COL4A1 and microangiopathy and leukoencephalopathy, pontine, autosomal dominant: Third, this insertion was associated with a strong upregulation of COL4A1 mRNA and protein levels, reminiscent of pontine autosomal dominant microangiopathy arteriopathy with leukoencephalopathy (PADMAL), another severe CSVD caused by a sequence variation in a COL4A1 microRNA binding site (miR29).9,16,17