Understanding Atherosclerosis in Hutchinson-Gilford Progeria Syndrome: A Path to New Treatments

By | October 7, 2024

Recent research has uncovered crucial insights into the causes of cardiovascular disease in patients with Hutchinson-Gilford Progeria Syndrome (HGPS), a rare genetic disorder that causes rapid aging. The study reveals a key mechanism behind atherosclerosis, a condition that leads to serious heart problems in these patients. This breakthrough could pave the way for new treatments for both HGPS and other age-related cardiovascular diseases.

What is Hutchinson-Gilford Progeria Syndrome?

Hutchinson-Gilford Progeria Syndrome is an extremely rare genetic condition that affects children. Here are some important points to understand about HGPS:

  • Genetic Disorder: Caused by a mutation in the LMNA gene, leading to the production of a toxic protein called progerin.
  • Accelerated Aging: Children with HGPS exhibit signs of aging much earlier than their peers, often showing symptoms by the age of two.
  • Cardiovascular Risks: The most severe consequence of HGPS is the early onset of cardiovascular disease, with patients typically facing serious health issues by their early teens, resulting in an average life expectancy of just 14.5 years.

The Research Team and Their Findings

The study was conducted by researchers from three prominent Spanish institutions:

  • Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC)
  • Centro de Investigaciones Biológicas Margarita Salas (CIB-CSIC)
  • Instituto de Ciencias de Materiales de Madrid (ICMM-CSIC)

Led by Dr. Vicente Andrés and Dr. Ignacio Benedicto, the researchers aimed to understand how cardiovascular problems arise in HGPS patients.

Key Discoveries:

  1. YAP/TAZ Pathway: The researchers found that the YAP/TAZ signaling pathway in endothelial cells (the cells lining blood vessels) is significantly activated in HGPS, contributing to atherosclerosis.
  2. Gene Expression Changes: Using advanced single-cell RNA sequencing, they observed that endothelial cells in HGPS mice show alterations in gene expression related to:
    • Inflammation
    • Immune cell recruitment
    • Stiffening of the extracellular matrix around cells
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A Closer Look at Atherosclerosis

Atherosclerosis is a condition where arteries become stiff and narrow, increasing the risk of heart attacks, strokes, and heart failure. In HGPS, this process begins early due to the effects of progerin on endothelial cells.

How the YAP/TAZ Pathway Affects Atherosclerosis:

  • Stiff Arteries: The stiffening of the arterial walls in HGPS activates the YAP/TAZ pathway.
  • Inflammation: This activation leads to inflammation and the accumulation of immune cells in the arteries, accelerating atherosclerosis.

Dr. Ana Barettino, the first author of the study, stated, “The stiffening of the arterial wall and changes in blood flow patterns in HGPS trigger the activation of the YAP/TAZ pathway in endothelial cells, promoting inflammation and immune cell buildup.”

Exploring Therapeutic Possibilities

Given these findings, the research team investigated whether inhibiting the YAP/TAZ pathway could slow down the progression of atherosclerosis in HGPS mice.

Therapeutic Approach:

  • Verteporfin: The team used verteporfin, a drug approved for treating age-related macular degeneration.
  • Results: HGPS mice treated with verteporfin showed a significant reduction in atherosclerosis burden. There was also a notable decrease in endothelial cell activation and immune cell accumulation in the aorta.

Dr. Vicente Andrés noted, “By targeting the YAP/TAZ pathway, we significantly reduced the progression of atherosclerosis in our HGPS mouse model.”

Future Implications

While these results are promising, the researchers caution that more studies are needed to ensure the safety of targeting the YAP/TAZ pathway in patients. Here are some considerations:

  • Normal Biological Processes: The YAP/TAZ pathway is involved in many essential processes, including tissue repair and regeneration. Thus, any therapies aimed at inhibiting this pathway must be carefully designed to avoid negative side effects.
  • Translating Findings: More research is needed to translate these findings into safe and effective treatments for HGPS patients and potentially for the general population.
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Broader Impact on Cardiovascular Disease

The insights gained from this study are not limited to HGPS. Atherosclerosis is a leading cause of death worldwide, and many of the mechanisms identified in this research, such as vascular stiffening and inflammation, also contribute to cardiovascular disease in older adults.

Dr. Benedicto emphasized, “By targeting the molecular pathways that drive vascular aging, we may develop new therapies that extend healthy lifespan and improve the quality of life.”

Conclusion

This research represents a significant advancement in understanding the mechanisms behind atherosclerosis in Hutchinson-Gilford Progeria Syndrome. The activation of the YAP/TAZ pathway offers a potential target for future therapies, not only for HGPS but also for broader applications in age-related cardiovascular diseases. As scientists continue to explore this avenue, there is hope for new treatments that can improve outcomes for patients facing these serious health challenges.

References

Barettino, A., et al. (2024). “Endothelial YAP/TAZ activation promotes atherosclerosis in a mouse model of Hutchinson-Gilford progeria syndrome.” Journal of Clinical Investigation. DOI: 10.1172/JCI173448.

Source: Centro Nacional de Investigaciones Cardiovasculares Carlos III (F.S.P.)