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From screening to strategy: Clinical implications of COL4A3/COL4A4 variants found in reproductive genetic testing 从筛选到策略:在生殖基因检测中发现COL4A3/COL4A4变异的临床意义
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-27 DOI: 10.1038/s41431-025-01953-3
Gráinne Butler, David J. Amor, Catherine Quinlan
Reproductive genetic carrier screening (RGCS) is expanding in both public and private healthcare. The primary aim is to identify carrier status for genetic disorders, inform reproductive decision making and promote reproductive autonomy. As screening panels have increased, the potential for findings with personal health implications rises. We report the prevalence of COL4A3/COL4A4 heterozygous variants within a population undergoing RGCS in a private setting and propose a comprehensive management plan for the ongoing care of this patient cohort. Acknowledging that comprehensive guidelines exist for genetic testing and management of Alport syndrome as a broad patient group, this communication seeks to highlight the increasingly common finding of autosomal dominant Alport syndrome and proposes accessible and practical strategies for the clinicians encountering these patients.
生殖遗传载体筛查(RGCS)在公共和私人医疗保健中都在扩大。主要目的是识别遗传疾病的携带者状态,为生殖决策提供信息,促进生殖自主。随着筛查小组的增加,对个人健康影响的潜在发现也在增加。我们报告了COL4A3/COL4A4杂合变异体在私人环境中接受RGCS的人群中的患病率,并为该患者队列的持续护理提出了综合管理计划。鉴于Alport综合征作为一个广泛的患者群体存在着全面的基因检测和管理指南,本文旨在强调常染色体显性Alport综合征日益普遍的发现,并为遇到这些患者的临床医生提出可获得和实用的策略。
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引用次数: 0
PKD1 5’UTR variants are a rare cause of disease in ADPKD and suggest a new focus for therapeutic development PKD1 5'UTR变异体是ADPKD中一种罕见的病因,提示了治疗发展的新焦点。
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-26 DOI: 10.1038/s41431-025-01949-z
Laura Wedd, Yvonne Hort, Chirag Patel, John A. Sayer, Rocio Rius, Andrew J. Mallett, Denny L. Cottle, Ian M. Smyth, Timothy Furlong, John Shine, Amali Mallawaarachchi
Autosomal Dominant Polycystic Kidney Disease (ADPKD), caused by pathogenic variants in PKD1 and PKD2, is the most common monogenic cause of kidney failure. Approximately 10% of ADPKD patients remain undiagnosed after coding-region focused genomic testing. Non-coding variants in regulatory regions are not an established cause of disease in ADPKD. We performed regulatory region analysis in a primary cohort of undiagnosed ADPKD patients (n = 20) and then extended this analysis to patients with undiagnosed cystic kidney disease within the Australian KidGen cohort (n = 42) and the Genomics England rare disease cohort (n = 1320). Through this genomic analysis we identified two rare, potentially disease-causing variants in the PKD1 5′untranslated region (UTR). We then designed a PKD1 5′UTR-luciferase translation assay to characterise these variants in vitro, which showed that a PKD1 variant c.−69dupG, reduced the translation efficiency of the main PKD1 open reading frame by ~87% compared to wildtype (p < 0.0001). The human PKD1 5′UTR contains two upstream open reading frames (uORFs). Using our model, we knocked-out the upstream open reading frames of the wildtype PKD1 5′UTR sequence, which increased expression of wildtype polycystin-1 (130%, p < 0.0001). We show that PKD1 5′-UTR variants are a currently overlooked rare cause of disease in ADPKD and that analysis of this region should be included in variant analysis pathways to increase diagnostic rates. In addition, we show that manipulation of the wildtype 5′UTR sequence can increase polycystin-1 expression, providing insights into regulation of PKD1 and suggested new approaches for therapeutic intervention in this haplo-insufficient disease.
