Two Novel Mutations in the EYS Gene Are Possible Major Causes of Autosomal Recessive Retinitis Pigmentosa in the Japanese Population

Retinitis pigmentosa (RP) is a highly heterogeneous genetic disease including autosomal recessive (ar), autosomal dominant (ad), and X-linked inheritance. Recently, arRP has been associated with mutations in EYS (Eyes shut homolog), which is a major causative gene for this disease. This study was conducted to determine the spectrum and frequency of EYS mutations in 100 Japanese arRP patients. To determine the prevalence of EYS mutations, all EYS exons were screened for mutations by polymerase chain reaction amplification, and sequence analysis was performed. We detected 67 sequence alterations in EYS, of which 21 were novel. Of these, 7 were very likely pathogenic mutations, 6 were possible pathogenic mutations, and 54 were predicted non-pathogenic sequence alterations. The minimum observed prevalence of distinct EYS mutations in our study was 18% (18/100, comprising 9 patients with 2 very likely pathogenic mutations and the remaining 9 with only one such mutation). Among these mutations, 2 novel truncating mutations, c.4957_4958insA (p.S1653KfsX2) and c.8868C>A (p.Y2956X), were identified in 16 patients and accounted for 57.1% (20/35 alleles) of the mutated alleles. Although these 2 truncating mutations were not detected in Japanese patients with adRP or Leber's congenital amaurosis, we detected them in Korean arRP patients. Similar to Japanese arRP results, the c.4957_4958insA mutation was more frequently detected than the c.8868C>A mutation. The 18% estimated prevalence of very likely pathogenic mutations in our study suggests a major involvement of EYS in the pathogenesis of arRP in the Japanese population. Mutation spectrum of EYS in 100 Japanese patients, including 13 distinct very likely and possible pathogenic mutations, was largely different from the previously reported spectrum in patients from non-Asian populations. Screening for c.4957_4958insA and c.8868C>A mutations in the EYS gene may therefore be very effective for the genetic testing and counseling of RP patients in Japan

Successful fat-only whole breast reconstruction using cultured mature adipocytes and conditioned medium containing MCP-1

Abstract A mastectomy is a curative treatment for breast cancer. It causes breast and soft tissue deficits, resulting in a chest with poor vascularity. Autologous tissue breast reconstruction is commonly associated with donor site morbidity. Breast implants are another reconstruction alternative, but they are associated with infection, rupture, and the need for replacement. Autologous aspirated fat grafting has appeared as an ideal breast reconstruction method, but low graft viability and high resorption remain as the main shortcomings. We developed a novel method for fat-only grafts using cultured mature adipocytes (CMAs) mixed with their condition medium. Twenty-five mastectomy patients, aged 32–72 years, received a mixed grafting of CMAs, MCP1-containing condition medium, and fat grafts for total breast reconstruction. In follow-up periods of 24–75 months, MRI analysis showed full thickness fat-engraftment. The cell proliferation marker Ki67 was negative in post-transplant biopsy specimens from all patients. Aesthetic full breast morphology was achieved, patient satisfaction was evaluated 1 year and 3–6 years after surgery. All grafts were confirmed safe, demonstrating high reliability and long-term sustainability

Predicted domain structure and distribution of identified <i>EYS</i> mutations.

<p>SMART (<a href="http://smart.embl-heidelberg.de/" target="_blank">http://smart.embl-heidelberg.de/</a>) and Pfam (<a href="http://pfam.sanger.ac.uk/" target="_blank">http://pfam.sanger.ac.uk/</a>) were used to search protein functional domains. A coiled-coil domain identified by Barragán et al. (2010) between the EGF-like domain and laminin G domain was also indicated. Novel very likely pathogenic mutations, novel possible pathogenic mutations, and a previously described mutation are shown in bold, normal, and italic type, respectively. Six out of 9 missense mutations were found in the EGF or laminin G domains. Furthermore, 7 were located in the latter half of the protein between the putative coiled-coil region and C-terminus.</p

Summary of the possible non-pathogenic sequence alterations in the <i>EYS</i> gene identified in this study.

<p>Fifty-four sequence alterations were identified in 100 patients. These alterations were predicted to be non-pathogenic for various reasons. Some have been reported as polymorphisms in previous reports. Newly identified alterations within the exons, except for c.334G>A and c.8923T>C, were also found in the control chromosome. The hyphen (-) indicates that genomic sequence of corresponding region in the species was reported to be unknown <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0031036#pone.0031036-Barragn1" target="_blank">[5]</a>.</p>a<p>hu/o/m/ho/d/op/p/c/z/dr denotes Human/Orangutan/Marmoset/Horse/Dog/Opossum/Platypus/Chicken/Zebrafish/Drosophila EYS orthologs, respectively.</p

Pedigrees of the families that was available for mutation analysis.

<p>Below the individuals, genotypes are presented for either p.S1653KfsX2 (M1), p.L2784R (M2), p.Y2956X (M3), p.Y841X (M4), or p.G2186E (M5) detected to segregate with RP. M1/M1 represents homozygous mutation. M1/+ indicates heterozygous carriers, +/+ indicates individuals carrying 2 wild-type alleles, whereas M1/M2 represents individuals presenting both mutations as compound heterozygous. Square boxes indicate men, circles denote women, and affected individuals are pointed out by a black symbol. Slashed symbols indicate deceased individuals. The probands are indicated with an arrow. NA denotes unavailable DNA samples.</p

Electropherograms of the 6 likely pathogenic <i>EYS</i> mutations.

<p>Partial sequence of the <i>EYS</i> gene showing the normal control sequences (A-1 through F-1), heterozygous mutation sequences (A-2 through F-2), and homozygous mutation sequences (A-3 and C-3). Deduced amino acids are indicated under the sequence trace. The mutation location is indicated either by an arrow (for a nucleotide change) or a horizontal line (to show 2 nucleotides between which the insertion occurred). (A) c.4957_4958insA; p.S1653KfsX2 (Exon 26), (B) c.6557G>A; p.G2186E (Exon 32), (C) c.8868C>A; p.Y2956X (Exon 44), (D) c.8351T>G; p.L2784R (Exon 44), (E) c.7793G>A; p.G2598D (Exon 40), (F) c.2522_2523insA; p.Y841X (Exon 16).</p