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常染色体隐性先天性鱼鳞病由 CLDN1 中的致病性错义变异引起。

Autosomal recessive congenital ichthyosis caused by a pathogenic missense variant in CLDN1.

机构信息

Division of Dermatology, Tel Aviv Medical Center, Tel Aviv, Israel.

Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

出版信息

Am J Med Genet A. 2022 Oct;188(10):2879-2887. doi: 10.1002/ajmg.a.62924. Epub 2022 Aug 3.

Abstract

Autosomal recessive congenital ichthyosis (ARCI) refers to a large and genetically heterogenous group of non-syndromic disorders of cornification featuring diffuse scaling. Ichthyosis, leukocyte vacuoles, alopecia, and sclerosing cholangitis (ILVASC) syndrome is a rare autosomal recessive syndromic form of ichthyosis. The disease usually results from premature termination codon-causing pathogenic variants in CLDN1 encoding CLAUDIN-1 (CLDN1). We used whole exome sequencing (WES), Sanger sequencing, 3D protein modeling, Western blotting, and immunofluorescence confocal microscopy to delineate the genetic basis of ichthyosis in two siblings with ichthyosis but no other ectodermal abnormalities. One of the two siblings underwent liver transplantation in early childhood due to biliary atresia. Both patients were found to carry a homozygous missense pathogenic variant, c.242G>A (p.Arg81His), in CLDN1. The variant resulted in decreased CLDN1 expression in patient skin. 3D protein modeling predicted that p.Arg81His induces deleterious conformational changes. Accordingly, HaCaT cells transfected with a construct expressing the mutant CLDN1 cDNA featured decreased levels and mislocation of CLDN1 as compared with cells expressing the wildtype cDNA. In conclusion, we describe the first pathogenic missense variant in CLDN1 shown to result in ARCI.

摘要

常染色体隐性先天性鱼鳞病(ARCI)是一组遗传性角化不良的非综合征性疾病,表现为弥漫性鳞屑。ILVASC 综合征是一种罕见的常染色体隐性遗传性鱼鳞病综合征形式。该病通常由 CLDN1 编码紧密连接蛋白 1(CLDN1)的导致提前终止密码子的致病性变异引起。我们使用全外显子组测序(WES)、Sanger 测序、3D 蛋白建模、Western 印迹和免疫荧光共聚焦显微镜来阐明两个有鱼鳞病但无其他外胚层异常的同胞的鱼鳞病遗传基础。其中一个同胞因胆道闭锁在幼儿期接受了肝移植。这两个患者均携带 CLDN1 中的纯合错义致病性变异 c.242G>A(p.Arg81His)。该变异导致患者皮肤中 CLDN1 表达减少。3D 蛋白建模预测 p.Arg81His 会引起有害的构象变化。因此,与表达野生型 cDNA 的细胞相比,转染表达突变型 CLDN1 cDNA 的 HaCaT 细胞中 CLDN1 的水平降低且定位异常。总之,我们描述了第一个导致 ARCI 的 CLDN1 致病错义变异。

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