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Publication : ROBO4 variants predispose individuals to bicuspid aortic valve and thoracic aortic aneurysm.

First Author  Gould RA Year  2019
Journal  Nat Genet Volume  51
Issue  1 Pages  42-50
PubMed ID  30455415 Mgi Jnum  J:292067
Mgi Id  MGI:6447627 Doi  10.1038/s41588-018-0265-y
Citation  Gould RA, et al. (2019) ROBO4 variants predispose individuals to bicuspid aortic valve and thoracic aortic aneurysm. Nat Genet 51(1):42-50
abstractText  Bicuspid aortic valve (BAV) is a common congenital heart defect (population incidence, 1-2%)(1-3) that frequently presents with ascending aortic aneurysm (AscAA)(4). BAV/AscAA shows autosomal dominant inheritance with incomplete penetrance and male predominance. Causative gene mutations (for example, NOTCH1, SMAD6) are known for </=1% of nonsyndromic BAV cases with and without AscAA(5-8), impeding mechanistic insight and development of therapeutic strategies. Here, we report the identification of variants in ROBO4 (which encodes a factor known to contribute to endothelial performance) that segregate with disease in two families. Targeted sequencing of ROBO4 showed enrichment for rare variants in BAV/AscAA probands compared with controls. Targeted silencing of ROBO4 or mutant ROBO4 expression in endothelial cell lines results in impaired barrier function and a synthetic repertoire suggestive of endothelial-to-mesenchymal transition. This is consistent with BAV/AscAA-associated findings in patients and in animal models deficient for ROBO4. These data identify a novel endothelial etiology for this common human disease phenotype.
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