常染色体显性多囊肾病(ADPKD)由PKD1和PKD2的致病变异引起,是肾衰竭最常见的单基因原因。大约10%的ADPKD患者在编码区集中的基因组检测后仍未被诊断出来。调控区域的非编码变异不是ADPKD的确定病因。我们在未确诊的ADPKD患者的主要队列(n = 20)中进行了调控区分析,然后将该分析扩展到澳大利亚KidGen队列(n = 42)和Genomics England罕见疾病队列(n = 1320)中未确诊的囊性肾病患者。通过基因组分析,我们在PKD1 5'非翻译区(UTR)发现了两种罕见的潜在致病变异。然后,我们设计了PKD1 5' utr -荧光素酶翻译实验来表征这些体外变异,结果表明PKD1变异c - 69dupg与野生型相比,使PKD1主开放阅读框的翻译效率降低了约87% (p
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引用次数: 0
A heterozygous 9q34 deletion encompassing SPTAN1 as a cause of distal myopathy 包含SPTAN1的9q34杂合缺失是远端肌病的原因。
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-25 DOI: 10.1038/s41431-025-01938-2
Liedewei Van de Vondel, Jonathan De Winter, Alice Monticelli, Natacha Camacho, Tine Deconinck, Katrien Janssens, Goedele Malfroid, Alicia Alonso-Jiménez, German Demidov, Steven Laurie, Willem De Ridder, Biljana Ermanoska, Vincent Timmerman, Jonathan Baets
We report a family affected with childhood onset distal muscle weakness with a heterozygous chromosome 9q34 deletion encompassing the SPTAN1 gene. The deletion was detected through exome-sequencing based copy number variant (CNV) detection, segregates in four patients and is non-penetrant in two other relatives. Electromyography, muscle MRI and muscle biopsy revealed a myopathic disease phenotype. Cellular consequences of the deletion were investigated using qPCR and western blotting on patient-derived fibroblasts, which revealed a reduction of RNA but not protein levels. Immunocytochemistry was performed on muscle tissue which did not reveal reduction of α-II-spectrin. SPTAN1 loss-of-function variants have previously been reported to cause distal hereditary motor neuropathy and recently distal myopathy. Here, we confirm the role of SPTAN1 haploinsufficiency as a cause of distal myopathy. We propose an age-dependent lack of α-II-spectrin and suggest CNV detection in repurposed exome sequencing as an important diagnostic tool.
我们报告了一个患有儿童期远端肌无力的家族,其中包含SPTAN1基因的杂合染色体9q34缺失。该缺失是通过基于外显子组测序的拷贝数变异(CNV)检测检测到的,在4名患者中分离,在另外2名亲属中非渗透。肌电图,肌肉MRI和肌肉活检显示肌病表型。使用qPCR和western blotting对患者来源的成纤维细胞研究了缺失的细胞后果,结果显示RNA减少,但蛋白质水平没有减少。肌肉组织免疫细胞化学未发现α- ii -谱素减少。SPTAN1功能丧失变异曾被报道引起远端遗传性运动神经病变和最近的远端肌病。在这里,我们证实SPTAN1单倍体功能不全是远端肌病的一个原因。我们提出了α- ii -谱蛋白的年龄依赖性缺乏,并建议在重定向外显子组测序中检测CNV作为重要的诊断工具。
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引用次数: 0
Pharmacogenomics in drug therapy: global regulatory guidelines for managing high-risk drug reactions 药物治疗中的药物基因组学:管理高风险药物反应的全球监管指南。
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-24 DOI: 10.1038/s41431-025-01950-6
Safa Omran, Siew Hua Gan, Siew Li Teoh
Pharmacogenomics is rapidly transforming precision medicine, yet regulatory policies governing its implementation vary widely across countries. This review aims to provide a global perspective on pharmacogenomics guidelines, with a particular focus on high-risk drug reactions such as carbamazepine therapy-induced severe cutaneous adverse reactions. Carbamazepine was selected as a representative example due to its inclusion on the World Health Organization’s essential medicines list and its well-documented association with high-risk alleles, which are linked to severe cutaneous adverse reactions such as Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis—conditions with significant mortality rates. Two databases, Overton and Dimensions, were searched to identify relevant national guidelines and policy documents in English. Countries were identified based on document availability and access to governmental sources. The review revealed that all examined countries recognized genetic variation in carbamazepine response within their guidelines, showing notable consistency. However, religious implications related to pharmacogenomics were largely absent. The findings also indicated a growing global momentum toward integrating pharmacogenomics into healthcare systems, although the depth and scope of regulation differ. The United States stands out for its comprehensive pharmacogenomics policy framework, which extends to clinical and industry settings. Lessons from the U.S. model can inform policy development in other regions, tailored to each country’s healthcare infrastructure and cultural context. In conclusion, global harmonization of pharmacogenomics policies is essential to foster international collaboration, enable data sharing, and enhance the safe and equitable implementation of pharmacogenomics in clinical practice.
