col4a1 syndrome life expectancy

Copyright 2023 NORD National Organization for Rare Disorders, Inc. All rights reserved. Compared to other COL4A1-related disorders, the brain is only mildly affected in HANAC syndrome. What are the different ways a genetic condition can be inherited? The information on this site should not be used as a substitute for professional medical care or advice. COL4A1 mutations and hereditary angiopathy, nephropathy, aneurysms, and muscle cramps. These disorders include autosomal dominant retinal vasculopathy with cerebral leukodystrophy (RVCL), hereditary endotheliopathy with retinopathy, nephropathy, and stroke (HERNS), cerebral autosomal recessive arteriopathy with subcortical infarcts and leukodystrophy (CARASIL), mitochondrial encephalopathy, lactic acidosis, and stroke-like episodes (MELAS), Fabry disease, and a variety of leukodystrophies, rare progressive metabolic disorders that affect the brain, spinal cord and often the peripheral nerves. She was struggling to advance both cognitively and physically because of uncontrolled epilepsy. The ultimate goal of IAMRARE is to unite patients and research communities in the improvement of care and drug development. NORD and MedicAlert Foundation have teamed up on a new program to provide protection to rare disease patients in emergency situations. Phone: 203-263-9938 Neurology. Quincy, MA 02169 Genet Med. It affects mainly young adults, children and more typically neonates. Vahedi K, Alamowitch S. Clinical spectrum of type IV collagen (COL4A1) (2014) 15:16. Gould Syndrome Foundation (COL4a1/COL4A2) seeks to educate the community on the rare disease COL4A1 and it's subcategorical diagnosis'. doi: 10.1056/NEJMoa1707914, 6. Aicardi-Goutieres syndrome - About the Disease - Genetic and Rare All individuals with this condition have arteries that twist and turn abnormally within the light-sensitive tissue at the back of the eyes (arterial retinal tortuosity). Gould Syndrome is diagnosed following a genetic test revealing a mutation in COL4A1 or COL4A2. Changing lives of those with rare disease. Raynaud phenomenon is typically triggered by changes in temperature and usually causes no long term damage. View CNBC interview with NORDs Peter Saltonstall and Boston Childrens Dr. Olaf Bodamer emphasizing the importance of investment in rare diseases. COL4A1 -Related Disorders - PubMed In: Adam MP, Everman DB, Mirzaa GM, Pagon RA, Wallace SE, Bean LJH, Gripp KW, Amemiya A, editors. Staals J, Makin SDJ, Doubal FN, Dennis MS, Wardlaw JM. Alamowitch S, Plaisier E, Favrole P, Prost C, Chen Z, Van Agtmael T, Marro B, Surgery may be necessary for individuals with severe cataracts. NORD is a registered 501(c)(3) charity organization. There are no standardized treatment protocols or guidelines for affected individuals. doi: 10.1136/jmg.2005.035584, 15. Am J Med Genet A. An MRI uses a magnetic field and radio waves to produce cross-sectional images of particular organs and bodily tissues, including the brain. ClinVar; [VCV000389182.3]. Another limitation is the systemic work-up based on described phenotypes and supposed affected organs. came with risks and was the hardest decision we had ever faced, yet we felt 100 mutation in Axenfeld-Rieger anomaly with leukoencephalopathy and stroke. Teaching families how to advocate for their loved ones and access medical information. The .gov means its official. These exceptions are nuanced and should be discussed with a genetic counselor. I cannot describe the feeling of seeing your child healed. Brain magnetic resonance imaging (MRI) scans were carried out on a three Tesla Brain MRI (Achieva, Ingenia; Philips Healthcare, Best, The Netherlands). Zagaglia Selch C, Nisevic JR, et al. The site is secure. In most cases, an affected person has one parent with the condition. Phone: 617-249-7300, Danbury, CT office Yet, five siblings, showing mild phenotype even in the second generation support a Mendelian transmission with variable expressivity and no other mechanism. doi: 10.1212/WNL.0b013e3181c3fd12, 9. Standards and guidelines for the interpretation of sequence variants: a joint consensus recommendation of the American College of Medical Genetics and Genomics and the Association for Molecular Pathology Sue. This is called genotype-phenotype correlation. doi: 10.1016/j.ejpn.2009.04.010, 27. Born at term after a 39-week pregnancy, IV-3 had an unremarkable first clinical evaluation at 3 months. The COL4A1 and COL4A2 genes were screened in proband IV-6. In the back of the eye, affected individuals have also twisting or