Clinical and biochemical profiles suggest fibromuscular dysplasia is a systemic disease with altered TGF-β expression and connective tissue features

Fibromuscular dysplasia (FMD) is a rare, nonatherosclerotic arterial disease for which the molecular basis is unknown. We comprehensively studied 47 subjects with FMD, including physical examination, spine magnetic resonance imaging, bone densitometry, and brain magnetic resonance angiography. Infla...

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Published inThe FASEB journal Vol. 28; no. 8; p. 3313
Main Authors Ganesh, Santhi K, Morissette, Rachel, Xu, Zhi, Schoenhoff, Florian, Griswold, Benjamin F, Yang, Jiandong, Tong, Lan, Yang, Min-Lee, Hunker, Kristina, Sloper, Leslie, Kuo, Shinie, Raza, Rafi, Milewicz, Dianna M, Francomano, Clair A, Dietz, Harry C, Van Eyk, Jennifer, McDonnell, Nazli B
Format Journal Article
LanguageEnglish
Published United States 01.08.2014
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Online AccessGet more information
ISSN1530-6860
DOI10.1096/fj.14-251207

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Abstract Fibromuscular dysplasia (FMD) is a rare, nonatherosclerotic arterial disease for which the molecular basis is unknown. We comprehensively studied 47 subjects with FMD, including physical examination, spine magnetic resonance imaging, bone densitometry, and brain magnetic resonance angiography. Inflammatory biomarkers in plasma and transforming growth factor β (TGF-β) cytokines in patient-derived dermal fibroblasts were measured by ELISA. Arterial pathology other than medial fibrodysplasia with multifocal stenosis included cerebral aneurysm, found in 12.8% of subjects. Extra-arterial pathology included low bone density (P<0.001); early onset degenerative spine disease (95.7%); increased incidence of Chiari I malformation (6.4%) and dural ectasia (42.6%); and physical examination findings of a mild connective tissue dysplasia (95.7%). Screening for mutations causing known genetically mediated arteriopathies was unrevealing. We found elevated plasma TGF-β1 (P=0.009), TGF-β2 (P=0.004) and additional inflammatory markers, and increased TGF-β1 (P=0.0009) and TGF-β2 (P=0.0001) secretion in dermal fibroblast cell lines from subjects with FMD compared to age- and gender-matched controls. Detailed phenotyping of patients with FMD allowed us to demonstrate that FMD is a systemic disease with alterations in common with the spectrum of genetic syndromes that involve altered TGF-β signaling and offers TGF-β as a marker of FMD.
AbstractList Fibromuscular dysplasia (FMD) is a rare, nonatherosclerotic arterial disease for which the molecular basis is unknown. We comprehensively studied 47 subjects with FMD, including physical examination, spine magnetic resonance imaging, bone densitometry, and brain magnetic resonance angiography. Inflammatory biomarkers in plasma and transforming growth factor β (TGF-β) cytokines in patient-derived dermal fibroblasts were measured by ELISA. Arterial pathology other than medial fibrodysplasia with multifocal stenosis included cerebral aneurysm, found in 12.8% of subjects. Extra-arterial pathology included low bone density (P<0.001); early onset degenerative spine disease (95.7%); increased incidence of Chiari I malformation (6.4%) and dural ectasia (42.6%); and physical examination findings of a mild connective tissue dysplasia (95.7%). Screening for mutations causing known genetically mediated arteriopathies was unrevealing. We found elevated plasma TGF-β1 (P=0.009), TGF-β2 (P=0.004) and additional inflammatory markers, and increased TGF-β1 (P=0.0009) and TGF-β2 (P=0.0001) secretion in dermal fibroblast cell lines from subjects with FMD compared to age- and gender-matched controls. Detailed phenotyping of patients with FMD allowed us to demonstrate that FMD is a systemic disease with alterations in common with the spectrum of genetic syndromes that involve altered TGF-β signaling and offers TGF-β as a marker of FMD.
Author Dietz, Harry C
Raza, Rafi
Francomano, Clair A
Ganesh, Santhi K
Milewicz, Dianna M
Yang, Jiandong
Kuo, Shinie
Hunker, Kristina
Morissette, Rachel
Xu, Zhi
Sloper, Leslie
Van Eyk, Jennifer
Tong, Lan
Schoenhoff, Florian
McDonnell, Nazli B
Yang, Min-Lee
Griswold, Benjamin F
Author_xml – sequence: 1
  givenname: Santhi K
  surname: Ganesh
  fullname: Ganesh, Santhi K
  email: nazli.mcdonnell@gmail.com, sganesh@umich.edu
  organization: Division of Cardiovascular Medicine, Department of Internal Medicine, and Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA; nazli.mcdonnell@gmail.com sganesh@umich.edu
– sequence: 2
  givenname: Rachel
  surname: Morissette
  fullname: Morissette, Rachel
  email: nazli.mcdonnell@gmail.com, sganesh@umich.edu
  organization: Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA; nazli.mcdonnell@gmail.com sganesh@umich.edu
