Rees, M;
Nikoopour, R;
Fukuzawa, A;
Kho, AL;
Fernandez-Garcia, MA;
Wraige, E;
Bodi, I;
Deshpande, C;
Özdemir, Ö;
Daimagüler, H-S;
et al.
Rees, M; Nikoopour, R; Fukuzawa, A; Kho, AL; Fernandez-Garcia, MA; Wraige, E; Bodi, I; Deshpande, C; Özdemir, Ö; Daimagüler, H-S; Pfuhl, M; Holt, M; Brandmeier, B; Grover, S; Fluss, J; Longman, C; Farrugia, ME; Matthews, E; Hanna, M; Muntoni, F; Sarkozy, A; Phadke, R; Quinlivan, R; Oates, EC; Schröder, R; Thiel, C; Reimann, J; Voermans, N; Erasmus, C; Kamsteeg, E-J; Konersman, C; Grosmann, C; McKee, S; Tirupathi, S; Moore, SA; Wilichowski, E; Hobbiebrunken, E; Dekomien, G; Richard, I; Van den Bergh, P; Domínguez-González, C; Cirak, S; Ferreiro, A; Jungbluth, H; Gautel, M
(2021)
Making sense of missense variants in TTN-related congenital myopathies.
Acta Neuropathol, 141 (3).
pp. 431-453.
ISSN 1432-0533
https://doi.org/10.1007/s00401-020-02257-0
SGUL Authors: Matthews, Emma Louise
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Abstract
Mutations in the sarcomeric protein titin, encoded by TTN, are emerging as a common cause of myopathies. The diagnosis of a TTN-related myopathy is, however, often not straightforward due to clinico-pathological overlap with other myopathies and the prevalence of TTN variants in control populations. Here, we present a combined clinico-pathological, genetic and biophysical approach to the diagnosis of TTN-related myopathies and the pathogenicity ascertainment of TTN missense variants. We identified 30 patients with a primary TTN-related congenital myopathy (CM) and two truncating variants, or one truncating and one missense TTN variant, or homozygous for one TTN missense variant. We found that TTN-related myopathies show considerable overlap with other myopathies but are strongly suggested by a combination of certain clinico-pathological features. Presentation was typically at birth with the clinical course characterized by variable progression of weakness, contractures, scoliosis and respiratory symptoms but sparing of extraocular muscles. Cardiac involvement depended on the variant position. Our biophysical analyses demonstrated that missense mutations associated with CMs are strongly destabilizing and exert their effect when expressed on a truncating background or in homozygosity. We hypothesise that destabilizing TTN missense mutations phenocopy truncating variants and are a key pathogenic feature of recessive titinopathies that might be amenable to therapeutic intervention.
Item Type: | Article | ||||||||||||||||||||||||||||||||||||
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Additional Information: | © The Author(s) 2021 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | ||||||||||||||||||||||||||||||||||||
Keywords: | 1103 Clinical Sciences, 1109 Neurosciences, Neurology & Neurosurgery | ||||||||||||||||||||||||||||||||||||
SGUL Research Institute / Research Centre: | Academic Structure > Molecular and Clinical Sciences Research Institute (MCS) | ||||||||||||||||||||||||||||||||||||
Journal or Publication Title: | Acta Neuropathol | ||||||||||||||||||||||||||||||||||||
ISSN: | 1432-0533 | ||||||||||||||||||||||||||||||||||||
Language: | eng | ||||||||||||||||||||||||||||||||||||
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Publisher License: | Creative Commons: Attribution 4.0 | ||||||||||||||||||||||||||||||||||||
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PubMed ID: | 33449170 | ||||||||||||||||||||||||||||||||||||
Web of Science ID: | WOS:000607987900001 | ||||||||||||||||||||||||||||||||||||
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URI: | https://openaccess.sgul.ac.uk/id/eprint/113756 | ||||||||||||||||||||||||||||||||||||
Publisher's version: | https://doi.org/10.1007/s00401-020-02257-0 |
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