Molecular and functional characterization of the BMPR2 gene in Pulmonary Arterial Hypertension

Sci Rep. 2017 May 15;7(1):1923. doi: 10.1038/s41598-017-02074-8.

Abstract

Pulmonary arterial hypertension is a progressive disease that causes the obstruction of precapillary pulmonary arteries and a sustained increase in pulmonary vascular resistance. The aim was to analyze functionally the variants found in the BMPR2 gene and to establish a genotype-phenotype correlation. mRNA expression studies were performed using pSPL3 vector, studies of subcellular localization were performed using pEGFP-N1 vector and luciferase assays were performed using pGL3-Basic vector. We have identified 30 variants in the BMPR2 gene in 27 of 55 patients. In 16 patients we detected pathogenic mutations. Minigene assays revealed that 6 variants (synonymous, missense) result in splicing defect. By immunofluorescence assay, we observed that 4 mutations affect the protein localization. Finally, 4 mutations located in the 5'UTR region showed a decreased transcriptional activity in luciferase assays. Genotype-phenotype correlation, revealed that patients with pathogenic mutations have a more severe phenotype (sPaP p = 0.042, 6MWT p = 0.041), a lower age at diagnosis (p = 0.040) and seemed to have worse response to phosphodiesterase-5-inhibitors (p = 0.010). Our study confirms that in vitro expression analysis is a suitable approach in order to investigate the phenotypic consequences of the nucleotide variants, especially in cases where the involved genes have a pattern of expression in tissues of difficult access.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • 5' Untranslated Regions
  • Adult
  • Alleles
  • Animals
  • Bone Morphogenetic Protein Receptors, Type II / genetics*
  • Bone Morphogenetic Protein Receptors, Type II / metabolism
  • Cohort Studies
  • DNA Mutational Analysis
  • Female
  • Genes, Reporter
  • Genetic Association Studies*
  • Genetic Predisposition to Disease*
  • Hemodynamics
  • Humans
  • Hypertension, Pulmonary / genetics*
  • Hypertension, Pulmonary / metabolism
  • Hypertension, Pulmonary / physiopathology*
  • Intracellular Space
  • Male
  • Middle Aged
  • Mutation
  • Protein Transport

Substances

  • 5' Untranslated Regions
  • BMPR2 protein, human
  • Bone Morphogenetic Protein Receptors, Type II