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Karaoglan M, Nacarkahya G, Aytac EH, Keskin M. Genotype and clinical phenotype of children with Marfan syndrome in Southeastern Anatolia. Eur J Pediatr 2024; 183:3219-3232. [PMID: 38700693 PMCID: PMC11263224 DOI: 10.1007/s00431-024-05579-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 03/19/2024] [Accepted: 04/19/2024] [Indexed: 07/23/2024]
Abstract
The cardinal phenotypic hallmarks of Marfan syndrome (MFS) include cardiac, ocular, and skeletal abnormalities. Since the clinical phenotype of MFS is highly heterogeneous, with certain symptoms appearing as children age, the diagnostic process and establishing a genotype-phenotype association in childhood MFS can be challenging. The lack of sufficient childhood studies also makes it difficult to interpret the subject. This study aims to evaluate the relationship between clinical symptoms used as diagnostic criteria and FBN1 variations in children with MFS. This study investigated the relationships between genotypes and phenotypes in 131 children suspected of having Marfan syndrome (MFS). Diagnosis of MFS was made according to the revised Ghent nosology. FBN1 variants were categorized based on exon regions, type of variant, and pathogenicity classes. These FBN1 variants were then correlated with the clinical manifestations including cardiovascular, ocular, facial, and skeletal abnormalities. Out of the children, 43 were diagnosed with MFS. FBN1 variant was identified in 32 (74.4%) of the MFS children. MFS diagnosis could not be made in five (15.6%) FBN1 variant-positive children. The most common cardinal finding is cardiac anomalies n = 38 (88.3%). The most common FBN1 pathogenic variant was c.1786 T > C/p.Cys596Arg n = 4 (12.5%). The distribution of pathogenic variants was as follows: 29 (90.6%) missense, 2 (6.3%) frameshift, and 1 (3.1%) nonsense. The numbers of AD and EL of the variant-positive children were 16 (50%) and 14 (43.7%), respectively. Ocular abnormalities were more common in children with FBN1-positive MFS (p = 0.009). There was no difference in the number of cardiac abnormalities between FBN1-positive and FBN1-negative MFS patients (p = 0.139). Conclusion: This study examines the relationship between FBN1 variants and clinical features used as diagnostic criteria in MFS children. The findings emphasize the importance of long-term monitoring of heterogeneous clinical phenotypes and bioinformatic reanalysis in determining the genotype-phenotype relationship in children, as MFS symptoms can vary with age. What is Known: • Marfan syndrome has highly variable phenotypic heterogeneity. • The genotype-phenotype relationship in childhood Marfan syndrome is not clear enough due to the variation in the time of onset of the findings. What is New: • This article provides regional data for the field of research on genotype-phenotype relationships in childhood Marfan syndrome. • Long-term follow-up of clinical findings and bioinformatics reanalysis is an important requirement for a well-established genotype-phenotype relationship in childhood Marfan syndrome.
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Affiliation(s)
- Murat Karaoglan
- Faculty of Medicine, Department of Pediatric Endocrinology, Gaziantep University, Gaziantep, Turkey.
