Sequence variation in PPP1R13L results in a novel form of cardio‐cutaneous syndrome

Abstract Dilated cardiomyopathy (DCM) is a life‐threatening disorder whose genetic basis is heterogeneous and mostly unknown. Five Arab Christian infants, aged 4–30 months from four families, were diagnosed with DCM associated with mild skin, teeth, and hair abnormalities. All passed away before age...

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Main Authors: Tzipora C Falik‐Zaccai, Yiftah Barsheshet, Hanna Mandel, Meital Segev, Avraham Lorber, Shachaf Gelberg, Limor Kalfon, Shani Ben Haroush, Adel Shalata, Liat Gelernter‐Yaniv, Sarah Chaim, Dorith Raviv Shay, Morad Khayat, Michal Werbner, Inbar Levi, Yishay Shoval, Galit Tal, Stavit Shalev, Eli Reuveni, Emily Avitan‐Hersh, Eugene Vlodavsky, Liat Appl‐Sarid, Dorit Goldsher, Reuven Bergman, Zvi Segal, Ora Bitterman‐Deutsch, Orly Avni
Format: Article
Language:English
Published: Springer Nature 2017-01-01
Series:EMBO Molecular Medicine
Subjects:
Online Access:https://doi.org/10.15252/emmm.201606523
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author Tzipora C Falik‐Zaccai
Yiftah Barsheshet
Hanna Mandel
Meital Segev
Avraham Lorber
Shachaf Gelberg
Limor Kalfon
Shani Ben Haroush
Adel Shalata
Liat Gelernter‐Yaniv
Sarah Chaim
Dorith Raviv Shay
Morad Khayat
Michal Werbner
Inbar Levi
Yishay Shoval
Galit Tal
Stavit Shalev
Eli Reuveni
Emily Avitan‐Hersh
Eugene Vlodavsky
Liat Appl‐Sarid
Dorit Goldsher
Reuven Bergman
Zvi Segal
Ora Bitterman‐Deutsch
Orly Avni
author_facet Tzipora C Falik‐Zaccai
Yiftah Barsheshet
Hanna Mandel
Meital Segev
Avraham Lorber
Shachaf Gelberg
Limor Kalfon
Shani Ben Haroush
Adel Shalata
Liat Gelernter‐Yaniv
Sarah Chaim
Dorith Raviv Shay
Morad Khayat
Michal Werbner
Inbar Levi
Yishay Shoval
Galit Tal
Stavit Shalev
Eli Reuveni
Emily Avitan‐Hersh
Eugene Vlodavsky
Liat Appl‐Sarid
Dorit Goldsher
Reuven Bergman
Zvi Segal
Ora Bitterman‐Deutsch
Orly Avni
author_sort Tzipora C Falik‐Zaccai
collection DOAJ
description Abstract Dilated cardiomyopathy (DCM) is a life‐threatening disorder whose genetic basis is heterogeneous and mostly unknown. Five Arab Christian infants, aged 4–30 months from four families, were diagnosed with DCM associated with mild skin, teeth, and hair abnormalities. All passed away before age 3. A homozygous sequence variation creating a premature stop codon at PPP1R13L encoding the iASPP protein was identified in three infants and in the mother of the other two. Patients’ fibroblasts and PPP1R13L‐knocked down human fibroblasts presented higher expression levels of pro‐inflammatory cytokine genes in response to lipopolysaccharide, as well as Ppp1r13l‐knocked down murine cardiomyocytes and hearts of Ppp1r13l‐deficient mice. The hypersensitivity to lipopolysaccharide was NF‐κB‐dependent, and its inducible binding activity to promoters of pro‐inflammatory cytokine genes was elevated in patients’ fibroblasts. RNA sequencing of Ppp1r13l‐knocked down murine cardiomyocytes and of hearts derived from different stages of DCM development in Ppp1r13l‐deficient mice revealed the crucial role of iASPP in dampening cardiac inflammatory response. Our results determined PPP1R13L as the gene underlying a novel autosomal‐recessive cardio‐cutaneous syndrome in humans and strongly suggest that the fatal DCM during infancy is a consequence of failure to regulate transcriptional pathways necessary for tuning cardiac threshold response to common inflammatory stressors.
