The ataxia-telangiectasia mutated (ATM) gene, which is mutated in the
autosomal recessive disorder ataxia-telangiectasia (AT), was isolated
in 1995 by positional cloning Although in vitro cell fusion studies ha
d suggested that AT was genetically heterogeneous, all AT patients stu
died to date have been found to harbor mutations in the ATM gene. More
than 100 ATM mutations occurring in AT patients have been documented.
The mutations are broadly distributed throughout the ATM gene. Except
for patients from families with known consanguinity, most AT patients
are compound heterozygotes. The majority (>70%) of mutations are pred
icted to lead to protein truncation. A significant number of the repor
ted mutations affect mRNA splicing with at least half of the coding ex
ons (32/62) having been observed to undergo exon skipping. The large s
ize of the ATM gene, 66 exons spanning similar to 150 kb of genomic DN
A, together with the diversity and broad distribution of mutations in
AT patients greatly limits the utility of direct mutation screening as
a diagnostic tool, or method of carrier identification, except where
founder effect mutations are involved. (C) 1997 Wiley-Liss, Inc.