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Kim SN, Viswanadham VV, Doan RN, Dou Y, Bizzotto S, Khoshkhoo S, Huang AY, Yeh R, Chhouk B, Truong A, Chappell KM, Beaudin M, Barton A, Akula SK, Rento L, Lodato M, Ganz J, Szeto RA, Li P, Tsai JW, Hill RS, Park PJ, Walsh CA. Cell lineage analysis with somatic mutations reveals late divergence of neuronal cell types and cortical areas in human cerebral cortex. bioRxiv 2023:2023.11.06.565899. [PMID: 37986891 PMCID: PMC10659282 DOI: 10.1101/2023.11.06.565899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
The mammalian cerebral cortex shows functional specialization into regions with distinct neuronal compositions, most strikingly in the human brain, but little is known in about how cellular lineages shape cortical regional variation and neuronal cell types during development. Here, we use somatic single nucleotide variants (sSNVs) to map lineages of neuronal sub-types and cortical regions. Early-occurring sSNVs rarely respect Brodmann area (BA) borders, while late-occurring sSNVs mark neuron-generating clones with modest regional restriction, though descendants often dispersed into neighboring BAs. Nevertheless, in visual cortex, BA17 contains 30-70% more sSNVs compared to the neighboring BA18, with clones across the BA17/18 border distributed asymmetrically and thus displaying different cortex-wide dispersion patterns. Moreover, we find that excitatory neuron-generating clones with modest regional restriction consistently share low-mosaic sSNVs with some inhibitory neurons, suggesting significant co-generation of excitatory and some inhibitory neurons in the dorsal cortex. Our analysis reveals human-specific cortical cell lineage patterns, with both regional inhomogeneities in progenitor proliferation and late divergence of excitatory/inhibitory lineages.
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Affiliation(s)
- Sonia Nan Kim
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
- Program in Biological and Biomedical Sciences, Harvard Medical School, Boston, 02115, MA, USA
| | - Vinayak V. Viswanadham
- Department of Biomedical Informatics, Harvard Medical School, Boston, 02115, MA, USA
- Bioinformatics and Integrative Genomics Program, Harvard Medical School, Boston, 02115, MA, USA
| | - Ryan N. Doan
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
| | - Yanmei Dou
- Department of Biomedical Informatics, Harvard Medical School, Boston, 02115, MA, USA
| | - Sara Bizzotto
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
| | - Sattar Khoshkhoo
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
- Department of Neurology, Brigham and Women’s Hospital, Boston, 02115, MA, USA
| | - August Yue Huang
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
| | - Rebecca Yeh
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
| | - Brian Chhouk
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
| | - Alex Truong
- Research Computing, Harvard Medical School, Boston, 02115, MA, USA
| | | | - Marc Beaudin
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
| | - Alison Barton
- Department of Biomedical Informatics, Harvard Medical School, Boston, 02115, MA, USA
- Bioinformatics and Integrative Genomics Program, Harvard Medical School, Boston, 02115, MA, USA
| | - Shyam K. Akula
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
| | - Lariza Rento
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
| | - Michael Lodato
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
| | - Javier Ganz
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
| | - Ryan A. Szeto
- Program in Biological and Biomedical Sciences, Harvard Medical School, Boston, 02115, MA, USA
| | - Pengpeng Li
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
| | - Jessica W. Tsai
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
| | - Robert Sean Hill
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
| | - Peter J. Park
- Department of Biomedical Informatics, Harvard Medical School, Boston, 02115, MA, USA
| | - Christopher A. Walsh
- Division of Genetics and Genomics, Manton Center for Orphan Disease Research, Department of Pediatrics, and Howard Hughes Medical Institute, Boston Children’s Hospital, Boston, 02115, MA, USA
- Departments of Pediatrics and Neurology, Harvard Medical School, Boston, 02115, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, 02142, MA, USA
- Program in Biological and Biomedical Sciences, Harvard Medical School, Boston, 02115, MA, USA
