Reclassification of Two MLH1 Variants of Uncertain Significance Utilizing Clinical and Functional Data.

IF 1.5 4区 医学 Q4 GENETICS & HEREDITY
Jane Hübertz Frederiksen, Ulf Birkedal, Sarah Bachmann, Elisabeth Victoria Eliesen, Lene Juel Rasmussen, Katja Venborg Pedersen, Lana Al-Zehhawi, Susanne E Boonen, Lotte Krogh, Karina Rønlund, Lise Graversen, Jannie Assenholt, Kjeld Schmiegelow, Karin Wadt, Anne-Marie Gerdes, Thomas V O Hansen
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引用次数: 0

Abstract

Background: Pathogenic variants in the mismatch repair genes are associated with an elevated lifetime risk of colorectal cancer (CRC). We previously identified two variants of uncertain significance (VUS) in the MLH1 gene, c.696_698del, p.(Cys233del) and c.1919C > G, p.(Pro640Arg), in Danish families with numerous occurrences of CRC.

Methods: To reclassify the variants we collected clinical data, initiated tumor and co-segregation analysis, and performed RNA splicing analysis, subcellular localization, and protein stability studies.

Results: The functional analysis revealed that the c.696_698del, p.(Cys233del) variant had an effect at the RNA level, on subcellular localization, and on protein stability, while the c.1919C > G, p.(Pro640Arg) variant showed decreased expression in localization studies and decreased protein stability. These results suggest both variants disrupt DNA mismatch repair.

Conclusion: By applying all collected data and functional results we propose to reclassify the c.696_698del, p.(Cys233del) and the c.1919C > G, p.(Pro640Arg) variants as likely pathogenic (class 4) using MMR gene-specific ACMG/AMP guidelines. Consequently, the two MLH1 variants can now be used for risk assessment of variant carriers, while family members without the variants can be excluded from intensified cancer surveillance and follow population recommendations.

利用临床和功能数据对两个意义不明的 MLH1 变异进行重新分类。
背景:错配修复基因中的致病变异与终生罹患结直肠癌(CRC)的风险升高有关。此前,我们在有大量 CRC 发病的丹麦家族中发现了 MLH1 基因中的两个不确定意义 (VUS) 变异,即 c.696_698del,p.(Cys233del) 和 c.1919C > G,p.(Pro640Arg):为了对变异进行重新分类,我们收集了临床数据,启动了肿瘤和共分离分析,并进行了 RNA 剪接分析、亚细胞定位和蛋白质稳定性研究:功能分析显示,c.696_698del, p.(Cys233del)变异体对RNA水平、亚细胞定位和蛋白质稳定性有影响,而c.1919C > G, p.(Pro640Arg)变异体在定位研究中表现为表达量减少和蛋白质稳定性降低。这些结果表明,这两个变体都会破坏 DNA 错配修复:结论:通过应用收集到的所有数据和功能结果,我们建议采用 MMR 基因特异性 ACMG/AMP 指南,将 c.696_698del、p.(Cys233del) 和 c.1919C > G、p.(Pro640Arg) 变体重新分类为可能致病(4 类)变体。因此,这两个 MLH1 变体现在可用于变体携带者的风险评估,而没有变体的家庭成员则可排除在强化癌症监测之外,并遵循人群建议。
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来源期刊
Molecular Genetics & Genomic Medicine
Molecular Genetics & Genomic Medicine Biochemistry, Genetics and Molecular Biology-Genetics
CiteScore
4.20
自引率
0.00%
发文量
241
审稿时长
14 weeks
期刊介绍: Molecular Genetics & Genomic Medicine is a peer-reviewed journal for rapid dissemination of quality research related to the dynamically developing areas of human, molecular and medical genetics. The journal publishes original research articles covering findings in phenotypic, molecular, biological, and genomic aspects of genomic variation, inherited disorders and birth defects. The broad publishing spectrum of Molecular Genetics & Genomic Medicine includes rare and common disorders from diagnosis to treatment. Examples of appropriate articles include reports of novel disease genes, functional studies of genetic variants, in-depth genotype-phenotype studies, genomic analysis of inherited disorders, molecular diagnostic methods, medical bioinformatics, ethical, legal, and social implications (ELSI), and approaches to clinical diagnosis. Molecular Genetics & Genomic Medicine provides a scientific home for next generation sequencing studies of rare and common disorders, which will make research in this fascinating area easily and rapidly accessible to the scientific community. This will serve as the basis for translating next generation sequencing studies into individualized diagnostics and therapeutics, for day-to-day medical care. Molecular Genetics & Genomic Medicine publishes original research articles, reviews, and research methods papers, along with invited editorials and commentaries. Original research papers must report well-conducted research with conclusions supported by the data presented.
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