Two novel CYP7B1 mutations in Italian families with SPG5: a clinical and genetic study |
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Authors: | Chiara Criscuolo Alessandro Filla Giovanni Coppola Carlo Rinaldi Rosa Carbone Stefano Pinto Qing Wang Maria Fulvia de Leva Elena Salvatore Sandro Banfi Arturo Brunetti Mario Quarantelli Daniel H Geschwind Sabina Pappatà Giuseppe De Michele |
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Institution: | (1) Dipartimento di Scienze Neurologiche, Università degli Studi di Napoli Federico II, Via Pansini 5, 80131 Naples, Italy;(2) Department of Biomorphological and Functional Sciences, Biostructure and Bioimaging Institute, National Research Council, Federico II University, Naples, Italy;(3) Telethon Institute of Genetics and Medicine, Naples, Italy;(4) Program in Neurogenetics, Department of Neurology and Semel Institute, University of California at Los Angeles, Los Angeles, CA, USA |
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Abstract: | Hereditary spastic paraplegias (HSPs) are a heterogeneous group of neurodegenerative disorders characterized by progressive
weakness and spasticity in the lower limbs. Spasticity may occur in isolation (‘‘pure’’ HSP) or may be accompanied by other
features. Although autosomal recessive HSPs usually have clinically complex phenotypes, mutations within a few genes underlie
pure forms. Recently the gene (CYP7B1) responsible for SPG5, a pure recessive HSP, has been identified. The six CYP7B1 coding exons were analysed in four Italian families. Complete clinical assessment was performed in all patients. Blood CYP7B1 mRNA levels were assessed in three patients and six controls. Brain MRI and 18F-fluoro-deoxy-glucose positron emission tomography (PET) scan were conducted in three patients. Two novel homozygous mutations
were identified. Both result in a frameshift and the introduction of a premature stop codon at the C-terminal of the protein.
Patients have reduced blood CYP7B1 mRNA levels, suggesting nonsense mediated RNA decay. Although clinical assessment showed a pure form of spastic paraplegia,
MRI demonstrated white matter abnormalities in three patients and PET scan revealed cerebellar hypometabolism in one. Based
on the results, we report the first Italian families with SPG5 molecular characterization and describe two novel truncating
mutations in CYP7B1. The recessive character, the truncating nature of the mutations, and the reduced peripheral blood CYP7B1 mRNA levels suggest that the development of the disease is associated with a loss of function. SPG5 is considered a pure
form of HSP, but MRI and PET findings in our patients suggest that SPG5 phenotype may be broader than the pure presentation. |
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Keywords: | Spastic paraplegia CYP7B1 SPG5 White matter abnormalities |
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