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Science 7 April 2006:
Vol. 312. no. 5770, pp. 117 - 121
DOI: 10.1126/science.1124287

Reports

Losartan, an AT1 Antagonist, Prevents Aortic Aneurysm in a Mouse Model of Marfan Syndrome

Jennifer P. Habashi,1* Daniel P. Judge,2* Tammy M. Holm,1 Ronald D. Cohn,1 Bart L. Loeys,1 Timothy K. Cooper,1,3 Loretha Myers,1 Erin C. Klein,1 Guosheng Liu,3 Carla Calvi,2 Megan Podowski,2 Enid R. Neptune,2 Marc K. Halushka,4 Djahida Bedja,3 Kathleen Gabrielson,3 Daniel B. Rifkin,5 Luca Carta,6 Francesco Ramirez,6 David L. Huso,3 Harry C. Dietz1,2{dagger}

Aortic aneurysm and dissection are manifestations of Marfan syndrome (MFS), a disorder caused by mutations in the gene that encodes fibrillin-1. Selected manifestations of MFS reflect excessive signaling by the transforming growth factor–ß (TGF-ß) family of cytokines. We show that aortic aneurysm in a mouse model of MFS is associated with increased TGF-ß signaling and can be prevented by TGF-ß antagonists such as TGF-ß–neutralizing antibody or the angiotensin II type 1 receptor (AT1) blocker, losartan. AT1 antagonism also partially reversed noncardiovascular manifestations of MFS, including impaired alveolar septation. These data suggest that losartan, a drug already in clinical use for hypertension, merits investigation as a therapeutic strategy for patients with MFS and has the potential to prevent the major life-threatening manifestation of this disorder.

1 Howard Hughes Medical Institute and Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
2 Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
3 Department of Molecular and Comparative Pathobiology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
4 Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD 21205, USA.
5 Departments of Cell Biology and Medicine, New York University School of Medicine, New York, NY 10016, USA.
6 Child Health Institute of New Jersey, University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School, New Brunswick, NJ 08903, USA.

* These authors contributed equally to this work.

{dagger} To whom correspondence should be addressed. E-mail: hdietz{at}jhmi.edu

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   Abstract »    Full Text »    PDF »
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   Full Text »    PDF »
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J. De Backer (2009)
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   Abstract »    Full Text »    PDF »
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   Abstract »    Full Text »    PDF »
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   Full Text »    PDF »
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   Abstract »    Full Text »    PDF »
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   Full Text »    PDF »
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M. Urbanek, S. Sam, R. S. Legro, and A. Dunaif (2007)
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   Abstract »    Full Text »    PDF »
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H. Pannu, V. Tran-Fadulu, C. L. Papke, S. Scherer, Y. Liu, C. Presley, D. Guo, A. L. Estrera, H. J. Safi, A. R. Brasier, et al. (2007)
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   Abstract »    Full Text »    PDF »
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   Abstract »    Full Text »    PDF »
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S. Belmadani, J. Bernal, C.-C. Wei, M. A. Pallero, L. Dell'Italia, J. E. Murphy-Ullrich, and K. H. Berecek (2007)
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   Abstract »    Full Text »    PDF »
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   Abstract »    Full Text »    PDF »
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H. A. Bird (2007)
Rheumatology 46, 902-903
   Full Text »    PDF »
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M. Ruiz-Ortega, J. Rodriguez-Vita, E. Sanchez-Lopez, G. Carvajal, and J. Egido (2007)
Cardiovasc Res 74, 196-206
   Abstract »    Full Text »    PDF »
Lasting Effects of Lost Vascular Elasticity.
R. M. Weiss (2007)
Circ. Res. 100, 604-606
   Full Text »    PDF »
Perturbations of Vascular Homeostasis and Aortic Valve Abnormalities in Fibulin-4 Deficient Mice.
K. Hanada, M. Vermeij, G. A. Garinis, M. C. de Waard, M. G.S. Kunen, L. Myers, A. Maas, D. J. Duncker, C. Meijers, H. C. Dietz, et al. (2007)
Circ. Res. 100, 738-746
   Abstract »    Full Text »    PDF »
Principles of Genetic Murine Models for Cardiac Disease.
K. E. Yutzey and J. Robbins (2007)
Circulation 115, 792-799
   Abstract »    Full Text »    PDF »
Fibrillin-1 regulates the bioavailability of TGF{beta}1.
S. S. Chaudhry, S. A. Cain, A. Morgan, S. L. Dallas, C. A. Shuttleworth, and C. M. Kielty (2007)
J. Cell Biol. 176, 355-367
   Abstract »    Full Text »    PDF »
On the Horizon From the ORS.
G. Gibson and D. Fyhrie (2007)
J. Am. Acad. Ortho. Surg. 15, 72-74
   Full Text »    PDF »
What's new in hypertension?.
J. F. E. Mann (2007)
Nephrol. Dial. Transplant. 22, 47-52
   Full Text »    PDF »
Marfan Syndrome.
J. A. CHAFFINS (2007)
Radiol. Technol. 78, 222-236
   Abstract »    Full Text »    PDF »
Decorin-Mediated Regulation of Fibrillin-1 in the Kidney Involves the Insulin-Like Growth Factor-I Receptor and Mammalian Target of Rapamycin.
L. Schaefer, W. Tsalastra, A. Babelova, M. Baliova, J. Minnerup, L. Sorokin, H.-J. Grone, D. P. Reinhardt, J. Pfeilschifter, R. V. Iozzo, et al. (2007)
Am. J. Pathol. 170, 301-315
   Abstract »    Full Text »    PDF »
Clinical features in a family with an R460H mutation in transforming growth factor {beta} receptor 2 gene.
C Law, D Bunyan, B Castle, L Day, I Simpson, G Westwood, and B Keeton (2006)
J. Med. Genet. 43, 908-916
   Abstract »    Full Text »    PDF »
Different patterns of aortic wall elasticity in patients with Marfan syndrome: A noninvasive follow-up study.
D. Baumgartner, C. Baumgartner, E. Schermer, G. Engl, U. Schweigmann, G. Matyas, B. Steinmann, and J. I. Stein (2006)
J. Thorac. Cardiovasc. Surg. 132, 811-819
   Abstract »    Full Text »    PDF »
Aneurysm Syndromes Caused by Mutations in the TGF-{beta} Receptor.
B. L. Loeys, U. Schwarze, T. Holm, B. L. Callewaert, G. H. Thomas, H. Pannu, J. F. De Backer, G. L. Oswald, S. Symoens, S. Manouvrier, et al. (2006)
N. Engl. J. Med. 355, 788-798
   Abstract »    Full Text »    PDF »
Marfan's Syndrome and Related Disorders -- More Tightly Connected Than We Thought.
B. D. Gelb (2006)
N. Engl. J. Med. 355, 841-844
   Full Text »    PDF »
Losartan in Marfan Syndrome--Beyond Blood Pressure Lowering: Losartan, an AT1 Antagonist, Prevents Aortic Aneurysm in a Mouse Model of Marfan Syndrome. Science 312: 117-121, 2006.
J.P. Habashi, D.P. Judge, T.M. Holm, R.D Cohn, B. Loeys, T.K. Cooper, L. Myers, E.C. Klein, G. Liu, C. Calvi, et al. (2006)
J. Am. Soc. Nephrol. 17, 1759-1764
   Full Text »    PDF »
Transforming Marfan Treatment.
(2006)
Journal Watch Dermatology 2006, 3
   Full Text »



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