distortion (tortuosity) of arteries in the retina (bilateral retinal arterial tortuosity) as part of the syndrome or as an isolated finding. doi: 10.1212/01.WNL.0000123113.46672.68, 25. Role of COL4A1 in Small-Vessel Disease and Hemorrhagic Stroke 2014 Mar;261(3):500-3. doi: 10.1007/s00415-013-7224-4. Oral expression was reduced and neuropsychological testing revealed language delay with a prominent expression deficit. COL4A1 Mutations Cause Neuromuscular Disease with - ScienceDirect Neurol. doi: 10.1126/science.1109418, 5. Oct;152A(10):2550-5. doi: 10.1002/ajmg.a.33659. The first time he came to meet us, Zeeva threw a sock at him. For example, an individual may carry genetic variants elsewhere in their genome that confers protection or susceptibly to the mutation and environmental experiences (trauma, anticoagulant use, physical exertion etc.) Information on current clinical trials is posted on the Internet at https://clinicaltrials.gov/. For example, networks of COL4A1 and COL4A2 are present in the basement membranes of blood vessels. However, in people with HANAC syndrome, these aneurysms typically do not burst. doi: 10.1001/archophthalmol.2010.42, 10. (1987) 8:4216. COL4A1 brain small-vessel disease is an autosomal dominant condition resulting from a mutation to the COL4A1 gene, located on the long arm of chromosome 13, that normally encodes for the alpha-1 chain of type IV collagen 1-6. This study clearly demonstrates that COL4A1 and COL4A2 mutations cause clinically variable cerebrovascular disease that includes characteristic features of cerebral small vessel disease. Various treatments have been reported in the medical literature as part of single case reports or small series of patients. Eur J Med Genet. For example, Type I collagen mutations cause Osteogenesis Imperfecta (brittle bone disease), Type II collagen mutations cause chondrodysplasias (defects of cartilage) and mutations in Type III collagen cause a form of Ehlers-Danlos Syndrome. The COL4A1 gene provides instructions for making one component of a protein called type IV collagen. Developmental defects to the front of the eye, which also includes the ocular drainage structures between the iris and cornea, can lead to increased pressure in the eye (elevated intraocular pressure, or IOP). COL4A1/A2-related disorders are dominant genetic disorders. 2018;91:e2078-e2088. While there are other explanations, parental mosaicism should be considered. Would you like email updates of new search results? doi: 10.1016/j.matbio.2016.10.003, 23. Most individuals diagnosed with a COL4A1-related disorder have an affected parent. If either parent also carries the mutation, it is considered inherited. At 1 month of age, a neuropediatric examination disclosed normal neck muscle tonus, normal Moro reflex, bilateral placing reaction, and open hands. Powered by NORD, the IAMRARE Registry Platform is driving transformative change in the study of rare disease. mutations: a novel genetic multisystem disease. ), A variety of rare genetic disorders may have symptoms similar to those found in COL4A1/A2-related disorders. COL4A1 -related brain small-vessel disease is characterized by weakening of the blood vessels in the brain. Acute urinary retention due to a novel collagen COL4A1 mutation. The conditions in this group have a range of signs and symptoms that involve fragile blood vessels. The risk is the same for males and females. If the mutation arises after fertilization, then some cells will carry the mutation and others will not this is called mosaicism. Fax: 203-263-9938, Washington, DC Office 2009 Jun 25 [Updated 2016 Jul 7]. She has regular physical, speech, and occupational therapy. http://www.centerwatch.com/, For information about clinical trials conducted in Europe, contact: COL4A1-related brain small-vessel disease is characterized by weakening of the blood vessels in the brain. Volonghi I, Pezzini A, Del Zotto E, Giossi A, Costa P, Ferrari D, Padovani A. Next generation sequencing uncovers a missense mutation in COL4A1 as the cause of familial retinal arteriolar tortuosity. COL4A1/A2-related disorders are rare, genetic, multi-system disorders. In the brain, intracerebral hemorrhage is the most frequent phenotype. This group rarely survives beyond 2 years. The COL4A1 gene provides instructions for making one component of a protein called type IV collagen. Common variation in COL4A1/COL4A2 is associated with sporadic cerebral small vessel disease. J Perinatol. 