Thesis (MSc)--University of Stellenbosch, 2004. / ENGLISH ABSTRACT: Progressive familial heart block type II (PFHBII) is an inherited cardiac conduction disorder of
unknown aetiology, which has been described in a South African family. The disorder was
mapped to a 2.9 centimorgan (cM) locus on chromosome 1q32.2-32.3. Clinically, PFHBII
manifests cardiac conduction aberrations, that progress to a disease of the heart muscle, dilated
cardiomyopathy (DCM). DCM is also reported as an end phase in hypertrophic cardiomyopathy
(HCM), another heart muscle disorder. These cardiomyopathies are genetically heterogeneous
with some of the genes reported as causes of both disorders. Therefore, genes identified as causes
of HCM and DCM were considered plausible candidates for PFHBII mutation analysis.
Additionally, this study provided an opportunity to assess potential modifiers of HCM. HCM
exhibits marked phenotypic variability, observed within and between families harbouring the
same causative mutation.
Genes within the PFHBII locus were selected for PCR-SSCP analysis based on homology to
genes previously reported as causing conduction system disorders associated with arrhythmias,
DCM and/or HCM. Results were confirmed by direct sequencing and association between the
detected variants and HCM parameters was assessed using a quantitative transmission
disequilibrium test (QTDT).
Eleven plausible candidate genes were selected within the PFHBII locus and two of the genes,
PFKFB2 and ATF3, that encode for 6-phosphofructo-2,6-bisphosphatase (PFK-2/FBPase-2) and
activating transcription factor 3 (ATF3), respectively, were analysed for PFHBII-causing and
HCM main locus and/or HCM modifying mutations. Mutation analysis of PFKFB2 and ATF3 in
the PFHBII family revealed no PFHBII causal mutation. PFKFB2 and ATF3 were later localised outside the PFHBII locus, and, therefore, were excluded as PFHBII plausible candidates. Further
analysis of the two genes for HCM main locus and/or HCM modifying mutations in the HCM
panel identified several sequence variants. QTDT analysis of these variants showed no significant
association.
Completion of the Human Genome Project (HGP) and annotation of new genes within the
PFHBII locus allowed the identification of more PFHBII plausible candidate genes. Identification
of causal mutations in plausible PFHBII candidate genes will allow molecular diagnosis of
PFHBII pathophysiology. Furthermore, identification of both HCM-modifying and HCM-causing
genes will give insight into the phenotypic variability noted among South African HCM-affected
individuals and into the molecular cause of the disease among individuals with HCM-like clinical
features. / AFRIKAANSE OPSOMMING: Progressiewe familiële hartblok tipe II (PFHBII) is ʼn oorgeërfde hart geleidingsiekte van
onbekende etiologie wat in ʼn Suid-Afrikaanse familie beskryf is. Die siekte is ʼn 2.9 sentimorgan
(cM) lokus op chromosoom 1q32.2-32.3 gekarteer. Klinies presenteer PFHBII met
geleidingsfwykings wat uitloop op gedilateerde kardiomiopatie (DCM). DCM word ook
gerapporteer as ʼn endfase in hipertrofiese kardiomiopatie (HCM), ʼn ander hartspiersiekte. Die
kardiomiopatieë is geneties heterogeen, met ʼn aantal gene wat as oorsaak van altwee
siektetoestande gerapporteer word. Daarom is alle gene wat geïdentifiseer is as oorsake van DCM
en HCM, as moontlike kandidaatgene vir PFHBII mutasieanaliese beskou. Bykomend het hierdie
studie die geleentheid gebied om potensiële modifiseerders van HCM te assesseer. HCM toon
beduidende fenotipiese variasie binne en tussen families wat dieselfde siekteveroorsakende
mutasie het.
Gene binne die PFHBII-lokus is geselekteer vir PCR-SSCP-analiese gebaseer op homologie met
gene wat voorheen gerapporteer is om betrokke te wees by geleidingsiesisteemsiektes,
geassosieerde arritmieë, DCM en/of HCM. Resultate is bevestig deur volgordebepaling.
Assosiasie tusssen ontdekte variante en die siekteparameter is bepaal met ʼn kwantitatiewe
transmissie disekwilibrium toets (QTDT).
Elf moontlike kandidaatgene in die PFHBII-lokus is geselekteer en twee van die gene, PFKFB2
en ATF3, wat kodeer vir 6-fosfofrukto-2,6-bifosfatase (PFK-2/FBPase-2) en
aktiveringstranskripsiefaktor 3 (ATF3) respektiewelik, is vir PFHBII-oorsakende en HCMhooflokus
en/of HCM-modifiseerende mutasies ondersoek. Mutasie-analiese van PFKFB2 en
ATF3 in die PFHBII-familie het nie ʼn siekteveroorsakende mutasie onthul/uitgelig nie. PFKFB2 en ATF3 is later buite die PFHBII-lokus geplaas en dus ook as moontlike PFHBII-kandidate
uitgesluit. Verdere ondersoek van díe twee gene vir HCM-hooflokus en/of HCM-modifiserende
mutasies in die HCM-paneel het ʼn aantal volgorde variante geïdentifiseer. QTDT-analiese van
die variante het geen beduidende assosiasies aangetoon nie.
Voltooiing van die Menslike Genoom Projek (HGP) en annotasie van nuwe gene in die PFHBIIlokus
het tot die identifikasie van verdere moontlike PFHBII-kandidaatgene gelei. Identifikase
van siekte-veroorsaakende mutasies in die moontlike PFHBII-kandidaatgene sal die molekulêre
diagnose van PFHBII toelaat en insig in die patofisiologie van die siekte gee. Verder,
identifikasie van beide HCM-veroorsakende of HCM-modifiserende gene kan insig gee in die
fenotipiese varieerbaarheid wat onder Suid-Afrikaanse HCM-geaffekteerde individue
waargeneem word en ook in die molekulêre oorsake van die siekte in individue met HCMsoortige
kliniese kenmerke.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:sun/oai:scholar.sun.ac.za:10019.1/16473 |
| Date | 12 1900 |
| Creators | Yako, Yandiswa |
| Contributors | Corfield, Valerie A., Moolman-Smook, Johanna C., University of Stellenbosch. Faculty of Health Sciences. Dept. of Biomedical Sciences. Molecular Biology and Human Genetics. |
| Publisher | Stellenbosch : University of Stellenbosch |
| Source Sets | South African National ETD Portal |
| Language | en_ZA |
| Detected Language | Unknown |
| Type | Thesis |
| Format | xvii, 163 leaves : ill. |
| Rights | University of Stellenbosch |
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