Pathogenic variants in THSD4, encoding the ADAMTS-like 6 protein, predispose to inherited thoracic aortic aneurysm

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 inTHSD4of which two heterozygous variants lead to a premature termination codon.THSD4encodes ADAMTSL6 (member of the ADAMTS/L superfamily), a microfibril-associated protein that promotes fibrillin-1 matrix assembly. TheTHSD4variants 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 aTHSD4variant and fromThsd4(+/-)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

Impact of major cardiovascular risk factors for atherosclerosis and aging on the endothelial function of femoral vessels in the risk of venous thrombosis

L’identification des facteurs de risque de la maladie thromboembolique veineuse (MVTE) est un enjeu pour la prévention de la maladie et de sa récidive. Nous avons montré chez l’homme que le cumul des facteurs de risque cardiovasculaires d’athérosclérose (FRCV) est associé à la MVTE non provoquée, à sa gravité et au risque de récidive. Le vieillissement, FRCV et facteur de risque de MVTE, induit chez le rat une dysfonction endothéliale de la veine fémorale liée aux cyclooxygénases (COX), associée à la génération de prostanoïdes au profil pro-thrombogène. Chez le rat obèse ZSF1 jeune, le cumul des FRCV induit une dysfonction endothéliale veineuse précoce liée aux COX-1 et 2. Un traitement par Ω-3 chez le rat vieillissant permet de moduler le métabolisme de l’acide arachidonique pour générer des prostanoïdes moins délétères COX-2-dépendants pouvant réduire le risque thrombogène, faisant des Ω-3 un traitement adjuvant potentiel de la MVTE.Identification of risk factors for venous thromboembolism (VTE) is a major concern for the prevention of the disease and its recurrence. We have shown in humans that the cumulative cardiovascular risk factors (CVFR) for atherosclerosis were associated with unprovoked VTE, its severity and the risk of recurrence. Aging, CVRF and VTE risk factor, induced an endothelial dysfunction in the rat femoral vein involving cyclooxygenases (COX) associated with potential pro-thrombogenic prostanoids generation. In the young obese ZSF1 rat, cumulative CVRF induced early venous endothelial dysfunction related to COX-1 and 2. Omega-3 treatment in aging rats modulates arachidonic acid pathway leading to COX-2-mediated formation of less deleterious prostanoids, associated with a decreased thrombogenic risk, making omega-3 a potential adjuvant treatment for VTE

Impact des facteurs de risque cardio-vasculaire majeurs d'athérosclérose et du vieillissement sur la fonction endothéliale des vaisseaux fémoraux dans le risque de thrombose veineuse

Identification of risk factors for venous thromboembolism (VTE) is a major concern for the prevention of the disease and its recurrence. We have shown in humans that the cumulative cardiovascular risk factors (CVFR) for atherosclerosis were associated with unprovoked VTE, its severity and the risk of recurrence. Aging, CVRF and VTE risk factor, induced an endothelial dysfunction in the rat femoral vein involving cyclooxygenases (COX) associated with potential pro-thrombogenic prostanoids generation. In the young obese ZSF1 rat, cumulative CVRF induced early venous endothelial dysfunction related to COX-1 and 2. Omega-3 treatment in aging rats modulates arachidonic acid pathway leading to COX-2-mediated formation of less deleterious prostanoids, associated with a decreased thrombogenic risk, making omega-3 a potential adjuvant treatment for VTE.L’identification des facteurs de risque de la maladie thromboembolique veineuse (MVTE) est un enjeu pour la prévention de la maladie et de sa récidive. Nous avons montré chez l’homme que le cumul des facteurs de risque cardiovasculaires d’athérosclérose (FRCV) est associé à la MVTE non provoquée, à sa gravité et au risque de récidive. Le vieillissement, FRCV et facteur de risque de MVTE, induit chez le rat une dysfonction endothéliale de la veine fémorale liée aux cyclooxygénases (COX), associée à la génération de prostanoïdes au profil pro-thrombogène. Chez le rat obèse ZSF1 jeune, le cumul des FRCV induit une dysfonction endothéliale veineuse précoce liée aux COX-1 et 2. Un traitement par Ω-3 chez le rat vieillissant permet de moduler le métabolisme de l’acide arachidonique pour générer des prostanoïdes moins délétères COX-2-dépendants pouvant réduire le risque thrombogène, faisant des Ω-3 un traitement adjuvant potentiel de la MVTE

Impact of major cardiovascular risk factors for atherosclerosis and aging on the endothelial function of femoral vessels in the risk of venous thrombosis

