1
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Nagy A, Molay F, Hargadon S, Brito Pires C, Grant N, De La Rosa Abreu L, Chen JY, D'Souza P, Macnamara E, Tifft C, Becker C, Melo De Gusmao C, Khurana V, Neumeyer AM, Eichler FS. The spectrum of neurological presentation in individuals affected by TBL1XR1 gene defects. Orphanet J Rare Dis 2024; 19:79. [PMID: 38378692 PMCID: PMC10880200 DOI: 10.1186/s13023-024-03083-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND TBL1XR1 encodes a F-box-like/WD40 repeat-containing protein that plays a role in transcription mediated by nuclear receptors and is a known genetic cause of neurodevelopmental disease of childhood (OMIM# 608628). Yet the developmental trajectory and progression of neurologic symptoms over time remains poorly understood. METHODS We developed and distributed a survey to two closed Facebook groups devoted to families of patients with TBL1XR1-related disorder. The survey consisted of 14 subsections focused upon the developmental trajectories of cognitive, behavioral, motor, and other neurological abnormalities. Data were collected and managed using REDCap electronic data capture tools. RESULTS Caregivers of 41 patients with a TBL1XR1-related disorder completed the cross-sectional survey. All reported variants affecting a single amino acid, including missense mutations and in-frame deletions, were found in the WD40 repeat regions of Tbl1xr1. These are domains considered important for protein-protein interactions that may plausibly underlie disease pathology. The majority of patients were diagnosed with a neurologic condition before they received their genetic diagnosis. Language appeared most significantly affected with only a minority of the cohort achieving more advanced milestones in this domain. CONCLUSION TBL1XR1-related disorder encompasses a spectrum of clinical presentations, marked by early developmental delay ranging in severity, with a subset of patients experiencing developmental regression in later childhood.
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Affiliation(s)
- Amanda Nagy
- Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Care Center 708, Boston, MA, 02114, USA
| | - Francine Molay
- Division of Clinical Research, Massachusetts General Hospital, 55 Fruit St, Boston, MA, 02114, USA
| | - Sarah Hargadon
- Fly Little Bird Foundation, PO Box 698, Excelsior, MN, 55331, USA
| | - Claudia Brito Pires
- Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Care Center 708, Boston, MA, 02114, USA
| | - Natalie Grant
- Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Care Center 708, Boston, MA, 02114, USA
| | - Lizbeth De La Rosa Abreu
- Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Care Center 708, Boston, MA, 02114, USA
| | - Jin Yun Chen
- Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Care Center 708, Boston, MA, 02114, USA
| | - Precilla D'Souza
- National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Ellen Macnamara
- National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Cynthia Tifft
- National Human Genome Research Institute, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA
| | - Catherine Becker
- Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Care Center 708, Boston, MA, 02114, USA
| | - Claudio Melo De Gusmao
- Division of Movement Disorders, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Hale Building for Transformative Medicine Room 10016L, 60 Fenwood Road, Boston, 02115, USA
| | - Vikram Khurana
- Division of Movement Disorders, Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Hale Building for Transformative Medicine Room 10016L, 60 Fenwood Road, Boston, 02115, USA
| | - Ann M Neumeyer
- Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Care Center 708, Boston, MA, 02114, USA
- Lurie Center for Autism, Massachusetts General Hospital, 1 Maguire Road, Lexington, MA, 02124, USA
| | - Florian S Eichler
- Department of Neurology, Massachusetts General Hospital, 55 Fruit St, Wang Ambulatory Care Center 708, Boston, MA, 02114, USA.