| | - Gulper Nacarkahya
- Department of Molecular Biology, Gaziantep University Faculty of Medicine, Gaziantep, Turkey
| | - Emel Hatun Aytac
- Faculty of Medicine, Department of Pediatric Endocrinology, Gaziantep University, Gaziantep, Turkey
| | - Mehmet Keskin
- Faculty of Medicine, Department of Pediatric Endocrinology, Gaziantep University, Gaziantep, Turkey
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Li D, Qiao J, Huang D, Guo R, Ji J, Liu W. Novel and recurrent FBN1 mutations causing Marfan syndrome in two Chinese families. Front Med (Lausanne) 2022; 9:1086844. [PMID: 36582279 PMCID: PMC9792469 DOI: 10.3389/fmed.2022.1086844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Background To explore the genetic defects of two families with autosomal dominant Marfan syndrome (MFS). Methods Two families with MFS were enrolled in this study. The detailed ocular presentations of the patients were recorded. Whole exome sequencing was performed to explore the pathogenic variants and Sanger sequencing was performed to confirm the gene mutations. Segregation analysis among the family members was made and bioinformatics analysis was performed to predict the functional impact of the mutations. Results The main ocular presentations of the probands were increased axial length and ectopia lentis. Using whole exome sequencing and Sanger sequencing, a novel heterozygous missense mutation (c.5060G > C, p.Cys1687Ser) and a recurrent missense mutation (c.2168A > T, p.Asp723Val) were identified within FBN1, which were co-segregated with the MFS phenotype in the families. Evolutionary conservation analysis showed that codons 723 and 1,687 were highly conserved among several species. Functional impact predictions made using several online programs suggested that the mutations were pathogenic. Conclusion We identified a novel and a recurrent missense mutation in FBN1 in two Chinese families with MFS using whole exome sequencing, and our bioinformatics analysis indicated that the mutations were disease-causing. Our results expand the mutation spectrum of FBN1 and could help us better understand the genetic defects of the patients with MFS.
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Affiliation(s)
- Dandan Li
- Department of Ophthalmology, Tianjin TEDA Hospital, Tianjin, China
| | - Jun Qiao
- Department of Ophthalmology, Lanzhou Huaxia Eye Hospital, Lanzhou, Gansu, China
| | - Dandan Huang
- Department of Ophthalmology, Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Ruru Guo
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Jian Ji
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China
| | - Wei Liu
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, China,*Correspondence: Wei Liu,
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LTBP1 promotes fibrillin incorporation into the extracellular matrix. Matrix Biol 2022; 110:60-75. [PMID: 35452817 DOI: 10.1016/j.matbio.2022.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 04/12/2022] [Accepted: 04/16/2022] [Indexed: 12/23/2022]
Abstract
LTBP1 is a large extracellular matrix protein and an associated ligand of fibrillin-microfibrils. Knowledge of LTBP1 functions is largely limited to its role in targeting and sequestering TGFβ growth factors within the extracellular matrix, thereby regulating their bioavailability. However, the recent description of a wide spectrum of phenotypes in multiple tissues in patients harboring LTBP1 pathogenic variants suggests a multifaceted role of the protein in the homeostasis of connective tissues. To better understand the human pathology caused by LTBP1 deficiency it is important to investigate its functional role in extracellular matrix formation. In this study, we show that LTBP1 coordinates the incorporation of fibrillin-1 and -2 into the extracellular matrix in vitro. We also demonstrate that this function is differentially exerted by the two isoforms, the short and long forms of LTBP1. Thereby our findings uncover a novel TGFβ-independent LTBP1 function potentially contributing to the development of connective tissue disorders.
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Zhou Y, Guo D, Cao Q, Zhang X, Jin G, Zheng D. Genotype variant screening and phenotypic analysis of FBN1 in Chinese patients with isolated ectopia lentis. Mol Med Rep 2021; 23:275. [PMID: 33576469 PMCID: PMC7893787 DOI: 10.3892/mmr.2021.11914] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 01/05/2021] [Indexed: 01/28/2023] Open
Abstract
Isolated ectopia lentis (IEL) can lead to blindness as result of severe complications, such as retinal detachment and secondary glaucoma. Pathogenic variants in the fibrillin 1 (FBN1) gene are a common cause of IEL. The aim of the present study was to investigate the frequency of pathogenic FBN1 variants in twelve probands with IEL and to evaluate their associated phenotypes. Systemic clinical examination of the twelve probands indicated that all had bilateral EL with a median age at diagnosis of three years. High myopia was the most common feature among the probands (83.3%; 10/12 cases). No extraocular symptoms (either cardiovascular or skeletal) were observed among these patients. Genomic DNA was extracted from peripheral blood leukocytes from all patients for targeted exome sequencing. Seven heterozygous missense variants in FBN1 were identified by bioinformatics analysis and further verified using Sanger sequencing. The seven variants were all classified as pathogenic after segregation analysis on available family members according to the American College of Medical Genetics and Genomics standards and guidelines. Of the seven variants, three were novel, namely c.2179T>C, c.2496T>G and c.3346G>C. The remaining four, namely c.184C>T, c.367T>C, c.1879C>T and c.4096G>A have been reported in previous studies. The seven pathogenic variants were identified in 8/12 (66.7%) probands with IEL. These results expand the variant spectrum of the FBN1 gene as well as the understanding of the molecular pathogenesis of IEL.
