# Developmental Mechanisms of Human Idiopathic Scoliosis

> **NIH NIH P01** · UT SOUTHWESTERN MEDICAL CENTER · 2022 · $1,427,879

## Abstract

Project Summary/Abstract (Overall)
Adolescent idiopathic scoliosis (AIS) is a twisting condition of the spine and is the most common pediatric
musculoskeletal disorder, affecting 3% of children worldwide. Children with AIS risk severe disfigurement, back
pain, and physiologic dysfunction later in life. Girls requiring treatment for AIS outnumber boys by more than
five-fold, for reasons that are unknown. Hospital charges for AIS surpass one billion dollars annually in the U.S.
and are rising significantly faster than for other pediatric procedures. AIS is treated symptomatically rather than
preventively because the underlying etiology has been poorly understood. Genetic contributions to AIS are
significant, but few human susceptibility loci were identified prior to the beginning of this Program. The
mechanisms driven by these loci were likewise largely unknown, as they mapped within non-coding genomic
regions that were not easily interpreted. The AIS field also lacked appropriate animal models that enable
mechanistic and therapeutic studies. To address these issues, we established an innovative collaborative
approach combining three Projects to lead unbiased gene discovery in humans, modeling and gene discovery
in zebrafish, and genomic analysis of postnatal spine development. Our program addressed six gaps in
knowledge: (i) identity of the tissue and cellular origins of AIS; (ii) defining the true beginning of AIS disease
pathogenesis; (iii) defining the genetic factors and genetic interactions underlying AIS; (iv) developing robust
vertebrate systems to functionally validate, interpret, and model human genetic findings; (v) defining the
molecular mechanisms controlling spinal development post-somitogenesis, and the correlation with AIS; (vi)
defining the basis of sexual dimorphism in AIS. In the prior award cycle our Program significantly advanced
each of these initiatives. Integrating data in humans and animal models, our data underscored cartilage as a
functional tissue in AIS and specifically highlighted the extracellular matrix compartment, new paradigms in the
field. Our Program discovered several new AIS genetic susceptibility loci in human and developed 73 new zebrafish
models of spine deformity. Data from each Project also converged on the hypomorphic nature of AIS disease alleles,
supporting multigenic inheritance. We defined the non-coding regulatory landscape of human and mouse AIS-related
tissues, and discovered that knockout of one such regulator linked to female AIS in humans produces a female-biased
phenotype in mouse. Here we propose a comprehensive plan to drive these discoveries forward to define AIS disease
mechanisms using genetically targeted mouse and zebrafish models, to define cell-specific transcriptional, epigenetic, and
signaling mechanisms underlying AIS, to continue identifying vertebrate models of spine deformity by forward genetic
screens in mouse and zebrafish, and to discover new high-risk alleles contributing to...

## Key facts

- **NIH application ID:** 10458398
- **Project number:** 2P01HD084387-06A1
- **Recipient organization:** UT SOUTHWESTERN MEDICAL CENTER
- **Principal Investigator:** Nadav Ahituv
- **Activity code:** P01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $1,427,879
- **Award type:** 2
- **Project period:** 2016-09-01 → 2027-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10458398

## Citation

> US National Institutes of Health, RePORTER application 10458398, Developmental Mechanisms of Human Idiopathic Scoliosis (2P01HD084387-06A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10458398. Licensed CC0.

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