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2
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Ren M, Zheng H, Lu X, Lian W, Feng B. Expanding the genotypic and phenotypic spectrum associated with TBL1XR1 de novo variants. Gene 2023; 886:147777. [PMID: 37683765 DOI: 10.1016/j.gene.2023.147777] [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: 03/20/2023] [Revised: 09/01/2023] [Accepted: 09/05/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND The TBL1XR1 gene encodes the protein transducin-beta-like 1 receptor1, widely distributed in the pituitary, hypothalamus, white and brown adipose tissue, muscle, and liver. Current evidence suggests that heterozygous TBL1XR1 pathogenic variants can lead to a wide spectrum of phenotypes. This study aims to reveal the clinical phenotype and genetic profiles of de novo TBL1XR1 variations and summarize the relevant clinical and genetic features. METHODS We analyzed four new cases harboring de novo TBL1XR1 variants and reviewed all reported cases. RESULTS All probands suffered from global developmental delay. Moreover, patient 1 exhibited susceptibility to startle, patient 2 had hypovitaminosis D, short stature and hyponatremia, and patients 3 and 4 both presented with ASD (Autism spectrum disorder) and short stature. They all had a de novo TBL1XR1 variant (NM_024665.7), c.1184A > G (p.Tyr395Cys), c.1108G > A (p.Asp370Asn), c.1047 + 1G > C, and c.1097C > T (p.Ser366Phe) respectively. In addition, pooled analysis of 51 cases showed that they had speech impairment (38/39), intellectual developmental disorder (28/28), global developmental delay (42/42), and hypotonia (24/27), and some of them had epilepsy (10/22), ASD (13/25), and developmental regression (4/13). CONCLUSIONS We report four new patients with de novo TBL1XR1 variants and provide a comprehensive overview of 47 previously reported individuals with TBL1XR1 variants, enriching the genotypic and phenotypic spectrum of TBL1XR1-related disease. This report further validates the pathogenicity de novo TBL1XR1 variants.
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Affiliation(s)
- Mingyue Ren
- School of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, China
| | - Hong Zheng
- School of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, China; The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China.
| | - Xiangpeng Lu
- The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Wenjun Lian
- The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
| | - Bin Feng
- School of Pediatrics, Henan University of Chinese Medicine, Zhengzhou, China; The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou, China
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3
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Tamma PL, Streff H, Murali CN. A novel de novo pathogenic variant in TBL1XR1 as a new proposed cause of Pierpont syndrome. Am J Med Genet A 2023; 191:1576-1580. [PMID: 36843287 DOI: 10.1002/ajmg.a.63162] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 12/27/2022] [Accepted: 01/31/2023] [Indexed: 02/28/2023]
Abstract
TBL1XR1, which encodes transducing β-like 1 X-linked receptor 1, is implicated in both Pierpont syndrome and intellectual developmental disorder, autosomal dominant-41 (MRD-41, OMIM #616944). While both conditions are autosomal dominant, variants associated with Pierpont syndrome are believed to behave in a dominant negative fashion, whereas those causing MRD-41 result in haploinsufficiency. Here, we present a patient with a de novo novel variant in TBL1XR1 (c.977G > A,p.S326N) identified by trio exome sequencing. Though a different variant at this same residue has previously been associated with MRD-41, our patient's presentation is suggestive of Pierpont syndrome. The patient's clinical phenotype, which includes short stature, developmental delay, dysmorphic craniofacial features, and plantar fat pads, more closely resembles that of known patients with Pierpont syndrome than MRD-41. Furthermore, this missense variant is directly adjacent to one previously associated with Pierpont syndrome and exists in the same region as all variants associated with Pierpont, on the inner surface of a WD40 ring. We propose this variant is a newly identified cause of Pierpont syndrome.
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Affiliation(s)
- Poornima L Tamma
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Haley Streff
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Chaya N Murali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
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4
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Pereira-Nunes J, Vilan A, Grangeia A, d’Oliveira R. Novel Arthrogryposis Multiplex Congenita Presentation in a Newborn With Pierpont Syndrome. J Investig Med High Impact Case Rep 2023; 11:23247096221150637. [PMID: 36691917 PMCID: PMC9880567 DOI: 10.1177/23247096221150637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 12/12/2022] [Accepted: 12/23/2022] [Indexed: 01/25/2023] Open
Abstract
Pierpont syndrome is a rare and recently described multiple congenital anomaly syndrome, classically characterized by global developmental delay, distinctive facial dysmorphic features, and abnormal fat distribution in distal limbs. Only few cases were previously documented. We report a case of a term male neonate admitted to the neonatal intensive care unit because of feeding difficulties. Intrauterine growth restriction, microcephaly, and bilateral equinovarus foot were diagnosed in the second trimester, and prenatal array comparative genomic hybridization showed no abnormality. Physical examination revealed bilateral flexion deformities of wrists, elbows, knees and clubfoot, large hands and feet, deep palmar and plantar grooves, and calcaneo-plantar fat pads. Craniofacial dysmorphism, axial hypotonia, and hypoactivity were also observed. Due to the presence of congenital and non-progressive joint contractures, arthrogryposis multiplex congenita (AMC) was considered. A comprehensive diagnostic workup, including a Next Generation Sequencing target panel, was performed but did not establish a diagnosis. The clinical exome identified an heterozygous pathogenic variant in the TBL1XR1 gene (NM_001321194.1: c.1337A>G, p.[Tyr446Cys]), allowing Pierpont syndrome diagnosis. Our case stands out for reporting the novel AMC presentation in a Pierpont syndrome newborn. The broader and precocious genetic testing proved to be an essential clarifying diagnostic tool. Our patient supports the relation between the p.Tyr446Cys sequence variant in TBL1XR1 gene with this rare syndrome, reinforcing its association with a distinctive and recognizable phenotype, as well as expanding its clinical features to include AMC.
