Gu Jia-Ning, Yang Chen-Xi, Ding Yuan-Yuan, Qiao Qi, Di Ruo-Min, Sun Yu-Min, Wang Jun, Yang Ling, Xu Ying-Jia, Yang Yi-Qing
Department of Cardiology, Shanghai Fifth People's Hospital, Fudan University, Shanghai 200240, China.
Shanghai Health Development Research Center, Shanghai Medical Information Center, Shanghai 200031, China.
Diagnostics (Basel). 2023 Jan 9;13(2):242. doi: 10.3390/diagnostics13020242.
Dilated cardiomyopathy (DCM), characterized by left ventricular or biventricular enlargement with systolic dysfunction, is the most common type of cardiac muscle disease. It is a major cause of congestive heart failure and the most frequent indication for heart transplantation. Aggregating evidence has convincingly demonstrated that DCM has an underlying genetic basis, though the genetic defects responsible for DCM in a larger proportion of cases remain elusive, motivating the ongoing research for new DCM-causative genes. In the current investigation, a multigenerational family affected with autosomal-dominant DCM was recruited from the Chinese Han population. By whole-exome sequencing and Sanger sequencing analyses of the DNAs from the family members, a new BMP10 variation, NM_014482.3:c.166C > T;p.(Gln56*), was discovered and verified to be in co-segregation with the DCM phenotype in the entire family. The heterozygous BMP10 variant was not detected in 268 healthy volunteers enrolled as control subjects. The functional measurement via dual-luciferase reporter assay revealed that Gln56*-mutant BMP10 lost the ability to transactivate its target genes NKX2.5 and TBX20, two genes that had been causally linked to DCM. The findings strongly indicate BMP10 as a new gene contributing to DCM in humans and support BMP10 haploinsufficiency as an alternative pathogenic mechanism underpinning DCM, implying potential implications for the early genetic diagnosis and precision prophylaxis of DCM.
扩张型心肌病(DCM)的特征是左心室或双心室扩大并伴有收缩功能障碍,是最常见的心肌病类型。它是充血性心力衰竭的主要原因,也是心脏移植最常见的适应症。越来越多的证据令人信服地表明,DCM有潜在的遗传基础,尽管在大部分病例中导致DCM的遗传缺陷仍不明确,这推动了对新的DCM致病基因的持续研究。在当前的研究中,从中国汉族人群中招募了一个患有常染色体显性DCM的多代家族。通过对家族成员DNA进行全外显子组测序和桑格测序分析,发现了一种新的BMP10变异,NM_014482.3:c.166C>T;p.(Gln56*),并证实其在整个家族中与DCM表型共分离。在作为对照受试者招募的268名健康志愿者中未检测到杂合的BMP10变异。通过双荧光素酶报告基因检测进行的功能测量表明,Gln56*突变的BMP10失去了激活其靶基因NKX2.5和TBX20的能力,这两个基因已被证明与DCM有因果关系。这些发现有力地表明BMP10是导致人类DCM的一个新基因,并支持BMP10单倍体不足是DCM的另一种致病机制,这对DCM的早期基因诊断和精准预防具有潜在意义。