Fitzgerald Jamie, Feist Cori, Dietz Paula, Moore Stephen, Basel Donald
Department of Orthopedic Surgery, Bone and Joint Center, Henry Ford Hospital System, Detroit, Michigan, USA.
Department of Orthopedics and Rehabilitation, Oregon Health and Science University, Portland, Oregon, USA.
Mol Syndromol. 2020 Dec;11(5-6):264-270. doi: 10.1159/000510286. Epub 2020 Sep 16.
We report a novel intronic variant in the gene in 4 males in a family with severe X-linked myotubular myopathy. The A>G variant in deep intronic space activates a cryptic 5' donor splice site resulting in the inclusion of a 48-bp pseudoexon into the mature mRNA. The variant is present in all affected males, absent in unaffected males, and heterozygous in the mother of the affected males. The included intronic sequence contains a premature stop codon, and experiments using a translational inhibitor indicate that the mutant mRNAs undergo nonsense-mediated decay. We conclude that affected males produce no, or low, levels of mRNA likely leading to a significant reduction of myotubularin-1 protein resulting in the severe neonatal myopathy present in this family. The study highlights the need to consider noncoding variants in genomic screening in families with X-linked myotubular myopathy.
我们报告了一个患有严重X连锁性肌管性肌病的家族中4名男性该基因的一个新的内含子变异。内含子深处的A>G变异激活了一个隐匿的5'供体剪接位点,导致在成熟的mRNA中包含一个48bp的假外显子。该变异存在于所有患病男性中,未患病男性中不存在,且在患病男性的母亲中为杂合子。所包含的内含子序列含有一个过早的终止密码子,使用翻译抑制剂的实验表明突变的mRNA经历无义介导的衰变。我们得出结论,患病男性产生的mRNA水平极低或不产生,这可能导致肌管素-1蛋白显著减少,从而导致该家族出现严重的新生儿肌病。该研究强调了在X连锁性肌管性肌病家族的基因组筛查中需要考虑非编码变异。