acyltransferases

酰基转移酶
  • 文章类型: Journal Article
    非酒精性脂肪性肝病(NAFLD)的发病率,或代谢功能障碍相关的脂肪肝疾病(MAFLD),在成人和儿童中正在增加。不幸的是,有效的药物治疗仍然不可用。含patatin类磷脂酶结构域的蛋白质(PNPLA3I148M)中的单核苷酸多态性(SNP)在疾病进展的所有阶段与疾病具有最重要的遗传关联。确定PNPLA3诱导的NAFLD的潜在治疗方法的障碍是缺乏概括PNPLA3I148M介导的脂质积累开始的人细胞平台。从PNPLA3-/-和PNPLA3I148M/M诱导的多能干细胞(iPSC)产生肝细胞样细胞。通过用BODIPY493/503染色测量脂质水平,发现在PNPLA3变体iPSC衍生的肝细胞中增加。小分子筛选鉴定了靶向Src/PI3K/Akt信号传导并且可以根除这些细胞中的脂质积累的多种化合物。我们发现,目前在临床试验中针对相同途径的癌症治疗药物也减少了PNPLA3变异细胞中的脂质积累。
    The incidence of nonalcoholic fatty liver disease (NAFLD), or metabolic dysfunction-associated fatty liver disease (MAFLD), is increasing in adults and children. Unfortunately, effective pharmacological treatments remain unavailable. Single nucleotide polymorphisms (SNPs) in the patatin-like phospholipase domain-containing protein (PNPLA3 I148M) have the most significant genetic association with the disease at all stages of its progression. A roadblock to identifying potential treatments for PNPLA3-induced NAFLD is the lack of a human cell platform that recapitulates the PNPLA3 I148M-mediated onset of lipid accumulation. Hepatocyte-like cells were generated from PNPLA3-/- and PNPLA3I148M/M-induced pluripotent stem cells (iPSCs). Lipid levels were measured by staining with BODIPY 493/503 and were found to increase in PNPLA3 variant iPSC-derived hepatocytes. A small-molecule screen identified multiple compounds that target Src/PI3K/Akt signaling and could eradicate lipid accumulation in these cells. We found that drugs currently in clinical trials for cancer treatment that target the same pathways also reduced lipid accumulation in PNPLA3 variant cells.
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  • 文章类型: Journal Article
    苯丙烷类,一类特殊的代谢产物,在植物生长和胁迫适应中起关键作用,包括多种酚类化合物,如类黄酮。苯丙氨酸氨裂解酶(PAL)和查尔酮合成酶(CHS)是在一般苯丙素生物合成和类黄酮生物合成的切入点发挥作用的必需酶。分别。在拟南芥中,PAL和CHS通过泛素化依赖性蛋白酶体降解而被翻转。作为泛素E3连接酶的成分,含有特定kelch结构域的F-Box(KFB)蛋白直接与PAL或CHS相互作用,导致多泛素化PAL和CHS,进而影响苯丙素和类黄酮的生产。虽然苯丙素类对番茄的营养价值和应激反应至关重要,番茄中PAL和CHS的翻译后调节仍然未知。我们在番茄基因组中鉴定了31个推定的KFB编码基因。我们的同源性分析和系统发育研究预测了四个PAL相互作用的SlKFBs,而SlKFB18被确定为CHS相互作用KFB的唯一候选。与它们的同源功能一致,预测的四个与PAL相互作用的SlKFBs在PAL降解中的作用。令人惊讶的是,SlKFB18不与番茄CHS相互作用,并且SlKFB18的过表达或敲除不影响番茄转基因品系中的苯丙烷含量,表明它与类黄酮代谢无关。我们的研究成功地发现了番茄中PAL的翻译后调控机制,同时强调了仅依靠基于同源性的方法来预测F-box蛋白的相互作用伴侣的局限性。
    Phenylpropanoids, a class of specialized metabolites, play crucial roles in plant growth and stress adaptation and include diverse phenolic compounds such as flavonoids. Phenylalanine ammonia-lyase (PAL) and chalcone synthase (CHS) are essential enzymes functioning at the entry points of general phenylpropanoid biosynthesis and flavonoid biosynthesis, respectively. In Arabidopsis, PAL and CHS are turned over through ubiquitination-dependent proteasomal degradation. Specific kelch domain-containing F-Box (KFB) proteins as components of ubiquitin E3 ligase directly interact with PAL or CHS, leading to polyubiquitinated PAL and CHS, which in turn influences phenylpropanoid and flavonoid production. Although phenylpropanoids are vital for tomato nutritional value and stress responses, the post-translational regulation of PAL and CHS in tomato remains unknown. We identified 31 putative KFB-encoding genes in the tomato genome. Our homology analysis and phylogenetic study predicted four PAL-interacting SlKFBs, while SlKFB18 was identified as the sole candidate for the CHS-interacting KFB. Consistent with their homolog function, the predicted four PAL-interacting SlKFBs function in PAL degradation. Surprisingly, SlKFB18 did not interact with tomato CHS and the overexpression or knocking out of SlKFB18 did not affect phenylpropanoid contents in tomato transgenic lines, suggesting its irreverence with flavonoid metabolism. Our study successfully discovered the post-translational regulatory machinery of PALs in tomato while highlighting the limitation of relying solely on a homology-based approach to predict interacting partners of F-box proteins.
