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      First genetic analysis of aneurysm genes in familial and sporadic abdominal aortic aneurysm

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          Abstract

          Genetic causes for abdominal aortic aneurysm (AAA) have not been identified and the role of genes associated with familial thoracic aneurysms in AAA has not been explored. We analyzed nine genes associated with familial thoracic aortic aneurysms, the vascular Ehlers–Danlos gene COL3A1 and the MTHFR p.Ala222Val variant in 155 AAA patients. The thoracic aneurysm genes selected for this study were the transforming growth factor-beta pathway genes EFEMP2, FBN1, SMAD3, TGBF2, TGFBR1, TGFBR2, and the smooth muscle cells genes ACTA2, MYH11 and MYLK. Sanger sequencing of all coding exons and exon–intron boundaries of these genes was performed. Patients with at least one first-degree relative with an aortic aneurysm were classified as familial AAA ( n = 99), the others as sporadic AAA. We found 47 different rare heterozygous variants in eight genes: two pathogenic, one likely pathogenic, twenty-one variants of unknown significance (VUS) and twenty-three unlikely pathogenic variants. In familial AAA we found one pathogenic and segregating variant ( COL3A1 p.Arg491X), one likely pathogenic and segregating ( MYH11 p.Arg254Cys), and fifteen VUS. In sporadic patients we found one pathogenic ( TGFBR2 p.Ile525Phefs*18) and seven VUS. Thirteen patients had two or more variants. These results show a previously unknown association and overlapping genetic defects between AAA and familial thoracic aneurysms, indicating that genetic testing may help to identify the cause of familial and sporadic AAA. In this view, genetic testing of these genes specifically or in a genome-wide approach may help to identify the cause of familial and sporadic AAA.

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          The online version of this article (doi:10.1007/s00439-015-1567-0) contains supplementary material, which is available to authorized users.

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          Most cited references31

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          Sequence variant classification and reporting: recommendations for improving the interpretation of cancer susceptibility genetic test results.

          Genetic testing of cancer susceptibility genes is now widely applied in clinical practice to predict risk of developing cancer. In general, sequence-based testing of germline DNA is used to determine whether an individual carries a change that is clearly likely to disrupt normal gene function. Genetic testing may detect changes that are clearly pathogenic, clearly neutral, or variants of unclear clinical significance. Such variants present a considerable challenge to the diagnostic laboratory and the receiving clinician in terms of interpretation and clear presentation of the implications of the result to the patient. There does not appear to be a consistent approach to interpreting and reporting the clinical significance of variants either among genes or among laboratories. The potential for confusion among clinicians and patients is considerable and misinterpretation may lead to inappropriate clinical consequences. In this article we review the current state of sequence-based genetic testing, describe other standardized reporting systems used in oncology, and propose a standardized classification system for application to sequence-based results for cancer predisposition genes. We suggest a system of five classes of variants based on the degree of likelihood of pathogenicity. Each class is associated with specific recommendations for clinical management of at-risk relatives that will depend on the syndrome. We propose that panels of experts on each cancer predisposition syndrome facilitate the classification scheme and designate appropriate surveillance and cancer management guidelines. The international adoption of a standardized reporting system should improve the clinical utility of sequence-based genetic tests to predict cancer risk. (c) 2008 Wiley-Liss, Inc.
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            Management of abdominal aortic aneurysms clinical practice guidelines of the European society for vascular surgery.

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              Extracellular control of TGFbeta signalling in vascular development and disease.

              The intracellular mechanism of transforming growth factor-beta (TGFbeta) signalling via kinase receptors and SMAD effectors is firmly established, but recent studies of human cardiovascular syndromes such as Marfan syndrome and pre-eclampsia have refocused attention on the importance of regulating the availability of active extracellular TGFbeta. It seems that elastic extracellular matrix (ECM) components have a crucial role in controlling TGFbeta signalling, while soluble and membrane bound forms of TGFbeta co-receptors add further layers of regulation. Together, these extracellular interactions determine the final bioavailability of TGFbeta to vascular cells, and dysregulation is associated with an increasing number of vascular pathologies.
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                Author and article information

                Contributors
                +31 10 703 4487 , d.majoor-krakauer@erasmusmc.nl
                Journal
                Hum Genet
                Hum. Genet
                Human Genetics
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                0340-6717
                1432-1203
                28 May 2015
                28 May 2015
                2015
                : 134
                : 8
                : 881-893
                Affiliations
                [ ]Department of Vascular Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
                [ ]Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, The Netherlands
                [ ]Department of Clinical Genetics, Suite-EE 2036, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
                [ ]Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
                [ ]Department of Bioinformatics, Erasmus University Medical Center, Rotterdam, The Netherlands
                Article
                1567
                10.1007/s00439-015-1567-0
                4495250
                26017485
                96b95933-fe12-4cd6-af36-3eec323035f9
                © The Author(s) 2015

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                : 8 February 2015
                : 17 May 2015
                Categories
                Original Investigation
                Custom metadata
                © Springer-Verlag Berlin Heidelberg 2015

                Genetics
                Genetics

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