Diamond-Blackfan anaemia (DBA) is a constitutional erythroblastopenia characterized by absent or decreased erythroid precursors. The disease, previously mapped to human chromosome 19q13, is frequently associated with a variety of malformations. To identify the gene involved in DBA, we cloned the chromosome 19q13 breakpoint in a patient with a reciprocal X;19 chromosome translocation. The breakpoint occurred in the gene encoding ribosomal protein S19. Furthermore, we identified mutations in RPS19 in 10 of 40 unrelated DBA patients, including nonsense, frameshift, splice site and missense mutations, as well as two intragenic deletions. These mutations are associated with clinical features that suggest a function for RPS19 in erythropoiesis and embryogenesis.

The ribosomal protein S19 (RPS19) is located in the small (40S) subunit and is one of 79 ribosomal proteins. The gene encoding RPS19 is mutated in approximately 25% of patients with Diamond-Blackfan anemia, which is a rare congenital erythroblastopenia. Affected individuals present with decreased numbers or the absence of erythroid precursors in the bone marrow, and associated malformations of various organs are common. We produced C57BL/6J mice with a targeted disruption of murine Rps19 to study its role in erythropoiesis and development. Mice homozygous for the disrupted Rps19 were not identified as early as the blastocyst stage, indicating a lethal effect. In contrast, mice heterozygous for the disrupted Rps19 allele have normal growth and organ development, including that of the hematopoietic system. Our findings indicate that zygotes which are Rps19 ؊/؊ do not form blastocysts, whereas one normal Rps19 allele in C57BL/6J mice is sufficient to maintain normal ribosomal and possibly extraribosomal functions.The ribosomal proteins constitute a major component of cellular proteins and are known to be mandatory for cellular growth. A reduced level of one ribosomal protein is rate limiting for the assembly of ribosomes and may constitute a bottleneck for protein synthesis in tissues with a high proliferative activity. Recently, Draptchinskaia et al. found that the gene encoding ribosomal protein S19 (RPS19) was mutated in 25% of patients with Diamond-Blackfan anemia (DBA) (5). DBA is a rare, congenital, and chronic anemia that is characterized by the absence or decreased numbers of erythroid precursors in the bone marrow but an otherwise normal cellularity (1, 4). Approximately 30% of affected patients with DBA show one or several dysmorphic features including growth retardation, hand and/or limb malformations, urogenital anomalies, and congenital heart defects (1, 2, 10). Clinical expression in DBA is highly variable (14,21), and the role of RPS19 in the pathogenesis of the disease is presently unknown.RPS19 is part of the 40S ribosomal unit and shows a high degree of sequence conservation across mammalian species at the protein level (5). In addition to its implication in erythropoiesis, there are indications that RPS19 has extraribosomal functions.A previous study has shown that a dimer of RPS19 may mediate chemotaxis (13). Free RPS19 has also been shown to interact with fibroblast growth factor 2 (FGF-2), and a possible role for RPS19 in embryonic development has been suggested (17). We hypothesized that an Rps19 null mutant would be deleterious for development and that mice heterozygous for Rps19 may present with hematological abnormalities. To clarify the role of RPS19 in erythropoiesis, we created a null mutation for murine Rps19 by homologous recombination in embryonic stem (ES) cells. The targeted Rps19 was introduced on a C57BL/6J background. We present here the results from our studies of this mouse model. MATERIALS AND METHODSConstruction of the Rps19 targeting vector. An Rps19 intron probe was used t...

Diamond-Blackfan anemia (DBA) is a rare pure red-cell hypoplasia of unknown etiology and pathogenesis. A major DBA locus has previously been localized to chromosome 19q13.2. Samples from additional families have been collected to identify key recombinations, microdeletions, and the possibility of heterogeneity for the disorder. In total, 29 multiplex DBA families and 50 families that comprise sporadic DBA cases have been analyzed with polymorphic 19q13 markers, including a newly identified short-tandem repeat in the critical gene region. The results from DNA analysis of 29 multiplex families revealed that 26 of these were consistent with a DBA gene on 19q localized to within a 4.1-cM interval restricted by loci D19S200 and D19S178; however, in three multiplex families, the DBA candidate region on 19q13 was excluded from the segregation of marker alleles. Our results suggest genetic heterogeneity for DBA, and we show that a gene region on chromosome 19q segregates with the disease in the majority of familial cases. Among the 50 families comprising sporadic DBA cases, we identified two novel and overlapping microdeletions on chromosome 19q13. In combination, the three known microdeletions associated with DBA restrict the critical gene region to approximately 1 Mb. The results indicate that a proportion of sporadic DBA cases are caused by deletions in the 19q13 region.

No abstract

Diamond-Blackfan anemia (DBA) is a rare constitutional erythroblastopenia characterized by a specific defect in erythroid differentiation. Recently, mutations in the gene encoding ribosomal protein (RP) S19 were found in a subset of patients with the disease. To characterize further RPS19 mutations and to investigate genotype-phenotype relationships, we screened this gene for mutations in patients with DBA by direct sequencing and Southern-blot analysis. Four novel mutations were identified. A G120A nonsense mutation resulting in a stop at codon 33, a C302T nonsense mutation introducing a premature stop at codon 84, and a 327delG which results in a frame shift at codon 103. A fourth and more complex mutation (TT157-158AA, 160insCT) resulting in a Leu45Gln and a frame shift from codon 47 was found in three affected family members with variable phenotypes. The different clinical expression for identical mutations suggest the presence of other modulating factors for the disease. The mutations presented here further support the role of RPS19 in erythropoietic differentiation and proliferation.