Vikkula M
Laboratoire de génétique moléculaire humaine, institut de pathologie cellulaire Christian-de-Duve, université catholique de Louvain, 74, avenue Hippocrate, 1200 Bruxelles, Belgique.
Ann Chir Plast Esthet. 2006 Aug-Oct;51(4-5):282-6. doi: 10.1016/j.anplas.2006.07.002. Epub 2006 Sep 25.
Vascular anomalies, divided into vascular tumors and vascular malformations, are localized defects of angiogenesis. Hemangiomas appear soon after birth, grow quickly, and then spontaneously, but slowly, disappear. In contrast, vascular malformations are congenital defects of vascular development that grow proportionately with the child. Most vascular anomalies are considered non-hereditary. However, due to detailed analysis inherited forms have been observed, which has led to identify mutations in three genes causing familial vascular malformations: in the angiopoietin receptor TIE2 in mucocutaneous venous malformations (VMCM), in glomulin in glomuvenous malformations (GVM) and in RASA1 in the newly recognized phenotype capillary malformation-arteriovenous malformation (CM-AVM). Identification of the causative genes has permitted more precise diagnosis and differential diagnosis, evaluation of phenotypic variability among patients with a proven mutation, study of used treatments in more homogeneous patient groups, and elucidation of the etiopathogenic mechanisms behind vascular malformations. Further studies are needed to unravel the role of genetic variations in the various vascular malformations and to unravel the precise molecular mechanisms that lead to development of these vascular lesions. This should provide development of new-targeted therapies.
血管异常分为血管肿瘤和血管畸形,是血管生成的局部缺陷。血管瘤在出生后不久出现,生长迅速,然后自发但缓慢地消失。相比之下,血管畸形是血管发育的先天性缺陷,与儿童成比例生长。大多数血管异常被认为是非遗传性的。然而,经过详细分析,已经观察到遗传形式,这导致在三个导致家族性血管畸形的基因中发现了突变:在黏膜皮肤静脉畸形(VMCM)中的血管生成素受体TIE2、在球静脉畸形(GVM)中的球蛋白以及在新认识的表型毛细血管畸形 - 动静脉畸形(CM - AVM)中的RASA1。致病基因的鉴定使得诊断和鉴别诊断更加精确,能够评估已证实有突变的患者之间的表型变异性,在更同质的患者群体中研究所用治疗方法,并阐明血管畸形背后的病因机制。需要进一步研究以阐明基因变异在各种血管畸形中的作用,并揭示导致这些血管病变发展的精确分子机制。这应该会推动新的靶向治疗的发展。