[HTML][HTML] ABCC9-related Intellectual disability Myopathy Syndrome is a KATP channelopathy with loss-of-function mutations in ABCC9

MF Smeland, C McClenaghan, HI Roessler… - Nature …, 2019 - nature.com
MF Smeland, C McClenaghan, HI Roessler, S Savelberg, GÅM Hansen, H Hjellnes…
Nature communications, 2019nature.com
Mutations in genes encoding KATP channel subunits have been reported for pancreatic
disorders and Cantú syndrome. Here, we report a syndrome in six patients from two families
with a consistent phenotype of mild intellectual disability, similar facies, myopathy, and
cerebral white matter hyperintensities, with cardiac systolic dysfunction present in the two
oldest patients. Patients are homozygous for a splice-site mutation in ABCC9 (c. 1320+ 1 G>
A), which encodes the sulfonylurea receptor 2 (SUR2) subunit of KATP channels. This …
Abstract
Mutations in genes encoding KATP channel subunits have been reported for pancreatic disorders and Cantú syndrome. Here, we report a syndrome in six patients from two families with a consistent phenotype of mild intellectual disability, similar facies, myopathy, and cerebral white matter hyperintensities, with cardiac systolic dysfunction present in the two oldest patients. Patients are homozygous for a splice-site mutation in ABCC9 (c.1320 + 1 G > A), which encodes the sulfonylurea receptor 2 (SUR2) subunit of KATP channels. This mutation results in an in-frame deletion of exon 8, which results in non-functional KATP channels in recombinant assays. SUR2 loss-of-function causes fatigability and cardiac dysfunction in mice, and reduced activity, cardiac dysfunction and ventricular enlargement in zebrafish. We term this channelopathy resulting from loss-of-function of SUR2-containing KATP channels ABCC9-related Intellectual disability Myopathy Syndrome (AIMS). The phenotype differs from Cantú syndrome, which is caused by gain-of-function ABCC9 mutations, reflecting the opposing consequences of KATP loss- versus gain-of-function.
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