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Novel mutations in collagen VI genes

Expansion of the Bethlem myopathy phenotype

From the Department of Molecular Genetics and Biochemistry (Drs. Scacheri and Hoffman, and M. Bingler), University of Pittsburgh School of Medicine, Pittsburgh, PA; Research Center for Genetic Medicine (Drs. Scacheri and Hoffman), Children’s National Medical Center, George Washington University, Washington, DC; Cancer Genetics Branch (Dr. Thakore and E.M. Gillanders), National Human Genome Research Institute, Bethesda, MD; Department of Neurology (Drs. Subramony and Vedanarayanan), University of Mississippi Medical Center, Jackson, MS; and Division of Genetics (Dr. Crowe), MetroHealth Medical Center, Cleveland, OH.

Address correspondence and reprint requests to Dr. Eric P. Hoffman, Research Center for Genetic Medicine, Children’s National Medical Center, 111 Michigan Ave. NW, Washington, DC 20010; e-mail: ehoffman{at}cnmc.org

Objective: To investigate the molecular basis of autosomal dominant limb-girdle muscular dystrophy (AD-LGMD) in three large new families.

Methods andResults: Genome-wide linkage was performed to show that the causative gene in all three families localized to chromosome 21q22.3 (Zmax = 10.3; = 0). This region contained the collagen VI 1 and 2 genes, which have been previously shown to harbor mutations causing a relatively mild congenital myopathy with contractures (Bethlem myopathy). Screening of the collagen VI 1 and 2 genes revealed novel, causative mutations in each family (COL6A1—K121R, G341D; COL6A2—D620N); two of these mutations were in novel regions of the proteins not previously associated with disease. Collagen VI is a ubiquitously expressed component of connective tissue; however, both limb-girdle muscular dystrophy and Bethlem myopathy patients show symptoms restricted to skeletal muscle. To address the muscle-specific symptoms resulting from collagen VI mutations, the authors studied three patient muscle biopsies at the molecular level (protein expression). A marked reduction of laminin ß1 protein in the myofiber basal lamina in all biopsies was found, although this protein was expressed normally in the neighboring capillary basal laminae.

Conclusions: The authors’ studies widen the clinical spectrum of Bethlem myopathy and suggest collagen VI etiology should be investigated in dominant limb-girdle muscular dystrophy. The authors hypothesize that collagen VI mutations lead to muscle-specific defects of the basal lamina, and may explain the muscle-specific symptoms of Bethlem and limb-girdle muscular dystrophy patients with collagen VI mutations.

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