L’identification des facteurs de risque de la maladie thromboembolique veineuse (MVTE) est un enjeu pour la prévention de la maladie et de sa récidive. Nous avons montré chez l’homme que le cumul des facteurs de risque cardiovasculaires d’athérosclérose (FRCV) est associé à la MVTE non provoquée, à sa gravité et au risque de récidive. Le vieillissement, FRCV et facteur de risque de MVTE, induit chez le rat une dysfonction endothéliale de la veine fémorale liée aux cyclooxygénases (COX), associée à la génération de prostanoïdes au profil pro-thrombogène. Chez le rat obèse ZSF1 jeune, le cumul des FRCV induit une dysfonction endothéliale veineuse précoce liée aux COX-1 et 2. Un traitement par Ω-3 chez le rat vieillissant permet de moduler le métabolisme de l’acide arachidonique pour générer des prostanoïdes moins délétères COX-2-dépendants pouvant réduire le risque thrombogène, faisant des Ω-3 un traitement adjuvant potentiel de la MVTE.Identification of risk factors for venous thromboembolism (VTE) is a major concern for the prevention of the disease and its recurrence. We have shown in humans that the cumulative cardiovascular risk factors (CVFR) for atherosclerosis were associated with unprovoked VTE, its severity and the risk of recurrence. Aging, CVRF and VTE risk factor, induced an endothelial dysfunction in the rat femoral vein involving cyclooxygenases (COX) associated with potential pro-thrombogenic prostanoids generation. In the young obese ZSF1 rat, cumulative CVRF induced early venous endothelial dysfunction related to COX-1 and 2. Omega-3 treatment in aging rats modulates arachidonic acid pathway leading to COX-2-mediated formation of less deleterious prostanoids, associated with a decreased thrombogenic risk, making omega-3 a potential adjuvant treatment for VTE

Thrombophilie (l'expérience d'une réunion de concertation pluridisciplinaire au CHRU de strasbourg.)

STRASBOURG-Medecine (674822101) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF

Intake of omega-3 formulation EPA:DHA 6:1 by old rats for 2 weeks improved endothelium-dependent relaxations and normalized the expression level of ACE/AT1R/NADPH oxidase and the formation of ROS in the mesenteric artery

International audienceOmega-3 polyunsaturated fatty acids (PUFAs) including eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) have been shown to protect the cardiovascular system, in part, by stimulating the endothelial formation of nitric oxide (NO). EPA:DHA 6:1 has been identified as a potent omega 3 PUFA formulation to induce endothelium-dependent vasorelaxation and activation of endothelial NO synthase (eNOS). This study examined whether intake of EPA:DHA 6:1 (500 mg/kg/day) for 2 weeks improves an established endothelial dysfunction in old rats (20 months old), and, if so, the underlying mechanism was subsequently determined. In the main mesenteric artery rings, an endothelial dysfunction characterized by a blunted NO component, an abolished endothelium-dependent hyperpolarization component, and increased endothelium-dependent contractile responses (EDCFs) are observed in old rats compared to young rats. Age-related endothelial dysfunction was associated with increased vascular formation of reactive oxygen species (ROS) and expression of eNOS, components of the local angiotensin system, senescence markers, and cyclooxygenase-2 (COX-2), and the downregulation of COX-1. The EPA:DHA 6:1 treatment improved the NO-mediated relaxation, reduced the EDCF-dependent contractile response and the vascular formation of ROS, and normalized the expression level of all target proteins in the old arterial wall. Thus, the present findings indicate that a 2-week intake of EPA:DHA 6:1 by old rats restored endotheliumdependent NO-mediated relaxations, most likely, by preventing the upregulation of the local angiotensin system and the subsequent formation of ROS

Oral Intake of EPA:DHA 6:1 by Middle-Aged Rats for One Week Improves Age-Related Endothelial Dysfunction in Both the Femoral Artery and Vein: Role of Cyclooxygenases

International audienceIn humans, aging is associated with endothelial dysfunction and an increased risk of venous thromboembolism. Although intake of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) at a ratio of 6:1 by old rats improved the endothelial dysfunction in arteries, the impact on veins remains unclear. Eight-month-old male Wistar rats were either untreated or orally administered corn oil, EPA:DHA 1:1, or EPA:DHA 6:1 (500 mg/kg/d) for seven days. Vascular reactivity was studied by myography. In middle-aged femoral artery rings, acetylcholine caused a partial relaxation at low concentrations and a contractile response at high concentrations, whereas in the old femoral vein only a partial relaxation was observed. The EPA:DHA 6:1 treatment blunted the contractile response to acetylcholine in the middle-aged femoral artery and both EPA:DHA 6:1 and 1:1 increased the relaxation to acetylcholine in the old femoral vein. No such effects were observed with corn oil. Both the non-selective cyclooxygenase inhibitor indomethacin and the COX-1 inhibitor SC-560 increased the relaxation to acetylcholine in the middle-aged femoral artery whereas the COX-2 inhibitor NS-398 increased that in the middle-aged femoral vein. In conclusion, our results indicate that aging is associated with an endothelial dysfunction in the femoral artery and vein, which can be improved by EPA:DHA 6:1 treatment-most likely via a cyclooxygenase-dependent mechanism