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De Luca A, Bottillo I, Sarkozy A, Carta C, Neri C, Bellacchio E, Schirinzi A, Conti E, Zampino G, Battaglia A, Majore S, Rinaldi MM, Carella M, Marino B, Pizzuti A, Digilio MC, Tartaglia M, Dallapiccola B. NF1 gene mutations represent the major molecular event underlying neurofibromatosis-Noonan syndrome. Am J Hum Genet 2005; 77:1092-101. [PMID: 16380919 PMCID: PMC1285166 DOI: 10.1086/498454] [Citation(s) in RCA: 107] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Accepted: 09/23/2005] [Indexed: 11/03/2022] Open
Abstract
Neurofibromatosis type 1 (NF1) demonstrates phenotypic overlap with Noonan syndrome (NS) in some patients, which results in the so-called neurofibromatosis-Noonan syndrome (NFNS). From a genetic point of view, NFNS is a poorly understood condition, and controversy remains as to whether it represents a variable manifestation of either NF1 or NS or is a distinct clinical entity. To answer this question, we screened a cohort with clinically well-characterized NFNS for mutations in the entire coding sequence of the NF1 and PTPN11 genes. Heterozygous NF1 defects were identified in 16 of the 17 unrelated subjects included in the study, which provides evidence that mutations in NF1 represent the major molecular event underlying this condition. Lesions included nonsense mutations, out-of-frame deletions, missense changes, small inframe deletions, and one large multiexon deletion. Remarkably, a high prevalence of inframe defects affecting exons 24 and 25, which encode a portion of the GAP-related domain of the protein, was observed. On the other hand, no defect in PTPN11 was observed, and no lesion affecting exons 11-27 of the NF1 gene was identified in 100 PTPN11 mutation-negative subjects with NS, which provides further evidence that NFNS and NS are genetically distinct disorders. These results support the view that NFNS represents a variant of NF1 and is caused by mutations of the NF1 gene, some of which have been demonstrated to cause classic NF1 in other individuals.
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Affiliation(s)
- Alessandro De Luca
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Irene Bottillo
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Anna Sarkozy
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Claudio Carta
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Cinzia Neri
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Emanuele Bellacchio
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Annalisa Schirinzi
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Emanuela Conti
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Giuseppe Zampino
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Agatino Battaglia
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Silvia Majore
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Maria M. Rinaldi
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Massimo Carella
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Bruno Marino
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Antonio Pizzuti
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Maria Cristina Digilio
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Marco Tartaglia
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
| | - Bruno Dallapiccola
- CSS Hospital, IRCCS, San Giovanni Rotondo and CSS-Mendel Institute, Department of Experimental Medicine and Pathology and Section of Pediatric Cardiology, Department of Pediatrics, University “La Sapienza,” Dipartimento di Biologia Cellulare e Neuroscienze, Istituto Superiore di Sanità, Istituto di Clinica Pediatrica, Università Cattolica del Sacro Cuore, AO San Camillo-Forlanini, and Medical Genetics, Bambino Gesù Hospital, IRCCS, Rome; Stella Maris Scientific Research Institute, Calambrone, Pisa; Genetica Medica, Ospedale Cardarelli, Naples, Italy; and Department of Pediatrics, Mount Sinai School of Medicine, New York
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