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1.
J Cell Sci ; 135(5)2022 03 01.
Article in English | MEDLINE | ID: mdl-34308968

ABSTRACT

The Sonic hedgehog (Shh) pathway controls embryonic development and tissue homeostasis after birth. Long-standing questions about this pathway include how the dual-lipidated, firmly plasma membrane-associated Shh ligand is released from producing cells to signal to distant target cells and how the resistance-nodulation-division transporter Dispatched 1 (Disp, also known as Disp1) regulates this process. Here, we show that inactivation of Disp in Shh-expressing human cells impairs proteolytic Shh release from its lipidated terminal peptides, a process called ectodomain shedding. We also show that cholesterol export from Disp-deficient cells is reduced, that these cells contain increased cholesterol amounts in the plasma membrane, and that Shh shedding from Disp-deficient cells is restored by pharmacological membrane cholesterol extraction and by overexpression of transgenic Disp or the structurally related protein Patched 1 (Ptc, also known as Ptch1; a putative cholesterol transporter). These data suggest that Disp can regulate Shh function via controlled cell surface shedding and that membrane cholesterol-related molecular mechanisms shared by Disp and Ptc exercise such sheddase control.


Subject(s)
Cell Membrane , Cholesterol , Hedgehog Proteins , Membrane Transport Proteins/genetics , Cells, Cultured , Hedgehog Proteins/genetics , Humans , Ligands , Signal Transduction
2.
Bioessays ; 43(11): e2100133, 2021 11.
Article in English | MEDLINE | ID: mdl-34611914

ABSTRACT

Two posttranslational lipid modifications present on all Hedgehog (Hh) morphogens-an N-terminal palmitate and a C-terminal cholesterol-are established and essential regulators of Hh biofunction. Yet, for several decades, the question of exactly how both lipids contribute to Hh signaling remained obscure. Recently, cryogenic electron microscopy revealed different modes by which one or both lipids may contribute directly to Hh binding and signaling to its receptor Patched1 (Ptc). Some of these modes demand that the established release factor Dispatched1 (Disp) extracts dual-lipidated Hh from the cell surface, and that another known upstream signaling modulator called Scube2 chaperones the dual-lipidated morphogen to Ptc. By mechanistically and biochemically aligning this concept with established in vivo and recent in vitro findings, this reflection identifies remaining questions in lipidated Hh transport and evaluates additional mechanisms of Disp- and Scube2-regulated release of a second bioactive Hh fraction that has one or both lipids removed.


Subject(s)
Drosophila Proteins , Hedgehog Proteins , Cholesterol , Drosophila Proteins/genetics , Drosophila Proteins/metabolism , Hedgehog Proteins/genetics , Hedgehog Proteins/metabolism , Protein Processing, Post-Translational , Signal Transduction
3.
Front Cell Dev Biol ; 8: 615698, 2020.
Article in English | MEDLINE | ID: mdl-33511123

ABSTRACT

Hedgehog (Hh) morphogens are involved in embryonic development and stem cell biology and, if misregulated, can contribute to cancer. One important post-translational modification with profound impact on Hh biofunction is its C-terminal cholesteroylation during biosynthesis. The current hypothesis is that the cholesterol moiety is a decisive factor in Hh association with the outer plasma membrane leaflet of producing cells, cell-surface Hh multimerization, and its transport and signaling. Yet, it is not decided whether the cholesterol moiety is directly involved in all of these processes, because their functional interdependency raises the alternative possibility that the cholesterol initiates early processes directly and that these processes can then steer later stages of Hh signaling independent of the lipid. We generated variants of the C-terminal Hh peptide and observed that these cholesteroylated peptides variably impaired several post-translational processes in producing cells and Hh biofunction in Drosophila melanogaster eye and wing development. We also found that substantial Hh amounts separated from cholesteroylated peptide tags in vitro and in vivo and that tagged and untagged Hh variants lacking their C-cholesterol moieties remained bioactive. Our approach thus confirms that Hh cholesteroylation is essential during the early steps of Hh production and maturation but also suggests that it is dispensable for Hh signal reception at receiving cells.

