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Publication : Somatic activating mutations in <i>PIK3CA</i> cause generalized lymphatic anomaly.

First Author  Rodriguez-Laguna L Year  2019
Journal  J Exp Med Volume  216
Issue  2 Pages  407-418
PubMed ID  30591517 Mgi Jnum  J:273211
Mgi Id  MGI:6284583 Doi  10.1084/jem.20181353
Citation  Rodriguez-Laguna L, et al. (2019) Somatic activating mutations in PIK3CA cause generalized lymphatic anomaly. J Exp Med 216(2):407-418
abstractText  Generalized lymphatic anomaly (GLA) is a vascular disorder characterized by diffuse or multifocal lymphatic malformations (LMs). The etiology of GLA is poorly understood. We identified four distinct somatic PIK3CA variants (Glu542Lys, Gln546Lys, His1047Arg, and His1047Leu) in tissue samples from five out of nine patients with GLA. These same PIK3CA variants occur in PIK3CA-related overgrowth spectrum and cause hyperactivation of the PI3K-AKT-mTOR pathway. We found that the mTOR inhibitor, rapamycin, prevented lymphatic hyperplasia and dysfunction in mice that expressed an active form of PIK3CA (His1047Arg) in their lymphatics. We also found that rapamycin reduced pain in patients with GLA. In conclusion, we report that somatic activating PIK3CA mutations can cause GLA, and we provide preclinical and clinical evidence to support the use of rapamycin for the treatment of this disabling and deadly disease.
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