title: Human myxomatous mitral valve prolapse: role of bone morphogenetic protein 4 in valvular interstitial cell activation.
abstract: Myxomatous mitral valve prolapse (MVP) is the most common cardiac valvular abnormality in industrialized countries and a leading cause of mitral valve surgery for isolated mitral regurgitation. The key role of valvular interstitial cells (VICs) during mitral valve development and homeostasis has been recently suggested, however little is known about the molecular pathways leading to MVP. We aim to characterize bone morphogenetic protein 4 (BMP4) as a cellular regulator of mitral VIC activation towards a pathologic synthetic phenotype and to analyze the cellular phenotypic changes and extracellular matrix (ECM) reorganization associated with the development of myxomatous MVP. Microarray analysis showed significant up regulation of BMP4-mediated signaling molecules in myxomatous MVP when compared to controls. Histological analysis and cellular characterization suggest that during myxomatous MVP development, healthy quiescent mitral VICs undergo a phenotypic activation via up regulation of BMP4-mediated pathway. In vitro hBMP4 treatment of isolated human mitral VICs mimics the cellular activation and ECM remodeling as seen in MVP tissues. The present study characterizes the cell biology of mitral VICs in physiological and pathological conditions and provides insights into the molecular and cellular mechanisms mediated by BMP4 during MVP. The ability to test and control the plasticity of VICs using different molecules may help in developing new diagnostic and therapeutic strategies for myxomatous MVP.
authors: Division of Cardiovascular Surgery, Department of Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA 19036, USA.
authors: Rachana
authors: R
authors: Sainger
authors: Juan B
authors: JB
authors: Grau
authors: Emanuela
authors: E
authors: Branchetti
authors: Paolo
authors: P
authors: Poggio
authors: William F
authors: WF
authors: Seefried
authors: Benjamin C
authors: BC
authors: Field
authors: Michael A
authors: MA
authors: Acker
authors: Robert C
authors: RC
authors: Gorman
authors: Joseph H
authors: JH
authors: Gorman
authors: Clark W
authors: CW
authors: Hargrove
authors: Joseph E
authors: JE
authors: Bavaria
authors: Giovanni
authors: G
authors: Ferrari
mesh_terms: D000328:Adult; D000368:Aged; D055415:Bone Morphogenetic Protein 4 / Q000235:genetics / Q000378:metabolism*; D016022:Case-Control Studies; D002478:Cells, Cultured; D019560:Echocardiography, Three-Dimensional; D005109:Extracellular Matrix / Q000378:metabolism*; D005260:Female; D005355:Fibrosis; D020869:Gene Expression Profiling / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D020411:Oligonucleotide Array Sequence Analysis; D010641:Phenotype; D015398:Signal Transduction
chemical_list: C525809:BMP4 protein, human; D055415:Bone Morphogenetic Protein 4