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Purpose  To identify a novel pathogenic gene mutation present in a Chinese family with hereditary hemorrhagic telangiectasia (HHT) and to determine if an intron mutation may influence the transcriptional activity of the  ACVRL1  gene.    Methods  HHT family members were ascertained following the presentation of proband and involved subjects. All family members (n = 5) and 113 healthy individuals were genotyped for the variant in intron 6 c.772+27G>C of  ACVRL1  gene. The genomic structure of  ACVRL1  in affected HHT patients and healthy individuals was determined by long range PCR and sequencing. The expression of  ACVRL1  mRNA and protein in patients with HHT was evaluated using real-time polymerase chain reaction and immunoblot analysis. Luciferase activity assay and electrophoretic mobility shift assay (EMSA) were performed to uncover the mechanism of intron-related transcriptional regulation.    Results  Only one novel mutation in intron 6 (c.772+27G>C) of  ACVRL1  gene, no other mutation, abnormal splice, gross genomic deletion or rearrangement was found in this HHT2 family. Compared with healthy individuals,  ACVRL1  mRNA and protein were significantly decreased in affected HHT2 individuals. Luciferase activity assay demonstrated that the transcriptional activity of the mutated  ACVRL1  was significantly lower than that of the wild-type of intron 6; EMSA results showed that intron 6 c.772+27G>C mutation was able to inhibit the binding of transcriptional factor Sp1.    Conclusions  A novel intron mutation in  ACVRL1  gene is associated with familial HHT2. The mechanisms may be involved in the down-regulation of  ACVRL1  gene transcription.

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An Intron Mutation in the ACVRL1 May Be Associated with a Transcriptional Regulation Defect in a Chinese Family with Hereditary Hemorrhagic Telangiectasia