Polymerase chain reaction amplified fragments were purified and directly sequenced

with the ABI3730 automatic DNA analyser (Applied Biosystems Inc., Foster City, CA, USA). To exclude the possibility that desmin mutations represented polymorphisms, identical genomic fragments from 100 healthy controls of Chinese origin were also examined. The mutated desmin cDNAs were generated by site-directed mutagenesis from a eukaryotic expression vector pcDNA3.1 (Invitrogen, Carlsbad, CA, USA) containing wild-type desmin. The accuracy of all clones was verified by sequence analysis. For transfection studies, we employed human adrenocortical carcinoma cells (SW13, vim-) and a mouse myoblast cell line (C2C12). SW13 cells are completely devoid of cytoplasmic intermediate filaments and are an ideal cell culture system to Selumetinib molecular weight investigate the potential of mutant desmin to form intermediate filaments [5]. To

evaluate the effects of mutant desmin on the pre-existing desmin filament network, C2C12 cells were used [23]. When cells were grown to 60% confluence, the wild-type and mutant desmin vectors were transfected into cell lines using Fugene 6 according to the manufacturer’s protocol (Roche, Basel, Switzerland). At 48 h after transfection, the cells were washed three times with phosphate-buffed saline and then fixed with paraformaldehyde for 15 min at room temperature. The cells were subsequently incubated with monoclonal antibody against human desmin (D33, Dako) for 1 h at 37°C and treated with a secondary antibody conjugated with Rhodamine (Santa Cruz, Santa Cruz, CA, USA). After washing with phosphate-buffed saline, the transfected cells were see more analysed by confocal immunofluorescence microscopy. A total of 41 patients (20 men and 21 women) were from five families with an autosomal dominant inherited pattern and two cases were sporadic (Supporting Information). Among the 16 deceased patients, apart from

one patient who died of lung cancer at 63 years of age, 15 died of cardiac Dimethyl sulfoxide failure or a presumed heart attack between 25 and 55 years of age. The age of onset in 25 living patients ranged from 13 to 45 years (mean 34 years), but only two patients developed symptoms before 20 years of age (Table 1). The onset symptoms were limb weakness in 18 patients (18/25, 72%), cardiac abnormalities in six patients (6/25, 24%) and chronic painless diarrhoea in one patient (1/25, 4%). With development of the disease, 24 patients (24/25, 96%) had cardiac involvement. The syndrome development patterns were subdivided as follows: 18 patients first had skeletal myopathy, followed by cardiomyopathy; one patient first presented with cardiomyopathy, followed by skeletal myopathy; one patient first manifested with skeletal myopathy, followed by respiratory difficulty; five patients presented with isolated cardiomyopathy. The age of 25 patients alive at diagnosis time varied from 18 to 65 years (mean 46 years).