PIK3CA-related overgrowth spectrum (PROS) zebrafish models reveal pan-lineage developmental dysregulation

Patchy, or mosaic, activating mutations in <i>PIK3CA</i> cause asymmetric human overgrowth due to aberrant hyperactivation of phosphoinositide 3-kinase (PI3K) signaling. Overgrowth prominently affects blood vessels and may be severely debilitating. While causation by <i>PIK3CA</i> mutations is clear, the explanation for the extent and pattern of associated overgrowth is not. Leveraging the power of zebrafish models for observation of early development, we now provide evidence for widely pervasive developmental effects of PIK3CA mutations extending beyond transcriptionally and phenotypically affected cells and lineages. This suggests potential therapeutic value of targeting secondary effects of PIK3CA activation as well as the activated PI3K itself.