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Affiliation(s)
- Yijing Zhou
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‑sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Dongwei Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‑sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Qianzhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‑sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Xinyu Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‑sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Guangming Jin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‑sen University, Guangzhou, Guangdong 510060, P.R. China
| | - Danying Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat‑sen University, Guangzhou, Guangdong 510060, P.R. China
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Detection of ten novel FBN1 mutations in Chinese patients with typical or incomplete Marfan syndrome and an overview of the genotype-phenotype correlations. Int J Cardiol 2019; 293:186-191. [PMID: 31279664 DOI: 10.1016/j.ijcard.2019.06.066] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2019] [Revised: 06/09/2019] [Accepted: 06/24/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of this study is to identify the mutation spectrum of FBN1 in patients with Marfan syndrome (MFS) or Marfan-Like Phenotypes and to analyze the genotype-phenotype correlations of existing literature. METHODS AND RESULTS A total of 21 unrelated patients with a definite or suspected clinical diagnosis of MFS were recruited for research. Eleven FBN1 mutations were identified in 12 patients who strictly fulfilled the Ghent criteria for MFS, and 1 FBN1 mutations were detected in 9 patients with suspected MFS by screening the mutations of FBN1. These FBN1 mutations include 10 novel mutations (c.357 C>A, c.493 C>T, c.1374 T>A, c.4143 delG, c. 6987 C>G, c.7238 G>A, c. 7765 A>G, c.8200 A>G, c. 8431 G>A, c.8547 T>G,) and 2 previously reported mutations (c.4567 C>T, c.4615 C>T). By searching PubMed and Embase (from 1990 up to December 2018), twenty nine studies (including the present study) with 890 subjects with MFS or Marfan-like phenotypes were included to analyze the genotype-phenotype correlations. Several genotype-phenotype correlations were founded. Firstly, mutations of premature termination codons (PTC) were associated with an increased risk of major cardiovascular involvements. Secondly, the frequency of patients with major cardiovascular involvement in exons 43-65 group was as high as that in exons 24-32 group (71.4% vs. 77.0%; p = 0.238). Finally, cysteine missense mutations might be associated with major cardiovascular involvements. CONCLUSIONS These results extended the FBN1 mutation spectrum of this rare disease and revealed the genotype-phenotype correlations in MFS by analyzing existing literature.