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  • 文章类型: Journal Article
    平面细胞极性(PCP)的缺陷与多种人类病理有关。Vangl2是对PCP信令至关重要的核心PCP组件之一。Vangl2的失调与严重的神经管缺陷和癌症有关。然而,Vangl2蛋白是如何在翻译后水平上被调节的还没有被很好地理解。使用脂肪酰化和生化验证的化学报告基因,在这里,我们提出Vangl2亚细胞定位受可逆的S-硬脂酰化循环调节.其动态过程主要受ZDHHC9酰基转移酶和脱酰基酶酰蛋白硫酯酶1(APT1)调控。Vangl2的硬脂酰化缺陷型突变体显示出降低的质膜定位,导致细胞迁移过程中PCP建立的破坏。遗传或药理学抑制ZDHHC9表型对Vangl2的硬脂酰化损失的影响。此外,Vangl2硬脂酰化的缺失增强了致癌Yes相关蛋白1(YAP)的激活,丝氨酸-苏氨酸激酶AKT,和细胞外信号调节蛋白激酶(ERK)信号并促进乳腺癌细胞生长和HRasG12V突变体(HRasV12)诱导的致癌转化。我们的结果揭示了Vangl2的调节机制,并提供了有关脂肪酸代谢和蛋白质脂肪酰化如何通过核心PCP蛋白质脂化调节PCP信号传导和肿瘤发生的机制见解。
    Defects in planar cell polarity (PCP) have been implicated in diverse human pathologies. Vangl2 is one of the core PCP components crucial for PCP signaling. Dysregulation of Vangl2 has been associated with severe neural tube defects and cancers. However, how Vangl2 protein is regulated at the posttranslational level has not been well understood. Using chemical reporters of fatty acylation and biochemical validation, here we present that Vangl2 subcellular localization is regulated by a reversible S-stearoylation cycle. The dynamic process is mainly regulated by acyltransferase ZDHHC9 and deacylase acyl-protein thioesterase 1 (APT1). The stearoylation-deficient mutant of Vangl2 shows decreased plasma membrane localization, resulting in disruption of PCP establishment during cell migration. Genetically or pharmacologically inhibiting ZDHHC9 phenocopies the effects of the stearoylation loss of Vangl2. In addition, loss of Vangl2 stearoylation enhances the activation of oncogenic Yes-associated protein 1 (YAP), serine-threonine kinase AKT, and extracellular signal-regulated protein kinase (ERK) signaling and promotes breast cancer cell growth and HRas G12V mutant (HRasV12)-induced oncogenic transformation. Our results reveal a regulation mechanism of Vangl2, and provide mechanistic insight into how fatty acid metabolism and protein fatty acylation regulate PCP signaling and tumorigenesis by core PCP protein lipidation.
