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Zodanu GKE, Hwang JH, Mehta Z, Sisniega C, Barsegian A, Kang X, Biniwale R, Si MS, Satou GM, Halnon N, UCLA Congenital Heart Defect BioCore Faculty, Grody WW, Van Arsdell GS, Nelson SF, Touma M. High-Throughput Genomics Identify Novel FBN1/2 Variants in Severe Neonatal Marfan Syndrome and Congenital Heart Defects. Int J Mol Sci 2024; 25:5469. [PMID: 38791509 PMCID: PMC11122089 DOI: 10.3390/ijms25105469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 05/10/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Fibrillin-1 and fibrillin-2, encoded by FBN1 and FBN2, respectively, play significant roles in elastic fiber assembly, with pathogenic variants causing a diverse group of connective tissue disorders such as Marfan syndrome (MFS) and congenital contractural arachnodactyly (CCD). Different genomic variations may lead to heterogeneous phenotypic features and functional consequences. Recent high-throughput sequencing modalities have allowed detection of novel variants that may guide the care for patients and inform the genetic counseling for their families. We performed clinical phenotyping for two newborn infants with complex congenital heart defects. For genetic investigations, we employed next-generation sequencing strategies including whole-genome Single-Nucleotide Polymorphism (SNP) microarray for infant A with valvular insufficiency, aortic sinus dilatation, hydronephrosis, and dysmorphic features, and Trio whole-exome sequencing (WES) for infant B with dextro-transposition of the great arteries (D-TGA) and both parents. Infant A is a term male with neonatal marfanoid features, left-sided hydronephrosis, and complex congenital heart defects including tricuspid regurgitation, aortic sinus dilatation, patent foramen ovale, patent ductus arteriosus, mitral regurgitation, tricuspid regurgitation, aortic regurgitation, and pulmonary sinus dilatation. He developed severe persistent pulmonary hypertension and worsening acute hypercapnic hypoxemic respiratory failure, and subsequently expired on day of life (DOL) 10 after compassionate extubation. Cytogenomic whole-genome SNP microarray analysis revealed a deletion within the FBN1 gene spanning exons 7-30, which overlapped with the exon deletion hotspot region associated with neonatal Marfan syndrome. Infant B is a term male prenatally diagnosed with isolated D-TGA. He required balloon atrial septostomy on DOL 0 and subsequent atrial switch operation, atrial septal defect repair, and patent ductus arteriosus ligation on DOL 5. Trio-WES revealed compound heterozygous c.518C>T and c.8230T>G variants in the FBN2 gene. Zygosity analysis confirmed each of the variants was inherited from one of the parents who were healthy heterozygous carriers. Since his cardiac repair at birth, he has been growing and developing well without any further hospitalization. Our study highlights novel FBN1/FBN2 variants and signifies the phenotype-genotype association in two infants affected with complex congenital heart defects with and without dysmorphic features. These findings speak to the importance of next-generation high-throughput genomics for novel variant detection and the phenotypic variability associated with FBN1/FBN2 variants, particularly in the neonatal period, which may significantly impact clinical care and family counseling.
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Affiliation(s)
- Gloria K. E. Zodanu
- Neonatal Congenital Heart Laboratory, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (G.K.E.Z.); (J.H.H.); (Z.M.); (C.S.); (A.B.); (X.K.)
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
| | - John H. Hwang
- Neonatal Congenital Heart Laboratory, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (G.K.E.Z.); (J.H.H.); (Z.M.); (C.S.); (A.B.); (X.K.)
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
| | - Zubin Mehta
- Neonatal Congenital Heart Laboratory, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (G.K.E.Z.); (J.H.H.); (Z.M.); (C.S.); (A.B.); (X.K.)
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
| | - Carlos Sisniega
- Neonatal Congenital Heart Laboratory, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (G.K.E.Z.); (J.H.H.); (Z.M.); (C.S.); (A.B.); (X.K.)
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
| | - Alexander Barsegian
- Neonatal Congenital Heart Laboratory, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (G.K.E.Z.); (J.H.H.); (Z.M.); (C.S.); (A.B.); (X.K.)
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
| | - Xuedong Kang
- Neonatal Congenital Heart Laboratory, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (G.K.E.Z.); (J.H.H.); (Z.M.); (C.S.); (A.B.); (X.K.)
