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Novel missense variants in CFL2 affect F-actin depolymerisation and expand the disease spectrum of CFL2-related myopathy
Journal article   Open access   Peer reviewed

Novel missense variants in CFL2 affect F-actin depolymerisation and expand the disease spectrum of CFL2-related myopathy

Lein N H Dofash, Chiara Folland, Jason Dyke, Emna Farhat, Myriam Chaabouni, Najoua Miladi, Merrilee Needham, Phillipa J Lamont, Catherine Ashton and Gianina Ravenscroft
Human molecular genetics, Online ahead of print
2025
PMID: 40581737
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Published (Version of Record)CC BY-NC V4.0 Open Access

Abstract

Cytoplasmic body myopathy Cofilin2 Nemaline myopathy Sarcomeric disorders
Cofilin-2, encoded by CFL2, is an actin-binding protein essential for regulating actin filament dynamics in skeletal muscle. Biallelic variants in CFL2 are associated with an ultra-rare, early-onset myopathy typically presenting as nemaline myopathy. Only 10 patients have been described to date from five unrelated families. Here, we describe two new cases from two unrelated families. The first proband presented clinically with rigid spine syndrome and a biopsy keeping with nemaline myopathy. The second proband presented with a relatively mild congenital myopathy which became rapidly progressive in the fourth decade, the muscle biopsy showed cytoplasmic bodies, internal nuclei and ringbinden. Exome and genome sequencing revealed three novel biallelic missense variants in CFL2, a homozygous c.115 T > G; p.(Cys39Gly) in the proband of Family 1, and bi-allelic heterozygous c.256G > A:(p.Asp86Asn), and c.283A > G (p.Lys95Glu) variants in the proband of Family 2. We characterised the effects of these substitutions using an in vitro F-actin depolymerisation assay and showed all three were associated with significantly reduced filamentous actin depolymerisation rates compared to the wildtype. Taken together, our findings are highly suggestive of a CFL2-related disease in these patients. Since CFL2-related myopathies are ultrarare, the application of ACMG/AMP guidelines and the diagnostic reportability of CFL2 variants identified in patients remains a challenge. The actin depolymerisation assay may be useful to elucidate the impact and pathogenicity of additional CFL2 variants and has the potential to guide variant classification in future.

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Collaboration types
Domestic collaboration
International collaboration
Citation topics
1 Clinical & Life Sciences
1.96 Cell Biology
1.96.492 Myosin
Web Of Science research areas
Biochemistry & Molecular Biology
Genetics & Heredity
ESI research areas
Molecular Biology & Genetics
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