Abstract
The Marfan syndrome (MFS) is a prominent member of heritable disorders of connective tissue with manifestations involving primarily the skeletal, ocular and cardiovascular systems but also and less systematically investigated the lung, skin and integument, and dura. Over the last two decades, a considerable amount of clinical, molecular and protein data had accumulated. In combination with the study of natural and transgenic animal models, this new information provides greater insight into the pathogenic mechanisms underlying not only the pleiotropic manifestations of MFS but also the important degree of clinical variability (age of onset and severity) observed between patients. The following aspects will be described in this review: the structure and function of fibrillin-1; the fibrillin proteins; mutations in the FBN1 gene and pathogenic mechanisms; animal models. Finally, the currently available laboratory diagnostic tests and their limits will be discussed.
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References
Marfan A . Un cas de déformation congénitale des quatre membres, plus prononcée aux extrémités, caractérisée par l'allongement des os avec un certain degré d'amincissement Bull Mém Soc Méd Hôp Paris 1896 13: 220–227
Beighton P, de Paepe A, Danks D et al. International nosology of heritable disorders of connective tissue Am J Med Genet 1988 29: 581–594
De-Paepe A, Devereux R, Dietz H, Hennekam R, Pyeritz R . Revised diagnostic criteria for the Marfan syndrome Am J Med Genet 1996 62: 417–426
Rose P, Levy H, Ahn N et al. A comparison of the Berlin and Ghent nosologies and the influence of dural ectasia in the diagnosis of Marfan syndrome Genetics in medicine 2000 2: 278–282
Weve H . Über Arachnodaktylie (dystrophia mesodermalis congenita, Typus Marfan) Archiv Augenheilk 1931 104: 1–46
McKusick VA . The cardiovascular aspects of Marfan's syndrome: A heritable disorder of connective tissue Circulation 1955 11: 321–341
Sakai L, Keene D, Engvall E . Fibrillin, a new 350 kD glycoprotein is a compound of extracellular microfibrils J Cell Biol 1986 103: 2499–2509
Hollister D, Godfrey M, Sakai L, Pyeritz R . Immunohistologic abnormalities of the microfibrillar system in the Marfan syndrome N Eng J Med 1990 323: 152–159
Dietz H, Cutting G, Pyeritz R et al. Marfan syndrome caused by a recurrent de novo missense mutation in the fibrillin gene Nature 1991 352: 337–339
Lee B, Godfrey M, Vitale E et al. Linkage of Marfan syndrome and a phenotypically related disorder to two different fibrillin genes Nature 1991 352: 330–334
Maslen C, Corson G, Maddox B, Glanville R, Sakai L . Partial sequence of a candidate gene for the Marfan syndrome Nature 1991 352: 334–337
Kainulainen K, Pulkkinen L, Savolainen A, Kaitila I, Peltonen L . Location on chromosome 15 of the gene defect causing Marfan syndrome N Eng J Med 1990 323: 935–939
Corson G, Chalberg S, Dietz H, Charbonneau N, Sakai L . Fibrillin binds calcium and is coded by cDNAs that reveal a multidomain structure and alternatively spliced exons at the 5′ end Genomics 1993 17: 476–484
Pereira L, d'Alessio M, Ramirez F et al. Genomic organization of the sequence coding for fibrillin, the defective gene product in Marfan syndrome Hum Mol Genet 1993 2: 961–968
Biery N, Eldadah Z, Moore C, Setten G, Spencer F, Dietz H . Revised genomic organization of FBN1 and significance for regulated gene expression Genomics 1999 56: 70–77
Dietz HC, Pyeritz RE . Mutations in the human gene for fibrillin-1 (FBN1) in the Marfan syndrome and related disorders Hum Mol Genet 1995 4: 1799–1809 Review
Sakamoto H, Brockelmann T, Cheresh D, Ramirez F, Rosenbloom J, Mecham R . Cell-type specific recognition of RGD- and non-RGD-containing cell binding domains in fibrillin-1 J Biol Chem 1996 271: 4916–4922
Handford PA, Downing AK, Reinhardt DP, Sakai LY . Fibrillin: From domain structure to supramolecular assembly Matrix Biol 2000 19: 457–470
Giltay R, Timpl R, Kostka G . Sequence, recombinant expression and tissue localization of two novel extracellular matrix proteins, fibulin-3 and fibulin-4 Matrix Biol 1999 18: 469–480
