New genetic drivers in hemorrhagic hereditary telangiectasia

Background: Hereditary hemorrhagic telangiectasia (HHT) is a rare vascular disease inherited in an autosomal dominant manner. Disease-causing variants in endoglin (ENG) and activin A receptor type II-like 1 (ACVRL1) genes are detected in around 90% of the patients; also 2% of patients harbor pathoge...

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Detalles Bibliográficos
Autores: Cerdà, Pau|||0000-0003-4368-6260, Castillo, Sandra D.|||0000-0002-7007-3155, Aguilera, Cinthia|||0000-0002-0363-8590, Iriarte, Adriana, Rocamora, José Luis, Larrinaga, Ane M., Viñals, Francesc|||0000-0002-9918-6751, Graupera, Mariona|||0000-0003-4608-4185, Riera Mestre, Antoni|||0000-0001-9411-804X
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:289558
Acceso en línea:https://ddd.uab.cat/record/289558
https://dx.doi.org/urn:doi:10.1016/j.ejim.2023.08.024
Access Level:acceso abierto
Palabra clave:Hereditary hemorrhagic telangiectasia
Rare diseases
Genetics
SMAD6
Hypoxia
Descripción
Sumario:Background: Hereditary hemorrhagic telangiectasia (HHT) is a rare vascular disease inherited in an autosomal dominant manner. Disease-causing variants in endoglin (ENG) and activin A receptor type II-like 1 (ACVRL1) genes are detected in around 90% of the patients; also 2% of patients harbor pathogenic variants at SMAD4 and GDF2. Importantly, the genetic cause of 8% of patients with clinical HHT remains unknown. Here, we present new putative genetic drivers of HHT. Methods: To identify new HHT genetic drivers, we performed exome sequencing of 19 HHT patients and relatives with unknown HHT genetic etiology. We applied a multistep filtration strategy to catalog deleterious variants and prioritize gene candidates based on their known relevance in endothelial cell biology. Additionally, we performed in vitro validation of one of the identified variants. Results: We identified variants in the INHA, HIF1A, JAK2, DNM2, POSTN, ANGPTL4, FOXO1 and SMAD6 genes as putative drivers in HHT. We have identified the SMAD6 p.(Glu407Lys) variant in one of the families; this is a loss-of-function variant leading to the activation of the BMP/TGFβ signaling in endothelial cells. Conclusions: Variants in these genes should be considered for genetic testing in patients with HHT phenotype and negative for ACVRL1/ENG mutations.