RAF1 mutations in childhood-onset dilated cardiomyopathy

Nat Genet. 2014 Jun;46(6):635-639. doi: 10.1038/ng.2963. Epub 2014 Apr 28.

Abstract

Dilated cardiomyopathy (DCM) is a highly heterogeneous trait with sarcomeric gene mutations predominating. The cause of a substantial percentage of DCMs remains unknown, and no gene-specific therapy is available. On the basis of resequencing of 513 DCM cases and 1,150 matched controls from various cohorts of distinct ancestry, we discovered rare, functional RAF1 mutations in 3 of the cohorts (South Indian, North Indian and Japanese). The prevalence of RAF1 mutations was ~9% in childhood-onset DCM cases in these three cohorts. Biochemical studies showed that DCM-associated RAF1 mutants had altered kinase activity, resulting in largely unaltered ERK activation but in AKT that was hyperactivated in a BRAF-dependent manner. Constitutive expression of these mutants in zebrafish embryos resulted in a heart failure phenotype with AKT hyperactivation that was rescued by treatment with rapamycin. These findings provide new mechanistic insights and potential therapeutic targets for RAF1-associated DCM and further expand the clinical spectrum of RAF1-related human disorders.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Age of Onset
  • Aged
  • Amino Acid Sequence
  • Animals
  • Cardiomyopathy, Dilated / ethnology
  • Cardiomyopathy, Dilated / genetics*
  • Case-Control Studies
  • Cohort Studies
  • Extracellular Signal-Regulated MAP Kinases / metabolism
  • Female
  • Fibroblasts / metabolism
  • HEK293 Cells
  • Humans
  • India
  • Japan
  • Male
  • Mice
  • Middle Aged
  • Molecular Sequence Data
  • Mutation*
  • Phenotype
  • Prevalence
  • Proto-Oncogene Proteins c-raf / genetics*
  • Sequence Homology, Amino Acid
  • Sirolimus / chemistry
  • Zebrafish

Substances

  • Proto-Oncogene Proteins c-raf
  • Extracellular Signal-Regulated MAP Kinases
  • Sirolimus