4.
Molecules ; 24(8)2019 Apr 23.
Article in English | MEDLINE | ID: mdl-31018591

ABSTRACT

Sonic hedgehog (Shh) signaling plays a tumor-promoting role in many epithelial cancers. Cancer cells produce soluble a Shh that signals to distant stromal cells that express the receptor Patched (Ptc). These receiving cells respond by producing other soluble factors that promote cancer cell growth, generating a positive feedback loop. To interfere with reinforced Shh signaling, we examined the potential of defined heparin and heparan sulfate (HS) polysaccharides to block Shh solubilization and Ptc receptor binding. We confirm in vitro and in vivo that proteolytic cleavage of the N-terminal Cardin-Weintraub (CW) amino acid motif is a prerequisite for Shh solubilization and function. Consistent with the established binding of soluble heparin or HS to the Shh CW target motif, both polysaccharides impaired proteolytic Shh processing and release from source cells. We also show that HS and heparin bind to, and block, another set of basic amino acids required for unimpaired Shh binding to Ptc receptors on receiving cells. Both modes of Shh activity downregulation depend more on HS size and overall charge than on specific HS sulfation modifications. We conclude that heparin oligosaccharide interference in the physiological roles of HS in Shh release and reception may be used to expand the field of investigation to pharmaceutical intervention of tumor-promoting Shh functions.


Subject(s)
Drosophila Proteins/chemistry , Drosophila Proteins/genetics , Hedgehog Proteins/chemistry , Heparin/pharmacology , Heparitin Sulfate/pharmacology , Patched-1 Receptor/genetics , Receptors, Cell Surface/genetics , Amino Acid Sequence , Animals , Binding Sites , Binding, Competitive , Cell Line, Tumor , Drosophila Proteins/antagonists & inhibitors , Drosophila Proteins/metabolism , Drosophila melanogaster/genetics , Drosophila melanogaster/growth & development , Drosophila melanogaster/metabolism , Embryo, Nonmammalian , Feedback, Physiological , Gene Expression Regulation, Developmental , HeLa Cells , Hedgehog Proteins/antagonists & inhibitors , Hedgehog Proteins/genetics , Hedgehog Proteins/metabolism , Heparin/chemistry , Heparitin Sulfate/chemistry , Humans , Models, Molecular , Patched-1 Receptor/metabolism , Protein Binding , Protein Interaction Domains and Motifs , Protein Structure, Secondary , Receptors, Cell Surface/metabolism , Signal Transduction , Solubility , Wings, Animal/growth & development , Wings, Animal/metabolism
5.
J Cell Sci ; 130(19): 3261-3271, 2017 Oct 01.
Article in English | MEDLINE | ID: mdl-28778988

ABSTRACT

Proteolytic processing of cell-surface-bound ligands, called shedding, is a fundamental system to control cell-cell signaling. Yet, our understanding of how shedding is regulated is still incomplete. One way to increase the processing of dual-lipidated membrane-associated Sonic hedgehog (Shh) is to increase the density of substrate and sheddase. This releases and also activates Shh by the removal of lipidated inhibitory N-terminal peptides from Shh receptor binding sites. Shh release and activation is enhanced by Scube2 [signal sequence, cubulin (CUB) domain, epidermal growth factor (EGF)-like protein 2], raising the question of how this is achieved. Here, we show that Scube2 EGF domains are responsible for specific proteolysis of the inhibitory Shh N-terminus, and that CUB domains complete the process by reversing steric masking of this peptide. Steric masking, in turn, depends on Ca2+ occupancy of Shh ectodomains, unveiling a new mode of shedding regulation at the substrate level. Importantly, Scube2 uncouples processing of Shh peptides from their lipid-mediated juxtamembrane positioning, and thereby explains the long-standing conundrum that N-terminally unlipidated Shh shows patterning activity in Scube2-expressing vertebrates, but not in invertebrates that lack Scube orthologs.


Subject(s)
Calcium/metabolism , Hedgehog Proteins/metabolism , Intercellular Signaling Peptides and Proteins/metabolism , Adaptor Proteins, Signal Transducing , Animals , Calcium-Binding Proteins , HEK293 Cells , Hedgehog Proteins/genetics , Humans , Intercellular Signaling Peptides and Proteins/genetics , Mice , Protein Domains
6.
J Cell Sci ; 127(Pt 8): 1726-37, 2014 Apr 15.
Article in English | MEDLINE | ID: mdl-24522195

