Skip to main content

Marfan Syndrome (MFS): Inherited Microfibrillar Disorder Caused by Mutations in the Fibrillin-1 Gene

  • Chapter
  • First Online:
Diagnosis and Management of Marfan Syndrome

Abstract

There have been several studies suggesting that FBN1 gene was responsible for the Marfan syndrome (MFS) phenotype [1–4] before announcing the localisation of the gene on chromosome 15q21.1 in 1991 [3, 5, 6]. Subsequently, many research laboratories started to screen FBN1 in their MFS patients. Many mutations have been mapped to this gene due to this increase in genetic screening and international collaborations confirming FBN1 as the gene responsible for Marfan syndrome [7–15]. This has been the final proof to confirm that the FBN1 gene is the cause of MFS.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sakai LY, Keene DR, Engvall E. Fibrillin, a new 350-kD glycoprotein, is a component of extracellular microfibrils. J Cell Biol. 1986;103(6 Pt 1):2499–509.

    Article  CAS  PubMed  Google Scholar 

  2. Hollister DW, Godfrey M, Sakai LY, Pyeritz RE. Immunohistologic abnormalities of the microfibrillar-fiber system in the Marfan syndrome. N Engl J Med. 1990;323(3):152–9.

    Article  CAS  PubMed  Google Scholar 

  3. Dietz HC, Pyeritz RE, Hall BD, Cadle RG, Hamosh A, Schwartz J, Meyers DA, Francomano CA. The Marfan syndrome locus: confirmation of assignment to chromosome 15 and identification of tightly linked markers at 15q15-q21.3. Genomics. 1991;9(2):355–61.

    Article  CAS  PubMed  Google Scholar 

  4. Kainulainen K, Pulkkinen L, Savolainen A, Kaitila I, Peltonen L. Location on chromosome 15 of the gene defect causing Marfan syndrome. N Engl J Med. 1990;323(14):935–9.

    Article  CAS  PubMed  Google Scholar 

  5. Magenis RE, Maslen CL, Smith L, Allen L, Sakai LY. Localization of the fibrillin (FBN) gene to chromosome 15, band q21.1. Genomics. 1991;11(2):346–51.

    Article  CAS  PubMed  Google Scholar 

  6. Lee B, Godfrey M, Vitale E, Hori H, Mattei MG, Sarfarazi M, Tsipouras P, Ramirez F, Hollister DW. Linkage of Marfan syndrome and a phenotypically related disorder to two different fibrillin genes. Nature. 1991;352(6333):330–4.

    Article  CAS  PubMed  Google Scholar 

  7. Comeglio P, Johnson P, Arno G, Brice G, Evans A, Aragon-Martin J, da Silva FP, Kiotsekoglou A, Child A. The importance of mutation detection in Marfan syndrome and Marfan-related disorders: report of 193 FBN1 mutations. Hum Mutat. 2007;28(9):928–50.

    Google Scholar 

  8. Collod-Béroud G, Lackmy-Port-Lys M, Jondeau G, Mathieu M, Maingourd Y, Coulon M, Guillotel M, Junien C, Boileau C. Demonstration of the recurrence of Marfan-like skeletal and cardiovascular manifestations due to germline mosaicism for an FBN1 mutation. Am J Hum Genet. 1999;65(3):917–21.

    Article  PubMed Central  PubMed  Google Scholar 

  9. Blyth M, Foulds N, Turner C, Bunyan D. Severe Marfan syndrome due to FBN1 exon deletions. Am J Med Genet A. 2008;146A(10):1320–4.

    Article  PubMed  Google Scholar 

  10. Montgomery RA, Geraghty MT, Bull E, Gelb BD, Johnson M, McIntosh I, Francomano CA, Dietz HC. Multiple molecular mechanisms underlying subdiagnostic variants of Marfan syndrome. Am J Hum Genet. 1998;63(6):1703–11.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Hayward C, Porteous ME, Brock DJ. Mutation screening of all 65 exons of the fibrillin-1 gene in 60 patients with Marfan syndrome: report of 12 novel mutations. Hum Mutat. 1997;10(4):280–9.

