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Hypomorphic NOTCH3 Alleles Do Not Cause CADASIL in Humans
Authors:Julie W. Rutten  Elles M.J. Boon  Michael K. Liem  Johannes G. Dauwerse  Margot J. Pont  Ellen Vollebregt  Anneke J. Maat‐Kievit  Hendrika B. Ginjaar  Phillis Lakeman  Sjoerd G. van Duinen  Gisela M. Terwindt  Saskia A.J. Lesnik Oberstein
Affiliation:1. Department of Human Genetics, Leiden University Medical Center, , Leiden, The Netherlands;2. Department of Clinical Genetics, Leiden University Medical Center, , Leiden, The Netherlands;3. Department of Radiology, Leiden University Medical Center, , Leiden, The Netherlands;4. Department of Clinical Genetics, Erasmus Medical Center, , Rotterdam, The Netherlands;5. Department of Clinical Genetics, Academic Medical Center, , Amsterdam, The Netherlands;6. Department of Clinical Genetics, VU University Medical Center, , Amsterdam, The Netherlands;7. Department of Pathology, Leiden University Medical Center, , Leiden, The Netherlands;8. Department of Neurology, Leiden University Medical Center, , Leiden, The Netherlands
Abstract:Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is caused by stereotyped missense mutations in NOTCH3. Whether these mutations lead to the CADASIL phenotype via a neomorphic effect, or rather by a hypomorphic effect, is subject of debate. Here, we report two novel NOTCH3 mutations, both leading to a premature stop codon with predicted loss of NOTCH3 function. The first mutation, c.307C>T, p.Arg103*, was detected in two brothers aged 50 and 55 years, with a brain MRI and skin biopsy incompatible with CADASIL. The other mutation was found in a 40‐year‐old CADASIL patient compound heterozygous for a pathogenic NOTCH3 mutation (c.2129A>G, p.Tyr710Cys) and an intragenic frameshift deletion. The deletion was inherited from his father, who did not have the skin biopsy abnormalities seen in CADASIL patients. These individuals with rare NOTCH3 mutations indicate that hypomorphic NOTCH3 alleles do not cause CADASIL.
Keywords:NOTCH3  CADASIL  nonsense mutation  deletion  hypomorphic allele
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