A deleterious gene-by-environment interaction imposed by calcium channel blockers in Marfan syndrome. Academic Article uri icon

Overview

abstract

  • Calcium channel blockers (CCBs) are prescribed to patients with Marfan syndrome for prophylaxis against aortic aneurysm progression, despite limited evidence for their efficacy and safety in the disorder. Unexpectedly, Marfan mice treated with CCBs show accelerated aneurysm expansion, rupture, and premature lethality. This effect is both extracellular signal-regulated kinase (ERK1/2) dependent and angiotensin-II type 1 receptor (AT1R) dependent. We have identified protein kinase C beta (PKCβ) as a critical mediator of this pathway and demonstrate that the PKCβ inhibitor enzastaurin, and the clinically available anti-hypertensive agent hydralazine, both normalize aortic growth in Marfan mice, in association with reduced PKCβ and ERK1/2 activation. Furthermore, patients with Marfan syndrome and other forms of inherited thoracic aortic aneurysm taking CCBs display increased risk of aortic dissection and need for aortic surgery, compared to patients on other antihypertensive agents.

authors

  • Devereux, Richard B
  • Doyle, Jefferson J
  • Doyle, Alexander J
  • Wilson, Nicole K
  • Habashi, Jennifer P
  • Bedja, Djahida
  • Whitworth, Ryan E
  • Lindsay, Mark E
  • Schoenhoff, Florian
  • Myers, Loretha
  • Huso, Nick
  • Bachir, Suha
  • Squires, Oliver
  • Rusholme, Benjamin
  • Ehsan, Hamid
  • Huso, David
  • Thomas, Craig J
  • Caulfield, Mark J
  • Van Eyk, Jennifer E
  • Judge, Daniel P
  • Dietz, Harry C

publication date

  • October 27, 2015

Research

keywords

  • Calcium Channel Blockers
  • Marfan Syndrome

Identity

PubMed Central ID

  • PMC4621743

Scopus Document Identifier

  • 84946605554

Digital Object Identifier (DOI)

  • 10.1371/journal.pone.0029622

PubMed ID

  • 26506064

Additional Document Info

volume

  • 4