Sex differences and risk factors for bleeding in Alagille syndrome

Spontaneous bleeds are a leading cause of death in the pediatric JAG1-related liver disease Alagille syndrome (ALGS). We asked whether there are sex differences in bleeding events in patients, whether Jag1(Ndr/Ndr) mice display bleeds or vascular defects, and whether discovered vascular pathology can be confirmed in patients non-invasively. We performed a systematic review of patients with ALGS and vascular events following PRISMA guidelines, in the context of patient sex, and found significantly more girls than boys reported with spontaneous intracranial hemorrhage. We investigated vascular development, homeostasis, and bleeding in Jag1(Ndr/Ndr) mice, using retina as a model. Jag1(Ndr/Ndr) mice displayed sporadic brain bleeds, a thin skull, tortuous blood vessels, sparse arterial smooth muscle cell coverage in multiple organs, which could be aggravated by hypertension, and sex-specific venous defects. Importantly, we demonstrated that retinographs from patients display similar characteristics with significantly increased vascular tortuosity. In conclusion, there are clinically important sex differences in vascular disease in ALGS, and retinography allows non-invasive vascular analysis in patients. Finally, Jag1(Ndr/Ndr) mice represent a new model for vascular compromise in ALGS.

MEDICIN OCH HÄLSOVETENSKAP Klinisk medicin Kardiologi hsv//swe
MEDICAL AND HEALTH SCIENCES Clinical Medicine Cardiac and Cardiovascular Systems hsv//eng
Alagille syndrome
Bleeding
Jagged1
Notch
Vasculature
aneurysmal subarachnoid hemorrhage
moyamoya-syndrome
vascular
abnormalities
human jagged1
children
mutations
notch3
hypertension
expression
patient
Research & Experimental Medicine

Van Hul, N.Karolinska Institutet (author)
Laznovsky, J. (author)
Verboven, E.Karolinska Institutet (author)
Mangold, K. (author)
Hensens, N. (author)
Adori, C. (author)
Verhoef, E. (author)
Zikmund, T. (author)
Dawit, F. (author)
Kavkova, M. (author)
Salplachta, J. (author)
Sjoqvist, M. (author)
Johansson, Bengt R,1947Gothenburg University,Göteborgs universitet,Institutionen för biomedicin,Institute of Biomedicine(Swepub:gu)xjbenp (author)
Hassan, M. G. (author)
Fredriksson, L.Karolinska Institutet (author)
Baumgartel, K. (author)
Bryja, V. (author)
Lendahl, U. (author)
Jheon, A. (author)
Alten, F. (author)
Fahnehjelm, K. T.Karolinska Institutet (author)
Fischler, B.Karolinska Institutet (author)
Kaiser, J. (author)
Andersson, E. R.Karolinska Institutet (author)
Karolinska InstitutetInstitutionen för biomedicin (creator_code:org_t)

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.