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Lack of CFAP54 causes primary ciliary dyskinesia in a mouse model and human patients

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Abstract

Primary ciliary dyskinesia (PCD) is a highly heterogeneous recessive inherited disorder. FAP54, the homolog of CFAP54 in Chlamydomonas reinhardtii, was previously demonstrated as the C1d projection of the central microtubule apparatus of flagella. A Cfap54 knockout mouse model was then reported to have PCD-relevant phenotypes. Through whole-exome sequencing, compound heterozygous variants c.2649_2657delinC (p. E883Dfs*47) and c.7312_7313insCGCAGGCTGAATTCTTGG (p. T2438delinsTQAEFLA) in a new suspected PCD-relevant gene, CFAP54, were identified in an individual with PCD. Two missense variants, c.4112A>C (p. E1371A) and c.6559C>T (p. P2187S), in CFAP54 were detected in another unrelated patient. In this study, a minigene assay was conducted on the frameshift mutation showing a reduction in mRNA expression. In addition, a CFAP54 in-frame variant knock-in mouse model was established, which recapitulated the typical symptoms of PCD, including hydrocephalus, infertility, and mucus accumulation in nasal sinuses. Correspondingly, two missense variants were deleterious, with a dramatic reduction in mRNA abundance from bronchial tissue and sperm. The identification of PCD-causing variants of CFAP54 in two unrelated patients with PCD for the first time provides strong supportive evidence that CFAP54 is a new PCD-causing gene. This study further helps expand the disease-associated gene spectrum and improve genetic testing for PCD diagnosis in the future.

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Acknowledgements

The authors thank all the patients and other participants in this study. This study was supported by the National Key Research and Development Program of China (No. 2016YFC0901502 to Kai-Feng Xu; No. 2016YFC0905100 to Xue Zhang; No. 2017YFC1001201 to Yaping Liu), the National Natural Science Foundation of China (NSFC) (No. 81788101 to Xue Zhang; No. 31271345 to Yaping Liu), and the CAMS Initiative for Medical Sciences (CIFMS) (Nos. 2021-1-I2M-018 and 2016-I2M-1-002 to Xue Zhang and Yaping Liu; Nos. 2020-I2M-C&T-B-002 and 2018-I2M-1-003 to Xinlun Tian).

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Authors and Affiliations

  1. McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100005, China

    Xinyue Zhao, Haijun Ge, Wenshuai Xu, Yaping Liu & Xue Zhang

  2. Department of Pulmonary and Critical Care Medicine, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, China

    Chongsheng Cheng, Wangji Zhou, Yan Xu, Junping Fan, Xinlun Tian & Kai-Feng Xu

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Conflicts of interest Xinyue Zhao, Haijun Ge, Wenshuai Xu, Chongsheng Cheng, Wangji Zhou, Yan Xu, Junping Fan, Yaping Liu, and Xinlun Tian declare that they have no conflict of interest. Kai-Feng Xu and Xue Zhang are members of the Editorial Board of Frontiers of Medicine, who were excluded from the peer-review process and all editorial decisions related to the acceptance and publication of this article. Peer-review was handled independently by the other editors to minimise bias.

The study was performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards, and it was approved by the Institutional Review Board committee at PUMCH. Informed consent was obtained from all patients for being included in the study. All institutional and national guidelines for the care and use of laboratory animals were followed.

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Zhao, X., Ge, H., Xu, W. et al. Lack of CFAP54 causes primary ciliary dyskinesia in a mouse model and human patients. Front. Med. 17, 1236–1249 (2023). https://doi.org/10.1007/s11684-023-0997-7

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