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Miranda V, Sabeh P, Seiltgens C, Molidperee S, Janelle C, Lemyre E, Campeau PM. Mild phenotypes in patients with different deletions in the 3' enhancer region of SHOX. Eur J Hum Genet 2024:10.1038/s41431-024-01646-3. [PMID: 38914686 DOI: 10.1038/s41431-024-01646-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 04/06/2024] [Accepted: 06/08/2024] [Indexed: 06/26/2024] Open
Abstract
Haploinsufficiency of the short stature homeobox-containing (SHOX) gene leads to a phenotypic spectrum ranging from Leri-Weill dyschondrosteosis (LWD) to SHOX-deficient short stature. SHOX nullizygosity leads to Langer mesomelic dysplasia. Pathogenic variants can include whole or partial gene deletions or duplications, point mutations within the coding sequence, and deletions of upstream and downstream regulatory elements. Here we report two families: a non-consanguineous family with a deletion downstream of SHOX, in which the homozygous proband presented with isolated Madelung deformity, without LWD or short stature, as well as a 9-year-old girl with Madelung deformities, mesomelia, a dominant family history of Madelung deformity and a heterozygous deletion of the CNE9 region in the 3' downstream region of SHOX. These case reports provide additional information on the effects of 3' downstream deletions of SHOX, by demonstrating the limited phenotype associated with the recurrent 47.5 kb deletion in a homozygous state and the CNE9 deletion in a heterozygous state.
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Affiliation(s)
- Valancy Miranda
- Shriners Hospital for Children, Montreal, QC, Canada
- Sainte Justine University Health Centre, Montreal, QC, Canada
| | - Pascale Sabeh
- Sainte Justine University Health Centre, Montreal, QC, Canada
| | | | | | - Chantal Janelle
- Shriners Hospital for Children, Montreal, QC, Canada
- Sainte Justine University Health Centre, Montreal, QC, Canada
| | | | - Philippe M Campeau
- Shriners Hospital for Children, Montreal, QC, Canada.
- Sainte Justine University Health Centre, Montreal, QC, Canada.
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Allou L, Mundlos S. Disruption of regulatory domains and novel transcripts as disease-causing mechanisms. Bioessays 2023; 45:e2300010. [PMID: 37381881 DOI: 10.1002/bies.202300010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 05/24/2023] [Accepted: 06/06/2023] [Indexed: 06/30/2023]
Abstract
Deletions, duplications, insertions, inversions, and translocations, collectively called structural variations (SVs), affect more base pairs of the genome than any other sequence variant. The recent technological advancements in genome sequencing have enabled the discovery of tens of thousands of SVs per human genome. These SVs primarily affect non-coding DNA sequences, but the difficulties in interpreting their impact limit our understanding of human disease etiology. The functional annotation of non-coding DNA sequences and methodologies to characterize their three-dimensional (3D) organization in the nucleus have greatly expanded our understanding of the basic mechanisms underlying gene regulation, thereby improving the interpretation of SVs for their pathogenic impact. Here, we discuss the various mechanisms by which SVs can result in altered gene regulation and how these mechanisms can result in rare genetic disorders. Beyond changing gene expression, SVs can produce novel gene-intergenic fusion transcripts at the SV breakpoints.
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Affiliation(s)
- Lila Allou
- RG Development & Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
- Institute for Medical and Human Genetics, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan Mundlos
- RG Development & Disease, Max Planck Institute for Molecular Genetics, Berlin, Germany
- Institute for Medical and Human Genetics, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Vodopiutz J, Steurer LM, Haufler F, Laccone F, Garczarczyk-Asim D, Hilkenmeier M, Steinbauer P, Janecke AR. Leri-Weill Dyschondrosteosis Caused by a Leaky Homozygous SHOX Splice-Site Variant. Genes (Basel) 2023; 14:genes14040877. [PMID: 37107635 PMCID: PMC10138022 DOI: 10.3390/genes14040877] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/01/2023] [Accepted: 04/04/2023] [Indexed: 04/29/2023] Open
Abstract
SHOX deficiency is a common genetic cause of short stature of variable degree. SHOX haploinsufficiency causes Leri-Weill dyschondrosteosis (LWD) as well as nonspecific short stature. SHOX haploinsufficiency is known to result from heterozygous loss-of-function variants with pseudo-autosomal dominant inheritance, while biallelic SHOX loss-of-function variants cause the more severe skeletal dysplasia, Langer mesomelic dyschondrosteosis (LMD). Here we report for the first time the pseudo-autosomal recessive inheritance of LWD in two siblings caused by a novel homozygous non-canonical, leaky splice-site variant in intron 3 of SHOX: c.544+5G>C. Transcript analyses in patient-derived fibroblasts showed homozygous patients to produce approximately equal amounts of normally spliced mRNA and mRNA with the abnormal retention of intron 3 and containing a premature stop codon (p.Val183Glyfs*31). The aberrant transcript was shown to undergo nonsense-mediated mRNA decay, and thus resulting in SHOX haploinsufficiency in the homozygous patient. Six healthy relatives who are of normal height are heterozygous for this variant and fibroblasts from a heterozygote for the c.544+5G>C variant produced wild-type transcript amounts comparable to healthy control. The unique situation reported here highlights the fact that the dosage of SHOX determines the clinical phenotype rather than the Mendelian inheritance pattern of SHOX variants. This study extends the molecular and inheritance spectrum of SHOX deficiency disorder and highlights the importance of functional testing of SHOX variants of unknown significance in order to allow appropriate counseling and precision medicine for each family individual.
