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Functional Assessment of Missense Variants in the ABCC6 Gene Implicated in Pseudoxanthoma Elasticum, a Heritable Ectopic Mineralization Disorder.

Abstract
Pseudoxanthoma elasticum, a heritable multisystem ectopic mineralization disorder, is caused by inactivating mutations in the ABCC6 gene. The encoded protein, ABCC6, a transmembrane transporter, has a specialized efflux function in hepatocytes by contributing to plasma levels of inorganic pyrophosphate, a potent inhibitor of mineralization in soft connective tissues. Reduced plasma inorganic pyrophosphate levels underlie the ectopic mineralization in pseudoxanthoma elasticum. In this study, we characterized the pathogenicity of three human ABCC6 missense variants using an adenovirus-mediated liver-specific ABCC6 transgene expression system in an Abcc6-/- mouse model of pseudoxanthoma elasticum. Variants p.L420V and p.R1064W were found benign because they had abundance and plasma membrane localization in hepatocytes similar to the wild-type human ABCC6 transgene, normalized plasma inorganic pyrophosphate levels, and prevented mineralization in the dermal sheath of vibrissae in muzzle skin, a phenotypic hallmark in the Abcc6-/- mice. In contrast, p.S400F was shown to be pathogenic because it failed to normalize plasma inorganic pyrophosphate levels and had no effect on ectopic mineralization despite its normal expression and proper localization in hepatocytes. These results showed that adenovirus-mediated hepatic ABCC6 expression in Abcc6-/- mice can provide a model system to effectively elucidate the multifaceted functional consequences of human ABCC6 missense variants identified in patients with pseudoxanthoma elasticum.
AuthorsLuke Kowal, Jianhe Huang, Hongbin Luo, Jagmohan Singh, Adam E Snook, Jouni Uitto, Qiaoli Li
JournalThe Journal of investigative dermatology (J Invest Dermatol) Vol. 142 Issue 4 Pg. 1085-1093 (04 2022) ISSN: 1523-1747 [Electronic] United States
PMID34597610 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
CopyrightCopyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
Chemical References
  • ABCC6 protein, human
  • Abcc6 protein, mouse
  • Diphosphates
  • Multidrug Resistance-Associated Proteins
Topics
  • Adenoviridae (genetics)
  • Animals
  • Calcinosis (pathology)
  • Diphosphates (metabolism)
  • Disease Models, Animal
  • Humans
  • Mice
  • Multidrug Resistance-Associated Proteins (genetics, metabolism)
  • Mutation, Missense
  • Pseudoxanthoma Elasticum (pathology)
  • Skin (pathology)

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