| | - Stijn E Verleden
- Laboratory of Respiratory Diseases and Thoracic Surgery, Department of Chronic Diseases, Metabolism and Ageing KU Leuven, Leuven, Belgium
| | - Séverine Remy
- INSERM UMR 1064, Center for Research in Transplantation and Immunology-ITUN et Transgenic Rats and Immunophenomic Platform, Nantes, France; and
| | - Ignacio Anegon
- INSERM UMR 1064, Center for Research in Transplantation and Immunology-ITUN et Transgenic Rats and Immunophenomic Platform, Nantes, France; and
| | - Harm Jan Bogaard
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Olaf Mercier
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and.,Service de Chirurgie Thoracique, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Elie Fadel
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and.,Service de Chirurgie Thoracique, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Gérald Simonneau
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Anton Vonk Noordegraaf
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Katrien Grünberg
- Amsterdam UMC, Vrije Universiteit Amsterdam, Pulmonary Medicine, Amsterdam Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Marc Humbert
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - David Montani
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Peter Dorfmüller
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and.,Department of Pathology and.,Department of Pathology, University of Giessen and Marburg Lung Center, Justus-Liebig University Giessen, German Center for Lung Research, Giessen, Germany
| | - Fabrice Antigny
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
| | - Frédéric Perros
- Université Paris-Saclay-Faculté de Médecine, Le Kremlin-Bicêtre, France.,AP-HP, Centre de Référence de l'Hypertension Pulmonaire, Service de Pneumologie et Réanimation Respiratoire, Hôpital de Bicêtre, Le Kremlin-Bicêtre, France.,UMRS 999, INSERM and Université Paris-Saclay, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, and
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20
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Manaud G, Vinhas M, Abdoulkarim B, Soubrier F, Bignard J, Claude O, Florio M, Banghua S, Nadaud S, Stijn V, Rémy S, Anegon I, Mercier O, Humbert M, Antigny F, Montani D, Perros F. CN2 regulates BMP signaling: Consequence for PVOD pathobiology and therapeutic management. Archives of Cardiovascular Diseases Supplements 2020. [DOI: 10.1016/j.acvdsp.2020.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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21
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El Hajjam M, Mekki A, Palmyre A, Eyries M, Soubrier F, Bourgault Villada I, Ozanne A, Carlier RY, Chinet T. RASA1 phenotype overlaps with hereditary haemorrhagic telangiectasia: two case reports. J Med Genet 2020; 58:645-647. [PMID: 32900839 DOI: 10.1136/jmedgenet-2019-106792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 12/19/2019] [Revised: 07/01/2020] [Accepted: 07/05/2020] [Indexed: 11/04/2022]
Abstract
Background We report two cases of RASA1-related capillary malformation-arteriovenous malformation (CM-AVM1) syndrome mimicking hereditary haemorrhagic telangiectasia (HHT).Methods and results A 28-year-old man, previously embolised for cerebral arteriovenous malformations (AVMs), presented with epistaxis and typical nasal telangiectasias of HHT. CT scan revealed a large portocaval shunt. The second patient was a 9-year-old girl presenting with cyanosis and several mucocutaneous telangiectasias, similar to those observed in typical cases of HHT. CT scan revealed a huge and complex pulmonary AVM of the right lower lobe and a hepatic AVM within the left lobe. HHT diagnosis was considered possible according to the Curaçao criteria for the two patients, with at least two criteria for each. Genetic tests did not find any mutation in the three classic genes (Endoglin, Activin receptor-like kinase 1 or Mothers against decapentaplegic homolog 4), but identified in both cases an RASA1 mutation, known to cause CM-AVM1 syndrome.Conclusions Pulmonary AVM and portocaval shunt, usually encountered in HHT, have not yet been described in the CM-AVM1 syndrome. RASA1 screening may be considered in case of HHT suspicion, particularly when mutations are not found in the usually affected genes.
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Affiliation(s)
- Mostafa El Hajjam
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France.,DMU Smart Imaging, AP-HP, Boulogne-Billancourt, France.,Medical Imaging department, APHP, Boulogne-Billancourt, France
| | - Ahmed Mekki
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France .,DMU Smart Imaging, AP-HP, Garches, France.,Medical Imaging department, APHP, Garches, France
| | - Aurelien Palmyre
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France.,Genetics, AP-HP, Boulogne-Billancourt, Île-de-France, France
| | - Melanie Eyries
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France.,Genetics, Groupe hospitalier Pitié-Salpêtrière, AP-HP, Paris, Île-de-France, France
| | - Florent Soubrier
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France.,Genetics, Groupe hospitalier Pitié-Salpêtrière, AP-HP, Paris, Île-de-France, France
| | - Isabelle Bourgault Villada
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France.,Department of Dermatology, AP-HP, Boulogne-Billancourt, France
| | - Augustin Ozanne
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France.,Department of Interventional Neuroradiology, Bicêtre Teaching Hospital, AP-HP, Le Kremlin-Bicêtre, France
| | - Robert Yves Carlier
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France.,Assistance Publique des Hôpitaux de Paris (AP-HP), GHU Paris-Saclay University, DMU Smart Imaging, Medical Imaging Department, Raymond Poincaré Teaching Hospital, Garches, France; INSERM U 1179, University of Versailles Saint-Quentin-en-Yvelines (UVSQ) Paris-Saclay, Paris, France
| | - Thierry Chinet
- Hereditary Hemorrhagic Telangiectasia Center of Paris, AP-HP, Boulogne-Billancourt, Île-de-France, France.,Department of Respiratory Diseases and Thoracic Oncology, AP-HP, Boulogne-Billancourt, Île-de-France, France
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22
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Affiliation(s)
- Florent Soubrier
- Genetics Department, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, UMR_S 1166-ICAN, Sorbonne-Université, INSERM, Paris, France
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23
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Eyries M, Montani D, Girerd B, Favrolt N, Riou M, Faivre L, Manaud G, Perros F, Gräf S, Morrell NW, Humbert M, Soubrier F. Familial pulmonary arterial hypertension by KDR heterozygous loss of function. Eur Respir J 2020; 55:13993003.02165-2019. [PMID: 31980491 DOI: 10.1183/13993003.02165-2019] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Accepted: 01/02/2020] [Indexed: 11/05/2022]
Abstract
Beyond the major gene BMPR2, several new genes predisposing to PAH have been identified during the last decade. Recently, preliminary evidence of the involvement of the KDR gene was found in a large genetic association study.We prospectively analysed the KDR gene by targeted panel sequencing in a series of 311 PAH patients referred to a clinical molecular laboratory for genetic diagnosis of PAH.Two index cases with severe PAH from two different families were found to carry a loss-of-function mutation in the KDR gene. These two index cases were clinically characterised by low diffusing capacity for carbon monoxide adjusted for haemoglobin (D LCOc) and interstitial lung disease. In one family, segregation analysis revealed that variant carriers are either presenting with PAH associated with low D LCOc, or have only decreased D LCOc, whereas non-carrier relatives have normal D LCOc. In the second family, a single affected carrier was alive. His carrier mother was unaffected with normal D LCOc.We provided genetic evidence for considering KDR as a newly identified PAH-causing gene by describing the segregation of KDR mutations with PAH in two families. In our study, KDR mutations are associated with a particular form of PAH characterised by low D LCOc and radiological evidence of parenchymal lung disease including interstitial lung disease and emphysema.
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Affiliation(s)
- Mélanie Eyries
- Hôpital Pitié-Salpêtrière, Département de génétique, Assistance Publique-Hôpitaux de Paris, Paris, France.,UMR_S1166-ICAN, Sorbonne Université, INSERM, Paris, France.,Equally contributing authors
| | - David Montani
- Univ. Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.,Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpital Bicêtre, Le Kremlin Bicêtre, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France.,Equally contributing authors
| | - Barbara Girerd
- Univ. Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.,Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpital Bicêtre, Le Kremlin Bicêtre, France
| | - Nicolas Favrolt
- Service de Pneumologie et Soins Intensifs Respiratoires, Centre de référence constitutif des maladies pulmonaires rares de l'adulte, Centre de compétence de l'hypertension pulmonaire, CHU Dijon-Bourgogne, Dijon, France
| | - Marianne Riou
- Service de pneumologie, Nouvel hôpital civil, Strasbourg, France
| | - Laurence Faivre
- Centre de génétique, FHU TRANSLAD, Institut GIMI et UMR INSERM 1231, CHU de Dijon et Université de Bourgogne, Dijon, France
| | - Grégoire Manaud
- UMR_S 999, Univ. Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Frédéric Perros
- UMR_S 999, Univ. Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Stefan Gräf
- NIHR Bioresource - Rare Diseases, Cambridge Biomedical Campus, Cambridge, UK.,Dept of Medicine, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK.,Dept of Haematology, University of Cambridge, Cambridge Biomedical Campus, Cambridge, UK
| | - Nicholas W Morrell
- NIHR Bioresource - Rare Diseases, Cambridge Biomedical Campus, Cambridge, UK.,Dept of Medicine, University of Cambridge School of Clinical Medicine, Addenbrooke's and Royal Papworth Hospitals, Cambridge, UK
| | - Marc Humbert
- Univ. Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France.,Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, Hôpital Bicêtre, Le Kremlin Bicêtre, France.,UMR_S 999, Univ. Paris-Sud, INSERM, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Florent Soubrier
- Hôpital Pitié-Salpêtrière, Département de génétique, Assistance Publique-Hôpitaux de Paris, Paris, France .,UMR_S1166-ICAN, Sorbonne Université, INSERM, Paris, France
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24
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Hodgson J, Swietlik EM, Salmon RM, Hadinnapola C, Nikolic I, Wharton J, Guo J, Liley J, Haimel M, Bleda M, Southgate L, Machado RD, Martin JM, Treacy CM, Yates K, Daugherty LC, Shamardina O, Whitehorn D, Holden S, Bogaard HJ, Church C, Coghlan G, Condliffe R, Corris PA, Danesino C, Eyries M, Gall H, Ghio S, Ghofrani HA, Gibbs JSR, Girerd B, Houweling AC, Howard L, Humbert M, Kiely DG, Kovacs G, Lawrie A, MacKenzie Ross RV, Moledina S, Montani D, Olschewski A, Olschewski H, Ouwehand WH, Peacock AJ, Pepke-Zaba J, Prokopenko I, Rhodes CJ, Scelsi L, Seeger W, Soubrier F, Suntharalingam J, Toshner MR, Trembath RC, Noordegraaf AV, Wort SJ, Wilkins MR, Yu PB, Li W, Gräf S, Upton PD, Morrell NW. Characterization of GDF2 Mutations and Levels of BMP9 and BMP10 in Pulmonary Arterial Hypertension. Am J Respir Crit Care Med 2020; 201:575-585. [PMID: 31661308 PMCID: PMC7047445 DOI: 10.1164/rccm.201906-1141oc] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [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: 02/02/2023] Open
Abstract
Rationale: Recently, rare heterozygous mutations in GDF2 were identified in patients with pulmonary arterial hypertension (PAH). GDF2 encodes the circulating BMP (bone morphogenetic protein) type 9, which is a ligand for the BMP2 receptor.Objectives: Here we determined the functional impact of GDF2 mutations and characterized plasma BMP9 and BMP10 levels in patients with idiopathic PAH.Methods: Missense BMP9 mutant proteins were expressed in vitro and the impact on BMP9 protein processing and secretion, endothelial signaling, and functional activity was assessed. Plasma BMP9 and BMP10 levels and activity were assayed in patients with PAH with GDF2 variants and in control subjects. Levels were also measured in a larger cohort of control subjects (n = 120) and patients with idiopathic PAH (n = 260).Measurements and Main Results: We identified a novel rare variation at the GDF2 and BMP10 loci, including copy number variation. In vitro, BMP9 missense proteins demonstrated impaired cellular processing and secretion. Patients with PAH who carried these mutations exhibited reduced plasma levels of BMP9 and reduced BMP activity. Unexpectedly, plasma BMP10 levels were also markedly reduced in these individuals. Although overall BMP9 and BMP10 levels did not differ between patients with PAH and control subjects, BMP10 levels were lower in PAH females. A subset of patients with PAH had markedly reduced plasma levels of BMP9 and BMP10 in the absence of GDF2 mutations.Conclusions: Our findings demonstrate that GDF2 mutations result in BMP9 loss of function and are likely causal. These mutations lead to reduced circulating levels of both BMP9 and BMP10. These findings support therapeutic strategies to enhance BMP9 or BMP10 signaling in PAH.