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Affiliation(s)
- Joana Pereira-Nunes
- Centro Hospitalar Universitário de São
João, Porto, Portugal
- Porto University, Porto, Portugal
| | - Ana Vilan
- Centro Hospitalar Universitário de São
João, Porto, Portugal
- Porto University, Porto, Portugal
| | - Ana Grangeia
- Centro Hospitalar Universitário de São
João, Porto, Portugal
- Porto University, Porto, Portugal
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5
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Tesarova M, Baxova A, Hansikova H, Lambert L, Vondrackova A, Leiska A, Zeman J. Pierpont syndrome due to mutation c.1337A>G in TBL1XR1 gene. Clin Dysmorphol 2022; 31:145-148. [PMID: 35165208 DOI: 10.1097/mcd.0000000000000416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
| | | | | | - Lukas Lambert
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | | | - Alena Leiska
- Department of Radiology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jiri Zeman
- Department of Paediatrics and Adolescent Medicine
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6
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Shen Y, Yuan M, Luo H, Yang Z, Liang M, Gan J. Rare variant of TBL1XR1 in West syndrome: A case report. Mol Genet Genomic Med 2022; 10:e1991. [PMID: 35611576 PMCID: PMC9266600 DOI: 10.1002/mgg3.1991] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 05/10/2022] [Accepted: 05/12/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND West syndrome (WS) is an epileptic encephalopathy (EE) that begins in children 4-7 months of age (in rare cases older than 2 years). To date, over 30 genes that have been reported to be related to WS. Reports involving the extremely rare pathogenic gene, transducin beta-like 1-X- linked receptor 1(TBL1XR1) are quite limited. METHODS We performed exome sequencing (ES) of family trios for this infant. We also collected and summarized the clinical data for reported heterozygous germline variants of TBL1XR1. Moreover, we reviewed all published cases and summarized the clinical features and genetic variants of TBL1XR1. RESULTS ES revealed a de novo variant in TBL1XR1 [NM_024665.5: exon4: c.187G > A (p.Glu63Lys)]. This variant was classified as likely pathogenic according to the ACMG (American College of Medical Genetics and Genomics) guidelines and was verified by Sanger sequencing. Further conservation analyses revealed a high conservation among several species. There was clinical heterogeneity among all patients with TBL1XR1-related West syndrome. CONCLUSION Our results expand the pathogenic variant spectrum of TBL1XR1 and strengthen the pathogenic evidence of TBL1XR1 in West syndrome.
