UPMC Univ Paris 6, INSERM, UMRS 956, AP-HP, 91 Boulevard de l'Hôpital, Paris F-75013, France.
Europace. 2013 Oct;15(10):1522-5. doi: 10.1093/europace/eut224. Epub 2013 Jul 14.
Arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D) is an inherited cardiomyopathy characterized by fibro-fatty replacement of the right ventricle and ventricular arrhythmias. The major disease-causing genes encode cardiac desmosomal components but are involved in only ∼50% of patients. To identify the missing genetic determinants, we used a candidate gene approach, focusing on the 3'-untranslated region (UTR) of the main ARVC/D gene PKP2 and on additional genes involved in desmosomal structure or function.
We screened a population of 64 ARVC/D probands with no identified mutations in any of the five known desmosomal genes (PKP2, DSG2, DSP, DSC2, and JUP). No putative mutation was identified in the 3'-UTR of PKP2 or in PNN, CTNNA3, CAV1, or PLN coding sequences. In a single proband, we identified two rare heterozygous missense variants affecting evolutionary conserved residues: c.175G>A (p.Gly59Arg) in PERP and c.1811A>G (p.Asp604Gly) in PKP4 (minor allele frequency <0.5% in control population).
Our study suggests that mutations in the candidate genes studied and regulation of PKP2 mRNA via 3'-UTR dependent mechanisms are unlikely to be major causes of ARVC/D in the studied population. Additional studies are needed to investigate the putative effects of rare PKP4 and PERP variants in this disease.
致心律失常性右室心肌病/发育不良(ARVC/D)是一种遗传性心肌病,其特征为右心室纤维脂肪替代和室性心律失常。主要致病基因编码心脏桥粒成分,但仅涉及约 50%的患者。为了确定缺失的遗传决定因素,我们采用候选基因方法,重点研究主要 ARVC/D 基因 PKP2 的 3'-非翻译区(UTR)和参与桥粒结构或功能的其他基因。
我们对 64 名 ARVC/D 先证者进行了筛选,这些先证者在五个已知的桥粒基因(PKP2、DSG2、DSP、DSC2 和 JUP)中均未发现突变。PKP2 的 3'-UTR 或 PNN、CTNNA3、CAV1 或 PLN 编码序列中未发现假定的突变。在一个先证者中,我们发现了两个影响进化保守残基的罕见杂合错义变异:PERP 中的 c.175G>A(p.Gly59Arg)和 PKP4 中的 c.1811A>G(p.Asp604Gly)(在对照人群中的等位基因频率<0.5%)。
我们的研究表明,在所研究的候选基因中突变以及通过 3'-UTR 依赖机制调节 PKP2 mRNA 不太可能是研究人群中 ARVC/D 的主要原因。需要进一步研究这些罕见的 PKP4 和 PERP 变异在该疾病中的潜在作用。