Investigating the extracellular matrix in vascular development and maintenance

描述(申请人提供)：脑出血(ICH)和出血性中风是一种特别致命的中风形式，也是导致长期残疾的重要原因。这 当它们影响到儿童和年轻人时尤其如此。出血性中风的有效治疗是有限的，因此预防脑出血对于减少这种衰弱疾病的影响至关重要。然而，预防性治疗通常需要了解脑出血的发病机制。遗传学研究已经成功地确定了某些形式的脑出血的病因，但在确定大多数形式的脑血管病的根本原因方面仍有巨大的未得到满足的需要。我们发现IV型胶原α1(COL4A1)基因突变可导致多种高穿透性脑血管疾病(CVD)，包括围产期中风、先天性多孔性脑病、白质脑病、脑微出血、颅内动脉瘤和脑出血。除了多个关于COL4A1突变导致主要遗传性CVD的报道外，我们最近的数据表明，5%-10%的散发性ICH患者存在COL4A1或其类似的COL4A2突变。因此，根据美国心脏协会的估计，COL4A1和COL4A2的突变每年可能在美国导致多达12,000例新的自发性脑出血病例，在全球范围内导致30万例。在这里，我们使用新的心血管疾病的遗传模型来确定COL4A1在血管发育和维护中的不同角色。使用遗传、分子和生化方法，我们将直接测试COL4A1对对正常血管发育至关重要的基本细胞信号通路的调节。最后，我们将使用新的临床前研究 我们已经产生了人类心血管疾病的模型，以确定可以开发用于患者的治疗方法，这些治疗方法可能会降低患者遭受衰弱或致命ICH的风险。

DESCRIPTION (provided by applicant): Intracerebral hemorrhages (ICH) and hemorrhagic stroke are a particularly fatal form of stroke and an important cause of long-term disability. This is especially true when they affect children and young adults. Effective treatments for hemorrhagic stroke are limited, and so ICH prevention is paramount for reducing the impact of this debilitating condition. However, preventative therapies often require an understanding of the pathogenic mechanism underlying ICH. Genetic studies have successfully defined the etiologies of some forms of ICH, however there is still a tremendous unmet need in determining the underlying causes of most forms of CVD. We have discovered that mutations in type IV collagen alpha 1 (COL4A1) cause a broad spectrum of highly penetrant cerebrovascular diseases (CVDs), including peri-natal stroke, congenital porencephaly, leukoencephalopathy, cerebral microbleeds, intracranial aneurysm, and ICH. In addition to multiple reports of COL4A1 mutations causing dominantly inherited CVD, our recent data suggest that 5-10% of patients suffering from sporadic ICHs have mutations in COL4A1 or its paralog COL4A2. Thus, according to American Heart Association estimates, mutations in COL4A1 and COL4A2 could cause up to 12,000 new cases of spontaneous ICH in the United States each year and 300,000 cases worldwide. Here we use novel genetic models of CVD to identify distinct roles for COL4A1 in vascular development and maintenance. Using genetic, molecular, and biochemical approaches we will directly test the regulation by COL4A1 of fundamental cell- signaling pathways that are critical for normal vascular development. Finally, we will use novel pre-clinical models of human CVD that we have generated to identify therapeutics that may be developed for use in patients and that may reduce their risk of suffering debilitating or fatal ICHs.