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Null ABCA3 in humans: Large homozygous ABCA3 deletion, correlation to clinical–pathological findings
Author(s) -
Carrera Paola,
Ferrari Maurizio,
Presi Silvia,
Ventura Luisa,
Vergani Barbara,
Lucchini Valeria,
Cogo Paola E.,
Carnielli Virgilio P.,
Somaschini Marco,
Tagliabue Paolo
Publication year - 2014
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.22983
Subject(s) - lamellar granule , pathological , medicine , null allele , immunohistochemistry , pathology , exon , gene , surfactant protein c , allele , biology , genetics , lung
Summary A study was undertaken to analyze the clinical presentation, pulmonary function, and pathological features in two female siblings with neonatal pulmonary surfactant metabolism dysfunction, type 3 (MIM 610921). The clinical records of the siblings were examined; the genes encoding surfactant protein B ( SFTPB ), surfactant protein C ( SFTPC ), and ATP‐binding cassette transporter 3 protein ( ABCA3 ) were analyzed with direct sequencing and Southern blotting. The infants were homozygous for a 5,983 bp deletion in ABCA3 including exons 2–5 as well as the start AUG codon and a putative Golgi exit signal motif. Dense abnormalities of lamellar bodies at electron microscopy and absence of ABCA3 at immunohistochemical staining were in agreement with the presence of two null alleles. In addition, an increased lipid synthesis suggested a compensatory mechanism. The clinical course in the two sisters was influenced by different environmental factors like the time needed for molecular confirmation, the ventilatory assistance adopted, the occurrence of infections. A less aggressive clinical approach did not improve the course of the disease; the prognosis was always poor. Development of a fast molecular test, able to detect also structural variants, is needed. Pediatr Pulmonol. 2014; 49:E116–E120. © 2014 Wiley Periodicals, Inc.