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Publication : Microvasculopathy in spinal muscular atrophy is driven by a reversible autonomous endothelial cell defect.

First Author  Zhou H Year  2022
Journal  J Clin Invest Volume  132
Issue  21 PubMed ID  36099045
Mgi Jnum  J:331574 Mgi Id  MGI:7384205
Doi  10.1172/JCI153430 Citation  Zhou H, et al. (2022) Microvasculopathy in spinal muscular atrophy is driven by a reversible autonomous endothelial cell defect. J Clin Invest 132(21):e153430
abstractText  Spinal muscular atrophy (SMA) is a neuromuscular disorder due to degeneration of spinal cord motor neurons caused by deficiency of the ubiquitously expressed SMN protein. Here, we present a retinal vascular defect in patients, recapitulated in SMA transgenic mice, driven by failure of angiogenesis and maturation of blood vessels. Importantly, the retinal vascular phenotype was rescued by early, systemic SMN restoration therapy in SMA mice. We also demonstrate in patients an unfavorable imbalance between endothelial injury and repair, as indicated by increased circulating endothelial cell counts and decreased endothelial progenitor cell counts in blood circulation. The cellular markers of endothelial injury were associated with disease severity and improved following SMN restoration treatment in cultured endothelial cells from patients. Finally, we demonstrated autonomous defects in angiogenesis and blood vessel formation, secondary to SMN deficiency in cultured human and mouse endothelial cells, as the underlying cellular mechanism of microvascular pathology. Our cellular and vascular biomarker findings indicate microvasculopathy as a fundamental feature of SMA. Our findings provide mechanistic insights into previously described SMA microvascular complications, and highlight the functional role of SMN in the periphery, including the vascular system, where deficiency of SMN can be addressed by systemic SMN-restoring treatment.
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