Try it
Biochemistry · Genetics: cystic fibrosis CFTR mutation
Sample itemA 2-year-old child with recurrent chest infections and steatorrhoea has a sweat chloride of 90 mmol/L. Genotyping shows homozygosity for the deltaF508 mutation. What is the effect of this mutation on the CFTR protein?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Misfolding with retention in the endoplasmic reticulum and degradation, so little reaches the cell surface
DeltaF508 is a 3-base-pair in-frame deletion removing phenylalanine at position 508, the most common CFTR mutation. The abnormal protein misfolds and is degraded by the proteasome after endoplasmic reticulum quality control, so the chloride channel is absent from the apical membrane (a class II defect). CFTR correctors such as elexacaftor and tezacaftor improve its folding and trafficking, and ivacaftor potentiates channel opening.
Option by option
A. Complete absence of the CFTR gene on chromosome 7
The gene is present in deltaF508 homozygotes and carries a small deletion.
B. Misfolding with retention in the endoplasmic reticulum and degradation, so little reaches the cell surface (correct)
Impaired folding and trafficking cause loss of surface channels.
C. Production of a normal protein with a defective chloride channel pore
A channel with a defective pore describes a gating or conductance mutation, not deltaF508.
D. Overproduction of CFTR with excessive chloride secretion
Chloride secretion is reduced in cystic fibrosis, not excessive.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
More Biochemistry questions
- Nucleotide metabolismA 4-year-old boy has intellectual disability, dystonia, self-mutilation and hyperuricaem…
- VitaminsA patient with megaloblastic anaemia and mild neurological signs has raised serum methyl…
- Amino acid metabolismA baby has a mousy odour, fair skin and developmental delay. Which enzyme is deficient?
- Glycogen storage diseasesA child has severe fasting hypoglycaemia, hepatomegaly, lactic acidosis and hyperuricaem…