BACKGROUND:
Cerebral cavernous malformations (CCMs) refer to vascular dysplasia primarily found in the brain, affecting ≈0.5% of the population. A somatic
Map3k3I441M
mutation has been found in ≈40% of patients with sporadic CCMs, which were typically accompanied by somatic gain-of-function mutations in
PIK3CA
. Although mouse models of adeno-associated virus-BR1–mediated mutant overexpression have been reported, these models have limitations in representing clinical specimens of CCMs, which typically harbor single allele mutation in
Map3k3
. A
Map3k3I441M
knock-in murine model of CCMs has not yet been established.
METHODS:
The
Map3k3I441M
knock-in mice were crossed with
Cdh5
-creER
T2
mice to induce mutant gene expression specifically in endothelial cells. Subsequently,
Map3k3I441M
mice were bred with
Ptenfl/fl
mice to generate
Map3k3I441M
;
Ptenfl/fl
mice. In both murine models, CCM lesions were examined using magnetic resonance imaging, while single-cell RNA sequencing and immunostaining were utilized to investigate the pathomechanism of the mutation. Finally, we administered an mTOR (mechanistic target of rapamycin) inhibitor to explore its therapeutic effect on lesions of both murine models.
RESULTS:
Both endothelial
Map3k3I441M
mutant juvenile mice and
Map3k3I441M
;
Ptenfl/fl
mice developed abnormal lesions with human CCM characteristics. In
Map3k3I441M
mice, the mutant promoted endothelial apoptosis, while activation of the PI3K (phosphatidylinositol 3-kinase) pathway was able to activate the downstream AKT (protein kinase B)/mTOR/p-S6 (phosphorylated S6 ribosomal protein) pathway and upregulate VEGFA (vascular endothelial growth factor A) expression, counteracting apoptosis, and facilitating lesion progression. The activation of PI3K signaling is required for
Map3k3I441M
to generate CCM-like lesions in adult mice. Finally, we demonstrated that rapamycin effectively inhibited the formation of lesions in the
Map3k3I441M
mice and
Map3k3I441M
;
Ptenfl/fl
mice.
CONCLUSIONS:Map3k3I441M
heterozygous is sufficient to induce lesions in juvenile mice, while the additional activation of PI3K signaling is required for the effective formation of CCMs at the adult stage. The
Map3k3I441M
murine model provides a preclinical model for further mechanistic and therapeutic studies of CCMs.