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意大利肥厚型心肌病患者的β-肌球蛋白重链和心肌肌球蛋白结合蛋白基因突变率出人意料地低。

Unexpectedly low mutation rates in beta-myosin heavy chain and cardiac myosin binding protein genes in Italian patients with hypertrophic cardiomyopathy.

机构信息

Instituto di Tecnologie Biomediche, Consiglio Nazionale delle Ricerche, Milan, Italy.

出版信息

J Cell Physiol. 2011 Nov;226(11):2894-900. doi: 10.1002/jcp.22636.

Abstract

Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiac disease. Fourteen sarcomeric and sarcomere-related genes have been implicated in HCM etiology, those encoding β-myosin heavy chain (MYH7) and cardiac myosin binding protein C (MYBPC3) reported as the most frequently mutated: in fact, these account for around 50% of all cases related to sarcomeric gene mutations, which are collectively responsible for approximately 70% of all HCM cases. Here, we used denaturing high-performance liquid chromatography followed by bidirectional sequencing to screen the coding regions of MYH7 and MYBPC3 in a cohort (n = 125) of Italian patients presenting with HCM. We found 6 MHY7 mutations in 9/125 patients and 18 MYBPC3 mutations in 19/125 patients. Of the three novel MYH7 mutations found, two were missense, and one was a silent mutation; of the eight novel MYBPC3 mutations, one was a substitution, three were stop codons, and four were missense mutations. Thus, our cohort of Italian HCM patients did not harbor the high frequency of mutations usually found in MYH7 and MYBPC3. This finding, coupled to the clinical diversity of our cohort, emphasizes the complexity of HCM and the need for more inclusive investigative approaches in order to fully understand the pathogenesis of this disease.

摘要

肥厚型心肌病(HCM)是最常见的遗传性心脏病。已有 14 个肌节和与肌节相关的基因与 HCM 的病因有关,其中编码β-肌球蛋白重链(MYH7)和心肌肌球蛋白结合蛋白 C(MYBPC3)的基因突变最为常见:事实上,这些基因约占所有与肌节基因突变相关病例的 50%,而这些基因突变共同导致了大约 70%的所有 HCM 病例。在这里,我们使用变性高效液相色谱法(DHPLC)结合双向测序技术,对 125 名意大利 HCM 患者的 MYH7 和 MYBPC3 编码区进行了筛查。在 9/125 名患者中发现了 6 种 MYH7 突变,在 19/125 名患者中发现了 18 种 MYBPC3 突变。在发现的三种新的 MYH7 突变中,两种是错义突变,一种是无义突变;在发现的八种新的 MYBPC3 突变中,一种是取代突变,三种是终止密码子突变,四种是错义突变。因此,我们的意大利 HCM 患者队列并未携带通常在 MYH7 和 MYBPC3 中发现的高频突变。这一发现,加上我们队列的临床表现多样性,强调了 HCM 的复杂性,需要更具包容性的研究方法,以全面了解这种疾病的发病机制。

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