Novel COL4A1 mutations cause cerebral small vessel disease by haploinsufficiency

R. Lemmens, A. Maugeri, H.W.M. Niessen, A. Goris, T. Tousseyn, P. Demaerel, A. Corveleyn, W. Robberecht, M.S. van der Knaap, V.N. Thijs, P.J.G. Zwijnenburg

Research output: Contribution to journalArticleAcademicpeer-review

48 Citations (Scopus)


Mutations in COL4A1 have been identified in families with hereditary small vessel disease of the brain presumably due to a dominant-negative mechanism. Here, we report on two novel mutations in COL4A1 in two families with porencephaly, intracerebral hemorrhage and severe white matter disease caused by haploinsufficiency. Two families with various clinical presentations of cerebral microangiopathy and autosomal dominant inheritance were examined. Clinical, neuroradiological and genetic investigations were performed. Electron microscopy of the skin was also performed. In one of the families, sequence analysis revealed a one base deletion, c.2085del, leading to a frameshift and a premature stopcodon, p.(Gly696fs). In the other family, a splice site mutation was identified, c.2194-1G>A, which most likely leads to skipping of an exon with a frameshift and premature termination as a result. In fibroblasts of affected individuals from both the families, nonsense-mediated decay (NMD) of the mutant COL4A1 messenger RNAs (mRNAs) and a clear reduction of COL4A1 protein expression were demonstrated, indicating haploinsufficiency of COL4A1. Moreover, thickening of the capillary basement membrane in the skin was documented, similar to reports in patients with COL4A1 missense mutations. These findings suggest haploinsufficiency, a different mechanism from the commonly assumed dominant-negative effect, for COL4A1 mutations as a cause of (antenatal) intracerebral hemorrhage and white matter disease. © The Author 2012. Published by Oxford University Press. All rights reserved.
Original languageEnglish
Pages (from-to)391-397
Number of pages7
JournalHuman Molecular Genetics
Issue number2
Publication statusPublished - 15 Jan 2013


  • Adult
  • Aged
  • Base Sequence
  • Basement Membrane
  • Brain
  • Case Reports
  • Cerebral Small Vessel Diseases
  • Collagen Type IV
  • Female
  • Fibroblasts
  • Haploinsufficiency
  • Humans
  • Journal Article
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Mutation
  • Pedigree
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Young Adult

Cite this