    Article  CAS  PubMed  Google Scholar 

  12. Hayward C, Keston M, Brock DJ, Dietz HC. Fibrillin (FBN1) mutations in Marfan syndrome. Hum Mutat. 1992;1(1):79.

    Article  CAS  PubMed  Google Scholar 

  13. Dietz HC, Cutting GR, Pyeritz RE, Maslen CL, Sakai LY, Corson GM, Puffenberger EG, Hamosh A, Nanthakumar EJ, Curristin SM. Marfan syndrome caused by a recurrent de novo missense mutation in the fibrillin gene. Nature. 1991;352(6333):337–9.

    Article  CAS  PubMed  Google Scholar 

  14. Dietz HC, McIntosh I, Sakai LY, Corson GM, Chalberg SC, Pyeritz RE, Francomano CA. Four novel FBN1 mutations: significance for mutant transcript level and EGF-like domain calcium binding in the pathogenesis of Marfan syndrome. Genomics. 1993;17(2):468–75.

    Article  CAS  PubMed  Google Scholar 

  15. Tynan K, Comeau K, Pearson M, Wilgenbus P, Levitt D, Gasner C, Berg MA, Miller DC, Francke U. Mutation screening of complete fibrillin-1 coding sequence: report of five new mutations, including two in 8-cysteine domains. Hum Mol Genet. 1993;2(11):1813–21.

    Article  CAS  PubMed  Google Scholar 

  16. McKUSICK VA. The cardiovascular aspects of Marfan’s syndrome: a heritable disorder of connective tissue. Circulation. 1955;11(3):321–42.

    Article  CAS  PubMed  Google Scholar 

  17. de Vries BB, Pals G, Odink R, Hamel BC. Homozygosity for a FBN1 missense mutation: clinical and molecular evidence for recessive Marfan syndrome. Eur J Hum Genet. 2007;15(9):930–5.

    Article  PubMed  Google Scholar 

  18. Hogue J, Lee C, Jelin A, Strecker MN, Cox VA, Slavotinek AM. Homozygosity for a FBN1 missense mutation causes a severe Marfan syndrome phenotype. Clin Genet. 2013;84(4):392–3.

    Article  CAS  PubMed  Google Scholar 

  19. Capotorti L, de Benedetti Gaddini R, Rizzo P. Contribution to the study of the heredity of Marfan’s syndrome: description of a family tree of 4 generations with marriage between consanguineous parents. Acta Genet Med Gemellol (Roma). 1959;8:455–82.

    Google Scholar 

  20. Chemke J, Nisani R, Feigl A, Garty R, Cooper M, Bårash Y, Duksin D. Homozygosity for autosomal dominant Marfan syndrome. J Med Genet. 1984;21(3):173–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  21. Schollin J, Bjarke B, Gustavson KH. Probable homozygotic form of the Marfan syndrome in a newborn child. Acta Paediatr Scand. 1988;77(3):452–6.

    Article  CAS  PubMed  Google Scholar 

  22. Karttunen L, Raghunath M, Lönnqvist L, Peltonen L. A compound-heterozygous Marfan patient: two defective fibrillin alleles result in a lethal phenotype. Am J Hum Genet. 1994;55(6):1083–91.

    CAS  PubMed Central  PubMed  Google Scholar 

  23. Van Dijk FS, Hamel BC, Hilhorst-Hofstee Y, Mulder BJ, Timmermans J, Pals G, Cobben JM. Compound-heterozygous Marfan syndrome. Eur J Med Genet. 2009;52(1):1–5.

    Article  PubMed  Google Scholar 

  24. Keane MG, Pyeritz RE. Medical management of Marfan syndrome. Circulation. 2008;117(21):2802–13.

    Article  PubMed  Google Scholar 

  25. Judge DP, Dietz HC. Marfan’s syndrome. Lancet. 2005;366(9501):1965–76.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Chiu HH, Wu MH, Chen HC, Kao FY, Huang SK. Epidemiological profile of Marfan syndrome in a general population: a national database study. Mayo Clin Proc. 2014;89(1):34–42.

    Article  PubMed  Google Scholar 

  27. Dean JC. Management of Marfan syndrome. Heart. 2002;88(1):97–103.

    Article  PubMed Central  PubMed  Google Scholar 

  28. Silverman DI, Burton KJ, Gray J, Bosner MS, Kouchoukos NT, Roman MJ, Boxer M, Devereux RB, Tsipouras P. Life expectancy in the Marfan syndrome. Am J Cardiol. 1995;75(2):157–60.

