Abstract
AbstractCystic fibrosis (CF) is an autosomal recessive disorder characterized by the accumulation of sticky and heavy mucus that can damage several organs. CF shows variable expressivity in affected individuals, but it typically causes respiratory and digestive complications as well as congenital bilateral absence of the vas deferens in males. Individuals with classic CF usually have variants that produce a defective protein from both alleles of the CFTR gene. Individuals with other variants may present with classic, non-classic, or milder forms of CF due to lower levels of functional CFTR protein. This article reports the genetic analysis of a female with features of asthma and mild or non-classic CF. CFTR sequencing demonstrated that she is a carrier for a maternally derived 5T/12TG variant. Deletion/duplication analysis by multiplex ligation-dependent probe amplification (MLPA) showed the presence of an intragenic paternally derived duplication involving exons 7–11 of the CFTR gene. This duplication is predicted to result in the production of a truncated CFTR protein lacking the terminal part of the nucleotide-binding domain 1 (NBD1) and thus is likely to be a non-functioning allele. The combination of this large intragenic duplication and 5T/12TG is the probable cause of the mild or non-classic CF features in this individual.
Topics

No keywords indexed for this article. Browse by subject →

References
35
[1]
Rosenstein, B. J. & Cutting, G. R. The diagnosis of cystic fibrosis: a consensus statement. Cystic Fibrosis Foundation Consensus Panel. J. Pediatr. 132(4), 589–595 (1998). 10.1016/s0022-3476(98)70344-0
[2]
Bombieri, C. et al. Recommendations for the classification of diseases as CFTR-related disorders. J. Cystic Fibrosis. 10(S2), S86–S102 (2011). 10.1016/s1569-1993(11)60014-3
[3]
Farrell, P. M. et al. Guidelines for diagnosis of cystic fibrosis in newborns through older adults: Cystic Fibrosis Consensus Report. J. Pediatr. 153(2), S4–S14 (2008). 10.1016/j.jpeds.2008.05.005
[4]
Wang, Y., Wrennall, J. A., Cai, Z., Li, H. & Sheppard, D. N. Understanding how cystic fibrosis mutations disrupt CFTR function: from single molecules to animal models. Int. J. Biochem. Cell Biol. 52, 47–57 (2014). 10.1016/j.biocel.2014.04.001
[5]
The Clinical and Functional TRanslation of CFTR (CFTR2). Available at: http://cftr2.org. (Accessed: 15th December 2015).
[6]
Bobadilla, J. L., Macek, M. Jr., Fine, J. P. & Farrell P. M. Cystic fibrosis: a worldwide analysis of CFTR mutations–correlation with incidence data and application to screening. Hum. Mutat. 19(6), 575–606 (2002). 10.1002/humu.10041
[7]
Hantash, F. M. et al. Characterization of a recurrent novel large duplication in the cystic fibrosis transmembrane conductance regulator gene. J. Mol. Diagn. 9(4), 556–560 (2007). 10.2353/jmoldx.2007.060141
[8]
Cystic fibrosis mutation database. Available at: http://www.genet.sickkids.on.ca/app. (Accessed: 15th December 2015).
[9]
Chillón, M. et al. Mutations in the cystic fibrosis gene in patients with congenital absence of the vas deferens. N. Engl. J. Med. 332(22), 1475–1480 (1995). 10.1056/nejm199506013322204
[10]
Genetic basis of variable exon 9 skipping in cystic fibrosis transmembrane conductance regulator mRNA

Chin-Shyan Chu, Bruce C. Trapnell, Sheila Curristin et al.

Nature Genetics 1993 10.1038/ng0293-151
[11]
A mutation in CFTR produces different phenotypes depending on chromosomal background

