LMNA gene

  • 文章类型: Journal Article
    心血管疾病,动脉粥样硬化,中风是Hutchinson-Gilford早衰综合征(HGPS)患者最常见的死亡原因。LMNA变异体c.1824C>T占HGPS病例的约90%。由于缺乏适当的体外模型,LaminA在心脏中的详细分子机制仍然难以捉摸。我们假设HGPS患者的诱导性多能干细胞(iPSC)衍生的心肌细胞(iCMC)将为研究与HGPS相关的心脏病理机制提供模型平台。为了阐明早衰素在心肌细胞中的作用,我们首先从一名去识别的HGPS患者(hPGP1,先证者)和双亲来自早衰症研究基金会的皮肤成纤维细胞(SF).通过Sanger测序和限制性片段长度多态性,酶EciI,靶向LaminA,我们将hPGP1-SF表征为LMNA变体c.1824C>T的杂合突变体。我们进行了LMNA外显子11亚硫酸氢盐测序以分析早衰细胞的甲基化状态.此外,我们将三个SF重新编程为iPSCs并将它们分化为iCMCs,在第7天遭到殴打。通过粒子图像测速分析,通过qRT-PCR和Westernblot,我们发现hPGP1-iCMCs具有不规则的收缩功能,心脏特异性基因和蛋白表达降低.与正常的iCMC相比,我们的早衰患者来源的iCMC在功能和结构上都有缺陷。该体外模型将有助于阐明LaminA在心脏疾病中的作用以及与早衰相关的心脏病理机制。它为研究人员提供了一个新的平台,以研究与早衰相关的心脏病的新治疗方法。
    Cardiovascular diseases, atherosclerosis, and strokes are the most common causes of death in patients with Hutchinson-Gilford progeria syndrome (HGPS). The LMNA variant c.1824C > T accounts for ~ 90% of HGPS cases. The detailed molecular mechanisms of Lamin A in the heart remain elusive due to the lack of appropriate in vitro models. We hypothesize that HGPS patient\'s induced pluripotent stem cell (iPSC)-derived cardiomyocytes (iCMCs) will provide a model platform to study the cardio-pathologic mechanisms associated with HGPS. To elucidate the effects of progerin in cardiomyocytes, we first obtained skin fibroblasts (SFs) from a de-identified HGPS patient (hPGP1, proband) and both parents from the Progeria Research Foundation. Through Sanger sequencing and restriction fragment length polymorphism, with the enzyme EciI, targeting Lamin A, we characterized hPGP1-SFs as heterozygous mutants for the LMNA variant c.1824 C > T. Additionally, we performed LMNA exon 11 bisulfite sequencing to analyze the methylation status of the progeria cells. Furthermore, we reprogrammed the three SFs into iPSCs and differentiated them into iCMCs, which gained a beating on day 7. Through particle image velocimetry analysis, we found that hPGP1-iCMCs had an irregular contractile function and decreased cardiac-specific gene and protein expressions by qRT-PCR and Western blot. Our progeria-patient-derived iCMCs were found to be functionally and structurally defective when compared to normal iCMCs. This in vitro model will help in elucidating the role of Lamin A in cardiac diseases and the cardio-pathologic mechanisms associated with progeria. It provides a new platform for researchers to study novel treatment approaches for progeria-associated cardiac diseases.
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  • 文章类型: Case Reports
    背景:基于特异性探针捕获和高通量第二代测序技术,全外显子组测序(WES)为遗传相关疾病的临床诊断和治疗提供了支持。家族性部分脂肪营养不良2型(FPLD2;OMIM#151660)或2型Köbberling-Dunnigan综合征伴胰岛素抵抗综合征在中国大陆和其他地区并不常见。
    目的:我们报告该病例,以便在WES的帮助下进一步了解FPLD2或2型Kobberling-Dunnigan综合征),并提高对该病的临床和遗传学认识和诊断。
    方法:2021年7月11日14:00我院干部科收治一名30岁女性,因高血糖,快速的心率,怀孕期间出汗过多。口服葡萄糖耐量试验(OGTT)显示,葡萄糖刺激后胰岛素和C肽缓慢增加,峰值向后扩展(表1)。提示患者出现了胰岛素抗体,导致胰岛素抵抗。她的临床特征和家族遗传与FPLD2(2型Kobberling-Dunnigan综合征)一致。WES结果表明LMNA基因第8外显子发生杂合突变,因为1444位的碱基C在转录过程中突变为T。该突变将编码蛋白质的氨基酸位置482从Arg改变为Trp。2型Kobberling-Dunnigan综合征与LMNA基因突变相关。根据患者的临床表现,推荐降糖降脂治疗。
    结论:WES可以帮助同时进行FPLD2的临床研究或确认,并有助于识别具有相似临床表型的疾病。该病例表明家族性部分脂肪营养不良与染色体1q21-22上的LMNA基因突变相关。这是由WES诊断的少数家族性部分脂肪营养不良病例之一。
    Whole exome sequencing (WES) provides support for clinical diagnosis and treatment of genetically related diseases based on specific probe capture and high-throughput second-generation sequencing technology. Familial partial lipodystrophy 2 (FPLD2; OMIM # 151660) or type 2 Köbberling-Dunnigan syndrome with insulin resistance syndrome is uncommon in mainland China and elsewhere.