2022 Sep;269(9):5153-5156. doi: 10.1007/s00415-022-11111-0. Epilepsy and related challenges in children with COL4A1 and - PubMed Stroke. Children with the most severe brain malformations may have: Intellectual impairment Seizures Hydrocephalus Spasticity People who have a disorder of the corpus callosum typically have: doi: 10.1001/archneur.1983.04050080067013, 17. By continuing to use this website, you agree to the Terms of Service & Privacy Policy, A Podcast For The Rare Disease Community, Policy Statements & Letters to Policymakers. COL4A1 is an essential component for basal membrane stability and exon mutations of COL4A1 gene mutations are responsible for a broad spectrum of systemic manifestations characterized by small vessel involvement of variable severity, including neurological (1) [porencephaly (24), hemorrhage (2, 57) and aneurysms (8)], ophthalmological (912) (retinal artery tortuosity, Axenfeld Rieger anomalies, cataracts, and severe hypermetropia), renal (13) (renal cysts, and microscopic hematuria), and systemic (13) findings (cramps with a high creatine kinase level [CK], Raynaud's phenomenon, and arrhythmias). 2009;73:1873-1882. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2881859/, Mao, M, Alavi MV, Labelle-Dumais, C, Gould DB. Neurology. The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. Molecular genetic testing can detect variations in the COL4A1 and COL4A2 genes that cause these disorders, but is available only as a diagnostic service at specialized laboratories. All patients suffering from HANAC syndrome display retinal arteriolar tortuosity and occasional retinal hemorrhages. Ann Neurol. Several factors including the small number of identified cases, the lack of large clinical studies, and the possibility of other genes or factors influencing the disorder make it challenging to develop a complete picture of associated symptoms and prognosis. COL4A1 Syndrome CADASIL percent confident in Dr. Madsen and the epilepsy team. Col4a1 mutation generates vascular abnormalities correlated with Collagen type IV alpha 1 (COL4A1) silence hampers the invasion, migration and epithelial-mesenchymal transition (EMT) of gastric cancer cells through blocking Hedgehog signaling pathway. Dev Med Child Neurol. The two genes that code for these proteins are tightly linked on chromosome 13 and dominant COL4A1 and COL4A2 gene mutations cause a highly variable, multisystem disorder. Fetal intracerebral hemorrhage and cataract: think COL4A1. Some of the patient advocacy organizations listed in the Resources section below provide support and information to affected individuals and their families. At least six affected families have been described in the scientific literature. Novel mutations in three families confirm a major role of COL4A1 in hereditary porencephaly. Contact a health care provider if you have questions about your health. It affects mainly young adults, children and more typically neonates. Yet, as for all COL4A1 mutations, no specific treatment is currently available, and, due to the variable penetrance, adapted follow-up is challenging. National Library of Medicine The cells of the retina trigger nerve impulses that run from the optic nerve to the brain to form sight. 13 and so Gould Syndrome is considered Autosomal and should affect males and females in equal numbers. The prevalence of HANAC syndrome (hereditary angiopathy-nephropathy-aneurysms-muscle cramps syndrome) is not available, but at least six affected families have been reported worldwide to date. Fetal origin of brain damage in 2 infants with a COL4A1 mutation: fetal and neonatal MRI. Contact a health care provider if you have questions about your health. This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. The outcomes are highly variable ranging from brain hemorrhage before birth (in utero) leading to cavities in the brain (porencephaly) to mild age-related brain abnormalities that can only be observed on a specialized x-ray called magnetic resonance imaging (MRI). 2018;61:765-772. https://nord1dev.wpengine.com/for-patients-and-families/information-resources/info-clinical-trials-and-research-studies/, For information about clinical trials sponsored by private sources, contact: doi: 10.1056/NEJMoa053727, 7. 