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Affiliation(s)
| | - Emilia M. Swietlik
- Department of Medicine and,Royal Papworth Hospital, Papworth, United Kingdom
| | | | | | - Ivana Nikolic
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | | | | | | | - Matthias Haimel
- Department of Medicine and,Department of Haematology, University of Cambridge, Cambridge, United Kingdom,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
| | | | - Laura Southgate
- Department of Medical and Molecular Genetics, King’s College London, London, United Kingdom,Molecular and Clinical Sciences Research Institute, St. George’s University of London, London, United Kingdom
| | - Rajiv D. Machado
- Molecular and Clinical Sciences Research Institute, St. George’s University of London, London, United Kingdom
| | - Jennifer M. Martin
- Department of Medicine and,Department of Haematology, University of Cambridge, Cambridge, United Kingdom,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
| | - Carmen M. Treacy
- Department of Medicine and,Royal Papworth Hospital, Papworth, United Kingdom
| | - Katherine Yates
- Department of Medicine and,Department of Haematology, University of Cambridge, Cambridge, United Kingdom,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
| | - Louise C. Daugherty
- Department of Haematology, University of Cambridge, Cambridge, United Kingdom,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
| | - Olga Shamardina
- Department of Haematology, University of Cambridge, Cambridge, United Kingdom,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
| | - Deborah Whitehorn
- Department of Haematology, University of Cambridge, Cambridge, United Kingdom,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
| | - Simon Holden
- Addenbrooke’s Hospital, Cambridge, United Kingdom
| | - Harm J. Bogaard
- Département de Génétique, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, and UMR_S 1166-ICAN, INSERM, UPMC Sorbonne Universités, Paris, France
| | - Colin Church
- Golden Jubilee National Hospital, Glasgow, United Kingdom
| | | | - Robin Condliffe
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | | | - Cesare Danesino
- Department of Molecular Medicine, University of Pavia, Pavia, Italy,Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Mélanie Eyries
- Département de Génétique, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, and UMR_S 1166-ICAN, INSERM, UPMC Sorbonne Universités, Paris, France
| | - Henning Gall
- University of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL) and of the Excellence Cluster Cardio-Pulmonary Institute, Giessen, Germany
| | - Stefano Ghio
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Hossein-Ardeschir Ghofrani
- Department of Medicine and,University of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL) and of the Excellence Cluster Cardio-Pulmonary Institute, Giessen, Germany
| | - J. Simon R. Gibbs
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Barbara Girerd
- Faculté de Médecine, Université Paris-Saclay, Université Paris-Sud, Paris, France,Service de Pneumologie, Centre de Référence de l’Hypertension Pulmonaire, Assistance Publique–Hôpitaux de Paris, Paris, France,Hôpital Bicêtre, Le Kremlin-Bicêtre, INSERM UMR_S 999, Paris, France
| | - Arjan C. Houweling
- Department of Clinical Genetics, Amsterdam Universitair Medische Centra, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - Marc Humbert
- Faculté de Médecine, Université Paris-Saclay, Université Paris-Sud, Paris, France,Service de Pneumologie, Centre de Référence de l’Hypertension Pulmonaire, Assistance Publique–Hôpitaux de Paris, Paris, France,Hôpital Bicêtre, Le Kremlin-Bicêtre, INSERM UMR_S 999, Paris, France
| | - David G. Kiely
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, United Kingdom
| | - Gabor Kovacs
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria,Medical University of Graz, Graz, Austria
| | - Allan Lawrie
- Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom
| | | | | | - David Montani
- Faculté de Médecine, Université Paris-Saclay, Université Paris-Sud, Paris, France,Service de Pneumologie, Centre de Référence de l’Hypertension Pulmonaire, Assistance Publique–Hôpitaux de Paris, Paris, France,Hôpital Bicêtre, Le Kremlin-Bicêtre, INSERM UMR_S 999, Paris, France
| | - Andrea Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria
| | - Horst Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, Austria,Medical University of Graz, Graz, Austria
| | - Willem H. Ouwehand
- Department of Haematology, University of Cambridge, Cambridge, United Kingdom,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
| | | | | | | | | | - Laura Scelsi
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Werner Seeger
- University of Giessen and Marburg Lung Center, member of the German Center for Lung Research (DZL) and of the Excellence Cluster Cardio-Pulmonary Institute, Giessen, Germany
| | - Florent Soubrier
- Département de Génétique, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, and UMR_S 1166-ICAN, INSERM, UPMC Sorbonne Universités, Paris, France
| | | | - Mark R. Toshner
- Department of Medicine and,Royal Papworth Hospital, Papworth, United Kingdom
| | - Richard C. Trembath
- Department of Medical and Molecular Genetics, King’s College London, London, United Kingdom
| | - Anton Vonk Noordegraaf
- Service de Pneumologie, Centre de Référence de l’Hypertension Pulmonaire, Assistance Publique–Hôpitaux de Paris, Paris, France
| | - Stephen J. Wort
- National Heart and Lung Institute, Imperial College London, London, United Kingdom,Royal Brompton Hospital, London, United Kingdom
| | | | - Paul B. Yu
- Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Wei Li
- Department of Medicine and
| | - Stefan Gräf
- Department of Medicine and,Department of Haematology, University of Cambridge, Cambridge, United Kingdom,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
| | | | - Nicholas W. Morrell
- Department of Medicine and,National Institute for Health Research BioResource–Rare Diseases, Cambridge, United Kingdom
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25
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Thoré P, Girerd B, Jaïs X, Savale L, Ghigna MR, Eyries M, Levy M, Ovaert C, Servettaz A, Guillaumot A, Dauphin C, Chabanne C, Boiffard E, Cottin V, Perros F, Simonneau G, Sitbon O, Soubrier F, Bonnet D, Remy-Jardin M, Chaouat A, Humbert M, Montani D. Phenotype and outcome of pulmonary arterial hypertension patients carrying a TBX4 mutation. Eur Respir J 2020; 55:13993003.02340-2019. [DOI: 10.1183/13993003.02340-2019] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 02/05/2020] [Indexed: 12/16/2022]
Abstract
IntroductionTBX4 mutation causes small patella syndrome (SPS) and/or pulmonary arterial hypertension (PAH). The characteristics and outcomes of PAH associated with TBX4 mutations are largely unknown.MethodsWe report the clinical, functional, radiologic, histologic and haemodynamic characteristics and outcomes of heritable PAH patients carrying a TBX4 mutation from the French pulmonary hypertension (PH) network.Results20 patients were identified in 17 families. They were characterised by a median age at diagnosis of 29 years (0–76 years) and a female to male ratio of three. Most of the patients (70%) were in New York Heart Association (NYHA) functional class III or IV with a severe haemodynamic impairment (median pulmonary vascular resistance (PVR) of 13.6 (6.2–41.8) Wood units). Skeletal signs of SPS were present in 80% of cases. Half of the patients had mild restrictive or obstructive limitation and diffusing capacity of the lung for carbon monoxide (DLCO) was decreased in all patients. High-resolution computed tomography (HRCT) showed bronchial abnormalities, peri-bronchial cysts, mosaic distribution and mediastinal lymphadenopathies. PAH therapy was associated with significant clinical improvement. At follow-up (median 76 months), two patients had died and two had undergone lung transplantation. One-year, three-year and five-year event-free survival rates were 100%, 94% and 83%, respectively. Histologic examination of explanted lungs revealed alveolar growth abnormalities, major pulmonary vascular remodelling similar to that observed in idiopathic pulmonary arterial hypertension (IPAH) and accumulation of cholesterol crystals within the lung parenchyma.ConclusionPAH due to TBX4 mutations may occur with or without skeletal abnormalities across a broad age range from birth to late adulthood. PAH is usually severe and associated with bronchial and parenchymal abnormalities.
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26
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Ulrich A, Wharton J, Thayer TE, Swietlik EM, Assad TR, Desai AA, Gräf S, Harbaum L, Humbert M, Morrell NW, Nichols WC, Soubrier F, Southgate L, Trégouët DA, Trembath RC, Brittain EL, Wilkins MR, Prokopenko I, Rhodes CJ. Mendelian randomisation analysis of red cell distribution width in pulmonary arterial hypertension. Eur Respir J 2020; 55:13993003.01486-2019. [PMID: 31744833 PMCID: PMC7015630 DOI: 10.1183/13993003.01486-2019] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 07/25/2019] [Accepted: 10/29/2019] [Indexed: 02/02/2023]
Abstract
Pulmonary arterial hypertension (PAH) is a rare disease that leads to premature death from right heart failure. It is strongly associated with elevated red cell distribution width (RDW), a correlate of several iron status biomarkers. High RDW values can signal early-stage iron deficiency or iron deficiency anaemia. This study investigated whether elevated RDW is causally associated with PAH.A two-sample Mendelian randomisation (MR) approach was applied to investigate whether genetic predisposition to higher levels of RDW increases the odds of developing PAH. Primary and secondary MR analyses were performed using all available genome-wide significant RDW variants (n=179) and five genome-wide significant RDW variants that act via systemic iron status, respectively.We confirmed the observed association between RDW and PAH (OR 1.90, 95% CI 1.80-2.01) in a multicentre case-control study (cases n=642, disease controls n=15 889). The primary MR analysis was adequately powered to detect a causal effect (odds ratio) between 1.25 and 1.52 or greater based on estimates reported in the RDW genome-wide association study or from our own data. There was no evidence for a causal association between RDW and PAH in either the primary (ORcausal 1.07, 95% CI 0.92-1.24) or the secondary (ORcausal 1.09, 95% CI 0.77-1.54) MR analysis.The results suggest that at least some of the observed association of RDW with PAH is secondary to disease progression. Results of iron therapeutic trials in PAH should be interpreted with caution, as any improvements observed may not be mechanistically linked to the development of PAH.
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Affiliation(s)
- Anna Ulrich
- National Heart and Lung Institute, Hammersmith Campus, Imperial College London, London, UK
| | - John Wharton
- National Heart and Lung Institute, Hammersmith Campus, Imperial College London, London, UK
| | - Timothy E. Thayer
- Vanderbilt University Medical Center, Division of Cardiovascular Medicine, Nashville, TN, USA
| | - Emilia M. Swietlik
- Dept of Medicine, University of Cambridge, Cambridge, UK,Pulmonary Vascular Disease Unit, Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | | | - Ankit A. Desai
- Dept of Medicine, Indiana University, Indianapolis, IN, USA
| | - Stefan Gräf
- Dept of Medicine, University of Cambridge, Cambridge, UK,NIHR BioResource – Rare Diseases, Cambridge, UK,Dept of Haematology, University of Cambridge, Cambridge, UK
| | - Lars Harbaum
- National Heart and Lung Institute, Hammersmith Campus, Imperial College London, London, UK
| | - Marc Humbert
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Paris, France,AP-HP, Service de Pneumologie, Centre de référence de l'hypertension pulmonaire, Hôpital Bicêtre, Le Kremlin-Bicêtre, France,INSERM UMR_S 999, Hôpital Marie Lannelongue, Le Plessis Robinson, France
| | - Nicholas W. Morrell
- Dept of Medicine, University of Cambridge, Cambridge, UK,NIHR BioResource – Rare Diseases, Cambridge, UK
| | - William C. Nichols
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Dept of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Florent Soubrier
- Sorbonne Universités, UPMC Univ. Paris 06, Institut National pour la Santé et la Recherche Médicale (INSERM), Unité Mixte de Recherche en Santé (UMR_S) 1166, Paris, France
| | - Laura Southgate
- Molecular and Clinical Sciences Research Institute, St George's University of London, London, UK
| | - David-Alexandre Trégouët
- INSERM UMR_S 1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France
| | - Richard C. Trembath
- Division of Genetics and Molecular Medicine, King's College London, London, UK
| | - Evan L. Brittain
- Vanderbilt University Medical Center, Division of Cardiovascular Medicine, Nashville, TN, USA,Vanderbilt Translational and Clinical Cardiovascular Research Center, Nashville, TN, USA
| | - Martin R. Wilkins
- National Heart and Lung Institute, Hammersmith Campus, Imperial College London, London, UK
| | - Inga Prokopenko
- Dept of Clinical and Experimental Medicine, University of Surrey, Guildford, UK,Dept of Metabolism, Digestion and Reproduction, Imperial College London, London, UK,These authors contributed equally
| | - Christopher J. Rhodes
- National Heart and Lung Institute, Hammersmith Campus, Imperial College London, London, UK,These authors contributed equally,Christopher J. Rhodes, National Heart and Lung Institute, Medicine, Imperial College London, London, W12 0NN, UK. E-mail:
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27
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Sellier J, Karam C, Beauchet A, Dallongeville A, Binsse S, Blivet S, Bourgault-Villada I, Charron P, Chinet T, Eyries M, Fagnou C, Lesniak J, Lesur G, Lucas J, Nicod-Tran A, Ozanne A, Palmyre A, Soubrier F, El Hajjam M, Lacombe P. Higher prevalence of splenic artery aneurysms in hereditary hemorrhagic telangiectasia: Vascular implications and risk factors. PLoS One 2020; 15:e0226681. [PMID: 31971937 PMCID: PMC6977744 DOI: 10.1371/journal.pone.0226681] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 12/02/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Splenic artery aneurysm (SAA) is a rare but potentially fatal condition. Rupture results in 25% mortality up to 75% in pregnant women with 95% fetal mortality. Brief reports suggest an increased risk of developing SAA in patients with HHT. METHODS We analyzed enhanced multidetector CT data in 186 HHT patients matched (gender and ± 5 year old) with 186 controls. We screened for SAA and recorded diameter of splenic and hepatic arteries and hepatic, pancreatic and splenic parenchymal involvements. We determined by univariate and multivariate analysis, the relationship with age, sex, genetic status, cardiovascular risk factors (CVRF) and visceral involvement. RESULTS SAA concerned 24.7% of HHT patients and 5.4% of controls, p<0.001. Factors associated with increased risk of SAA in HHT were female gender (p = 0.04, OR = 2.12, IC 95% = 1.03-4.50), age (p = 0.0003, OR = 1.04, 95% CI = 1.02-1.06) and pancreatic parenchymal involvement (p = 0.04, OR = 2.13, 95% CI = 1.01-4.49), but not type of mutation, hepatic or splenic parenchymal involvements, splenic size or splenic artery diameter or CVRF. CONCLUSIONS We found a 4.57 higher rate of SAA in HHT patients without evidence of splenic high output related disease or increased CVRF. These results suggest the presence of a vascular intrinsic involvement. It should lead to screening all HHT patients for SAA. The vasculopathy hypothesis could require a change in management as screening of all systemic arteries and even the aorta and to further research in the field.
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Affiliation(s)
- Jacques Sellier
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Carma Karam
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
- * E-mail:
| | - Alain Beauchet
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Axel Dallongeville
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Stephen Binsse
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Sandra Blivet
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Isabelle Bourgault-Villada
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Philippe Charron
- Pitié-Salpêtrière Hospital, Department of Genetics, AP-HP, Paris, France
| | - Thierry Chinet
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Mélanie Eyries
- Pitié-Salpêtrière Hospital, Department of Genetics, AP-HP, Paris, France
| | - Carole Fagnou
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Jérome Lesniak
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Gilles Lesur
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Jérome Lucas
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Agnès Nicod-Tran
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Augustin Ozanne
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Aurélien Palmyre
- Pitié-Salpêtrière Hospital, Department of Genetics, AP-HP, Paris, France
| | - Florent Soubrier
- Pitié-Salpêtrière Hospital, Department of Genetics, AP-HP, Paris, France
| | - Mostafa El Hajjam
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
| | - Pascal Lacombe
- Ambroise Paré Hospital, AP-HP, Boulogne-Billancourt, University of Versailles-Saint Quentin en Yvelines, France
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28
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Bohnen MS, Ma L, Zhu N, Qi H, McClenaghan C, Gonzaga-Jauregui C, Dewey FE, Overton JD, Reid JG, Shuldiner AR, Baras A, Sampson KJ, Bleda M, Hadinnapola C, Haimel M, Bogaard HJ, Church C, Coghlan G, Corris PA, Eyries M, Gibbs JSR, Girerd B, Houweling AC, Humbert M, Guignabert C, Kiely DG, Lawrie A, MacKenzie Ross RV, Martin JM, Montani D, Peacock AJ, Pepke-Zaba J, Soubrier F, Suntharalingam J, Toshner M, Treacy CM, Trembath RC, Vonk Noordegraaf A, Wharton J, Wilkins MR, Wort SJ, Yates K, Gräf S, Morrell NW, Krishnan U, Rosenzweig EB, Shen Y, Nichols CG, Kass RS, Chung WK. Loss-of-Function ABCC8 Mutations in Pulmonary Arterial Hypertension. Circ Genom Precis Med 2019; 11:e002087. [PMID: 30354297 DOI: 10.1161/circgen.118.002087] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In pulmonary arterial hypertension (PAH), pathological changes in pulmonary arterioles progressively raise pulmonary artery pressure and increase pulmonary vascular resistance, leading to right heart failure and high mortality rates. Recently, the first potassium channelopathy in PAH, because of mutations in KCNK3, was identified as a genetic cause and pharmacological target. METHODS Exome sequencing was performed to identify novel genes in a cohort of 99 pediatric and 134 adult-onset group I PAH patients. Novel rare variants in the gene identified were independently identified in a cohort of 680 adult-onset patients. Variants were expressed in COS cells and function assessed by patch-clamp and rubidium flux analysis. RESULTS We identified a de novo novel heterozygous predicted deleterious missense variant c.G2873A (p.R958H) in ABCC8 in a child with idiopathic PAH. We then evaluated all individuals in the original and a second cohort for rare or novel variants in ABCC8 and identified 11 additional heterozygous predicted damaging ABCC8 variants. ABCC8 encodes SUR1 (sulfonylurea receptor 1)-a regulatory subunit of the ATP-sensitive potassium channel. We observed loss of ATP-sensitive potassium channel function for all ABCC8 variants evaluated and pharmacological rescue of all channel currents in vitro by the SUR1 activator, diazoxide. CONCLUSIONS Novel and rare missense variants in ABCC8 are associated with PAH. Identified ABCC8 mutations decreased ATP-sensitive potassium channel function, which was pharmacologically recovered.
