The filamins are cytoplasmic proteins that regulate the structure and activity of the cytoskeleton by cross-linking actin into three-dimensional networks, linking the cell membrane to the cytoskeleton and serving as scaffolds on which intracellular signaling and protein trafficking pathways are organized (reviewed in refs. 1,2). We identified mutations in the gene encoding filamin B in four human skeletal disorders. We found homozygosity or compound heterozygosity with respect to stop-codon mutations in autosomal recessive spondylocarpotarsal syndrome (SCT, OMIM 272460) and missense mutations in individuals with autosomal dominant Larsen syndrome (OMIM 150250) and the perinatal lethal atelosteogenesis I and III phenotypes (AOI, OMIM 108720; AOIII, OMIM 108721). We found that filamin B is expressed in human growth plate chondrocytes and in the developing vertebral bodies in the mouse. These data indicate an unexpected role in vertebral segmentation, joint formation and endochondral ossification for this ubiquitously expressed cytoskeletal protein.Morphogenesis in vertebrate organisms requires the integration of extracellular signals with alterations in the cellular cytoskeleton. Filamins regulate the organization of cytoskeletal F-actin into either parallel bundles or orthogonal gel networks 3 and also mediate interactions between subcortical actin networks and transmembrane receptors to modulate cell-cell, cell-matrix and intracytoplasmic signal transduction 1,2,4 . Mammals have three filamin genes, FLNA, FLNB and FLNC. FLNA and FLNB seem to be ubiquitously expressed 5,6 ; FLNC is predominantly expressed in muscle. Human filamin genes are highly similar with conserved exon-intron structure, and there is ∼70% homology at the protein level 2,7 . The filamin monomer comprises an N-terminal actin binding domain (ABD) followed by a series of 24 β-sheet repeats that collectively bind many cytoplasmic and transmembrane proteins 1,2 . Filamins exist in vivo as dimers. Dimerization, leading to homo-and possibly heterodimer formation, is mediated by interactions between C-terminal sequences 5,8,9 . Mutations in FLNA produce a spectrum of X-linked malformation and osteochondrodysplasia syndromes. FLNA loss-of-function mutations are usually embryonically lethal in males and underlie a neuronal migration disorder in females 10 . Mutations producing structural changes in the protein lead to numerous developmental anomalies in the brain, skeleton and viscera 11 .Recently the gene associated with SCT, an autosomal recessive disorder characterized by short stature and vertebral, carpal and tarsal fusions 12,13 , was localized on chromosome 3p14 (ref. 14). These studies and further recombination mapping (data not shown) identified a 4.7-cM candidate region, which included a 1.4-Mb region of homozygosity containing 14 genes. Mutations were not found in the candidate genes WNT5A 14 , ASB14 and IL17RD (also known as SEF) in affected individuals from the linked families. The gene FLNB localizes to this interval and, considering the r...

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The spinocerebellar ataxias (SCAs) are a heterogeneous group of neurodegenerative disorders varying in both clinical manifestations and mode of inheritance. Six different genes causing autosomal dominant SCA are mapped: SCA1, SCA2, Machado-Joseph disease (MJD)/SCA3, SCA4, SCA5, and dentatorubropallidoluysian atrophy (DRPLA). Expansions of an unstable trinucleotide CAG repeat cause three of these disorders: SCA type 1 (SCA1), MJD, and DRPLA. We determine the frequency of the SCA1, DRPLA, and MJD mutations in a large group of unrelated SCA patients with various patterns of inheritance and different ethnic backgrounds. We studied 92 unrelated SCA patients. The frequency of the SCA1 mutation was 3% in the overall patient group and 10% in the non-Portuguese dominantly inherited SCA subgroup. We found that DRPLA mutation in only one Japanese patient, who was previously diagnosed with this disease. We identified the MJD mutation in 41% of the overall patient group, which included 38 autosomal dominant kindreds of Portuguese origin; the frequency of the MJD mutation among the non-Portuguese dominantly inherited cases was 17%. These results suggest that SCA may be occasionally caused by the SCA1 mutation and rarely caused by the DRPLA mutation and that, to date, the MJD mutation seems to be the most common cause of dominantly inherited SCA. Finally, our results suggest that recessively inherited cases of SCA are not caused by the known trinucleotide repeat expansions.

SHH mutations overall result in milder disease than mutations in other common HPE related genes. HPE is more frequent in individuals with truncating mutations, but clinical predictions at the individual level remain elusive.

Mucopolysaccharidoses (MPS) form a group of inherited metabolic disorders characterized by intralysosomal storage of glycosaminoglycans. This study aimed to investigate the path followed by Brazilian patients from birth to diagnosis. An interview was conducted with patient's parents or guardians with subsequent review of patient's medical records. One hundred thirteen patients with MPS were included (MPS I: 18, MPS II: 43, MPS IIIA: 2, MPS IIIB: 3, MPS IIIC: 1, MPS IVA: 15, MPS IVB: 1, MPS VI: 29, MPS VII: 1) from 97 families. Median age at the onset of signs/symptoms was 18 months (MPS I: 18, MPS II: 24, MPS IVA: 8, MPS VI: 8). Skeletal abnormalities (for MPS IVA and MPS VI), joint contractures (for MPS II), and typical facial features (for MPS I) were the most frequently reported first signs/symptoms. Several health professionals were involved in patient's care as of the onset of symptoms until biochemical diagnosis was established. Median age at diagnosis was 76 months (MPS I: 75, MPS II: 95, MPS IVA: 75, MPS VI: 52). Considering the group as a whole, there was a 4.8-year delay between the onset of signs/symptoms and the establishment of the diagnosis. Considering that specific therapies are available for some of these disorders and that early treatment is likely to change more favorably the natural history of the disease, efforts should be made to minimize this delay. We believe that this situation can be improved by measures that both increase awareness of health professionals about MPS and improve access to diagnostic tests.