Endothelial TGF-β signaling instructs smooth muscle development in the cardiac outflow tract

The development of the cardiac outflow tract (OFT), which connects the heart to the great arteries, relies on a complex crosstalk between endothelial (ECs) and smooth muscle (SMCs) cells. Defects in OFT development can lead to severe malformations, including aortic aneurysms, which have often been associated with impaired TGF-{beta} signaling. To further investigate the role of TGF-{beta} signaling in OFT formation, we generated zebrafish lacking the type I TGF-{beta} receptor Alk5 and found a strikingly specific dilation of the OFT. alk5 mutants also exhibit increased EC numbers, extracellular matrix (ECM) and SMC disorganization. Surprisingly, endothelial-specific alk5 overexpression in alk5 mutants rescues both endothelial and SMC defects. Furthermore, modulation of the ECM gene fibulin-5, a TGF-{beta} target, partially restores OFT morphology and function. These findings reveal a new requirement for endothelial TGF-{beta} signaling in OFT morphogenesis and suggest an important role for the endothelium in the etiology of aortic malformations.