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spelling doaj-art-3bda5fe3b264454bbafad929188d4a0f2025-08-20T03:06:00ZengSpringer NatureEMBO Molecular Medicine1757-46761757-46842017-01-019331933610.15252/emmm.201606523Sequence variation in PPP1R13L results in a novel form of cardio‐cutaneous syndromeTzipora C Falik‐Zaccai0Yiftah Barsheshet1Hanna Mandel2Meital Segev3Avraham Lorber4Shachaf Gelberg5Limor Kalfon6Shani Ben Haroush7Adel Shalata8Liat Gelernter‐Yaniv9Sarah Chaim10Dorith Raviv Shay11Morad Khayat12Michal Werbner13Inbar Levi14Yishay Shoval15Galit Tal16Stavit Shalev17Eli Reuveni18Emily Avitan‐Hersh19Eugene Vlodavsky20Liat Appl‐Sarid21Dorit Goldsher22Reuven Bergman23Zvi Segal24Ora Bitterman‐Deutsch25Orly Avni26Institute of Human Genetics, Galilee Medical CenterFaculty of Medicine in the Galilee, Bar‐Ilan UniversityMetabolic Disease Unit, Rambam Health Care CampusFaculty of Medicine in the Galilee, Bar‐Ilan UniversityRappaport Faculty of Medicine, Technion, Israel Institute of TechnologyFaculty of Medicine in the Galilee, Bar‐Ilan UniversityInstitute of Human Genetics, Galilee Medical CenterInstitute of Human Genetics, Galilee Medical CenterThe Winter Genetic Institute, Bnei Zion Medical CenterPediatric Cardiology Clinic, Bnei Zion Medical CenterInstitute of Human Genetics, Galilee Medical CenterInstitute of Human Genetics, Galilee Medical CenterThe Genetic Institute, Ha'emek Medical CenterFaculty of Medicine in the Galilee, Bar‐Ilan UniversityInstitute of Human Genetics, Galilee Medical CenterInstitute of Human Genetics, Galilee Medical CenterMetabolic Disease Unit, Rambam Health Care CampusRappaport Faculty of Medicine, Technion, Israel Institute of TechnologyFaculty of Medicine in the Galilee, Bar‐Ilan UniversityDepartment of Dermatology, Rambam Health Care CampusRappaport Faculty of Medicine, Technion, Israel Institute of TechnologyDepartment of Pathology, Galilee Medical CenterRappaport Faculty of Medicine, Technion, Israel Institute of TechnologyRappaport Faculty of Medicine, Technion, Israel Institute of TechnologyFaculty of Medicine in the Galilee, Bar‐Ilan UniversityFaculty of Medicine in the Galilee, Bar‐Ilan UniversityFaculty of Medicine in the Galilee, Bar‐Ilan UniversityAbstract Dilated cardiomyopathy (DCM) is a life‐threatening disorder whose genetic basis is heterogeneous and mostly unknown. Five Arab Christian infants, aged 4–30 months from four families, were diagnosed with DCM associated with mild skin, teeth, and hair abnormalities. All passed away before age 3. A homozygous sequence variation creating a premature stop codon at PPP1R13L encoding the iASPP protein was identified in three infants and in the mother of the other two. Patients’ fibroblasts and PPP1R13L‐knocked down human fibroblasts presented higher expression levels of pro‐inflammatory cytokine genes in response to lipopolysaccharide, as well as Ppp1r13l‐knocked down murine cardiomyocytes and hearts of Ppp1r13l‐deficient mice. The hypersensitivity to lipopolysaccharide was NF‐κB‐dependent, and its inducible binding activity to promoters of pro‐inflammatory cytokine genes was elevated in patients’ fibroblasts. RNA sequencing of Ppp1r13l‐knocked down murine cardiomyocytes and of hearts derived from different stages of DCM development in Ppp1r13l‐deficient mice revealed the crucial role of iASPP in dampening cardiac inflammatory response. Our results determined PPP1R13L as the gene underlying a novel autosomal‐recessive cardio‐cutaneous syndrome in humans and strongly suggest that the fatal DCM during infancy is a consequence of failure to regulate transcriptional pathways necessary for tuning cardiac threshold response to common inflammatory stressors.https://doi.org/10.15252/emmm.201606523dilated cardiomyopathygeneticsinflammationmyocarditisPPP1R13L
spellingShingle Tzipora C Falik‐Zaccai
Yiftah Barsheshet
Hanna Mandel
Meital Segev
Avraham Lorber
Shachaf Gelberg
Limor Kalfon
Shani Ben Haroush
Adel Shalata
Liat Gelernter‐Yaniv
Sarah Chaim
Dorith Raviv Shay
Morad Khayat
Michal Werbner
Inbar Levi
Yishay Shoval
Galit Tal
Stavit Shalev
Eli Reuveni
Emily Avitan‐Hersh
Eugene Vlodavsky
Liat Appl‐Sarid
Dorit Goldsher
Reuven Bergman
Zvi Segal
Ora Bitterman‐Deutsch
Orly Avni
Sequence variation in PPP1R13L results in a novel form of cardio‐cutaneous syndrome
EMBO Molecular Medicine
dilated cardiomyopathy
genetics
inflammation
myocarditis
PPP1R13L
title Sequence variation in PPP1R13L results in a novel form of cardio‐cutaneous syndrome
title_full Sequence variation in PPP1R13L results in a novel form of cardio‐cutaneous syndrome
title_fullStr Sequence variation in PPP1R13L results in a novel form of cardio‐cutaneous syndrome
title_full_unstemmed Sequence variation in PPP1R13L results in a novel form of cardio‐cutaneous syndrome
title_short Sequence variation in PPP1R13L results in a novel form of cardio‐cutaneous syndrome
title_sort sequence variation in ppp1r13l results in a novel form of cardio cutaneous syndrome
topic dilated cardiomyopathy
genetics
inflammation
myocarditis
PPP1R13L
url https://doi.org/10.15252/emmm.201606523
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