2008 May;192(5):971-84; discussion 984-6. MedlinePlus links to health information from the National Institutes of Health and other federal government agencies. Progressive cerebral atrophies in three children with COL4A1 mutations. NORD strives to open new assistance programs as funding allows. Lecordier S, Manrique-Castano D, El Moghrabi Y, ElAli A. Careers. doi: 10.1038/nmeth.2890, 22. doi: 10.1212/WNL.0000000000001309, 8. Internet. PS: wrote thi paper and performed the review of the literature under the supervision of GN. No use, distribution or reproduction is permitted which does not comply with these terms. Childhood presentation of COL4A1 mutations. Migraines can occur with or without aura. A dashed arrow indicates secondary atrophy in the left cerebral peduncle. IV-5Brain MRI revealing porencephalic cyst of frontal horn of lateral right ventricle (C). FOIA Stay Informed With NORDs Email Newsletter, Launching Registries & Natural History Studies. 1900 Crown Colony Drive Lenses corrected for hypermetropia. Plaisier E, Chen Z, Gekeler F, Benhassine S, Dahan K, Marro B, Alamowitch S, Paques M, Ronco P. Am J Med Genet A. Zenteno JC, Cresp J, Buentello-Volante B, Buil JA, Bassaganyas F, Vela-Segarra JI, et al. Molecular analysis in the father disclosed a heterozygous variant c.2228G>T (p.Gly743Val) in exon 30 of the COL4A1 gene that segregated with the phenotype. and transmitted securely. Phone: 202-588-5700. Type IV collagen is an important component of basement membranes in many tissues, especially blood vessels 1-6. In the eye, patients may have retinal arteriolar tortuosities and retinal hemorrhages or anterior segment dysgenesis. Vilain C, Van Regemorter N, Verloes A, David P, Van Bogaert P. Neuroimaging fails to identify asymptomatic carriers of familial porencephaly. Epub 2022 Apr 14. The causative gene of HANAC is COL4A1 (13q34) encoding the alpha1 chain of collagen IV, a major component of basement membranes also involved in . Mutations in the gene have been linked to diseases of the brain, muscle, kidney, eye, and cardiovascular system. IV-3 and IV-6 are closely followed by a neuropediatrician (VW). (2012) 54:56974. Mutated patients develop a diffuse small vessel disease of the brain as shown by a diffuse leukoencephalopathy on MRI. the basement membranes surrounding the body's blood vessels, National Organization for Rare Disorders (NORD), BRAIN SMALL VESSEL DISEASE 1 WITH OR WITHOUT OCULAR ANOMALIES. Porencephaly refers to the formation of fluid-filled cysts or cavities within of the brain. (For more information on these disorders, choose the specific disorder name as your search term in the Rare Disease Database.). In cases where the mutation is inherited, the carrier parent is often clinically unaffected. Dev Med Child Neurol. INTERNET Berg R, Aleck A, Kaplan A. Familial porencephaly. Children inherit a full complement of chromosomes from each of their parent and so we carry two copies of each gene. Zeeva woke up after a ten-hour procedure, opened her eyes, and it felt like we were seeing her for the first time. COL4A1 is a subunit of the type IV collagen and plays a role in angiogenesis. Services that may be beneficial for some affected individuals include medical, social, and/or vocational services such as special remedial education. Our experience with Boston Childrens was very different from the other places we had been for epilepsy and neurology treatment. Cereb Circ Cogn Behav. Fragile or damaged blood vessels or basement membranes in the kidneys can lead to blood in the urine (hematuria). doi: 10.1111/cge.12379, 13. A dominantly inherited mutation in collagen IV A1 (COL4A1) causing childhood onset stroke without porencephaly. Vahedi K, Alamowitch S. Clinical spectrum of type IV collagen (COL4A1) (2004) 62:16135. 2022 May 27;13:827165. doi: 10.3389/fneur.2022.827165. Cataracts, which are a clouding of the lenses of the eyes, are often present from birth (congenital) and may be one of the first identifiable signs of the syndrome. Colin E, Sentilhes L, Sarfati A, Mine M, Guichet A, Ploton C, et al. Genet Med. Hereditary cerebral small vessel diseases: a review. The size and location of cerebral cavities contributes to clinical variability. N Engl J Med. View CNBC interview with NORDs Peter Saltonstall and Boston Childrens Dr. Olaf Bodamer emphasizing the importance of investment in rare diseases. Shah S, Kumar Y, McLean B, Churchill A, Stoodley N, Rankin J, et al. Please enable it to take advantage of the complete set of features! Cerebral small vessel disease with hemorrhage is likely milder continuum from porencephaly and exhibits many of the same symptoms (with the exception of the brain cavities). Type IV collagen molecules attach to each other to form complex protein networks. 