Department of Neurology, Second Hospital of Hebei Medical University, Shijiazhuang, China.
Neurological Laboratory of Hebei Province, Shijiazhuang, China.
Mol Genet Genomic Med. 2023 Aug;11(8):e2222. doi: 10.1002/mgg3.2222. Epub 2023 Jun 5.
Frontotemporal dementia (FTD) has genetic heterogeneity, and the endosomal ESCRTIII-complex subunit CHMP2B variant is a rare cause of FTD. The mutations in CHMP2B were first identified in a large Danish pedigree with autosomal dominant FTD, and have also been found in several individuals from Belgium, France, the United States, and Türkiye. In the Chinese population, cases of CHMP2B variant-associated FTD have never been reported.
The spectrum of clinical symptoms and the genetic analysis of the presented patient were identified and investigated. Besides this case, we assessed previously reported cases with CHMP2B gene mutations.
This study presents a Chinese patient harboring a novel heterozygous A-to-T variant (NM_014043:c.532-2A>T) in CHMP2B with a phenotype compatible with FTD. Although previous reports suggested cases of CHMP2B variant-associated FTD initially presented with personality changes and stereotypical movements at the age of 50, this case was characterized by psychosis involving delusion of persecution, auditory hallucination, and suspiciousness at the earlier onset age of 44. Minigene splicing assay revealed that the splice-site variant could result in the retention of intron 5.
This is the first case of CHMP2B variant-associated FTD reported in the Chinese population. The novel c.532-2A>T variant in the acceptor splice site of exon 6 retaining intron 5 was predicted to cause truncated protein and protein conformation changes. This discovery may expand the genetic and phenotypic spectrum of CHMP2B variant-associated FTD.
额颞叶痴呆(FTD)具有遗传异质性,内体 ESCRTIII 复合物亚基 CHMP2B 变体是 FTD 的罕见病因。CHMP2B 的突变首先在一个具有常染色体显性遗传的大型丹麦家族中被发现,并且也在比利时、法国、美国和土耳其的几个个体中被发现。在中国人群中,从未报道过 CHMP2B 变体相关 FTD 的病例。
鉴定并研究了所呈现患者的临床症状谱和遗传分析。除了本病例外,我们还评估了具有 CHMP2B 基因突变的先前报道的病例。
本研究提出了一名中国患者,其 CHMP2B 中存在一种新的杂合 A 到 T 变体(NM_014043:c.532-2A>T),表型与 FTD 相兼容。尽管先前的报告表明 CHMP2B 变体相关 FTD 的病例最初在 50 岁时表现出人格改变和刻板运动,但该病例的特征是精神病,涉及迫害妄想、幻听和多疑,发病年龄更早为 44 岁。小基因拼接分析表明,剪接位点变体可导致内含子 5 的保留。
这是首例在中国人群中报道的 CHMP2B 变体相关 FTD 病例。外显子 6 的受体剪接位点中的新型 c.532-2A>T 变体预计会导致截短蛋白和蛋白质构象改变。这一发现可能会扩展 CHMP2B 变体相关 FTD 的遗传和表型谱。