ABSTRACT

All morphogens of the Hedgehog (Hh) family are synthesized as dual-lipidated proteins, which results in their firm attachment to the surface of the cell in which they were produced. Thus, Hh release into the extracellular space requires accessory protein activities. We suggested previously that the proteolytic removal of N- and C-terminal lipidated peptides (shedding) could be one such activity. More recently, the secreted glycoprotein Scube2 (signal peptide, cubulin domain, epidermal-growth-factor-like protein 2) was also implicated in the release of Shh from the cell membrane. This activity strictly depended on the CUB domains of Scube2, which derive their name from the complement serine proteases and from bone morphogenetic protein-1/tolloid metalloproteinases (C1r/C1s, Uegf and Bmp1). CUB domains function as regulators of proteolytic activity in these proteins. This suggested that sheddases and Scube2 might cooperate in Shh release. Here, we confirm that sheddases and Scube2 act cooperatively to increase the pool of soluble bioactive Shh, and that Scube2-dependent morphogen release is unequivocally linked to the proteolytic processing of lipidated Shh termini, resulting in truncated soluble Shh. Thus, Scube2 proteins act as protease enhancers in this setting, revealing newly identified Scube2 functions in Hh signaling regulation.


Subject(s)
Hedgehog Proteins/metabolism , Membrane Proteins/physiology , ADAM Proteins/metabolism , Acyltransferases/genetics , Acyltransferases/metabolism , Adaptor Proteins, Signal Transducing , Amino Acid Sequence , Animals , Calcium-Binding Proteins , Cell Line , Cricetinae , Drosophila Proteins/metabolism , Drosophila melanogaster , Gene Expression , Humans , Membrane Proteins/metabolism , Mice , Molecular Sequence Data , Protein Processing, Post-Translational , Protein Sorting Signals , Proteolysis , Solubility
7.
Mol Genet Metab ; 95(1-2): 66-73, 2008.
Article in English | MEDLINE | ID: mdl-18672388

ABSTRACT

The rare genetic disorder Fanconi anemia, caused by a deficiency in any of at least thirteen identified genes, is characterized by cellular sensitivity to DNA interstrand crosslinks and genome instability. The excision repair cross complementing protein, ERCC1, first identified as a participant in nucleotide excision repair, appears to also act in crosslink repair, possibly in incision and at a later stage. We have investigated the relationship of ERCC1 to the Fanconi anemia pathway, using depletion of ERCC1 by siRNA in transformed normal human fibroblasts and fibroblasts from Fanconi anemia patients. We find that depletion of ERCC1 does not hinder formation of double strand breaks in crosslink repair as indexed by gammaH2AX. However, the monoubiquitination of FANCD2 protein in response to MMC treatment is decreased and the localization of FANCD2 to nuclear foci is eliminated. Arrest of DNA replication by hydroxyurea, producing double strand breaks without crosslinks, also requires ERRC1 for FANCD2 localization to nuclear foci. Our results support a role for ERCC1 after creation of a double strand break for full activation of the Fanconi anemia pathway.


Subject(s)
Cell Nucleus/metabolism , DNA-Binding Proteins/metabolism , Endonucleases/metabolism , Fanconi Anemia Complementation Group D2 Protein/metabolism , Fanconi Anemia/metabolism , Cell Line, Transformed , Cell Nucleus/genetics , Cell Survival/drug effects , Cells, Cultured , DNA Breaks, Double-Stranded , DNA-Binding Proteins/genetics , Endonucleases/genetics , Fanconi Anemia/genetics , Fanconi Anemia Complementation Group D2 Protein/genetics , Fibroblasts/drug effects , Fibroblasts/metabolism , Histones/genetics , Histones/metabolism , Humans , Mutagens/pharmacology , Protein Transport/drug effects , RNA, Small Interfering/genetics , Ubiquitination/drug effects
8.
Am Heart J ; 156(1): 161-9, 2008 Jul.
Article in English | MEDLINE | ID: mdl-18585512

ABSTRACT

BACKGROUND: Lamin A/C mutations are a well-established cause of dilated cardiomyopathy (DCM), although their frequency has not been examined in a large cohort of patients. We sought to examine the frequency of mutations in LMNA, the gene encoding lamin A/C, in patients with idiopathic (IDC) or familial dilated cardiomyopathy (FDC). METHODS: Clinical cardiovascular data, family histories, and blood samples were collected from 324 unrelated IDC probands, of whom 187 had FDC. DNA samples were sequenced for nucleotide alterations in LMNA. Likely protein-altering mutations were followed up by evaluating additional family members, when possible. RESULTS: We identified 18 protein-altering LMNA variants in 19 probands or 5.9% of all cases (7.5% of FDC; 3.6% of IDC). Of the 18 alterations, 11 were missense (one present in 2 kindreds), 3 were nonsense, 3 were insertion/deletions, and 1 was a splice site alteration. Conduction system disease and DCM were common in carriers of LMNA variants. Unexpectedly, in 6 of the 19 kindreds with a protein-altering LMNA variant (32%), at least one affected family member was negative for the LMNA variant. CONCLUSIONS: Lamin A/C variants were observed with a frequency of 5.9% in probands with DCM. The novel observation of FDC pedigrees in which not all affected individuals carry the putative disease-causing LMNA mutation suggests that some protein-altering LMNA variants are not causative or that some proportion of FDC may be because of multiple causative factors. These findings warrant increased caution in FDC research and molecular diagnostics.


