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Lu X, Wang R, Li M, Zhang B, Rao H, Huang X, Chen X, Wu Y. Identification of two novel large deletions in FBN1 gene by next-generation sequencing and multiplex ligation-dependent probe amplification. BMC Med Genomics 2024; 17:47. [PMID: 38317175 PMCID: PMC10840365 DOI: 10.1186/s12920-024-01822-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 01/30/2024] [Indexed: 02/07/2024] Open
Abstract
BACKGROUND Mutations in fibrillin-1 (FBN1) are known to be associated with Marfan syndrome (MFS), an autosomal dominant connective tissue disorder. Most FBN1 mutations are missense or nonsense mutations. Traditional molecular genetic testing for the FBN1 gene, like Sanger sequencing, may miss disease-causing mutations in the gene's regulatory regions or non-coding sequences, as well as partial or complete gene deletions and duplications. METHODS Next-generation sequencing, multiplex ligation-dependent probe amplification and gap PCR were conducted on two MFS patients to screen for disease-causing mutations. RESULTS We identified two large deletions in FBN1 from two MFS patients. One patient had a 0.23 Mb deletion (NC_000015.9:g.48550506_48779360del) including 5'UTR-exon6 of FBN1. The other patient harbored a 1416 bp deletion (NC_000015.9:g.48410869_48412284del) affecting the last exon, exon 66, of the FBN1 gene. CONCLUSION Our results expanded the number of large FBN1 deletions and highlighted the importance of screening for large deletions in FBN1 in clinical genetic testing, especially for those with the classic MFS phenotype.
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Affiliation(s)
- Xinxin Lu
- Center of Clinical Laboratory, Zhongshan Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, 361004, China
| | - Ren Wang
- Department of Cardiovascular Surgery, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China
| | - Mingjie Li
- Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China
| | - Biao Zhang
- Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China
| | - Huiying Rao
- Department of Ophthalmology, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China
| | - Xiaoli Huang
- Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China
| | - Xijun Chen
- Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China
| | - Yan'an Wu
- Department of Clinical Laboratory, Fujian Provincial Hospital, Fuzhou, 350001, Fujian, China.
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Buki G, Szalai R, Pinter A, Hadzsiev K, Melegh B, Rauch T, Bene J. Correlation between large FBN1 deletions and severe cardiovascular phenotype in Marfan syndrome: Analysis of two novel cases and analytical review of the literature. Mol Genet Genomic Med 2023:e2166. [PMID: 36945115 DOI: 10.1002/mgg3.2166] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 01/26/2023] [Accepted: 03/01/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND Marfan syndrome (MFS) is a clinically heterogeneous hereditary connective tissue disorder. Severe cardiovascular manifestations (i.e., aortic aneurysm and dissection) are the most life-threatening complications. Most of the cases are caused by mutations, a minor group of which are copy number variations (CNV), in the FBN1 gene. METHODS Multiplex ligation-dependent probe amplification test was performed to detect CNVs in 41 MFS patients not carrying disease-causing mutations in FBN1 gene. Moreover, the association was analyzed between the localization of CNVs, the affected regulatory elements and the cardiovascular phenotypes among all cases known from the literature. RESULTS A large two-exon deletion (exon 46 and 47) was identified in two related patients, which was associated with a mild form of cardiovascular phenotype. Severe cardiovascular symptoms were found significantly more frequent in patients with FBN1 large deletion compared to our patients with intragenic small scale FBN1 mutation. Bioinformatic data analyses of regulatory elements located within the FBN1 gene revealed an association between the deletion of STAT3 transcription factor-binding site and cardiovascular symptoms in five out of 25 patients. CONCLUSION Our study demonstrated that large CNVs are often associated with severe cardiovascular manifestations in MFS and the localization of these CNVs affect the phenotype severity.
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Affiliation(s)
- Gergely Buki
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Renata Szalai
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Adrienn Pinter
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Kinga Hadzsiev
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Bela Melegh
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
| | - Tibor Rauch
- Department of Biochemistry and Medical Chemistry, Medical School, University of Pécs, Pécs, Hungary
| | - Judit Bene
- Department of Medical Genetics, Clinical Center, Medical School, University of Pécs, Pécs, Hungary
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Taniguchi Y, Takeda N, Inuzuka R, Matsubayashi Y, Kato S, Doi T, Yagi H, Yamauchi H, Ando M, Oshima Y, Tanaka S. Impact of pathogenic FBN1 variant types on the development of severe scoliosis in patients with Marfan syndrome. J Med Genet 2023; 60:74-80. [PMID: 34916231 PMCID: PMC9811093 DOI: 10.1136/jmedgenet-2021-108186] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 11/18/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND Among the several musculoskeletal manifestations in patients with Marfan syndrome, spinal deformity causes pain and respiratory impairment and is a great hindrance to patients' daily activities. The present study elucidates the genetic risk factors for the development of severe scoliosis in patients with Marfan syndrome. METHODS We retrospectively evaluated 278 patients with pathogenic or likely pathogenic FBN1 variants. The patients were divided into those with (n=57) or without (n=221) severe scoliosis. Severe scoliosis was defined as (1) patients undergoing surgery before 50 years of age or (2) patients with a Cobb angle exceeding 50° before 50 years of age. The variants were classified as protein-truncating variants (PTVs), which included variants creating premature termination codons and inframe exon-skipping, or non-PTVs, based on their location and predicted amino acid alterations, and the effect of the FBN1 genotype on the development of severe scoliosis was examined. The impact of location of FBN1 variants on the development of severe scoliosis was also investigated. RESULTS Univariate and multivariate analyses revealed that female sex, PTVs of FBN1 and variants in the neonatal region (exons 25-33) were all independent significant predictive factors for the development of severe scoliosis. Furthermore, these factors were identified as predictors of progression of existing scoliosis into severe state. CONCLUSIONS We elucidated the genetic risk factors for the development of severe scoliosis in patients with Marfan syndrome. Patients harbouring pathogenic FBN1 variants with these genetic risk factors should be monitored carefully for scoliosis progression.
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Affiliation(s)
- Yuki Taniguchi
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan,Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Norifumi Takeda
- Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan,Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Ryo Inuzuka
- Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan,Department of Pediatrics, The University of Tokyo Hospital, Tokyo, Japan
| | | | - So Kato
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Toru Doi
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroki Yagi
- Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan,Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Haruo Yamauchi
- Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan,Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Masahiko Ando
- Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan,Department of Cardiac Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Yasushi Oshima
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
| | - Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo Hospital, Tokyo, Japan
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Yagi H, Takeda N, Amiya E, Akiyama N, Chang H, Ishiura H, Sato J, Akazawa H, Morita H, Komuro I. Nonsyndromic arteriopathy and aortopathy and vascular Ehlers-Danlos syndrome causing COL3A1 variants. Am J Med Genet A 2022; 188:2777-2782. [PMID: 35543214 DOI: 10.1002/ajmg.a.62774] [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: 01/12/2022] [Revised: 03/08/2022] [Accepted: 04/09/2022] [Indexed: 01/25/2023]
Abstract
Vascular Ehlers-Danlos syndrome (vEDS) is an autosomal dominant genetic disorder characterized by soft connective tissue vulnerability due to dysfunction of Type III collagen and caused by the pathogenic variants in COL3A1 gene. In the era of next-generation sequencing, multiple genes including COL3A1 can be simultaneously analyzed, and among patients suffering from aortopathy even without any other clinical features suggestive of vEDS, pathogenic COL3A1 variants have been increasingly identified. Here, we briefly summarize the characteristics of 12 Japanese patients from 11 families with arteriopathy and pathogenic or likely pathogenic COL3A1 variants in our hospital. Five patients did not have any extra-arterial clinical features, however, the multigene panel testing for hereditary thoracic aortic aneurysm and dissection unexpectedly revealed that two had glycine substitutions in the triple-helical region and three had haploinsufficient type variants in the COL3A1 gene, whose pathogenicities were all classified as pathogenic or likely pathogenic. Further genetic screening and identification of pathogenic variants in patients with nonsyndromic arteriopathy and aortopathy will enable us to develop risk-stratification and management based on the genetic diagnosis.
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Affiliation(s)
- Hiroki Yagi
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Norifumi Takeda
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan
| | - Eisuke Amiya
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Nana Akiyama
- Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan.,Department of Genomic Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Hyangri Chang
- Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan.,Department of Genomic Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroyuki Ishiura
- Marfan Syndrome Center, The University of Tokyo Hospital, Tokyo, Japan.,Department of Genomic Medicine, The University of Tokyo Hospital, Tokyo, Japan.,Department of Neurology, The University of Tokyo Hospital, Tokyo, Japan
| | - Jiro Sato
- Department of Radiology, Tokyo Metropolitan Police Hospital, Tokyo, Japan
| | - Hiroshi Akazawa
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Hiroyuki Morita
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Issei Komuro
- Department of Cardiovascular Medicine, The University of Tokyo Hospital, Tokyo, Japan
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Yagi H, Takiguchi H, Takeda N, Inuzuka R, Taniguchi Y, Porto KJ, Ishiura H, Mitsui J, Morita H, Komuro I. Family with congenital contractural arachnodactyly due to a novel multiexon deletion of the FBN2 gene. Clin Case Rep 2022; 10:e05335. [PMID: 35154713 PMCID: PMC8826123 DOI: 10.1002/ccr3.5335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 01/10/2022] [Accepted: 01/14/2022] [Indexed: 11/21/2022] Open
Abstract
Congenital contractural arachnodactyly (CCA) is caused by pathogenic FBN2 variants; however, the contributions of copy number variations (CNVs) to CCA are still unknown. Here, we report on a familial case of CCA, in which a novel multiexon deletion of exons 35-39 in FBN2 was identified after simple CNV prediction.
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Affiliation(s)
- Hiroki Yagi
- Department of Cardiovascular MedicineThe University of Tokyo HospitalTokyoJapan
- Marfan Syndrome CenterThe University of Tokyo HospitalTokyoJapan
| | - Hiroshi Takiguchi
- Department of Cardiovascular MedicineThe University of Tokyo HospitalTokyoJapan
| | - Norifumi Takeda
- Department of Cardiovascular MedicineThe University of Tokyo HospitalTokyoJapan
- Marfan Syndrome CenterThe University of Tokyo HospitalTokyoJapan
| | - Ryo Inuzuka
- Marfan Syndrome CenterThe University of Tokyo HospitalTokyoJapan
- Department of PediatricsThe University of Tokyo HospitalTokyoJapan
| | - Yuki Taniguchi
- Marfan Syndrome CenterThe University of Tokyo HospitalTokyoJapan
- Department of Orthopedic SurgeryThe University of Tokyo HospitalTokyoJapan
| | | | - Hiroyuki Ishiura
- Department of NeurologyThe University of Tokyo HospitalTokyoJapan
| | - Jun Mitsui
- Department of NeurologyThe University of Tokyo HospitalTokyoJapan
| | - Hiroyuki Morita
- Department of Cardiovascular MedicineThe University of Tokyo HospitalTokyoJapan
| | - Issei Komuro
- Department of Cardiovascular MedicineThe University of Tokyo HospitalTokyoJapan
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