Aneurysms

        Drug Week   October 13, 2006   ANEURYSMS; Vascular aneurysm syndromes are distinguished by transforming growth factor-beta receptor mutations   SECTION: EXPANDED REPORTING; Pg. 57   LENGTH: 526  words    Vascular aneurysm syndromes are distinguished by transforming growth factor-beta receptor (TGFBR) mutations.  According to recent research published in the New England Journal of Medicine, "The Loeys-Dietz syndrome is a recently described autosomal dominant aortic-aneurysm syndrome with widespread systemic involvement. The disease is characterized by the triad of arterial tortuosity and aneurysms, hypertelorism, and bifid uvula or cleft palate and is caused by heterozygous mutations in the genes encoding TGFBR1 and TGFBR2, respectively. We undertook the clinical and molecular characterization of 52 affected families."  B.L. Loeys and colleagues, State University of Ghent Hospital, wrote, "Forty probands presented with typical manifestations of the Loeys-Dietz syndrome. In view of the phenotypic overlap between this syndrome and vascular Ehlers-Danlos syndrome, we screened an additional cohort of 40 patients who had vascular Ehlers-Danlos syndrome without the characteristic type III collagen abnormalities or the craniofacial features of the Loeys-Dietz syndrome.  "We found a mutation in TGFBR1 or TGFBR2 in all probands with typical Loeys-Dietz syndrome (type I) and in 12 probands presenting with vascular Ehlers-Danlos syndrome (Loeys-Dietz syndrome type II). The natural history of both types was characterized by aggressive arterial aneurysms (mean age at death, 26.0 years) and a high incidence of pregnancy-related complications (in 6 of 12 women). Patients with Loeys-Dietz syndrome type I, as compared with those with type II, underwent cardiovascular surgery earlier (mean age, 16.9 years vs. 26.9 years) and died earlier (22.6 years vs. 31.8 years)."  Study authors said, "There were 59 vascular surgeries in the cohort, with one death during the procedure. This low rate of intraoperative mortality distinguishes the Loeys-Dietz syndrome from vascular Ehlers-Danlos syndrome. Mutations in either TGFBR1 or TGFBR2 predispose patients to aggressive and widespread vascular disease. The severity of the clinical presentation is predictive of the outcome."  "Genotyping of patients presenting with symptoms like those of vascular Ehlers-Danlos syndrome may be used to guide therapy, including the use and timing of prophylactic vascular surgery."  Loeys and colleagues published their study in New England Journal of Medicine (Aneurysm syndromes caused by mutations in the TGF-beta receptor. N Engl J Med, 2006;355(8):788-798).  For additional information, contact B.L. Loeys, State University of Ghent Hospital, Center Genetics Medical, Bldg 0K5, De Pintelaan 185, B-9000 Ghent, Belgium.  The publisher's contact information for the New England Journal of Medicine is: Massachusetts Medical Society, Waltham Woods Center, 860 Winter St., Waltham, MA 02451-1413, USA.  Keywords:  Ghent,  Belgium, Aneurysm, Angiology, Cardiology, Cardiovascular Disease, Cleft Lip and Palate, Ehlers-Danlos Syndrome, Genetics, Vascular Disease, Loeys-Dietz Syndrome, Mutagenesis, Transforming Growth Factor-Beta Receptor, Vascular Surgery.  This article was prepared by Drug Week editors from staff and other reports.  Copyright 2006, Drug Week via NewsRx.com.   LOAD-DATE: October 25, 2006   LANGUAGE: ENGLISH   PUBLICATION-TYPE: Newsletter     Copyright 2006 Drug Week via NewsRx.com & NewsRx.net