Department of Pediatrics, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06510, USA.
Biochemistry and Molecular Biology Department, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Baltimore, MD 21205, USA.
Int J Mol Sci. 2023 Dec 28;25(1):430. doi: 10.3390/ijms25010430.
Up to 50% of patients with severe congenital heart disease (CHD) develop life-altering neurodevelopmental disability (NDD). It has been presumed that NDD arises in CHD cases because of hypoxia before, during, or after cardiac surgery. Recent studies detected an enrichment in de novo mutations in CHD and NDD, as well as significant overlap between CHD and NDD candidate genes. However, there is limited evidence demonstrating that genes causing CHD can produce NDD independent of hypoxia. A patient with hypoplastic left heart syndrome and gross motor delay presented with a de novo mutation in . Modeling mutation of in embryos resulted in reduced heart size, decreased brain length, and disrupted patterning. To evaluate the cardiac development, we induced the conditional knockout (cKO) of in mouse cardiomyocytes, which led to the depletion of mature cardiomyocytes and abnormal contractility. To test a role for specifically in the brain, we induced cKO in the mouse central nervous system, which resulted in decreased brain volume, and diminished connectivity between areas related to motor function but did not affect vascular or brain ventricular volume. We propose that genetic factors, rather than hypoxia alone, can contribute when NDD and CHD cases occur concurrently.
高达 50%的严重先天性心脏病 (CHD) 患者会出现改变生活的神经发育障碍 (NDD)。人们推测,CHD 患者在心脏手术前后或手术期间会因缺氧而出现 NDD。最近的研究发现,CHD 和 NDD 中存在新生突变的富集,以及 CHD 和 NDD 候选基因之间存在显著重叠。然而,目前仅有有限的证据表明,导致 CHD 的基因可以在不依赖缺氧的情况下产生 NDD。一名患有左心发育不全综合征和粗大运动发育迟缓的患者携带一种新的突变。在胚胎中模拟突变导致心脏体积减小、脑长度减少以及模式紊乱。为了评估心脏发育,我们诱导了心肌细胞中 的条件性敲除 (cKO),导致成熟心肌细胞耗竭和异常收缩力。为了测试 在大脑中的特定作用,我们在小鼠中枢神经系统中诱导 cKO,导致脑体积减小,与运动功能相关的区域之间的连通性减弱,但不影响血管或脑室内体积。我们提出,当 NDD 和 CHD 同时发生时,遗传因素而不仅仅是缺氧会起作用。
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