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Affiliation(s)
- Yajun Shen
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education
| | - Meng Yuan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education
| | - Huan Luo
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education
| | | | | | - Jing Gan
- Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University) Ministry of Education
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7
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Bajaj S, Gadgil P, Seenappa V, Setty PN, Joshi V, Shah S. Novel De Novo TBL1XR1 Variant Causing PIERPONT Syndrome in an Indian Child: A Case Report and Genotype–Phenotype Review of Reported Patients. JOURNAL OF PEDIATRIC NEUROLOGY 2022. [DOI: 10.1055/s-0042-1745808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AbstractThe transducin β-like-1 X-linked-receptor-1 gene (TBL1XR1) encodes for the TBL1XR1 protein which is involved in transcription. Single-nucleotide variants (SNVs) in the TBL1XR1 gene have been reported to be associated with Pierpont's syndrome (PS) which exhibits numerous features including global developmental delay (GDD), intellectual disability (ID), varying neurobehavioral and psychiatric manifestations with/without autism spectrum disorder (ASD), abnormal fat distribution in the distal extremities, short stature (SS), head circumference abnormalities, hearing loss (HL), and facial dysmorphisms. Eight PS patients, having a de novo mutation resulting in p.Tyr446Cys, showed no manifestations of ASD. The three other PS patients, having mutations resulting in p.Tyr446His, p.Cys325Tyr and p.Gly237Asp, respectively, and without the p.Tyr446Cys alteration, were in addition associated with neurobehavioral abnormalities, including ASD, hyperactivity, and self-mutilation tendencies. Here, via trio whole exome sequencing, we describe a 12th PS patient, the first from the Indian subcontinent, reflecting a novel TBL1XR1 p.His348Arg alteration. The proband is a 4.5-year-old male having GDD, speech delay, facial dysmorphisms, abnormal digital fat pads, hypotonia, microcephaly, patent ductus arteriosus, and ASD features. Our report strengthens the hypothesis that TBL1XR1 variants coding for the TBL1XR1 protein other than p.Tyr446Cys might be more commonly associated with a neurobehavioral phenotype and autistic tendencies.
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Affiliation(s)
- Shruti Bajaj
- Department of Clinical Genetics, The Purple Gene Clinic, Mumbai, Maharashtra, India
| | - Pradnya Gadgil
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Venu Seenappa
- LifeCell International Pvt. Ltd., Chennai, Tamil Nadu, India
| | - Phani N. Setty
- LifeCell International Pvt. Ltd., Chennai, Tamil Nadu, India
| | - Vaishali Joshi
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Centre, Mumbai, Maharashtra, India
| | - Shailee Shah
- Kokilaben Dhirubhai Ambani Hospital and Medical Research Centre, Mumbai, Maharashtra, India
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8
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Ismaili–Jaha V, Spahiu‐Konusha S, Jaha A. Pierpont syndrome-Report of a new patient. Clin Case Rep 2021; 9:2113-2116. [PMID: 33936649 PMCID: PMC8077337 DOI: 10.1002/ccr3.3959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/21/2021] [Accepted: 02/08/2021] [Indexed: 11/12/2022] Open
Abstract
We report on a 6-year-old girl with Pierpont Syndrome who was diagnosed using the whole-exome sequencing technique. In addition to commonly recognized traits, our patient had scoliosis, a feature reported only in one other occasion.
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Affiliation(s)
- Vlora Ismaili–Jaha
- Department of Pediatric GastroenterologyFaculty of Medical SciencesUniversity of PrishtinaPrishtinaAlbania
| | - Shqipe Spahiu‐Konusha
- Department of GeneticsFaculty of Medical SciencesUniversity of PrishtinaPrishtinaAlbania
| | - Art Jaha
- Faculty of Medical SciencesUniversity of PrishtinaPrishtinaAlbania
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9
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Arroyo Carrera I, Fernández-Burriel M, Lapunzina P, Tenorio JA, García Navas VD, Márquez Isidro E. TBL1XR1 associated intellectual disability, a new missense variant with dysmorphic features plus autism: Expanding the phenotypic spectrum. Clin Genet 2021; 99:812-817. [PMID: 33527360 DOI: 10.1111/cge.13937] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/23/2021] [Accepted: 01/30/2021] [Indexed: 11/27/2022]
Abstract
Missense and frameshift pathogenic variants and microdeletions involving TBL1XR1 gene have been described in patients with intellectual disability, autism, Rett-like features and schizophrenia, some of them with the clinical diagnosis of Pierpont syndrome, a rare pattern of multiple congenital anomalies, but others without dysmorphic findings or with non-specific ones, and also patients with only some of the features associated with Pierpont syndrome. We here present a case with a de novo novel missense variant in TBL1XR1 gene with overlapping features with Pierpont syndrome and autism, a neurobehavioral manifestation not previously reported in Pierpont syndrome. This patient expands the phenotypic spectrum of TBL1XR1 gene pathogenic variants.