    We report the case in order to have a further understanding of FPLD2 or type 2 Kobberling- Dunnigan syndrome) with the assistance of WES and improve the clinical and genetic understanding and diagnosis of this disease.
    A 30-year-old woman was admitted to the cadre department of our hospital at 14:00 on July 11, 2021, because of hyperglycemia, a rapid heart rate, and excessive sweating during pregnancy. An oral glucose tolerance test (OGTT) showed that insulin and C-peptide increased slowly after glucose stimulation, and the peak value was extended backward (Table 1). It was suggested that the patient had developed insulin antibodies, resulting in insulin resistance. Her clinical features and familial inheritance were consistent with FPLD2 (type 2 Kobberling-Dunnigan syndrome). The results of WES indicated that a heterozygous mutation occurred in exon 8 of the LMNA gene, because the base C at position 1444 was mutated into T during transcription. This mutation changed the amino acid position 482 of the encoded protein from Arg to Trp. Type 2 Kobberling- Dunnigan syndrome is associated with an LMNA gene mutation. According to the patient\'s clinical manifestations, hypoglycemic and lipid-lowering therapy is recommended.
    WES can assist in the simultaneous clinical investigation or confirmation of FPLD2 and help identify diseases with similar clinical phenotypes. This case demonstrates that familial partial lipodystrophy is associated with an LMNA gene mutation on chromosome 1q21-22. This is one of the few cases of familial partial lipodystrophy diagnosed by WES.
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  • 文章类型: Case Reports
    层流病是由LMNA基因突变引起的肌营养不良。其特征在于心脏疾病如心房颤动。我们报告了一例49岁的患有心源性中风的妇女的椎板病。她从小就经历过四肢腰带肌肉的虚弱,心房颤动,心肌病,踝关节轻度挛缩,有家族性心脏病史.基因分析确定了一个新的杂合变体,c.1135C>A(p.Leu379Ile),LMNA基因.层流病可能是缺血性中风的潜在疾病,尤其是年轻到中年。
    Laminopathy is muscular dystrophy caused by an LMNA gene mutation. It is characterized by cardiac disease such as atrial fibrillation. We report a case of laminopathy in a 49-year-old woman who presented with cardiogenic stroke. She had experienced weakness in her limb-girdle muscles since childhood, atrial fibrillation, cardiomyopathy, and mild contracture of the ankle joints, and had a familial history of heart disease. Gene analysis identified a novel heterozygous variant, c. 1135C>A (p.Leu379Ile), in the LMNA gene. Laminopathy can be an underlying disease in ischemic stroke, especially in young to middle age.
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  • 文章类型: Case Reports
    在没有其他心脏危险因素的情况下,年轻人群中的心肌病和室性心律失常可出现基因突变。LMNA基因突变是扩张型心肌病(DCM)的病因之一,可表现为传导异常和心律失常。我们介绍了一名非裔美国男性的LMNA基因突变病例,该男性在最初模仿心脏结节病的扩张型心肌病的情况下出现室性心动过速。诊断挑战包括心脏MRI提示的心脏结节病的初步印象,但心内膜活检组织病理学阴性,FDGPET扫描活性阴性。治疗包括启动β受体阻滞剂和植入式心脏除颤器放置以进行二级预防。
    Genetic mutations can present with cardiomyopathies and ventricular arrhythmias in young population in the absence of other cardiac risk factors. LMNA genetic mutation is one of the causes of dilated cardiomyopathy (DCM) which can present with conduction abnormalities and arrhythmias. We present a case of LMNA genetic mutation in an African American male who presented with ventricular tachycardia in the absence of dilated cardiomyopathy initially mimicking cardiac sarcoidosis. Diagnostic challenges included initial impression of cardiac sarcoidosis as suggested by cardiac MRI, but negative tissue pathology on endomyocardial biopsy and negative activity on FDG PET scan. Treatment involved initiation of beta blocker and an implantable cardiac defibrillator placement for secondary prevention.