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
| | - Reshma Biniwale
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA;
| | - Ming-Sing Si
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA;
| | - Gary M. Satou
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
| | - Nancy Halnon
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
| | - UCLA Congenital Heart Defect BioCore Faculty
- Neonatal Congenital Heart Laboratory, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (G.K.E.Z.); (J.H.H.); (Z.M.); (C.S.); (A.B.); (X.K.)
| | - Wayne W. Grody
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Glen S. Van Arsdell
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
- Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA;
| | - Stanley F. Nelson
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
| | - Marlin Touma
- Neonatal Congenital Heart Laboratory, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (G.K.E.Z.); (J.H.H.); (Z.M.); (C.S.); (A.B.); (X.K.)
- Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA; (R.B.); (G.M.S.); (N.H.); (W.W.G.); (G.S.V.A.); (S.F.N.)
- Molecular Biology Institute, University of California, Los Angeles, CA 90095, USA
- Children’s Discovery and Innovation Institute, University of California, Los Angeles, CA 90095, USA
- Eli and Edyth Broad Stem Cell Research Center, University of California, Los Angeles, CA 90095, USA
- Cardiovascular Research Laboratories, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA
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Lu Z, Lu Z, Lai Y, Zhou H, Li Z, Cai W, Xu Z, Luo H, Chen Y, Li J, Zhang J, He Z, Tang F. A comprehensive analysis of FBN2 in bladder cancer: A risk factor and the tumour microenvironment influencer. IET Syst Biol 2023; 17:162-173. [PMID: 37337404 PMCID: PMC10439492 DOI: 10.1049/syb2.12067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 04/15/2023] [Accepted: 05/28/2023] [Indexed: 06/21/2023] Open
Abstract
Bladder cancer (BLCA) is a common and difficult-to-manage disease worldwide. Most common type of BLCA is urothelial carcinoma (UC). Fibrillin 2 (FBN2) was first discovered while studying Marfan syndrome, and its encoded products are associated with elastin fibres. To date, the role of FBN2 in BLCA remains unclear. The authors first downloaded data from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO). The patients were divided into high FBN2 expression and low FBN2 expression groups, and the survival curve, clinical characteristics, tumour microenvironment (TME), and immune cell differences were analysed between the two groups. Then, the differentially expressed genes (DEGs) were filtered, and functional enrichment for DEGs was performed. Finally, chemotherapy drug susceptibility analysis based on the high and low FBN2 groups was conducted. The authors found upregulated expression of FBN2 in BLCA and proved that FBN2 could be an independent prognostic factor for BLCA. TME analysis showed that the expression of FBN2 affects several aspects of the TME. The upregulated expression of FBN2 was associated with a high stromal score, which may lead to immunosuppression and be detrimental to immunotherapy. In addition, the authors found that NK cells resting, macrophage M0 infiltration, and other phenomena of immune cell infiltration appeared in the high expression group of FBN2. The high expression of FBN2 was related to the high sensitivity of some chemotherapy drugs. The authors systematically investigated the effects and mechanisms of FBN2 on BLCA and provided a new understanding of the role of FBN2 as a risk factor and TME influencer in BLCA.
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Affiliation(s)
- Zechao Lu
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Zeguang Lu
- The Second Clinical College of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Yongchang Lai
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Haobin Zhou
- The First Clinical College of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Zhibiao Li
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Wanyan Cai
- Department of Social and Behavioural SciencesCity University of Hong KongHong KongChina
| | - Zeyao Xu
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Hongcheng Luo
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Yushu Chen
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Jianyu Li
- The First Clinical College of Guangzhou Medical UniversityGuangzhouGuangdongChina
| | - Jishen Zhang
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Zhaohui He
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
| | - Fucai Tang
- Department of UrologyThe Eighth Affiliated HospitalSun Yat‐sen UniversityShenzhenGuangdongChina
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Li AL, He JQ, Zeng L, Hu YQ, Wang M, Long JY, Chang SH, Jin JY, Xiang R. Case report: Identification of novel fibrillin-2 variants impacting disulfide bond and causing congenital contractural arachnodactyly. Front Genet 2023; 14:1035887. [PMID: 36936417 PMCID: PMC10020613 DOI: 10.3389/fgene.2023.1035887] [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: 09/03/2022] [Accepted: 02/07/2023] [Indexed: 03/06/2023] Open
Abstract
Background: Congenital contractural arachnodactyly (CCA) is an autosomal dominant connective tissue disorder with clinical features of arthrogryposis, arachnodactyly, crumpled ears, scoliosis, and muscular hypoplasia. The heterozygous pathogenic variants in FBN2 have been shown to cause CCA. Fibrillin-2 is related to the elasticity of the tissue and has been demonstrated to play an important role in the constitution of extracellular microfibrils in elastic fibers, providing strength and flexibility to the connective tissue that sustains the body's joints and organs. Methods: We recruited two Chinese families with arachnodactyly and bilateral arthrogryposis of the fingers. Whole-exome sequencing (WES) and co-segregation analysis were employed to identify their genetic etiologies. Three-dimensional protein models were used to analyze the pathogenic mechanism of the identified variants. Results: We have reported two CCA families and identified two novel missense variants in FBN2 (NM_001999.3: c.4093T>C, p.C1365R and c.2384G>T, p.C795F). The structural models of the mutant FBN2 protein in rats exhibited that both the variants could break disulfide bonds. Conclusion: We detected two FBN2 variants in two families with CCA. Our description expands the genetic profile of CCA and emphasizes the pathogenicity of disulfide bond disruption in FBN2.
