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Novel genetic strategies for the characterization of Familial Hypercholesterolemia phenotype

datacite.subject.fosCiências Médicas::Ciências da Saúdept_PT
dc.contributor.advisorBourbon, Mafalda
dc.contributor.advisorEnguita, Francisco
dc.contributor.advisorAlves, Ana Catarina
dc.contributor.authorMedeiros, Ana
dc.date.accessioned2025-03-19T16:29:33Z
dc.date.embargo2027-12
dc.date.issued2024-11-18
dc.date.submitted2024-01-17
dc.description.abstractFamilial Hypercholesterolemia (FH) is the most common genetic lipid disorder with increased risk of atherosclerotic cardiovascular disease due to lifelong elevated low density lipoprotein cholesterol (LDL-C). FH is known to be caused by pathogenic/likely pathogenic (P/LP) variants in LDLR, APOB, PCSK9 genes, but remains underdiagnosed worldwide due to lack of clinical identification. In 40-70% of the clinical FH cases, depending on clinical criteria applied, no P/LP variants are found in FH genes. An extended next generation sequencing (NGS) panel was developed and divided in three genetic strategies to characterize the FH phenotype in individuals of the Portuguese FH cohort. In a first approach, a virtual FH panel was analysed, covering 8 genes and a polygenic risk score (PRS). FH was genetically confirmed in 42% of the cohort. In the FH-negative individuals, other causes were identified, as hyper-lipoprotein(a) (30%), high PRS (16%), other monogenic lipid metabolism disorders (1%) and heterozygous pathogenic variants in FH-phenocopy genes (2%). In a second approach, SNPs within 3’-UTR sequence of FH genes (LDLR and PCSK9) were analysed in FH-negative individuals. These SNPs were predicted to disturb miRNA:mRNA interactions, potentially affecting the post-transcriptional regulatory effect of miRNAs, and possibly contributing to hypercholesterolemia in 6,4% of FH-negative individuals. These individuals had a higher frequency of SNPs within miRNA-binding sites in PCSK9 3’-UTR (4.2%), which can lead to an increase in PCSK9 expression. In a third approach, a virtual NGS panel covering 27 candidate lipid genes associated to hyperlipidemia was explored. An accumulation of rare variants was identified in 51% of the FH-negative individuals, suggesting top 5 relevant genes that could potentially disrupt lipoprotein metabolism. This work unravels other genetic causes of the FH phenotype. Understanding the genetic background of FH-negative cases is crucial for an accurate disease diagnosis and to tailor the treatment for the specific affected pathway.pt_PT
dc.identifier.tid101547277pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.5/99500
dc.language.isoengpt_PT
dc.relatione_FH. The role of epigenetics in Familial Hypercholesterolaemia phenotypes - towards a more precise medicine
dc.subjectFamilial Hypercholesterolemia (FH)pt_PT
dc.subjectFH-phenocopy genespt_PT
dc.subjectpolygenic hypercholesterolemiapt_PT
dc.subject3’-UTR variantspt_PT
dc.subjectcandidate lipid genespt_PT
dc.subjectHipercolesterolemia Familiarpt_PT
dc.subjectgenes fenocópias de FHpt_PT
dc.subjecthipercolesterolemia poligénicapt_PT
dc.subjectvariantes 3’-UTRpt_PT
dc.subjectgenes candidatospt_PT
dc.titleNovel genetic strategies for the characterization of Familial Hypercholesterolemia phenotypept_PT
dc.typedoctoral thesis
dspace.entity.typePublication
oaire.awardNumberSFRH/BD/113017/2015
oaire.awardTitlee_FH. The role of epigenetics in Familial Hypercholesterolaemia phenotypes - towards a more precise medicine
oaire.awardURIinfo:eu-repo/grantAgreement/FCT//SFRH%2FBD%2F113017%2F2015/PT
person.familyNameCabeleira Medeiros
person.givenNameAna Margarida
person.identifier.ciencia-id191C-D374-9E19
person.identifier.orcid0000-0003-2972-0872
project.funder.identifierhttp://doi.org/10.13039/501100001871
project.funder.nameFundação para a Ciência e a Tecnologia
rcaap.rightsembargoedAccesspt_PT
rcaap.typedoctoralThesispt_PT
relation.isAuthorOfPublicatione9a075b3-0d17-4e7f-aa37-97f69213e447
relation.isAuthorOfPublication.latestForDiscoverye9a075b3-0d17-4e7f-aa37-97f69213e447
relation.isProjectOfPublication0ad0262a-412c-4811-98d2-fb0f40b5b739
relation.isProjectOfPublication.latestForDiscovery0ad0262a-412c-4811-98d2-fb0f40b5b739
thesis.degree.nameTese de doutoramento, Bioquímica (Genética Molecular), Universidade de Lisboa, Faculdade de Ciências, 2024pt_PT

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