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Lack of Flvcr2 impairs brain angiogenesis without affecting the blood-brain barrier
Nicolas Santander, … , Christer Betsholtz, Thomas D. Arnold
Nicolas Santander, … , Christer Betsholtz, Thomas D. Arnold
Published May 5, 2020
Citation Information: J Clin Invest. 2020;130(8):4055-4068. https://doi.org/10.1172/JCI136578.
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Research Article Angiogenesis Development

Lack of Flvcr2 impairs brain angiogenesis without affecting the blood-brain barrier

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Abstract

Fowler syndrome is a rare autosomal recessive brain vascular disorder caused by mutation in FLVCR2 in humans. The disease occurs during a critical period of brain vascular development, is characterized by glomeruloid vasculopathy and hydrocephalus, and is almost invariably prenatally fatal. Here, we sought to gain insights into the process of brain vascularization and the pathogenesis of Fowler syndrome by inactivating Flvcr2 in mice. We showed that Flvcr2 was necessary for angiogenic sprouting in the brain, but surprisingly dispensable for maintaining the blood-brain barrier. Endothelial cells lacking Flvcr2 had altered expression of angiogenic factors, failed to adopt tip cell properties, and displayed reduced sprouting, leading to vascular malformations similar to those seen in humans with Fowler syndrome. Brain hypovascularization was associated with hypoxia and tissue infarction, ultimately causing hydrocephalus and death of mutant animals. Strikingly, despite severe vascular anomalies and brain tissue infarction, the blood-brain barrier was maintained in Flvcr2 mutant mice. Our Fowler syndrome model therefore defined the pathobiology of this disease and provided new insights into brain angiogenesis by showing uncoupling of vessel morphogenesis and blood-brain barrier formation.

Authors

Nicolas Santander, Carlos O. Lizama, Eman Meky, Gabriel L. McKinsey, Bongnam Jung, Dean Sheppard, Christer Betsholtz, Thomas D. Arnold

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Figure 5

BBB is intact in Flvcr2GFP/GFP embryos.

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BBB is intact in Flvcr2GFP/GFP embryos.
(A) Red blood cells were detecte...
(A) Red blood cells were detected in embryonic brains using an antibody against TER119. Ventricles are delineated by green dotted lines. Boxes indicate magnified areas. Hemorrhages are identified by the presence of TER119+ cells outside of CD31+ areas, as shown in Tgfbr2ΔiEC/ΔiEC embryos. Representative image of 2 Tgfbr2ΔiEC/ΔiEC embryos. Scale bars: 100 μm. (B) Embryos were injected intrahepatically with 10 kDa dextran labeled with TMR at E18.5. The fluorescence of the labeled dextran was observed in brain sections stained for GFP and CD31 to test the ability of the tracer to leak into the brain parenchyma. Scale bar: 100 μm. (C) Endogenous mouse IgG was detected in brain sections at E18.5 with a fluorescently labeled antibody. Sections representative of brain parenchyma of the indicated number of embryos are shown. Scale bar: 100 μm. (D) Flvcr2 inactivation was induced by injecting tamoxifen in the indicated number of adult mice, and animals were perfused with sulfo-NHS-biotin 10 days after the last induction. (E) Biotin presence was detected with fluorescently labeled streptavidin in brain, and localization outside of CD31+ cells was assessed. Scale bar: 100 μm. (F) Recombination was induced in adult mice, and Evans blue was injected i.p. 10 days later. Brains were collected after perfusion and photographed intact. n = 3. (G and H) Fluorescently labeled cadaverine was injected i.v. into WT and Flvcr2ΔiEC/ΔiEC mice, and brains were collected 3 hours later. The brain from one animal was sectioned to visualize dye localization. Scale bar: 100 μm. Brains from cadaverine-injected mice were homogenized and tissue fluorescence was quantified. n = 4.

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ISSN: 0021-9738 (print), 1558-8238 (online)

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