PUBLICATION

Loss of function mutations in EPHB4 are responsible for vein of Galen aneurysmal malformation

Authors
Vivanti, A., Ozanne, A., Grondin, C., Saliou, G., Quevarec, L., Maurey, H., Aubourg, P., Benachi, A., Gut, M., Gut, I., Martinovic, J., Sénat, M.V., Tawk, M., Melki, J.
ID
ZDB-PUB-180223-11
Date
2018
Source
Brain : a journal of neurology   141(4): 979-988 (Journal)
Registered Authors
Tawk, Marcel
Keywords
EPHB4 mutation, arteriovenous malformation, exome sequencing, vein of Galen aneurysmal malformation, zebrafish
MeSH Terms
  • Angiography, Digital Subtraction
  • Animals
  • Animals, Genetically Modified
  • Cohort Studies
  • Cranial Nerves/abnormalities
  • DNA Mutational Analysis
  • Disease Models, Animal
  • Embryo, Nonmammalian
  • Exome Sequencing
  • Female
  • Gestational Age
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Mutation/genetics*
  • Oligodeoxyribonucleotides, Antisense/pharmacology
  • RNA, Messenger/genetics
  • RNA, Messenger/metabolism
  • Receptor, EphB4/genetics*
  • Receptor, EphB4/metabolism
  • Vein of Galen Malformations/diagnostic imaging
  • Vein of Galen Malformations/genetics*
  • Zebrafish
PubMed
29444212 Full text @ Brain
Abstract
Vein of Galen aneurysmal malformation is a congenital anomaly of the cerebral vasculature representing 30% of all paediatric vascular malformations. We conducted whole exome sequencing in 19 unrelated patients presenting this malformation and subsequently screened candidate genes in a cohort of 32 additional patients using either targeted exome or Sanger sequencing. In a cohort of 51 patients, we found five affected individuals with heterozygous mutations in EPHB4 including de novo frameshift (p.His191Alafs*32) or inherited deleterious splice or missense mutations predicted to be pathogenic by in silico tools. Knockdown of ephb4 in zebrafish embryos leads to specific anomalies of dorsal cranial vessels including the dorsal longitudinal vein, which is the orthologue of the median prosencephalic vein and the embryonic precursor of the vein of Galen. This model allowed us to investigate EPHB4 loss-of-function mutations in this disease by the ability to rescue the brain vascular defect in knockdown zebrafish co-injected with wild-type, but not truncated EPHB4, mimicking the p.His191Alafs mutation. Our data showed that in both species, loss of function mutations of EPHB4 result in specific and similar brain vascular development anomalies. Recently, EPHB4 germline mutations have been reported in non-immune hydrops fetalis and in cutaneous capillary malformation-arteriovenous malformation. Here, we show that EPHB4 mutations are also responsible for vein of Galen aneurysmal malformation, indicating that heterozygous germline mutations of EPHB4 result in a large clinical spectrum. The identification of EPHB4 pathogenic mutations in patients presenting capillary malformation or vein of Galen aneurysmal malformation should lead to careful follow-up of pregnancy of carriers for early detection of anomaly of the cerebral vasculature in order to propose optimal neonatal care. Endovascular embolization indeed greatly improved the prognosis of patients.
Genes / Markers
Figures
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Phenotype
Mutations / Transgenics
Human Disease / Model
Sequence Targeting Reagents
Fish
Antibodies
Orthology
Engineered Foreign Genes
Mapping