    Article  CAS  PubMed  Google Scholar 

  29. Pyeritz RE. Marfan syndrome: 30 years of research equals 30 years of additional life expectancy. Heart. 2009;95(3):173–5.

    Article  PubMed  Google Scholar 

  30. Corson GM, Chalberg SC, Dietz HC, Charbonneau NL, Sakai LY. Fibrillin binds calcium and is coded by cDNAs that reveal a multidomain structure and alternatively spliced exons at the 5’ end. Genomics. 1993;17(2):476–84.

    Article  CAS  PubMed  Google Scholar 

  31. Pereira L, D’Alessio M, Ramirez F, Lynch JR, Sykes B, Pangilinan T, Bonadio J. Genomic organization of the sequence coding for fibrillin, the defective gene product in Marfan syndrome. Hum Mol Genet. 1993;2(7):961–8.

    Article  CAS  PubMed  Google Scholar 

  32. Summers KM, Nataatmadja M, Xu D, West MJ, McGill JJ, Whight C, Colley A, Adès LC. Histopathology and fibrillin-1 distribution in severe early onset Marfan syndrome. Am J Med Genet A. 2005;139(1):2–8.

    Article  CAS  PubMed  Google Scholar 

  33. Milewicz DM, Pyeritz RE, Crawford ES, Byers PH. Marfan syndrome: defective synthesis, secretion, and extracellular matrix formation of fibrillin by cultured dermal fibroblasts. J Clin Invest. 1992;89(1):79–86.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  34. Raghunath M, Kielty CM, Steinmann B. Truncated profibrillin of a Marfan patient is of apparent similar size as fibrillin: intracellular retention leads to over-N-glycosylation. J Mol Biol. 1995;248(5):901–9.

    Article  CAS  PubMed  Google Scholar 

  35. Kainulainen K, Karttunen L, Puhakka L, Sakai L, Peltonen L. Mutations in the fibrillin gene responsible for dominant ectopia lentis and neonatal Marfan syndrome. Nat Genet. 1994;6(1):64–9.

    Article  CAS  PubMed  Google Scholar 

  36. Milewicz DM, Duvic M. Severe neonatal Marfan syndrome resulting from a de novo 3-bp insertion into the fibrillin gene on chromosome 15. Am J Hum Genet. 1994;54(3):447–53.

    CAS  PubMed Central  PubMed  Google Scholar 

  37. Putnam EA, Cho M, Zinn AB, Towbin JA, Byers PH, Milewicz DM. Delineation of the Marfan phenotype associated with mutations in exons 23–32 of the FBN1 gene. Am J Med Genet. 1996;62(3):233–42.

    Article  CAS  PubMed  Google Scholar 

  38. Sakai LY, Keene DR. Fibrillin: monomers and microfibrils. Methods Enzymol. 1994;245:29–52.

    Article  CAS  PubMed  Google Scholar 

  39. Biery NJ, Eldadah ZA, Moore CS, Stetten G, Spencer F, Dietz HC. Revised genomic organization of FBN1 and significance for regulated gene expression. Genomics. 1999;56(1):70–7.

    Article  CAS  PubMed  Google Scholar 

  40. Collod-Béroud G, Le Bourdelles S, Ades L, Ala-Kokko L, Booms P, Boxer M, Child A, Comeglio P, De Paepe A, Hyland JC. and others. Update of the UMD-FBN1 mutation database and creation of an FBN1 polymorphism database. Hum Mutat. 2003;22(3):199–208.

    Article  PubMed  Google Scholar 

  41. Dietz HC, Saraiva JM, Pyeritz RE, Cutting GR, Francomano CA. Clustering of fibrillin (FBN1) missense mutations in Marfan syndrome patients at cysteine residues in EGF-like domains. Hum Mutat. 1992;1(5):366–74.

    Article  CAS  PubMed  Google Scholar 

  42. Smallridge RS, Whiteman P, Doering K, Handford PA, Downing AK. EGF-like domain calcium affinity modulated by N-terminal domain linkage in human fibrillin-1. J Mol Biol. 1999;286(3):661–8.

    Article  CAS  PubMed  Google Scholar 

  43. Kielty CM, Rantamäki T, Child AH, Shuttleworth CA, Peltonen L. Cysteine-to-arginine point mutation in a ‘hybrid’ eight-cysteine domain of FBN1: consequences for fibrillin aggregation and microfibril assembly. J Cell Sci. 1995;108(Pt 3):1317–23.

