Intracranial aneurysm (IA), which is characterized by the ballooning of an intracerebral artery, is a common vascular abnormality, with a prevalence of 2% to 5% in the general population, and frequently leads to vascular rupture with high mortality.1,2 IA is considered to be influenced by various acquired and inherited factors. [3][4][5] Although IA incidence is associated with several acquired risk factors, including smoking and hypertension, 6-9 its genetic factors are poorly understood, and the generation of reliable disease models to recapitulate its pathogenesis has therefore been difficult. Current treatment of IA depends largely on surgical clipping or endovascular coiling without any therapeutic drug administration.
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Clinical Perspective on p 1005In recent attempts to reveal genetic factors related to IA, a series of genome-wide association studies based on a large population of patients with IA suggested a few susceptible candidate loci, including Sox17. [11][12][13] The transcription factor Sox17 is an essential player in vascular development through the regulation of angiogenesis 14 and arterial differentiation.
15Although Sox17 plays a crucial role in tumor angiogenesis, 16 the relationship between Sox17 and other vascular abnormalities, including IA, during adulthood has not yet been studied. Because IA pathology has focused on vascular walls rather than on endothelial layers, how Sox17, which is specifically expressed in endothelial cells, is involved in IA formation remains to be explored. To address a potential link between IA formation and Sox17, we investigated the vascular changes in intracerebral arteries of a Sox17 loss-of-function mouse model.
MethodsAn expanded Methods section can be found in the online-only Data Supplement.Background-Intracranial aneurysm (IA) is a common vascular disorder that frequently leads to fatal vascular rupture. Although various acquired risk factors associated with IA have been identified, the hereditary basis of IA remains poorly understood. As a result, genetically modified animals accurately modeling IA and related pathogenesis have been lacking, and subsequent drug development has been delayed. Methods and Results-The transcription factor Sox17 is robustly expressed in endothelial cells of normal intracerebral arteries. The combination of Sox17 deficiency and angiotensin II infusion in mice induces vascular abnormalities closely resembling the cardinal features of IA such as luminal dilation, wall thinning, tortuosity, and subarachnoid hemorrhages. This combination impairs junctional assembly, cell-matrix adhesion, regeneration capacity, and paracrine secretion in endothelial cells of intracerebral arteries, highlighting key endothelial dysfunctions that lead to IA pathogenesis. Moreover, human IA samples showed reduced Sox17 expression and impaired endothelial integrity, further strengthening the applicability of this animal model to clinical settings.
Conclusions-Our findings demonstrate that
Vascular Corrosion Casting and Scanning Electron MicroscopyMi...