title: Alu-mediated nonallelic homologous and nonhomologous recombination in the BMPR2 gene in heritable pulmonary arterial hypertension.
abstract: OBJECTIVE
  The purpose of this study was to undertake thorough genetic analysis of the bone morphogenetic protein type 2 receptor (BMPR2) gene in patients with pulmonary arterial hypertension.
  
  
  METHODS
  We conducted a systematic analysis for larger gene rearrangements together with conventional mutation analysis in 152 pulmonary arterial hypertension patients including 43 patients diagnosed as having idiopathic pulmonary arterial hypertension and 10 diagnosed as having familial pulmonary arterial hypertension.
  
  
  RESULTS
  Analysis of the BMPR2 gene revealed each of the four kinds of nonsense and frameshift mutations, one missense mutation, one splice-site mutation, and two types of exonic deletion. For cases in which exons 1-3 were deleted, the 5' and 3' break points were located in the AluY repeat sequences in the 5' side of the adjacent NOP58 gene and in the AluY repeat sequences in intron 3, suggesting an AluY-mediated nonallelic homologous recombination as the mechanism responsible for the deletion. For the case in which exon 10 was deleted, nonhomologous recombination took place between the AluSx site in intron 9 and a unique sequence in intron 10.
  
  
  CONCLUSIONS
  Exonic deletions of BMPR2 account for at least part of BMPR2 mutations associated with heritable pulmonary arterial hypertension in Japan, as previously reported in other populations. One of our cases was mediated via Alu-mediated nonallelic homologous recombination and another was mediated via nonhomologous recombination.
authors.affiliation: 1] Division of Cardiology, Second Department of Internal Medicine, Kyorin University School of Medicine, Tokyo, Japan [2] Department of Cardiology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Kataoka
authors.forename: Yuki
authors.initials: Y
authors.lastname: Aimi
authors.forename: Ryoji
authors.initials: R
authors.lastname: Yanagisawa
authors.forename: Masae
authors.initials: M
authors.lastname: Ono
authors.forename: Akira
authors.initials: A
authors.lastname: Oka
authors.forename: Keiichi
authors.initials: K
authors.lastname: Fukuda
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yoshino
authors.forename: Toru
authors.initials: T
authors.lastname: Satoh
authors.forename: Shinobu
authors.initials: S
authors.lastname: Gamou
mesh_terms: D000293:Adolescent; D000328:Adult; D020087:Alu Elements; D052006:Bone Morphogenetic Protein Receptors, Type II / Q000235:genetics*; D002648:Child; D056905:Chromosome Breakpoints; D056915:DNA Copy Number Variations; D004252:DNA Mutational Analysis; D005091:Exons; D065627:Familial Primary Pulmonary Hypertension; D005260:Female; D055106:Genome-Wide Association Study; D059765:Homologous Recombination; D006801:Humans; D006976:Hypertension, Pulmonary / Q000235:genetics*; D007438:Introns; D007564:Japan; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010375:Pedigree; D017354:Point Mutation; D011995:Recombination, Genetic; D017384:Sequence Deletion; D055815:Young Adult
chemical_list: C498218:BMPR2 protein, human; D052006:Bone Morphogenetic Protein Receptors, Type II