1
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Onnée M, Bénézit A, Bastu S, Nadaj-Pakleza A, Lannes B, Ader F, Thèze C, Cintas P, Cances C, Carlier RY, Metay C, Cossée M, Malfatti E. The FLNC Ala1186Val Variant Linked to Cytoplasmic Body Myopathy and Cardiomyopathy Causes Protein Instability. Biomedicines 2024; 12:322. [PMID: 38397924 PMCID: PMC10887408 DOI: 10.3390/biomedicines12020322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/18/2024] [Accepted: 01/22/2024] [Indexed: 02/25/2024] Open
Abstract
Filamin C-related disorders include myopathies and cardiomyopathies linked to variants in the FLNC gene. Filamin C belongs to a family of actin-binding proteins involved in sarcomere stability. This study investigates the pathogenic impact of the FLNC c.3557C > T (p.Ala1186Val) pathogenic variant associated with an early-onset cytoplasmic body myopathy and cardiomyopathy in three unrelated patients. We performed clinical imaging and myopathologic and genetic characterization of three patients with an early-onset myopathy and cardiomyopathy. Bioinformatics analysis, variant interpretation, and protein structure analysis were performed to validate and assess the effects of the filamin C variant. All patients presented with a homogeneous clinical phenotype marked by a severe contractural myopathy, leading to loss of gait. There was prominent respiratory involvement and restrictive or hypertrophic cardiomyopathies. The Ala1186Val variant is located in the interstrand loop involved in intradomain stabilization and/or interdomain interactions with neighbor Ig-like domains. 3D modeling highlights local structural changes involving nearby residues and probably impacts the protein stability, causing protein aggregation in the form of cytoplasmic bodies. Myopathologic studies have disclosed the prominent aggregation and upregulation of the aggrephagy-associated proteins LC3B and p62. As a whole, the Ala1186Val variant in the FLNC gene provokes a severe myopathy with contractures, respiratory involvement, and cardiomyopathy due to protein aggregation in patients' muscles.
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Affiliation(s)
- Marion Onnée
- Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, 94010 Créteil, France; (M.O.); (S.B.)
| | - Audrey Bénézit
- Neurologie et Réanimation Pédiatrique, Assistance Publique–Hôpitaux de Paris, Université Paris Saclay, Département Médico-Universitaire Santé de l’Enfant et de l’Adolescent, Hôpital Raymond Poincaré, 92380 Garches, France;
| | - Sultan Bastu
- Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, 94010 Créteil, France; (M.O.); (S.B.)
| | - Aleksandra Nadaj-Pakleza
- Centre de Référence des Maladies Neuromusculaires Nord Est Ile-de-France, Service de Neurologie, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France;
- European Reference Network, EURO-NMD, Neuromuscular Centre at Hautepierre Hospital, Hôpitaux Universitaires de Strasbourg, 67200 Strasbourg, France
| | - Béatrice Lannes
- Département de Pathologie, Hôpitaux Universitaires de Strasbourg, 67091 Strasbourg, France;
| | - Flavie Ader
- Assistance Publique–Hôpitaux de Paris, Sorbonne Université, Département Médico-Universitaire BioGem, Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire et Cellulaire, 75013 Paris, France;
- Institut National de la Santé et de la Recherche Médicale UMRS1166, Université Paris Cité, 75006 Paris, France
| | - Corinne Thèze
- Laboratoire de Génétique Moléculaire, Centre Hospitalier Universitaire de Montpellier, Université de Montpellier, 34095 Montpellier, France;
| | - Pascal Cintas
- Centre de Référence des Maladies Neuromusculaires AOC (Atlantique-Occitanie-Caraïbes), Département de Neurologie, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France; (P.C.); (M.C.)
| | - Claude Cances
- Centre de Référence des Maladies Neuromusculaires AOC (Atlantique-Occitanie-Caraïbes), Unité de Neurologie Pédiatrique, Hôpital des Enfants, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France;
| | - Robert-Yves Carlier
- Assistance Publique–Hôpitaux de Paris, Groupe Hospitalier Universitaire Paris Saclay, Département Médico-Universitaire Smart Imaging, Service d’Imagerie Médicale, Institut National de la Santé et de la Recherche Médicale UMR1179, Hôpital Raymond Poincaré, 92380 Garches, France;
| | - Corinne Metay
- Unité Fonctionnelle de Cardiogénétique et Myogénétique Moléculaire et Cellulaire, Centre de Génétique Moléculaire et Chromosomique, Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Institut de Myologie, Groupe Hospitalier La Pitié-Salpêtrière, 75013 Paris, France;
| | - Mireille Cossée
- Centre de Référence des Maladies Neuromusculaires AOC (Atlantique-Occitanie-Caraïbes), Département de Neurologie, Hôpital Pierre-Paul Riquet, Centre Hospitalier Universitaire de Toulouse, 31059 Toulouse, France; (P.C.); (M.C.)
- PhyMedExp, Université de Montpellier, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, 34295 Montpellier, France
| | - Edoardo Malfatti
- Institut Mondor de Recherche Biomédicale, Université Paris Est Créteil, Institut National de la Santé et de la Recherche Médicale U955, 94010 Créteil, France; (M.O.); (S.B.)