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  • 文章类型: Journal Article
    生物分子缩合物在许多细胞过程中起着重要作用,包括一些发生在脂质双层膜表面的。越来越多的证据表明,细胞膜贩运现象,包括通过胞吞作用使质膜内化,是由多价蛋白质-蛋白质相互作用介导的,可以导致相分离。我们最近发现,与网格蛋白无关的内吞途径有关的蛋白质称为FastEndophilin介导的内吞,可以在溶液中和脂质双层膜上进行液-液相分离(LLPS)。这里,与溶液中的相分离所需的蛋白质溶液浓度相比,观察到的相分离所需的蛋白质溶液浓度显著较小。通常,LLPS在蜂窝系统中系统地表征是具有挑战性的,特别是在生物膜上。模型膜方法更适合于该目的,因为它们允许精确控制存在于混合物中的组分的性质和量。在这里,我们描述了一种能够在固体支持的脂质双层上成像LLPS结构域形成的方法。这些可以方便地成像,提供长期稳定性,并避免在多价膜相互作用蛋白的存在下聚集囊泡和囊泡附着的特征(例如芽和系链)。
    Biomolecular condensates play a major role in numerous cellular processes, including several that occur on the surface of lipid bilayer membranes. There is increasing evidence that cellular membrane trafficking phenomena, including the internalization of the plasma membrane through endocytosis, are mediated by multivalent protein-protein interactions that can lead to phase separation. We have recently found that proteins involved in the clathrin-independent endocytic pathway named Fast Endophilin Mediated Endocytosis can undergo liquid-liquid phase separation (LLPS) in solution and on lipid bilayer membranes. Here, the protein solution concentrations required for phase separation to be observed are significantly smaller compared to those required for phase separation in solution. LLPS is challenging to systematically characterize in cellular systems in general, and on biological membranes in particular. Model membrane approaches are more suitable for this purpose as they allow for precise control over the nature and amount of the components present in a mixture. Here we describe a method that enables the imaging of LLPS domain formation on solid supported lipid bilayers. These allow for facile imaging, provide long-term stability, and avoid clustering of vesicles and vesicle-attached features (such as buds and tethers) in the presence of multi-valent membrane interacting proteins.
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  • 文章类型: Journal Article
    背景:纤维化-4(FIB4)是一种推荐的非侵入性测试,用于评估代谢功能障碍相关脂肪变性肝病(MASLD)患者的肝纤维化。这里,我们使用FIB4轨迹随着时间的推移(即,FIB4的“斜率”)作为肝纤维化进展的替代标志物,并检查FIB4斜率是否与百万退伍军人计划队列中临床定义的MASLD个体中的临床和遗传因素相关。
    方法:在这项回顾性队列研究中,对于基线时临床定义的MASLD和FIB4<2.67的参与者,通过线性回归估算FIB4斜率。使用逻辑回归和Cox比例风险模型,FIB4斜率与人口统计学参数和临床结果相关。FIB4斜率作为定量表型用于祖先特异性分析和使用METAL的多祖先荟萃分析中的全基因组关联分析。
    结果:FIB4斜率,从98,361名MASLD受试者(16,045非洲,74,320欧洲,和7996西班牙裔),表现出与性别的显著关联,祖先,和心脏代谢危险因素(p<0.05)。FIB4斜率也与肝脏结局密切相关,并且与肝硬化时间独立相关。在欧洲血统受试者中,五个遗传基因座显示出与FIB4斜率的全基因组显着关联(p<5×10-8),包括2个已知基因座(PNPLA3和TM6SF2)和3个新基因座(TERT5.1×10-11;LINC01088,3.9×10-8;和MRC1,2.9×10-9)。
    结论:FIB4的线性轨迹与进展到肝硬化的时间显著相关,具有MASLD和已知和新的遗传基因座的个体与肝脏相关的结果。FIB4斜率可用作纤维化进展的替代量度。
    BACKGROUND: Fibrosis-4 (FIB4) is a recommended noninvasive test to assess hepatic fibrosis among patients with metabolic dysfunction-associated steatotic liver disease (MASLD). Here, we used FIB4 trajectory over time (ie, \"slope\" of FIB4) as a surrogate marker of liver fibrosis progression and examined if FIB4 slope is associated with clinical and genetic factors among individuals with clinically defined MASLD within the Million Veteran Program Cohort.
    METHODS: In this retrospective cohort study, FIB4 slopes were estimated through linear regression for participants with clinically defined MASLD and FIB4 <2.67 at baseline. FIB4 slope was correlated with demographic parameters and clinical outcomes using logistic regression and Cox proportional hazard models. FIB4 slope as a quantitative phenotype was used in a genome-wide association analysis in ancestry-specific analysis and multiancestry meta-analysis using METAL.
