title: Clinical, Molecular, and Functional Characterization of CLCN1 Mutations in Three Families with Recessive Myotonia Congenita.
abstract: Myotonia congenita (MC) is an inherited muscle disease characterized by impaired muscle relaxation after contraction, resulting in muscle stiffness. Both recessive (Becker's disease) or dominant (Thomsen's disease) MC are caused by mutations in the CLCN1 gene encoding the voltage-dependent chloride ClC-1 channel, which is quite exclusively expressed in skeletal muscle. More than 200 CLCN1 mutations have been associated with MC. We provide herein a detailed clinical, molecular, and functional evaluation of four patients with recessive MC belonging to three different families. Four CLCN1 variants were identified, three of which have never been characterized. The c.244A>G (p.T82A) and c.1357C>T (p.R453W) variants were each associated in compound heterozygosity with c.568GG>TC (p.G190S), for which pathogenicity is already known. The new c.809G>T (p.G270V) variant was found in the homozygous state. Patch-clamp studies of ClC-1 mutants expressed in tsA201 cells confirmed the pathogenicity of p.G270V, which greatly shifts the voltage dependence of channel activation toward positive potentials. Conversely, the mechanisms by which p.T82A and p.R453W cause the disease remained elusive, as the mutated channels behave similarly to WT. The results also suggest that p.G190S does not exert dominant-negative effects on other mutated ClC-1 subunits. Moreover, we performed a RT-PCR quantification of selected ion channels transcripts in muscle biopsies of two patients. The results suggest gene expression alteration of sodium and potassium channel subunits in myotonic muscles; if confirmed, such analysis may pave the way toward a better understanding of disease phenotype and a possible identification of new therapeutic options.
authors.affiliation: Department of Neurosciences, University of Messina, Messina, Italy.
authors.forename: Simona
authors.initials: S
authors.lastname: Portaro
authors.forename: Concetta
authors.initials: C
authors.lastname: Altamura
authors.forename: Norma
authors.initials: N
authors.lastname: Licata
authors.forename: Giulia M
authors.initials: GM
authors.lastname: Camerino
authors.forename: Paola
authors.initials: P
authors.lastname: Imbrici
authors.forename: Olimpia
authors.initials: O
authors.lastname: Musumeci
authors.forename: Carmelo
authors.initials: C
authors.lastname: Rodolico
authors.forename: Diana
authors.initials: D
authors.lastname: Conte Camerino
authors.forename: Antonio
authors.initials: A
authors.lastname: Toscano
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Desaphy
mesh_terms: D000328:Adult; D002460:Cell Line; D018118:Chloride Channels / Q000737:chemistry / Q000235:genetics* / Q000502:physiology; D002712:Chlorides / Q000378:metabolism; D003241:Consanguinity; D017124:Conserved Sequence; D005091:Exons / Q000235:genetics; D005260:Female; D005808:Genes, Recessive; D056726:Genetic Association Studies; D006801:Humans; D015640:Ion Channel Gating; D008297:Male; D018482:Muscle, Skeletal / Q000473:pathology; D009224:Myotonia Congenita / Q000235:genetics*; D018408:Patch-Clamp Techniques; D017354:Point Mutation; D060888:Real-Time Polymerase Chain Reaction; D011993:Recombinant Fusion Proteins / Q000378:metabolism; D016415:Sequence Alignment; D017422:Sequence Analysis, DNA; D017386:Sequence Homology, Amino Acid; D013329:Structure-Activity Relationship; D055815:Young Adult
chemical_list: C086321:CLC-1 channel; D018118:Chloride Channels; D002712:Chlorides; D011993:Recombinant Fusion Proteins