药物基因组学正在迅速改变精准医疗,但各国实施药物基因组学的监管政策差异很大。本综述旨在提供药物基因组学指南的全球视角,特别关注高风险药物反应,如卡马西平治疗引起的严重皮肤不良反应。卡马西平被选为一个代表性的例子,因为它被列入世界卫生组织的基本药物清单,并且有充分证据表明它与高风险等位基因有关,这些等位基因与严重的皮肤不良反应有关,如史蒂文斯-约翰逊综合征和中毒性表皮坏死松解,这些情况具有很高的死亡率。检索了两个数据库,即Overton和Dimensions,以确定相关的英文国家准则和政策文件。根据文件的可得性和获得政府来源的机会确定了国家。审查结果显示,所有被检查的国家都在其指导方针内承认卡马西平反应的遗传变异,显示出显著的一致性。然而,与药物基因组学相关的宗教含义在很大程度上是缺席的。研究结果还表明,将药物基因组学整合到医疗保健系统的全球势头正在增长,尽管监管的深度和范围有所不同。美国因其全面的药物基因组学政策框架而脱颖而出,该框架延伸到临床和工业环境。美国模式的经验教训可以为其他地区的政策制定提供参考,并根据每个国家的医疗基础设施和文化背景进行调整。总之,药物基因组学政策的全球协调对于促进国际合作、实现数据共享以及加强药物基因组学在临床实践中的安全和公平实施至关重要。
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引用次数: 0
LNKing genotype to phenotype: the expanding clinical spectrum of SH2B3 disorders. 连接基因型与表型:扩大SH2B3疾病的临床谱。
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-23 DOI: 10.1038/s41431-025-01942-6
Enrico Attardi, Marcin W Wlodarski
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引用次数: 0
Expanding the molecular spectrum of aggrecanopathies: exploring 24 patients with ACAN significant variants 扩大聚集性病变的分子谱:探索24例ACAN显著变异患者。
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-23 DOI: 10.1038/s41431-025-01943-5
Melek Trigui, Nathalie Pallares-Ruiz, David Geneviève, Cyril Amouroux, Thomas Edouard, Sabine Sigaudy, Marjolaine Willems, Mouna Barat-Houari
Short stature is a prevalent clinical manifestation in children. While certain causes of short stature can be readily identifiable through routine biological tests, often physicians struggle to ascertain any underlying pathogenic cause, resulting in the diagnosis of idiopathic short stature (ISS). Aggrecan, encoded by ACAN, plays a crucial role in cartilage function and bone growth. The aim of our study is to establish a genotype-phenotype correlation in 24 patients carrying distinct ACAN variants. We conducted a panel-based analysis, including 82 genes associated with genetic skeletal disorders and/or short stature, in 388 French patients who consulted for short stature and/or or skeletal features. Genotype-phenotype correlation analysis was performed for all included subjects. Of all positive patients, 24 (≃20%) were found to carry pathogenic or likely pathogenic ACAN variants distributed across the gene, 20 of which had not been previously reported. We report 23 heterozygous cases and one original case with a homozygous SNV. Two patients harboured the same novel nonsense variant, yet exhibited different phenotypes. Familial studies performed in 21 families demonstrated that ACAN variants were inherited in 20 cases. The cohort demonstrated marked phenotypic heterogeneity, even among affected members within the same family. Radiological skeletal abnormalities were observed in 66% of patients. A comprehensive genomic approach is crucial to identify the true proportion of ISS with a monogenic condition. Our results expand the number of pathogenic ACAN variants with their associated phenotypic spectrum. Aggrecanopathies are heterogeneous and particularly frequent in apparently ISS, even without overt skeletal dysplasia.
