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Publication : A deleterious gene-by-environment interaction imposed by calcium channel blockers in Marfan syndrome.

First Author  Doyle JJ Year  2015
Journal  Elife Volume  4
PubMed ID  26506064 Mgi Jnum  J:227260
Mgi Id  MGI:5700089 Doi  10.7554/eLife.08648
Citation  Doyle JJ, et al. (2015) A deleterious gene-by-environment interaction imposed by calcium channel blockers in Marfan syndrome. Elife 4:e08648
abstractText  Calcium channel blockers (CCBs) are prescribed to patients with Marfan syndrome for prophylaxis against aortic aneurysm progression, despite limited evidence for their efficacy and safety in the disorder. Unexpectedly, Marfan mice treated with CCBs show accelerated aneurysm expansion, rupture, and premature lethality. This effect is both extracellular signal-regulated kinase (ERK1/2) dependent and angiotensin-II type 1 receptor (AT1R) dependent. We have identified protein kinase C beta (PKCbeta) as a critical mediator of this pathway and demonstrate that the PKCbeta inhibitor enzastaurin, and the clinically available anti-hypertensive agent hydralazine, both normalize aortic growth in Marfan mice, in association with reduced PKCbeta and ERK1/2 activation. Furthermore, patients with Marfan syndrome and other forms of inherited thoracic aortic aneurysm taking CCBs display increased risk of aortic dissection and need for aortic surgery, compared to patients on other antihypertensive agents.
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