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Affiliation(s)
- Michael S Bohnen
- Department of Pharmacology, College of Physicians and Surgeons (M.S.B., K.J.S., R.S.K.), Columbia University, New York, NY
| | - Lijiang Ma
- Department of Pediatrics, College of Physicians and Surgeons (L.M., N.Z., U.K., E.B.R., W.K.C.), Columbia University, New York, NY
| | - Na Zhu
- Department of Pediatrics, College of Physicians and Surgeons (L.M., N.Z., U.K., E.B.R., W.K.C.), Columbia University, New York, NY.,Department of Systems Biology (N.Z., H.Q., Y.S.), Columbia University, New York, NY
| | - Hongjian Qi
- Department of Applied Physics and Applied Mathematics (H.Q., Y.S.), Columbia University, New York, NY.,Department of Systems Biology (N.Z., H.Q., Y.S.), Columbia University, New York, NY
| | - Conor McClenaghan
- Department of Cell Biology and Physiology (C.M., C.G.N.) and Center for the Investigation of Membrane Excitability Diseases (C.M., C.G.N.), Washington University School of Medicine, Washington University in St. Louis, MO
| | - Claudia Gonzaga-Jauregui
- Regeneron Genetics Center, Regeneron Pharmaceuticals, Inc, Tarrytown, NY (C.G.-J., F.E.D., J.D.O., J.G.R., A.R.S., A.B.)
| | - Frederick E Dewey
- Regeneron Genetics Center, Regeneron Pharmaceuticals, Inc, Tarrytown, NY (C.G.-J., F.E.D., J.D.O., J.G.R., A.R.S., A.B.)
| | - John D Overton
- Regeneron Genetics Center, Regeneron Pharmaceuticals, Inc, Tarrytown, NY (C.G.-J., F.E.D., J.D.O., J.G.R., A.R.S., A.B.)
| | - Jeffrey G Reid
- Regeneron Genetics Center, Regeneron Pharmaceuticals, Inc, Tarrytown, NY (C.G.-J., F.E.D., J.D.O., J.G.R., A.R.S., A.B.)
| | - Alan R Shuldiner
- Regeneron Genetics Center, Regeneron Pharmaceuticals, Inc, Tarrytown, NY (C.G.-J., F.E.D., J.D.O., J.G.R., A.R.S., A.B.)
| | - Aris Baras
- Regeneron Genetics Center, Regeneron Pharmaceuticals, Inc, Tarrytown, NY (C.G.-J., F.E.D., J.D.O., J.G.R., A.R.S., A.B.)
| | - Kevin J Sampson
- Department of Pharmacology, College of Physicians and Surgeons (M.S.B., K.J.S., R.S.K.), Columbia University, New York, NY
| | - Marta Bleda
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom
| | - Charaka Hadinnapola
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom
| | - Matthias Haimel
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom
| | - Harm J Bogaard
- VU University Medical Center, Amsterdam, the Netherlands (H.J.B., A.C.H., A.V.N.)
| | - Colin Church
- Golden Jubilee National Hospital, Glasgow, Scotland (C.C., A.J.P.)
| | | | - Paul A Corris
- Newcastle University (P.A.C.) and Newcastle upon Tyne Hospitals National Health Service Foundation Trust (P.A.C.), United Kingdom
| | - Mélanie Eyries
- Dépat de Génétique, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (M.E., F.S.) and UMR_S 1166-ICAN, INSERM (Institut National de la Santé et de la Recherche Médicale) (M.E., F.S.), UPMC (Pierre and Marie Curie University) Sorbonne Universités, France
| | - J Simon R Gibbs
- National Heart and Lung Institute, Imperial College London, United Kingdom (J.S.R.G., S.J.W.)
| | - Barbara Girerd
- AP-HP (Assistance Publique - Hôpitaux de Paris), Centre de référence de l'hypertension pulmonaire sévère, INSERM UMR_S 999, Hôpital Bicêtre, Université Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France (B.G., M.H., C.G., D.M.)
| | - Arjan C Houweling
- VU University Medical Center, Amsterdam, the Netherlands (H.J.B., A.C.H., A.V.N.)
| | - Marc Humbert
- AP-HP (Assistance Publique - Hôpitaux de Paris), Centre de référence de l'hypertension pulmonaire sévère, INSERM UMR_S 999, Hôpital Bicêtre, Université Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France (B.G., M.H., C.G., D.M.)
| | - Christophe Guignabert
- AP-HP (Assistance Publique - Hôpitaux de Paris), Centre de référence de l'hypertension pulmonaire sévère, INSERM UMR_S 999, Hôpital Bicêtre, Université Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France (B.G., M.H., C.G., D.M.)
| | - David G Kiely
- Sheffield Clinical Research Facility, Royal Hallamshire, Sheffield, United Kingdom (D.G.K.)
| | - Allan Lawrie
- Department of Infection, Immunity, and Cardiovascular Disease, University of Sheffield, Sheffield, United Kingdom (A.L.)
| | | | - Jennifer M Martin
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom
| | - David Montani
- AP-HP (Assistance Publique - Hôpitaux de Paris), Centre de référence de l'hypertension pulmonaire sévère, INSERM UMR_S 999, Hôpital Bicêtre, Université Paris-Sud, Université Paris-Saclay, Le Kremlin-Bicêtre, France (B.G., M.H., C.G., D.M.)
| | - Andrew J Peacock
- Golden Jubilee National Hospital, Glasgow, Scotland (C.C., A.J.P.)
| | | | - Florent Soubrier
- Dépat de Génétique, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris (M.E., F.S.) and UMR_S 1166-ICAN, INSERM (Institut National de la Santé et de la Recherche Médicale) (M.E., F.S.), UPMC (Pierre and Marie Curie University) Sorbonne Universités, France
| | | | - Mark Toshner
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom.,Papworth Hospital, Cambridge, United Kingdom (J.P.-Z., M.T.)
| | - Carmen M Treacy
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom
| | - Richard C Trembath
- Division of Genetics and Molecular Medicine, King's College London, London, England (R.C.T.)
| | | | - John Wharton
- Department of Medicine, Imperial College London, Hammersmith Campus, London, United Kingdom (J.W., M.R.W.)
| | - Martin R Wilkins
- Department of Medicine, Imperial College London, Hammersmith Campus, London, United Kingdom (J.W., M.R.W.)
| | - Stephen J Wort
- National Heart and Lung Institute, Imperial College London, United Kingdom (J.S.R.G., S.J.W.).,Royal Brompton Hospital, London, United Kingdom (S.J.W.)
| | - Katherine Yates
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom
| | - Stefan Gräf
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom.,Department of Hematology (S.G.), Addenbrookes Hospital, University of Cambridge, United Kingdom
| | - Nicholas W Morrell
- Department of Medicine (M.B., C.H., M.H., J.M.M., M.T., C.M.T., K.Y., S.G., N.W.M.), University of Cambridge, United Kingdom
| | - Usha Krishnan
- Department of Pediatrics, College of Physicians and Surgeons (L.M., N.Z., U.K., E.B.R., W.K.C.), Columbia University, New York, NY
| | - Erika B Rosenzweig
- Department of Pediatrics, College of Physicians and Surgeons (L.M., N.Z., U.K., E.B.R., W.K.C.), Columbia University, New York, NY
| | - Yufeng Shen
- Department of Applied Physics and Applied Mathematics (H.Q., Y.S.), Columbia University, New York, NY.,Department of Systems Biology (N.Z., H.Q., Y.S.), Columbia University, New York, NY
| | - Colin G Nichols
- Department of Cell Biology and Physiology (C.M., C.G.N.) and Center for the Investigation of Membrane Excitability Diseases (C.M., C.G.N.), Washington University School of Medicine, Washington University in St. Louis, MO
| | - Robert S Kass
- Department of Pharmacology, College of Physicians and Surgeons (M.S.B., K.J.S., R.S.K.), Columbia University, New York, NY
| | - Wendy K Chung
- Department of Pediatrics, College of Physicians and Surgeons (L.M., N.Z., U.K., E.B.R., W.K.C.), Columbia University, New York, NY
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29
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Eyries M, Montani D, Nadaud S, Girerd B, Levy M, Bourdin A, Trésorier R, Chaouat A, Cottin V, Sanfiorenzo C, Prevot G, Reynaud-Gaubert M, Dromer C, Houeijeh A, Nguyen K, Coulet F, Bonnet D, Humbert M, Soubrier F. Widening the landscape of heritable pulmonary hypertension mutations in paediatric and adult cases. Eur Respir J 2019; 53:13993003.01371-2018. [PMID: 30578383 DOI: 10.1183/13993003.01371-2018] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 11/23/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Heritable forms of pulmonary arterial hypertension (PAH) and pulmonary veno-occlusive disease/pulmonary capillary haemangiomatosis (PVOD/PCH) diverge by lung histopathological lesions, clinical and para-clinical presentation, their responsible genes, and mode of transmission. Since the identification of the BMPR2 gene in families affected by PAH, mutations in several other genes have been discovered for both forms. The mutation landscape in these new genes is not yet well known. METHODS We set up a next-generation sequencing-based targeted sequencing gene panel allowing known genes for PAH and PVOD/PCH to be analysed simultaneously. Genetic analysis was prospectively performed on 263 PAH and PVOD/PCH patients (adult and paediatric cases). RESULTS Pathogenic mutations were identified in 19.5% of sporadic PAH patients (n=180), 54.5% of familial PAH patients and 13.3% of PVOD/PCH patients. BMPR2 was the most frequently mutated gene, followed by TBX4 in both paediatric and adult PAH. BMP9 mutations were identified in 1.2% of adult PAH cases. EIF2AK4 biallelic mutations were restricted to PVOD/PCH. A truncating mutation and a predicted loss-of-function variant were also identified in BMP10 in two severely affected sporadic PAH female patients. CONCLUSION Our results confirm that mutations are found in genes beyond BMPR2 in heritable PAH, emphasise the role of TBX4 and BMP9, and designate BMP10 as a new PAH gene.
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Affiliation(s)
- Mélanie Eyries
- Département de Génétique, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.,UMR_S1166, Sorbonne Université, INSERM, and Institute for Cardiometabolism and Nutrition (ICAN), Paris, France
| | - David Montani
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, INSERM UMR_S999, Hôpital de Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - Sophie Nadaud
- UMR_S1166, Sorbonne Université, INSERM, and Institute for Cardiometabolism and Nutrition (ICAN), Paris, France
| | - Barbara Girerd
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, INSERM UMR_S999, Hôpital de Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - Marilyne Levy
- M3C-Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Arnaud Bourdin
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France.,Département de Pneumologie et Addictologie, CHU Montpellier, Montpellier, France
| | - Romain Trésorier
- Service de Cardiologie Maladies Vasculaires, CHU Gabriel Montpied, Clermont-Ferrand, France
| | - Ari Chaouat
- Département de Pneumologie, CHRU Nancy, Université de Lorraine, INSERM U1116, Nancy, France
| | - Vincent Cottin
- Service de Pneumologie, Centre National de Référence des Maladies Pulmonaires Rares, Hôpital Louis Pradel, Université Claude Bernard Lyon 1, UMR754, Lyon, France
| | | | | | | | - Claire Dromer
- Service de Pneumologie, CHU de Bordeaux Hôpital Haut-Levêque, Pessac, France
| | - Ali Houeijeh
- Service de Cardiologie Infantile et Congénitale, CHRU Lille-Hôpital Cardiologique, Lille, France
| | - Karine Nguyen
- Département de Génétique Médicale, CHU la Timone Enfants, AP-HM, Marseille, France
| | - Florence Coulet
- Département de Génétique, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France
| | - Damien Bonnet
- M3C-Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Marc Humbert
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire, INSERM UMR_S999, Hôpital de Bicêtre, AP-HP, Le Kremlin-Bicêtre, France
| | - Florent Soubrier
- Département de Génétique, Hôpital Pitié-Salpêtrière, AP-HP, Paris, France.,UMR_S1166, Sorbonne Université, INSERM, and Institute for Cardiometabolism and Nutrition (ICAN), Paris, France
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30
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Morrell NW, Aldred MA, Chung WK, Elliott CG, Nichols WC, Soubrier F, Trembath RC, Loyd JE. Genetics and genomics of pulmonary arterial hypertension. Eur Respir J 2019; 53:13993003.01899-2018. [PMID: 30545973 PMCID: PMC6351337 DOI: 10.1183/13993003.01899-2018] [Citation(s) in RCA: 252] [Impact Index Per Article: 50.4] [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: 10/05/2018] [Accepted: 10/09/2018] [Indexed: 12/17/2022]
Abstract
Since 2000 there have been major advances in our understanding of the genetic and genomics of pulmonary arterial hypertension (PAH), although there remains much to discover. Based on existing knowledge, around 25-30% of patients diagnosed with idiopathic PAH have an underlying Mendelian genetic cause for their condition and should be classified as heritable PAH (HPAH). Here, we summarise the known genetic and genomic drivers of PAH, the insights these provide into pathobiology, and the opportunities afforded for development of novel therapeutic approaches. In addition, factors determining the incomplete penetrance observed in HPAH are discussed. The currently available approaches to genetic testing and counselling, and the impact of a genetic diagnosis on clinical management of the patient with PAH, are presented. Advances in DNA sequencing technology are rapidly expanding our ability to undertake genomic studies at scale in large cohorts. In the future, such studies will provide a more complete picture of the genetic contribution to PAH and, potentially, a molecular classification of this disease.