Subject(s)
Cardiomyopathy, Dilated/genetics , Genetic Predisposition to Disease/epidemiology , Heterozygote , Mutation, Missense , Adult , Cardiomyopathy, Dilated/epidemiology , Cardiomyopathy, Dilated/pathology , Cohort Studies , DNA Mutational Analysis , Female , Gene Expression Regulation , Humans , Lamin Type A/genetics , Male , Middle Aged , Nuclear Lamina/genetics , Pedigree , Polymerase Chain Reaction , Prognosis , Severity of Illness Index , Survival Analysis
9.
J Biol Chem ; 283(25): 17075-82, 2008 Jun 20.
Article in English | MEDLINE | ID: mdl-18434313

ABSTRACT

Although there exists compelling genetic evidence for a homologous recombination-independent pathway for repair of interstrand cross-links (ICLs) involving translesion synthesis (TLS), biochemical support for this model is lacking. To identify DNA polymerases that may function in TLS past ICLs, oligodeoxynucleotides were synthesized containing site-specific ICLs in which the linkage was between N(2)-guanines, similar to cross-links formed by mitomycin C and enals. Here, data are presented that mammalian cell replication of DNAs containing these lesions was approximately 97% accurate. Using a series of oligodeoxynucleotides that mimic potential intermediates in ICL repair, we demonstrate that human polymerase (pol) kappa not only catalyzed accurate incorporation opposite the cross-linked guanine but also replicated beyond the lesion, thus providing the first biochemical evidence for TLS past an ICL. The efficiency of TLS was greatly enhanced by truncation of both the 5 ' and 3 ' ends of the nontemplating strand. Further analyses showed that although yeast Rev1 could incorporate a dCTP opposite the cross-linked guanine, no evidence was found for TLS by pol zeta or a pol zeta/Rev1 combination. Because pol kappa was able to bypass these ICLs, biological evidence for a role for pol kappa in tolerating the N(2)-N(2)-guanine ICLs was sought; both cell survival and chromosomal stability were adversely affected in pol kappa-depleted cells following mitomycin C exposure. Thus, biochemical data and cellular studies both suggest a role for pol kappa in the processing of N(2)-N(2)-guanine ICLs.


Subject(s)
DNA-Directed DNA Polymerase/physiology , Guanine/chemistry , Animals , Base Sequence , COS Cells , Cell Survival , Chlorocebus aethiops , Chromosomes/ultrastructure , Cross-Linking Reagents/chemistry , DNA Repair , DNA-Directed DNA Polymerase/chemistry , Molecular Sequence Data , Mutagens , Oligonucleotides/chemistry , Reproducibility of Results
10.
Clin Transl Sci ; 1(1): 21-6, 2008 May.
Article in English | MEDLINE | ID: mdl-19412328

ABSTRACT

BACKGROUND: More than 20 genes have been reported to cause idiopathic and familial dilated cardiomyopathy (IDC/FDC), but the frequency of genetic causation remains poorly understood. METHODS AND RESULTS: Blood samples were collected and DNA prepared from 313 patients, 183 with FDC and 130 with IDC. Genomic DNA underwent bidirectional sequencing of six genes, and mutation carriers were followed up by evaluation of additional family members. We identified in 36 probands, 31 unique protein-altering variants (11.5% overall) that were not identified in 253 control subjects (506 chromosomes). These included 13 probands (4.2%) with 12 beta-myosin heavy chain (MYH7) mutations, nine probands (2.9%) with six different cardiac troponin T (TNNT2) mutations, eight probands (2.6%) carrying seven different cardiac sodium channel (SCN5A) mutations, three probands (1.0%) with three titin-cap or telethonin (TCAP) mutations, three probands (1.0%) with two LIM domain binding 3 (LDB3) mutations, and one proband (0.3%) with a muscle LIM protein (CSRP3) mutation. Four nucleotide changes did not segregate with phentoype and/or did not alter a conserved amino acid and were therefore considered unlikely to be disease-causing. Mutations in 11 probands were assessed as likely disease-causing, and in 21 probands were considered possibly disease-causing. These 32 probands included 14 of the 130 with IDC (10.8%) and 18 of 183 with FDC (9.8%) CONCLUSIONS: Mutations of these six genes each account for a small fraction of the genetic cause of FDC/IDC. The frequency of possible or likely disease-causing mutations in these genes is similar for IDC and FDC.


