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10.1136/jmedgenet-2015-103220

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suck abstract from ncbi


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pmid26101329      J+Med+Genet 2015 ; 52 (9): 612-6
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  • Continued Lessons from the INS Gene: An Intronic Mutation Causing Diabetes through a Novel Mechanism #MMPMID26101329
  • Carmody D; Park SY; Ye H; Perrone ME; Alkorta-Aranburu G; Highland HM; Hanis CL; Philipson LH; Bell GI; Greeley SAW
  • J Med Genet 2015[Sep]; 52 (9): 612-6 PMID26101329show ga
  • Background: Diabetes in neonates usually has a monogenic etiology; however, the cause remains unknown in 20?30%. Heterozygous INS mutations represent one of the most common gene causes of neonatal diabetes mellitus. Methods: Clinical and functional characterization of a novel homozygous intronic mutation (c.187+241G>A) in the insulin gene in a child identified through the Monogenic Diabetes Registry (http://monogenicdiabetes.uchicago.edu). Results: The proband had insulin-requiring diabetes from birth. Ultrasonography revealed a structurally normal pancreas and C-peptide was undetectable despite readily detectable amylin, suggesting the presence of dysfunctional beta cells. Whole exome sequencing revealed the novel mutation. In silico analysis predicted a mutant mRNA product resulting from preferential recognition of a newly created splice site.Wild-type and mutant human insulin gene constructs were derived and transiently expressed in INS-1 cells. We confirmed the predicted transcript and found an additional transcript created via an ectopic splice acceptor site. Conclusion: Dominant INS mutations cause diabetes via a mutated translational product causing ER stress. We describe a novel mechanism of diabetes, without beta cell death, due to creation of two unstable mutant transcripts predicted to undergo nonsense and non-stop mediated decay respectively. Our discovery may have broader implications for those with insulin deficiency later in life.
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