    RESULTS: FIB4 slopes, generated from 98,361 subjects with MASLD (16,045 African, 74,320 European, and 7996 Hispanic), showed significant associations with sex, ancestry, and cardiometabolic risk factors (p < 0.05). FIB4 slopes also correlated strongly with hepatic outcomes and were independently associated with time to cirrhosis. Five genetic loci showed genome-wide significant associations (p < 5 × 10-8) with FIB4 slope among European ancestry subjects, including 2 known (PNPLA3 and TM6SF2) and 3 novel loci (TERT 5.1 × 10-11; LINC01088, 3.9 × 10-8; and MRC1, 2.9 × 10-9).
    CONCLUSIONS: Linear trajectories of FIB4 correlated significantly with time to progression to cirrhosis, with liver-related outcomes among individuals with MASLD and with known and novel genetic loci. FIB4 slope may be useful as a surrogate measure of fibrosis progression.
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  • 文章类型: Journal Article
    糖基化磷脂酰肌醇(GPI)锚定蛋白是真核细胞中普遍存在的翻译后修饰。GPI锚定蛋白(GPI-AP)在酶促、信令,监管,和粘附过程。超过20种酶参与GPI合成,附着在客户蛋白质上,依恋后的重塑。GPI转酰胺酶(GPI-T),一个位于内质网膜的大型复合体,通过用GPI替换前蛋白的C末端信号肽来催化附着步骤。在过去的三十年里,对转酰胺化反应的机理进行了广泛的研究,GPI-T复合体的组成部分,每个亚基的作用,和底物特异性。最近的两项研究报道了GPI-T的三维结构,它们代表了路径的第一个结构。这些结构提供了详细的组装机制,使先前的生化结果和亚基依赖性稳定性数据合理化。虽然结构数据证实了PIGK的催化作用,它可能使用胱天蛋白酶样机制来切割前蛋白,他们认为与以前提出的不同,GPAA1不是催化亚基。该结构还揭示了GPI结合的共享腔。有点出乎意料,PIGT,一种单程膜蛋白,在GPI识别中起着至关重要的作用。与组装机制和活动站点体系结构一致,大多数疾病突变发生在活性位点或亚基界面附近。最后,催化对偶位于距离GPI结合位点的膜界面约22埃外,并且这种结构可以通过底物和细长活性位点之间的拓扑匹配来赋予底物特异性。到目前为止进行的研究揭示了GPI锚定所涉及的复杂过程,并为GPI-T的进一步机理研究铺平了道路。
    Glycosylphosphatidylinositol (GPI) anchoring of proteins is a ubiquitous posttranslational modification in eukaryotic cells. GPI-anchored proteins (GPI-APs) play critical roles in enzymatic, signaling, regulatory, and adhesion processes. Over 20 enzymes are involved in GPI synthesis, attachment to client proteins, and remodeling after attachment. The GPI transamidase (GPI-T), a large complex located in the endoplasmic reticulum membrane, catalyzes the attachment step by replacing a C-terminal signal peptide of proproteins with GPI. In the last three decades, extensive research has been conducted on the mechanism of the transamidation reaction, the components of the GPI-T complex, the role of each subunit, and the substrate specificity. Two recent studies have reported the three-dimensional architecture of GPI-T, which represent the first structures of the pathway. The structures provide detailed mechanisms for assembly that rationalizes previous biochemical results and subunit-dependent stability data. While the structural data confirm the catalytic role of PIGK, which likely uses a caspase-like mechanism to cleave the proproteins, they suggest that unlike previously proposed, GPAA1 is not a catalytic subunit. The structures also reveal a shared cavity for GPI binding. Somewhat unexpectedly, PIGT, a single-pass membrane protein, plays a crucial role in GPI recognition. Consistent with the assembly mechanisms and the active site architecture, most of the disease mutations occur near the active site or the subunit interfaces. Finally, the catalytic dyad is located ~22 Å away from the membrane interface of the GPI-binding site, and this architecture may confer substrate specificity through topological matching between the substrates and the elongated active site. The research conducted thus far sheds light on the intricate processes involved in GPI anchoring and paves the way for further mechanistic studies of GPI-T.
