Preprint Article Version 1 Preserved in Portico This version is not peer-reviewed

Endothelial to Mesenchymal Transition in an HHT-like pediatric case of Multiple Pulmonary Arteriovenous Malformations

Version 1 : Received: 26 April 2024 / Approved: 26 April 2024 / Online: 27 April 2024 (07:39:28 CEST)

How to cite: Lorente-Herraiz, L.; Cuesta, Á.M.; Recio-Poveda, L.; Botella, L.M.; Albiñana, V. Endothelial to Mesenchymal Transition in an HHT-like pediatric case of Multiple Pulmonary Arteriovenous Malformations. Preprints 2024, 2024041781. https://doi.org/10.20944/preprints202404.1781.v1 Lorente-Herraiz, L.; Cuesta, Á.M.; Recio-Poveda, L.; Botella, L.M.; Albiñana, V. Endothelial to Mesenchymal Transition in an HHT-like pediatric case of Multiple Pulmonary Arteriovenous Malformations. Preprints 2024, 2024041781. https://doi.org/10.20944/preprints202404.1781.v1

Abstract

Pulmonary arteriovenous malformations (PAVMs) are vascular anomalies resulting in abnormal connection between pulmonary arteries and veins. In 80% of cases, PAVMs are present from birth, but clinical manifestations are rarely seen in childhood. These congenital malformations are typically associated with Hereditary Hemorrhagic Telangiectasia (HHT), a rare disease that affects 1 in 5,000/8,000 individuals. HHT disease is frequently caused by mutations in genes involved in the TGF-β pathway. However, approximately 15% of patients do not have a genetic diagnosis and, among the genetically diagnosed, more than 33% do not meet the Curaçao Criteria. This makes clinical diagnosis even more challenging in the pediatric age group. Here, we introduce an 8 years old patient bearing a severe phenotype of multiple diffuse PAVMs caused by an unknown mutation which ended in lung transplantation. Phenotypically, the case of study follows a molecular pattern HHT-like. Therefore, molecular biology and cellular functional analysis has been performed in primary endothelial cells (ECs) isolated from the explanted lung. The findings revealed a loss of functionality in lung endothelial tissue and a stimulation of endothelial to mesenchymal transition. Understanding the molecular basis of this transition could potentially offer new therapeutic strategies to delay lung transplantation in severe cases.

Keywords

Vascular rare disease; Pulmonary arteriovenous malformations (PAVMs); Endothelial to Mesenchymal Transition (EndMT); angiogenesis; TGF-β

Subject

Biology and Life Sciences, Biochemistry and Molecular Biology

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