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Semaphorin 3d signaling defects are associated with anomalous pulmonary venous connections

Nature Medicine volume 19, pages 760–765 (2013)Cite this article

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Abstract

Total anomalous pulmonary venous connection (TAPVC) is a potentially lethal congenital disorder that occurs when the pulmonary veins do not connect normally to the left atrium, allowing mixing of pulmonary and systemic blood1. In contrast to the extensive knowledge of arterial vascular patterning, little is known about the patterning of veins. Here we show that the secreted guidance molecule semaphorin 3d (Sema3d) is crucial for the normal patterning of pulmonary veins. Prevailing models suggest that TAPVC occurs when the midpharyngeal endothelial strand (MES), the precursor of the common pulmonary vein, does not form at the proper location on the dorsal surface of the embryonic common atrium2,3. However, we found that TAPVC occurs in Sema3d mutant mice despite normal formation of the MES. In these embryos, the maturing pulmonary venous plexus does not anastomose uniquely with the properly formed MES. In the absence of Sema3d, endothelial tubes form in a region that is normally avascular, resulting in aberrant connections. Normally, Sema3d provides a repulsive cue to endothelial cells in this area, establishing a boundary. Sequencing of SEMA3D in individuals with anomalous pulmonary veins identified a phenylalanine-to-leucine substitution that adversely affects SEMA3D function. These results identify Sema3d as a crucial pulmonary venous patterning cue and provide experimental evidence for an alternate developmental model to explain abnormal pulmonary venous connections.

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Figure 1: Sema3d−/− mice have TAPVC.
Figure 2: Pulmonary vein patterning defects are present in Sema3d−/− embryos as early as E10.5.
Figure 3: Sema3d-expressing cells form a boundary that restricts the pulmonary endothelium.
Figure 4: Sema3d binds to Nrp-1 and is capable of repelling endothelial cells.

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Acknowledgements

We thank S.B. Bleyl for helpful comments and critical reading of the manuscript, N.A. Speck for technical assistance and B. Gelb and V. Garg for assistance with genetic analyses. This work was supported by US National Institutes of Health (NIH) grants NIH 5K12HD043245-07 (K.D.), NIH 5K08KL094763-02 (K.D.), NIH T32 GM07229 (H.A.) and NIH UO1 HL100405 (J.A.E.), the Spain Fund (J.A.E.) and the WW Smith Endowed Chair (J.A.E.).

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Author notes

  1. Karl Degenhardt, Manvendra K Singh and Haig Aghajanian: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of Pediatrics, Division of Cardiology, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Karl Degenhardt

  2. Department of Cell and Developmental Biology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Manvendra K Singh, Haig Aghajanian, Daniele Massera, Qiaohong Wang, Jun Li, Li Li, Connie Choi, Amanda D Yzaguirre & Jonathan A Epstein

  3. Cardiovascular Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Manvendra K Singh, Haig Aghajanian, Daniele Massera, Qiaohong Wang, Jun Li, Li Li, Connie Choi & Jonathan A Epstein

  4. Institute for Regenerative Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Manvendra K Singh, Haig Aghajanian, Daniele Massera, Qiaohong Wang, Jun Li, Li Li, Connie Choi & Jonathan A Epstein

  5. Abramson Family Cancer Research Institute, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Amanda D Yzaguirre

  6. Department of Pediatrics, Division of Human Genetics, Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA

    Lauren J Francey, Emily Gallant & Ian D Krantz

  7. Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah, USA

    Peter J Gruber

  8. Department of Molecular Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA

    Peter J Gruber

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  1. Karl Degenhardt
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Contributions

K.D., M.K.S., H.A. and J.A.E. performed project planning, experimental work, data interpretation and preparation of the manuscript. D.M., Q.W., J.L., L.L., C.C. and A.D.Y. performed experimental work. L.J.F., E.G., I.D.K. and P.J.G. participated in the identification of SEMA3D variants. J.A.E. supervised all aspects of the research.

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Correspondence to Jonathan A Epstein.

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Supplementary information

Supplementary Text and Figures

Supplementary Figures 1–10 and Supplementary Table 1 (PDF 1939 kb)

Supplementary Video 1

Echocardiograms showing normal chamber sizes in a wild type mouse heart, as compared to right-sided chamber dilatation a Sema3d–/– mouse heart. First, a single cardiac cycle from a control mouse is shown at slow speed. Note that the right ventricle (RV) and right atrium (RA) are relatively small compared to the left ventricle (LV) and left atrium (LA) in this view. Next, an echocardiogram of a Sema3d–/– mouse (Sema3d mutant) with TAPVC shows a single cardiac cycle at slow speed. Note that the right ventricle (RV) and right atrium (RA) are very large compared to the left ventricle (LV) and left atrium (LA) in this view. Right-sided chamber dilation results from persistent left-to-right shunting of blood. (MOV 597 kb)

Supplementary Video 2

Volume rendered microCT of a newborn mouse to highlight vascular connections. The movie begins in a left lateral view and the image is rotated to a dorsal view with cranial angulation. LA – left atrium, LV – left ventricle, LSVC – left superior vena cava, CS – coronary sinus, PV - pulmonary veins, RA – right atrium, RSVC – right superior vena cava. (MOV 717 kb)

Supplementary Video 3

Optical projection tomography of a heart-lung block dissected from control and Sema3d mutant E12.5 mouse embryos. First, multiplanar reconstruction (MPR) at a roughly cross sectional plane moving from anterior to posterior allows one to follow the course of the pulmonary vein (arrow) from the lung to the left atrium in the control. Next, similar MPR planes show an E12.5 Sema3d–/– embryo and traces the course of a pulmonary vein from the lung to the coronary sinus (CS), which then connects to the right atrium. (MOV 409 kb)

Supplementary Video 4

Sema3d repels endothelial cells in culture, while control HEK293 cells do not, and Sema3d (F602L) variant has a markedly reduced ability to repel compared to Sema3d. Timelapse microphotographs (20 × magnification, 5 min intervals per frame) of HEK293 cells (arrows) co-cultured with HUVECs. The HEK293 cells were infected with a lentiviral vector for wild type Sema3d, GFP or variant Sema3d (F602L). Note that the HUVECs are repelled and do not make contact with the cell overexpressing Sema3d. The control-GFP expressing cell contacts and intermingles with the HUVECs. The cell expressing Sema3d (F602L) has a reduced ability to repel. (MOV 1155 kb)

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Degenhardt, K., Singh, M., Aghajanian, H. et al. Semaphorin 3d signaling defects are associated with anomalous pulmonary venous connections. Nat Med 19, 760–765 (2013). https://doi.org/10.1038/nm.3185

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