Figure Results of duplication analysis and patient 11's chorein analysis and geographical distribution of VPS13A mutations Results of duplication analysis.

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Figure Results of duplication analysis and patient 11's chorein analysis and geographical distribution of VPS13A mutations Results of duplication analysis and patient 11's chorein analysis and geographical distribution of VPS13A mutations Results of qPCR for each exon of the VPS13A gene (A), results of genomic PCR performed with a forward primer located in intron 45 and reverse primer located in intron 35 (B), breakpoint in genomic sequence (C), Western blotting for patient 11 (D), and geographical distribution of VPS13A mutations (E). (A) The RQ value of normal controls is approximately 1.0. The extent of a predicted duplication is indicated by arrows. The figure shows the results of qPCR for each exon of the VPS13A gene in patient 16. Comparable results were observed in patient 17. These results suggest heterozygous duplication of exon 36–45. (B) A direct connection between introns 45 and 35 was observed in the genomic DNA of patients. In this connection, a repeated AAAA sequence, which was common between the 5′ end of intron 35 and the 3′ end of intron 45, was observed. (C) Forward primer was located in intron 45. Reverse primer was located in intron 35. Genomic PCR using this combination of primers led to an approximately 7,300 bp PCR product (theoretically 7,319 bp long; arrow) including the predicted junction in 2 patients, but no PCR product in the control. (D) Equal loading was shown by staining with Memcode Reversible Protein Stain (Thermo Fisher Scientific, Waltham, MA), shown in the right panel. Chorein immunoreactivity at 360 kDa was observed in the normal control, but not in patients with ChAc other than patient 11. A considerable reduction in chorein levels was observed for patient 11. (E) Solid-colored circles represent patients who have homozygous mutations. Gradient-colored circles represent patients who have heterozygous mutations. Single red circles indicate exon 60–61 deletion, and single blue circles indicate exon 37 4411C>T mutations. The patients carrying these 2 mutations are localized in western Japan. Some patients who could not identify their ancestral origin provided their address. The map was obtained from aoki2.si.gunma-u.ac.jp/map/map.cgi. ChAc = chorea-acanthocytosis; qPCR = quantitative PCR; VPS13A = vacuolar protein sorting 13A. Yoshiaki Nishida et al. Neurol Genet 2019;5:e332 Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.