title: Evaluation of RET polymorphisms in a six-generation family with G533C RET mutation: specific RET variants may modulate age at onset and clinical presentation.
abstract: BACKGROUND
  We previously described a six-generation family with G533C RET mutation and medullary thyroid carcinoma, in the largest family reported do date. Of particular interest, phenotype variability regarding the age of onset and clinical presentation of the disease, was observed.
  
  
  OBJECTIVE
  We evaluate whether single SNPs within RET oncogene or haplotype comprising the RET variants (defined by Haploview) could predispose to early development of MTC in this family and influence the clinical manifestation.
  
  
  METHODS
  Eight SNPs were selected based on their previous association with the clinical course of hereditary or sporadic MTC, in particular promoting an early onset of disease. The variants were initially tested in 77 G533C-carriers and 100 controls using either PCR-direct sequencing or PCR-RFLP. Association between a SNP or haplotype and age at diagnosis or presence of lymph node metastasis was tested in 34 G533C-carries with MTC. Different bioinformatic tools were used to evaluate the potential effects on RNA splicing.
  
  
  RESULTS
  An association was found between IVS1-126G > T and age at diagnosis. The variant [IVS8 +82A > G; 85-86 insC] was associated with the presence of lymph node metastases at diagnosis. In silico analysis suggested that this variant may induce abnormal splicing. This in silico analysis predicted that the [IVS8 +82A > G; 85-86 insC] could alter the splicing by disrupting and/or creating exonic splicing enhancer motifs.
  
  
  CONCLUSIONS
  We here identified two RET variants that were associated with phenotype variability in G533C-carriers, which highlights the fact that the modifier effect of a variant might depend on the type of mutation.
authors.affiliation: Division of Genetics, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Rosana
authors.initials: R
authors.lastname: Tamanaha
authors.forename: Cléber P
authors.initials: CP
authors.lastname: Camacho
authors.forename: Alexandre C
authors.initials: AC
authors.lastname: Pereira
authors.forename: Adriana M Alvares
authors.initials: AM
authors.lastname: da Silva
authors.forename: Rui M B
authors.initials: RM
authors.lastname: Maciel
authors.forename: Janete M
authors.initials: JM
authors.lastname: Cerutti
mesh_terms: D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D018276:Carcinoma, Medullary / Q000453:epidemiology* / Q000235:genetics* / Q000473:pathology; D020022:Genetic Predisposition to Disease; D014644:Genetic Variation; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D017354:Point Mutation; D020641:Polymorphism, Single Nucleotide; D051096:Proto-Oncogene Proteins c-ret / Q000235:genetics*; D013964:Thyroid Neoplasms / Q000453:epidemiology* / Q000235:genetics* / Q000473:pathology
chemical_list: D051096:Proto-Oncogene Proteins c-ret; C099282:RET protein, human