Abstract
Spinal muscular atrophy (SMA) is caused by deletions/mutations in SMN1. Most heterozygous SMA carriers have only one SMN1 copy in one of the alleles (1/0 carriers). However, a few carriers lack SMN1 in one of their chromosomes, but present two gene copies in the other. These “2/0 carriers” are undistinguishable from non-carrier individuals (1/1) with currently available methods. Previous association of SMN1 variants c.*3 + 80 T > G and c.*211_*212del with two SMN1 copies in cis in Ashkenazi population prompted us to analyze them in 270 Spanish individuals (SMA carriers, patients and general population). Both variants were much more frequently detected in chromosomes with 2 SMN1 copies in cis in comparison with chromosomes carrying one copy (17.9 vs. 0.7%; p < 0.001). In particular, one-fifth of 2/0 SMA carriers harboured one or both variants compared to none of 99 non-carriers with two SMN1 copies (p < 0.001). The c.*211_*212del variant was also much more frequent in exon 8 of SMN2–SMN1 hybrids than in that of intact SMN1 genes (20 vs. 0.83%, p < 0.001), suggesting its association with chromosomal rearrangements. Although absence of these variants does not exclude that a particular individual is a 2/0 SMA carrier, their presence is valuable to substantially increase residual risk in putative carriers, thus improving genetic counselling.
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References
Sugarman EA, Nagan N, Zhu H, et al. Pan-ethic carrier screening and prenatal diagnosis for spinal muscular atrophy: Clinical laboratory analysis of 72,400 specimens. Eur J Hum Genet. 2012;20:27–32.
Alías S, Barceló M, Bernal S, et al. Improving detection and genetic counseling in carriers of Spinal Muscular Atrophy with two copies of the SMN1 gene. Clin Genet. 2014;85:470–5.
Talbot K, Tizzano EF. The clinical landscape for SMA in a new therapeutic era. Gene Ther. 2017;24:529–33.
Lefebvre S, Bürglen L, Reboullet S, et al. Identification and characterization of a Spinal Muscular Atrophy-determining gene. Cell. 1995;80:155–65.
Prior TW, Krainer AR, Hua Y. et al: A positive modifier of spinal muscular atrophy in the SMN2 gene. Am J Hum Genet. 2009;85:408–13.
Calucho M, Bernal S, Alias L, et al: Correlation between SMA type and SMN2 copy number revisited: An analysis of 625 unrelated Spanish patients and a compilation of 2,834 reported cases. Neuromuscul Disord. 2018;28:208–15.
Wirth B. An update of the mutation spectrum of the survival motor neuron gene (SMN1) in autosomal recessive spinal muscular atrophy (SMA). Hum Mutat. 2000;15:228–37.
Alías L, Bernal S, Fuentes-Prior P, et al. Mutation update of Spinal Muscular Atrophy in Spain: molecular characterization of 745 unrelated patients and identification of four novel mutations in the SMN1 gene. Hum Genet. 2009;125:29–39.
Hahnen E, Schönling J, Rudnik-Schöneborn S, Zerres K, Wirth B. Hybrid survival motor neuron genes in patients with autosomal recessive spinal muscular atrophy: new insights into molecular mechanisms responsible for the disease. Am J Hum Genet. 1996;59:1057–65.
Cuscó I, Barceló MJ, del Rio E, et al. Characterization of SMN hybrid genes in Spanish SMA patients: de novo, homozygous and compound heterozygous cases. Hum Genet. 2001;108:222–9.
Luo M, Liu L, Peter I, et al. An Ashkenazi Jewish SMN1 haplotype specific to duplication alleles improves pan-ethnic carrier screening for spinal muscular atrophy. Genet Med. 2014;16:149–56.
Alías L, Bernal S, Barceló MJ, et al. Accuracy of marker analysis, quantitative real-time polymerase chain reaction, and multiple ligation-dependent probe amplification to determine SMN2 copy number in patients with Spinal Muscular Atrophy. Genet Test Mol Biomark. 2011;15:587–94.
Barceló MJ, Alías L, Caselles L, Robles Y, Baiget M, Tizzano EF. Two independent mutations of the SMN1 gene in the same Spinal Muscular Atrophy family branch: Lessons for carrier diagnosis. Genet Med. 2006;8:259–62.
den Dunnen JT, Antonarakis SE. Nomenclature for the description of human sequence variations. Hum Genet. 2001;109:121–4.
Bürglen L, Lefebvre S, Clermont O, et al. Structure and organization of the human survival motor neuron (SMN) gene. Genomics. 1996;32:479–82.
Hendrickson BC, Donohoe C, Akmaev VR, et al. Differences in SMN1 allele frequencies among ethnic groups within North America. J Med Genet. 2009;46:641–4.
Acknowledgements
This work was supported by Grants from Fundación Privada Daniel Bravo Andreu (to EFT and PFP and supporting MC). LA is supported by CIBERER. We wish to thank the consenting individuals who made this study possible and colleagues for referral of families.
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Alías, L., Bernal, S., Calucho, M. et al. Utility of two SMN1 variants to improve spinal muscular atrophy carrier diagnosis and genetic counselling. Eur J Hum Genet 26, 1554–1557 (2018). https://doi.org/10.1038/s41431-018-0193-4
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DOI: https://doi.org/10.1038/s41431-018-0193-4
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