[Auricular septal aneurysms with other congenital heart defects].
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BACKGROUND: Congenital cardiovascular diseases are the most common form of birth defects in humans. A substantial portion of these defects has been associated with inappropriate induction, migration, differentiation and patterning of pluripotent cardiac neural crest stem cells. While TGF-beta-superfamily signaling has been strongly implicated in neural crest cell development, the detailed molecular signaling mechanisms in vivo are still poorly understood. RESULTS: We deleted the TGF-beta type I receptor Alk5 specifically in the mouse neural crest cell lineage. Failure in signaling via ALK5 leads to severe cardiovascular and pharyngeal defects, including inappropriate remodeling of pharyngeal arch arteries, abnormal aortic sac development, failure in pharyngeal organ migration and persistent truncus arteriosus. While ALK5 is not required for neural crest cell migration, our results demonstrate that it plays an important role in the survival of post-migratory cardiac neural crest cells. CONCLUSION: Our results demonstrate that ALK5-mediated signaling in neural crest cells plays an essential cell-autonomous role in the pharyngeal and cardiac outflow tract development.
Most congenital cardiovascular malformations have their origins during early morphogenesis, and some forms of adult-onset cardiovascular disease also arise during embryonic development. Conotruncal heart defects comprise a major category of congenital heart disease and are found in children with a relative high frequency. These defects are associated with a high mortality risk in utero, and after postnatal surgical repair; embryologically they are linked with dextroposed aorta, which is an anomaly of the ventricular outflow tract with malalignment of the great arteries. The etiology and pathogenesis of dextroposed aorta is not known but is thought to be due to abnormal looping and/or incorrect "wedging" of the outflow tract (i.e., wedged positioning of the aorta between the atrioventricular valves) during early heart development. We have studied the morphology and visual development of the embryonic heart in an animal model of dextropsed aorta in a series of experiments to determine possible mechanisms for dextropositioning of the aorta. At this, we have employed besides established methods for analysis of anatomy and pathology (morphological studies, cardiac morphometry, histology, scanning electron microscopy and immunhistochemistry) also new imaging techniques (videocinephotography and time-lapse studies with a digital high-speed video camera, confocal and scanning electron microscopy, optical coherence tomography (OCT) and magnetic resonance microscopy (MRM) for 3D reconstruction of the heart) to achieve a better visualization of normal and pathological changes during heart development. The paper at hand summarizes the results of these studies.