Wang M, Clericuzio CL, Godfrey M . Familial occurrence of typical and severe lethal congenital contractural arachnodactyly caused by missplicing of exon 34 of fibrillin-2 Am J Hum Genet 1996 59: 1027–1034
Ikegawa S, Toda T, Okui K, Nakamura Y . Structure and chromosomal assignment of the human S1-5 gene (FBNL) that is highly homologous to fibrillin Genomics 1996 35: 590–592
Stone EM, Lotery AJ, Munier FL et al. A single EFEMP1 mutation associated with both malattia Leventinese and Doyne honeycomb retinal dystrophy Nature Genetics 1999 22: 199–202
Zhang H, Apfelroth S, Hu W et al. Structure and expression of fibrillin-2 a novel microfibrillar component preferentially located in elastic matrices J Cell Biol 1994 124: 855–863
Raghunath M, Putnam EA, Ritty T et al. Carboxy-terminal conversion of profibrillin to fibrillin at a basic site by PACE/furin-like activity required for incorporation in the matrix J Cell Science 1999 112: 1093–1100
Trask TM, Ritty TM, Broekelmann T, Tisdale C, Mecham RP . N-terminal domains of fibrillin 1 and fibrillin 2 direct the formation of homodimers: a possible first step in microfibril assembly Biochem J 1999 340: 693–701
Glanville RW, Qian RQ, McClure DW, Maslen CL . Calcium binding, hydroxylation, and glycosylation of the precursor epidermal growth factor-like domains of fibrillin-1, the Marfan gene protein J Biol Chem 1994 269: 26630–26634
Yuan X, Downing AK, Knott V, Handford PA . Solution structure of the transforming growth factor β-binding protein-like module, a domain associated with matrix fibrils EMBO J 1997 16: 6659–6666
Baldock C, Koster A, Ziese U et al. The supramolecular organization of fibrillin-rich microfibrils J Cell Biol 2001 152: 1045–1056
Zhang H, Hu W, Ramirez F . Developmental expression of fibrillin genes suggests heterogeneity of extracellular microfibrils J Cell Biol 1995 129: 1165–1176
Reinhardt DP, Ono RN, Sakai LY . Calcium stabilizes fibrillin-1 against proteolytic degradation J Biol Chem 1997 272: 1231–1236
Reinhardt DP, Ono RN, Notbohm H, Muller PK, Bachinger HP, Sakai LY . Mutations in calcium-binding epidermal growth factor modules render fibrillin-1 susceptible to proteolysis. A potential disease-causing mechanism in Marfan syndrome J Biol Chem 2000 275: 12339–12345
Ashworth J, Murphy G, Rock M et al. Fibrillin degradation by matrix metalloproteinases: Implications for connective tissue remodeling Biochem J 1999 340: 171–181
McGettrick AJ, Knott V, Willis A, Handford PA . Molecular effects of calcium binding mutations in Marfan syndrome depend on domain context Hum Mol Genet 2000 9: 1987–1994
Collod-Béroud G, Béroud C, Adès L et al. Marfan Database (third edition): new mutations and new routines for the software Nucleic Acids Res 1998 26: 229–233
Kainulainen K, Sakai LY, Child A et al. Two mutations in Marfan syndrome resulting in truncated fibrillin polypeptides Proc Natl Acad Sci USA 1992 89: 5917–5921
Liu W, Schrijver I, Brenn T, Furthmayr H, Francke U . Multi-exon deletions of the FBN1 gene in Marfan syndrome BMC Med Genet 2001 2: 11–19
Kainulainen K, Karttunen L, Puhakka L, Sakai L, Peltonen L . Mutations in the fibrillin gene responsible for dominant ectopia lentis and neonatal Marfan syndrome Nature Genetics 1994 6: 64–69
Milewicz D, Grossfield J, Cao SN, Kielty C, Covitz W, Jewett T . A mutation in FBN1 disrupts profibrillin processing and results in isolated skeletal features of the Marfan syndrome J Clin Invest 1995 95: 2373–2378
Sood S, Eldadah Z, Krause W, McIntosh I, Dietz H . Mutation in fibrillin-1 and the Marfanoid-craniosynostosis (Shprintzen-Goldberg) syndrome Nature Genetics 1996 12: 209–211
Milewicz D, Michael K, Fisher N, Coselli J, Markello T, Biddinger A . Fibrillin-1 (FBN1) mutations in patients with thoracic aortic aneurysms Circulation 1996 94: 2708–2711
Collod G, Béroud C, Soussi T, Junien C, Boileau C . Software and database for the analysis of mutations in the human FBN1 gene Nucl Acids Res 1996 24: 137–140
Collod-Béroud G, Béroud C, Adès L et al. Marfan database (second edition): Software and database for the analysis of mutations in the human FBN1 gene Nucl Acids Res 1997 25: 147–150