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Gallitto E, Faggioli G, Vacirca A, Lodato M, Cappiello A, Logiacco A, Feroldi F, Pini R, Gargiulo M. Superior mesenteric artery-related outcomes in fenestrated/branched endografting for complex aortic aneurysms. Front Cardiovasc Med 2023; 10:1252533. [PMID: 37771670 PMCID: PMC10526822 DOI: 10.3389/fcvm.2023.1252533] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
Aim Early/follow-up durability of superior mesenteric artery (SMA) stent-grafts is crucial after fenestrated/branched endografting (FB-EVAR) in complex abdominal aortic aneurysms (CAAAs) and thoracoabdominal aortic aneurysms (TAAAs). The study aimed to report early/midterm outcomes of SMA incorporated during FB-EVAR procedures. Methods FB-EVAR procedures performed between 2016 and 2021 in a single institution were reviewed. Anatomical SMA characteristics were analyzed. The SMA configuration was classified into three types according to the angle between the SMA main trunk and the aorta: (A) perpendicular, (B) downward, and (C) upward. SMA-related technical success (SMA-TS: cannulation and stenting, patency at completion angiography without endoleak, stenosis/kinking, dissection, bleeding, and 24-h mortality) and SMA-adverse events (SMA-AEs: one among bowel ischemia, stenosis, occlusion, endoleak, reinterventions, or SMA-related mortality) were assessed. Results Two hundred FB-EVAR procedures with SMA as the target artery were performed. The indication for FB-EVAR was CAAAs and TAAAs in 99 (49%) and 101 (51%) cases, respectively. The SMA configuration was A, B, and C in 132 (66%), 63 (31%), and 5 (3%) cases, respectively. SMA was incorporated with fenestrations and branches in 131 (66%) and 69 (34%) cases, respectively. Directional branch (P < .001), aortic diameter ≥35 mm at the SMA level (P < .001), and ≥2 SMA bridging stent-grafts (P = .001) were more frequent in TAAAs. Relining of the SMA stent-graft with a bare metal stent was necessary in 41 (21%) cases to correct an acute angle between the stent-graft and native artery (39), stent-graft stenosis (1), or SMA dissection (1). Relining was associated with type A or C SMA configuration (OR: 17; 95% CI: 1.8-157.3; P = .01). SMA-TS was achieved in all cases. Overall, 15 (7.5%) patients had SMA-AEs [early: 9 (60%), follow-up: 6 (40%)] due to stenosis (2), endoleak (8), and bowel ischemia (5). Aortic diameter ≥35 mm at the SMA level was an independent risk factor for SMA-AEs (OR: 4; 95% CI: 1.4-13.8; P = .01). Fourteen (7%) patients died during hospitalization with 10 (5%) events within the 30-postoperative day. Emergency cases (OR: 33; 95% CI: 5.7-191.3; P = .001), peripheral arterial occlusive disease (OR: 14; 95% CI: 2.3-88.8; P = .004), and bowel ischemia (OR: 41; 95% CI: 1.9-87.9; P = .01) were risk factors for 30-day/in-hospital mortality. The mean follow-up was 32 ± 24 months; estimated 3-year survival was 81%, with no case of late SMA-related mortality or occlusion. The estimated 3-year freedom from overall and SMA-related reinterventions was 74% and 95%, respectively. Conclusion SMA orientation determines the necessity of stent-graft relining. Aortic diameter ≥35 mm at the SMA level is a predictor of SMA-AEs. Nevertheless, SMA-related outcomes of FB-EVAR are satisfactory, with excellent technical success and promising clinical outcomes during the follow-up.
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Affiliation(s)
- E. Gallitto
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
- Vascular Surgery Unit, IRCCS, University Hospital Policlinico S. Orsola, Bologna, Italy
| | - G. Faggioli
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
- Vascular Surgery Unit, IRCCS, University Hospital Policlinico S. Orsola, Bologna, Italy
| | - A. Vacirca
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
- Vascular Surgery Unit, IRCCS, University Hospital Policlinico S. Orsola, Bologna, Italy
| | - M. Lodato
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
| | - A. Cappiello
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
| | - A. Logiacco
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
| | - F. Feroldi
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
| | - R. Pini
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
- Vascular Surgery Unit, IRCCS, University Hospital Policlinico S. Orsola, Bologna, Italy
| | - M. Gargiulo
- Vascular Surgery, University of Bologna—DIMEC, Bologna, Italy
- Vascular Surgery Unit, IRCCS, University Hospital Policlinico S. Orsola, Bologna, Italy
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