Pathogenic Variants in the Myosin Chaperone UNC-45B Cause Progressive Myopathy with Eccentric Cores

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Donkervoort, Sandra | Kutzner, Carl | Hu, Ying | Lornage, Xavière | Rendu, John | Stojkovic, Tanya | Baets, Jonathan | Neuhaus, Sarah | Tanboon, Jantima | Maroofian, Reza | Bolduc, Véronique | Mroczek, Magdalena | Conijn, Stefan | Kuntz, Nancy | Töpf, Ana | Monges, Soledad | Lubieniecki, Fabiana | Mccarty, Riley | Chao, Katherine | Governali, Serena | Böhm, Johann | Boonyapisit, Kanokwan | Malfatti, Edoardo | Sangruchi, Tumtip | Horkayne-Szakaly, Iren | Hedberg-Oldfors, Carola | Efthymiou, Stephanie | Noguchi, Satoru | Djeddi, Sarah | Iida, Aritoshi | Di Rosa, Gabriella | Fiorillo, Chiara | Salpietro, Vincenzo | Darin, Niklas | Fauré, Julien | Houlden, Henry | Oldfors, Anders | Nishino, Ichizo | de Ridder, Willem | Straub, Volker | Pokrzywa, Wojciech | Laporte, Jocelyn | Foley, A. Reghan | Romero, Norma | Ottenheijm, Coen | Hoppe, Thorsten | Bönnemann, Carsten

Edité par CCSD ; Elsevier (Cell Press) -

The myosin-directed chaperone UNC-45B is essential for sarcomeric organization and muscle function from Caenorhabditis elegans to humans. The pathological impact of UNC-45B in muscle disease remained elusive. We report ten individuals with bi-allelic variants in UNC45B who exhibit childhood-onset progressive muscle weakness. We identified a common UNC45B variant that acts as a complex hypomorph splice variant. Purified UNC-45B mutants showed changes in folding and solubility. In situ localization studies further demonstrated reduced expression of mutant UNC-45B in muscle combined with abnormal localization away from the A-band towards the Z-disk of the sarcomere. The physiological relevance of these observations was investigated in C. elegans by transgenic expression of conserved UNC-45 missense variants, which showed impaired myosin binding for one and defective muscle function for three. Together, our results demonstrate that UNC-45B impairment manifests as a chaperonopathy with progressive muscle pathology, which discovers the previously unknown conserved role of UNC-45B in myofibrillar organization.

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