– sequence: 3
  givenname: Zhi
  surname: Xu
  fullname: Xu, Zhi
  organization: Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
– sequence: 4
  givenname: Florian
  surname: Schoenhoff
  fullname: Schoenhoff, Florian
  organization: Johns Hopkins Bayview Proteomics Center, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
– sequence: 5
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  surname: Griswold
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  organization: Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
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  givenname: Jiandong
  surname: Yang
  fullname: Yang, Jiandong
  organization: Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
– sequence: 7
  givenname: Lan
  surname: Tong
  fullname: Tong, Lan
  organization: Division of Cardiovascular Medicine, Department of Internal Medicine, and Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
– sequence: 8
  givenname: Min-Lee
  surname: Yang
  fullname: Yang, Min-Lee
  organization: Division of Cardiovascular Medicine, Department of Internal Medicine, and Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
– sequence: 9
  givenname: Kristina
  surname: Hunker
  fullname: Hunker, Kristina
  organization: Division of Cardiovascular Medicine, Department of Internal Medicine, and Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
– sequence: 10
  givenname: Leslie
  surname: Sloper
  fullname: Sloper, Leslie
  organization: Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
– sequence: 11
  givenname: Shinie
  surname: Kuo
  fullname: Kuo, Shinie
  organization: Division of Cardiovascular Medicine, Department of Internal Medicine, and Department of Human Genetics, University of Michigan, Ann Arbor, Michigan, USA
– sequence: 12
  givenname: Rafi
  surname: Raza
  fullname: Raza, Rafi
  organization: Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA
– sequence: 13
  givenname: Dianna M
  surname: Milewicz
  fullname: Milewicz, Dianna M
  organization: Division of Medical Genetics, Department of Internal Medicine, University of Texas Health Science Center, Houston, Texas, USA
– sequence: 14
  givenname: Clair A
  surname: Francomano
  fullname: Francomano, Clair A
  organization: Greater Baltimore Medical Center, Towson, Maryland, USA
– sequence: 15
  givenname: Harry C
  surname: Dietz
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  organization: McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; and Howard Hughes Medical Institute, Baltimore, Maryland, USA
– sequence: 16
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  surname: Van Eyk
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  organization: Johns Hopkins Bayview Proteomics Center, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA
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  givenname: Nazli B
  surname: McDonnell
  fullname: McDonnell, Nazli B
  email: nazli.mcdonnell@gmail.com, sganesh@umich.edu
  organization: Laboratory of Clinical Investigation, National Institute on Aging, Baltimore, Maryland, USA; nazli.mcdonnell@gmail.com sganesh@umich.edu
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pathway aneurysm
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biomarker
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– reference: 23248062 - Circulation. 2012 Dec 18;126(25):2925-7
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Snippet Fibromuscular dysplasia (FMD) is a rare, nonatherosclerotic arterial disease for which the molecular basis is unknown. We comprehensively studied 47 subjects...
SourceID pubmed
SourceType Index Database
StartPage 3313
SubjectTerms Adult
Aged
Arnold-Chiari Malformation - complications
Biomarkers - blood
Bone Density
Bone Diseases, Metabolic - etiology
Case-Control Studies
Cell Cycle
Cell Line
Connective Tissue - pathology
Dermis - pathology
Dilatation, Pathologic
Dura Mater - pathology
Female
Fibroblasts - secretion
Fibromuscular Dysplasia - complications
Fibromuscular Dysplasia - metabolism
Fibromuscular Dysplasia - pathology
Humans
Inflammation - blood
Inflammation - etiology
Inflammation Mediators - blood
Joint Instability - etiology
Male
Middle Aged
Phenotype
Renal Artery - pathology
Single-Blind Method
Spine - pathology
Transforming Growth Factor beta1 - biosynthesis
Transforming Growth Factor beta1 - blood
Transforming Growth Factor beta1 - secretion
Transforming Growth Factor beta2 - blood
Transforming Growth Factor beta2 - secretion
Young Adult
Title Clinical and biochemical profiles suggest fibromuscular dysplasia is a systemic disease with altered TGF-β expression and connective tissue features
URI https://www.ncbi.nlm.nih.gov/pubmed/24732132
Volume 28
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