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Pinard A, Ye W, Fraser SM, Rosenfeld JA, Pichurin P, Hickey SE, Guo D, Cecchi AC, Boerio ML, Guey S, Aloui C, Lee K, Kraemer M, Alyemni SO, Bamshad MJ, Nickerson DA, Tournier-Lasserve E, Haider S, Jin SC, Smith ER, Kahle KT, Jan LY, He M, Milewicz DM. Rare variants in ANO1, encoding a calcium-activated chloride channel, predispose to moyamoya disease. Brain 2023; 146:3616-3623. [PMID: 37253099 PMCID: PMC10473557 DOI: 10.1093/brain/awad172] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 03/24/2023] [Accepted: 04/16/2023] [Indexed: 06/01/2023] Open
Abstract
Moyamoya disease, a cerebrovascular disease leading to strokes in children and young adults, is characterized by progressive occlusion of the distal internal carotid arteries and the formation of collateral vessels. Altered genes play a prominent role in the aetiology of moyamoya disease, but a causative gene is not identified in the majority of cases. Exome sequencing data from 151 individuals from 84 unsolved families were analysed to identify further genes for moyamoya disease, then candidate genes assessed in additional cases (150 probands). Two families had the same rare variant in ANO1, which encodes a calcium-activated chloride channel, anoctamin-1. Haplotype analyses found the families were related, and ANO1 p.Met658Val segregated with moyamoya disease in the family with an LOD score of 3.3. Six additional ANO1 rare variants were identified in moyamoya disease families. The ANO1 rare variants were assessed using patch-clamp recordings, and the majority of variants, including ANO1 p.Met658Val, displayed increased sensitivity to intracellular Ca2+. Patients harbouring these gain-of-function ANO1 variants had classic features of moyamoya disease, but also had aneurysm, stenosis and/or occlusion in the posterior circulation. Our studies support that ANO1 gain-of-function pathogenic variants predispose to moyamoya disease and are associated with unique involvement of the posterior circulation.
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Affiliation(s)
- Amélie Pinard
- Department of Internal Medicine, Division of Medical Genetics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Wenlei Ye
- Howard Hughes Medical Institute, Department of Physiology, University of California San Francisco, San Francisco, CA 94158, USA
| | - Stuart M Fraser
- Department of Pediatrics, Division of Child Neurology, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Jill A Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Pavel Pichurin
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN 55902, USA
| | - Scott E Hickey
- Department of Pediatrics, The Ohio State University, Columbus, OH 43210, USA
- Division of Genetic and Genomic Medicine, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Dongchuan Guo
- Department of Internal Medicine, Division of Medical Genetics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Alana C Cecchi
- Department of Internal Medicine, Division of Medical Genetics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Maura L Boerio
- Department of Internal Medicine, Division of Medical Genetics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
| | - Stéphanie Guey
- Université de Paris, Inserm U1141, AP-HP Groupe hospitalier Lariboisière Saint Louis, 75019 Paris, France
| | - Chaker Aloui
- Université de Paris, Inserm U1141, AP-HP Groupe hospitalier Lariboisière Saint Louis, 75019 Paris, France
| | - Kwanghyuk Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
| | - Markus Kraemer
- Department of Neurology, Alfried Krupp-Hospital, 45131 Essen, Germany
- Department of Neurology, Medical Faculty, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | | | | | - Michael J Bamshad
- Division of Genetics Medicine, Department of Pediatrics, University of Washington, Seattle, WA 98195, USA
| | - Deborah A Nickerson
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
| | - Elisabeth Tournier-Lasserve
- Université de Paris, Inserm U1141, AP-HP Groupe hospitalier Lariboisière Saint Louis, 75019 Paris, France
- AP-HP, Service de génétique moléculaire neurovasculaire, Centre de Référence des Maladies Vasculaires Rares du Cerveau et de l’oeil, Groupe Hospitalier Saint-Louis Lariboisière, 75010 Paris, France
| | - Shozeb Haider
- UCL School of Pharmacy, Bloomsbury, London WC1N 1AX, UK
- UCL Centre for Advanced Research Computing, University College London, London WC1H 9RN, UK
| | - Sheng Chih Jin
- Department of Genetics, Washington University School of Medicine, St Louis, MO 63110, USA
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO 63110, USA
| | - Edward R Smith
- Department of Neurosurgery, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA
| | - Kristopher T Kahle
- Department of Neurosurgery, Yale University School of Medicine, New Haven, CT 06510, USA
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Broad Institute of Harvard and MIT, Cambridge, MA 02142, USA
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA 02115, USA
| | - Lily Yeh Jan
- Howard Hughes Medical Institute, Department of Physiology, University of California San Francisco, San Francisco, CA 94158, USA
| | - Mu He
- Howard Hughes Medical Institute, Department of Physiology, University of California San Francisco, San Francisco, CA 94158, USA
- School of Biomedical Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR, China
| | - Dianna M Milewicz
- Department of Internal Medicine, Division of Medical Genetics, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX 77030, USA
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