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Cao Y, Tan H, Li Z, Linpeng S, Long X, Liang D, Wu L. Three Novel Mutations in FBN1 and TGFBR2 in Patients with the Syndromic Form of Thoracic Aortic Aneurysms and Dissections. Int Heart J 2018; 59:1059-1068. [DOI: 10.1536/ihj.18-046] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Yingxi Cao
- Center for Medical Genetics, School of Life Sciences, Central South University
| | - Hu Tan
- Center for Medical Genetics, School of Life Sciences, Central South University
| | - Zhuo Li
- Center for Medical Genetics, School of Life Sciences, Central South University
| | - Siyuan Linpeng
- Center for Medical Genetics, School of Life Sciences, Central South University
| | - Xigui Long
- Center for Medical Genetics, School of Life Sciences, Central South University
| | - Desheng Liang
- Center for Medical Genetics, School of Life Sciences, Central South University
| | - Lingqian Wu
- Center for Medical Genetics, School of Life Sciences, Central South University
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7
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Zhang M, Zhou Y, Peng Y, Jin L. Two rare missense mutations in the fibrillin‑1 gene associated with atypical cardiovascular manifestations in a Chinese patient affected by Marfan syndrome. Mol Med Rep 2018; 18:877-881. [PMID: 29845260 PMCID: PMC6059719 DOI: 10.3892/mmr.2018.9041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 03/21/2017] [Indexed: 12/03/2022] Open
Abstract
The present report aimed to evaluate the results of screen mutations of the fibrillin (FBN) 1 gene and analyze the symptoms in one Chinese patient clinically diagnosed with Marfan syndrome (MFS). Clinical data were collected and FBN1 gene sequencing was performed. Genomic DNA was extracted from the blood sample of the patient. All 65 exons were screened using a polymerase chain reaction assay. The diagnosis of MFS was confirmed via identification of symptoms presenting in the skeletal system (arachnodactyly, walker wrist and thumb signs) and the ocular system (ectopia lentis), in addition to a positive family history. The patient's cardiovascular manifestations (dilatation of the four cardiac chambers, severe mitral valve regurgitation and a large saccular aneurysm of the non-coronary sinus of Valsalva) were atypical to those that most frequently occur in cases of MFS. Following gene sequencing, two novel heterozygous mutations of the FBN-1 gene were identified: c.3442C>G in exon 27, proline replaced with alanine (p. Pro1148Ala) and c.6388G>A in exon 52, glutamic acid replaced with lysine (p. Glu2130Lys). The clinical symptoms and family history were important in the diagnosis of MFS, however the atypical signs that presented in the cardiovascular system may be associated with the disease, and may be noted for further cases in the future. Gene sequencing further verified the correct diagnosis of MFS.
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Affiliation(s)
- Miao Zhang
- Department of Cardiology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, P.R. China
| | - Yaqi Zhou
- Department of Cardiology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, P.R. China
| | - Yang Peng
- Department of Cardiology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, P.R. China
| | - Lijun Jin
- Department of Cardiology, The First Affiliated Hospital of Yangtze University, Jingzhou, Hubei 434000, P.R. China
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8
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Mohammad AN, Atwal PS. A 2-Year-Old Child with Bilateral Ectopis Lentis and a Novel FBN1 Gene Variant Cys129Ser. J Pediatr Genet 2018; 7:83-85. [PMID: 29707410 DOI: 10.1055/s-0037-1612592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 11/13/2017] [Indexed: 01/16/2023]
Abstract
Marfan syndrome and dominant ectopia lentis are part of type 1 fibrillinopathies that are caused by FBN1 pathogenic variants. Making a diagnosis could be challenging due to the clinical overlap between these disorders. The revised Ghent criteria used for Marfan syndrome diagnosis helped in resolving some of the confusion, especially in younger children. We report on a case of bilateral ectopia lentis in a 2-year-old child with a normal echocardiogram. FBN1 sequencing revealed a novel likely pathogenic variant described as c.385T > A (p.Cys129Ser). The patient's father also has a history of bilateral ectopia lentis and his genetic analysis detected the same FBN1 variant as the proband.
