Wang Yidong, Fang Yuan, Lu Pengfei, Wu Bingruo, Zhou Bin
The Institute of Cardiovascular Sciences, School of Basic Medical Sciences, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Department of Genetics, Albert Einstein College of Medicine, Bronx, NY, United States.
Front Cardiovasc Med. 2021 Jun 22;8:682298. doi: 10.3389/fcvm.2021.682298. eCollection 2021.
NOTCH intercellular signaling mediates the communications between adjacent cells involved in multiple biological processes essential for tissue morphogenesis and homeostasis. The mutations are the first identified human genetic variants that cause congenital bicuspid aortic valve (BAV) and calcific aortic valve disease (CAVD). Genetic variants affecting other genes in the NOTCH signaling pathway may also contribute to the development of BAV and the pathogenesis of CAVD. While CAVD occurs commonly in the elderly population with tri-leaflet aortic valve, patients with BAV have a high risk of developing CAVD at a young age. This observation indicates an important role of NOTCH signaling in the postnatal homeostasis of the aortic valve, in addition to its prenatal functions during aortic valve development. Over the last decade, animal studies, especially with the mouse models, have revealed detailed information in the developmental etiology of congenital aortic valve defects. In this review, we will discuss the molecular and cellular aspects of aortic valve development and examine the embryonic pathogenesis of BAV. We will focus our discussions on the NOTCH signaling during the endocardial-to-mesenchymal transformation (EMT) and the post-EMT remodeling of the aortic valve. We will further examine the involvement of the NOTCH mutations in the postnatal development of CAVD. We will emphasize the deleterious impact of the embryonic valve defects on the homeostatic mechanisms of the adult aortic valve for the purpose of identifying the potential therapeutic targets for disease intervention.
NOTCH细胞间信号传导介导相邻细胞间的通讯,这些通讯参与了组织形态发生和内稳态所必需的多个生物学过程。这些突变是首次鉴定出的导致先天性二叶主动脉瓣(BAV)和钙化性主动脉瓣疾病(CAVD)的人类遗传变异。影响NOTCH信号通路中其他基因的遗传变异也可能促成BAV的发生和CAVD的发病机制。虽然CAVD常见于具有三叶主动脉瓣的老年人群,但BAV患者在年轻时发生CAVD的风险很高。这一观察结果表明,NOTCH信号除了在主动脉瓣发育的产前功能外,在主动脉瓣出生后的内稳态中也起着重要作用。在过去十年中,动物研究,尤其是小鼠模型研究,已经揭示了先天性主动脉瓣缺陷发育病因的详细信息。在这篇综述中,我们将讨论主动脉瓣发育的分子和细胞方面,并研究BAV的胚胎发病机制。我们将重点讨论心内膜-间充质转化(EMT)期间以及主动脉瓣EMT后重塑过程中的NOTCH信号。我们还将进一步研究NOTCH突变在CAVD出生后发育中的作用。为了确定疾病干预的潜在治疗靶点,我们将强调胚胎瓣膜缺陷对成人主动脉瓣内稳态机制的有害影响。