Educational paper. Connective tissue disorders with vascular involvement: from gene to therapy.
Heritable connective tissue diseases comprise a heterogeneous group of multisystemic disorders that are characterized by significant morbidity and mortality. These disorders do not merely result from defects in the amount or structure of one of the components of the extracellular matrix, as the extracellular matrix also serves other functions, including sequestration of cytokines, such as transforming growth factor beta (TGFβ). Indeed, disturbed TGFβ signaling was demonstrated in several heritable connective tissue diseases, including syndromic forms such as Marfan or Loeys-Dietz syndrome and non-syndromic presentations of thoracic aortic aneurysm/dissection. Because of these findings, new therapeutic targets have been unveiled, leading to the initiation of large clinical trials with angiotensin II type 1 receptor antagonists that also have an inhibiting effect on TGFβ signaling. Here, we present an overview of the clinical characteristics, the molecular findings, and the therapeutic strategies for the currently known syndromic and non-syndromic forms of thoracic aortic aneurysm/dissection.
Center for Medical Genetics, Faculty of Medicine and Health Sciences, University of Antwerp and Antwerp University Hospital, Prins Boudewijnlaan 43, 2650 Antwerp, Edegem, Belgium.
Lut
L
Van Laer
Dorien
D
Proost
Bart L
BL
Loeys
D000784:Aortic Dissection / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology; D047228:Angiotensin II Type 1 Receptor Blockers / Q000378:metabolism / Q000627:therapeutic use*; D017545:Aortic Aneurysm, Thoracic / Q000188:drug therapy / Q000235:genetics / Q000503:physiopathology; D006801:Humans; D016212:Transforming Growth Factor beta / Q000235:genetics* / Q000378:metabolism
D047228:Angiotensin II Type 1 Receptor Blockers; D016212:Transforming Growth Factor beta