Abstract

BackgroundConotruncal defects (CTDs) are a type of heterogeneous congenital heart diseases (CHDs), but little is known about their etiology. Increasing evidence has demonstrated that fibroblast growth factor (FGF) 8 and FGF10 may be involved in the pathogenesis of CTDs.MethodsThe variants of FGF8 and FGF10 in unrelated Chinese Han patients with CHDs (n = 585), and healthy controls (n = 319) were investigated. The expression and function of these patient-identified variants were detected to confirm the potential pathogenicity of the non-synonymous variants. The expression of FGF8 and FGF10 during the differentiation of human embryonic stem cells (hESCs) to cardiomyocytes and in Carnegie stage 13 human embryo was also identified.ResultsTwo probable deleterious variants (p.C10Y, p.R184H) of FGF8 and one deletion mutant (p.23_24del) of FGF10 were identified in three patients with CTD. Immunofluorescence suggested that variants did not affect the intracellular localization, whereas ELISA showed that the p.C10Y and p.23_24del variants reduced the amount of secreted FGF8 and FGF10, respectively. Quantitative RT-PCR and western blotting showed that the expression of FGF8 and FGF10 variants was increased compared with wild-type; however, their functions were reduced. And we found that FGF8 and FGF10 were expressed in the outflow tract (OFT) during human embryonic development, and were dynamically expressed during the differentiation of hESCs into cardiomyocytes.ConclusionOur results provided evidence that damaging variants of FGF8 and FGF10 were likely contribute to the etiology of CTD. This discovery expanded the spectrum of FGF mutations and underscored the pathogenic correlation between FGF mutations and CTD.

Highlights

  • Conotruncal defects (CTDs) are a type of heterogeneous congenital heart diseases (CHDs), but little is known about their etiology

  • Variants of FGF8 and FGF10 in patients with nonsyndromic CTD Target sequencing only detected genes exons related to cardiac development, we excluded the effects of other possible genes, and identified two mutant variants of FGF8 (Fig. 1b, d) in two patients with tetralogy of Fallot (TOF) (Additional file 1: Figure S1a, b) and one deleted variant of FGF10 (Fig. 1f ) in a patient with single atrium, single ventricle, complete atrioventricular valve defect, and pulmonary valve stenosis (Additional file 1: Figure S1c)

  • The allelic frequencies of the FGF8 p.R184H (NM_033163.4: c.551G>A) and FGF10 p.23_24del (NM_004465.1: c.68_70del) variants found in the ExAC database were 8.379e-06 and 0.0004322, respectively

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Summary

Introduction

Conotruncal defects (CTDs) are a type of heterogeneous congenital heart diseases (CHDs), but little is known about their etiology. Increasing evidence has demonstrated that fibroblast growth factor (FGF) 8 and FGF10 may be involved in the pathogenesis of CTDs. Conotruncal defects (CTDs) are a complex type of congenital heart diseases (CHDs) with an approximate prevalence of 0.1‰ among live births [1], and approximately 25–30% of all non-syndromic CHDs. CTDs include the following conditions: tetralogy of Fallot (TOF), double outlet of right ventricle (DORV), pulmonary atresia with ventricular septal defect (PA/VSD), transposition of the great arteries (TGA), interrupted aortic arch (IAA), and persistent truncus arteriosus (PTA). The OFT undergoes a series of elaborate remodeling processes, including the development of the secondary heart field (SHF) and the cardiac neural crest (CNC) [5], which forms the basis of the aorta and pulmonary artery [4]. Increasing studies have shown the major role of genetic factors in the pathogenesis of CTDs, the underlying mechanisms of genetic determinants remain unclear [6, 7]

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