Arimura Takuro, Hayashi Yukiko K, Murakami Terumi, Oya Yasushi, Funabe Sayaka, Arikawa-Hirasawa Eri, Hattori Nobutaka, Nishino Ichizo, Kimura Akinori
Department of Molecular Pathogenesis, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan.
Circ J. 2009 Jan;73(1):158-61. doi: 10.1253/circj.cj-08-0722. Epub 2008 Nov 17.
Mutations in FKTN encoding for fukutin cause Fukuyama-type congenital muscular dystrophy characterized by severe muscle wasting and hypotonia with mental retardation. Fukuyama-type congenital muscular dystrophy is a recessive genetic trait. FKTN mutations in patients with dilated cardiomyopathy (DCM) have been investigated by our research group. The patients showed hyper-CKemia with mild or no muscle weakness and without mental retardation, suggesting that the clinical spectrum of FKTN mutations are wider than previously thought. The current study was designed to further explore the association of FKTN mutations with DCM or hypertrophic cardiomyopathy (HCM).
A total of 172 patients with DCM, 144 patients with familial HCM and 384 control individuals were analyzed for FKTN mutations. There was a DCM patient who was a compound heterozygote of a 3-kb insertion mutation and a missense mutation Cys101Phe. The patient showed hyper-CKemia with mild muscle involvement and no brain involvement. In contrast, 2 other DCM patients and 3 controls were heterozygous for the insertion mutation and normal allele, showing that the heterozygous insertion mutation itself was not associated with DCM. No mutation was found in the HCM patients.
These observations indicated that the compound heterozygous FKTN mutation was a rare cause of DCM. Hyper-CKemia might be indicative of FKTN mutation in DCM.
编码福库蛋白的FKTN基因突变会导致福山型先天性肌营养不良,其特征为严重的肌肉萎缩、肌张力减退以及智力发育迟缓。福山型先天性肌营养不良是一种隐性遗传性状。我们的研究小组对扩张型心肌病(DCM)患者的FKTN基因突变进行了研究。这些患者表现为高肌酸激酶血症,伴有轻度或无肌肉无力且无智力发育迟缓,这表明FKTN基因突变的临床谱比之前认为的更广泛。本研究旨在进一步探讨FKTN基因突变与DCM或肥厚型心肌病(HCM)之间的关联。
对总共172例DCM患者、144例家族性HCM患者以及384名对照个体进行了FKTN基因突变分析。有1例DCM患者是一个3kb插入突变和错义突变Cys101Phe的复合杂合子。该患者表现为高肌酸激酶血症,伴有轻度肌肉受累且无脑部受累。相比之下,另外2例DCM患者和3名对照是插入突变和正常等位基因的杂合子,表明杂合插入突变本身与DCM无关。在HCM患者中未发现突变。
这些观察结果表明,复合杂合FKTN突变是DCM的一种罕见病因。高肌酸激酶血症可能提示DCM中的FKTN突变。