55 Kenosia Avenue January 31, 2019 Federal government websites often end in .gov or .mil. Thats not to say Zeeva hasnt had to work hard since the surgery. Suggestive evidence for linkage to chromosome 13qter for autosomal dominant type 1 porencephaly. Gould Syndrome is an ultra rare genetic, multi-system disorder. PS and NL: followed III-3 at the Erasme Neurology outpatients clinic. COL4A1/A2-related disorders are caused by dominant mutations in the COL4A1 or COL4A2 genes. Some individuals with COL4A1-related brain small-vessel disease do not have any signs or symptoms of the condition. Available online at: https://www.ncbi.nlm.nih.gov/clinvar/variation/VCV000389182.3 (accessed March 20, 2020). Comparisons may be useful for a differential diagnosis: CADASIL is a rare genetic disorder affecting the small blood vessels in the brain. Received: 06 January 2020; Accepted: 01 July 2020; Published: 11 September 2020. In some people, serious, life-threatening complications may occur in infancy; in others, only minor complications may occur and intelligence is unaffected. The disorder causes many symptoms, not the least of which are strokes and epilepsy. Hereditary angiopathy with nephropathy, aneurysms, and - MedlinePlus Systemic work-up including renal function, CK levels, urinary sediment test, and renal ultrasound proved unremarkable. doi: 10.1055/s-0031-1275343, 24. Am J Med Genet. doi: 10.1038/gim.2014.210, 3. Alamowitch S, Plaisier E, Favrole P, Prost C, Chen Z, Van Agtmael T, et al. Gould Syndrome - COL4A1 - COL4A2 genes - Gould Syndrome Foundation This condition is inherited in an autosomal dominant pattern, which means one copy of the altered gene in each cell is sufficient to cause the disorder. In addition to porencephaly there can be other forms of damage to the brain present at birth. Collagen, type IV, alpha 1 - Wikipedia 2022 Mar 24;3:100140. doi: 10.1016/j.cccb.2022.100140. Subsequently, it has been recognized that autosomal dominant COL4A1 and COL4A2 mutations cause a broad spectrum of cerebrovascular disease, whose onset occurs from fetal life onward and whose severity may range from small-vessel disease to fatal intraparenchymal hemorrhage.,, While epilepsy is known to be a clinical feature of porencephaly, the Autosomal Dominant Familial Porencephaly Type I. The main symptom is single or repeated bleeding inside the skull (intracranial hemorrhaging) that can occur without cause (spontaneously), after trauma, or when taking drugs that slow blood clotting (anticoagulants). I dont think we will ever be able to truly articulate our appreciation for Dr. Madsen and Boston Childrens for all that they did for Zeeva and our family. Clipboard, Search History, and several other advanced features are temporarily unavailable. Abnormal retinal arteries are prone to rupture causing bleeding associated with temporary loss of vision or even retinal detachments that can cause permanent vision loss. small vessel disease: a systematic review. Hereditary angiopathy with nephropathy, aneurysms, and muscle cramps (HANAC) syndrome is part of a group of conditions called the COL4A1 -related disorders. Individuals with this condition are at increased risk of having more than one stroke in their lifetime. She also showed severe hypermetropia. 2011 Suite 500 Dr. Joseph Madsen was as wonderful in person as he had been on the phone. The brain MRI of IV-6 disclosed a large right-sided frontoparietal cavity (Figure 3B) with communication to the lateral ventricle, isosignal to CFS. COL4A1 is an essential component for basal membrane stability. Still other individuals may not develop any symptoms until well into adulthood. She had seizures every day, couldnt gain weight, sleep right, or generally enjoy her life. Hereditary angiopathy with nephropathy, aneurysms, and muscle cramps (HANAC) syndrome is part of a group of conditions called the COL4A1-related disorders. (No doctor had ever taken a call on their lunch break to speak with me). Written informed consent was obtained from the patient and the patient's parents for publication of this case report. Affected individuals may also experience seizures and migraine headaches accompanied by visual sensations known as auras. For the nucleotide numbering, the HVGS terms (www.hgvs.org) were applied with the nucleotide A of the ATG startcodon = c.1. Breedveld G, De Coo IF, Lequin MH, Arts WFM, Heutink P, Gould DB, et al. IV-5 had microcephaly without motor deficits, a language delay, a mental retardation (IQ of 62) that required adapted schooling, and severe hypermetropia. Stroke. The timeline for the clinical examination and ancillary tests performed is illustrated in Figure 2. doi: Some affected individuals may develop weakness or paralysis of one side of the body (hemiparesis or hemiplegia) and have seizures. 