Abstract

BackgroundHereditary hemorrhagic telangiectasia (HHT), also known as Rendu-Osler-Weber syndrome, is an autosomal dominant disorder which is clinically characterised by recurrent epistaxis, mucocutaneous telangiectasia and visceral arteriovenous malformations. Genetic linkage studies identified two genes primarily related to HHT: endoglin (ENG) on chromosome 9q33-34 and activin receptor-like kinase1 (ACVRL1) on chromosome 12q13. We have screened a total of 41 unselected German patients with the suspected diagnosis of HHT. Mutation analysis for the ENG and ACVRL1 genes in all patients was performed by PCR amplification. Sequences were then compared to the HHT database http://www.hhtmutation.org sequences of the ENG mRNA (accession no. BC014271.2) and the ACVRL1 mRNA (accession no. NM000020.1).ResultsWe identified 15 different mutations in 18 cases by direct sequencing. Among these mutations, one novel ENG mutation could be detected which has not yet been described in the literature before. The genotype-phenotype correlation was consistent with a higher frequency of pulmonary arteriovenous malformations in patients with ENG mutations than in patients with ACVRL1 mutations in our collective.ConclusionFor rapid genotyping of mutations and SNPs (single nucleotide polymorphisms) in ENG and ACVRL1, allele-specific PCR methods with sequence-specific primers (PCR-SSP) were established and their value analysed.

Highlights

  • Hereditary hemorrhagic telangiectasia (HHT), known as Rendu-Osler-Weber syndrome, is an autosomal dominant disorder which is clinically characterised by recurrent epistaxis, mucocutaneous telangiectasia and visceral arteriovenous malformations

  • The sequence data were compared to each other and to the ENG and activin receptor-like kinase1 (ACVRL1) sequences published in databases (HHT Mutation Database: http://www.hhtmuta tion.org)

  • Sequence analysis of ENG ENG mutations We identified 5 different ENG mutations in 6 out of 41 HHT patients

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Summary

Introduction

Hereditary hemorrhagic telangiectasia (HHT), known as Rendu-Osler-Weber syndrome, is an autosomal dominant disorder which is clinically characterised by recurrent epistaxis, mucocutaneous telangiectasia and visceral arteriovenous malformations. HHT has a prevalence of 1 in 10.000 individuals [1,2] This multi-systemic angiogenic disorder is clinically characterized by severe and recurrent hemorrhages due to epistaxis, mucocutaneous telangiectasia and arteriovenous malformations. Electron microscopy studies on lesion biopsies revealed that dilated postcapillary venules connect directly to arterioles without intervening capillary bed [10,11]. As a result, these vascular lesions can be the cause for severe complications involving gastrointestinal bleedings, the risk of embolism, stroke and abscesses [12]

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