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Affiliation(s)
- Ahmed N Mohammad
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, Florida, United States.,Center for Individualized Medicine, Mayo Clinic, Jacksonville, Florida, United States
| | - Paldeep S Atwal
- Department of Clinical Genomics, Mayo Clinic, Jacksonville, Florida, United States.,Center for Individualized Medicine, Mayo Clinic, Jacksonville, Florida, United States
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9
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Casanova EL, Sharp JL, Edelson SM, Kelly DP, Casanova MF. A Cohort Study Comparing Women with Autism Spectrum Disorder with and without Generalized Joint Hypermobility. Behav Sci (Basel) 2018; 8:bs8030035. [PMID: 29562607 PMCID: PMC5867488 DOI: 10.3390/bs8030035] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 02/26/2018] [Accepted: 03/15/2018] [Indexed: 01/22/2023] Open
Abstract
Reports suggest comorbidity between autism spectrum disorder (ASD) and the connective tissue disorder, Ehlers-Danlos syndrome (EDS). People with EDS and the broader spectrum of Generalized Joint Hypermobility (GJH) often present with immune- and endocrine-mediated conditions. Meanwhile, immune/endocrine dysregulation is a popular theme in autism research. We surveyed a group of ASD women with/without GJH to determine differences in immune/endocrine exophenotypes. ASD women 25 years or older were invited to participate in an online survey. Respondents completed a questionnaire concerning diagnoses, immune/endocrine symptom history, experiences with pain, and seizure history. ASD women with GJH (ASD/GJH) reported more immune- and endocrine-mediated conditions than their non-GJH counterparts (p = 0.001). Autoimmune conditions were especially prominent in the ASD/GJH group (p = 0.027). Presence of immune-mediated symptoms often co-occurred with one another (p < 0.001–0.020), as did endocrine-mediated symptoms (p < 0.001–0.045), irrespective of the group. Finally, the numbers of immune- and endocrine-mediated symptoms shared a strong inter-relationship (p < 0.001), suggesting potential system crosstalk. While our results cannot estimate comorbidity, they reinforce concepts of an etiological relationship between ASD and GJH. Meanwhile, women with ASD/GJH have complex immune/endocrine exophenotypes compared to their non-GJH counterparts. Further, we discuss how connective tissue regulates the immune system and how the immune/endocrine systems in turn may modulate collagen synthesis, potentially leading to higher rates of GJH in this subpopulation.
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Affiliation(s)
- Emily L Casanova
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA.
- Department of Pediatrics, Greenville Health System Children's Hospital, Greenville, SC 29605, USA.
| | - Julia L Sharp
- Department of Statistics, Colorado State University, Fort Collins, CO 80523, USA.
| | | | - Desmond P Kelly
- Department of Pediatrics, Greenville Health System Children's Hospital, Greenville, SC 29605, USA.
| | - Manuel F Casanova
- Department of Biomedical Sciences, University of South Carolina School of Medicine Greenville, Greenville, SC 29605, USA.
- Department of Pediatrics, Greenville Health System Children's Hospital, Greenville, SC 29605, USA.
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10
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Identification of Novel Clinically Relevant Variants in 70 Southern Chinese patients with Thoracic Aortic Aneurysm and Dissection by Next-generation Sequencing. Sci Rep 2017; 7:10035. [PMID: 28855619 PMCID: PMC5577253 DOI: 10.1038/s41598-017-09785-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 07/28/2017] [Indexed: 12/31/2022] Open
Abstract
Thoracic Aortic Aneurysm and Dissection (TAAD) is a life-threatening pathology and remains challenging worldwide. Up to 40% of TAAD are hereditary with complex heterogeneous genetic backgrounds. Recently, next-generation sequencing (NGS) has been successfully applied to identify genetic variants in an efficient and cost-effective manner. In our study, NGS coupled with DNA target-capture array was used to screen 11 known causative genes of TAAD in 70 patients from Southern China. All the identified variants were confirmed by Sanger sequencing. We identified forty variants in 36 patients (51.4%), including three known pathogenic (7.5%), 10 likely pathogenic variants (25%, 9 in FBN1, 1 in ACTA2), and 27 variants with uncertain significance (VUS) (67.5%). Among the 27 VUS, 14 (51.9%) were in the FBN1 gene, 3 in Col5A2, 2 in ACTA2, 2 in MYH11, 2 in MYLK, 2 in SLC2A10, 1 in MSTN and 1 in SMAD3 respectively. Based on the segregation data and independent reports, five known likely pathogenic variants and four VUS were upgraded to pathogenic variant and likely pathogenic variant respectively. Our data indicate that NGS is a highly efficient genetic method for identification of pathogenic variants in TAAD patients.
