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Highly prevalent NF-kappa B signaling pathway-activating somatic mutations in intracranial aneurysms

Intracranial aneurysms (IAs) are a high-risk factor for life-threatening subarachnoid hemorrhage. Their etiology, however, remains mostly unknown. We conducted screening for somatic mutations in 65 IA tissues and identified 16 genes that were mutated with a high prevalence (92%). In particular, six genes, including PDGFRB, were mutated commonly in fusiform and saccular IAs and are linked to the NF-kappa B signaling pathway. Mutant PDGFRBs constitutively activate NF-kappa B signaling and induce inflammation-related gene expression in vitro. Spatial transcriptomics also detected similar changes in IA tissues. Virus-mediated expression of a mutant PDGFRB induces a fusiform-like dilatation of the basilar artery in mice. This study reveals a high prevalence of somatic mutations in NF-kappa B signaling genes in IAs and opens a new avenue of research toward development of its pharmacological interventions.