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  • 文章类型: Case Reports
    背景:氨基病变是一组由LMNA基因突变引起的疾病。先天性LMN营养不良是一种罕见的疾病,文献中描述的病例少于100例。
    我们介绍了一位患有先天性肌营养不良症的患者的临床病例,该患者与LMNA基因未描述的突变有关。
    结果:患者出现10个月的进行性运动延迟,体格检查包括整体张力减退,双侧翼状肩胛骨,无反射,髋关节和膝关节屈曲姿势,和积极的Gowers。患者出现进行性无力伴颈部张力丧失,功能损害,和5年时的步态丧失。
    结论:迄今为止,已经发现了20多个与先天性LMNA肌营养不良相关的突变,大多数是由于单个氨基酸变化(aa),由于我们病人的几个aa的得失,很少。
    BACKGROUND: Laminopathies are a group of diseases caused by mutations in the LMNA gene. Congenital dystrophy of the LMN is a rare disease, with less than 100 cases described in the literature.
    UNASSIGNED: We present the clinical case of a patient with congenital muscular dystrophy associated with an undescribed mutation in the LMNA gene.
    RESULTS: The patient presented progressive motor delay from 10 months with a physical examination consisting of global hypotonia, bilateral winged scapula, areflexia, hip and knee flexion posture, and positive Gowers. The patient developed progressive weakness with neck tone loss, functional impairment, and loss of gait at 5 years.
    CONCLUSIONS: To date, more than 20 mutations associated with congenital LMNA muscular dystrophy have been identified, most due to a single amino acid change (aa), few due to the gain or loss of several aa as in our patient.
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  • 文章类型: Journal Article
    A型层是细胞核的主要结构成分,主要位于细胞核外围。首先,A型薄片,连同B-型层合蛋白和内核膜的蛋白质,形成坚硬的结构-核层。除了维持细胞核细胞的形状,A型层蛋白在许多细胞事件中起关键作用,如基因转录和表观遗传调控。如今,很明显,层板在决定细胞命运的决定中起着非常重要的作用。编码A型层粘连蛋白的基因中的各种突变导致人类不同类型组织的损伤,统称为层粘连病,很明显,A型层粘连蛋白参与细胞分化和干性的调节。然而,这一规定的机制尚不清楚.在这次审查中,我们讨论了A型层粘连蛋白如何在确定细胞分化状态中发挥调节作用。我们总结了最近的数据,这些数据集中在不同来源的干细胞的细胞分化和身份发育的调节中的层粘连蛋白A/C作用机制。我们还讨论了这些知识如何促进进一步的研究,以更深入地了解层粘连蛋白A/C突变在层粘连蛋白病中的作用。
    A-type lamins are the main structural components of the nucleus, which are mainly localized at the nucleus periphery. First of all, A-type lamins, together with B-type lamins and proteins of the inner nuclear membrane, form a stiff structure-the nuclear lamina. Besides maintaining the nucleus cell shape, A-type lamins play a critical role in many cellular events, such as gene transcription and epigenetic regulation. Nowadays it is clear that lamins play a very important role in determining cell fate decisions. Various mutations in genes encoding A-type lamins lead to damages of different types of tissues in humans, collectively known as laminopathies, and it is clear that A-type lamins are involved in the regulation of cell differentiation and stemness. However, the mechanisms of this regulation remain unclear. In this review, we discuss how A-type lamins can execute their regulatory role in determining the differentiation status of a cell. We have summarized recent data focused on lamin A/C action mechanisms in regulation of cell differentiation and identity development of stem cells of different origin. We also discuss how this knowledge can promote further research toward a deeper understanding of the role of lamin A/C mutations in laminopathies.
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  • 文章类型: English Abstract
    A 49-year-old man with dilated cardiomyopathy (left ventricular ejection fraction 50%, unremarkable left ventricular biopsy) developed atrioventricular conduction abnormalities (AV block II type Wenckebach) during exercise testing.
