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Human Molecular Genetics, 2003, Vol. 12, No. 10 1111-1120
DOI: 10.1093/hmg/ddg131
© 2003 Oxford University Press

New type of disease causing mutations: the example of the composite exonic regulatory elements of splicing in CFTR exon 12

Franco Pagani1, Cristiana Stuani1, Maria Tzetis2, Emmanuel Kanavakis2, Alexandra Efthymiadou2, Stavros Doudounakis3, Teresa Casals4 and Francisco E. Baralle1,*

1International Centre for Genetic Engineering and Biotechnology, Padriciano 99, Trieste 34012, Italy, 2Department of Medical Genetics, Athens University, ‘Aghia Sophia’ Children's Hospital, Thivon and Livadias, Athens 11527, Greece, 3Cystic Fibrosis Department, ‘Aghia Sophia’ Children's Hospital, Athens, Greece and 4Centro de Genética Medica y Molecular, Instituto Recerca Oncológica (IRO), Hospital Duran y Reynals, Gran Via s/n km 2,7 08907 Barcelona, Spain

Received December 16, 2002; Accepted March 17, 2003

The increase in genome scanning data, derived from clinical genetics practice, is producing a wealth of information on human sequence variability. The critical issue is to identify if a given nucleotide change results in a benign polymorphism or a disease-causing mutation. We have focused on one specific gene expression step, pre-mRNA processing, where we can functionally define the effect of nucleotide changes and in turn the patient's mutation can shed light on the basic pre mRNA splicing mechanisms. Our results show that several nucleotide changes in CFTR exon 12 induce a variable extent of exon skipping that leads to reduced levels of normal transcripts. This is the case in both natural mutations D565G and G576A (the latter having previously considered a neutral polymorphism) and several site-directed silent substitutions. We demonstrate here that this phenomenon is due to the interference with a new regulatory element that we have named composite exonic regulatory element of splicing (CERES). The effect of single nucleotide substitutions at CERES cannot be predicted by neither SR matrices nor enhancer identification. The recognition and characterization of splicing abnormalities, caused by exon sequence variations at CERES elements, may represent a frequent disease-causing mechanism that also relates to the phenotypic variability. Our results indicate that even the most benign looking polymorphism in an exon cannot be ignored as it may affect the splicing process. Hence, appropriate functional splicing assays should be included in genotype screenings to distinguish between polymorphisms and pathogenic mutations.

* To whom correspondence should be addressed. Tel: +39 0403757337; Fax: +39 0403757361; Email: baralle{at}icgeb.org


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