End‐plate acetylcholine receptor deficiency due to nonsense mutations in the ε subunit

AG Engel, K Ohno, C Bouzat, SM Sine… - Annals of Neurology …, 1996 - Wiley Online Library
AG Engel, K Ohno, C Bouzat, SM Sine, RC Griggs
Annals of Neurology: Official Journal of the American Neurological …, 1996Wiley Online Library
We describe a congenital myasthenic syndrome associated with severe end‐plate (EP)
acetylcholine receptor (AChR) deficiency not associated with an EP myopathy, and with
evidence of immature AChR, containing the γ instead of the epsiv; subunit (γ‐AChR) at the
EPs. Molecular genetic analysis of AChR‐subunit genes revealed two mutations in the ε‐
subunit gene: insertion of a thymine after ε nucleotide 1101 (ε1101insT) that generates a
nonsense condon directly, and insertionof a guanine after ε nucleotide 1293 (ε1293insG) …
Abstract
We describe a congenital myasthenic syndrome associated with severe end‐plate (EP) acetylcholine receptor (AChR) deficiency not associated with an EP myopathy, and with evidence of immature AChR, containing the γ instead of the epsiv; subunit (γ‐AChR) at the EPs. Molecular genetic analysis of AChR‐subunit genes revealed two mutations in the ε‐subunit gene: insertion of a thymine after ε nucleotide 1101 (ε1101insT) that generates a nonsense condon directly, and insertionof a guanine after ε nucleotide 1293 (ε1293insG) that generates three missense codons followed by a nonsense codon. Each mutation predits truncation of the ε subunit at the level of the long cytoplasmic loop, between the third (M3) and fourth (M4) membrane spanning domains. The propositus' asymptomatic son carries ε1293G, indicating that the two mutations are heteroallelic. Expression of AChR harboring either mutation in human embryonic kidney (HEK) fibroblasts was markedly reduced. Single‐channel activit recorded from HEK cells cells expressin ε 1101insT‐AChR was infrequent but resembled activty of wild‐tpe AChR channels in amplitude and open duration. No channel activity could be recorded from HEK cells expressing ε 1293insG‐AChR. Expression of γAChR at the EPs may serve as the means of phenotypic rescue from potentially fatal nonsense mutations in the ε‐subunit gene.
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