Service de Rythmologie, Hôpital Cardiologique Louis-Pradel, 28, avenue du Doyen Jean Lépine, 69677, Bron, France.
Université Lyon 1, 69003, Lyon, France.
Mol Diagn Ther. 2018 Apr;22(2):219-223. doi: 10.1007/s40291-018-0324-1.
Hypertrophic cardiomyopathy (HCM), a common and clinically heterogeneous disease characterized by unexplained ventricular myocardial hypertrophy, is mostly caused by mutations in sarcomeric genes. Identifying the genetic cause is important for management, therapy, and genetic counseling.
A molecular diagnosis was performed on a 51-year-old woman diagnosed with HCM using a next-generation sequencing workflow based on a panel designed for sequencing the most prevalent cardiomyopathy-causing genes. Segregation analysis was performed on the woman's family.
A novel myosin regulatory light chain (MYL2) missense variant, NM_000432.3:c485G>A, p.Gly162Glu, was identified and firstly considered as a putative pathogenic mutation. Among the 27 family members tested, 16 were carriers for the MYL2-p.Gly162Glu mutation, of whom 12 with the phenotype were positive. None of the 11 family members without mutation had cardiomyopathy.
Genetic analysis combined with a segregation study allowed us to classify this novel MYL2 variation, p.Gly162Glu, as a novel pathogenic mutation leading to a familial form of HCM. Due to absence of fast in vitro approaches to evaluate the functional impact of missense variants on HCM-causing genes, segregation studies remain, when possible, the easiest approach to evaluate the putative pathogenicity of novel gene variants, more particularly missense ones.
肥厚型心肌病(HCM)是一种常见且临床表现具有异质性的疾病,其特征为不明原因的心室心肌肥厚,主要由肌节基因的突变引起。确定遗传病因对于管理、治疗和遗传咨询很重要。
采用基于针对最常见致心肌病基因突变设计的panel 的下一代测序工作流程,对一名 51 岁被诊断为 HCM 的女性进行分子诊断。对该女性的家族进行了分离分析。
鉴定出一种新型肌球蛋白调节轻链(MYL2)错义变异,NM_000432.3:c485G>A,p.Gly162Glu,最初被认为是一种潜在的致病性突变。在 27 名受检的家族成员中,有 16 名携带 MYL2-p.Gly162Glu 突变,其中 12 名有表型的为阳性。11 名无突变的家族成员均无心肌病。
遗传分析结合分离研究使我们能够将这种新型 MYL2 变异,p.Gly162Glu,归类为导致家族性 HCM 的新型致病性突变。由于缺乏快速的体外方法来评估导致 HCM 的基因突变的错义变异的功能影响,因此当可能时,分离研究仍然是评估新型基因变异(尤其是错义变异)潜在致病性的最简单方法。