    CAS  PubMed  Google Scholar 

  44. Micheal S, Khan MI, Akhtar F, Weiss MM, Islam F, Ali M, Qamar R, Maugeri A, den Hollander AI. Identification of a novel FBN1 gene mutation in a large Pakistani family with Marfan syndrome. Mol Vis. 2012;18:1918–26.

    CAS  PubMed Central  PubMed  Google Scholar 

  45. Collod-Béroud G, Béroud C, Ades L, Black C, Boxer M, Brock DJ, Holman KJ, de Paepe A, Francke U, Grau U. Marfan Database (third edition): new mutations and new routines for the software. Nucleic Acids Res. 1998;26(1):229–33.

    Article  PubMed Central  PubMed  Google Scholar 

  46. Liu WO, Oefner PJ, Qian C, Odom RS, Francke U. Denaturing HPLC-identified novel FBN1 mutations, polymorphisms, and sequence variants in Marfan syndrome and related connective tissue disorders. Genet Test. 1997;1(4):237–42.

    Article  CAS  PubMed  Google Scholar 

  47. Lönnqvist L, Child A, Kainulainen K, Davidson R, Puhakka L, Peltonen L. A novel mutation of the fibrillin gene causing ectopia lentis. Genomics. 1994;19(3):573–6.

    Article  PubMed  Google Scholar 

  48. Reinhardt DP, Mechling DE, Boswell BA, Keene DR, Sakai LY, Bächinger HP. Calcium determines the shape of fibrillin. J Biol Chem. 1997;272(11):7368–73.

    Article  CAS  PubMed  Google Scholar 

  49. Reinhardt DP, Ono RN, Sakai LY. Calcium stabilizes fibrillin-1 against proteolytic degradation. J Biol Chem. 1997;272(2):1231–6.

    Article  CAS  PubMed  Google Scholar 

  50. Reinhardt DP, Ono RN, Notbohm H, Müller PK, Bächinger HP, Sakai LY. Mutations in calcium-binding epidermal growth factor modules render fibrillin-1 susceptible to proteolysis. A potential disease-causing mechanism in Marfan syndrome. J Biol Chem. 2000;275(16):12339–45.

    Article  CAS  PubMed  Google Scholar 

  51. Ashworth JL, Murphy G, Rock MJ, Sherratt MJ, Shapiro SD, Shuttleworth CA, Kielty CM. Fibrillin degradation by matrix metalloproteinases: implications for connective tissue remodelling. Biochem J. 1999;340(Pt 1):171–81.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  52. McGettrick AJ, Knott V, Willis A, Handford PA. Molecular effects of calcium binding mutations in Marfan syndrome depend on domain context. Hum Mol Genet. 2000;9(13):1987–94.

    Article  CAS  PubMed  Google Scholar 

  53. Loeys B, Nuytinck L, Van Acker P, Walraedt S, Bonduelle M, Sermon K, Hamel B, Sanchez A, Messiaen L, De Paepe A. Strategies for prenatal and preimplantation genetic diagnosis in Marfan syndrome (MFS). Prenat Diagn. 2002;22(1):22–8.

    Article  CAS  PubMed  Google Scholar 

  54. Schrijver I, Liu W, Brenn T, Furthmayr H, Francke U. Cysteine substitutions in epidermal growth factor-like domains of fibrillin-1: distinct effects on biochemical and clinical phenotypes. Am J Hum Genet. 1999;65(4):1007–20.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  55. Gillis E, Kempers M, Salemink S, Timmermans J, Cheriex EC, Bekkers SC, Fransen E, De Die-Smulders CE, Loeys BL, Van Laer L. An FBN1 deep intronic mutation in a familial case of Marfan syndrome: an explanation for genetically unsolved cases? Hum Mutat. 2014;35(5):571–4.

    Article  CAS  PubMed  Google Scholar 

  56. Dietz HC, Valle D, Francomano CA, Kendzior RJ, Pyeritz RE, Cutting GR. The skipping of constitutive exons in vivo induced by nonsense mutations. Science. 1993;259(5095):680–3.

