Open AccessIntracranial Aneurysms: Pathology, Genetics, and Molecular Mechanisms
Author(s) -
Zhen Xu,
Yanning Rui,
John P. Hagan,
Dong Kim
Publication year - 2019
Publication title -
neuromolecular medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.098
H-Index - 73
eISSN - 1559-1174
pISSN - 1535-1084
DOI - 10.1007/s12017-019-08537-7
Subject(s) - genome wide association study , neurology , medicine , subarachnoid hemorrhage , stroke (engine) , focal adhesion , pathology , molecular genetics , biology , bioinformatics , neuroscience , genetics , signal transduction , single nucleotide polymorphism , genotype , gene , mechanical engineering , engineering
Intracranial aneurysms (IA) are local dilatations in cerebral arteries that predominantly affect the circle of Willis. Occurring in approximately 2-5% of adults, these weakened areas are susceptible to rupture, leading to subarachnoid hemorrhage (SAH), a type of hemorrhagic stroke. Due to its early age of onset and poor prognosis, SAH accounts for > 25% of years lost for all stroke victims under the age of 65. In this review, we describe the cerebrovascular pathology associated with intracranial aneurysms. To understand IA genetics, we summarize syndromes with elevated incidence, genome-wide association studies (GWAS), whole exome studies on IA-affected families, and recent research that established definitive roles for Thsd1 (Thrombospondin Type 1 Domain Containing Protein 1) and Sox17 (SRY-box 17) in IA using genetically engineered mouse models. Lastly, we discuss the underlying molecular mechanisms of IA, including defects in vascular endothelial and smooth muscle cells caused by dysfunction in mechanotransduction, Thsd1/FAK (Focal Adhesion Kinase) signaling, and the Transforming Growth Factor β (TGF-β) pathway. As illustrated by THSD1 research, cell adhesion may play a significant role in IA.