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Affiliation(s)
- Julia Vodopiutz
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria
- Vienna Bone and Growth Center, 1130 Vienna, Austria
| | - Lisa-Maria Steurer
- Vienna Bone and Growth Center, 1130 Vienna, Austria
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria
| | - Florentina Haufler
- Department of Pediatrics and Adolescent Medicine, Division of Pediatric Pulmonology, Allergology and Endocrinology, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria
| | - Franco Laccone
- Institute of Medical Genetics, Medical University of Vienna, 1090 Vienna, Austria
| | | | - Matthias Hilkenmeier
- Department of Pediatrics I, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Philipp Steinbauer
- Department of Pediatrics and Adolescent Medicine, Division of Neonatology, Pediatric Intensive Care and Neuropediatrics, Comprehensive Center for Pediatrics, Medical University of Vienna, 1090 Vienna, Austria
| | - Andreas R Janecke
- Department of Pediatrics I, Medical University of Innsbruck, 6020 Innsbruck, Austria
- Division of Human Genetics, Medical University of Innsbruck, 6020 Innsbruck, Austria
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Gherlan I, Braha E, Manole D, Radomir L, Nedelcu I, Popa O, Schipor S. RARE DOSAGE ABNORMALITIES - COPY NUMBER VARIATIONS FLANKING THE SHOX GENE. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2023; 19:115-124. [PMID: 37601716 PMCID: PMC10439321 DOI: 10.4183/aeb.2023.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Background Molecular defects in the SHOX gene including deletions, duplications or pathogenic point mutations are responsible for well-known pathologies involving short stature as a clinical manifestation: Léri-Weill dyschondrosteosis, Langer mesomelic dysplasia, Turner syndrome or idiopathic short stature. Duplications flanking the SHOX gene (upstream or downstream of the intact SHOX gene involving conserved non-coding cis-regulatory DNA elements - CNEs) have been described but their clinical involvement is still difficult to understand. Results We describe two cases with short stature and normal GH-IGF1 status. Multiplex ligation-dependent probe amplification (MLPA) and array comparative genomic hybridization (arrayCGH) identified in both cases heterozygous duplications involving downstream regions of SHOX gene, within CNEs (CNE8, CNE9 and CNE4, CNE5, CNE6, ECR1, CNE8, CNE9 and surrounding areas, respectively). One of the cases showed a maternally inherited duplication. Although every case has several particularities, we consider that duplications in these non-coding regions of SHOX gene may explain the short stature phenotype. Conclusion To our knowledge, these are the first Romanian-reported cases of ISS with a large duplication of downstream SHOX enhancers CNEs region. The spectrum of phenotypic consequences and the exact mechanism of the presumed clinical expression of these genetic alterations still needs to be evaluated and described.
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Affiliation(s)
- I. Gherlan
- Pediatric Endocrinology Department, “C.I. Parhon” National Institute of Endocrinology Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy, Faculty of Dentistry, Bucharest, Romania
| | - E. Braha
- Research Department, “C.I. Parhon” National Institute of Endocrinology Bucharest, Romania
| | - D.C. Manole
- Pediatric Endocrinology Department, “C.I. Parhon” National Institute of Endocrinology Bucharest, Romania
| | - L. Radomir
- Pediatric Endocrinology Department, “C.I. Parhon” National Institute of Endocrinology Bucharest, Romania
| | - I. Nedelcu
- Research Department, “C.I. Parhon” National Institute of Endocrinology Bucharest, Romania
| | - O. Popa
- Research Department, “C.I. Parhon” National Institute of Endocrinology Bucharest, Romania
| | - S. Schipor
- Research Department, “C.I. Parhon” National Institute of Endocrinology Bucharest, Romania
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Giordano M, Stuppia L. Editorial: Novel Insights Into the Genetics of Growth Disorders. Front Genet 2022; 13:920469. [PMID: 35754806 PMCID: PMC9214029 DOI: 10.3389/fgene.2022.920469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/27/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Mara Giordano
- Laboratory of Genetics, SCDU Clinical Biochemistry, University Hospital "Maggiore della Carità", Novara and Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Liborio Stuppia
- Department of Psychological, Health and Territorial Sciences and Center for Advanced Sciences and Technology (CAST), G. d'Annunzio University, Chieti-Pescara, Italy
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