Kuechler Alma, Altmüller Janine, Nürnberg Peter, Kotthoff Stefan, Kubisch Christian, Borck Guntram
Institut für Humangenetik, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany.
Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany; Institute of Human Genetics, University of Cologne, Cologne, Germany.
Mol Cell Probes. 2015 Oct;29(5):330-4. doi: 10.1016/j.mcp.2015.07.003. Epub 2015 Jul 13.
Marfan syndrome (MFS) and Loeys-Dietz syndrome (LDS) are clinically related autosomal dominant systemic connective tissue disorders. Although mutations in several genes of the TGF-beta signalling and related pathways have been identified in the past (e.g. FBN1, TGFBR1, TGFBR2, SMAD3, TGFB2), there are still many individuals with "marfanoid" phenotypes in whom no causative mutations are identified. We performed whole exome sequencing in two of three affected individuals from a family with phenotypic features overlapping MFS and LDS. The two affected children and their affected father had tall stature, arachnodactyly, hyperextensible joints, hypertelorism, bifid uvula, but no cardiac involvement, aortic dilation or eye involvement. We detected a novel heterozygous mutation in TGFB3, c.898C>G, predicting the missense substitution p.Arg300Gly. Sanger sequencing confirmed the mutation and its segregation with the phenotype. The first two TGFB3 mutations were reported previously in two unrelated individuals with marfanoid features: one individual with growth retardation carried a heterozygous loss-of-function mutation (c.1226G>A; p.Cys409Tyr; Rienhoff et al., 2013), whereas a child with overgrowth carried a mutation in the same codon as the mutation identified in the three affected individuals reported here (c.899G>A; p.Arg300Gln; Matyas et al., 2014). The mutations at codon Arg300 presumably lead to increased TGF-beta signalling, suggesting that the short or tall stature seen in patients with TGFB3 mutations may result from opposing effects of mutations on TGF-beta signalling. Thus, we add a novel human TGFB3 mutation, contribute to the clinical delineation of the emerging connective tissue disorder tentatively called Rienhoff syndrome and compare the data with a very recent report (Bertoli-Avella et al., 2015) on TGFB3 mutations associated with aortic aneurysms or dissections.
马凡综合征(MFS)和洛伊迪茨综合征(LDS)是临床上相关的常染色体显性全身性结缔组织疾病。尽管过去已在转化生长因子-β(TGF-β)信号传导及相关途径的多个基因中鉴定出突变(如FBN1、TGFBR1、TGFBR2、SMAD3、TGFB2),但仍有许多具有“类马凡”表型的个体未发现致病突变。我们对一个具有重叠MFS和LDS表型特征的家族中的三名受影响个体中的两名进行了全外显子组测序。这两名受影响的儿童及其受影响的父亲身材高大、手指细长、关节过度伸展、眼距增宽、悬雍垂裂,但无心脏受累、主动脉扩张或眼部受累。我们在TGFB3中检测到一个新的杂合突变,c.898C>G,预测错义替代p.Arg300Gly。桑格测序证实了该突变及其与表型的分离。先前在另外两名具有类马凡特征的无关个体中报道了前两个TGFB3突变:一名生长发育迟缓的个体携带杂合功能丧失突变(c.1226G>A;p.Cys409Tyr;里恩霍夫等人,2013年),而一名生长过速的儿童在与本文报道的三名受影响个体相同的密码子中发生了突变(c.899G>A;p.Arg300Gln;马蒂亚斯等人,2014年)。密码子Arg300处的突变可能导致TGF-β信号传导增加,这表明TGFB3突变患者中出现的身材矮小或高大可能是由于突变对TGF-β信号传导的相反作用所致。因此,我们添加了一个新的人类TGFB3突变,有助于对暂称为里恩霍夫综合征的新兴结缔组织疾病进行临床描述,并将数据与最近一篇关于与主动脉瘤或夹层相关的TGFB3突变的报告(贝托利-阿韦拉等人,2015年)进行比较。