Marfan Syndrome

Marfan syndrome is a common autosomal dominant hereditary disorder of connective tissue with prominent manifestations in the eye, skeleton and cardiovascular system. Mutations in the gene for fibrillin-1 (FBN1) can cause Marfan syndrome.

Keywords: Marfan syndrome; fibrillinopathy; microfibril; connective tissue; aortic dissection

Figure 1. Diagram of a calcium-binding epidermal growth factor-like module (cbEGF). Fibrillin-1 contains 43 cbEGF modules, which comprise about 42 amino acid residues with six cysteine residues (C) which together form three disulfide bonds in a 1–3, 2–4, 5–6 arrangement. cbEGF modules additionally contain a calcium-binding consensus: D/N–X–D/N–E/Q–Xm–D/N*–Xn–Y/F (where m and n are variable and * indicates potential beta hydroxylation). (Figure modified from Robinson PN and Booms P (2001) Cellular and Molecular Life Sciences 58: 1698–1707.)
Figure 2. Domain organization of fibrillin-1. Fourteen putative N-glycosylation sites are shown as black dots above the protein, N- and C-terminal proteolytic processing sites are shown as arrows and an RGD motif cell-attachment signal is shown as an open triangle. EGF: epidermal growth factor; cbEGF: calcium-binding epidermal growth factor-like module; LTBP: latent transforming growth factor 1 binding protein (module also referred to as the TGF1bp). (Figure modified from Robinson PN and Booms P (2001) Cellular and Molecular Life Sciences 58: 1698–1707.)
Figure 3. Proposed dominant negative model of the pathogenesis of Marfan syndrome. Top: wild-type (wt) fibrillin-1 monomers polymerize with one another and with a series of other proteins to form aggregate structures called microfibrils. Bottom: a missense mutation (represented as an asterisk) is likely to alter the conformation of affected fibrillin-1 monomers, which could interfere with polymerization, destabilize the polymeric microfibrils causing a progressive loss of microfibrils or otherwise interfere with proper microfibrillar function. (Figure modified from Robinson PN and Booms P (2001) Cellular and Molecular Life Sciences 58: 1698–1707.)
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 References
    De Paepe A, Devereux RB, Dietz HC, Hennekam RC and Pyeritz RE (1996) Revised diagnostic criteria for the Marfan syndrome. American Journal of Medical Genetics 62: 417–426.
    Dietz HC, Cutting GR, Pyeritz RE, et al. (1991) Marfan syndrome caused by a recurrent de novo missense mutation in the fibrillin gene. Nature 352: 337–339.
    Downing AK, Knott V, Werner JM, et al. (1996) Solution structure of a pair of calcium-binding epidermal growth factor-like domains: implications for the Marfan syndrome and other genetic disorders. Cell 85: 597–605.
    Gott VL, Greene PS, Alejo DE, et al. (1999) Replacement of the aortic root in patients with Marfan's syndrome. New England Journal of Medicine 340: 1307–1313.
    Pereira L, Lee SY, Gayraud B, et al. (1999) Pathogenetic sequence for aneurysm revealed in mice underexpressing fibrillin-1. Proceedings of the National Academy of Sciences of the United States of America 96: 3819–3823.
    Pyeritz RE (2000) The Marfan syndrome. Annual Review of Medicine 51: 481–510.
    Reinhardt DP, Mechling DE, Boswell BA, et al. (1997) Calcium determines the shape of fibrillin. Journal of Biological Chemistry 272: 7368–7373.
    Robinson PN and Booms P (2001) The molecular pathogenesis of the Marfan syndrome. Cellular and Molecular Life Sciences 58: 1698–1707.
    Sakai LY, Keene DR and Engvall E (1986) Fibrillin, a new 350-kD glycoprotein, is a component of extracellular microfibrils. Journal of Cell Biology 103: 2499–2509.
    Shores J, Berger KR, Murphy EA and Pyeritz RE (1994) Progression of aortic dilatation and the benefit of long-term beta-adrenergic blockade in Marfan's syndrome. New England Journal of Medicine 330: 1335–1341.
    Zhang H, Hu W and Ramirez F (1995) Developmental expression of fibrillin genes suggests heterogeneity of extracellular microfibrils. Journal of Cell Biology 129: 1165–1176.
 Further Reading
    Handford PA (2000) Fibrillin-1, a calcium binding protein of extracellular matrix. Biochimica et Biophysica Acta 1498: 84–90.
    book Pyeritz RE (2002) "BR Marfan syndrome and other disorders of fibrillin". In: Rimoin DL, Connor JM, Pyeritz RE and Korf B (eds.) Emery and Rimoin's Principles and Practice of Medical Genetics, 4th ed., pp. 3977–4020. London, UK: Churchill Livingstone.
    Ramirez F, Gayraud B and Pereira L (1999) Marfan syndrome: new clues to genotype–phenotype correlations. Annals of Medicine 31: 202–207.
    Robinson PN and Godfrey M (2000) The molecular genetics of Marfan syndrome and related microfibrillopathies. Journal of Medical Genetics 37: 9–25.
 Web Links
    ePath Online Mendelian Inheritance in Man: Marfan syndrome http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=154700
    ePath Fibrillin-1 (Marfan syndrome) (FBN1); Locus ID: 2200. LocusLink: http://www.ncbi.nlm.nih.gov/LocusLink/LocRpt.cgi?l=2200
    ePath Fibrillin 2 (congenital contractural arachnodactyly) (FBN2); Locus ID: 2201. LocusLink: http://www.ncbi.nlm.nih.gov/LocusLink/LocRpt.cgi?l=2201
    ePath Fibrillin-1 (Marfan syndrome) (FBN1); MIM number: 134797. OMIM: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=134797
    ePath Fibrillin 2 (congenital contractural arachnodactyly) (FBN2); MIM number: 121050. OMIM: http://www.ncbi.nlm.nih.gov/entrez/dispomim.cgi?id=121050
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How to Cite close
Robinson, Peter N(Jan 2006) Marfan Syndrome. In: eLS. John Wiley & Sons Ltd, Chichester. http://www.els.net [doi: 10.1038/npg.els.0006087]