    UNASSIGNED: Bei einem 49-jährigen Patienten mit einer dilatativen Kardiomyopathie (linksventrikuläre Ejektionsfraktion: 50 %, unauffällige linksventrikuläre Biopsie) fallen atrioventrikuläre Leitungsstörungen (ein AV-Block 2. Grades Typ Wenckebach) im Belastungs-EKG auf.
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  • 文章类型: Journal Article
    BACKGROUND: Hutchinson-Gilford progeria syndrome (HGPS) also known as progeria of childhood or progeria is a rare, rapid, autosomal dominant genetic disorder characterized by premature aging which occurs shortly after birth. HGPS occurs as a result of de novo point mutation in the gene recognized as LMNA gene that encodes two proteins Lamin A protein and Lamin C protein which are the structural components of the nuclear envelope. Mutations in the gene trigger abnormal splicing and induce internal deletion of 50 amino acids leading to the development of a truncated form of Lamin A protein known as Progerin. Progerin generation can be considered as the crucial step in HGPS since the protein is highly toxic to human cells, permanently farnesylated, and exhibits variation in several biochemical and structural properties within the individual. HGPS also produces complications such as skin alterations, growth failure, atherosclerosis, hair and fat loss, and bone and joint diseases. We have also revised all relevant patents relating to Hutchinson-gilford progeria syndrome and its therapy in the current article.
    METHODS: The goal of the present review article is to provide information about Hutchinson-Gilford progeria syndrome (HGPS) and the use of CRISPR/Cas technology as a promising treatment approach in the treatment of the disease. The review also discusses about different pharmacological and non-pharmacological methods of treatment currently used for HGPS.
    RESULTS: The main limitation associated with progeria is the lack of a definitive cure. The existing treatment modality provides only symptomatic relief. Therefore, it is high time to develop a therapeutic method that hastens premature aging in such patients.
    CONCLUSIONS: CRISPR/Cas technology is a novel gene-editing tool that allows genome editing at specific loci, and is found to be a promising therapeutic approach for the treatment of genetic disorders such as HGPS where dominant-negative mutations take place.
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  • 文章类型: Case Reports
    2型家族性部分脂肪营养不良(FPLD2)患者通常会出现各种严重的代谢并发症。然而,它们通常不受原发性心肌病和传导系统紊乱的影响,尽管文献中已经报道了一些FPLD2和心肌病的病例。这些都是由于氨基末端杂合层板蛋白A/C突变,被认为是重叠综合征的新形式。
    在这里,我们报告了由于LMNA基因外显子3中的杂合错义变异c.604G>A而鉴定的FPLD2女性患者,导致氨基酸取代(p.Glu202Lys)位于层蛋白A/C的中心α-螺旋棒结构域中,具有形成卷曲螺旋二聚体的高倾向。在基因诊断后,患者的心脏评估显示心律紊乱得到及时的药物治疗。
    本报告支持以下观点:有“非典型形式的FPLD2与心肌病”,特别是当致病变体影响层板蛋白A/C头或α-螺旋杆域时。它还强调了如何增加对基因型-表型相关性的理解可以帮助临床医生安排对脂肪营养不良患者的个性化监测。为了防止不常见但可能的破坏性表现,包括心律失常和猝死.
    Familial partial lipodystrophy type 2 (FPLD2) patients generally develop a wide variety of severe metabolic complications. However, they are not usually affected by primary cardiomyopathy and conduction system disturbances, although a few cases of FPLD2 and cardiomyopathy have been reported in the literature. These were all due to amino-terminal heterozygous lamin A/C mutations, which are considered as new forms of overlapping syndromes.
    Here we report the identification of a female patient with FPLD2 due to a heterozygous missense variant c.604G>A in the exon 3 of the LMNA gene, leading to amino acid substitution (p.Glu202Lys) in the central alpha-helical rod domain of lamin A/C with a high propensity to form coiled-coil dimers. The patient\'s cardiac evaluations that followed the genetic diagnosis revealed cardiac rhythm disturbances which were promptly treated pharmacologically.
    This report supports the idea that there are \"atypical forms\" of FPLD2 with cardiomyopathy, especially when a pathogenic variant affects the lamin A/C head or alpha-helical rod domain. It also highlights how increased understanding of the genotype-phenotype correlation could help clinicians to schedule personalized monitoring of the lipodystrophic patient, in order to prevent uncommon but possible devastating manifestations, including arrhythmias and sudden death.