- Assistance Publique–Hôpitaux de Paris, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Hôpital Henri Mondor, 94000 Créteil, France
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Velardo D, D'Angelo MG, Citterio A, Panzeri E, Napoli L, Cinnante C, Moggio M, Comi GP, Ronchi D, Bassi MT. Case Reports: Novel Missense Variants in the Filamin C Actin Binding Domain Cause Variable Phenotypes. Front Neurol 2022; 13:930039. [PMID: 35903116 PMCID: PMC9315448 DOI: 10.3389/fneur.2022.930039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 06/22/2022] [Indexed: 11/24/2022] Open
Abstract
Filamin C is a large dimeric actin-binding protein, most prevalent in skeletal and cardiac muscle Z-discs, where it participates in sarcomere mechanical stabilization and intracellular signaling, interacting with numerous binding partners. Dominant heterozygous mutations of Filamin C gene cause several forms of myopathy and structural or arrhythmogenic cardiomyopathy. In this report we describe clinical and molecular findings of two Italian patients, in whom we identified two novel missense variants located within the Filamin C actin binding domain. Muscle imaging, histological and ultrastructural findings are also reported. Our results underline the extreme inter- and intrafamilial variability of clinical manifestations, hence the need to extend the investigation also to asymptomatic relatives, and the relevance of a broad diagnostic approach involving muscle electron microscopy, skeletal muscle magnetic resonance imaging and next generation sequencing techniques.
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Affiliation(s)
- Daniele Velardo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Milan, Italy
- *Correspondence: Daniele Velardo
| | - Maria Grazia D'Angelo
- NeuroMuscular Unit, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) E. Medea, Bosisio Parini, Italy
| | - Andrea Citterio
- Laboratory of Molecular Biology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) E. Medea, Bosisio Parini, Italy
| | - Elena Panzeri
- Laboratory of Molecular Biology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) E. Medea, Bosisio Parini, Italy
| | - Laura Napoli
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Milan, Italy
| | - Claudia Cinnante
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuroradiology Unit, Milan, Italy
- Department of Radiology, Istituto Auxologico Italiano, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), Milan, Italy
| | - Maurizio Moggio
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Milan, Italy
| | - Giacomo Pietro Comi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Diseases Unit, Department of Neuroscience, Milan, Italy
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Neuroscience Section, University of Milan, Milan, Italy
| | - Dario Ronchi
- Department of Pathophysiology and Transplantation, Dino Ferrari Center, Neuroscience Section, University of Milan, Milan, Italy
| | - Maria Teresa Bassi
- Laboratory of Molecular Biology, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS) E. Medea, Bosisio Parini, Italy
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3
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A novel nonsense mutation in the dimerization domain of FLNC causing mild myofibrillar myopathy. Clin Neurol Neurosurg 2022; 221:107386. [DOI: 10.1016/j.clineuro.2022.107386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/22/2022]
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4
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Upper body involvement in GNE myopathy assessed by muscle imaging. Neuromuscul Disord 2022; 32:410-418. [DOI: 10.1016/j.nmd.2021.12.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Revised: 12/16/2021] [Accepted: 12/29/2021] [Indexed: 11/19/2022]
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Evangelista T, Lornage X, Carlier PG, Bassez G, Brochier G, Chanut A, Lacène E, Bui MT, Metay C, Oppermann U, Böhm J, Laporte J, Romero NB. A Heterozygous Mutation in the Filamin C Gene Causes an Unusual Nemaline Myopathy With Ring Fibers. J Neuropathol Exp Neurol 2021; 79:908-914. [PMID: 32607581 DOI: 10.1093/jnen/nlaa052] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Indexed: 11/13/2022] Open
Abstract
Autosomal dominant pathogenic variants in the filamin C gene (FLNC) have been associated with myofibrillar myopathies, distal myopathies, and isolated cardiomyopathies. Mutations in different functional domains of FLNC can cause various clinical phenotypes. A novel heterozygous missense variant c.608G>A, p.(Cys203Tyr) in the actin binding domain of FLCN was found to cause an upper limb distal myopathy (MIM #614065). The muscle MRI findings are similar to those observed in FLNC-myofibrillar myopathy (MIM #609524). However, the muscle biopsy revealed >20% of muscle fibers with nemaline bodies, in addition to numerous ring fibers and a predominance of type 1 fibers. Overall, this case shows some unique and rare aspects of FLNC-myopathy constituting a new morphologic phenotype of FLNC-related myopathies.