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Affiliation(s)
- Nicholas W Morrell
- University of Cambridge School of Clinical Medicine, Addenbrooke's and Papworth Hospitals, Cambridge, UK
| | | | - Wendy K Chung
- Columbia University Medical Center, New York, NY, USA
| | - C Gregory Elliott
- Intermountain Medical Center and University of Utah, Salt Lake City, UT, USA
| | | | | | - Richard C Trembath
- Division of Genetics and Molecular Medicine, School of Basic and Medical Biosciences, King's College London, London, UK
| | - James E Loyd
- Vanderbilt University Medical Center, Nashville, TN, USA
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31
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Girard E, Eon-Marchais S, Olaso R, Renault AL, Damiola F, Dondon MG, Barjhoux L, Goidin D, Meyer V, Le Gal D, Beauvallet J, Mebirouk N, Lonjou C, Coignard J, Marcou M, Cavaciuti E, Baulard C, Bihoreau MT, Cohen-Haguenauer O, Leroux D, Penet C, Fert-Ferrer S, Colas C, Frebourg T, Eisinger F, Adenis C, Fajac A, Gladieff L, Tinat J, Floquet A, Chiesa J, Giraud S, Mortemousque I, Soubrier F, Audebert-Bellanger S, Limacher JM, Lasset C, Lejeune-Dumoulin S, Dreyfus H, Bignon YJ, Longy M, Pujol P, Venat-Bouvet L, Bonadona V, Berthet P, Luporsi E, Maugard CM, Noguès C, Delnatte C, Fricker JP, Gesta P, Faivre L, Lortholary A, Buecher B, Caron O, Gauthier-Villars M, Coupier I, Servant N, Boland A, Mazoyer S, Deleuze JF, Stoppa-Lyonnet D, Andrieu N, Lesueur F. Familial breast cancer and DNA repair genes: Insights into known and novel susceptibility genes from the GENESIS study, and implications for multigene panel testing. Int J Cancer 2018; 144:1962-1974. [PMID: 30303537 PMCID: PMC6587727 DOI: 10.1002/ijc.31921] [Citation(s) in RCA: 36] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Revised: 09/11/2018] [Accepted: 09/25/2018] [Indexed: 12/16/2022]
Abstract
Pathogenic variants in BRCA1 and BRCA2 only explain the underlying genetic cause of about 10% of hereditary breast and ovarian cancer families. Because of cost‐effectiveness, multigene panel testing is often performed even if the clinical utility of testing most of the genes remains questionable. The purpose of our study was to assess the contribution of rare, deleterious‐predicted variants in DNA repair genes in familial breast cancer (BC) in a well‐characterized and homogeneous population. We analyzed 113 DNA repair genes selected from either an exome sequencing or a candidate gene approach in the GENESIS study, which includes familial BC cases with no BRCA1 or BRCA2 mutation and having a sister with BC (N = 1,207), and general population controls (N = 1,199). Sequencing data were filtered for rare loss‐of‐function variants (LoF) and likely deleterious missense variants (MV). We confirmed associations between LoF and MV in PALB2, ATM and CHEK2 and BC occurrence. We also identified for the first time associations between FANCI, MAST1, POLH and RTEL1 and BC susceptibility. Unlike other associated genes, carriers of an ATM LoF had a significantly higher risk of developing BC than carriers of an ATM MV (ORLoF = 17.4 vs. ORMV = 1.6; pHet = 0.002). Hence, our approach allowed us to specify BC relative risks associated with deleterious‐predicted variants in PALB2, ATM and CHEK2 and to add MAST1, POLH, RTEL1 and FANCI to the list of DNA repair genes possibly involved in BC susceptibility. We also highlight that different types of variants within the same gene can lead to different risk estimates. What's new? Pathogenic variants in BRCA1 and BRCA2 only explain the genetic cause of about 10% of hereditary breast and ovarian cancer families, and the clinical usefulness of testing other genes following the recent introduction of cost‐effective multigene panel sequencing in diagnostics laboratories remains questionable. This large case‐control study describes genetic variation in 113 DNA repair genes and specifies breast cancer relative risks associated with rare deleterious‐predicted variants in PALB2, ATM, and CHEK2. Importantly, different types of variants within the same gene can lead to different risk estimates. The results may help improve risk prediction models and define gene‐specific consensus management guidelines.
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Affiliation(s)
- Elodie Girard
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Séverine Eon-Marchais
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Robert Olaso
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Evry, France
| | - Anne-Laure Renault
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | | | - Marie-Gabrielle Dondon
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Laure Barjhoux
- Département de Biopathologie, Centre Léon Bérard, Lyon, France
| | - Didier Goidin
- Life Sciences and Diagnostics Group, Agilent Technologies France, Les Ulis, France
| | - Vincent Meyer
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Evry, France
| | - Dorothée Le Gal
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Juana Beauvallet
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Noura Mebirouk
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Christine Lonjou
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Juliette Coignard
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France.,Université Paris Sud, Paris, France
| | - Morgane Marcou
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Eve Cavaciuti
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Céline Baulard
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Evry, France
| | - Marie-Thérèse Bihoreau
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Evry, France
| | | | - Dominique Leroux
- Département de Génétique, CHU de Grenoble, Hôpital Couple-Enfant, Grenoble, France
| | - Clotilde Penet
- Consultation d'Oncogénétique, Institut Jean-Godinot & ICC Courlancy, Reims, France
| | | | - Chrystelle Colas
- Département de Génétique Groupe Hospitalier Pitié-Salpêtrière, APHP, Paris, France.,Service de Génétique, Institut Curie, Paris, France
| | - Thierry Frebourg
- Département de Génétique, Hôpital Universitaire de Rouen, Rouen, France
| | - François Eisinger
- Institut Paoli Calmette, Département d'Anticipation et de Suivi des Cancers, Oncogénétique Clinique, Institut Paoli-Calmettes & Aix Marseille Université, Inserm, IRD, SESSTIM, Marseille, France
| | - Claude Adenis
- Service de Génétique, Centre Oscar-Lambret, Lille, France
| | - Anne Fajac
- Service d'Oncogénétique, Hôpital Tenon, Paris, France
| | - Laurence Gladieff
- Service d'Oncologie Médicale, Institut Claudius Regaud - IUCT-Oncopole, Toulouse, France
| | - Julie Tinat
- Département de Génétique, Hôpital Universitaire de Rouen, Rouen, France
| | | | | | - Sophie Giraud
- Service de Génétique, Hospices Civils de Lyon, Groupement Hospitalier EST, Bron, France
| | | | | | | | | | - Christine Lasset
- Université Claude Bernard Lyon 1, Villeurbanne; CNRS UMR 5558, Unité de Prévention et Epidémiologie Génétique, Lyon, Centre, Léon Bérard, France
| | | | - Hélène Dreyfus
- Clinique Sainte Catherine, Avignon & CHU de Grenoble, Département de Génétique, Hôpital Couple-Enfant, Grenoble, France
| | - Yves-Jean Bignon
- Université Clermont Auvergne; Inserm, U1240, Centre Jean Perrin, Clermont-Ferrand, France
| | | | - Pascal Pujol
- Service de Génétique Médicale et Oncogénétique, Hôpital Arnaud de Villeneuve, CHU Montpellier & INSERM 896, CRCM Val d'Aurelle, Montpellier, France
| | | | - Valérie Bonadona
- Université Claude Bernard Lyon 1, Villeurbanne; CNRS UMR 5558, Unité de Prévention et Epidémiologie Génétique, Lyon, Centre, Léon Bérard, France
| | - Pascaline Berthet
- Unité de Pathologie Gynécologique, Centre François Baclesse, Caen, France
| | - Elisabeth Luporsi
- Service de Génétique UF4128 CHR Metz-Thionville, Hôpital de Mercy, Metz, France
| | - Christine M Maugard
- Hôpitaux Universitaires de Strasbourg, UF1422 Oncogénétique moléculaire, Laboratoire d'Oncobiologie & UF6948 Oncogénétique Evaluation familiale et suivi, Strasbourg, France
| | - Catherine Noguès
- Institut Paoli Calmette, Département d'Anticipation et de Suivi des Cancers, Oncogénétique Clinique, Institut Paoli-Calmettes & Aix Marseille Université, Inserm, IRD, SESSTIM, Marseille, France
| | - Capucine Delnatte
- Unité d'Oncogénétique, Centre René Gauducheau, Nantes, Saint Herblain, France
| | | | - Paul Gesta
- Service d'Oncogénétique Régional Poitou-Charentes, Niort, France
| | - Laurence Faivre
- Institut GIMI, CHU de Dijon, Hôpital d'Enfants, Oncogénétique & Centre de Lutte contre le Cancer Georges François Leclerc, Dijon, France
| | - Alain Lortholary
- Service d'Oncologie Médicale, Centre Catherine de Sienne, Nantes, France
| | | | - Olivier Caron
- Gustave Roussy, Université Paris-Saclay, Département de Médecine Oncologique, Villejuif, France
| | | | - Isabelle Coupier
- Service de Génétique Médicale et Oncogénétique, Hôpital Arnaud de Villeneuve, CHU Montpellier & INSERM 896, CRCM Val d'Aurelle, Montpellier, France
| | - Nicolas Servant
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Evry, France
| | - Sylvie Mazoyer
- Inserm, U1028, CNRS UMR5292, Centre de Recherche en Neurosciences de Lyon, France
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine, Institut de Biologie François Jacob, CEA, Evry, France
| | - Dominique Stoppa-Lyonnet
- Service de Génétique, Institut Curie, Paris, France.,Inserm, U830, Institut Curie, Paris, France.,Université Paris Descartes, Paris, France
| | - Nadine Andrieu
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
| | - Fabienne Lesueur
- Inserm, Paris, France.,Institut Curie, Paris, France.,Mines ParisTech, Fontainebleau, France.,PSL Research University, Paris, France
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Gräf S, Haimel M, Bleda M, Hadinnapola C, Southgate L, Li W, Hodgson J, Liu B, Salmon RM, Southwood M, Machado RD, Martin JM, Treacy CM, Yates K, Daugherty LC, Shamardina O, Whitehorn D, Holden S, Aldred M, Bogaard HJ, Church C, Coghlan G, Condliffe R, Corris PA, Danesino C, Eyries M, Gall H, Ghio S, Ghofrani HA, Gibbs JSR, Girerd B, Houweling AC, Howard L, Humbert M, Kiely DG, Kovacs G, MacKenzie Ross RV, Moledina S, Montani D, Newnham M, Olschewski A, Olschewski H, Peacock AJ, Pepke-Zaba J, Prokopenko I, Rhodes CJ, Scelsi L, Seeger W, Soubrier F, Stein DF, Suntharalingam J, Swietlik EM, Toshner MR, van Heel DA, Vonk Noordegraaf A, Waisfisz Q, Wharton J, Wort SJ, Ouwehand WH, Soranzo N, Lawrie A, Upton PD, Wilkins MR, Trembath RC, Morrell NW. Identification of rare sequence variation underlying heritable pulmonary arterial hypertension. Nat Commun 2018; 9:1416. [PMID: 29650961 PMCID: PMC5897357 DOI: 10.1038/s41467-018-03672-4] [Citation(s) in RCA: 231] [Impact Index Per Article: 38.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 03/02/2018] [Indexed: 12/20/2022] Open
Abstract
Pulmonary arterial hypertension (PAH) is a rare disorder with a poor prognosis. Deleterious variation within components of the transforming growth factor-β pathway, particularly the bone morphogenetic protein type 2 receptor (BMPR2), underlies most heritable forms of PAH. To identify the missing heritability we perform whole-genome sequencing in 1038 PAH index cases and 6385 PAH-negative control subjects. Case-control analyses reveal significant overrepresentation of rare variants in ATP13A3, AQP1 and SOX17, and provide independent validation of a critical role for GDF2 in PAH. We demonstrate familial segregation of mutations in SOX17 and AQP1 with PAH. Mutations in GDF2, encoding a BMPR2 ligand, lead to reduced secretion from transfected cells. In addition, we identify pathogenic mutations in the majority of previously reported PAH genes, and provide evidence for further putative genes. Taken together these findings contribute new insights into the molecular basis of PAH and indicate unexplored pathways for therapeutic intervention.
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Affiliation(s)
- Stefan Gräf
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom.
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom.
| | - Matthias Haimel
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom
| | - Marta Bleda
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Charaka Hadinnapola
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Laura Southgate
- Molecular and Clinical Sciences Research Institute, St George's, University of London, London, SW17 0RE, United Kingdom
- Division of Genetics & Molecular Medicine, King's College London, London, WC2R 2LS, United Kingdom
| | - Wei Li
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Joshua Hodgson
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Bin Liu
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Richard M Salmon
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Mark Southwood
- Royal Papworth Hospital, Papworth Everard, Cambridge, CB23 3RE, United Kingdom
| | - Rajiv D Machado
- Institute of Medical and Biomedical Education, St George's University of London, London, SW17 0RE, United Kingdom
| | - Jennifer M Martin
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom
| | - Carmen M Treacy
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Royal Papworth Hospital, Papworth Everard, Cambridge, CB23 3RE, United Kingdom
| | - Katherine Yates
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom
| | - Louise C Daugherty
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom
| | - Olga Shamardina
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom
| | - Deborah Whitehorn
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom
| | - Simon Holden
- Addenbrooke's Hospital, Cambridge, CB2 0QQ, United Kingdom
| | | | - Harm J Bogaard
- VU University Medical Center, Amsterdam, 1007 MB, The Netherlands
| | - Colin Church
- Golden Jubilee National Hospital, Glasgow, G81 4DY, United Kingdom
| | - Gerry Coghlan
- Royal Free Hospital, London, NW3 2QG, United Kingdom
| | - Robin Condliffe
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, S10 2JF, United Kingdom
| | - Paul A Corris
- University of Newcastle, Newcastle, NE1 7RU, United Kingdom
| | - Cesare Danesino
- Department of Molecular Medicine, University of Pavia, Pavia, 27100, Italy
- Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy
| | - Mélanie Eyries
- Département de génétique, hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, and UMR_S 1166-ICAN, INSERM, UPMC Sorbonne Universités, Paris, 75252, France
| | - Henning Gall
- University of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL) and of the Excellence Cluster Cardio-Pulmonary System (ECCCPS), Giessen, 35392, Germany
| | - Stefano Ghio
- Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy
| | - Hossein-Ardeschir Ghofrani
- University of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL) and of the Excellence Cluster Cardio-Pulmonary System (ECCCPS), Giessen, 35392, Germany
- Imperial College London, London, SW7 2AZ, United Kingdom
| | - J Simon R Gibbs
- National Heart & Lung Institute, Imperial College London, London, SW3 6LY, United Kingdom
| | - Barbara Girerd
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay; AP-HP, Service de Pneumologie, Centre de référence de l'hypertension pulmonaire; INSERM UMR_S 999, Hôpital Bicêtre, Le Kremlin-Bicêtre, Paris, 94270, France
| | | | - Luke Howard
- Imperial College London, London, SW7 2AZ, United Kingdom
| | - Marc Humbert
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay; AP-HP, Service de Pneumologie, Centre de référence de l'hypertension pulmonaire; INSERM UMR_S 999, Hôpital Bicêtre, Le Kremlin-Bicêtre, Paris, 94270, France
| | - David G Kiely
- Sheffield Pulmonary Vascular Disease Unit, Royal Hallamshire Hospital, Sheffield, S10 2JF, United Kingdom
| | - Gabor Kovacs
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, 8010, Austria
- Medical University of Graz, Graz, 8036, Austria
| | | | - Shahin Moledina
- Great Ormond Street Hospital, London, WC1N 3JH, United Kingdom
| | - David Montani
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay; AP-HP, Service de Pneumologie, Centre de référence de l'hypertension pulmonaire; INSERM UMR_S 999, Hôpital Bicêtre, Le Kremlin-Bicêtre, Paris, 94270, France
| | - Michael Newnham
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Andrea Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, 8010, Austria
| | - Horst Olschewski
- Ludwig Boltzmann Institute for Lung Vascular Research, Graz, 8010, Austria
- Medical University of Graz, Graz, 8036, Austria
| | - Andrew J Peacock
- Golden Jubilee National Hospital, Glasgow, G81 4DY, United Kingdom
| | - Joanna Pepke-Zaba
- Royal Papworth Hospital, Papworth Everard, Cambridge, CB23 3RE, United Kingdom
| | | | | | - Laura Scelsi
- Fondazione IRCCS Policlinico San Matteo, Pavia, 27100, Italy
| | - Werner Seeger
- University of Giessen and Marburg Lung Center (UGMLC), member of the German Center for Lung Research (DZL) and of the Excellence Cluster Cardio-Pulmonary System (ECCCPS), Giessen, 35392, Germany
| | - Florent Soubrier
- Département de génétique, hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, and UMR_S 1166-ICAN, INSERM, UPMC Sorbonne Universités, Paris, 75252, France
| | - Dan F Stein
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Jay Suntharalingam
- Royal United Hospitals Bath NHS Foundation Trust, Bath, BA1 3NG, United Kingdom
| | - Emilia M Swietlik
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - Mark R Toshner
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | - David A van Heel
- Blizard Institute, Queen Mary University of London, London, E1 2AT, United Kingdom
| | | | - Quinten Waisfisz
- VU University Medical Center, Amsterdam, 1007 MB, The Netherlands
| | - John Wharton
- Imperial College London, London, SW7 2AZ, United Kingdom
| | - Stephen J Wort
- Imperial College London, London, SW7 2AZ, United Kingdom
- Royal Brompton Hospital, London, SW3 6NP, United Kingdom
| | - Willem H Ouwehand
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom
| | - Nicole Soranzo
- Department of Haematology, University of Cambridge, Cambridge, CB2 0PT, United Kingdom
- Wellcome Trust Sanger Institute, Hinxton, CB10 1SA, United Kingdom
| | - Allan Lawrie
- Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, S10 2RX, United Kingdom
| | - Paul D Upton
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom
| | | | - Richard C Trembath
- Division of Genetics & Molecular Medicine, King's College London, London, WC2R 2LS, United Kingdom
| | - Nicholas W Morrell
- Department of Medicine, University of Cambridge, Cambridge, CB2 0QQ, United Kingdom.
