1. Pathogenic variants in THSD4, encoding the ADAMTS-like 6 protein, predispose to inherited thoracic aortic aneurysm
- Author
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Olivier Milleron, Marie Paule Jacob, Benoît Ho-Tin-Noé, Marjolijn Renard, Nadine Hanna, Guillaume Jondeau, Laurent Gouya, Marie Sylvie Gross, Sebastien Dupont, Sandy Elbitar, Sébastien Gaertner, Marianne Abifadel, Jeremie Jonquet, Ketty Kessler, Bertrand Isidor, Catherine Boileau, Yves Alembik, Kiyotoshi Sekiguchi, Dianna M. Milewicz, Laurent Tosolini, Mathilde Varret, Mélodie Aubart, Yara Abou Khalil, Youmna Ghaleb, Dongchuan Guo, Jean-Baptiste Michel, Maud Langeois, Louise Benarroch, Ko Tsutsui, Vincenzo Dattilo, Pauline Arnaud, Julie De Backer, Carine Le Goff, Lynn Y. Sakai, and Petra El Khoury
- Subjects
0301 basic medicine ,Marfan syndrome ,diagnosis ,Fibrillin-1 ,FIBRONECTIN ,thoracic aortic aneurysm ,THSD4 ,030105 genetics & heredity ,Biology ,Thoracic aortic aneurysm ,DISSECTIONS ,DISEASE ,Article ,Pathogenesis ,Mice ,03 medical and health sciences ,ADAMTSL6 ,medicine.artery ,Medicine and Health Sciences ,medicine ,Animals ,Humans ,Thoracic aorta ,Genetics(clinical) ,Exome ,FBN1 ,Genetics (clinical) ,Exome sequencing ,Genetics ,Aortic Aneurysm, Thoracic ,MUTATIONS ,ADAMTS ,MOUSE MODEL ,FIBRILLIN-1 ,medicine.disease ,GENE ,MARFAN-SYNDROME ,TGFBR2 ,ADAM Proteins ,Aortic Dissection ,030104 developmental biology ,Haploinsufficiency ,Fibrillin - Abstract
Purpose: Thoracic aortic aneurysm and dissection (TAAD) is a life-threatening disease with often unrecognized inherited forms. We sought to identify novel pathogenic variants associated with autosomal dominant inheritance of TAAD. Methods: We analyzed exome sequencing data from 35 French TAAD families and performed next-generation sequencing capture panel of genes in 1114 unrelated TAAD patients. Functional effects of pathogenic variants identified were validated in cell, tissue, and mouse models. Results: We identified five functional variants in THSD4 of which two heterozygous variants lead to a premature termination codon. THSD4 encodes ADAMTSL6 (member of the ADAMTS/L superfamily), a microfibril-associated protein that promotes fibrillin-1 matrix assembly. The THSD4 variants studied lead to haploinsufficiency or impaired assembly of fibrillin-1 microfibrils. Thsd4+/− mice showed progressive dilation of the thoracic aorta. Histologic examination of aortic samples from a patient carrying a THSD4 variant and from Thsd4+/− mice, revealed typical medial degeneration and diffuse disruption of extracellular matrix. Conclusion: These findings highlight the role of ADAMTSL6 in aortic physiology and TAAD pathogenesis. They will improve TAAD management and help develop new targeted therapies.
- Published
- 2021