Mutations in smooth muscle alpha-actin (ACTA2) cause coronary artery disease, stroke, and Moyamoya disease, along with thoracic aortic disease.

TitleMutations in smooth muscle alpha-actin (ACTA2) cause coronary artery disease, stroke, and Moyamoya disease, along with thoracic aortic disease.
Publication TypeJournal Article
Year of Publication2009
AuthorsGuo, D-chuan, Papke, CL, Tran-Fadulu, V, Regalado, ES, Avidan, N, Johnson, RJay, Kim, DH, Pannu, H, Willing, MC, Sparks, E, Pyeritz, RE, Singh, MN, Dalman, RL, Grotta, JC, Marian, AJ, Boerwinkle, E, Frazier, LQ, LeMaire, SA, Coselli, JS, Estrera, AL, Safi, HJ, Veeraraghavan, S, Muzny, DM, Wheeler, DA, Willerson, JT, Yu, RK, Shete, SS, Scherer, SE, Raman, CS, L Buja, M, Milewicz, DM
JournalAm J Hum Genet
Volume84
Issue5
Pagination617-27
Date Published2009 May
ISSN1537-6605
KeywordsActins, Adolescent, Adult, Aneurysm, Dissecting, Aortic Aneurysm, Thoracic, Cell Proliferation, Cells, Cultured, Coronary Artery Disease, Female, Genetic Predisposition to Disease, Humans, Male, Middle Aged, Models, Molecular, Moyamoya Disease, Mutation, Myocytes, Smooth Muscle, Protein Isoforms, Stroke, Young Adult
Abstract

The vascular smooth muscle cell (SMC)-specific isoform of alpha-actin (ACTA2) is a major component of the contractile apparatus in SMCs located throughout the arterial system. Heterozygous ACTA2 mutations cause familial thoracic aortic aneurysms and dissections (TAAD), but only half of mutation carriers have aortic disease. Linkage analysis and association studies of individuals in 20 families with ACTA2 mutations indicate that mutation carriers can have a diversity of vascular diseases, including premature onset of coronary artery disease (CAD) and premature ischemic strokes (including Moyamoya disease [MMD]), as well as previously defined TAAD. Sequencing of DNA from patients with nonfamilial TAAD and from premature-onset CAD patients independently identified ACTA2 mutations in these patients and premature onset strokes in family members with ACTA2 mutations. Vascular pathology and analysis of explanted SMCs and myofibroblasts from patients harboring ACTA2 suggested that increased proliferation of SMCs contributed to occlusive diseases. These results indicate that heterozygous ACTA2 mutations predispose patients to a variety of diffuse and diverse vascular diseases, including TAAD, premature CAD, ischemic strokes, and MMD. These data demonstrate that diffuse vascular diseases resulting from either occluded or enlarged arteries can be caused by mutations in a single gene and have direct implications for clinical management and research on familial vascular diseases.

DOI10.1016/j.ajhg.2009.04.007
Alternate JournalAm. J. Hum. Genet.
PubMed ID19409525
PubMed Central IDPMC2680995
Grant ListR01 HL062594 / HL / NHLBI NIH HHS / United States
P50 NS044227 / NS / NINDS NIH HHS / United States
UL1 RR024148 / RR / NCRR NIH HHS / United States
P50NS044227 / NS / NINDS NIH HHS / United States
P50HL083794-01 / HL / NHLBI NIH HHS / United States
R01 HL62594 / HL / NHLBI NIH HHS / United States
P50 HL083794 / HL / NHLBI NIH HHS / United States