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• W2155488847 abstract "<h3>Objective</h3> Progressive familial intrahepatic cholestasis type 3 (PFIC3) is a potentially lethal autosomal recessive liver disease associated with mutations in <i>ABCB4</i>, the gene encoding the canalicular translocator of phosphatidylcholine MDR3. While some affected children benefit from ursodeoxycholic acid (UDCA) therapy, others evolve to end-stage liver disease. We aimed to evaluate whether these different outcomes are related to the impact of <i>ABCB4</i> mutations. <h3>Design</h3> Six children with PFIC3 were investigated by sequencing of <i>ABCB4</i> exons and flanking intron-exon boundaries and by immunohistochemistry. <i>ABCB4</i> missense mutations were phenotyped in vitro by assessing their effects on MDR3 expression, subcellular localisation, and phosphatidylcholine-translocating activity. The resulting data were contrasted with the clinical outcomes. <h3>Results</h3> Eight distinct <i>ABCB4</i> mutations were identified: one nonsense, one splicing and six missense mutations, four of which (G68R, T201M, P479L, D459H) affected MDR3 expression level. G68R and D459H also led to retention of the protein in endoplasmic reticulum. Phosphatidylcholine efflux assays indicated that T201M, P479L, S978P and E1118K mutations impaired MDR3 activity to variable degrees. Three children with mutations that caused a total loss of MDR3 expression/function manifested progressive liver disease refractory to UDCA treatment. This was also the case in a patient carrying two different mutations that, in combination, resulted in a 90% reduction in total MDR3 activity. A favourable response to UDCA was achieved in two patients with estimated MDR3 activities of 50% and 33%, respectively. <h3>Conclusions</h3> These data provide experimental evidence of the correlation between the degree of MDR3 floppase activity and the clinical outcomes of PFIC3." @default.
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• W2155488847 date "2014-03-04" @default.
• W2155488847 modified "2023-10-17" @default.
• W2155488847 title "Functional analysis of<i>ABCB4</i>mutations relates clinical outcomes of progressive familial intrahepatic cholestasis type 3 to the degree of MDR3 floppase activity" @default.
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• W2155488847 doi "https://doi.org/10.1136/gutjnl-2014-306896" @default.
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