Cerebral cavernous malformations are driven by ADAMTS5 proteolysis of versican.

Journal Article (Journal Article)

Cerebral cavernous malformations (CCMs) form following loss of the CCM protein complex in brain endothelial cells due to increased endothelial MEKK3 signaling and KLF2/4 transcription factor expression, but the downstream events that drive lesion formation remain undefined. Recent studies have revealed that CCM lesions expand by incorporating neighboring wild-type endothelial cells, indicative of a cell nonautonomous mechanism. Here we find that endothelial loss of ADAMTS5 reduced CCM formation in the neonatal mouse model. Conversely, endothelial gain of ADAMTS5 conferred early lesion genesis in the absence of increased KLF2/4 expression and synergized with KRIT1 loss of function to create large malformations. Lowering versican expression reduced CCM burden, indicating that versican is the relevant ADAMTS5 substrate and that lesion formation requires proteolysis but not loss of this extracellular matrix protein. These findings identify endothelial secretion of ADAMTS5 and cleavage of versican as downstream mechanisms of CCM pathogenesis and provide a basis for the participation of wild-type endothelial cells in lesion formation.

Full Text

Duke Authors

Cited Authors

  • Hong, CC; Tang, AT; Detter, MR; Choi, JP; Wang, R; Yang, X; Guerrero, AA; Wittig, CF; Hobson, N; Girard, R; Lightle, R; Moore, T; Shenkar, R; Polster, SP; Goddard, LM; Ren, AA; Leu, NA; Sterling, S; Yang, J; Li, L; Chen, M; Mericko-Ishizuka, P; Dow, LE; Watanabe, H; Schwaninger, M; Min, W; Marchuk, DA; Zheng, X; Awad, IA; Kahn, ML

Published Date

  • October 5, 2020

Published In

Volume / Issue

  • 217 / 10

PubMed ID

  • 32648916

Pubmed Central ID

  • PMC7537394

Electronic International Standard Serial Number (EISSN)

  • 1540-9538

Digital Object Identifier (DOI)

  • 10.1084/jem.20200140


  • eng

Conference Location

  • United States