身材矮小是儿童常见的临床表现。虽然矮小的某些原因可以很容易地通过常规的生物学检查确定,但医生往往很难确定任何潜在的致病原因,从而导致特发性矮小(ISS)的诊断。由ACAN编码的聚集蛋白在软骨功能和骨生长中起着至关重要的作用。我们研究的目的是在24例携带不同ACAN变异的患者中建立基因型-表型相关性。我们对388名因身材矮小和/或骨骼特征就诊的法国患者进行了一项基于小组的分析,包括82个与遗传性骨骼疾病和/或身材矮小相关的基因。对所有纳入的受试者进行基因型-表型相关分析。在所有阳性患者中,24个(20%)被发现携带跨基因的致病性或可能致病性ACAN变异,其中20个以前没有报道过。我们报告了23例杂合子病例和1例纯合子SNV原发病例。两名患者携带相同的新型无义变异,但表现出不同的表型。在21个家庭中进行的家族性研究表明,在20例中遗传了ACAN变异。该队列显示出显著的表型异质性,甚至在同一家族的受影响成员中也是如此。66%的患者出现骨骼影像学异常。一个全面的基因组方法是至关重要的,以确定ISS与单基因条件的真实比例。我们的研究结果扩大了致病性ACAN变异及其相关表型谱的数量。聚集性病变是异质性的,在明显的ISS中尤其常见,即使没有明显的骨骼发育不良。
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引用次数: 0
Toward minimal SNP sets for record-matching with CODIS STR profiles. 朝着与CODIS STR档案记录匹配的最小SNP集的方向发展。
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-22 DOI: 10.1038/s41431-025-01941-7
Tamara Gjorgjieva, Noah A Rosenberg

Genetic record-matching is a technique by which profiles with one set of genetic markers can be queried against databases of profiles with a different set of markers to determine if profiles containing different marker sets trace to the same individual. In forensic genetics, the potential for using genetic record-matching to test single-nucleotide polymorphism (SNP) profiles for genetic matches to short-tandem repeat (STR) profiles could enable development of backward-compatible SNP marker systems to ultimately replace existing forensic STR systems. This study aims to identify minimal SNP sets for achieving record-matching accuracies comparable to those previously observed with tens or hundreds of thousands of SNPs. Using phased SNP-STR reference data in a worldwide panel of individuals, we evaluate record-matching accuracy with SNP sets chosen by each of a variety of SNP selection strategies. When selecting SNPs randomly, ~9000 SNPs are required for achieving record-matching accuracy comparable to that seen with the full SNP set in the "needle-in-haystack" matching scenario, namely 99% of SNP and STR profiles correctly paired with no false-positive identifications in the median accuracy for test sets of size 626 profile pairs. Selecting SNPs based on various thresholds for their minimal minor allele frequency and physical distance to the STR, however, panels of 1800 SNPs, and as few as 900 SNPs, suffice. These results advance toward a potential minimal size for backward-compatible forensic SNP systems that proceed by genetic record-matching.

遗传记录匹配是一种技术,通过该技术,可以将具有一组遗传标记的档案与具有不同标记集的档案数据库进行查询,以确定包含不同标记集的档案是否可追溯到同一个人。在法医遗传学中,利用遗传记录匹配来测试单核苷酸多态性(SNP)谱的潜力,以获得短串联重复序列(STR)谱的遗传匹配,这可能有助于开发向后兼容的SNP标记系统,最终取代现有的法医STR系统。本研究旨在确定最小SNP集,以实现与先前观察到的数万或数十万SNP相媲美的记录匹配准确性。利用全球范围内个体的阶段性SNP- str参考数据,我们评估了由每种SNP选择策略选择的SNP集的记录匹配准确性。在随机选择SNP时,需要约9000个SNP才能达到与“大海捞针”匹配场景中完整SNP集的记录匹配精度,即在626对SNP对的测试集中,99%的SNP和STR图谱正确配对,并且没有假阳性鉴定。然而,根据最小等位基因频率和与STR的物理距离的不同阈值选择SNPs, 1800个SNPs和900个SNPs就足够了。这些结果推进了通过遗传记录匹配进行的向后兼容法医SNP系统的潜在最小尺寸。
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引用次数: 0
Further phenotypical delineation of DLG3-related neurodevelopmental disorders dlg3相关神经发育障碍的进一步表型描述。
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-22 DOI: 10.1038/s41431-025-01937-3
Marlène Malbos, Thierry Gautier, Amelle Shillington, Estelle Colin, Xavier Le Guillou, Oana Caluseriu, Bertrand Isidor, Benjamin Cogné, Cyril Mignot, Boris Keren, Sacha Weber, Clémence Jacquin, Tracy Dudding, Daniel Calame, Juliette Piard, Jonathan Levy, Xenia Latypova, Alain Verloes, Tanguy Niclass, Aurélia Jacquette, Lori White, Marie-Pierre Moizard, Hélène Dollfus, Sébastien Moutton, Julian Delanne, Caroline Racine, Quentin Thomas, Anne-Sophie Denommé-Pichon, Frédéric Tran Mau-Them, Ange-Line Bruel, Hana Safraou, Christophe Philippe, Yannis Duffourd, Christel Thauvin-Robinet, Jérôme Govin, Antonio Vitobello, Laurence Faivre
SAP102, a member of the membrane-associated guanylate kinase proteins family, is a scaffolding protein encoded by the DLG3 gene whose hemizygous variants with loss-of-function effect are associated with X-linked Intellectual developmental disorder 90. We gathered international data from 17 new individuals with 16 different DLG3 variants (10 with pathogenic loss-of-function and 6 variants of uncertain significance), and reviewed genotypic and phenotypic data from 37 previously published families with 34 different variants. Using family segregation, frequency in publication databases, protein structure modelling and in silico prediction scores, we reclassified six missense variants (five from the literature and one common to our cohort and the literature) as likely benign. Among the individuals newly reported with likely pathogenic or pathogenic DLG3 variants, intellectual disability was more frequently associated with morphological features than in the literature, leading to a proposed extension of the associated X-linked intellectual developmental disorder 90 to a more syndromic neurodevelopmental disorder. In conclusion, we provide here an international clinical series of novel individuals with DLG3 variants in order to better define the clinical and molecular spectrum associated with this condition, and a review of the literature.
