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Circulation. 2015 May 5;131(18):1555-65. doi: 10.1161/CIRCULATIONAHA.114.013395. Epub 2015 Mar 9.

Molecular and Genetic Analyses of Collagen Type IV Mutant Mouse Models of Spontaneous Intracerebral Hemorrhage Identify Mechanisms for Stroke Prevention.

Author information

1
From Departments of Ophthalmology and Anatomy, Institute for Human Genetics, University of California, San Francisco (UCSF).
2
From Departments of Ophthalmology and Anatomy, Institute for Human Genetics, University of California, San Francisco (UCSF). GouldD@vision.ucsf.edu.

Abstract

BACKGROUND:

Collagen type IV alpha1 (COL4A1) and alpha2 (COL4A2) form heterotrimers critical for vascular basement membrane stability and function. Patients with COL4A1 or COL4A2 mutations suffer from diverse cerebrovascular diseases, including cerebral microbleeds, porencephaly, and fatal intracerebral hemorrhage (ICH). However, the pathogenic mechanisms remain unknown, and there is a lack of effective treatment.

METHODS AND RESULTS:

Using Col4a1 and Col4a2 mutant mouse models, we investigated the genetic complexity and cellular mechanisms underlying the disease. We found that Col4a1 mutations cause abnormal vascular development, which triggers small-vessel disease, recurrent hemorrhagic strokes, and age-related macroangiopathy. We showed that allelic heterogeneity, genetic context, and environmental factors such as intense exercise or anticoagulant medication modulated disease severity and contributed to phenotypic heterogeneity. We found that intracellular accumulation of mutant collagen in vascular endothelial cells and pericytes was a key triggering factor of ICH. Finally, we showed that treatment of mutant mice with a US Food and Drug Administration-approved chemical chaperone resulted in a decreased collagen intracellular accumulation and a significant reduction in ICH severity.

CONCLUSIONS:

Our data are the first to show therapeutic prevention in vivo of ICH resulting from Col4a1 mutation and imply that a mechanism-based therapy promoting protein folding might also prevent ICH in patients with COL4A1 and COL4A2 mutations.

KEYWORDS:

cerebrovascular disorders; collagen; genetics; hemorrhage; stroke

PMID:
25753534
PMCID:
PMC4497509
DOI:
10.1161/CIRCULATIONAHA.114.013395
[Indexed for MEDLINE]
Free PMC Article

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