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2015 ; 7
(6
): 848-58
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English Wikipedia
Homozygous NOTCH3 null mutation and impaired NOTCH3 signaling in recessive
early-onset arteriopathy and cavitating leukoencephalopathy
#MMPMID25870235
Pippucci T
; Maresca A
; Magini P
; Cenacchi G
; Donadio V
; Palombo F
; Papa V
; Incensi A
; Gasparre G
; Valentino ML
; Preziuso C
; Pisano A
; Ragno M
; Liguori R
; Giordano C
; Tonon C
; Lodi R
; Parmeggiani A
; Carelli V
; Seri M
EMBO Mol Med
2015[Jun]; 7
(6
): 848-58
PMID25870235
show ga
Notch signaling is essential for vascular physiology. Neomorphic heterozygous
mutations in NOTCH3, one of the four human NOTCH receptors, cause cerebral
autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
(CADASIL). Hypomorphic heterozygous alleles have been occasionally described in
association with a spectrum of cerebrovascular phenotypes overlapping CADASIL,
but their pathogenic potential is unclear. We describe a patient with
childhood-onset arteriopathy, cavitating leukoencephalopathy with cerebral white
matter abnormalities presented as diffuse cavitations, multiple lacunar
infarctions and disseminated microbleeds. We identified a novel homozygous
c.C2898A (p.C966*) null mutation in NOTCH3 abolishing NOTCH3 expression and
causing NOTCH3 signaling impairment. NOTCH3 targets acting in the regulation of
arterial tone (KCNA5) or expressed in the vasculature (CDH6) were downregulated.
Patient's vessels were characterized by smooth muscle degeneration as in CADASIL,
but without deposition of granular osmiophilic material (GOM), the CADASIL
hallmark. The heterozygous parents displayed similar but less dramatic trends in
decrease in the expression of NOTCH3 and its targets, as well as in vessel
degeneration. This study suggests a functional link between NOTCH3 deficiency and
pathogenesis of vascular leukoencephalopathies.