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ADVIRC is caused by distinct mutations in BEST1 that alter pre-mRNA splicing
  1. R Burgess1,
  2. R E MacLaren2,3,
  3. A E Davidson1,
  4. J E Urquhart1,
  5. G E Holder2,3,
  6. A G Robson2,3,
  7. A T Moore2,3,
  8. R O’ Keefe4,
  9. G C M Black1,5,
  10. F D C Manson1,5
  1. 1
    Genetic Medicine, University of Manchester, Manchester Academic Heath Science Centre, Central Manchester University Hospitals NHS Foundation Trust, St. Mary's Hospital, Manchester, UK
  2. 2
    Moorfields Eye Hospital, London, UK
  3. 3
    Institute of Ophthalmology, University College London, London, UK
  4. 4
    Faculty of Life Sciences, The University of Manchester, Manchester, UK
  5. 5
    Manchester Royal Eye Hospital, University of Manchester, Manchester Academic Heath Science Centre, University Hospitals NHS Foundation Trust, Manchester, UK
  1. Correspondence to Dr F Manson, AV Hill Building room 1,002. The University of Manchester, Oxford Road, Manchester, M13 9PT, UK; forbes.manson{at}


Autosomal dominant vitreoretinochoroidopathy (ADVIRC), a retinal dystrophy often associated with glaucoma and cataract, forms part of a phenotypic spectrum of ‘bestrophinopathies’. It has been shown previously that ADVIRC results from BEST1 mutations that cause exon skipping and lead to the production of shortened and internally deleted isoforms. This study describes a novel ADVIRC mutation and show that it disrupts an exonic splice enhancer (ESE) site, altering the binding of a splicing-associated SR protein. As with previous ADVIRC mutations, the novel c.704T→C mutation in exon 6 altered normal splicing in an ex vivo splicing assay. Both this and another exon 6 ADVIRC-causing mutation (c.707G→A) either weakened or abolished splicing in an ESE-dependent splice assay compared with a nearby exon 6 mutation associated with Best disease (c.703G→C). Gel shift assays were undertaken with RNA oligonucleotides encompassing the ADVIRC and Best disease mutations with four of the most commonly investigated SR proteins. Although SC35, SRp40 and SRp55 proteins all bound to the wild-type and mutated sequences with similar intensities, there was increased binding of ASF/SF2 to the two ADVIRC-mutated sequences compared with the wild-type or Best disease-mutated sequences. The exon skipping seen for these two exon 6 ADVIRC mutations and their affinity for ASF/SF2 suggests that the region encompassing these mutations may form part of a CERES (composite exonic regulatory elements of splicing) site.

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  • Funding Wellcome Trust (GR067443MA to RB); National Eye Research Centre (SCIAD051 to AD); EVI-Genoret and Foundation Fighting Blindness USA (to ATM); Manchester Biomedical Research Centre; Manchester Academic Health Sciences Centre (MAHSC) and the NIHR Manchester Biomedical Research Centre.

  • Competing interests None.

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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