- NIHR BioResource-Rare Diseases, Cambridge, CB2 0PT, United Kingdom.
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Saliou G, Eyries M, Iacobucci M, Knebel J, Waill M, Coulet F, Ozanne A, Soubrier F. Clinical and genetic findings in children with central nervous system arteriovenous fistulas. Ann Neurol 2017; 82:972-980. [DOI: 10.1002/ana.25106] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 10/26/2017] [Accepted: 11/19/2017] [Indexed: 12/31/2022]
Affiliation(s)
- Guillaume Saliou
- Department of NeuroradiologyCentre Hospitalier Universitaire VaudoisLausanne Switzerland
- Department of NeuroradiologyBicêtre HospitalLe Kremlin Bicêtre France
| | - Mélanie Eyries
- Department of geneticsHopital Pitié‐SalpêtrièreParis France
- UMR‐S 1166‐ICAN; INSERM and UPMC Sorbonne UniversityParis France
| | - Marta Iacobucci
- Department of NeuroradiologyBicêtre HospitalLe Kremlin Bicêtre France
| | - Jean‐François Knebel
- département de Radiologie, Centre d'Imagerie Biomédicale, Hôpital Nestlé, CHUVLausanne Switzerland
| | | | | | - Augustin Ozanne
- Department of NeuroradiologyBicêtre HospitalLe Kremlin Bicêtre France
| | - Florent Soubrier
- Department of geneticsHopital Pitié‐SalpêtrièreParis France
- UMR‐S 1166‐ICAN; INSERM and UPMC Sorbonne UniversityParis France
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34
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Coulet F, Godard V, Verdy E, Soubrier F. Lack of Association of the Prothrombin Gene Variant G20210A with Myocardial Infarction in Caucasian Males. Thromb Haemost 2017. [DOI: 10.1055/s-0037-1613918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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35
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Palmyre A, Eyries M, Senat MV, Ozanne A, Staraci S, Dufour P, Chinet T, Lacombe P, Soubrier F, Charron P. Prenatal molecular diagnosis in RASA1
-related disease. Prenat Diagn 2017; 37:1261-1264. [DOI: 10.1002/pd.5165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 09/04/2017] [Accepted: 09/29/2017] [Indexed: 01/22/2023]
Affiliation(s)
- Aurélien Palmyre
- Service de Génétique, Hôpital Ambroise Paré; Assistance Publique Hôpitaux de Paris; Boulogne-Billancourt France
- Centre de compétence pour la maladie de Rendu Osler; Hôpital Ambroise Paré; Boulogne-Billancourt France
| | - Mélanie Eyries
- Département de Génétique & ICAN, Hôpital Pitié-Salpêtrière; Assistance Publique Hôpitaux de Paris; Paris France
| | - Marie-Victoire Senat
- Service Gynécologie Obstétrique, Hôpital Bicêtre; Assistance Publique Hôpitaux de Paris; Paris France
| | - Augustin Ozanne
- Service de Neuroradiologie Interventionnelle; GHU Paris-Sud - Hôpital de Bicêtre, Assistance Publique Hôpitaux de Paris; Paris France
- Centre de compétence pour la maladie de Rendu Osler; Hôpital Ambroise Paré; Boulogne-Billancourt France
| | - Stéphanie Staraci
- Service de Génétique, Hôpital Ambroise Paré; Assistance Publique Hôpitaux de Paris; Boulogne-Billancourt France
- Département de Génétique & ICAN, Hôpital Pitié-Salpêtrière; Assistance Publique Hôpitaux de Paris; Paris France
| | - Philippe Dufour
- Service Maternité et suites de naissances; Hôpital Jeanne de Flandre, CHRU de Lille; Lille France
| | - Thierry Chinet
- Service de Pneumologie et Oncologie Thoracique; Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris; Boulogne-Billancourt France
- Centre de compétence pour la maladie de Rendu Osler; Hôpital Ambroise Paré; Boulogne-Billancourt France
| | - Pascal Lacombe
- Service d'Imagerie Diagnostique et Interventionnelle; Hôpital Ambroise Paré, Assistance Publique Hôpitaux de Paris; Boulogne-Billancourt France
- Centre de compétence pour la maladie de Rendu Osler; Hôpital Ambroise Paré; Boulogne-Billancourt France
| | - Florent Soubrier
- Département de Génétique & ICAN, Hôpital Pitié-Salpêtrière; Assistance Publique Hôpitaux de Paris; Paris France
| | - Philippe Charron
- Service de Génétique, Hôpital Ambroise Paré; Assistance Publique Hôpitaux de Paris; Boulogne-Billancourt France
- Département de Génétique & ICAN, Hôpital Pitié-Salpêtrière; Assistance Publique Hôpitaux de Paris; Paris France
- Centre de compétence pour la maladie de Rendu Osler; Hôpital Ambroise Paré; Boulogne-Billancourt France
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36
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Nossent EJ, Antigny F, Montani D, Bogaard HJ, Ghigna MR, Lambert M, Thomas de Montpréville V, Girerd B, Jaïs X, Savale L, Mercier O, Fadel E, Soubrier F, Sitbon O, Simonneau G, Vonk Noordegraaf A, Humbert M, Perros F, Dorfmüller P. Pulmonary vascular remodeling patterns and expression of general control nonderepressible 2 (GCN2) in pulmonary veno-occlusive disease. J Heart Lung Transplant 2017; 37:647-655. [PMID: 29108819 DOI: 10.1016/j.healun.2017.09.022] [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] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 08/23/2017] [Accepted: 09/26/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Heritable pulmonary veno-occlusive disease (PVOD) is linked to mutations in the eukaryotic initiation factor 2 alpha kinase 4 (EIF2AK4) gene, leading to a loss of general control nonderepressible 2 (GCN2). The role of GCN2 expression in pulmonary vascular remodeling remains obscure. We sought to identify specific histologic and biologic features in heritable PVOD. METHODS Clinical data and lung histology of 24 PVOD patients (12 EIF2AK4 mutation carriers, 12 non-carriers) were submitted to systematic histologic analysis and semiautomated morphometry. GCN2 expression was quantified by Western blotting in 24 PVOD patients, 44 patients with pulmonary arterial hypertension (PAH; 23 bone morphogenetic protein receptor type II [BMPR2] mutation carriers, 21 non-carriers), and 3 experimental pulmonary hypertension models. RESULTS PVOD patients showed a significant decrease of pulmonary arterial patency (p < 0.0001) compared with healthy controls. Histology of EIF2AK4 mutation carriers was distinctive from non-carriers regarding (1) arterial remodeling, with significantly more severe intimal fibrosis (p = 0.001), less severe medial hypertrophy (p = 0.001), and (2) stronger muscular hyperplasia of interlobular septal veins (p = 0.002). GCN2 expression was abolished in heritable PVOD (p < 0.0001), but also importantly decreased in sporadic PVOD (p = 0.03) as well as in heritable (p = 0.002) and idiopathic PAH (p = 0.003); moreover, GCN2 was abolished in 2 experimental pulmonary hypertension models and importantly decreased in 1 model (p < 0.0001 for all models). CONCLUSIONS Pulmonary arterial remodeling in PVOD is present to an important extent. A significant decrease of GCN2 expression is a common denominator of all tested groups of PVOD and PAH, including their respective experimental models. Our results underline specific morphologic and biologic similarities between PAH and PVOD and let us consider both conditions rather in one large spectrum of disease than as two distinct and clear-cut entities.
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Affiliation(s)
- Esther J Nossent
- Department of Pulmonary Diseases, Vrije Universiteit University Medical Center, Institute for Cardiovascular Research, Amsterdam, The Netherlands; Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France
| | - Fabrice Antigny
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France
| | - David Montani
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; National Reference Center of Pulmonary Hypertension, Department of Pulmonology and Intensive Care Unit for Respiratory Diseases, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre, Paris, France
| | - Harm Jan Bogaard
- Department of Pulmonary Diseases, Vrije Universiteit University Medical Center, Institute for Cardiovascular Research, Amsterdam, The Netherlands
| | - Maria Rosa Ghigna
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; Department of Pathology, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France
| | - Mélanie Lambert
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France
| | | | - Barbara Girerd
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; National Reference Center of Pulmonary Hypertension, Department of Pulmonology and Intensive Care Unit for Respiratory Diseases, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre, Paris, France
| | - Xavier Jaïs
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; National Reference Center of Pulmonary Hypertension, Department of Pulmonology and Intensive Care Unit for Respiratory Diseases, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre, Paris, France
| | - Laurent Savale
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; National Reference Center of Pulmonary Hypertension, Department of Pulmonology and Intensive Care Unit for Respiratory Diseases, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre, Paris, France
| | - Olaf Mercier
- Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; Department of Thoracic and Vascular Surgery, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France
| | - Elie Fadel
- Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; Department of Thoracic and Vascular Surgery, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France
| | - Florent Soubrier
- Department of Clinical Genetics, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris and Unités Mixtes de Recherche_S 1166-ICAN, Institut National De La Santé Et De La Recherche Unités Mixtes De Recherche, Université Pierre et Marie Curie Sorbonne Universités, Paris, France
| | - Olivier Sitbon
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; National Reference Center of Pulmonary Hypertension, Department of Pulmonology and Intensive Care Unit for Respiratory Diseases, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre, Paris, France
| | - Gérald Simonneau
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; National Reference Center of Pulmonary Hypertension, Department of Pulmonology and Intensive Care Unit for Respiratory Diseases, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre, Paris, France
| | - Anton Vonk Noordegraaf
- Department of Pulmonary Diseases, Vrije Universiteit University Medical Center, Institute for Cardiovascular Research, Amsterdam, The Netherlands
| | - Marc Humbert
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; National Reference Center of Pulmonary Hypertension, Department of Pulmonology and Intensive Care Unit for Respiratory Diseases, Hôpital Bicêtre, Assistance Publique-Hôpitaux de Paris, Kremlin-Bicêtre, Paris, France
| | - Frédéric Perros
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France
| | - Peter Dorfmüller
- Institut National de la Santé et de la Recherche Unités Mixtes de Recherche_S 999, Pulmonary Hypertension: Pathophysiology and Novel Therapies, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France; Faculty of Medicine, Paris-South University, Kremlin-Bicêtre, Paris, France; Department of Pathology, Hôpital Marie Lannelongue, Le Plessis-Robinson, Paris, France.
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Hadinnapola C, Bleda M, Haimel M, Screaton N, Swift A, Dorfmüller P, Preston SD, Southwood M, Hernandez-Sanchez J, Martin J, Treacy C, Yates K, Bogaard H, Church C, Coghlan G, Condliffe R, Corris PA, Gibbs S, Girerd B, Holden S, Humbert M, Kiely DG, Lawrie A, Machado R, MacKenzie Ross R, Moledina S, Montani D, Newnham M, Peacock A, Pepke-Zaba J, Rayner-Matthews P, Shamardina O, Soubrier F, Southgate L, Suntharalingam J, Toshner M, Trembath R, Vonk Noordegraaf A, Wilkins MR, Wort SJ, Wharton J, Gräf S, Morrell NW. Phenotypic Characterization of EIF2AK4 Mutation Carriers in a Large Cohort of Patients Diagnosed Clinically With Pulmonary Arterial Hypertension. Circulation 2017; 136:2022-2033. [PMID: 28972005 DOI: 10.1161/circulationaha.117.028351] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [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: 03/14/2017] [Accepted: 08/25/2017] [Indexed: 01/08/2023]
Abstract
BACKGROUND Pulmonary arterial hypertension (PAH) is a rare disease with an emerging genetic basis. Heterozygous mutations in the gene encoding the bone morphogenetic protein receptor type 2 (BMPR2) are the commonest genetic cause of PAH, whereas biallelic mutations in the eukaryotic translation initiation factor 2 alpha kinase 4 gene (EIF2AK4) are described in pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis. Here, we determine the frequency of these mutations and define the genotype-phenotype characteristics in a large cohort of patients diagnosed clinically with PAH. METHODS Whole-genome sequencing was performed on DNA from patients with idiopathic and heritable PAH and with pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis recruited to the National Institute of Health Research BioResource-Rare Diseases study. Heterozygous variants in BMPR2 and biallelic EIF2AK4 variants with a minor allele frequency of <1:10 000 in control data sets and predicted to be deleterious (by combined annotation-dependent depletion, PolyPhen-2, and sorting intolerant from tolerant predictions) were identified as potentially causal. Phenotype data from the time of diagnosis were also captured. RESULTS Eight hundred sixty-four patients with idiopathic or heritable PAH and 16 with pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis were recruited. Mutations in BMPR2 were identified in 130 patients (14.8%). Biallelic mutations in EIF2AK4 were identified in 5 patients with a clinical diagnosis of pulmonary veno-occlusive disease/pulmonary capillary hemangiomatosis. Furthermore, 9 patients with a clinical diagnosis of PAH carried biallelic EIF2AK4 mutations. These patients had a reduced transfer coefficient for carbon monoxide (Kco; 33% [interquartile range, 30%-35%] predicted) and younger age at diagnosis (29 years; interquartile range, 23-38 years) and more interlobular septal thickening and mediastinal lymphadenopathy on computed tomography of the chest compared with patients with PAH without EIF2AK4 mutations. However, radiological assessment alone could not accurately identify biallelic EIF2AK4 mutation carriers. Patients with PAH with biallelic EIF2AK4 mutations had a shorter survival. CONCLUSIONS Biallelic EIF2AK4 mutations are found in patients classified clinically as having idiopathic and heritable PAH. These patients cannot be identified reliably by computed tomography, but a low Kco and a young age at diagnosis suggests the underlying molecular diagnosis. Genetic testing can identify these misclassified patients, allowing appropriate management and early referral for lung transplantation.