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  • 文章类型: Journal Article
    结核病(TB),由结核分枝杆菌引起,仍然是世界上单一传染因子死亡的主要原因。结核分枝杆菌感染也可能导致临床慢性感染,称为潜伏性结核感染(LTBI)。与目前有限的治疗相比,几种亚单位疫苗显示出免疫治疗作用,并被纳入临床试验.在这项研究中,将具有新型粘膜佐剂c-di-AMP(Ag85B:c-di-AMP)的Ag85B亚单位疫苗鼻内递送至持续性结核分枝杆菌H37Ra感染小鼠模型,这也呈现了LTBI的无症状特征。与Ag85B免疫相比,Ag85B:c-di-AMP疫苗可诱导更强的体液免疫应答,显著更高的CD4+T细胞募集,增强了肺中的Th1/Th2/Th17谱反应,肺部病理病变减少,减少小鼠的结核分枝杆菌负荷。一起来看,Ag85B:c-di-AMP粘膜途径免疫对持续性结核分枝杆菌H37Ra感染提供了免疫治疗作用,和c-di-AMP,作为一种有前途的潜在粘膜佐剂,可进一步用于持续性结核分枝杆菌感染和LTBI的治疗性或预防性疫苗策略。
    Tuberculosis (TB), caused by Mycobacterium tuberculosis, remains the leading cause of mortality by a single infectious agent in the world. M. tuberculosis infection could also result in clinical chronic infection, known as latent TB infection (LTBI). Compared to the current limited treatment, several subunit vaccines showed immunotherapeutic effects and were included in clinical trials. In this study, a subunit vaccine of Ag85B with a novel mucosal adjuvant c-di-AMP (Ag85B:c-di-AMP) was delivered intranasally to a persistent M. tuberculosis H37Ra infection mouse model, which also presented the asymptomatic characteristics of LTBI. Compared with Ag85B immunization, Ag85B:c-di-AMP vaccination induced stronger humoral immune responses, significantly higher CD4+ T cells recruitment, enhanced Th1/Th2/Th17 profile response in the lung, decreased pathological lesions of the lung, and reduced M. tuberculosis load in mice. Taken together, Ag85B:c-di-AMP mucosal route immunization provided an immunotherapeutic effect on persistent M. tuberculosis H37Ra infection, and c-di-AMP, as a promising potential mucosal adjuvant, could be further used in therapeutic or prophylactic vaccine strategies for persistent M. tuberculosis infection as well as LTBI.
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  • 文章类型: Journal Article
    细胞死亡途径,铁性凋亡,发生在分生孢子细胞中,对感染结构的形成和功能至关重要,theappressorium,稻瘟病真菌稻瘟病菌。在这项研究中,我们鉴定了一种直向同源溶血磷脂酸酰基转移酶(Lpaat),其作用于磷脂酰乙醇胺(PE)生物合成的上游,是此类真菌铁死亡和致病性所必需的.两种PE,DOPE和SLPE,依赖于Lpaat功能的生产足以诱导脂质过氧化和随之而来的铁凋亡,从而正向调节真菌的致病性。另一方面,DOPE和SLPE均对自噬有正调控作用。LPAAT基因的缺失导致自噬蛋白Atg8的脂化形式减少,这可能是lpaatΔ突变体的自噬缺陷的原因。GFP-Lpaat主要位于脂滴(LD)的膜上,这些脂滴被荧光染料单烷基戊烷(MDH)染色,这表明LDs是膜PE生物合成的脂质来源,也可能是自噬体的膜来源。总的来说,我们的结果揭示了基于Lpaat介导的脂质代谢的新的细胞内膜结合细胞器动力学,提供铁死亡和自噬的时间和空间联系。
    A cell death pathway, ferroptosis, occurs in conidial cells and is critical for formation and function of the infection structure, the appressorium, in the rice blast fungus Magnaporthe oryzae. In this study, we identified an orthologous lysophosphatidic acid acyltransferase (Lpaat) acting at upstream of phosphatidylethanolamines (PEs) biosynthesis and which is required for such fungal ferroptosis and pathogenicity. Two PE species, DOPE and SLPE, that depend on Lpaat function for production were sufficient for induction of lipid peroxidation and the consequent ferroptosis, thus positively regulating fungal pathogenicity. On the other hand, both DOPE and SLPE positively regulated autophagy. Loss of the LPAAT gene led to a decrease in the lipidated form of the autophagy protein Atg8, which is probably responsible for the autophagy defect of the lpaatΔ mutant. GFP-Lpaat was mostly localized on the membrane of lipid droplets (LDs) that were stained by the fluorescent dye monodansylpentane (MDH), suggesting that LDs serve as a source of lipids for membrane PE biosynthesis and probably as a membrane source of autophagosome. Overall, our results reveal novel intracellular membrane-bound organelle dynamics based on Lpaat-mediated lipid metabolism, providing a temporal and spatial link of ferroptosis and autophagy.