SAP102是膜相关鸟苷酸激酶蛋白家族的成员,是一种由DLG3基因编码的支架蛋白,其具有功能丧失效应的半合子变异与x连锁智力发育障碍相关。我们收集了来自17个具有16种不同DLG3变体的新个体的国际数据(10个具有致病性功能丧失,6个具有不确定意义的变体),并回顾了来自37个先前发表的具有34种不同变体的家族的基因型和表型数据。利用家族分离、出版数据库中的频率、蛋白质结构建模和计算机预测评分,我们将6种错义变体(5种来自文献,1种来自我们的队列和文献)重新分类为可能是良性的。在新近报道的可能具有致病性或致病性DLG3变异的个体中,智力残疾比文献中更多地与形态学特征相关,导致相关的x连锁智力发育障碍90延伸为更具综合征性的神经发育障碍。总之,我们在这里提供了一个新的DLG3变异个体的国际临床系列,以便更好地定义与该疾病相关的临床和分子谱,并对文献进行了回顾。
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引用次数: 0
Older research participants are motivated to receive genetic results for the benefit of younger relatives. 年长的研究参与者为了年轻的亲属的利益而获得基因结果。
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-22 DOI: 10.1038/s41431-025-01940-8
Amanda M Willis, Florence Chiew, Philomena Horsley, Sommon Klumsathian, Ezekiel Ling, Chris Jacobs, Paul Lacaze, Jane Tiller, Mary-Anne Young

The benefit of returning medically actionable genetic research findings is widely recognised. However, there is uncertainty regarding the return of results to older people (>70 years), given the reduced actionability in this age group. The goal of this study was to assess whether older people were motivated to receive genetic results, primarily for the benefit of younger relatives. Semi-structured interviews were conducted with individuals aged ≥70 enrolled in the ASPirin in Reducing Events in the Elderly (ASPREE) study. Participants received medically actionable genetic results in Hereditary Breast and Ovarian Cancer, Lynch syndrome or Familial Hypercholesterolaemia genes. Data were analysed using reflexive thematic analysis. Sixteen individuals were interviewed (mean age 82 years). While participants recognised the limited actionability of the genetic results for themselves, the perceived benefits for younger family members motivated them to receive genetic findings and share with relatives. Participants reported positive experiences of receiving genetic results, underpinned by their existing relationship with the ASPREE trial, and reported that their age promoted their adaptation to results. These findings illustrate positive impact from returning genetic research results to older research participants and suggest that older people desire genetic information to benefit their younger family members.