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Affiliation(s)
- Charaka Hadinnapola
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.)
| | - Marta Bleda
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.)
| | - Matthias Haimel
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.).,NIHR BioResource-Rare Diseases (M.H., J.M., K.Y., P.R.-M., O.S., S. Gräf, N.W.M.)
| | - Nicholas Screaton
- Papworth Hospital, Cambridge, UK (N.S., S.D.P., M.S., J.H.-S., J.P.-Z., M.T.)
| | | | | | - Stephen D Preston
- Papworth Hospital, Cambridge, UK (N.S., S.D.P., M.S., J.H.-S., J.P.-Z., M.T.)
| | - Mark Southwood
- Papworth Hospital, Cambridge, UK (N.S., S.D.P., M.S., J.H.-S., J.P.-Z., M.T.)
| | | | - Jennifer Martin
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.).,NIHR BioResource-Rare Diseases (M.H., J.M., K.Y., P.R.-M., O.S., S. Gräf, N.W.M.)
| | - Carmen Treacy
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.)
| | - Katherine Yates
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.).,NIHR BioResource-Rare Diseases (M.H., J.M., K.Y., P.R.-M., O.S., S. Gräf, N.W.M.)
| | - Harm Bogaard
- VU University Medical Centre, Amsterdam, the Netherlands (H.B., A.V.N.)
| | - Colin Church
- Golden Jubilee Hospital, Glasgow, UK (C.C., A.P.)
| | | | | | | | - Simon Gibbs
- Imperial College London, UK (S. Gibbs, M.R.W., J.W.)
| | | | | | - Marc Humbert
- Université Paris-Sud, France (P.D., B.G., M.H., D.M.)
| | - David G Kiely
- Royal Hallamshire Hospital, Sheffield, UK (R.C., D.G.K.)
| | | | | | | | | | - David Montani
- Université Paris-Sud, France (P.D., B.G., M.H., D.M.)
| | - Michael Newnham
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.)
| | | | - Joanna Pepke-Zaba
- Papworth Hospital, Cambridge, UK (N.S., S.D.P., M.S., J.H.-S., J.P.-Z., M.T.)
| | | | - Olga Shamardina
- NIHR BioResource-Rare Diseases (M.H., J.M., K.Y., P.R.-M., O.S., S. Gräf, N.W.M.)
| | | | - Laura Southgate
- King's College London, UK (L.S., R.T.).,St George's, University of London, UK (L.S.)
| | | | - Mark Toshner
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.).,Papworth Hospital, Cambridge, UK (N.S., S.D.P., M.S., J.H.-S., J.P.-Z., M.T.)
| | | | | | | | | | - John Wharton
- Imperial College London, UK (S. Gibbs, M.R.W., J.W.)
| | | | - Stefan Gräf
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.).,NIHR BioResource-Rare Diseases (M.H., J.M., K.Y., P.R.-M., O.S., S. Gräf, N.W.M.).,Department of Haematology, University of Cambridge, UK (S. Gräf)
| | - Nicholas W Morrell
- Department of Medicine, University of Cambridge, UK (C.H., M.B., M.H., J.M., C.T., K.Y., M.N., M.T., S. Gräf, N.W.M.) .,NIHR BioResource-Rare Diseases (M.H., J.M., K.Y., P.R.-M., O.S., S. Gräf, N.W.M.)
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Girerd B, Montani D, Jais X, Levy M, Savale L, Dorfmuller P, Lau E, Le Pavec J, Parent F, Bonnet D, Soubrier F, Fadel E, Sitbon O, Simonneau G, Humbert M. 5022Clinical phenotypes and outcomes of heritable and sporadic pulmonary veno-occlusive disease. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.5022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Soysal N, Eyries M, Verlhac S, Escabasse V, Remus N, Tamalet A, Rioux JY, Franchi-Abella S, Vasile M, Robert S, Delestrain C, Hau I, Ducou-Le Pointe H, Soubrier F, Carette MF, Epaud R. Non-invasive CT screening for pulmonary arteriovenous malformations in children with confirmed hereditary hemorrhagic telangiectasia: Results from two pediatric centers. Pediatr Pulmonol 2017; 52:642-649. [PMID: 28165669 DOI: 10.1002/ppul.23649] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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: 08/01/2016] [Revised: 11/11/2016] [Accepted: 11/17/2016] [Indexed: 12/27/2022]
Abstract
BACKGROUND Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant genetic disorder that is caused by mutations in mainly two genes, that is ENG, encoding endoglin (HHT1), or ACVRL1, encoding activin receptor-like kinase 1 (ALK-1/HHT2). HHT is characterized by recurrent epistaxis, mucocutaneous telangiectasia, and vascular visceral dysplasia responsible for visceral arteriovenous malformations (AVM). AIM to report the experience of two university hospitals (Trousseau, Paris, and CHIC, Creteil) with screening children for HHT and pulmonary AVM (PAVM) using high resolution computed tomography (HRCT). METHODS parents with confirmed HHT were offered to have their children screened for the mutation identified in their family, and informed consent was obtained. Children carrying the same mutation as their parents underwent HRCT of the chest without contrast. RESULTS between 2008 and 2015, 99 children were screened for HHT mutations. Mutations were identified in 59 patients, that is 24 HHT1 and 35 HHT2. Radiologic and clinical screening was possible in 52 patients (21 HHT-1 and 31 HHT-2). Among those, PAVM was identified in 13 patients (25%; n = 8 HHT1; n = 5 HHT2), and four of them required embolization therapy. CONCLUSION This study highlights the usefulness of genetic screening in children with known HHT family. It also suggests that a non-invasive protocol such as HRTC is an efficient approach to detect non-symptomatic lesions that are present early on in children carrying the ENG (HHT1), but also the ACVRL1 mutations (HHT2). Pediatr Pulmonol. 2017;52:642-649. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Nurcan Soysal
- Service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil 94000, France
| | - Mélanie Eyries
- Département de Génétique, Hôpital Pitié-Salpetrière, UF d'Oncogénétique et d'Angiogénétique Moléculaire, Paris, France
| | - Suzanne Verlhac
- Service de Radiologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Virginie Escabasse
- Service d'ORL, Centre Hospitalier Intercommunal de Créteil, Créteil, France.,Inserm, U955, Equipe 5, Créteil 94000, France.,Université Paris-Est, Faculté de Médecine, Créteil 94000, France
| | - Natascha Remus
- Service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil 94000, France
| | - Aline Tamalet
- Service de Pneumologie Pédiatrique, Hôpital Armand-Trousseau, Paris, France.,Centre des Maladies Respiratoires Rares, RESPIRARE®, Paris 75012, France
| | - Jean-Yves Rioux
- Service de Radiologie pédiatrique, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Assistance Publique Hôpitaux de Paris, Kremlin-Bicêtre, France
| | - Stéphanie Franchi-Abella
- Service de Radiologie pédiatrique, Hôpital Bicêtre, Hôpitaux Universitaires Paris-Sud, Assistance Publique Hôpitaux de Paris, Kremlin-Bicêtre, France
| | - Manuela Vasile
- Service de Radiologie, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Sarah Robert
- Sorbonne Universités, UPMC Univ Paris 06, Institut Pierre Louis d'épidémiologie et de Santé Publique (IPLESP UMRS 1136)
| | - Céline Delestrain
- Service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil 94000, France.,Inserm, U955, Equipe 5, Créteil 94000, France.,Université Paris-Est, Faculté de Médecine, Créteil 94000, France
| | - Isabelle Hau
- Service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil 94000, France
| | - Hubert Ducou-Le Pointe
- Service de Radiologie, Hôpital Armand-Trousseau, Paris, France.,Faculté de Médecine Pierre et Marie Curie, Sorbonne Université-UPMC, Paris, France
| | - Florent Soubrier
- Département de Génétique, Hôpital Pitié-Salpetrière, UF d'Oncogénétique et d'Angiogénétique Moléculaire, Paris, France
| | - Marie-France Carette
- Faculté de Médecine Pierre et Marie Curie, Sorbonne Université-UPMC, Paris, France.,Service de Radiologie, Hôpital Tenon, Paris, France.,Centre de Compétence Maladie de Rendu Osler, Hôpital Tenon, Paris 75020, France
| | - Ralph Epaud
- Service de Pédiatrie, Centre Hospitalier Intercommunal de Créteil, Créteil 94000, France.,Inserm, U955, Equipe 5, Créteil 94000, France.,Université Paris-Est, Faculté de Médecine, Créteil 94000, France.,Centre des Maladies Respiratoires Rares, RESPIRARE®, Paris 75012, France.,Centre de Compétence Maladie de Rendu Osler, Hôpital Tenon, Paris 75020, France
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Nadaud S, Laumonnier Y, Soubrier F. Aspects moléculaires de l’expression et de la régulation de la synthase endothéliale du monoxyde d’azote. ACTA ACUST UNITED AC 2017. [DOI: 10.1051/jbio/2000194030131] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Montani D, Girerd B, Jaïs X, Levy M, Amar D, Savale L, Dorfmüller P, Seferian A, Lau EM, Eyries M, Le Pavec J, Parent F, Bonnet D, Soubrier F, Fadel E, Sitbon O, Simonneau G, Humbert M. Clinical phenotypes and outcomes of heritable and sporadic pulmonary veno-occlusive disease: a population-based study. Lancet Respir Med 2017; 5:125-134. [PMID: 28087362 DOI: 10.1016/s2213-2600(16)30438-6] [Citation(s) in RCA: 104] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 11/14/2016] [Accepted: 11/17/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND Bi-allelic mutations of the EIF2AK4 gene cause heritable pulmonary veno-occlusive disease and/or pulmonary capillary haemangiomatosis (PVOD/PCH). We aimed to assess the effect of EIF2AK4 mutations on the clinical phenotypes and outcomes of PVOD/PCH. METHODS We did a population-based study using clinical, functional, and haemodynamic data from the registry of the French Pulmonary Hypertension Network. We reviewed the clinical data and outcomes from all patients referred to the French Referral Centre (Pulmonary Department, Hospital Kremlin-Bicêtre, University Paris-Sud) with either confirmed or highly probable PVOD/PCH with DNA available for mutation screening (excluding patients with other risk factors of pulmonary hypertension, such as chronic respiratory diseases). We sequenced the coding sequence and intronic junctions of the EIF2AK4 gene, and compared clinical characteristics and outcomes between EIF2AK4 mutation carriers and non-carriers. Medical therapies approved for pulmonary arterial hypertension (prostacyclin derivatives, endothelin receptor antagonists and phosphodiesterase type-5 inhibitors) were given to patients according to the clinical judgment and discretion of treating physicians. The primary outcome was the event-free survival (death or transplantation). Secondary outcomes included response to therapies for pulmonary arterial hypertension and survival after lung transplantation. A satisfactory clinical response to specific therapy for pulmonary arterial hypertension was defined by achieving New York Heart Association functional class I or II, a 6-min walk distance of more than 440 m, and a cardiac index greater than 2·5 L/min per m2 at the first reassessment after initiation of specific therapy for pulmonary arterial hypertension. FINDINGS We obtained data from Jan 1, 2003, to June 1, 2016, and identified 94 patients with sporadic or heritable PVOD/PCH (confirmed or highly probable). 27 (29%) of these patients had bi-allelic EIF2AK4 mutations. PVOD/PCH due to EIF2AK4 mutations occurred from birth to age 50 years, and these patients were younger at presentation than non-carriers (median 26·0 years [range 0-50.3] vs 60·0 years [6·7-81·4] years; p<0·0001). At diagnosis, both mutations carriers and non-carriers had similarly severe precapillary pulmonary hypertension and functional impairment. 22 (81%) of mutations carriers and 63 (94%) of non-carriers received therapy approved for pulmonary arterial hypertension. Drug-induced pulmonary oedema occurred in five (23%) of treated EIF2AK4 mutations carriers and 13 (21%) of treated non-carriers. Follow-up assessment after initiation of treatment showed that only three (4%) patients with PVOD/PCH reached the predefined criteria for satisfactory clinical response. The probabilities of event-free survival (death or transplantation) at 1 and 3 years were 63% and 32% in EIF2AK4 mutations carriers, and 75% and 34% in non-carriers. No significant differences occurred in event-free survival between the 2 groups (p=0·38). Among the 33 patients who had lung transplantation, estimated post-transplantation survival rates at 1, 2, and 5 years were 84%, 81%, and 73%, respectively. INTERPRETATION Heritable PVOD/PCH due to bi-allelic EIF2AK4 mutations is characterised by a younger age at diagnosis but these patients display similar disease severity compared with mutation non-carriers. Response to therapy approved for pulmonary arterial hypertension in PVOD/PCH is rare. PVOD/PCH is a devastating condition and lung transplantation should be considered for eligible patients. FUNDING None.
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Affiliation(s)
- David Montani
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Barbara Girerd
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Xavier Jaïs
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Marilyne Levy
- M3C-Necker, Reference Centre for Complex Congenital Heart Diseases, Hôpital Universitaire Necker-Enfants malades, AP-HP, Université Paris Descartes, Paris, France
| | - David Amar
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Laurent Savale
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Peter Dorfmüller
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France; Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, Paris, France
| | - Andrei Seferian
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Edmund M Lau
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; Sydney Medical School, University of Sydney, Camperdown, VIC, Australia; Royal Prince Alfred Hospital, Camperdown, VIC, Australia
| | - Mélanie Eyries
- Département de Génétique, Hôpital Pitié Salpétrière, AP-HP, UMR_S1166-ICAN, Paris, France; INSERM and UPMC Sorbonne Universités, Paris, France
| | - Jérôme Le Pavec
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, Paris, France
| | - Florence Parent
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Damien Bonnet
- M3C-Necker, Reference Centre for Complex Congenital Heart Diseases, Hôpital Universitaire Necker-Enfants malades, AP-HP, Université Paris Descartes, Paris, France
| | - Florent Soubrier
- Département de Génétique, Hôpital Pitié Salpétrière, AP-HP, UMR_S1166-ICAN, Paris, France; INSERM and UPMC Sorbonne Universités, Paris, France
| | - Elie Fadel
- Centre Chirurgical Marie Lannelongue, Service de Chirurgie Thoracique, Vasculaire et Transplantation Cardiopulmonaire, Le Plessis Robinson, Paris, France
| | - Olivier Sitbon
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France
| | - Gérald Simonneau
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France
| | - Marc Humbert
- University Paris-Sud, Faculté de Médecine, Paris, F-94270, France; AP-HP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire (DHU) Thorax Innovation (TORINO), Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, Paris, France; UMR_S 999, Univ. Paris-Sud, INSERM, Laboratoire d'Excellence (LabEx) en Recherche sur le Médicament et l'Innovation Thérapeutique (LERMIT), Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, Paris, France.