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  • 文章类型: Journal Article
    LMNA相关的先天性肌营养不良(L-CMD)是最严重的表型形式的骨骼肌层蛋白病。本文报道了来自13个遗传证实的骨骼肌层病变家庭的15名波兰患者的临床表现。在所有这些患者中,松软的婴儿综合征是该疾病的第一个表现。通过下一代测序(靶向组或外显子组;11名患者)或经典Sanger测序(4名患者)建立遗传诊断。除了已知的致病性LMNA变体外:c.116A>G(p。Asn39Ser),c.745C>T(p。Arg249Trp),c.746G>A(p。Arg249Gln),c.1072G>A(p。Glu358Lys),c.147G>A(p。Glu383Lys),c.1163G>C(p。Arg388Pro),c.1357C>T(p。Arg453Trp),c.1583C>G(p。Thr528Arg),我们已经确定了三个新的:c.121C>G(p。Arg41Gly),c.1127A>G(p。Tyr376Cys)和c.1160T>C(第Leu387Pro)。11名患者有从头突变,4-家族。在一个家庭中,我们观察到临床过程的家族内变异性:男性先证者中的严重L-CMD,他妹妹的中间形式,母亲的无症状。一位无症状的父亲患有躯体马赛克。在婴儿期肌张力减退和运动发育迟缓的儿童中应怀疑L-CMD,头部控制能力差的人,严重的过度前凸和不稳定和笨拙的步态。血清肌酸激酶可能较高(~1000IU/l)。肌肉无力的进展很快,导致早期固定。在某些L-CMD患者中,关节挛缩会随着时间的推移而发展。MRI显示最常受累的肌肉是前锯齿肌,腰椎旁,臀肌,vastus,内收肌magnus,腿筋,腓肠肌和比目鱼肌内侧头。超罕见层粘连蛋白病可能是儿童广泛性张力减退的相对常见原因。广泛的基因组测序方法的引入是具有巨大临床和遗传变异性的疾病诊断的突破,并且允许“从基因型做表型”的方法。然而,在具有提示层蛋白病的临床表现的选定患者中,可以考虑对LMNA基因进行靶测序。
    LMNA-related congenital muscular dystrophy (L-CMD) is the most severe phenotypic form of skeletal muscle laminopathies. This paper reports clinical presentation of the disease in 15 Polish patients from 13 families with genetically confirmed skeletal muscle laminopathy. In all these patients floppy infant syndrome was the first manifestation of the disease. The genetic diagnosis was established by next generation sequencing (targeted panel or exome; 11 patients) or classic Sanger sequencing (4 patients). In addition to known pathogenic LMNA variants: c.116A > G (p.Asn39Ser), c.745C > T (p.Arg249Trp), c.746G > A (p.Arg249Gln), c.1072G > A (p.Glu358Lys), c.1147G > A (p.Glu383Lys), c.1163G > C (p.Arg388Pro), c.1357C > T (p.Arg453Trp), c.1583C > G (p.Thr528Arg), we have identified three novel ones: c.121C > G (p.Arg41Gly), c.1127A > G (p.Tyr376Cys) and c.1160T > C (p.Leu387Pro). Eleven patients had de novo mutations, 4 - familial. In one family we observed intrafamilial variability of clinical course: severe L-CMD in the male proband, intermediate form in his sister and asymptomatic in their mother. One asymptomatic father had somatic mosaicism. L-CMD should be suspected in children with hypotonia in infancy and delayed motor development, who have poor head control, severe hyperlordosis and unstable and awkward gait. Serum creatine kinase may be high (~1000IU/l). Progression of muscle weakness is fast, leading to early immobilization. In some patients with L-CMD joint contractures can develop with time. MRI shows that the most frequently affected muscles are the serratus anterior, lumbar paraspinal, gluteus, vastus, adductor magnus, hamstrings, medial head of gastrocnemius and soleus. Ultra-rare laminopathies can be a relatively common cause of generalized hypotonia in children. Introduction of wide genome sequencing methods was a breakthrough in diagnostics of diseases with great clinical and genetic variability and allowed approach \"from genotype do phenotype\". However target sequencing of LMNA gene could be considered in selected patients with clinical picture suggestive for laminopathy.
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