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  • 文章类型: Journal Article
    目的:寻找有效的角化相关生物标志物,探讨口腔鳞状细胞癌(OSCC)的发生和发展。
    方法:所有原始数据均从癌症基因组图谱(TCGA)数据库下载。使用单变量Cox分析和Kaplan-Meier生存分析来鉴定与生存相关的基因。肿瘤免疫评估资源2.0(TIMER2.0)用于揭示各种肿瘤中角化相关基因脂酰转移酶1(LIPT1)的不同表达。
    结果:LIPT1,作为一个与角化相关的基因,发现在OSCC组和对照组中差异表达。还发现这与OSCC的预后有关。泛癌症分析显示LIPT1也参与了各种肿瘤。
    结论:所有结果均表明,角化凋亡相关基因LIPT1在OSCC的发生和发展过程中高度参与。这些发现为进一步研究OSCC中与角化相关的生物标志物提供了新的见解。
    OBJECTIVE: To find efficient cuproptosis-related biomarkers to explore the oncogenesis and progression of oral squamous cell carcinoma (OSCC).
    METHODS: All the original data were downloaded from the Cancer Genome Atlas (TCGA) database. Univariate Cox analysis and Kaplan-Meier survival analysis were used to identify the gene related to survival. Tumor Immune Estimation Resource 2.0 (TIMER 2.0) was used to reveal the different expression of cuproptosis-related gene lipoyltransferase 1 (LIPT1) in various kinds of tumours.
    RESULTS: LIPT1, as a cuproptosis-related gene, was found to be differentially expressed in the OSCC group and the control group. It was also found to be related to the prognosis of OSCC. Pan cancer analysis showed LIPT1 was also involved in various kinds of tumours.
    CONCLUSIONS: All the results demonstrate that the cuproptosis-related gene LIPT1 is highly involved in the oncogenesis and progression of OSCC. These findings give new insight for further research into the cuproptosis-related biomarkers in OSCC.
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  • 文章类型: Journal Article
    目的:探讨1例中性脂质贮积症伴肌病(NLSDM)患儿的临床表型及遗传基础。
    方法:选取2021年2月郑州大学第一附属医院收治的肌酸激酶(CK)升高2个月以上患儿作为研究对象。进行了临床和实验室检查,孩子接受了整个外显子组测序。通过她的家庭成员的Sanger测序来验证候选变体。
    结果:患者,一个9岁的女性,表现出下肢无力,升高CK水平,和顽固性心肌萎缩症.基因检测显示她藏有c.32C>G(p。S11W)和c.516C>G(p。N172K)PNPLA2基因的复合杂合变体,分别从她的母亲和父亲那里继承。根据美国医学遗传学和基因组学学院(ACMG)的指南,两种变体均被评为可能致病(PM1+PM2_支持+PP3+PP4).
    结论:c.32C>G(p。S11W)和c.516C>G(p。PNPLA2基因的N172K)复合杂合变体可能是该儿童重症肌无力和肌酸激酶升高的基础。
    OBJECTIVE: To explore the clinical phenotype and genetic basis of a child with Neutral lipid storage disease with myopathy (NLSDM).
    METHODS: A child who was admitted to the First Affiliated Hospital of Zhengzhou University in February 2021 for a history of elevated creatine kinase (CK) for over 2 months was selected as the study subject. Clinical and laboratory examinations were carried out, and the child was subjected to whole exome sequencing. Candidate variants were validated by Sanger sequencing of her family members.
    RESULTS: The patient, a 9-year-old female, had exhibited weakness in the lower limbs, elevated CK level, and refractory cardiomyotrophy. Genetic testing revealed that she has harbored c.32C>G (p.S11W) and c.516C>G (p.N172K) compound heterozygous variants of the PNPLA2 gene, which were respectively inherited from her mother and father. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG), both variants were rated as likely pathogenic (PM1+PM2_Supporting+PP3+PP4).
    CONCLUSIONS: The c.32C>G (p.S11W) and c.516C>G (p.N172K) compound heterozygous variants of the PNPLA2 gene probably underlay the myasthenia gravis and elevated creatine kinase in this child.
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