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Publication : Loss of ADAMTS19 causes progressive non-syndromic heart valve disease.

First Author  Wünnemann F Year  2020
Journal  Nat Genet Volume  52
Issue  1 Pages  40-47
PubMed ID  31844321 Mgi Jnum  J:287334
Mgi Id  MGI:6415919 Doi  10.1038/s41588-019-0536-2
Citation  Wunnemann F, et al. (2020) Loss of ADAMTS19 causes progressive non-syndromic heart valve disease. Nat Genet 52(1):40-47
abstractText  Valvular heart disease is observed in approximately 2% of the general population(1). Although the initial observation is often localized (for example, to the aortic or mitral valve), disease manifestations are regularly observed in the other valves and patients frequently require surgery. Despite the high frequency of heart valve disease, only a handful of genes have so far been identified as the monogenic causes of disease(2-7). Here we identify two consanguineous families, each with two affected family members presenting with progressive heart valve disease early in life. Whole-exome sequencing revealed homozygous, truncating nonsense alleles in ADAMTS19 in all four affected individuals. Homozygous knockout mice for Adamts19 show aortic valve dysfunction, recapitulating aspects of the human phenotype. Expression analysis using a lacZ reporter and single-cell RNA sequencing highlight Adamts19 as a novel marker for valvular interstitial cells; inference of gene regulatory networks in valvular interstitial cells positions Adamts19 in a highly discriminatory network driven by the transcription factor lymphoid enhancer-binding factor 1 downstream of the Wnt signaling pathway. Upregulation of endocardial Kruppel-like factor 2 in Adamts19 knockout mice precedes hemodynamic perturbation, showing that a tight balance in the Wnt-Adamts19-Klf2 axis is required for proper valve maturation and maintenance.
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