Why the study?
Variants in six key Z-disc proteins have been linked to myopathies and cardiomyopathies, but their pathogenicity requires critical re-evaluation based on variant frequency in normal population cohorts.
This review highlights the role of six key Z-disc proteins in myopathies and cardiomyopathies, emphasizing the use of population allele frequencies to critically re-evaluate variant pathogenicity.
Re-evaluation of Z-disc variants via GnomAD frequencies warrants clinical caution in pathogenicity calls; leaves open need for functional validation in cardiomyopathies.
The Z-disc acts as a protein-rich structure to tether thin filament in the contractile units, the sarcomeres, of striated muscle cells. Proteins found in the Z-disc are integral for maintaining the architecture of the sarcomere. They also enable it to function as a (bio-mechanical) signalling hub. Numerous proteins interact in the Z-disc to facilitate force transduction and intracellular signalling in both cardiac and skeletal muscle. This review will focus on six key Z-disc proteins: α-actinin 2, filamin C, myopalladin, myotilin, telethonin and Z-disc alternatively spliced PDZ-motif (ZASP), which have all been linked to myopathies and cardiomyopathies. We will summarise pathogenic variants identified in the six genes coding for these proteins and look at their involvement in myopathy and cardiomyopathy. Listing the Minor Allele Frequency (MAF) of these variants in the Genome Aggregation Database (GnomAD) version 3.1 will help to critically re-evaluate pathogenicity based on variant frequency in normal population cohorts.
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Wadmore et al. (2021) studied this question.
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