1. Somatic activating mutations in
- Author
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Lara, Rodriguez-Laguna, Noelia, Agra, Kristina, Ibañez, Gloria, Oliva-Molina, Gema, Gordo, Noor, Khurana, Devon, Hominick, María, Beato, Isabel, Colmenero, Gonzalo, Herranz, Juan M, Torres Canizalez, Rebeca, Rodríguez Pena, Elena, Vallespín, Rubén, Martín-Arenas, Ángela, Del Pozo, Cristina, Villaverde, Ana, Bustamante, Carmen, Ayuso, Pablo, Lapunzina, Juan C, Lopez-Gutierrez, Michael T, Dellinger, and Victor, Martinez-Glez
- Subjects
Adult ,Male ,Sirolimus ,Adolescent ,Class I Phosphatidylinositol 3-Kinases ,TOR Serine-Threonine Kinases ,Mutation, Missense ,nutritional and metabolic diseases ,Article ,Lymphatic System ,Amino Acid Substitution ,Child, Preschool ,Humans ,lipids (amino acids, peptides, and proteins) ,Female ,cardiovascular diseases ,Lymphangioleiomyomatosis ,Child ,Proto-Oncogene Proteins c-akt ,hormones, hormone substitutes, and hormone antagonists ,Research Articles ,Signal Transduction - Abstract
Generalized lymphatic anomaly (GLA) is a vascular disorder characterized by diffuse or multifocal lymphatic malformations (LMs). Here, Rodriguez-Laguna et al. report that somatic activating PIK3CA mutations can cause GLA, and we provide preclinical and clinical evidence to support the use of rapamycin for the treatment of GLA., Generalized lymphatic anomaly (GLA) is a vascular disorder characterized by diffuse or multifocal lymphatic malformations (LMs). The etiology of GLA is poorly understood. We identified four distinct somatic PIK3CA variants (Glu542Lys, Gln546Lys, His1047Arg, and His1047Leu) in tissue samples from five out of nine patients with GLA. These same PIK3CA variants occur in PIK3CA-related overgrowth spectrum and cause hyperactivation of the PI3K–AKT–mTOR pathway. We found that the mTOR inhibitor, rapamycin, prevented lymphatic hyperplasia and dysfunction in mice that expressed an active form of PIK3CA (His1047Arg) in their lymphatics. We also found that rapamycin reduced pain in patients with GLA. In conclusion, we report that somatic activating PIK3CA mutations can cause GLA, and we provide preclinical and clinical evidence to support the use of rapamycin for the treatment of this disabling and deadly disease.
- Published
- 2018