Vascular anomalies in Alagille syndrome.

To the Editor: We read with interest the article by Kamath et al1 about vascular anomalies in Alagille syndrome (AGS). We know that hypotheses are not anyone’s property, but it is unfair to omit two previously published papers from our team. Indeed, we suggested after studying JAGGED1 expression during human embryogenesis that abnormal angiogenesis was implicated in the pathogenesis of AGS and particularly the paucity of interlobular bile duct.2 Furthermore, we recently suggested that defects of Notch signaling pathway may impair both angiogenesis and hemostasis in AGS patients and that arterial endothelial cells, which mainly express JAGGED1, play a pivotal role.3