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Ghigna MR, Guignabert C, Montani D, Girerd B, Jaïs X, Savale L, Hervé P, Thomas de Montpréville V, Mercier O, Sitbon O, Soubrier F, Fadel E, Simonneau G, Humbert M, Dorfmüller P. BMPR2 mutation status influences bronchial vascular changes in pulmonary arterial hypertension. Eur Respir J 2016; 48:1668-1681. [PMID: 27811071 DOI: 10.1183/13993003.00464-2016] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2016] [Accepted: 08/29/2016] [Indexed: 12/22/2022]
Abstract
The impact of bone morphogenetic protein receptor 2 (BMPR2) gene mutations on vascular remodelling in pulmonary arterial hypertension (PAH) is unknown. We sought to identify a histological profile of BMPR2 mutation carriers.Clinical data and lung histology from 44 PAH patients were subjected to systematic analysis and morphometry.Bronchial artery hypertrophy/dilatation and bronchial angiogenesis, as well as muscular remodelling of septal veins were significantly increased in PAH lungs carrying BMPR2 mutations. We found that patients displaying increased bronchial artery remodelling and bronchial microvessel density, irrespective of the mutation status, were more likely to suffer from severe haemoptysis. History of substantial haemoptysis (>50 mL) was significantly more frequent in BMPR2 mutation carriers. 43.5% of BMPR2 mutation carriers, as opposed to 9.5% of noncarriers, displayed singular large fibrovascular lesions, which appear to be closely related to the systemic lung vasculature.Our analysis provides evidence for the involvement of the pulmonary systemic circulation in BMPR2 mutation-related PAH. We show that BMPR2 mutation carriers are more prone to haemoptysis and that haemoptysis is closely correlated to bronchial arterial remodelling and angiogenesis; in turn, pronounced changes in the systemic vasculature correlate with increased pulmonary venous remodelling, creating a distinctive profile in PAH patients harbouring a BMPR2 mutation.
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Affiliation(s)
- Maria-Rosa Ghigna
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Dept of Pathology, Marie Lannelongue Hospital, Le Plessis-Robinson, France
| | - Christophe Guignabert
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France
| | - David Montani
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,AP-HP, Dept of Pulmonology, DHU Thorax Innovation, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Barbara Girerd
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,AP-HP, Dept of Pulmonology, DHU Thorax Innovation, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Xavier Jaïs
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,AP-HP, Dept of Pulmonology, DHU Thorax Innovation, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Laurent Savale
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,AP-HP, Dept of Pulmonology, DHU Thorax Innovation, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Philippe Hervé
- Dept of Thoracic and Vascular Surgery, Marie Lannelongue Hospital, Le Plessis-Robinson, France
| | | | - Olaf Mercier
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Dept of Thoracic and Vascular Surgery, Marie Lannelongue Hospital, Le Plessis-Robinson, France
| | - Olivier Sitbon
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,AP-HP, Dept of Pulmonology, DHU Thorax Innovation, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Florent Soubrier
- AP-HP, Dept of Genetics, Pitié-Salpétrière Hospital, Université Pierre et Marie Curie, Paris, France
| | - Elie Fadel
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Dept of Thoracic and Vascular Surgery, Marie Lannelongue Hospital, Le Plessis-Robinson, France
| | - Gérald Simonneau
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,AP-HP, Dept of Pulmonology, DHU Thorax Innovation, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Marc Humbert
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France.,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,AP-HP, Dept of Pulmonology, DHU Thorax Innovation, Bicêtre Hospital, Kremlin-Bicêtre, France
| | - Peter Dorfmüller
- INSERM UMR_S 999, LabEx LERMIT, Marie Lannelongue Hospital, Le Plessis-Robinson, France .,School of Medicine, Paris South University, Université Paris-Saclay, Le Kremlin-Bicêtre, France.,Dept of Pathology, Marie Lannelongue Hospital, Le Plessis-Robinson, France
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Eyries M, Soubrier F. Molecular Genetic Diagnosis of Pulmonary Arterial Hypertension: An Increased Complexity. ACTA ACUST UNITED AC 2016; 69:1003-1004. [PMID: 27634583 DOI: 10.1016/j.rec.2016.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 05/17/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Mélanie Eyries
- Department of Genetics, GH Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris; UMR_S 1166, Université Paris-Sorbonne UPMC, and INSERM, Paris, France
| | - Florent Soubrier
- Department of Genetics, GH Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris; UMR_S 1166, Université Paris-Sorbonne UPMC, and INSERM, Paris, France.
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Levy M, Eyries M, Szezepanski I, Ladouceur M, Nadaud S, Bonnet D, Soubrier F. Genetic analyses in a cohort of children with pulmonary hypertension. Eur Respir J 2016; 48:1118-1126. [PMID: 27587546 DOI: 10.1183/13993003.00211-2016] [Citation(s) in RCA: 66] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 06/07/2016] [Indexed: 11/05/2022]
Abstract
The prevalence of germline mutations in paediatric pulmonary hypertension (PH) is poorly documented. The objective of this study was to determine the mutation frequency in PH genes in a paediatric cohort and describe the clinical characteristics of mutation carriers.The study involved 66 index cases with PH: 35 children with idiopathic pulmonary arterial hypertension (IPAH); five children with familial PAH (FPAH); three children with pulmonary veno-occlusive disease (PVOD); and 23 children with PAH associated with congenital heart disease (APAH-CHD).No mutations were found in the 23 children with APAH-CHD. In the 40 children with IPAH or FPAH, 12 mutations were found: five on BMPR2; four on ACVRL1; and three on TBX4. In the three PVOD cases, two carried the EIF2AK4 mutation. Mutation carriers had a more severe disease at diagnosis and more aggressive first-line therapy was required. The three patients with PVOD had a very severe disease at diagnosis and required a lung transplantation.The genetic architecture of paediatric PAH is enriched in ACVRL1 and TBX4 mutations compared to adult PAH, but further studies are required to confirm these results. Childhood-onset PAH in children carrying a mutation in one of the genes tested has a more severe presentation at diagnosis but a similar outcome to that observed in non-carriers.
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Affiliation(s)
- Marilyne Levy
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France M3C-Unité Médico-Chirugicale de Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Mélanie Eyries
- Genetics Dept, GH Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1166-ICAN, Paris, France ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Isabelle Szezepanski
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France M3C-Unité Médico-Chirugicale de Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Magalie Ladouceur
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France M3C-Unité Médico-Chirugicale de Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Sophie Nadaud
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1166-ICAN, Paris, France ICAN Institute for Cardiometabolism and Nutrition, Paris, France
| | - Damien Bonnet
- Université Paris Descartes, Sorbonne Paris Cité, Paris, France M3C-Unité Médico-Chirugicale de Cardiologie Pédiatrique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Florent Soubrier
- Genetics Dept, GH Pitié-Salpêtrière, Assistance Publique Hôpitaux de Paris, Paris, France Sorbonne Universités, UPMC Univ Paris 06, INSERM, UMR_S 1166-ICAN, Paris, France ICAN Institute for Cardiometabolism and Nutrition, Paris, France
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Chrifi I, Dierick F, Dumitriu IE, Schuchardt M, Jover E, Yan Z, Fontijn RD, Borges L, Brandt MM, Cheng C, Duncker DJGM, Monceau V, Hoareau B, Mougenot N, Marazzi G, Sassoon D, Hulot JS, Soubrier F, Nadaud S, Baruah P, Dinkla S, Bullenkamp J, Kaski JC, Tu Y, Pruefer N, Toelle M, Chebli S, Zidek W, Van Der Giet M, Silvente A, Marin F, Rodriguez C, Martinez-Gonzalez J, Puche CM, Valdes M, Hernandez Romero D, Tan J, Yang L, Valent ET, Leyen TA, Szulcek R, Baggen JM, Geerts D, Van Nieuw Amerongen GP, Horrevoets AJG, Alvarenga LAA, Falcao RSP, Dias RR, Lacchini S, Gutierrez PS, Michel JB. Moderated Poster session - Vascular26Identification of CMTM3 as a new pro-angiogenic factor essential for vessel stabilization27Regulation of pulmonary vascular PW1+ progenitor cells recruitment during early chronic hypoxia-induced vessel neomuscularization28Impaired interleukin-10 production in response to CpG and depletion of the regulatory CD19+CD24hiCD38hi B cell compartment in patients with coronary atherosclerosis29Inflammatory effects of serum amyloid A via TLR2 and TLR4 in vascular cells30Collagen cross-linking enzymes are involved in vascular smooth muscle cells calcification31miR-504 inhibits venous smooth muscle cell proliferation and migration by targeting LAMTOR132Diaphenous related formin 2 (DRF2) is essential for KLF2-induced resistance of endothelial cells to flow forces.33Inhibition of TGfb axis and renin-angiotensin system in human ascending aorta aneurysms. Cardiovasc Res 2016. [DOI: 10.1093/cvr/cvw133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Montani D, Lau EM, Dorfmüller P, Girerd B, Jaïs X, Savale L, Perros F, Nossent E, Garcia G, Parent F, Fadel E, Soubrier F, Sitbon O, Simonneau G, Humbert M. Pulmonary veno-occlusive disease. Eur Respir J 2016; 47:1518-34. [DOI: 10.1183/13993003.00026-2016] [Citation(s) in RCA: 155] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 02/04/2016] [Indexed: 12/11/2022]
Abstract
Pulmonary veno-occlusive disease (PVOD) is a rare form of pulmonary hypertension (PH) characterised by preferential remodelling of the pulmonary venules. In the current PH classification, PVOD and pulmonary capillary haemangiomatosis (PCH) are considered to be a common entity and represent varied expressions of the same disease. The recent discovery of biallelic mutations in the EIF2AK4 gene as the cause of heritable PVOD/PCH represents a major milestone in our understanding of the molecular pathogenesis of PVOD. Although PVOD and pulmonary arterial hypertension (PAH) share a similar clinical presentation, with features of severe precapillary PH, it is important to differentiate these two conditions as PVOD carries a worse prognosis and life-threatening pulmonary oedema may occur following the initiation of PAH therapy. An accurate diagnosis of PVOD based on noninvasive investigations is possible utilising oxygen parameters, low diffusing capacity for carbon monoxide and characteristic signs on high-resolution computed tomography of the chest. No evidence-based medical therapy exists for PVOD at present and lung transplantation remains the preferred definitive therapy for eligible patients.
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Evans JDW, Girerd B, Montani D, Wang XJ, Galiè N, Austin ED, Elliott G, Asano K, Grünig E, Yan Y, Jing ZC, Manes A, Palazzini M, Wheeler LA, Nakayama I, Satoh T, Eichstaedt C, Hinderhofer K, Wolf M, Rosenzweig EB, Chung WK, Soubrier F, Simonneau G, Sitbon O, Gräf S, Kaptoge S, Di Angelantonio E, Humbert M, Morrell NW. BMPR2 mutations and survival in pulmonary arterial hypertension: an individual participant data meta-analysis. Lancet Respir Med 2016; 4:129-37. [PMID: 26795434 PMCID: PMC4737700 DOI: 10.1016/s2213-2600(15)00544-5] [Citation(s) in RCA: 256] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/15/2015] [Accepted: 12/17/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND Mutations in the gene encoding the bone morphogenetic protein receptor type II (BMPR2) are the commonest genetic cause of pulmonary arterial hypertension (PAH). However, the effect of BMPR2 mutations on clinical phenotype and outcomes remains uncertain. METHODS We analysed individual participant data of 1550 patients with idiopathic, heritable, and anorexigen-associated PAH from eight cohorts that had been systematically tested for BMPR2 mutations. The primary outcome was the composite of death or lung transplantation. All-cause mortality was the secondary outcome. Hazard ratios (HRs) for death or transplantation and all-cause mortality associated with the presence of BMPR2 mutation were calculated using Cox proportional hazards models stratified by cohort. FINDINGS Overall, 448 (29%) of 1550 patients had a BMPR2 mutation. Mutation carriers were younger at diagnosis (mean age 35·4 [SD 14·8] vs 42·0 [17·8] years), had a higher mean pulmonary artery pressure (60·5 [13·8] vs 56·4 [15·3] mm Hg) and pulmonary vascular resistance (16·6 [8·3] vs 12·9 [8·3] Wood units), and lower cardiac index (2·11 [0·69] vs 2·51 [0·92] L/min per m(2); all p<0·0001). Patients with BMPR2 mutations were less likely to respond to acute vasodilator testing (3% [10 of 380] vs 16% [147 of 907]; p<0·0001). Among the 1164 individuals with available survival data, age-adjusted and sex-adjusted HRs comparing BMPR2 mutation carriers with non-carriers were 1·42 (95% CI 1·15-1·75; p=0·0011) for the composite of death or lung transplantation and 1·27 (1·00-1·60; p=0·046) for all-cause mortality. These HRs were attenuated after adjustment for potential mediators including pulmonary vascular resistance, cardiac index, and vasoreactivity. HRs for death or transplantation and all-cause mortality associated with BMPR2 mutation were similar in men and women, but higher in patients with a younger age at diagnosis (p=0·0030 for death or transplantation, p=0·011 for all-cause mortality). INTERPRETATION Patients with PAH and BMPR2 mutations present at a younger age with more severe disease, and are at increased risk of death, and death or transplantation, compared with those without BMPR2 mutations. FUNDING Cambridge NIHR Biomedical Research Centre, Medical Research Council, British Heart Foundation, Assistance Publique-Hôpitaux de Paris, INSERM, Université Paris-Sud, Intermountain Research and Medical Foundation, Vanderbilt University, National Center for Advancing Translational Sciences, National Institutes of Health, National Natural Science Foundation of China, and Beijing Natural Science Foundation.
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Affiliation(s)
- Jonathan D W Evans
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK; Department of Cardiology, Papworth Hospital, Cambridge, UK
| | - Barbara Girerd
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France; APHP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire Thorax Innovation, Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France; INSERM UMR_S 999, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - David Montani
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France; APHP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire Thorax Innovation, Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France; INSERM UMR_S 999, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Xiao-Jian Wang
- Thrombosis and Vascular Medicine Center, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Nazzareno Galiè
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, Italy
| | - Eric D Austin
- Department of Paediatrics, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Greg Elliott
- Department of Medicine, Intermountain Medical Center and the University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Koichiro Asano
- Division of Pulmonary Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Ekkehard Grünig
- Centre for Pulmonary Hypertension, Thorax Clinic, University Hospital Heidelberg, Heidelberg, Germany
| | - Yi Yan
- Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhi-Cheng Jing
- Thrombosis and Vascular Medicine Center, State Key Laboratory of Cardiovascular Disease, FuWai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; Department of Cardio-Pulmonary Circulation, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China
| | | | - Massimiliano Palazzini
- Department of Experimental, Diagnostic and Specialty Medicine-DIMES, University of Bologna, Bologna, Italy
| | - Lisa A Wheeler
- Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Ikue Nakayama
- Department of Medicine, Intermountain Medical Center and the University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Toru Satoh
- Division of Cardiology, Department of Medicine, Kyorin University School of Medicine, Tokyo, Japan
| | - Christina Eichstaedt
- Centre for Pulmonary Hypertension, Thorax Clinic, University Hospital Heidelberg, Heidelberg, Germany; Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Katrin Hinderhofer
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Matthias Wolf
- Centre for Pulmonary Hypertension, Thorax Clinic, University Hospital Heidelberg, Heidelberg, Germany; Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Erika B Rosenzweig
- Department of Pediatric Cardiology, Columbia University Medical Center, New York, NY USA
| | - Wendy K Chung
- Departments of Pediatrics and Medicine, Columbia University Medical Center, New York, NY USA
| | - Florent Soubrier
- Université Pierre et Marie Curie-Paris 6, Laboratoire d'Oncogénétique et Angiogénétique Moléculaire, Groupe Hospitalier Pitié-Salpétrière, Paris, France
| | - Gérald Simonneau
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France; APHP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire Thorax Innovation, Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France; INSERM UMR_S 999, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Olivier Sitbon
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France; APHP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire Thorax Innovation, Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France; INSERM UMR_S 999, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Stefan Gräf
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK; Department of Haematology, University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Stephen Kaptoge
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | | | - Marc Humbert
- Université Paris-Sud, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre, France; APHP, Centre de Référence de l'Hypertension Pulmonaire Sévère, Département Hospitalo-Universitaire Thorax Innovation, Service de Pneumologie, Hôpital de Bicêtre, Le Kremlin Bicêtre, France; INSERM UMR_S 999, Laboratoire d'Excellence en Recherche sur le Médicament et l'Innovation Thérapeutique, Centre Chirurgical Marie Lannelongue, Le Plessis Robinson, France
| | - Nicholas W Morrell
- Department of Medicine, University of Cambridge School of Clinical Medicine, Cambridge, UK.