    Article  CAS  PubMed  Google Scholar 

  57. Kainulainen K, Sakai LY, Child A, Pope FM, Puhakka L, Ryhänen L, Palotie A, Kaitila I, Peltonen L. Two mutations in Marfan syndrome resulting in truncated fibrillin polypeptides. Proc Natl Acad Sci U S A. 1992;89(13):5917–21.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  58. Körkkö J, Kaitila I, Lönnqvist L, Peltonen L, Ala-Kokko L. Sensitivity of conformation sensitive gel electrophoresis in detecting mutations in Marfan syndrome and related conditions. J Med Genet. 2002;39(1):34–41.

    Article  PubMed Central  PubMed  Google Scholar 

  59. Franken R, den Hartog A, Radonic T, Micha D, Maugeri A, van Dijk FS, Meijers-Heijboer HE, Timmermans J, Scholte AJ, van den Berg MP. Beneficial Outcome of Losartan Therapy Depends on Type of FBN1 Mutation in Marfan Syndrome. Circ Cardiovasc Genet. 2015;8(2):383–8.

    Article  CAS  PubMed  Google Scholar 

  60. Franken R, Heesterbeek T, de Waard V, Zwinderman A, Pals G, Mulder B, Groenink M. Diagnosis and genetics of Marfan syndrome. Expert Opinion Orphan Drugs. 2014;2(10):1049–62.

    Article  CAS  Google Scholar 

  61. Attias D, Stheneur C, Roy C, Collod-Béroud G, Detaint D, Faivre L, Delrue MA, Cohen L, Francannet C, Béroud C. and others. Comparison of clinical presentations and outcomes between patients with TGFBR2 and FBN1 mutations in Marfan syndrome and related disorders. Circulation. 2009;120(25):2541–9.

    Article  CAS  PubMed  Google Scholar 

  62. Hilhorst-Hofstee Y, Hamel BC, Verheij JB, Rijlaarsdam ME, Mancini GM, Cobben JM, Giroth C, Ruivenkamp CA, Hansson KB, Timmermans J. and others. The clinical spectrum of complete FBN1 allele deletions. Eur J Hum Genet. 2011;19(3):247–52.

    Article  PubMed Central  PubMed  Google Scholar 

  63. Nijbroek G, Sood S, McIntosh I, Francomano CA, Bull E, Pereira L, Ramirez F, Pyeritz RE, Dietz HC. Fifteen novel FBN1 mutations causing Marfan syndrome detected by heteroduplex analysis of genomic amplicons. Am J Hum Genet. 1995;57(1):8–21.

    CAS  PubMed Central  PubMed  Google Scholar 

  64. McInerney-Leo AM, Marshall MS, Gardiner B, Coucke PJ, Van Laer L, Loeys BL, Summers KM, Symoens S, West JA, West MJ. Whole exome sequencing is an efficient, sensitive and specific method of mutation detection in osteogenesis imperfecta and Marfan syndrome. Bonekey Rep. 2013;2:456.

    Article  PubMed Central  PubMed  Google Scholar 

  65. Bayley H. Sequencing single molecules of DNA. Curr Opin Chem Biol. 2006;10(6):628–37.

    Article  CAS  PubMed  Google Scholar 

  66. Schneider GF, Dekker C. DNA sequencing with nanopores. Nat Biotechnol. 2012;30(4):326–8.

    Article  CAS  PubMed  Google Scholar 

  67. Wang Y, Yang Q, Wang Z. The evolution of nanopore sequencing. Front Genet. 2014;5:449.

    PubMed Central  PubMed  Google Scholar 

  68. Boileau C, Jondeau G, Babron MC, Coulon M, Alexandre JA, Sakai L, Melki J, Delorme G, Dubourg O, Bonaïti-Pellié C. Autosomal dominant Marfan-like connective-tissue disorder with aortic dilation and skeletal anomalies not linked to the fibrillin genes. Am J Hum Genet. 1993;53(1):46–54.

    CAS  PubMed Central  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jose Antonio Aragon-Martin PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer-Verlag London

About this chapter

Cite this chapter

Aragon-Martin, J.A., Child, A.H. (2016). Marfan Syndrome (MFS): Inherited Microfibrillar Disorder Caused by Mutations in the Fibrillin-1 Gene. In: Child, A. (eds) Diagnosis and Management of Marfan Syndrome. Springer, London. https://doi.org/10.1007/978-1-4471-5442-6_22

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-5442-6_22

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-5441-9

  • Online ISBN: 978-1-4471-5442-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics