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Palladino A, Papa AA, Petillo R, Scutifero M, Morra S, Passamano L, Nigro V, Politano L. The Role of TRPM4 Gene Mutations in Causing Familial Progressive Cardiac Conduction Disease: A Further Contribution. Genes (Basel) 2022; 13:genes13020258. [PMID: 35205305 PMCID: PMC8871839 DOI: 10.3390/genes13020258] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 12/22/2022] Open
Abstract
Progressive cardiac conduction disease (PCCD) is a relatively common condition in young and elderly populations, related to rare mutations in several genes, including SCN5A, SCN1B, LMNA and GJA5, TRPM4. Familial cases have also been reported. We describe a family with a large number of individuals necessitating pacemaker implantation, likely due to varying degrees of PCCD. The proband is a 47-year-old-patient, whose younger brother died at 25 years of unexplained sudden cardiac death. Three paternal uncles needed a pacemaker (PM) implantation between 40 and 65 years for unspecified causes. At the age of 42, he was implanted with a PM for two episodes of syncope and the presence of complete atrioventricular block (AVB). NGS analysis revealed the missense variation c. 2351G>A, p.Gly844Asp in the exon 17 of the TRPM4 gene. This gene encodes the TRPM4 channel, a calcium-activated nonselective cation channel of the transient receptor potential melastatin (TRPM) ion channel family. Variations in TRPM4 have been shown to cause an increase in cell surface current density, which results in a gain of gene function. Our report broadens and supports the causative role of TRPM4 gene mutations in PCCD. Genetic screening and identification of the causal mutation are critical for risk stratification and family counselling.
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Affiliation(s)
- Alberto Palladino
- Cardiomiology and Medical Genetics, University Hospital of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.P.); (R.P.); (M.S.); (S.M.); (L.P.)
| | - Andrea Antonio Papa
- Division of Cardiology, Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Monaldi Hospital, 80131 Naples, Italy;
| | - Roberta Petillo
- Cardiomiology and Medical Genetics, University Hospital of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.P.); (R.P.); (M.S.); (S.M.); (L.P.)
| | - Marianna Scutifero
- Cardiomiology and Medical Genetics, University Hospital of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.P.); (R.P.); (M.S.); (S.M.); (L.P.)
| | - Salvatore Morra
- Cardiomiology and Medical Genetics, University Hospital of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.P.); (R.P.); (M.S.); (S.M.); (L.P.)
| | - Luigia Passamano
- Cardiomiology and Medical Genetics, University Hospital of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.P.); (R.P.); (M.S.); (S.M.); (L.P.)
| | - Vincenzo Nigro
- Department of Precision Medicine, University of Campania Luigi Vanvitelli, 80138 Naples, Italy;
| | - Luisa Politano
- Cardiomiology and Medical Genetics, University Hospital of Campania Luigi Vanvitelli, 80138 Naples, Italy; (A.P.); (R.P.); (M.S.); (S.M.); (L.P.)
- Correspondence:
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2
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Hayashi K, Teramoto R, Nomura A, Asano Y, Beerens M, Kurata Y, Kobayashi I, Fujino N, Furusho H, Sakata K, Onoue K, Chiang DY, Kiviniemi TO, Buys E, Sips P, Burch ML, Zhao Y, Kelly AE, Namura M, Kita Y, Tsuchiya T, Kaku B, Oe K, Takeda Y, Konno T, Inoue M, Fujita T, Kato T, Funada A, Tada H, Hodatsu A, Nakanishi C, Sakamoto Y, Tsuda T, Nagata Y, Tanaka Y, Okada H, Usuda K, Cui S, Saito Y, MacRae CA, Takashima S, Yamagishi M, Kawashiri MA, Takamura M. Impact of functional studies on exome sequence variant interpretation in early-onset cardiac conduction system diseases. Cardiovasc Res 2020; 116:2116-2130. [PMID: 31977013 DOI: 10.1093/cvr/cvaa010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 10/02/2019] [Accepted: 01/17/2020] [Indexed: 12/20/2022] Open
Abstract
AIMS The genetic cause of cardiac conduction system disease (CCSD) has not been fully elucidated. Whole-exome sequencing (WES) can detect various genetic variants; however, the identification of pathogenic variants remains a challenge. We aimed to identify pathogenic or likely pathogenic variants in CCSD patients by using WES and 2015 American College of Medical Genetics and Genomics (ACMG) standards and guidelines as well as evaluating the usefulness of functional studies for determining them. METHODS AND RESULTS We performed WES of 23 probands diagnosed with early-onset (<65 years) CCSD and analysed 117 genes linked to arrhythmogenic diseases or cardiomyopathies. We focused on rare variants (minor allele frequency < 0.1%) that were absent from population databases. Five probands had protein truncating variants in EMD and LMNA which were classified as 'pathogenic' by 2015 ACMG standards and guidelines. To evaluate the functional changes brought about by these variants, we generated a knock-out zebrafish with CRISPR-mediated insertions or deletions of the EMD or LMNA homologs in zebrafish. The mean heart rate and conduction velocities in the CRISPR/Cas9-injected embryos and F2 generation embryos with homozygous deletions were significantly decreased. Twenty-one variants of uncertain significance were identified in 11 probands. Cellular electrophysiological study and in vivo zebrafish cardiac assay showed that two variants in KCNH2 and SCN5A, four variants in SCN10A, and one variant in MYH6 damaged each gene, which resulted in the change of the clinical significance of them from 'Uncertain significance' to 'Likely pathogenic' in six probands. CONCLUSION Of 23 CCSD probands, we successfully identified pathogenic or likely pathogenic variants in 11 probands (48%). Functional analyses of a cellular electrophysiological study and in vivo zebrafish cardiac assay might be useful for determining the pathogenicity of rare variants in patients with CCSD. SCN10A may be one of the major genes responsible for CCSD.
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Affiliation(s)
- Kenshi Hayashi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Ryota Teramoto
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.,Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Akihiro Nomura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Yoshihiro Asano
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Manu Beerens
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Yasutaka Kurata
- Department of Physiology, Kanazawa Medical University, Uchinada, Japan
| | - Isao Kobayashi
- Faculty of Biological Science and Technology, Institute of Science and Engineering, Kanazawa University, Kanazawa, Japan
| | - Noboru Fujino
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Hiroshi Furusho
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Kenji Sakata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Kenji Onoue
- Cardiovascular Medicine, Nara Medical University, Kashihara, Japan
| | - David Y Chiang
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Tuomas O Kiviniemi
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Eva Buys
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Patrick Sips
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.,Center for Medical Genetics Ghent, Department of Biomolecular Medicine, Ghent University, Ghent, Belgium
| | - Micah L Burch
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Yanbin Zhao
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Amy E Kelly
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Masanobu Namura
- Department of Cardiology, Kanazawa Cardiovascular Hospital, Kanazawa, Japan
| | - Yoshihito Kita
- Department of Internal Medicine, Wajima Municipal Hospital, Wajima, Japan
| | - Taketsugu Tsuchiya
- Trans-catheter Cardiovascular Therapeutics, Kanazawa Medical University, Uchinada, Japan
| | - Bunji Kaku
- Division of Cardiovascular Medicine, Toyama Red Cross Hospital, Toyama, Japan
| | - Kotaro Oe
- Division of Internal Medicine, Saiseikai Kanazawa Hospital, Kanazawa, Japan
| | - Yuko Takeda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Tetsuo Konno
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Masaru Inoue
- Department of Cardiology, Ishikawa Prefectural Central Hospital, Kanazawa, Japan
| | - Takashi Fujita
- Division of Cardiology, Kouseiren Takaoka Hospital, Takaoka, Japan
| | - Takeshi Kato
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Akira Funada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Hayato Tada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Akihiko Hodatsu
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Chiaki Nakanishi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | | | - Toyonobu Tsuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Yoji Nagata
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Yoshihiro Tanaka
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Hirofumi Okada
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Keisuke Usuda
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Shihe Cui
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Yoshihiko Saito
- Cardiovascular Medicine, Nara Medical University, Kashihara, Japan
| | - Calum A MacRae
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Seiji Takashima
- Department of Medical Biochemistry, Osaka University Graduate School of Medicine, Suita, Japan
| | - Masakazu Yamagishi
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan.,Osaka University of Human Sciences, Settu, Japan
| | - Masa-Aki Kawashiri
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
| | - Masayuki Takamura
- Department of Cardiovascular Medicine, Kanazawa University Graduate School of Medical Sciences, 13-1, Takara-machi, Kanazawa, Ishikawa 920-8641, Japan
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Huang Y, Hu D, Huang C, Nichols CG. Genetic Discovery of ATP-Sensitive K + Channels in Cardiovascular Diseases. Circ Arrhythm Electrophysiol 2020; 12:e007322. [PMID: 31030551 DOI: 10.1161/circep.119.007322] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The ATP-sensitive K+ (KATP) channels are hetero-octameric protein complexes comprising 4 pore-forming (Kir6.x) subunits and 4 regulatory sulfonylurea receptor (SURx) subunits. They are prominent in myocytes, pancreatic β cells, and neurons and link cellular metabolism with membrane excitability. Using genetically modified animals and genomic analysis in patients, recent studies have implicated certain ATP-sensitive K+ channel subtypes in physiological and pathological processes in a variety of cardiovascular diseases. In this review, we focus on the causal relationship between ATP-sensitive K+ channel activity and pathophysiology in the cardiovascular system, particularly from the perspective of genetic changes in human and animal models.
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Affiliation(s)
- Yan Huang
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University, PR China (Y.H., D.H., C.H.).,Hubei Key Laboratory of Cardiology, Wuhan, PR China (Y.H., D.H., C.H.)
| | - Dan Hu
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University, PR China (Y.H., D.H., C.H.).,Hubei Key Laboratory of Cardiology, Wuhan, PR China (Y.H., D.H., C.H.)
| | - Congxin Huang
- Department of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University, PR China (Y.H., D.H., C.H.).,Hubei Key Laboratory of Cardiology, Wuhan, PR China (Y.H., D.H., C.H.)
| | - Colin G Nichols
- Center for the Investigation of Membrane Excitability Diseases and Department of Cell Biology and Physiology, Washington University School of Medicine, Saint Louis, MO (C.G.N.)
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5
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Ko JS, Guo S, Hassel J, Celestino-Soper P, Lynnes TC, Tisdale JE, Zheng JJ, Taylor SE, Foroud T, Murray MD, Kovacs RJ, Li X, Lin SF, Chen Z, Vatta M, Chen PS, Rubart M. Ondansetron blocks wild-type and p.F503L variant small-conductance Ca 2+-activated K + channels. Am J Physiol Heart Circ Physiol 2018; 315:H375-H388. [PMID: 29677462 PMCID: PMC6139629 DOI: 10.1152/ajpheart.00479.2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2017] [Revised: 04/11/2018] [Accepted: 04/11/2018] [Indexed: 01/24/2023]
Abstract
Apamin-sensitive small-conductance Ca2+-activated K+ (SK) current ( IKAS) is encoded by Ca2+-activated K+ channel subfamily N ( KCNN) genes. IKAS importantly contributes to cardiac repolarization in conditions associated with reduced repolarization reserve. To test the hypothesis that IKAS inhibition contributes to drug-induced long QT syndrome (diLQTS), we screened for KCNN variants among patients with diLQTS, determined the properties of heterologously expressed wild-type (WT) and variant KCNN channels, and determined if the 5-HT3 receptor antagonist ondansetron blocks IKAS. We searched 2,306,335 records in the Indiana Network for Patient Care and found 11 patients with diLQTS who had DNA available in the Indiana Biobank. DNA sequencing discovered a heterozygous KCNN2 variant (p.F503L) in a 52-yr-old woman presenting with corrected QT interval prolongation at baseline (473 ms) and further corrected QT interval lengthening (601 ms) after oral administration of ondansetron. That patient was also heterozygous for the p.S38G and p.P2835S variants of the QT-controlling genes KCNE1 and ankyrin 2, respectively. Patch-clamp experiments revealed that the p.F503L KCNN2 variant heterologously expressed in human embryonic kidney (HEK)-293 cells augmented Ca2+ sensitivity, increasing IKAS density. The fraction of total F503L-KCNN2 protein retained in the membrane was higher than that of WT KCNN2 protein. Ondansetron at nanomolar concentrations inhibited WT and p.F503L SK2 channels expressed in HEK-293 cells as well as native SK channels in ventricular cardiomyocytes. Ondansetron-induced IKAS inhibition was also demonstrated in Langendorff-perfused murine hearts. In conclusion, the heterozygous p.F503L KCNN2 variant increases Ca2+ sensitivity and IKAS density in transfected HEK-293 cells. Ondansetron at therapeutic (i.e., nanomolar) concentrations is a potent IKAS blocker. NEW & NOTEWORTHY We showed that ondansetron, a 5-HT3 receptor antagonist, blocks small-conductance Ca2+-activated K+ (SK) current. Ondansetron may be useful in controlling arrhythmias in which increased SK current is a likely contributor. However, its SK-blocking effects may also facilitate the development of drug-induced long QT syndrome.
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Affiliation(s)
- Jum-Suk Ko
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
- Wonkwang University School of Medicine and Hospital, Iksan, South Korea
| | - Shuai Guo
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
| | - Jonathan Hassel
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
| | - Patricia Celestino-Soper
- Department of Medical and Molecular Genetics, Indiana University School of Medicine , Indianapolis, Indiana
| | - Ty C Lynnes
- Department of Medical and Molecular Genetics, Indiana University School of Medicine , Indianapolis, Indiana
| | - James E Tisdale
- Department of Pharmacy Practice, College of Pharmacy, Purdue University , West Lafayette, Indiana
- Division of Clinical Pharmacology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
| | | | - Stanley E Taylor
- Department of Biostatistics, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine , Indianapolis, Indiana
| | - Michael D Murray
- Department of Pharmacy Practice, College of Pharmacy, Purdue University , West Lafayette, Indiana
- Regenstrief Institute , Indianapolis, Indiana
| | - Richard J Kovacs
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
| | - Xiaochun Li
- Department of Biostatistics, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
| | - Shien-Fong Lin
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
- Institute of Biomedical Engineering, National Chiao-Tung University, Hsin-Chu, Taiwan
| | - Zhenhui Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
| | - Matteo Vatta
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
- Department of Medical and Molecular Genetics, Indiana University School of Medicine , Indianapolis, Indiana
- Department of Pediatrics, Riley Heart Research Center, Indiana University School of Medicine , Indianapolis, Indiana
| | - Peng-Sheng Chen
- The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine , Indianapolis, Indiana
| | - Michael Rubart
- Department of Pediatrics, Riley Heart Research Center, Indiana University School of Medicine , Indianapolis, Indiana
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Celestino-Soper PBS, Lynnes TC, Zhang L, Ouyang K, Wann S, Clyde VL, Vatta M. Genetic analyses in a bonobo (Pan paniscus) with arrhythmogenic right ventricular cardiomyopathy. Sci Rep 2018. [PMID: 29531232 PMCID: PMC5847517 DOI: 10.1038/s41598-018-22334-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a disorder that may lead to sudden death and can affect humans and other primates. In 2012, the alpha male bonobo of the Milwaukee County Zoo died suddenly and histologic evaluation found features of ARVC. This study sought to discover a possible genetic cause for ARVC in this individual. We sequenced our subject's DNA to search for deleterious variants in genes involved in cardiovascular disorders. Variants found were annotated according to the human genome, following currently available classification used for human diseases. Sequencing from the DNA of an unrelated unaffected bonobo was also used for prediction of pathogenicity. Twenty-four variants of uncertain clinical significance (VUSs) but no pathogenic variants were found in the proband studied. Further familial, functional, and bonobo population studies are needed to determine if any of the VUSs or a combination of the VUSs found may be associated with the clinical findings. Future genotype-phenotype establishment will be beneficial for the appropriate care of the captive zoo bonobo population world-wide as well as conservation of the bobono species in its native habitat.
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Affiliation(s)
- Patrícia B S Celestino-Soper
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Ty C Lynnes
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Lili Zhang
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Karen Ouyang
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Samuel Wann
- Milwaukee County Zoo, Milwaukee, WI, 53226, USA
| | | | - Matteo Vatta
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, 46202, USA. .,Krannert Institute of Cardiology, Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
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