Mutational Analysis of ATP7B in North Chinese Patients with Wilson Disease
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Journal of Human Genetics (2013) 58, 67–72 & 2013 The Japan Society of Human Genetics All rights reserved 1434-5161/13 www.nature.com/jhg ORIGINAL ARTICLE Mutational analysis of ATP7B in north Chinese patients with Wilson disease Kui Li1, Wei-Min Zhang2, Sheng Lin1,6,LuWen1,7, Zi-Feng Wang1, Dan Xie3, Min Wei4, Zheng-Qing Qiu4, Yi Dai5, Marie C M Lin3, Hsiang-Fu Kung3 and Feng-Xia Yao2 Wilson disease (WD) is an autosomal recessive inherited disease caused by abnormalities of the copper-transporting protein encoding gene ATP7B. In this study, we examined ATP7B for mutations in 114 individuals of Chinese Han population living in north China who were diagnosed as WD. Totally, we identified 36 mutations and 11 single-nucleotide polymorphisms (SNPs), of which 14 mutations have never been reported previously and 5 were firstly described in Chinese. Among these, p.R778L (21.5%), p.A874V (7.5%) and p.P992L (6.1%) were the most frequent mutations. A genotype of p.L770L þ p.R778L þ p.P992L was the most frequent triple mutations and two pairs of mutations, p.L770L/p.R778L and p.A874V/ p.I929V, were closely related. In addition, a database was established to summarize all ATP7B mutations, including those reported previously and those identified in this study. Popular algorithms were used to predict the functional effects of these mutations, and finally, by comparative genomics approaches, we predicted a group of mutation hot spots for ATP7B. Our study will broaden our knowledge about ATP7B mutations in WD patients in north China, and be helpful for clinical genetic testing. Journal of Human Genetics (2013) 58, 67–72; doi:10.1038/jhg.2012.134; published online 13 December 2012 Keywords: ATP7B; Chinese; genotype; mutational analysis; susceptibility; Wilson disease INTRODUCTION ATP7B and its homolog ATP7A are the two main copper-transporting Wilson disease (WD/WND, NCBI MIM No. 277900) is an autosomal proteins.7 Defects of ATP7A impair the entry of copper from recessive inherited disease characterized by excess accumulation of enterocytes into circulation and thereby cause deficiency of copper, 8 intracellular hepatic copper with subsequent hepatic and neurologic known as the Menkes disease, an X-linked disorder. The role of abnormalities. It was first reported by Dr Samuel Alexander Kinnier ATP7B is quite different and it mainly functions as transforming Wilson in 1912 and since then a growing number of cases were apoceruloplasmin into ceruloplasmin and excreting copper into the identified worldwide.1 It is estimated that the disease frequency is biliary canaliculi. Defects of ATP7B reduce the blood ceruloplasmin about 1/5000 to 1/30 000 and the carrier frequency is even higher.2 and are harmful to hepatocytes. Many other organs, such as the brain WD patients have a very poor prognosis if not diagnosed at an early and kidney, can also be affected.9 stage and treated appropriately. A life-span treatment is required for Up to now, more than 500 forms of genetic mutations in ATP7B WD patients with severe symptom or early onset age, and an early have been reported and there are 1343 known single-nucleotide diagnosis and therapy will remarkably improve life quality with a polymorphisms (SNPs), suggesting that ATP7B is susceptible to hope of complete symptomatic recovery.3–5 Therefore, quick and mutation.10 In this study, we identified 36 mutations from 114 accurate genetic testing for WD patients and efficient screening for individuals in north China Han populations who were diagnosed as carriers in the population are urgently required. WD, of which 14 mutations have never been reported previously and WD is one of the most prevalent inherited diseases caused by 5 are firstly described in the Chinese. We also performed a abnormalities of a single gene, the ATP7B, which encodes a copper- bioinformatic analysis to predict the functional effects of these transporting ATPase 2 b protein.3,6 It is located at 13q14.3, spanning a mutations, and predicted a group of amino-acid residues of the genomic region of B78 kb and including 21 exons and 20 introns. ATP7B protein to be mutation hot spots. 1Laboratory of Integrated Biosciences, Life Science School, Sun Yat-sen University, Guangzhou, Guangdong, China; 2Clinical Research Lab, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China; 3State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China; 4Department of Pediatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China and 5Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China 6Current address: Laboratory of Medical Genetics, Research Institute of Population and Family Planning, ShenZhen, China. 