title: Premutation allele pool in myotonic dystrophy type 2.
abstract: BACKGROUND
  The myotonic dystrophies (DM1, DM2) are the most common adult muscle diseases and are characterized by multisystem involvement. DM1 has been described in diverse populations, whereas DM2 seems to occur primarily in European Caucasians. Both are caused by the expression of expanded microsatellite repeats. In DM1, there is a reservoir of premutation alleles; however, there have been no reported premutation alleles for DM2. The (CCTG)(DM2) expansion is part of a complex polymorphic repeat tract of the form (TG)(n)(TCTG)(n)(CCTG)(n)(NCTG)(n)(CCTG)(n). Expansions are as large as 40 kb, with the expanded (CCTG)(n) motif uninterrupted. Reported normal alleles have up to (CCTG)(26) with one or more interruptions.
  
  
  METHODS
  To identify and characterize potential DM2 premutation alleles, we cloned and sequenced 43 alleles from 23 individuals. Uninterrupted alleles were identified, and their instability was confirmed by small-pool PCR. We determined the genotype of a nearby single nucleotide polymorphism (rs1871922) known to be in linkage disequilibrium with the DM2 mutation.
  
  
  RESULTS
  We identified three classes of large non-DM2 repeat alleles: 1) up to (CCTG)(24) with two interruptions, 2) up to (CCTG)(32) with up to four interruptions, and 3) uninterrupted (CCTG)(22-33). Large non-DM2 alleles were more common in African Americans than in European Caucasians. Uninterrupted alleles were significantly more unstable than interrupted alleles (p = 10(-4) to 10(-7)). Genotypes at rs1871922 were consistent with the hypothesis that all large alleles occur on the same haplotype as the DM2 expansion.
  
  
  CONCLUSIONS
  We conclude that unstable uninterrupted (CCTG)(22-33) alleles represent a premutation allele pool for DM2 full mutations.
authors.affiliation: Department of Cancer Genetics, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Blvd., Houston, TX 77030-4009, USA.
authors.forename: L L
authors.initials: LL
authors.lastname: Bachinski
authors.forename: T
authors.initials: T
authors.lastname: Czernuszewicz
authors.forename: L S
authors.initials: LS
authors.lastname: Ramagli
authors.forename: T
authors.initials: T
authors.lastname: Suominen
authors.forename: M D
authors.initials: MD
authors.lastname: Shriver
authors.forename: B
authors.initials: B
authors.lastname: Udd
authors.forename: M J
authors.initials: MJ
authors.lastname: Siciliano
authors.forename: R
authors.initials: R
authors.lastname: Krahe
mesh_terms: D000328:Adult; D005060:Europe / Q000453:epidemiology; D005260:Female; D005787:Gene Frequency / Q000235:genetics*; D020022:Genetic Predisposition to Disease / Q000235:genetics; D005820:Genetic Testing / Q000379:methods*; D014644:Genetic Variation / Q000235:genetics; D006801:Humans; D008297:Male; D009223:Myotonic Dystrophy / Q000145:classification / Q000175:diagnosis* / Q000235:genetics*; D020641:Polymorphism, Single Nucleotide / Q000235:genetics*; D012091:Repetitive Sequences, Nucleic Acid / Q000235:genetics*; D014481:United States