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Franken R, Heesterbeek TJ, de Waard V, Zwinderman AH, Pals G, Mulder BJM, Groenink M. Diagnosis and genetics of Marfan syndrome. Expert Opin Orphan Drugs 2014. [DOI: 10.1517/21678707.2014.950223] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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12
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Pees C, Michel-Behnke I, Hagl M, Laccone F. Detection of 15 novel mutations in 52 children from 40 families with the Marfan or Loeys-Dietz syndrome and phenotype-genotype correlations. Clin Genet 2013; 86:552-7. [DOI: 10.1111/cge.12314] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Revised: 10/31/2013] [Accepted: 11/04/2013] [Indexed: 11/30/2022]
Affiliation(s)
- C. Pees
- Pediatric Marfan Syndrome Outpatient Clinic; Medical University Vienna; Vienna Austria
- Department of Pediatric Cardiology, Pediatric Heart Center Vienna; University Children's Hospital; Vienna Austria
| | - I. Michel-Behnke
- Pediatric Marfan Syndrome Outpatient Clinic; Medical University Vienna; Vienna Austria
- Department of Pediatric Cardiology, Pediatric Heart Center Vienna; University Children's Hospital; Vienna Austria
| | - M. Hagl
- Pediatric Marfan Syndrome Outpatient Clinic; Medical University Vienna; Vienna Austria
- Institute for Medical Genetics; Medical University Vienna; Vienna Austria
| | - F. Laccone
- Pediatric Marfan Syndrome Outpatient Clinic; Medical University Vienna; Vienna Austria
- Institute for Medical Genetics; Medical University Vienna; Vienna Austria
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Yadin D, Robertson I, McNaught-Davis J, Evans P, Stoddart D, Handford P, Jensen S, Redfield C. Structure of the fibrillin-1 N-terminal domains suggests that heparan sulfate regulates the early stages of microfibril assembly. Structure 2013; 21:1743-56. [PMID: 24035709 PMCID: PMC3794157 DOI: 10.1016/j.str.2013.08.004] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2013] [Revised: 07/23/2013] [Accepted: 08/05/2013] [Indexed: 11/29/2022]
Abstract
The human extracellular matrix glycoprotein fibrillin-1 is the primary component of the 10- to 12-nm-diameter microfibrils, which perform key structural and regulatory roles in connective tissues. Relatively little is known about the molecular mechanisms of fibrillin assembly into microfibrils. Studies using recombinant fibrillin fragments indicate that an interaction between the N- and C-terminal regions drives head-to-tail assembly. Here, we present the structure of a fibrillin N-terminal fragment comprising the fibrillin unique N-terminal (FUN) and the first three epidermal growth factor (EGF)-like domains (FUN-EGF3). Two rod-like domain pairs are separated by a short, flexible linker between the EGF1 and EGF2 domains. We also show that the binding site for the C-terminal region spans multiple domains and overlaps with a heparin interaction site. These data suggest that heparan sulfate may sequester fibrillin at the cell surface via FUN-EGF3 prior to aggregation of the C terminus, thereby regulating microfibril assembly.
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Affiliation(s)
- David A. Yadin
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
| | - Ian B. Robertson
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
| | - Joanne McNaught-Davis
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
| | - Paul Evans
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
| | - David Stoddart
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
| | - Penny A. Handford
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
| | - Sacha A. Jensen
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
| | - Christina Redfield
- Department of Biochemistry, University of Oxford, South Parks Road, Oxford OX1 3QU, UK
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Abstract
The field of aortopathy, in common with other genomic disorders, is undergoing a revolution. This is largely driven by the implementation of newer forms of genetic sequencing (massively parallel or next-generation sequencing). Advantages conferred by this technology include reduced costs, reduced sequencing time and the ability to simultaneously test multiple genes. This has a significant advantage in the identification of genes disrupted in heritable aortopathies. These advances are enabling scientists and clinicians to identify key molecular pathways; translating fundamental genetic findings into a better understanding of disease mechanisms is ultimately leading to effective treatments. In outlining contemporary knowledge of genetic biomarkers in aortopathy we seek to demonstrate that the era of genomically orientated decision-making is here.
