Doubly heterozygous LMNA and TTN mutations revealed by exome sequencing in a severe form of dilated cardiomyopathy
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Doubly heterozygous LMNA and TTN mutations revealed by exome sequencing in a severe form of dilated cardiomyopathy. / Roncarati, Roberta; Viviani Anselmi, Chiara; Krawitz, Peter; Lattanzi, Giovanna; von Kodolitsch, Yskert; Perrot, Andreas; di Pasquale, Elisa; Papa, Laura; Portararo, Paola; Columbaro, Marta; Forni, Alberto; Faggian, Giuseppe; Condorelli, Gianluigi; Robinson, Peter N.
in: EUR J HUM GENET, Jahrgang 21, Nr. 10, 10.2013, S. 1105-1111.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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T1 - Doubly heterozygous LMNA and TTN mutations revealed by exome sequencing in a severe form of dilated cardiomyopathy
AU - Roncarati, Roberta
AU - Viviani Anselmi, Chiara
AU - Krawitz, Peter
AU - Lattanzi, Giovanna
AU - von Kodolitsch, Yskert
AU - Perrot, Andreas
AU - di Pasquale, Elisa
AU - Papa, Laura
AU - Portararo, Paola
AU - Columbaro, Marta
AU - Forni, Alberto
AU - Faggian, Giuseppe
AU - Condorelli, Gianluigi
AU - Robinson, Peter N
PY - 2013/10
Y1 - 2013/10
N2 - Familial dilated cardiomyopathy (DCM) is a heterogeneous disease; although 30 disease genes have been discovered, they explain only no more than half of all cases; in addition, the causes of intra-familial variability in DCM have remained largely unknown. In this study, we exploited the use of whole-exome sequencing (WES) to investigate the causes of clinical variability in an extended family with 14 affected subjects, four of whom showed particular severe manifestations of cardiomyopathy requiring heart transplantation in early adulthood. This analysis, followed by confirmative conventional sequencing, identified the mutation p.K219T in the lamin A/C gene in all 14 affected patients. An additional variant in the gene for titin, p.L4855F, was identified in the severely affected patients. The age for heart transplantation was substantially less for LMNA:p.K219T/TTN:p.L4855F double heterozygotes than that for LMNA:p.K219T single heterozygotes. Myocardial specimens of doubly heterozygote individuals showed increased nuclear length, sarcomeric disorganization, and myonuclear clustering compared with samples from single heterozygotes. In conclusion, our results show that WES can be used for the identification of causal and modifier variants in families with variable manifestations of DCM. In addition, they not only indicate that LMNA and TTN mutational status may be useful in this family for risk stratification in individuals at risk for DCM but also suggest titin as a modifier for DCM.
AB - Familial dilated cardiomyopathy (DCM) is a heterogeneous disease; although 30 disease genes have been discovered, they explain only no more than half of all cases; in addition, the causes of intra-familial variability in DCM have remained largely unknown. In this study, we exploited the use of whole-exome sequencing (WES) to investigate the causes of clinical variability in an extended family with 14 affected subjects, four of whom showed particular severe manifestations of cardiomyopathy requiring heart transplantation in early adulthood. This analysis, followed by confirmative conventional sequencing, identified the mutation p.K219T in the lamin A/C gene in all 14 affected patients. An additional variant in the gene for titin, p.L4855F, was identified in the severely affected patients. The age for heart transplantation was substantially less for LMNA:p.K219T/TTN:p.L4855F double heterozygotes than that for LMNA:p.K219T single heterozygotes. Myocardial specimens of doubly heterozygote individuals showed increased nuclear length, sarcomeric disorganization, and myonuclear clustering compared with samples from single heterozygotes. In conclusion, our results show that WES can be used for the identification of causal and modifier variants in families with variable manifestations of DCM. In addition, they not only indicate that LMNA and TTN mutational status may be useful in this family for risk stratification in individuals at risk for DCM but also suggest titin as a modifier for DCM.
KW - Adolescent
KW - Adult
KW - Aged
KW - Cardiomyopathy, Dilated/diagnosis
KW - Child
KW - Connectin/genetics
KW - Exome
KW - Female
KW - Heterozygote
KW - Humans
KW - Lamin Type A/genetics
KW - Male
KW - Middle Aged
KW - Mutation
KW - Pedigree
KW - Sarcomeres/pathology
KW - Sequence Analysis, DNA/methods
U2 - 10.1038/ejhg.2013.16
DO - 10.1038/ejhg.2013.16
M3 - SCORING: Journal article
C2 - 23463027
VL - 21
SP - 1105
EP - 1111
JO - EUR J HUM GENET
JF - EUR J HUM GENET
SN - 1018-4813
IS - 10
ER -