Evidence map›Paper›PMID 34904380›Full record

ArticleAmerican journal of medical genetics. Part A2022

Identification and validation of a novel pathogenic variant in GDF2 (BMP9) responsible for hereditary hemorrhagic telangiectasia and pulmonary arteriovenous malformations.

Srimmitha Balachandar, Tamara J Graves, Anika Shimonty, Katie Kerr, Jill Kilner, Sihao Xiao, Richard Slade, Manveer Sroya, Mary Alikian, Emanuel Curetean and 15 more

2 registry-linked trialsOpen access · hybridAbstract readCase Reports
In one paragraph

Article in American journal of medical genetics. Part A, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 40 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
40citing papers in PubMed, 1 pooled it
5.5field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00230620 recruitingnot on this map

Molecular Studies on Hereditary Haemorrhagic Telangiectasia Families With Pulmonary Arteriovenous Malformations

TypeobservationalSponsorImperial College LondonRan1998 to 2030Enrolled1,000ConditionsTelangiectasia, Hereditary Hemorrhagic
NCT00230633 active not recruitingnot on this map

Studies of White Blood Cells Derived From HHT Patients

TypeobservationalSponsorImperial College LondonRan2002 to 2026Enrolled200ConditionsTelangiectasia, Hereditary Hemorrhagic
3 · Its place in the literature

Who cites it

40 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.

  1. Translational relevance of animal models available on brain arteriovenous malformations, a systematic review.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026
    Pooled it
  2. Article
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  12. Clinical Phenotypes of a Pediatric Cohort withJournal of clinical medicine · 2025
    Article
  13. Prodomain processing controls BMP-10 bioactivity and targeting to fibrillin-1 in latent conformation.FASEB journal : official publication of the Federation of American Societies for Experimental Biology · 2025
    Article
  14. Review
  15. Hereditary haemorrhagic telangiectasia.Nature reviews. Disease primers · 2025
    Review
  16. Review
  17. Molecular landscape and classification of vascular anomalies.Hematology. American Society of Hematology. Education Program · 2024
    Review
  18. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

25 authors at 7 institutions in 2 countries.

Srimmitha BalachandarDivision of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Tamara J GravesDivision of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Anika ShimontyDivision of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Katie KerrSchool of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Jill KilnerSchool of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Sihao XiaoNational Heart and Lung Institute, Imperial College London, London, UK.
Richard SladeNational Heart and Lung Institute, Imperial College London, London, UK.
Manveer SroyaDepartment of Surgery and Cancer, Imperial College London, London, UK.
Mary AlikianGenomics England Respiratory Clinical Interpretation Partnership (GeCIP), London, UK.
Emanuel CureteanWest London Genomic Medicine Centre, Imperial College Healthcare NHS Trust, London, UK.
Ellen ThomasWest London Genomic Medicine Centre, Imperial College Healthcare NHS Trust, London, UK.
Vivienne P M McConnellRegional Genetics Service, Belfast Health and Social Care Trust, Belfast, UK.
Shane McKeeRegional Genetics Service, Belfast Health and Social Care Trust, Belfast, UK.
Freya Boardman-PrettyGenomics England, London, UK.
Andrew DevereauGenomics England, London, UK.
Tom A FowlerGenomics England, London, UK.
Mark J CaulfieldGenomics England, London, UK.
Eric W AltonNational Heart and Lung Institute, Imperial College London, London, UK.
Teena FergusonWest London Genomic Medicine Centre, Imperial College Healthcare NHS Trust, London, UK.
Julian RedheadWest London Genomic Medicine Centre, Imperial College Healthcare NHS Trust, London, UK.
Amy J McKnightSchool of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK.
Geraldine A ThomasDepartment of Surgery and Cancer, Imperial College London, London, UK.
Genomics England Research ConsortiumGenomics England, London, UK.
Micheala A AldredDivision of Pulmonary, Critical Care, Sleep and Occupational Medicine, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Claire L ShovlinNational Heart and Lung Institute, Imperial College London, London, UK.ORCID 0000-0001-9007-5775
Genomics England · GBImperial College Healthcare NHS Trust · GBIndiana University School of MedicineQueen's University Belfast · GBBelfast Health and Social Care Trust · GBImperial College London · GBQueen Mary University of London · GB

Funding

Genomics of Pulmonary Vascular DiseaseR35HL140019 · NHLBI · INDIANA UNIVERSITY INDIANAPOLIS · PI ALDRED, MICHEALA A · 2018 to 2024
$5.6M
Department of HealthMedical Research Council MC_EX_MR/M009203/1Medical Research Council MC_PC_14089Medical Research Council MC_PC_16018Medical Research Council MR/M009203/1NHLBI NIH HHS R35 HL140019Wellcome Trust
6 · The paper itself

Abstract

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant multisystemic vascular dysplasia, characterized by arteriovenous malformations (AVMs), mucocutaneous telangiectasia and nosebleeds. HHT is caused by a heterozygous null allele in ACVRL1, ENG, or SMAD4, which encode proteins mediating bone morphogenetic protein (BMP) signaling. Several missense and stop-gain variants identified in GDF2 (encoding BMP9) have been reported to cause a vascular anomaly syndrome similar to HHT, however none of these patients met diagnostic criteria for HHT. HHT families from UK NHS Genomic Medicine Centres were recruited to the Genomics England 100,000 Genomes Project. Whole genome sequencing and tiering protocols identified a novel, heterozygous GDF2 sequence variant in all three affected members of one HHT family who had previously screened negative for ACVRL1, ENG, and SMAD4. All three had nosebleeds and typical HHT telangiectasia, and the proband also had severe pulmonary AVMs from childhood. In vitro studies showed the mutant construct expressed the proprotein but lacked active mature BMP9 dimer, suggesting the mutation disrupts correct cleavage of the protein. Plasma BMP9 levels in the patients were significantly lower than controls. In conclusion, we propose that this heterozygous GDF2 variant is a rare cause of HHT associated with pulmonary AVMs.

Indexed as

Arteriovenous MalformationsTelangiectasia, Hereditary HemorrhagicActivin Receptors, Type IIArteriovenous FistulaChildEndoglinEpistaxisGrowth Differentiation Factor 2HumansMutationPulmonary ArteryPulmonary VeinsActivin Receptors, Type IIACVRL1 protein, humanEndoglinGDF2 protein, humanGrowth Differentiation Factor 2arteriovenous malformationsbone morphogenetic protein 9hereditary hemorrhagic telangiectasia

Identifiers

PMID34904380
PMCPMC9939255
OpenAlexW4200165304

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.