Karmouch Jennifer, Protonotarios Alexandros, Syrris Petros
Center for Cardiovascular Genetics, Institute of Molecular Medicine, The University of Texas Health Sciences Center, Houston, Texas, USA.
Centre for Heart Muscle Disease, Institute of Cardiovascular Science, University College London, London, UK.
Curr Opin Cardiol. 2018 May;33(3):276-281. doi: 10.1097/HCO.0000000000000509.
To date 16 genes have been associated with arrhythmogenic cardiomyopathy (ACM). Mutations in these genes can lead to a broad spectrum of phenotypic expression ranging from disease affecting predominantly the right or left ventricle, to biventricular subtypes. Understanding the genetic causes of ACM is important in diagnosis and management of the disorder. This review summarizes recent advances in molecular genetics and discusses the application of next-generation sequencing technology in genetic testing in ACM.
Use of next-generation sequencing methods has resulted in the identification of novel causative variants and genes for ACM. The involvement of filamin C in ACM demonstrates the genetic overlap between ACM and other types of cardiomyopathy. Putative pathogenic variants have been detected in cadherin 2 gene, a protein involved in cell adhesion. Large genomic rearrangements in desmosome genes have been systematically investigated in a cohort of ACM patients.
Recent studies have identified novel causes of ACM providing new insights into the genetic spectrum of the disease and highlighting an overlapping phenotype between ACM and dilated cardiomyopathy. Next-generation sequencing is a useful tool for research and genetic diagnostic screening but interpretation of identified sequence variants requires caution and should be performed in specialized centres.
迄今为止,已有16个基因与致心律失常性心肌病(ACM)相关。这些基因的突变可导致广泛的表型表达,从主要影响右心室或左心室的疾病,到双心室亚型。了解ACM的遗传病因对于该疾病的诊断和管理至关重要。本综述总结了分子遗传学的最新进展,并讨论了下一代测序技术在ACM基因检测中的应用。
使用下一代测序方法已鉴定出ACM的新型致病变异和基因。细丝蛋白C与ACM的关联表明了ACM与其他类型心肌病之间的遗传重叠。在参与细胞黏附的蛋白质钙黏蛋白2基因中检测到了推定的致病变异。已在一组ACM患者中系统地研究了桥粒基因中的大基因组重排。
最近的研究已经确定了ACM的新病因,为该疾病的遗传谱提供了新的见解,并突出了ACM与扩张型心肌病之间的重叠表型。下一代测序是研究和基因诊断筛查的有用工具,但对已鉴定序列变异的解释需要谨慎,应在专业中心进行。