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Affiliation(s)
- An-Lei Li
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, China
- School of Life Sciences, Central South University, Changsha, China
| | - Ji-Qiang He
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Lei Zeng
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
| | - Yi-Qiao Hu
- School of Life Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Animal Models for Human Diseases, School of Life Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China
| | - Min Wang
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital of Central South University, Changsha, China
- Department of Nephrology, Xiangya Hospital of Central South University, Changsha, China
| | - Jie-Yi Long
- School of Life Sciences, Central South University, Changsha, China
| | - Si-Hua Chang
- School of Life Sciences, Central South University, Changsha, China
| | - Jie-Yuan Jin
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, China
- Hunan Key Laboratory of Animal Models for Human Diseases, School of Life Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China
- *Correspondence: Jie-Yuan Jin, ; Rong Xiang,
| | - Rong Xiang
- Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha, China
- School of Life Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Animal Models for Human Diseases, School of Life Sciences, Central South University, Changsha, China
- Hunan Key Laboratory of Medical Genetics, School of Life Sciences, Central South University, Changsha, China
- *Correspondence: Jie-Yuan Jin, ; Rong Xiang,
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Peeters S, De Kinderen P, Meester JAN, Verstraeten A, Loeys BL. The fibrillinopathies: new insights with focus on the paradigm of opposing phenotypes for both FBN1 and FBN2. Hum Mutat 2022; 43:815-831. [PMID: 35419902 PMCID: PMC9322447 DOI: 10.1002/humu.24383] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 04/03/2022] [Accepted: 04/07/2022] [Indexed: 11/26/2022]
Abstract
Different pathogenic variants in the fibrillin‐1 gene (FBN1) cause Marfan syndrome and acromelic dysplasias. Whereas the musculoskeletal features of Marfan syndrome involve tall stature, arachnodactyly, joint hypermobility, and muscle hypoplasia, acromelic dysplasia patients present with short stature, brachydactyly, stiff joints, and hypermuscularity. Similarly, pathogenic variants in the fibrillin‐2 gene (FBN2) cause either a Marfanoid congenital contractural arachnodactyly or a FBN2‐related acromelic dysplasia that most prominently presents with brachydactyly. The phenotypic and molecular resemblances between both the FBN1 and FBN2‐related disorders suggest that reciprocal pathomechanistic lessons can be learned. In this review, we provide an updated overview and comparison of the phenotypic and mutational spectra of both the “tall” and “short” fibrillinopathies. The future parallel functional study of both FBN1/2‐related disorders will reveal new insights into how pathogenic fibrillin variants differently affect the fibrillin microfibril network and/or growth factor homeostasis in clinically opposite syndromes. This knowledge may eventually be translated into new therapeutic approaches by targeting or modulating the fibrillin microfibril network and/or the signaling pathways under its control.
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Affiliation(s)
- Silke Peeters
- Centre of Medical Genetics, University of Antwerp and Antwerp University Hospital, Edegem, Belgium
| | - Pauline De Kinderen
- Centre of Medical Genetics, University of Antwerp and Antwerp University Hospital, Edegem, Belgium
| | - Josephina A N Meester
- Centre of Medical Genetics, University of Antwerp and Antwerp University Hospital, Edegem, Belgium
| | - Aline Verstraeten
- Centre of Medical Genetics, University of Antwerp and Antwerp University Hospital, Edegem, Belgium
| | - Bart L Loeys
- Centre of Medical Genetics, University of Antwerp and Antwerp University Hospital, Edegem, Belgium.,Department of Clinical Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
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