7Current address: Biodynamic Optical Imaging Center, College of Life Sciences, Peking University, Beijing, China. Correspondence: Dr F-X Yao, Clinical Research Lab, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical college, Beijing 100730, China. E-mail: [email protected] Received 7 April 2012; revised 19 September 2012; accepted 21 October 2012; published online 13 December 2012 ATP7B mutations in WD patients in north China KLiet al 68 MATERIALS AND METHODS Meanwhile, allele frequency and heterozygosity of SNPs identified in this study Subjects were also analyzed and subsequently compared with those obtained from the A total of 114 individuals, who belonged to the Han population from north dbSNP database. China and were diagnosed as WD, were recruited in this study, of which 76 A self-writing program was used for genotyping and paired relevance were males and 38 were females, with onset ages from 7 to 44 years and a analysis of the identified mutations. median age of 25. One hundred and eleven unrelated individuals and three siblings were set as the control, and all of them were fully informed and signed Computational prediction of deleterious variants of ATP7B for agreement. All the patients were diagnosed as WD at the Peking Union To predict the deleterious effects of a mutation to the structure and function Medical College Hospital generally based on the following criteria: (1) liver or of the protein, we applied three popular programs: PolyPhen-2 (http:// brain failure symptoms; (2) presence of K-F ring in the cornea by slit-lamp À1 genetics.bwh.harvard.edu/pph2/index.shtml), PMut (http://mmb2.pcb.ub.es: examination; (3) reduced serum ceruloplasmin (o0.20 g l )and/orelevated 8080/PMut/) and SNAP (http://rostlab.org/services/snap/).19–22 To predict 4 m 24-hour urinary copper excretion ( 1.0 mol per day) and/or hepatic copper deleterious SNPs located in the introns, upstream and downstream of the 4 m 11 content 250 g per g of dry weight. coding region, the FastSNP program was used (http://fastsnp.ibms.sinica. edu.tw/pages/input_CandidateGeneSearch.jsp).17 All the programs were run by Data source their default parameters with optimization. Reference ATP7B mRNA (NM_000053.3) and protein sequences (NP_000044.2) were retrieved from the NCBI Entrez database, and SNPs were retrieved from the NCBI database (db) SNP (http://www.ncbi.nlm.nih. Predication of mutation hot spots for ATP7B gov/snp/), including all SNPs in the ATP7B gene region except the clinical ATP7B protein sequences of 13 non-human organisms, including monkey submission items.12 (XP_001103242.2), rat (NP_036643.2), mouse (NP_031537.2), dog (NP_001020438.1), cattle (XP_002691840.1), sheep (NP_001009732.1), horse Multiple approaches were applied to obtain the known genetic mutations of ATP7B, including (1) the Wilson Disease Mutation Database in the University (XP_001488500.1), duck (XP_001378265.2), chicken (XP_417073.3), panda of Alberta, maintained by the Cox Lab (http://www.wilsondisease.med.ualberta (XP_002917723.1), platypus (XP_001513328.2), lizard (XP_003215344.1) .ca/database.asp);10 (2) the UniProt (Universal Protein Resource) accession and zebrafish (XP_684415.4), were retrieved from the NCBI database. Multiple sequences alignment of these sequences together with the human ATP7B of ATP7B protein P35670 (http://www.uniprot.org/uniprot/P35670); (3) the protein sequence was performed by the Clustal X software (http://www. Human Gene Mutation Database (HGMD) Professional at the Institute of 18 Medical Genetics in Cardiff, a product of BIOBASE (http://www.hgmd.org/).13 clustal.org/) with default parameters. Conservative scores of each residue HGMD is a commercial knowledge base service, being established and were calculated and outputted, ranging from 0 to 100. An amino-acid residue with the conservative score 480 was considered to be a high-conservative site maintained manually, and the last update was at 30 September 2011. This database is thought to be the most precise and complete collection of the and more than five consecutive such sites were defined as a conservative ATP7B gene variants. All the missense/nonsense mutations with an accession in segment. To identify mutation hot spots for ATP7B,allATP7B missense/nonsense the above databases were merged into a new set (Supplementary Table 1) and other forms of mutations, such as insert, deletion, indels, synonymous and mutations, including those identified in this study and those reported noncoding mutations, were mainly based on the HGMD database annotation. previously, were mapped into the conservative track. We defined a mutation hot spot when (1) there are more than one form of missense/nonsense mutations for a high-conservative site, or (2) there is only one form of DNA extraction, PCR and sequencing mutation, but it is within a conservative segment. Genomic DNAs were extracted from the peripheral blood leukocytes of the patients by QIAamp blood kits (Qiagen, Hilden, Germany) according to the manufacturer’s instruction. Eleven exons (2, 5, 8–12, 13, 16, 18 and 19) of the RESULTS ATP7B gene and their flanking intron sequences, which are a total of 5687 bp Identification of novel and/or prevalent ATP7B genetic variants of in length, were amplified by PCR.