[HTML][HTML] Angiotensin II–dependent TGF-β signaling contributes to Loeys-Dietz syndrome vascular pathogenesis

EM Gallo, DC Loch, JP Habashi… - The Journal of …, 2014 - Am Soc Clin Investig
EM Gallo, DC Loch, JP Habashi, JF Calderon, Y Chen, D Bedja, C Van Erp, EE Gerber…
The Journal of clinical investigation, 2014Am Soc Clin Investig
Loeys-Dietz syndrome (LDS) is a connective tissue disorder that is characterized by a high
risk for aneurysm and dissection throughout the arterial tree and phenotypically resembles
Marfan syndrome. LDS is caused by heterozygous missense mutations in either TGF-β
receptor gene (TGFBR1 or TGFBR2), which are predicted to result in diminished TGF-β
signaling; however, aortic surgical samples from patients show evidence of paradoxically
increased TGF-β signaling. We generated 2 knockin mouse strains with LDS mutations in …
Loeys-Dietz syndrome (LDS) is a connective tissue disorder that is characterized by a high risk for aneurysm and dissection throughout the arterial tree and phenotypically resembles Marfan syndrome. LDS is caused by heterozygous missense mutations in either TGF-β receptor gene (TGFBR1 or TGFBR2), which are predicted to result in diminished TGF-β signaling; however, aortic surgical samples from patients show evidence of paradoxically increased TGF-β signaling. We generated 2 knockin mouse strains with LDS mutations in either Tgfbr1 or Tgfbr2 and a transgenic mouse overexpressing mutant Tgfbr2. Knockin and transgenic mice, but not haploinsufficient animals, recapitulated the LDS phenotype. While heterozygous mutant cells had diminished signaling in response to exogenous TGF-β in vitro, they maintained normal levels of Smad2 phosphorylation under steady-state culture conditions, suggesting a chronic compensation. Analysis of TGF-β signaling in the aortic wall in vivo revealed progressive upregulation of Smad2 phosphorylation and TGF-β target gene output, which paralleled worsening of aneurysm pathology and coincided with upregulation of TGF-β1 ligand expression. Importantly, suppression of Smad2 phosphorylation and TGF-β1 expression correlated with the therapeutic efficacy of the angiotensin II type 1 receptor antagonist losartan. Together, these data suggest that increased TGF-β signaling contributes to postnatal aneurysm progression in LDS.
The Journal of Clinical Investigation