AKAGAWA HIROYUKI
   Department   Research Institutes and Facilities, Research Institutes and Facilities
   Position   Associate Professor
Article types Original article
Language English
Peer review Peer reviewed
Title Functional characterization of variants found in Japanese patients with hereditary hemorrhagic telangiectasia.
Journal Formal name:Clinical genetics
Abbreviation:Clin Genet
ISSN code:13990004/00099163
Domestic / ForeginForegin
Volume, Issue, Page Online ahead of print,pp.1-6
Author and coauthor Morita Shuhei, Nomura Shunsuke, Azuma Kenko, Chida-Nagai Ayako, Furutani Yoshiyuki, Inai Kei, Inoue Tatsuya, Niimi Yasunari, Iizuka Yuo, Tsutsumi Yoshiyuki, Ishizaki Reina, Yamagishi Hiroyuki, Kawamata Takakazu, Akagawa Hiroyuki
Publication date 2024/01
Summary Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant form of vascular dysplasia. Genetic diagnosis is made by identifying loss-of-function variants in genes, such as ENG and ACVRL1. However, the causal mechanisms of various variants of unknown significance remains unclear. In this study, we analyzed 12 Japanese patients from 11 families who were clinically diagnosed with HHT. Sequencing analysis identified 11 distinct variants in ACVRL1 and ENG. Three of the 11 were truncating variants, leading to a definitive diagnosis, whereas the remaining eight were splice-site and missense variants that required functional analyses. In silico splicing analyses demonstrated that three variants, c.526-3C > G and c.598C > G in ACVRL1, and c.690-1G > A in ENG, caused aberrant splicing, as confirmed by a minigene assay. The five remaining missense variants were p.Arg67Gln, p.Ile256Asn, p.Leu285Pro, and p.Pro424Leu in ACVRL and p.Pro165His in ENG. Nanoluciferase-based bioluminescence analyses demonstrated that these ACVRL1 variants impaired cell membrane trafficking, resulting in the loss of bone morphogenetic protein 9 (BMP9) signal transduction. In contrast, the ENG mutation impaired BMP9 signaling despite normal cell membrane expression. The updated functional analysis methods performed in this study will facilitate effective genetic testing and appropriate medical care for patients with HHT.
DOI 10.1111/cge.14483
PMID 38225712