2010;41:e513-518. Phone: 202-588-5700. No microbleeds or cystic cavities were found. Similar blood vessel weakness and breakage occurs in the eyes of some affected individuals. Seattle, WA: University of Washington, Seattle; 1993-. Individuals with COL4A1 or COL4A2 mutations can also develop formation of clefts or slits in the two halves of the brain (schizencephaly) in which cerebral hemispheres are missing and replaced with sacs filled with cerebrospinal fluid (hydranencephaly), abnormal folds in the brain surface (polymicrogyria) or abnormalities in the normal laying of the neuronal cells in the brain (cortical lamination defects). Suite 500 doi: 10.1038/jp.2013.135, 29. 1900 Crown Colony Drive Cerebrovascular disease related to COL4A1 mutations in HANAC syndrome. If individuals have muscle cramps, blood tests can reveal elevated levels creatine kinase, which is a muscle enzyme. (2017) 5758:2944. COL4A2 mutation causing adult onset recurrent intracerebral hemorrhage and leukoencephalopathy. This first-of-its-kind assistance program is designed for caregivers of a child or adult diagnosed with a rare disorder. Affected individuals have kidney disease (nephropathy) causing blood in the urine (hematuria) that can either be seen by the naked eye (gross hematuria) or only visible when tested (microscopic hematuria). Some may only develop specific symptoms such as isolated migraines or strokes in childhood or adulthood. Abnormal blood vessels in the brain are a major consequence of COL4A1 and COL4A2 gene mutations. What are the different ways a genetic condition can be inherited? He was confident this would reduce or stop the In the human genome, there are 46 chromosomes. There is in addition a specific phenotype called HANAC with constant nephropathy, muscle cramps and frequent intracranial aneurysms. Mutations in COL4A1 or COL4A2 cause Gould Syndrome and, because these two proteins are found in almost all tissues; nearly any organ can be affected. For example, the position of the mutation along the length of the protein can influence the severity of cerebrovascular disease and mutations in functional subdomains can influence the likelihood of tissue-specific involvement (for example, muscle). COL4A1 codes for extracellular matrix proteins that form heterotrimers that are major components of nearly all organ basal membranes. GeneReviews. Copyright 2023 by Gould Syndrome Foundation -. Secondly, the p.Gly743Val variant is a missense mutation that shares features with other missense pathogenic mutations that occur in the COL4A1 gene exon 30: congenital porencephaly, epilepsy, and neuropsychological anomalies in p.Gly749Ser (23, 24), ophthalmologic defects and neuropsychological deficits in absence of systemic signs in variant p.Gly755Arg (2527), and antenatal fetal intracerebral hemorrhage, ocular anomalies associated to cerebral leukoencephalopathy in variant p.Gly773Arg (12, 28, 29). doi: 10.1002/ajmg.10452, 18. doi: 10.1186/s12881-014-0097-2, 11. mutations: a novel genetic multisystem disease. For example, if the mutation arises during the formation of the sperm or the egg, then all of the cells that make up the child will carry the mutation. The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. J Neurol Sci. COL4A1 Mutation in a Neonate With Intrauterine Stroke and Anterior Segment Dysgenesis. Plaisier E, Ronco P. COL4A1-Related Disorders. Six alpha chains of type IV. By continuing to use this website, you agree to the Terms of Service & Privacy Policy. These protein networks are the main components of basement membranes, which are thin sheet-like structures that separate and support cells in many tissues. Figure 3. For information about clinical trials being conducted at the NIH Clinical Center in Bethesda, MD, contact the NIH Patient Recruitment Office: Toll-free: (800) 411-1222 In people with COL4A1-related brain small-vessel disease, the vasculature in the brain weakens, which can lead to blood vessel breakage and stroke. Dr. Madsen suggested Zeeva have an operation called a The networks formed by the COL4A1 and COL4A2 proteins are called basement membranes and are present in every organ of the body. Molecular Dynamics Investigation on the Effects of Protonation and Lysyl Hydroxylation on Sulfilimine Cross-links in Collagen IV. 10.2174/092986710790936293. (For more information on this disorder, choose cadasil as your search term in the Rare Disease Database. Gunda B, Mine M, Kovcs T, Hornyk C, Bereczki D, Vrallyay G, Rudas G, Audrezet MP, Tournier-Lasserve E. J Neurol.