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Affiliation(s)
- Teresinha Evangelista
- From the Neuromuscular Morphology Unit, Myology Institute.,Sorbonne Université, AP-HP, INSERM, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
| | - Xavière Lornage
- Department of Translational Medicine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), INSERM U1258, CNRS UMR7104, Université de Strasbourg, Illkirch, France
| | | | - Guillaume Bassez
- From the Neuromuscular Morphology Unit, Myology Institute.,Sorbonne Université, AP-HP, INSERM, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
| | - Guy Brochier
- From the Neuromuscular Morphology Unit, Myology Institute.,Sorbonne Université, AP-HP, INSERM, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
| | - Anais Chanut
- From the Neuromuscular Morphology Unit, Myology Institute
| | - Emmanuelle Lacène
- From the Neuromuscular Morphology Unit, Myology Institute.,Sorbonne Université, AP-HP, INSERM, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
| | - Mai-Thao Bui
- From the Neuromuscular Morphology Unit, Myology Institute
| | - Corinne Metay
- AP-HP, Centre de Génétique Moléculaire et Chromosomique, UF de Cardiomyogénétique et Myogénétique Moléculaire et Cellulaire, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
| | - Ursula Oppermann
- Department of Translational Medicine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), INSERM U1258, CNRS UMR7104, Université de Strasbourg, Illkirch, France
| | - Johann Böhm
- Department of Translational Medicine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), INSERM U1258, CNRS UMR7104, Université de Strasbourg, Illkirch, France
| | - Jocelyn Laporte
- Department of Translational Medicine and Neurogenetics, IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), INSERM U1258, CNRS UMR7104, Université de Strasbourg, Illkirch, France
| | - Norma B Romero
- From the Neuromuscular Morphology Unit, Myology Institute.,Sorbonne Université, AP-HP, INSERM, Centre de Référence des Maladies Neuromusculaires Nord/Est/Ile de France, Groupe Hospitalier Universitaire La Pitié-Salpêtrière, Paris, France
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6
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Lee HCH, Wong S, Sheng B, Pan NYK, Leung YKF, Lau KKD, Cheng YS, Ho LC, Li R, Lee CN, Tsoi TH, Cheung YFN, Fu YPM, Kan NCA, Chu YP, Au WCL, Yeung HMJ, Li SH, Cheung CFM, Tong HF, Hung LYE, Chan TYC, Li CT, Tong TYT, Tong TWC, Leung HYC, Lee KH, Yeung SYS, Lee SYB, Lau TCG, Lam CW, Mak CM, Chan AYW. Clinical and pathological characterization of FLNC-related myofibrillar myopathy caused by founder variant c.8129G>A in Hong Kong Chinese. Clin Genet 2020; 97:747-757. [PMID: 32022900 DOI: 10.1111/cge.13715] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/17/2020] [Accepted: 01/28/2020] [Indexed: 12/18/2022]
Abstract
FLNC-related myofibrillar myopathy could manifest as autosomal dominant late-onset slowly progressive proximal muscle weakness; involvements of cardiac and/or respiratory functions are common. We describe 34 patients in nine families of FLNC-related myofibrillar myopathy in Hong Kong ethnic Chinese diagnosed over the last 12 years, in whom the same pathogenic variant c.8129G>A (p.Trp2710*) was detected. Twenty-six patients were symptomatic when diagnosed; four patients died of pneumonia and/or respiratory failure. Abnormal amorphous material or granulofilamentous masses were detected in half of the cases, with mitochondrial abnormalities noted in two-thirds. We also show by haplotype analysis the founder effect associated with this Hong Kong variant, which might have occurred 42 to 71 generations ago or around Tang and Song dynasties, and underlain a higher incidence of myofibrillar myopathy among Hong Kong Chinese. The late-onset nature and slowly progressive course of the highly penetrant condition could have significant impact on the family members, and an early diagnosis could benefit the whole family. Considering another neighboring founder variant in FLNC in German patients, we advocate development of specific therapies such as chaperone-based or antisense oligonucleotide strategies for this particular type of myopathy.
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Affiliation(s)
| | - Shun Wong
- Department of Pathology, Princess Margaret Hospital, Hong Kong.,Pathology Department, St. Paul's Hospital, Hong Kong
| | - Bun Sheng
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | - Nin-Yuan Keith Pan
- Department of Diagnostic Radiology, Princess Margaret Hospital, Hong Kong
| | | | | | - Yue Sandy Cheng
- Department of Clinical Pathology, Pamela Youde Nethersole Eastern Hospital, Hong Kong.,Department of Clinical Laboratory, Gleneagles Hong Kong Hospital, Hong Kong
| | - Luen-Cheung Ho
- Department of Pathology, Queen Elizabeth Hospital, Hong Kong
| | - Richard Li
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Chi-Nam Lee
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | - Tak-Hong Tsoi
- Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong
| | | | | | | | - Yim-Pui Chu
- Department of Medicine and Geriatrics, Princess Margaret Hospital, Hong Kong
| | - Wing-Chi Lisa Au
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | | | - Siu-Hung Li
- Department of Medicine, North District Hospital, Hong Kong
| | | | - Hok-Fung Tong
- Department of Pathology, Princess Margaret Hospital, Hong Kong
| | | | | | - Chi Terence Li
- Department of Pathology, Princess Margaret Hospital, Hong Kong
| | | | | | | | - Ka-Ho Lee
- Department of Pathology, Princess Margaret Hospital, Hong Kong
| | | | | | | | - Ching-Wan Lam
- Department of Pathology, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Chloe Miu Mak
- Department of Pathology, Princess Margaret Hospital, Hong Kong
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