Hereditary Hemorrhagic Telangiectasia: Pathogenetic Mechanisms and Potential Therapies

A special issue of Cells (ISSN 2073-4409). This special issue belongs to the section "Cells of the Nervous System".

Deadline for manuscript submissions: closed (20 June 2023) | Viewed by 1286

Special Issue Editors


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Guest Editor
Barrow Neurological Institute, Phoenix, AZ, USA
Interests: arteriovenous malformation; hereditary hemorrhagic telangiectasia; animal models; vascular biology; activin receptor-like kinase 1; bone morphogenetic proteins; signal transduction

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Guest Editor
School of Public Health, University of Pittsburgh, 130 De Soto Street, Pittsburgh, PA 15261, USA
Interests: vascular development; hereditary hemorrhagic telangiectasia; zebrafish; BMP signaling; mechanotransduction

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Guest Editor
The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY 11030, USA
Interests: Alzheimer’s disease; hereditary hemorrhagic telangiectasia
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Special Issue Information

Dear Colleagues,

Discoveries of pathogenic mutations in ENG and ACVRL1 for hereditary hemorrhagic telangiectasia (HHT) were reported over a quarter of a century ago.  Since then, animal studies have demonstrated that a linear signaling defect in the BMP9/10-ENG-ALK1-SMAD pathway in endothelial cells is a central driver for the pathogenesis of HHT. Genetic studies in mouse models and HHT patients have also revealed that disease manifestation—i.e., formation of the arteriovenous malformations (AVMs)—requires secondary hits, most likely in the form of biallelic loss of the relevant HHT genes, as well as proangiogenic stimuli triggered by, for instance, inflammation or healing.  However, detailed mechanisms by which the defects in this signaling pathway elicit HHT pathogenesis remain elusive, and although some progress has been made with the possible repurposing of anti-angiogenic and anti-proliferative drugs, an effective cure is still out of reach. Specifically, the downstream signaling mediators and effector genes of this signaling associated with the disease have not been clearly defined. Key cellular and biological impacts caused by the signaling defect for the initiation, progression and maintenance of AVMs are also unclear. The molecular nature of the interactions of this signaling pathway with other pathways is poorly understood. Downstream targets identified from proteomics and transcriptomic studies provide insights for the development of therapeutic targets for this malady. Supplementations of physiological or synthetic ligands for ENG-ALK1 signaling are also considered for therapy. This Special Issue focuses on the research topic of molecular mechanisms underlying AVM development, progression and rupture in HHT patients, and we welcome both original research and review manuscripts.

Prof. Dr. S. Paul Oh
Dr. Beth L. Roman
Dr. Philippe Marambaud
Guest Editors

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Keywords

  • hereditary hemorrhagic telangiectasia
  • activin receptor-like kinase 1
  • endoglin
  • SMAD4
  • arteriovenous malformation
  • endothelial cell
  • animal model
  • angiogenesis

Published Papers (1 paper)

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Research

24 pages, 5252 KiB  
Article
Shear Stress and Sub-Femtomolar Levels of Ligand Synergize to Activate ALK1 Signaling in Endothelial Cells
by Ya-Wen Cheng, Anthony R. Anzell, Stefanie A. Morosky, Tristin A. Schwartze, Cynthia S. Hinck, Andrew P. Hinck, Beth L. Roman and Lance A. Davidson
Cells 2024, 13(3), 285; https://doi.org/10.3390/cells13030285 - 05 Feb 2024
Viewed by 946
Abstract
Endothelial cells (ECs) respond to concurrent stimulation by biochemical factors and wall shear stress (SS) exerted by blood flow. Disruptions in flow-induced responses can result in remodeling issues and cardiovascular diseases, but the detailed mechanisms linking flow-mechanical cues and biochemical signaling remain unclear. [...] Read more.
Endothelial cells (ECs) respond to concurrent stimulation by biochemical factors and wall shear stress (SS) exerted by blood flow. Disruptions in flow-induced responses can result in remodeling issues and cardiovascular diseases, but the detailed mechanisms linking flow-mechanical cues and biochemical signaling remain unclear. Activin receptor-like kinase 1 (ALK1) integrates SS and ALK1-ligand cues in ECs; ALK1 mutations cause hereditary hemorrhagic telangiectasia (HHT), marked by arteriovenous malformation (AVM) development. However, the mechanistic underpinnings of ALK1 signaling modulation by fluid flow and the link to AVMs remain uncertain. We recorded EC responses under varying SS magnitudes and ALK1 ligand concentrations by assaying pSMAD1/5/9 nuclear localization using a custom multi-SS microfluidic device and a custom image analysis pipeline. We extended the previously reported synergy between SS and BMP9 to include BMP10 and BMP9/10. Moreover, we demonstrated that this synergy is effective even at extremely low SS magnitudes (0.4 dyn/cm2) and ALK1 ligand range (femtogram/mL). The synergistic response to ALK1 ligands and SS requires the kinase activity of ALK1. Moreover, ALK1’s basal activity and response to minimal ligand levels depend on endocytosis, distinct from cell–cell junctions, cytoskeleton-mediated mechanosensing, or cholesterol-enriched microdomains. However, an in-depth analysis of ALK1 receptor trafficking’s molecular mechanisms requires further investigation. Full article
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