Subject(s)
Cardiac Myosins/genetics , Cardiomyopathy, Dilated/genetics , DNA Mutational Analysis , Muscle Proteins/genetics , Mutation , Myosin Heavy Chains/genetics , Sodium Channels/genetics , Troponin T/genetics , Connectin , Ethnicity , Exons , Family Health , Humans , Introns , LIM Domain Proteins , NAV1.5 Voltage-Gated Sodium Channel , Protein Structure, Tertiary
11.
Am J Hum Genet ; 79(6): 1030-9, 2006 Dec.
Article in English | MEDLINE | ID: mdl-17186461

ABSTRACT

Two common disorders of the elderly are heart failure and Alzheimer disease (AD). Heart failure usually results from dilated cardiomyopathy (DCM). DCM of unknown cause in families has recently been shown to result from genetic disease, highlighting newly discovered disease mechanisms. AD is the most frequent neurodegenerative disease of older Americans. Familial AD is caused most commonly by presenilin 1 (PSEN1) or presenilin 2 (PSEN2) mutations, a discovery that has greatly advanced the field. The presenilins are also expressed in the heart and are critical to cardiac development. We hypothesized that mutations in presenilins may also be associated with DCM and that their discovery could provide new insight into the pathogenesis of DCM and heart failure. A total of 315 index patients with DCM were evaluated for sequence variation in PSEN1 and PSEN2. Families positive for mutations underwent additional clinical, genetic, and functional studies. A novel PSEN1 missense mutation (Asp333Gly) was identified in one family, and a single PSEN2 missense mutation (Ser130Leu) was found in two other families. Both mutations segregated with DCM and heart failure. The PSEN1 mutation was associated with complete penetrance and progressive disease that resulted in the necessity of cardiac transplantation or in death. The PSEN2 mutation showed partial penetrance, milder disease, and a more favorable prognosis. Calcium signaling was altered in cultured skin fibroblasts from PSEN1 and PSEN2 mutation carriers. These data indicate that PSEN1 and PSEN2 mutations are associated with DCM and heart failure and implicate novel mechanisms of myocardial disease.


Subject(s)
Calcium Signaling , Heart Failure/genetics , Mutation , Presenilin-1/genetics , Presenilin-2/genetics , Adult , Aged , Alzheimer Disease/genetics , Amino Acid Sequence , Calcium/metabolism , Cardiomyopathy, Dilated/etiology , Cardiomyopathy, Dilated/genetics , Cells, Cultured , Female , Fibroblasts/metabolism , Heart Failure/etiology , Humans , Male , Middle Aged , Molecular Sequence Data , Pedigree , Penetrance , Presenilin-1/metabolism , Presenilin-2/metabolism
12.
Blood ; 102(1): 7-16, 2003 Jul 01.
Article in English | MEDLINE | ID: mdl-12637330

ABSTRACT

Myelodysplastic and leukemic stem cell clones that evolve in children and adults with Fanconi anemia universally bear complex cytogenetic abnormalities. The abnormalities are generally recurring deletions or chromosomal loss and involve precisely the same chromosomes with the same frequency as has been described in marrow cells from patients with secondary acute leukemia induced by alkylating agents. Reasoning that acquired Fanconi anemia protein dysfunction might contribute to cytogenetic instability in secondary acute myelogenous leukemia (AML) cells, we analyzed leukemic cells bearing characteristic complex cytogenetic defects obtained from a 68-year-old man whose lymphoblasts showed no evidence of Fanconi anemia. Unlike the lymphoblasts, this myeloid leukemia cell line (UoC-M1) was hypersensitive to mitomycin-C (MMC) and diepoxybutane (DEB) and exhibited a marked decrease in nuclear FANCA, FANCG, and FANCD2-L. Retroviral transduction of FANCA significantly reduced MMC sensitivity but FANCF, FANCG, and FANCC did not. Overexpression of FANCA restored levels of both FANCA and FANCG, whereas overexpression of FANCG or FANCC did not restore FANCA levels. The molecular mass of cytoplasmic FANCA, FANCG, FANCC, and nuclear FANCD2 were normal. All exons of FANCA and FANCG were sequenced, and no mutations were found. We conclude that perturbations of as yet unidentified factors that govern the binding activity or intracellular localization of FANCA may promote cytogenetic instability and clonal progression in patients with AML who do not have Fanconi anemia.


