Article Text
Abstract
Background Although pure GAA expansion is considered pathogenic in SCA27B, non-GAA repeat motif is mostly mixed into longer repeat sequences. This study aimed to unravel the complete sequencing of FGF14 repeat expansion to elucidate its repeat motifs and pathogenicity.
Methods We screened FGF14 repeat expansion in a Japanese cohort of 460 molecularly undiagnosed adult-onset cerebellar ataxia patients and 1022 controls, together with 92 non-Japanese controls, and performed nanopore sequencing of FGF14 repeat expansion.
Results In the Japanese population, the GCA motif was predominantly observed as the non-GAA motif, whereas the GGA motif was frequently detected in non-Japanese controls. The 5′-common flanking variant was observed in all Japanese GAA repeat alleles within normal length, demonstrating its meiotic stability against repeat expansion. In both patients and controls, pure GAA repeat was up to 400 units in length, whereas non-pathogenic GAA-GCA repeat was larger, up to 900 units, but they evolved from different haplotypes, as rs534066520, located just upstream of the repeat sequence, completely discriminated them. Both (GAA)≥250 and (GAA)≥200 were enriched in patients, whereas (GAA-GCA)≥200 was similarly observed in patients and controls, suggesting the pathogenic threshold of (GAA)≥200 for cerebellar ataxia. We identified 14 patients with SCA27B (3.0%), but their single-nucleotide polymorphism genotype indicated different founder alleles between Japanese and Caucasians. The low prevalence of SCA27B in Japanese may be due to the lower allele frequency of (GAA)≥250 in the Japanese population than in Caucasians (0.15% vs 0.32%–1.26%).
Conclusions FGF14 repeat expansion has unique features of pathogenicity and allelic origin, as revealed by a single ethnic study.
- GENETICS
- CEREBELLAR ATAXIA
Data availability statement
The anonymised data obtained in this study are available from the corresponding author on reasonable request.
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Data availability statement
The anonymised data obtained in this study are available from the corresponding author on reasonable request.
Footnotes
X @VANVANVAN1965
SM, HD, HY and EK contributed equally.
Contributors SM, HD, HY, FT, IY and NM contributed to the conception and design of the study; EK, NK, TMatsubara, YM, KK, YS, TT, SS, MM, MO, TW, MK, KJ, RM, YO, TMiyama, MS, AF, YU, NT, KM, KH, HH, TMizuguchi, HM, YI, TS, KY, HA, FT, IY and NM contributed to the acquisition and analysis of data; SM and NM contributed to drafting the text. All authors approved the manuscript. NM is responsible for the overall content as guarantor.
Funding This work was supported by the Japan Agency for Medical Research and Development (AMED) under grant numbers JP23ek0109674, JP23ek0109549, JP23ek0109617 (NM), JP23ek0109648 (FT, NM and HD) and JP23bm1423020 (HD and FT); JSPS KAKENHI under grant numbers JP23H02829 (SM) and JP21K07869 (EK); the Research Committee on the Medical Basis of Motor Ataxias, Health and Labor Sciences Research Grants of the Ministry of Health, Labor and Welfare, Japan under grant number 23FC1010 (IY) and the Takeda Science Foundation with no grant numbers (TMizuguchi and NM).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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