The novel mutation c.1210-3C>G in cis with a poly-T tract of 5T affects CFTR mRNA splicing in a Chinese patient with cystic fibrosis
Abstract Purpose To identify potential pathogenic mutations in a Chinese patient with cystic fibrosis (CF) and subsequently study its splicing effect on cystic fibrosis transmembrane conductance regulator (CFTR) mRNA in vitro. Methods Genomic DNA was extracted from peripheral blood leukocytes of the patient and his parents. To detect the possible pathogenic mutations in this patient, Sanger sequencing was conducted on all 27 coding exons of CFTR and their flanking intronic regions. Minigene constructs of the wild type and the identified mutant type were produced and transfected into HEK293T cells. Total RNA was extracted and reverse-transcribed into cDNA, with which as the template polymerase chain reaction (PCR) was performed to amplify the corresponding region. Original TA cloning and Sanger sequencing of the resultant PCR products were performed to analyze their splicing patterns. Results The patient is a compound heterozygote of c.2909G>A, p.Gly970Asp in exon 18 and c.1210-3C>G in cis with a poly-T of 5T (T5) sequence, 3 bp upstream in intron 9. As reported, c.2909G>A, p.Gly970Asp is considered to be the most frequent CFTR mutation among Chinese CF patients. c.1210-3C>G, a variant adjacent to the 3’ splice site, may affect splicing and reduce the levels of normal mRNA. We validated this hypothesis by a minigene assay in vitro, which showed that the wild-type plasmid containing c.1210-3C together with the T7 sequence produced a normal transcript as well as a partial exon 10-skipping transcript, whereas the mutant plasmid containing c.1210-3G in cis with the T5 sequence caused almost all mRNA to skip exon 10. Conclusion c.1210-3C>G, newly identified in our patient, in combination with the T5 sequence in cis affects CFTR gene splicing and produces nearly no normal transcripts in vitro, which makes it a pathogenic mutation in this patient. Moreover, this patient carries a p.Gly970Asp mutation, which reinforces the high frequency of this mutation in Chinese CF patients.