Subject(s)
Cell Cycle Proteins , Chromosome Aberrations , Leukemia, Myeloid, Acute/pathology , Proteins/physiology , Aged , Alkylating Agents/pharmacology , Chromosome Aberrations/chemically induced , Clone Cells , DNA Mutational Analysis , DNA-Binding Proteins/analysis , Fanconi Anemia Complementation Group A Protein , Fanconi Anemia Complementation Group C Protein , Fanconi Anemia Complementation Group D2 Protein , Fanconi Anemia Complementation Group G Protein , Fanconi Anemia Complementation Group Proteins , Humans , Leukemia, Myeloid, Acute/etiology , Leukemia, Myeloid, Acute/genetics , Male , Mitomycin/pharmacology , Models, Genetic , Nuclear Proteins/analysis , Proteins/analysis , Proteins/genetics , Tumor Cells, Cultured
13.
Am Heart J ; 144(6): 1081-6, 2002 Dec.
Article in English | MEDLINE | ID: mdl-12486434

ABSTRACT

BACKGROUND: The LMNA gene, which encodes the nuclear envelope protein lamin A/C, is thought to be the most common of 8 autosomal disease genes implicated in familial dilated cardiomyopathy (FDC). Each family reported to date has a unique mutation and variable degrees of cardiac conduction system, dilated cardiomyopathy, or skeletal muscle disease. METHODS AND RESULTS: Coding regions of the LMNA gene were screened in 12 biological members of a family with dilated cardiomyopathy and conduction system disease. A novel missense mutation (Leu215Pro) in exon 4 was identified in 8 subjects. Disease was manifested as brady- and tachyarrhythmias, often necessitating permanent pacemaker implantation, and later onset of dilated cardiomyopathy and heart failure. No features of skeletal muscle disease were noted. The high percentage of affected individuals who needed pacemaker therapy (88%) was a unique characteristic of this family compared with other FDC families with LMNA mutations. CONCLUSIONS: Careful examination of clinical data in families with FDC and LMNA mutations may reveal subtle genotype-phenotype correlations. Knowledge of such correlations may help to further define the mechanisms of disease in LMNA-associated FDC and can assist in the monitoring of disease for at-risk family members.


Subject(s)
Arrhythmias, Cardiac/complications , Arrhythmias, Cardiac/genetics , Cardiomyopathy, Dilated/complications , Cardiomyopathy, Dilated/genetics , Lamin Type A/genetics , Mutation, Missense , Adult , Arrhythmias, Cardiac/surgery , Cardiomyopathy, Dilated/surgery , Female , Humans , Male , Middle Aged , Pacemaker, Artificial , Pedigree , Phenotype
14.
J Card Fail ; 8(1): 28-32, 2002 Feb.
Article in English | MEDLINE | ID: mdl-11862580

ABSTRACT

BACKGROUND: The gene for cardiac troponin T (TNNT2) is 1 of 7 autosomal disease genes implicated in familial dilated cardiomyopathy (FDC). Identical deletions in exon 13 of TNNT2 have been reported in 2 families with FDC, but little is known about the frequency of this deletion among patients with FDC and idiopathic dilated cardiomyopathy (IDC) and the associated phenotype. METHODS AND RESULTS: Exon 13 of the cardiac troponin T gene was sequenced in 61 subjects with FDC and 53 subjects with IDC. A 3-base pair deletion (DeltaLys210), identified in 1 family with at least 7 clinically affected family members, is reported. Age of disease onset and disease severity varied widely among affected individuals; phenotypic findings included dilated cardiomyopathy, sudden cardiac death, conduction system disease including atrial fibrillation and atrioventricular block, and heart failure. Sudden-onset, rapidly progressive disease was observed in younger individuals. CONCLUSIONS: Cardiac troponin T exon 13 lysine deletions can cause FDC of varying severity and are an important but uncommon cause of FDC.


Subject(s)
Cardiomyopathy, Dilated/genetics , Troponin T/genetics , Cardiomyopathy, Hypertrophic, Familial/genetics , Exons , Female , Gene Deletion , Humans , Lysine/genetics , Male , Middle Aged , Mutation , Pedigree
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