Xiao Feifan, Wei Qiufen, Wu Bingbing, Liu Xu, Mading Aiyao, Yang Lin, Li Yan, Liu Fang, Pan Xinnian, Wang Huijun
Depatment of Neonatology, Children's Hospital of Fudan University, Shanghai 201102, China.
Center for Molecular Medicine, Children's Hospital of Fudan University; Institutes of Biomedical Sciences, Fudan University, Shanghai 201102, China.
Transl Pediatr. 2020 Feb;9(1):21-33. doi: 10.21037/tp.2019.12.02.
FLNC encodes actin-binding protein and is mainly concentrated in skeletal and cardiac muscle. Mutations in were found in cardiomyopathies. To date, studies on FLNC-cardiomyopathies have mainly been reported in adults. There are limited studies that have investigated variants in pediatric patients with cardiomyopathies.
We summarized the patients who carried rare variants of from May 2016 to May 2019 in the Center for Molecular Medicine, Children's Hospital of Fudan University, from clinical exome sequencing data.
A total of 5 patients with rare variants were included. Of them, 3 were male and 2 were female. The median age was 3 months (range from 19 days to 30 months). A1186V was a known pathogenic variant reported in pediatric patients with cardiomyopathy (PMID: 29858533), and the other four variants were novel. In the four novel variants, there are one splicing (c.2265+4del) and three missense (p.R441I, p.C1639Y, and p.A2648S). Two patients (patients 1 and 3) were diagnosed with restrictive cardiomyopathy, two patients (patients 2 and 5) were diagnosed with dilated cardiomyopathy, and one patient (patient 4) was diagnosed with arrhythmia.
All five patients have survived to date. In summary, FLNC rare variants identified by clinical exome sequencing provide genetic evidence to make early diagnosis of cardiomyopathy in infant patients.
FLNC编码肌动蛋白结合蛋白,主要集中在骨骼肌和心肌中。已在心肌病中发现FLNC的突变。迄今为止,关于FLNC相关心肌病的研究主要在成人中报道。对患有心肌病的儿科患者中FLNC变异的研究有限。
我们从复旦大学附属儿科医院分子医学中心2016年5月至2019年5月的临床外显子组测序数据中总结了携带FLNC罕见变异的患者。
共纳入5例携带FLNC罕见变异的患者。其中,3例为男性,2例为女性。中位年龄为3个月(范围从19天至30个月)。A1186V是在患有心肌病的儿科患者中报道的已知致病变异( PMID:29858533),其他四个变异是新发现的。在这四个新发现的变异中,有一个剪接变异(c.2265 + 4del)和三个错义变异(p.R441I、p.C1639Y和p.A2648S)。两名患者(患者1和3)被诊断为限制型心肌病,两名患者(患者2和5)被诊断为扩张型心肌病,一名患者(患者4)被诊断为心律失常。
所有五例患者至今均存活。总之,通过临床外显子组测序鉴定出的FLNC罕见变异为婴儿患者心肌病的早期诊断提供了遗传学证据。