Beroud C, Collod-Beroud G, Boileau C, Soussi T, Junien C . UMD (Universal mutation database): A generic software to build and analyze locus-specific databases Hum Mutat 2000 15: 86–94
Dietz HC, Pyeritz RE, Puffenberger EG et al. Marfan phenotype variability in a family segregating a missense mutation in the epidermal growth factor-like motif of the fibrillin gene J Clin Invest 1992 89: 1674–1680
Buntinx I, Willems P, Spitaels S, VanReempst P, DePaepe A, Dumon J . Neonatal Marfan syndrome with congenital arachnodactyly, flexion contractures, and severe cardiac valve insufficiency J Med Genet 1991 28: 267–273
Godfrey M, Raghunath M, Cisler J et al. Abnormal morphology of fibrillin microfibrils in fibroblast cultures from patients with neonatal Marfan syndrome Am J Pathol 1995 146: 1414–1421
Putnam E, Cho M, Zinn A, Towbin J, Byers P, Milewicz D . Delineation of the Marfan phenotype associated with mutations in exons 23-32 of the FBN1 gene Am J Med Genet 1996 62: 233–242
Karttunen L, Raghunath M, Lonnqvist L, Peltonen L . A compound heterozygous Marfan patient: Two defective fibrillin alleles result in a lethal phenotype Am J Hum Genet 1994 55: 1083–1091
Knott V, Downing A, Cardy C, Handford P . Calcium binding properties of an epidermal growth factor-like domain pair from human fibrillin-1 J Mol Biol 1996 255: 22–27
Boileau C, Jondeau G, Babron MC et al. Familial Marfan-like aortic dilatation and skeletal anomalies are not linked to the fibrillin genes Am J Hum Genet 1993 53: 46–57
Collod G, Babron MC, Jondeau G et al. A second locus for Marfan syndrome maps to chromosome 3p24.2-p25 Nature Genetics 1994 8: 264–268
Collod G, Chu ML, Sasaki T et al. Fibuline-2: Genetic mapping and exclusion as a candidate in Marfan syndrome type 2 Eur J Hum Genet 1996 4: 292–295
McGookey-Milewicz D, Pyeritz R, Crawford ES, Byers P . Marfan syndrome: Defective synthesis, secretion, and extracellular matrix formation of fibrillin by cultured dermal fibroblasts J Clin Invest 1992 89: 79–86
Aoyama T, Francke U, Dietz H, Furthmayer H . Quantitative differences in biosynthesis and extracellular deposition of fibrillin in cultured fibroblasts distinguish five groups of Marfan syndrome patients and suggest distinct pathogenic mechanisms J Clin Invest 1994 94: 130–137
Besser TE, Potter KA, Bryan GM, Knowlen GG . An animal model of the Marfan syndrome Am J Med Genet 1990 37: 159–165
Potter KA, Hoffman Y, Sakai LY, Byers PH, Besser TE, Milewicz DM . Abnormal fibrillin metabolism in bovine Marfan syndrome Am J Pathol 1993 142: 803–810
Kielty CM, Raghunath M, Siracusa L et al. The tight skin mouse: demonstration of mutant fibrillin-1 production and assembly into abnormal microfibrils J Cell Biol 1998 140: 1159–1166
Pereira L, Andrikopoulos K, Tian J et al. Targetting of the gene encoding fibrillin-1 recapitulates the vascular aspect of Marfan syndrome Nature Genetics 1997 17: 218–222
Pereira L, Lee SY, Gayraud B et al. Pathogenetic sequence for aneurysm revealed in mice underexpressing fibrillin-1 Proc Natl Acad Sci USA 1999 96: 3819–3823
Jaubert J, Jaubert F, Martin N et al. Three new allelic mouse mutations that cause skeletal overgrowth involve the natriuretic peptide receptor C gene (Npr3) Proc Natl Acad Sci USA 1999 96: 10278–10283
Pereira L, Levran O, Ramirez F et al. A molecular approach to the stratification of cardiovascular risk in families with Marfan's syndrome N Eng J Med 1994 331: 148–153
Godfrey M, Vandemark N, Wang M et al. Prenatal diagnosis and a donor splice site mutation in fibrillin in a family with Marfan syndrome Am J Hum Genet 1993 53: 472–480
Rantamäki T, Raghunath M, Karttunen L, Lönnqvist L, Child A, Peltonen L . Prenatal diagnosis of Marfan syndrome: Identification of a fibrillin-1 mutation in chorionic villus sample Prenat Diag 1995 15: 1176–1181
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Collod-Béroud, G., Boileau, C. Marfan syndrome in the third Millennium. Eur J Hum Genet 10, 673–681 (2002). https://doi.org/10.1038/sj.ejhg.5200876
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DOI: https://doi.org/10.1038/sj.ejhg.5200876
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