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Analysis of publicly available LDLR, APOB, and PCSK9 variants associated with familial hypercholesterolemia: application of ACMG guidelines and implications for familial hypercholesterolemia diagnosis

dc.contributor.authorChora, J.R.
dc.contributor.authorMedeiros, A.M.
dc.contributor.authorAlves, A.C.
dc.contributor.authorBourbon, M.
dc.date.accessioned2018-03-06T17:34:31Z
dc.date.available2018-03-06T17:34:31Z
dc.date.issued2017-10-26
dc.description.abstractPurposeFamilial hypercholesterolemia (FH) is an autosomal disorder of lipid metabolism presenting with increased cardiovascular risk. Although more than 1,700 variants have been associated with FH, the great majority have not been functionally proved to affect the low-density lipoprotein receptor cycle. We aimed to classify all described variants associated with FH and to establish the proportion of variants that lack evidence to support their pathogenicity.MethodsWe followed American College of Medical Genetics and Genomics (ACMG) guidelines for the classification, and collected information from a variety of databases and individual reports. A worldwide overview of publicly available FH variants was also performed.ResultsA total of 2,104 unique variants were identified as being associated with FH, but only 166 variants have been proven by complete in vitro functional studies to be causative of disease. Additionally, applying the ACMG guidelines, 1,097 variants were considered pathogenic or likely pathogenic. Only seven variants were found in all five continents.ConclusionThe lack of functional evidence for about 85% of all variants found in FH patients can compromise FH diagnosis and patient prognosis. ACMG classification improves variant interpretation, but functional studies are necessary to understand the effect of about 40% of all variants reported. Nevertheless, ACMG guidelines need to be adapted to FH for a better diagnosis.pt_PT
dc.description.sponsorshipThis work was partly supported by a grant from Genediag. J.R.C. and A.M.M. acknowledge their PhD fellowships funded by the Science and Technology Foundation (SFRH/BD/108503/2015 and SFRH/BD/113017/2015, respectively).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationGenet Med. 2018 Jun;20(6):591-598. doi: 10.1038/gim.2017.151. Epub 2017 Oct 26pt_PT
dc.identifier.doidoi:10.1038/gim.2017.151.pt_PT
dc.identifier.issn1098-3600
dc.identifier.urihttp://hdl.handle.net/10400.18/5232
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherNature Publishing Group/ American College of Medical Geneticspt_PT
dc.relation.publisherversionhttps://www.nature.com/articles/gim2017151pt_PT
dc.subjectACMG Classificationpt_PT
dc.subjectFamilial Hypercholesterolemiapt_PT
dc.subjectFH Diagnosispt_PT
dc.subjectFunctional Studiespt_PT
dc.subjectDoenças Cardio e Cérebro-vascularespt_PT
dc.titleAnalysis of publicly available LDLR, APOB, and PCSK9 variants associated with familial hypercholesterolemia: application of ACMG guidelines and implications for familial hypercholesterolemia diagnosispt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage8pt_PT
oaire.citation.startPage1pt_PT
oaire.citation.titleGenetics in Medicinept_PT
rcaap.rightsembargoedAccesspt_PT
rcaap.typearticlept_PT

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