Pulmonary vascular phenotype identified in patients with GDF2 (BMP9) or BMP10 variants : an international multicentre study

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BACKGROUND: Bone morphogenetic proteins 9 and 10 (BMP9 and BMP10), encoded by GDF2 and BMP10, respectively, play a pivotal role in pulmonary vascular regulation. GDF2 variants have been reported in pulmonary arterial hypertension (PAH) and hereditary haemorrhagic telangiectasia (HHT). However, the phenotype of GDF2 and BMP10 carriers remains largely unexplored.

METHODS: We report the characteristics and outcomes of PAH patients in GDF2 and BMP10 carriers from the French and Dutch pulmonary hypertension registries. A literature review explored the phenotypic spectrum of these patients.

RESULTS: 26 PAH patients were identified: 20 harbouring heterozygous GDF2 variants, one homozygous GDF2 variant, four heterozygous BMP10 variants, and one with both GDF2 and BMP10 variants. The prevalence of GDF2 and BMP10 variants was 1.3% and 0.4%, respectively. Median age at PAH diagnosis was 30 years, with a female/male ratio of 1.9. Congenital heart disease (CHD) was present in 15.4% of the patients. At diagnosis, most of the patients (61.5%) were in New York Heart Association Functional Class III or IV with severe haemodynamic compromise (median (range) pulmonary vascular resistance 9.0 (3.3-40.6) WU). Haemoptysis was reported in four patients; none met the HHT criteria. Two patients carrying BMP10 variants underwent lung transplantation, revealing typical PAH histopathology. The literature analysis showed that 7.6% of GDF2 carriers developed isolated HHT, and identified cardiomyopathy and developmental disorders in BMP10 carriers.

CONCLUSIONS: GDF2 and BMP10 pathogenic variants are rare among PAH patients, and occasionally associated with CHD. HHT cases among GDF2 carriers are limited according to the literature. BMP10 full phenotypic ramifications warrant further investigation.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:63

Enthalten in:

The European respiratory journal - 63(2024), 4 vom: 01. Apr.

Sprache:

Englisch

Beteiligte Personen:

Grynblat, Julien [VerfasserIn]
Bogaard, Harm Jan [VerfasserIn]
Eyries, Mélanie [VerfasserIn]
Meyrignac, Olivier [VerfasserIn]
Savale, Laurent [VerfasserIn]
Jaïs, Xavier [VerfasserIn]
Ghigna, Maria-Rosa [VerfasserIn]
Celant, Lucas [VerfasserIn]
Meijboom, Lilian [VerfasserIn]
Houweling, Arjan C [VerfasserIn]
Levy, Marilyne [VerfasserIn]
Antigny, Fabrice [VerfasserIn]
Chaouat, Ari [VerfasserIn]
Cottin, Vincent [VerfasserIn]
Guignabert, Christophe [VerfasserIn]
Coulet, Florence [VerfasserIn]
Sitbon, Olivier [VerfasserIn]
Bonnet, Damien [VerfasserIn]
Humbert, Marc [VerfasserIn]
Montani, David [VerfasserIn]
and the French PH Network PULMOTENSION Investigators [VerfasserIn]

Links:

Volltext

Themen:

BMP10 protein, human
Bone Morphogenetic Proteins
GDF2 protein, human
Growth Differentiation Factor 2
Journal Article
Review

Anmerkungen:

Date Completed 08.04.2024

Date Revised 08.04.2024

published: Electronic-Print

Citation Status MEDLINE

doi:

10.1183/13993003.01634-2023

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM370036735