Validation of LDLr Activity as a Tool to Improve Genetic Diagnosis of Familial Hypercholesterolemia: A Retrospective on Functional Characterization of LDLr Variants

Familial hypercholesterolemia (FH) is an autosomal dominant disorder characterized by high blood-cholesterol levels mostly caused by mutations in the low-density lipoprotein receptor (LDLr). With a prevalence as high as 1/200 in some populations, genetic screening for pathogenic LDLr mutations is a...

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Bibliographic Details
Authors: Benito Vicente, Asier, Belloso Uribe, Kepa, Jebari Benslaiman, Shifa, Galicia García, Unai, Ostolaza Echabe, Elena Amaya, Martín Plágaro, César Augusto
Format: article
Publication Date:2018
Country:España
Institution:Universidad del País Vasco
Repository:Addi. Archivo Digital para la Docencia y la Investigación
OAI Identifier:oai:addi.ehu.eus:10810/31910
Online Access:http://hdl.handle.net/10810/31910
Access Level:Open access
Keyword:low density lipoprotein receptor (LDLr)
variants
familial hypercholesterolemia
is silico
in vitro
functional validation
density-lipoprotein receptor
autosomal-dominant hypercholesterolemia
ligand-binding domain
cysteine-rich repeats
growth-factor repeat
mutational analysis
cytoplasmic domain
point mutation
south-african
molecular-genetics
Description
Summary:Familial hypercholesterolemia (FH) is an autosomal dominant disorder characterized by high blood-cholesterol levels mostly caused by mutations in the low-density lipoprotein receptor (LDLr). With a prevalence as high as 1/200 in some populations, genetic screening for pathogenic LDLr mutations is a cost-effective approach in families classified as definite' or probable' FH and can help to early diagnosis. However, with over 2000 LDLr variants identified, distinguishing pathogenic mutations from benign mutations is a long-standing challenge in the field. In 1998, the World Health Organization (WHO) highlighted the importance of improving the diagnosis and prognosis of FH patients thus, identifying LDLr pathogenic variants is a longstanding challenge to provide an accurate genetic diagnosis and personalized treatments. In recent years, accessible methodologies have been developed to assess LDLr activity in vitro, providing experimental reproducibility between laboratories all over the world that ensures rigorous analysis of all functional studies. In this review we present a broad spectrum of functionally characterized missense LDLr variants identified in patients with FH, which is mandatory for a definite diagnosis of FH.