1. Academic Validation
  2. PPIL4 is essential for brain angiogenesis and implicated in intracranial aneurysms in humans

PPIL4 is essential for brain angiogenesis and implicated in intracranial aneurysms in humans

  • Nat Med. 2021 Dec;27(12):2165-2175. doi: 10.1038/s41591-021-01572-7.
Tanyeri Barak # 1 2 3 4 Emma Ristori # 2 5 A Gulhan Ercan-Sencicek 1 2 3 4 Danielle F Miyagishima 1 2 3 4 Carol Nelson-Williams 2 Weilai Dong 2 6 Sheng Chih Jin 2 6 7 Andrew Prendergast 5 William Armero 2 5 Octavian Henegariu 1 2 3 4 E Zeynep Erson-Omay 1 2 3 4 Akdes Serin Harmancı 1 2 3 4 Mikhael Guy 8 Batur Gültekin 1 Deniz Kilic 1 Devendra K Rai 1 2 3 4 Nükte Goc 1 Stephanie Marie Aguilera 1 Burcu Gülez 1 Selin Altinok 1 Kent Ozcan 1 Yanki Yarman 1 Süleyman Coskun 1 2 3 4 Emily Sempou 9 Engin Deniz 9 Jared Hintzen 5 Andrew Cox 2 Elena Fomchenko 1 Su Woong Jung 10 Ali Kemal Ozturk 11 Angeliki Louvi 1 4 Kaya Bilgüvar 2 4 12 E Sander Connolly Jr 13 Mustafa K Khokha 2 9 Kristopher T Kahle 1 14 15 16 Katsuhito Yasuno 1 2 3 4 Richard P Lifton 2 6 Ketu Mishra-Gorur 17 18 19 20 Stefania Nicoli 21 22 23 Murat Günel 24 25 26 27
Affiliations

Affiliations

  • 1 Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.
  • 2 Department of Genetics, Yale School of Medicine, New Haven, CT, USA.
  • 3 Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA.
  • 4 Yale Program on Neurogenetics, Yale School of Medicine, New Haven, CT, USA.
  • 5 Yale Cardiovascular Research Center, Department of Internal Medicine, Section of Cardiology, Yale School of Medicine, New Haven, CT, USA.
  • 6 Laboratory of Human Genetics and Genomics, The Rockefeller University, New York, NY, USA.
  • 7 Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA.
  • 8 Yale Center for Research Computing, Yale University, New Haven, CT, USA.
  • 9 Department of Pediatrics, Yale School of Medicine, New Haven, CT, USA.
  • 10 Division of Nephrology, Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Seoul, Korea.
  • 11 Department of Neurosurgery, Pennsylvania Hospital, University of Pennsylvania Health System, Philadelphia, Pennsylvania, USA.
  • 12 Yale Center for Genome Analysis, Yale University, New Haven, CT, USA.
  • 13 Department of Neurosurgery, Columbia University College of Physicians and Surgeons, New York, NY, USA.
  • 14 Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
  • 15 Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA, USA.
  • 16 Broad Institute of MIT and Harvard, Massachusetts Institute of Technology, Cambridge, MA, USA.
  • 17 Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA. ketu.mishra@yale.edu.
  • 18 Department of Genetics, Yale School of Medicine, New Haven, CT, USA. ketu.mishra@yale.edu.
  • 19 Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA. ketu.mishra@yale.edu.
  • 20 Yale Program on Neurogenetics, Yale School of Medicine, New Haven, CT, USA. ketu.mishra@yale.edu.
  • 21 Department of Genetics, Yale School of Medicine, New Haven, CT, USA. stefania.nicoli@yale.edu.
  • 22 Yale Cardiovascular Research Center, Department of Internal Medicine, Section of Cardiology, Yale School of Medicine, New Haven, CT, USA. stefania.nicoli@yale.edu.
  • 23 Department of Pharmacology, Yale School of Medicine, New Haven, CT, USA. stefania.nicoli@yale.edu.
  • 24 Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA. murat.gunel@yale.edu.
  • 25 Department of Genetics, Yale School of Medicine, New Haven, CT, USA. murat.gunel@yale.edu.
  • 26 Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA. murat.gunel@yale.edu.
  • 27 Yale Program on Neurogenetics, Yale School of Medicine, New Haven, CT, USA. murat.gunel@yale.edu.
  • # Contributed equally.
Abstract

Intracranial aneurysm (IA) rupture leads to subarachnoid hemorrhage, a sudden-onset disease that often causes death or severe disability. Although genome-wide association studies have identified common genetic variants that increase IA risk moderately, the contribution of variants with large effect remains poorly defined. Using whole-exome Sequencing, we identified significant enrichment of rare, deleterious mutations in PPIL4, encoding peptidyl-prolyl cis-trans isomerase-like 4, in both familial and index IA cases. Ppil4 depletion in vertebrate models causes intracerebral hemorrhage, defects in cerebrovascular morphology and impaired Wnt signaling. Wild-type, but not IA-mutant, PPIL4 potentiates Wnt signaling by binding JMJD6, a known angiogenesis regulator and Wnt activator. These findings identify a novel PPIL4-dependent Wnt signaling mechanism involved in brain-specific angiogenesis and maintenance of cerebrovascular integrity and implicate PPIL4 gene mutations in the pathogenesis of IA.

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