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Affiliation(s)
- Gillian Rea
- NIHR Biomedical Research Unit in Cardiovascular Disease, Royal Brompton & Harefield NHS Foundation Trust & Imperial College London, BRU Cardiovascular Genetics Office, Royal Brompton Hospital, Sydney Street, London, SW3 6NP, UK
- Northern Ireland Regional Genetics Service, Level A, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, UK
| | - Fiona J Stewart
- Northern Ireland Regional Genetics Service, Level A, Belfast City Hospital, Lisburn Road, Belfast, BT9 7AB, UK
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15
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Franken R, den Hartog AW, van de Riet L, Timmermans J, Scholte AJ, van den Berg MP, de Waard V, Zwinderman AH, Groenink M, Yip JW, Mulder BJ. Clinical Features Differ Substantially Between Caucasian and Asian Populations of Marfan Syndrome. Circ J 2013; 77:2793-8. [DOI: 10.1253/circj.cj-13-0584] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Romy Franken
- Department of Cardiology, Academic Medical Center
- Interuniversity Cardiology Institute of the Netherlands
| | - Alexander W. den Hartog
- Department of Cardiology, Academic Medical Center
- Interuniversity Cardiology Institute of the Netherlands
| | | | | | | | | | | | | | - Maarten Groenink
- Department of Cardiology, Academic Medical Center
- Department of Radiology, Academic Medical Center
- Interuniversity Cardiology Institute of the Netherlands
| | - James W. Yip
- Department of Cardiology, National University Hospital
| | - Barbara J.M. Mulder
- Department of Cardiology, Academic Medical Center
- Interuniversity Cardiology Institute of the Netherlands
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Colovati ME, da Silva LR, Takeno SS, Mancini TI, N Dutra AR, Guilherme RS, de Mello CB, Melaragno MI, A Perez AB. Marfan syndrome with a complex chromosomal rearrangement including deletion of the FBN1 gene. Mol Cytogenet 2012; 5:5. [PMID: 22260333 PMCID: PMC3339390 DOI: 10.1186/1755-8166-5-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2011] [Accepted: 01/19/2012] [Indexed: 11/10/2022] Open
Abstract
Background The majority of Marfan syndrome (MFS) cases is caused by mutations in the fibrillin-1 gene (FBN1), mapped to chromosome 15q21.1. Only few reports on deletions including the whole FBN1 gene, detected by molecular cytogenetic techniques, were found in literature. Results We report here on a female patient with clinical symptoms of the MFS spectrum plus craniostenosis, hypothyroidism and intellectual deficiency who presents a 1.9 Mb deletion, including the FBN1 gene and a complex rearrangement with eight breakpoints involving chromosomes 6, 12 and 15. Discussion This is the first report of MFS with a complex chromosome rearrangement involving a deletion of FBN1 and contiguous genes. In addition to the typical clinical findings of the Marfan syndrome due to FBN1 gene haploinsufficiency, the patient presents features which may be due to the other gene deletions and possibly to the complex chromosome rearrangement.
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Affiliation(s)
- Mileny Es Colovati
- Departamento de Morfologia e Genética, Universidade Federal de São Paulo, São Paulo, SP, Brasil.
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Guidelines for Genetic Testing of Inherited Cardiac Disorders. Heart Lung Circ 2011; 20:681-7. [DOI: 10.1016/j.hlc.2011.07.013] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 07/22/2011] [Indexed: 11/17/2022]
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Arslan-Kirchner M, Epplen JT, Faivre L, Jondeau G, Schmidtke J, De Paepe A, Loeys B. Clinical utility gene card for: Loeys-Dietz syndrome (TGFBR1/2) and related phenotypes. Eur J Hum Genet 2011; 19:ejhg201168. [PMID: 21522183 DOI: 10.1038/ejhg.2011.68] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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