期刊
SCIENCE TRANSLATIONAL MEDICINE
卷 11, 期 493, 页码 -出版社
AMER ASSOC ADVANCEMENT SCIENCE
DOI: 10.1126/scitranslmed.aax0290
关键词
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资金
- Fondation Leducq (Paris, France) Mitral Transatlantic Network of Excellence [07CVD04]
- Innovation in Clinical Research award of the Doris Duke Charitable Foundation
- National Institutes of Health from the Extramural Research Facilities Program of the National Center for Research Resources [C06 RR018823]
- National Heart Lung and Blood Institute [HL131546, HL122906, HL33756, COBRE GM103342, HL142159, GM103444, HL127692, HL116652, HL007260, HL128099, HL141917]
- National Institute of Diabetes, Digestive, and Kidney Diseases [P30DK074038]
- U.S. Department of Veterans Affairs [I01 BX000820]
- National Institute of Mental Health [R00-MH095867]
- National Institute of General Medical Sciences [R01GM114429]
- National Institute of Drug Abuse [U01DA045300]
- Hassenfeld Scholar Program
- March of Dimes
- MGH Scholars Program
- American Heart Association [17CSA33590067, 2261354, 16PRE30970048, 18PRE34080172]
- National Science Foundation [EPS-0903795]
- European Research Council [Stg-ROSALING-716628]
- German Research Foundation Emmy Noether Fellowship
- Chinese Scientific Council Scholarship
- French Ministry of Research: ANR grant [ANR-16-CE17-0015-01]
- French Society of Cardiology
- Federation Francaise de Cardiologie
- Fondation Coeur et Recherche
- French Ministry of Health
- INSERM Translational Research Grant
- Ellison Foundation, Boston, MA
- Agence Nationale de la Recherche (ANR) [ANR-16-CE17-0015] Funding Source: Agence Nationale de la Recherche (ANR)
Mitral valve prolapse (MVP) affects 1 in 40 people and is the most common indication for mitral valve surgery. MVP can cause arrhythmias, heart failure, and sudden cardiac death, and to date, the causes of this disease are poorly understood. We now demonstrate that defects in primary cilia genes and their regulated pathways can cause MVP in familial and sporadic nonsyndromic MVP cases. Our expression studies and genetic ablation experiments confirmed a role for primary cilia in regulating ECM deposition during cardiac development. Loss of primary cilia during development resulted in progressive myxomatous degeneration and profound mitral valve pathology in the adult setting. Analysis of a large family with inherited, autosomal dominant nonsyndromic MVP identified a deleterious missense mutation in a cilia gene, DZIP1. A mouse model harboring this variant confirmed the pathogenicity of this mutation and revealed impaired ciliogenesis during development, which progressed to adult myxomatous valve disease and functional MVP. Relevance of primary cilia in common forms of MVP was tested using pathway enrichment in a large population of patients with MVP and controls from previously generated genome-wide association studies (GWAS), which confirmed the involvement of primary cilia genes in MVP. Together, our studies establish a developmental basis for MVP through altered cilia-dependent regulation of ECM and suggest that defects in primary cilia genes can be causative to disease phenotype in some patients with MVP.
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