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Sinilnikova OM, Dondon MG, Eon-Marchais S, Damiola F, Barjhoux L, Marcou M, Verny-Pierre C, Sornin V, Toulemonde L, Beauvallet J, Le Gal D, Mebirouk N, Belotti M, Caron O, Gauthier-Villars M, Coupier I, Buecher B, Lortholary A, Dugast C, Gesta P, Fricker JP, Noguès C, Faivre L, Luporsi E, Berthet P, Delnatte C, Bonadona V, Maugard CM, Pujol P, Lasset C, Longy M, Bignon YJ, Adenis C, Venat-Bouvet L, Demange L, Dreyfus H, Frenay M, Gladieff L, Mortemousque I, Audebert-Bellanger S, Soubrier F, Giraud S, Lejeune-Dumoulin S, Chevrier A, Limacher JM, Chiesa J, Fajac A, Floquet A, Eisinger F, Tinat J, Colas C, Fert-Ferrer S, Penet C, Frebourg T, Collonge-Rame MA, Barouk-Simonet E, Layet V, Leroux D, Cohen-Haguenauer O, Prieur F, Mouret-Fourme E, Cornélis F, Jonveaux P, Bera O, Cavaciuti E, Tardivon A, Lesueur F, Mazoyer S, Stoppa-Lyonnet D, Andrieu N. GENESIS: a French national resource to study the missing heritability of breast cancer. BMC Cancer 2016; 16:13. [PMID: 26758370 PMCID: PMC4711059 DOI: 10.1186/s12885-015-2028-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 02/02/2015] [Accepted: 12/17/2015] [Indexed: 11/26/2022] Open
Abstract
Background Less than 20 % of familial breast cancer patients who undergo genetic testing for BRCA1 and BRCA2 carry a pathogenic mutation in one of these two genes. The GENESIS (GENE SISter) study was designed to identify new breast cancer susceptibility genes in women attending cancer genetics clinics and with no BRCA1/2 mutation. Methods The study involved the French national network of family cancer clinics. It was based on enrichment in genetic factors of the recruited population through case selection relying on familial criteria, but also on the consideration of environmental factors and endophenotypes like mammary density or tumor characteristics to assess potential genetic heterogeneity. One of the initial aims of GENESIS was to recruit affected sibpairs. Siblings were eligible when index cases and at least one affected sister were diagnosed with infiltrating mammary or ductal adenocarcinoma, with no BRCA1/2 mutation. In addition, unrelated controls and unaffected sisters were recruited. The enrolment of patients, their relatives and their controls, the collection of the clinical, epidemiological, familial and biological data were centralized by a coordinating center. Results Inclusion of participants started in February 2007 and ended in December 2013. A total of 1721 index cases, 826 affected sisters, 599 unaffected sisters and 1419 controls were included. 98 % of participants completed the epidemiological questionnaire, 97 % provided a blood sample, and 76 % were able to provide mammograms. Index cases were on average 59 years old at inclusion, were born in 1950, and were 49.7 years of age at breast cancer diagnosis. The mean age at diagnosis of affected sisters was slightly higher (51.4 years). The representativeness of the control group was verified. Conclusions The size of the study, the availability of biological specimens and the clinical data collection together with the detailed and complete epidemiological questionnaire make this a unique national resource for investigation of the missing heritability of breast cancer, by taking into account environmental and life style factors and stratifying data on endophenotypes to decrease genetic heterogeneity.
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Affiliation(s)
- Olga M Sinilnikova
- Cancer Research Centre of Lyon, CNRS UMR5286, Inserm U1052, Université Claude Bernard Lyon 1, Centre Léon Bérard, Lyon, France.,Unité Mixte de Génétique Constitutionnelle des Cancers Fréquents, Hospices Civils de Lyon, Centre Léon Bérard, Lyon, France
| | - Marie-Gabrielle Dondon
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | - Séverine Eon-Marchais
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | - Francesca Damiola
- Cancer Research Centre of Lyon, CNRS UMR5286, Inserm U1052, Université Claude Bernard Lyon 1, Centre Léon Bérard, Lyon, France.
| | - Laure Barjhoux
- Cancer Research Centre of Lyon, CNRS UMR5286, Inserm U1052, Université Claude Bernard Lyon 1, Centre Léon Bérard, Lyon, France.
| | - Morgane Marcou
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | - Carole Verny-Pierre
- Cancer Research Centre of Lyon, CNRS UMR5286, Inserm U1052, Université Claude Bernard Lyon 1, Centre Léon Bérard, Lyon, France.
| | - Valérie Sornin
- Cancer Research Centre of Lyon, CNRS UMR5286, Inserm U1052, Université Claude Bernard Lyon 1, Centre Léon Bérard, Lyon, France.
| | - Lucie Toulemonde
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | - Juana Beauvallet
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | - Dorothée Le Gal
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | - Noura Mebirouk
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | | | - Olivier Caron
- Institut de Cancérologie Gustave Roussy, Service d'Oncologie Génétique, Villejuif, France.
| | | | - Isabelle Coupier
- Hôpital Arnaud de Villeneuve, CHU Montpellier, Service de Génétique médicale et Oncogénétique, Montpellier, France. .,ICM Val d'Aurel, Unité d'Oncogénétique, Montpellier, France.
| | - Bruno Buecher
- Institut Curie, Service de Génétique, Paris, France.
| | - Alain Lortholary
- Centre Catherine de Sienne, Service d'Oncologie Médicale, Nantes, France.
| | | | - Paul Gesta
- CH Georges Renon, Service Oncogénétique pour la consultation oncogénétique régionale Poitou-Charentes, Niort, France.
| | | | | | - Laurence Faivre
- Hôpital d'Enfants, Service de Génétique Médicale, Dijon, France. .,Centre Georges François Leclerc, Oncogénétique, Dijon, France.
| | - Elisabeth Luporsi
- ICL Alexis Vautrin, Unité d'Oncogénétique, Vandœuvre-lès-Nancy, France.
| | - Pascaline Berthet
- Centre François Baclesse, Unité de pathologie gynécologique, Caen, France.
| | - Capucine Delnatte
- Centre René Gauducheau, Unité d'Oncogénétique, Nantes Saint Herblain, France.
| | - Valérie Bonadona
- Université Claude Bernard Lyon 1, Villeurbanne, France. .,CNRS UMR 5558, Lyon, France. .,Centre Léon Bérard, Unité de Prévention et Epidémiologie Génétique, Lyon, France.
| | - Christine M Maugard
- Hôpitaux Universitaires de Strasbourg, UF1422 Oncogénétique moléculaire, Laboratoire de diagnostic génétique, Strasbourg, France. .,Hôpitaux Universitaires de Strasbourg, UF6948 Oncogénétique, Service d'Hémato-Oncologie, Strasbourg, France.
| | - Pascal Pujol
- Hôpital Arnaud de Villeneuve, CHU Montpellier, Service de Génétique médicale et Oncogénétique, Montpellier, France. .,Inserm, U896, CRCM Val d'Aurel, Montpellier, France.
| | - Christine Lasset
- Université Claude Bernard Lyon 1, Villeurbanne, France. .,CNRS UMR 5558, Lyon, France. .,Centre Léon Bérard, Unité de Prévention et Epidémiologie Génétique, Lyon, France.
| | | | | | | | | | | | - Hélène Dreyfus
- Clinique Sainte Catherine, Avignon, France. .,CHU de Grenoble, Hôpital Couple-Enfant, Département de Génétique, Grenoble, France.
| | - Marc Frenay
- Centre Antoine Lacassagne, Unité d'Oncogénétique, Nice, France.
| | - Laurence Gladieff
- Institut Claudius Regaud - IUCT-Oncopole, Service d'Oncologie Médicale, Toulouse, France.
| | | | | | | | - Sophie Giraud
- Hôpital Edouard Herriot, Service de Génétique Moléculaire, Lyon, France.
| | | | - Annie Chevrier
- Hôpital Universitaire de Rouen, Département de Génétique, Rouen, France.
| | | | | | - Anne Fajac
- Hôpital Tenon, Service d'Oncogénétique, Paris, France.
| | | | - François Eisinger
- IPC, Département d'Anticipation et de Suivi des Cancers, Marseille, France. .,Inserm, UMR 912, Marseille, France.
| | - Julie Tinat
- Hôpital Universitaire de Rouen, Département de Génétique, Rouen, France.
| | - Chrystelle Colas
- Groupe Hospitalier Pitié-Salpêtrière, Département de Génétique, APHP, Paris, France.
| | | | - Clotilde Penet
- Institut Jean-Godinot, Reims, France. .,ICC Courlancy, Cs Oncogénétique, Reims, France.
| | - Thierry Frebourg
- Hôpital Universitaire de Rouen, Département de Génétique, Rouen, France.
| | - Marie-Agnès Collonge-Rame
- CHU Hôpital Saint-Jacques, Service Génétique et Biologie du Développement - Histologie, Besançon, France.
| | | | | | - Dominique Leroux
- CHU de Grenoble, Hôpital Couple-Enfant, Département de Génétique, Grenoble, France.
| | | | - Fabienne Prieur
- CHU de Saint-Etienne, Hôpital Nord, Service de Génétique, Saint-Etienne, France.
| | | | | | - Philippe Jonveaux
- CHU Hôpital de Brabois, Laboratoire de Génétique, Vandœuvre-lès-Nancy, France.
| | - Odile Bera
- CHU de Martinique, Unité d'Oncogénétique, Fort-de-France, France.
| | - Eve Cavaciuti
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | - Anne Tardivon
- Institut Curie, Département d'imagerie médicale, Paris, France.
| | - Fabienne Lesueur
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
| | - Sylvie Mazoyer
- Cancer Research Centre of Lyon, CNRS UMR5286, Inserm U1052, Université Claude Bernard Lyon 1, Centre Léon Bérard, Lyon, France.
| | - Dominique Stoppa-Lyonnet
- PSL Research University, Paris, France. .,Institut Curie, Service de Génétique, Paris, France. .,Inserm, U830, Paris, France. .,Université Paris-Descartes, Paris, France.
| | - Nadine Andrieu
- Inserm, U900, Paris, France. .,Institut Curie, Paris, France. .,PSL Research University, Paris, France. .,Mines ParisTech, Fontainebleau, France.
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50
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Dierick F, Héry T, Hoareau-Coudert B, Mougenot N, Monceau V, Claude C, Crisan M, Besson V, Dorfmüller P, Marodon G, Fadel E, Humbert M, Yaniz-Galende E, Hulot JS, Marazzi G, Sassoon D, Soubrier F, Nadaud S. Resident PW1+ Progenitor Cells Participate in Vascular Remodeling During Pulmonary Arterial Hypertension. Circ Res 2016; 118:822-33. [PMID: 26838788 DOI: 10.1161/circresaha.115.307035] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [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: 06/16/2015] [Accepted: 01/12/2016] [Indexed: 12/20/2022]
Abstract
RATIONALE Pulmonary arterial hypertension is characterized by vascular remodeling and neomuscularization. PW1(+) progenitor cells can differentiate into smooth muscle cells (SMCs) in vitro. OBJECTIVE To determine the role of pulmonary PW1(+) progenitor cells in vascular remodeling characteristic of pulmonary arterial hypertension. METHODS AND RESULTS We investigated their contribution during chronic hypoxia-induced vascular remodeling in Pw1(nLacZ+/-) mouse expressing β-galactosidase in PW1(+) cells and in differentiated cells derived from PW1(+) cells. PW1(+) progenitor cells are present in the perivascular zone in rodent and human control lungs. Using progenitor markers, 3 distinct myogenic PW1(+) cell populations were isolated from the mouse lung of which 2 were significantly increased after 4 days of chronic hypoxia. The number of proliferating pulmonary PW1(+) cells and the proportion of β-gal(+) vascular SMC were increased, indicating a recruitment of PW1(+) cells and their differentiation into vascular SMC during early chronic hypoxia-induced neomuscularization. CXCR4 inhibition using AMD3100 prevented PW1(+) cells differentiation into SMC but did not inhibit their proliferation. Bone marrow transplantation experiments showed that the newly formed β-gal(+) SMC were not derived from circulating bone marrow-derived PW1(+) progenitor cells, confirming a resident origin of the recruited PW1(+) cells. The number of pulmonary PW1(+) cells was also increased in rats after monocrotaline injection. In lung from pulmonary arterial hypertension patients, PW1-expressing cells were observed in large numbers in remodeled vascular structures. CONCLUSIONS These results demonstrate the existence of a novel population of resident SMC progenitor cells expressing PW1 and participating in pulmonary hypertension-associated vascular remodeling.
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Affiliation(s)
- France Dierick
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Tiphaine Héry
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Bénédicte Hoareau-Coudert
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Nathalie Mougenot
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Virginie Monceau
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Caroline Claude
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Mihaela Crisan
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Vanessa Besson
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Peter Dorfmüller
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Gilles Marodon
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Elie Fadel
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Marc Humbert
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Elisa Yaniz-Galende
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Jean-Sébastien Hulot
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Giovanna Marazzi
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - David Sassoon
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Florent Soubrier
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.)
| | - Sophie Nadaud
- From the INSERM, Institute of Cardiometabolism and Nutrition, UMR_S 1166-ICAN (F.D., T.H., V.M., C.C., V.B., E.Y.-G., J.-S.H., G.M., D.S., F.S., S.N.), UMS-030 CyPS, Paris, France (B.H.-C.), PECMV UMS28 (N.M.), INSERM, CNRS, CR7, Centre d'Immunologie et des Maladies Infectieuses (CIMI), U1135, ERL 8255 (G.M.), Sorbonne Universités, UPMC Univ Paris 06, Paris, France; Erasmus MC Stem Cell Institute, Rotterdam, The Netherlands (M.C.); Univ Paris-Sud, Université Paris Saclay, INSERM UMR-S 999, Labex LERMIT, Le Plessis-Robinson, Paris, France (P.D., E.F., M.H.); Service d'Anatomie Pathologique, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, Paris, France (P.D.); Service de Chirurgie Thoracique et Vasculaire, Centre Chirurgical Marie Lannelongue, Le Plessis-Robinson, France (E.F.); Univ Paris-Sud, Université Paris Saclay, Le Kremlin-Bicêtre, Paris, France (M.H.); and Assistance Publique Hôpitaux de Paris, Service de Pneumologie, Centre de Référence de l'Hypertension Pulmonaire Sévère, Hôpital Bicêtre, Le Kremlin Bicêtre, France (M.H.).
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