Distribution of RET proto‐oncogene variants in children with appendicitis

• Published in: Molecular genetics & genomic medicine Vol. 10; no. 2; pp. e1864 - n/a
• Main Authors: Schultz, Jurek, Freibothe, Ines, Haase, Michael, Glatte, Patrick, Barreton, Gustavo, Ziegler, Andreas, Görgens, Heike, Fitze, Guido
• Format: Journal Article
• Language: English
• Published: United States John Wiley & Sons, Inc 01.02.2022; John Wiley and Sons Inc; Wiley
• Subjects: Appendectomy; Appendicitis; Appendicitis - genetics; Blood & organ donations; Children; Deoxyribonucleic acid; DNA; DNA sequencing; Etiology; Families & family life; Family medical history; Gangrene; Gene expression; Gene loci; general surgery; genetic association studies; Genotype & phenotype; Heterogeneity; Hirschsprung Disease - genetics; Humans; Immune response; Kinases; Mutation; Oncogenes; Original; Paraffin; Paraffins; Patients; pediatrics; Peripheral blood; Peristalsis; Phenotypes; Population; Proto-Oncogene Mas; Proto-Oncogene Proteins - genetics; Proto-Oncogene Proteins c-ret - genetics; Proto-Oncogenes; proto‐oncogene protein ret; Ret protein; general surgery; appendicitis; proto-oncogene protein ret; genetic association studies; pediatrics
• ISSN: 2324-9269; 2324-9269
• DOI: 10.1002/mgg3.1864

Background In addition to patient‐related systemic factors directing the immune response, the pathomechanisms of appendicitis (AP) might also include insufficient drainage leading to inflammation caused by decreased peristalsis. Genetic predisposition accounts for 30%–50% of AP. M. Hirschsprung (HSCR), also characterized by disturbed peristalsis, is associated with variants in the RET proto‐oncogene. We thus hypothesized that RET variants contribute to the etiology of AP. Methods DNA from paraffin‐embedded appendices and clinical data of 264 children were analyzed for the RET c.135A>G variant (rs1800858, NC_000010.11:g.43100520A>G). In 46 patients with gangrenous or perforated AP (GAP), peripheral blood DNA was used for RET sequencing. Results Germline mutations were found in 13% of GAP, whereas no RET mutations were found in controls besides the benign variant p.Tyr791Phe (NC_000010.11:g.43118460A>T). In GAP, the polymorphic G‐allele in rs2435352 (NC_000010.11:g.43105241A>G) in intron 4 was underrepresented (p = 0.0317). Conclusion Our results suggest an impact of the RET proto‐oncogene in the etiology of AP. Mutations were similar to patients with HSCR but no clinical features of HSCR were observed. The pathological phenotypes in both populations might thus represent a multigenic etiology including RET germline mutations with phenotypic heterogeneity and incomplete penetrance. In a case–control study, we found germline variants in 13% of gangrenous appendicitis, and the polymorphic G‐allele in rs2435352 (NC_000010.11:g.43105241A>G) in intron 4 was underrepresented (p = 0.0317). Like in Hirschsprung's disease, the RET germline variants in acute appendicitis might represent a multigenic etiology with phenotypic heterogeneity and incomplete penetrance.