Report of two pedigrees with heterozygous HTRA1 variants‐related cerebral small vessel disease and literature review

Abstract Background Biallelic HTRA1 pathogenic variants are associated with autosomal recessive cerebral arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL). Recent studies have indicated that heterozygous HTRA1 variants are related to autosomal dominant hereditary cerebral smal...

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Main Authors: Hui Zhou, Bin Jiao, Ziyu Ouyang, Qihui Wu, Lu Shen, Liangjuan Fang
Format: Article
Language:English
Published: Wiley 2022-10-01
Series:Molecular Genetics & Genomic Medicine
Subjects:
Online Access:https://doi.org/10.1002/mgg3.2032
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author Hui Zhou
Bin Jiao
Ziyu Ouyang
Qihui Wu
Lu Shen
Liangjuan Fang
author_facet Hui Zhou
Bin Jiao
Ziyu Ouyang
Qihui Wu
Lu Shen
Liangjuan Fang
author_sort Hui Zhou
collection DOAJ
description Abstract Background Biallelic HTRA1 pathogenic variants are associated with autosomal recessive cerebral arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL). Recent studies have indicated that heterozygous HTRA1 variants are related to autosomal dominant hereditary cerebral small vessel disease (CSVD). However, few studies have assessed heterozygous HTRA1 carriers or the genotype–phenotype correlation. Methods The clinical data of two unrelated Chinese Han families with CSVD were collected. Panel sequencing was used to search for pathogenic genes, Sanger sequencing was used for verification, three‐dimensional protein models were constructed, and pathogenicity was analyzed. Published HTRA1‐related phenotypes included in PubMed up to September 2021 were extensively reviewed, and the patients' genetic and clinical characteristics were summarized. Results We report a novel heterozygous variant c.920T>C p.L307P in the HTRA1, whose main clinical and neuroimaging phenotypes are stroke and gait disturbance. We report another patient with the previously reported pathogenic variant HTRA1 c.589C>T p.R197X characterized by early cognitive decline. A literature review indicated that compared with CARASIL, HTRA1‐related autosomal dominant hereditary CSVD has a later onset age, milder clinical symptoms, fewer extraneurological symptoms, and slower progression, indicating a milder CARASIL phenotype. In addition, HTRA1 heterozygous variants were related to a higher proportion of vascular risk factors (p < .001) and male sex (p = .022). Conclusion These findings broaden the known mutational spectrum and possible clinical phenotype of HTRA1. Considering the semidominant characteristics of HTRA1‐related phenotypes, we recommend that all members of HTRA1 variant families undergo genetic screening and clinical follow‐up if carrying pathogenic variants.
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spelling doaj.art-db179a0b7330417c9d9a9d82d1a55ca92022-12-22T02:26:09ZengWileyMolecular Genetics & Genomic Medicine2324-92692022-10-011010n/an/a10.1002/mgg3.2032Report of two pedigrees with heterozygous HTRA1 variants‐related cerebral small vessel disease and literature reviewHui Zhou0Bin Jiao1Ziyu Ouyang2Qihui Wu3Lu Shen4Liangjuan Fang5Department of Neurology Xiangya Hospital, Central South University Changsha ChinaDepartment of Neurology Xiangya Hospital, Central South University Changsha ChinaDepartment of Neurology Xiangya Hospital, Central South University Changsha ChinaTranslational Research Institute of Brain and Brain‐Like Intelligence Shanghai Fourth People's Hospital affiliated to Tongji University School of Medicine Shanghai ChinaDepartment of Neurology Xiangya Hospital, Central South University Changsha ChinaDepartment of Neurology Xiangya Hospital, Central South University Changsha ChinaAbstract Background Biallelic HTRA1 pathogenic variants are associated with autosomal recessive cerebral arteriopathy with subcortical infarcts and leukoencephalopathy (CARASIL). Recent studies have indicated that heterozygous HTRA1 variants are related to autosomal dominant hereditary cerebral small vessel disease (CSVD). However, few studies have assessed heterozygous HTRA1 carriers or the genotype–phenotype correlation. Methods The clinical data of two unrelated Chinese Han families with CSVD were collected. Panel sequencing was used to search for pathogenic genes, Sanger sequencing was used for verification, three‐dimensional protein models were constructed, and pathogenicity was analyzed. Published HTRA1‐related phenotypes included in PubMed up to September 2021 were extensively reviewed, and the patients' genetic and clinical characteristics were summarized. Results We report a novel heterozygous variant c.920T>C p.L307P in the HTRA1, whose main clinical and neuroimaging phenotypes are stroke and gait disturbance. We report another patient with the previously reported pathogenic variant HTRA1 c.589C>T p.R197X characterized by early cognitive decline. A literature review indicated that compared with CARASIL, HTRA1‐related autosomal dominant hereditary CSVD has a later onset age, milder clinical symptoms, fewer extraneurological symptoms, and slower progression, indicating a milder CARASIL phenotype. In addition, HTRA1 heterozygous variants were related to a higher proportion of vascular risk factors (p < .001) and male sex (p = .022). Conclusion These findings broaden the known mutational spectrum and possible clinical phenotype of HTRA1. Considering the semidominant characteristics of HTRA1‐related phenotypes, we recommend that all members of HTRA1 variant families undergo genetic screening and clinical follow‐up if carrying pathogenic variants.https://doi.org/10.1002/mgg3.2032Alzheimer's diseaseCARASILcerebral small vessel diseaseheterozygous variantHTRA1
spellingShingle Hui Zhou
Bin Jiao
Ziyu Ouyang
Qihui Wu
Lu Shen
Liangjuan Fang
Report of two pedigrees with heterozygous HTRA1 variants‐related cerebral small vessel disease and literature review
Molecular Genetics & Genomic Medicine
Alzheimer's disease
CARASIL
cerebral small vessel disease
heterozygous variant
HTRA1
title Report of two pedigrees with heterozygous HTRA1 variants‐related cerebral small vessel disease and literature review
title_full Report of two pedigrees with heterozygous HTRA1 variants‐related cerebral small vessel disease and literature review
title_fullStr Report of two pedigrees with heterozygous HTRA1 variants‐related cerebral small vessel disease and literature review
title_full_unstemmed Report of two pedigrees with heterozygous HTRA1 variants‐related cerebral small vessel disease and literature review
title_short Report of two pedigrees with heterozygous HTRA1 variants‐related cerebral small vessel disease and literature review
title_sort report of two pedigrees with heterozygous htra1 variants related cerebral small vessel disease and literature review
topic Alzheimer's disease
CARASIL
cerebral small vessel disease
heterozygous variant
HTRA1
url https://doi.org/10.1002/mgg3.2032
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