将医学上可行的基因研究成果返回的好处已得到广泛认可。然而,考虑到老年人(70岁以下)的可操作性降低,对老年人的结果返回存在不确定性。这项研究的目的是评估老年人是否有动力接受遗传结果,主要是为了年轻亲属的利益。对参加阿司匹林减少老年人事件(ASPREE)研究的年龄≥70岁的个体进行半结构化访谈。参与者获得了遗传性乳腺癌和卵巢癌、Lynch综合征或家族性高胆固醇血症基因的医学上可操作的遗传结果。数据分析采用反身性主题分析。16人接受了访谈(平均年龄82岁)。虽然参与者认识到基因结果对自己的可操作性有限,但对年轻家庭成员的感知好处促使他们接受基因发现并与亲戚分享。参与者报告了接受基因结果的积极经历,这得到了他们与ASPREE试验现有关系的支持,并报告说他们的年龄促进了他们对结果的适应。这些发现说明了将基因研究成果回馈给老年研究参与者的积极影响,并表明老年人希望遗传信息有利于他们年轻的家庭成员。
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引用次数: 0
PIGC-related encephalopathy: Lessons learned from 18 new probands pigc相关脑病:18例新先证者的经验教训
IF 4.6 2区 生物学 Q2 BIOCHEMISTRY & MOLECULAR BIOLOGY Pub Date : 2025-09-17 DOI: 10.1038/s41431-025-01923-9
Allan Bayat, Maria Carla Borroto, Smrithi Salian, Maha S. Zaki, Hind Benkerroum, Hasnaa M. Elbendary, Thi Tuyet Mai Nguyen, Abdelrahim A. Sadek, Diana Carli, Alfredo Brusco, Giovanni Battista Ferrero, Marco Tartaglia, Eleanor Hay, Ilona Krey, Rami A. Jamra, Tobias Bartolomaeus, Alexej Knaus, Joseph G. Gleeson, Henry Houlden, Natalia Dominik, Adam Jackson, Sofia Douzgou Houge, Siddharth Banka, Javad Mohammadi-asl, Mohammadreza Hajjari, Reza Azizimalamiri, Pardis Nourbakhsh, Mostafa Neissi, Annarita Scardamaglia, Dianfan Li, Taroh Kinoshita, Reza Maroofian, Yoshiko Murakami, Philippe M. Campeau
PIGC encodes a protein essential for the biosynthesis of glycophosphatidylinositol-anchored proteins (GPI-APs). So far, three families with biallelic PIGC variants have been reported to exhibit developmental delay/intellectual disability and seizures. Our aim was to further elucidate the clinical and biomolecular characteristics of PIGC pathogenic or likely pathogenic variants. We established a cohort of 18 previously unreported probands. Clinical data were collected, and causative variants were identified though genome/exome sequencing. Variants were modelled in silico using AlphaFold2. Flow cytometry was performed to analyze the cell-surface expression of GPI-APs. The probands displayed a severe neurodevelopmental disorder characterized by developmental and cognitive impairment, early-onset and treatment-resistant seizures, and premature death affecting 10 out of 18 individuals (median age of 40 months, ranging from 40 days to 7 years). Additional features included brain imaging abnormalities (14/15), hypotonia (15/18), and skeletal anomalies (5/17). One patient exhibited mildly elevated alkaline phosphatase levels. All harbored biallelic PIGC variants, with 14 out of 18 of those being homozygous variants. Analysis of samples derived from probands and cellular models showed reduced cell surface levels of GPI-APs. This study confirms the association of PIGC biallelic variants with refractory seizures, severe developmental and cognitive impairments, and highlights their association with childhood-onset mortality. Additionally, it shows that dysfunctional PIGC results in defective biosynthesis of GPI-AP.
PIGC编码糖磷脂酰肌醇锚定蛋白(GPI-APs)生物合成所必需的蛋白质。到目前为止,据报道有三个双等位基因PIGC变异的家庭表现出发育迟缓/智力残疾和癫痫发作。我们的目的是进一步阐明PIGC致病性或可能致病性变异的临床和生物分子特征。我们建立了一个18个以前未报道的先证者的队列。收集临床资料,通过基因组/外显子组测序鉴定致病变异。变体使用AlphaFold2在计算机上建模。流式细胞术检测GPI-APs细胞表面表达情况。先证者表现出严重的神经发育障碍,其特征是发育和认知障碍,早发性和治疗抵抗性癫痫发作,18人中有10人过早死亡(中位年龄为40个月,从40天到7岁不等)。其他特征包括脑成像异常(14/15)、张力低下(15/18)和骨骼异常(5/17)。1例患者碱性磷酸酶水平轻度升高。所有人都携带双等位基因的PIGC变体,其中18个中有14个是纯合变体。先证者和细胞模型的样本分析显示,GPI-APs的细胞表面水平降低。这项研究证实了PIGC双等位基因变异与难治性癫痫发作、严重发育和认知障碍的关联,并强调了它们与儿童期发病死亡率的关联。此外,这表明功能失调的PIGC会导致GPI-AP的生物合成缺陷。
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European Journal of Human Genetics
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