Sequence variations of ACVRL1 play a critical role in hepatic vascular malformations in hereditary hemorrhagic telangiectasia.


Journal

Orphanet journal of rare diseases
ISSN: 1750-1172
Titre abrégé: Orphanet J Rare Dis
Pays: England
ID NLM: 101266602

Informations de publication

Date de publication:
22 09 2020
Historique:
received: 08 04 2020
accepted: 07 09 2020
entrez: 23 9 2020
pubmed: 24 9 2020
medline: 19 5 2021
Statut: epublish

Résumé

Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by multiple telangiectases and caused by germline disease-causing variants in the ENG (HHT1), ACVRL1 (HHT2) and, to a lesser extent MADH4 and GDF2, which encode proteins involved in the TGF-β/BMP9 signaling pathway. Common visceral complications of HHT are caused by pulmonary, cerebral, or hepatic arteriovenous malformations (HAVMs). There is large intrafamilial variability in the severity of visceral involvement, suggesting a role for modifier genes. The objective of the present study was to investigate the potential role of ENG, ACVRL1, and of other candidate genes belonging to the same biological pathway in the development of HAVMs. We selected 354 patients from the French HHT patient database who had one disease causing variant in either ENG or ACVRL1 and who underwent hepatic exploration. We first compared the distribution of the different types of variants with the occurrence of HAVMs. Then, we genotyped 51 Tag-SNPs from the Hap Map database located in 8 genes that encode proteins belonging to the TGF-β/BMP9 pathway (ACVRL1, ENG, GDF2, MADH4, SMAD1, SMAD5, TGFB1, TGFBR1), as well as in two additional candidate genes (PTPN14 and ADAM17). We addressed the question of a possible genetic association with the occurrence of HAVMs. The proportion of patients with germline ACVRL1 variants and the proportion of women were significantly higher in HHT patients with HAVMs. In the HHT2 group, HAVMs were more frequent in patients with truncating variants. Six SNPs (3 in ACVRL1, 1 in ENG, 1 in SMAD5, and 1 in ADAM17) were significantly associated with HAVMs. After correction for multiple testing, only one remained significantly associated (rs2277383). In this large association study, we confirmed the strong relationship between ACVRL1 and the development of HAVMs. Common polymorphisms of ACVRL1 may also play a role in the development of HAVMs, as a modifying factor, independently of the disease-causing variants.

Sections du résumé

BACKGROUND
Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disorder characterized by multiple telangiectases and caused by germline disease-causing variants in the ENG (HHT1), ACVRL1 (HHT2) and, to a lesser extent MADH4 and GDF2, which encode proteins involved in the TGF-β/BMP9 signaling pathway. Common visceral complications of HHT are caused by pulmonary, cerebral, or hepatic arteriovenous malformations (HAVMs). There is large intrafamilial variability in the severity of visceral involvement, suggesting a role for modifier genes. The objective of the present study was to investigate the potential role of ENG, ACVRL1, and of other candidate genes belonging to the same biological pathway in the development of HAVMs.
METHODS
We selected 354 patients from the French HHT patient database who had one disease causing variant in either ENG or ACVRL1 and who underwent hepatic exploration. We first compared the distribution of the different types of variants with the occurrence of HAVMs. Then, we genotyped 51 Tag-SNPs from the Hap Map database located in 8 genes that encode proteins belonging to the TGF-β/BMP9 pathway (ACVRL1, ENG, GDF2, MADH4, SMAD1, SMAD5, TGFB1, TGFBR1), as well as in two additional candidate genes (PTPN14 and ADAM17). We addressed the question of a possible genetic association with the occurrence of HAVMs.
RESULTS
The proportion of patients with germline ACVRL1 variants and the proportion of women were significantly higher in HHT patients with HAVMs. In the HHT2 group, HAVMs were more frequent in patients with truncating variants. Six SNPs (3 in ACVRL1, 1 in ENG, 1 in SMAD5, and 1 in ADAM17) were significantly associated with HAVMs. After correction for multiple testing, only one remained significantly associated (rs2277383).
CONCLUSIONS
In this large association study, we confirmed the strong relationship between ACVRL1 and the development of HAVMs. Common polymorphisms of ACVRL1 may also play a role in the development of HAVMs, as a modifying factor, independently of the disease-causing variants.

Identifiants

pubmed: 32962750
doi: 10.1186/s13023-020-01533-2
pii: 10.1186/s13023-020-01533-2
pmc: PMC7507685
doi:

Substances chimiques

Endoglin 0
ACVRL1 protein, human EC 2.7.11.30
Activin Receptors, Type II EC 2.7.11.30

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

254

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Auteurs

Sophie Giraud (S)

Hospices Civils de Lyon, Service de Génétique, Groupement Hospitalier Est, 69677, Bron, France.

Claire Bardel (C)

Service de Biostatistique-Bioinformatique, plateforme de séquençage à haut débit, Hospices Civils de Lyon, Lyon, France.
Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France.
CNRS UMR 5558, Laboratoire de Biométrie et Biologie Evolutive, Equipe Biotatistique-Santé, F-69100, Villeurbanne, France.

Sophie Dupuis-Girod (S)

Hospices Civils de Lyon, Service de Génétique, Groupement Hospitalier Est, 69677, Bron, France.
Centre de Référence National pour la maladie de Rendu-Osler, Groupement Hospitalier Est, Bron, France.

Marie-France Carette (MF)

Service de Radiologie, Hôpital Tenon, Paris, France.

Brigitte Gilbert-Dussardier (B)

Service Génétique, CHU de Poitiers, Poitiers, France.
EA3808, Université de Poitiers, Poitiers, France.

Sophie Riviere (S)

CHU de Montpellier, Service de Médecine Interne, Hôpital St Eloi, Montpellier, France.

Jean-Christophe Saurin (JC)

Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France.
Hospices Civils de Lyon, Service de Gastro-Entérologie, Hôpital E. Herriot, Lyon, France.

Mélanie Eyries (M)

Assistance Publique-Hôpitaux de Paris, Département de Génétique, GH Pitié-Salpêtrière, Paris, France.

Sylvie Patri (S)

CHU la Milétrie, Laboratoire de Génétique, Poitiers, France.

Evelyne Decullier (E)

Unité de recherche clinique du pole IMER of the Hospices Civils de Lyon, Lyon, France.

Alain Calender (A)

Hospices Civils de Lyon, Service de Génétique, Groupement Hospitalier Est, 69677, Bron, France.
Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France.
Equipe EA7426, Immunopathologie des voies respiratoires, Université Lyon 1, Lyon, France.

Gaëtan Lesca (G)

Hospices Civils de Lyon, Service de Génétique, Groupement Hospitalier Est, 69677, Bron, France. gaetan.lesca@chu-lyon.fr.
Université Claude Bernard Lyon 1, Université de Lyon, Villeurbanne, France. gaetan.lesca@chu-lyon.fr.

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Classifications MeSH