S. Kiesewetter, M. Macek, C. Davis et al.

Nature Genetics 1993 10.1038/ng1193-274
[12]
Witt, D. R. et al. Cystic fibrosis heterozygote screening in 5,161 pregnant women. Am J Hum Genet. 58(4), 823–835 (1996).
[13]
Brock, D. J., Gilfillan, A. & Holloway, S. The incidence of cystic fibrosis in Scotland calculated from heterozygote frequencies. Clin Genet. 53(1), 47–49 (1998). 10.1034/j.1399-0004.1998.531530109.x
[14]
Cuppens, H. et al. Polyvariant mutant cystic fibrosis transmembrane conductance regulator genes. The polymorphic (Tg)m locus explains the partial penetrance of the T5 polymorphism as a disease mutation. J. Clin. Invest. 101(2), 487–496 (1998). 10.1172/jci639
[15]
Mak, V. et al. Proportion of cystic fibrosis gene mutations not detected by routine testing in men with obstructive azoospermia. JAMA. 281(23), 2217–2224 (1999). 10.1001/jama.281.23.2217
[16]
Wang, Z., Milunsky, J., Yamin, M., Maher, T., Oates, R. & Milunsky, A. Analysis by mass spectrometry of 100 cystic fibrosis gene mutations in 92 patients with congenital bilateral absence of the vas deferens. Hum Reprod. 17(8), 2066–2072 (2002). 10.1093/humrep/17.8.2066
[17]
McKone, E. F., Emerson, S. S., Edwards, K. L. & Aitken, M. L. Effect of genotype on phenotype and mortality in cystic fibrosis: a retrospective cohort study. Lancet. 361(9370), 1671–1676 (2003). 10.1016/s0140-6736(03)13368-5
[18]
Groman, J. D. et al. Variation in a repeat sequence determines whether a common variant of the cystic fibrosis transmembrane conductance regulator gene is pathogenic or benign. Am. J. Hum. Genet. 74(1), 176–179 (2004). 10.1086/381001
[19]
Ratbi, I. et al. Detection of cystic fibrosis transmembrane conductance regulator (CFTR) gene rearrangements enriches the mutation spectrum in congenital bilateral absence of the vas deferens and impacts on genetic counselling. Hum. Reprod. 22(5), 1285–1291 (2007). 10.1093/humrep/dem024
[20]
Cottin, V. et al. Late CF caused by homozygous IVS8-5T CFTR polymorphism. Thorax. 60(11), 974–975 (2005). 10.1136/thx.2005.048207
[21]
Montagnani, M. et al. A patient with pancreas divisum, recurrent acute pancreatitis, and homozygosity for the cystic fibrosis transmembrane regulator-associated protein 5T allele. Clin. Gastroenterol. Hepatol. 11(5), 579–581 (2013). 10.1016/j.cgh.2013.02.012
[22]
Zielenski, J. et al. CFTR gene variant for patients with congenital absence of vas deferens. Am. J. Hum. Genet. 57(4), 958–960 (1995).
[23]
Niksic, M., Romano, M., Buratti, E., Pagani, F. & Baralle, F. E. Functional analysis of cis-acting elements regulating the alternative splicing of human CFTR exon 9. Hum. Mol. Genet. 8(13), 2339–2349 (1999). 10.1093/hmg/8.13.2339
[24]
Mailman, M. D. et al. The NCBI dbGaP Database of Genotypes and Phenotypes. Nat. Genet. 39(10), 1181–1186 (2007). 10.1038/ng1007-1181
[25]
NCBI’s Database of Genotypes and Phenotypes: dbGaP

Kimberly A. Tryka, Luning Hao, Anne Sturcke et al.

Nucleic Acids Research 2013 10.1093/nar/gkt1211
[26]
The Human Genome Browser at UCSC

W. James Kent, Charles W. Sugnet, Terrence S. Furey et al.

Genome Research 2002 10.1101/gr.229102
[27]
NIGMS human genetic cell repository online catalog at the Coriell Institute for Medical Research. Available at: https://catalog.coriell.org/1/NIGMS. (Accessed: 15th December 2015).
[28]
Firth, H. V. et al. DECIPHER: Database of Chromosomal Imbalance and Phenotype in Humans Using Ensembl Resources. Am. J. Hum. Genet. 84(4), 524–533 (2009). 10.1016/j.ajhg.2009.03.010
[29]
MacDonald, J. R., Ziman, R., Yuen, R. K., Feuk, L. & Scherer, S. W. The database of genomic variants: a curated collection of structural variation in the human genome. Nucleic Acids Res. 42(Database issue), D986–D992 (2014). 10.1093/nar/gkt958
[30]
Liu, X. et al. Characterization of the segmental duplication LCR7-20 in the human genome. Genomics 83(2), 262–269 (2004). 10.1016/j.ygeno.2003.08.003
[31]
El-Seedy, A. et al. Influence of the duplication of CFTR exon 9 and its flanking sequences on diagnosis of cystic fibrosis mutations. J. Mol. Diagn. 11(5), 488–493 (2009). 10.2353/jmoldx.2009.090005
[32]
Niel, F. et al. Rapid detection of CFTR gene rearrangements impacts on genetic counselling in cystic fibrosis. J. Med. Genet. 41(11), e118 (2004). 10.1136/jmg.2004.022400
[33]
Costantino, L. et al. A wide methodological approach to identify a large duplication in CFTR gene in a CF patient uncharacterised by sequencing analysis. J. Cyst. Fibros. 10(6), 412–417 (2011). 10.1016/j.jcf.2011.06.007
[34]
Quemener, S. et al. Complete ascertainment of intragenic copy number mutations (CNMs) in the CFTR gene and its implications for CNM formation at other autosomal loci. Hum. Mutat. 31(4), 421–428 (2010). 10.1002/humu.21196
[35]
Chu, C. S. et al. Extensive posttranscriptional deletion of the coding sequences for part of nucleotide-binding fold 1 in respiratory epithelial mRNA transcripts of the cystic fibrosis transmembrane conductance regulator gene is not associated with the clinical manifestations of cystic fibrosis. J. Clin. Invest. 90(3), 785–790 (1992). 10.1172/jci115952
Metrics
4
Citations
35
References
Details
Published
Dec 20, 2016
Vol/Issue
6(1)
License
View
Cite This Article
Patricia B. S. Celestino-Soper, Edward Simpson, Danika Tumbleson Brink, et al. (2016). Intragenic CFTR Duplication and 5T/12TG Variant in a Patient with Non-Classic Cystic Fibrosis. Scientific Reports, 6(1). https://doi.org/10.1038/srep38776