LTBP4 genotype predicts age of ambulatory loss in Duchenne muscular dystrophy.

LTBP4 genotype predicts age of ambulatory loss in Duchenne muscular dystrophy.
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DOI:
10.1002/ana.23819
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发表时间:
2013-04
影响因子:
11.2
通讯作者:
Weiss, Robert B.
Weiss, Robert B.
中科院分区:
医学1区
文献类型:
--
作者:
Flanigan, Kevin M.;Ceco, Ermelinda;Lamar, Kay-Marie;Kaminoh, Yuuki;Dunn, Diane M.;Mendell, Jerry R.;King, Wendy M.;Pestronk, Alan;Florence, Julaine M.;Mathews, Katherine D.;Finkel, Richard S.;Swoboda, Kathryn J.;Gappmaier, Eduard;Howard, Michael T.;Day, John W.;McDonald, Craig;McNally, Elizabeth M.;Weiss, Robert B.

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杜氏肌营养不良症(DMD)显示的临床范围不能完全解释的主要DMD突变。Ltbp 4编码潜伏性转化生长因子-β结合蛋白4,先前在全基因组扫描中发现其为鼠肌营养不良症的修饰物。我们试图确定LTBP 4基因型是否影响DMD的严重程度在一个大的患者队列。我们分析了254例已知DMD突变的卧床受试者中LTBP 4的非同义SNP。这些SNP,V194 I,T787 A,T820 A和T1140 M,形成“VTTT”和“IAAM”LTBP 4单倍型。个体纯合子IAAM LTBP 4单倍型保持走动显着长于那些杂合子或纯合子VTTT单倍型。糖皮质激素治疗的IAAM纯合子患者在12.5 ± 3.3年时失访,而治疗的VTTT杂合子或纯合子患者在10.7 ± 2.1年时失访。与VTTT成纤维细胞相比,暴露于TGFβ的IAAM成纤维细胞显示出减少的磷酸-SMAD信号传导,这与LTBP 4作为TGFβ调节剂的作用一致。LTBP 4单倍型影响失肌年龄,在DMD患者的管理中应予以考虑。
Duchenne Muscular Dystrophy (DMD) displays a clinical range that is not fully explained by the primary DMD mutations. Ltbp4, encoding latent transforming growth factor-β binding protein 4, was previously discovered in a genomewide scan as a modifier of murine muscular dystrophy. We sought to determine whether LTBP4 genotype influenced DMD severity in a large patient cohort. We analyzed nonsynonymous SNPs from human LTBP4 in 254 nonambulatory subjects with known DMD mutations. These SNPs, V194I, T787A, T820A, and T1140M, form “VTTT” and “IAAM” LTBP4 haplotypes. Individuals homozygous for the IAAM LTBP4 haplotype remained ambulatory significantly longer than those heterozygous or homozygous for the VTTT haplotype. Glucocorticoid-treated patients who were IAAM homozygotes lost ambulation at 12.5 ± 3.3 years compared to 10.7 ± 2.1 years for treated VTTT heterozygotes or homozygotes. IAAM fibroblasts exposed to TGFβ displayed reduced phospho-SMAD signaling compared to VTTT fibroblasts, consistent with LTBP4's role as regulator of TGFβ. LTBP4 haplotype influences age at loss of ambulation, and should be considered in the management of DMD patients.
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