Etude et caractérisation des gènes impliqués dans la tachycardie ventriculaire polymorphe catécholaminergique

Abstract : Catecholaminergic polymorphic ventricular tachycardia (CPVT) is a rare and severe inherited arrhythmogenic disorder, responsible for sudden death in young patients. It is a genetically heterogenous pathology with an autosomal dominant form associated with mutations of the RYR2 gene, and a recessive form associated with mutations of the CASQ2 gene. The ryanodine receptor RyR2 is a Ca2+ channel, and the calsequestrin Casq2 is the major calcium storage protein, located in the sarcoplasmic reticulum of the cardiomyocytes. They belong to the calcium release complex (CRC) that plays a central role in excitation-contraction coupling. In this work, we report the identification of RYR2 and CASQ2 mutations in 75 and 11 CPVT probands, respectively. We identified two cases of germline and somatic mosaicism in RYR2. Two splicing mutations of CASQ2 have been validated using a splicing minigene assay. We searched for mutations among 97 CPVT probands, negative for RYR2 and CASQ2, in three candidate genes: TRDN, ASPH and FKBP1B, encoding three proteins of the CRC. We did not identify any mutation of ASPH and FKBP1B genes. However, we found three mutations in the TRDN gene, encoding the cardiac triadin: a microdeletion, a nonsense mutation, both leading to a premature stop codon, and a missense mutation. We demonstrated that the missense mutation induces a drastic reduction of the protein in cellular and animal models. All the three mutations would thus be associated with the absence of triadin, leading to dysfunction of the CRC, and arythmias. In conclusion, our results confirm that RYR2 is the major gene implicated in CPVT, and CASQ2 rarely implicated. Moreover, we report mutations of the TRDN gene for the first time in pathology, as a third gene associated with a rare autosomal recessive form of CPVT.
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Nathalie Roux-Buisson. Etude et caractérisation des gènes impliqués dans la tachycardie ventriculaire polymorphe catécholaminergique. Sciences agricoles. Université de Grenoble, 2012. Français. ⟨NNT : 2012GRENV010⟩. ⟨tel-00767106⟩

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