Missense mutations have unexpected consequences: The McArdle disease paradigm

Inés García-Consuegra, Sara Asensio-Peña, Alfonsina Ballester-Lopez, Rosario Francisco-Velilla, Tomás Pinos, Guillem Pintos-Morell, Jaume Coll-Cantí, Adrián González-Quintana, Antoni L. Andreu, Joaquín Arenas, Alejandro Lucia, Gisela Nogales-Gadea, Miguel A. Martín

Research output: Contribution to journalArticleResearch

5 Citations (Scopus)


© 2018 Wiley Periodicals, Inc. McArdle disease is a disorder of muscle glycogen metabolism caused by mutations in the PYGM gene, encoding for the muscle-specific isoform of glycogen phosphorylase (M-GP). The activity of this enzyme is completely lost in patients’ muscle biopsies, when measured with a standard biochemical test which, does not allow to determine M-GP protein levels. We aimed to determine M-GP protein levels in the muscle of McArdle patients, by studying biopsies of 40 patients harboring a broad spectrum of PYGM mutations and 22 controls. Lack of M-GP protein was found in muscle in the vast majority (95%) of patients, irrespective of the PYGM genotype, including those carrying missense mutations, with few exceptions. M-GP protein biosynthesis is not being produced by PYGM mutations inducing premature termination codons (PTC), neither by most PYGM missense mutations. These findings explain the lack of PYGM genotype–phenotype correlation and have important implications for the design of molecular-based therapeutic approaches.
Original languageEnglish
Pages (from-to)1338-1343
JournalHuman Mutation
Publication statusPublished - 1 Oct 2018


  • genotype–phenotype correlation
  • McArdle disease
  • missense mutations
  • muscle glycogen phosphorylase


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