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Affiliation(s)
| | | | - Pablo Lapunzina
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
| | - Jair Antonio Tenorio
- Institute of Medical and Molecular Genetics (INGEMM), La Paz University Hospital, IdiPAZ, Universidad Autónoma de Madrid, Madrid, Spain
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10
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Nuclear receptor corepressors in intellectual disability and autism. Mol Psychiatry 2020; 25:2220-2236. [PMID: 32034290 PMCID: PMC7842082 DOI: 10.1038/s41380-020-0667-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Revised: 12/24/2019] [Accepted: 01/28/2020] [Indexed: 02/06/2023]
Abstract
Autism spectrum disorder (ASD) is characterized by neurocognitive dysfunctions, such as impaired social interaction and language learning. Gene-environment interactions have a pivotal role in ASD pathogenesis. Nuclear receptor corepressors (NCORs) are transcription co-regulators physically associated with histone deacetylases (HDACs) and many known players in ASD etiology such as transducin β-like 1 X-linked receptor 1 and methyl-CpG binding protein 2. The epigenome-modifying NCOR complex is sensitive to many ASD risk factors, including HDAC inhibitor valproic acid and a variety of endocrine factors, xenobiotic chemicals, or metabolites that can directly bind to multiple nuclear receptors. Here, we review recent studies of NCORs in neurocognition using animal models and human genetics approaches. We discuss functional interplays between NCORs and other known players in ASD etiology. It is conceivable that the NCOR complex may bridge the in utero environmental risk factors of ASD with epigenetic remodeling and can serve as a converging point for many gene-environment interactions in the pathogenesis of ASD and intellectual disability.
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11
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Sun Z, Xu Y. Nuclear Receptor Coactivators (NCOAs) and Corepressors (NCORs) in the Brain. Endocrinology 2020; 161:5843759. [PMID: 32449767 PMCID: PMC7351129 DOI: 10.1210/endocr/bqaa083] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 05/20/2020] [Indexed: 01/20/2023]
Abstract
Nuclear receptor coactivators (NCOAs) and corepressors (NCORs) bind to nuclear hormone receptors in a ligand-dependent manner and mediate the transcriptional activation or repression of the downstream target genes in response to hormones, metabolites, xenobiotics, and drugs. NCOAs and NCORs are widely expressed in the mammalian brain. Studies using genetic animal models started to reveal pivotal roles of NCOAs/NCORs in the brain in regulating hormonal signaling, sexual behaviors, consummatory behaviors, exploratory and locomotor behaviors, moods, learning, and memory. Genetic variants of NCOAs or NCORs have begun to emerge from human patients with obesity, hormonal disruption, intellectual disability, or autism spectrum disorders. Here we review recent studies that shed light on the function of NCOAs and NCORs in the central nervous system.
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Affiliation(s)
- Zheng Sun
- Department of Molecular and Cellular Biology; Baylor College of Medicine, Houston, Texas
- Department of Medicine, Division of Diabetes, Endocrinology and Metabolism; Baylor College of Medicine, Houston, Texas
- Correspondence: Zheng Sun, PhD, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030. E-mail: ; or Yong Xu, PhD, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030. E-mail:
| | - Yong Xu
- Department of Molecular and Cellular Biology; Baylor College of Medicine, Houston, Texas
- USDA/ARS Children’s Nutrition Research Center, Department of Pediatrics; Baylor College of Medicine, Houston, Texas
- Correspondence: Zheng Sun, PhD, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030. E-mail: ; or Yong Xu, PhD, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030. E-mail:
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12
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Thiffault I, Cadieux-Dion M, Farrow E, Caylor R, Miller N, Soden S, Saunders C. On the verge of diagnosis: Detection, reporting, and investigation of de novo variants in novel genes identified by clinical sequencing. Hum Mutat 2019; 39:1505-1516. [PMID: 30311385 DOI: 10.1002/humu.23646] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Revised: 08/16/2018] [Accepted: 08/30/2018] [Indexed: 12/11/2022]
Abstract
The variable evidence supporting gene-disease associations contributes to the difficulty of accurate variant reporting in a clinical setting. An evidence-based scoring system for evaluating the clinical validity of gene-disease associations, proposed by ClinGen, considers experimental as well as genetic evidence. De novo variants are heavily weighted, given the overall rarity in the genome and their contribution to human disease, however they are reported as "genes of unknown significance" in our center when there is insufficient evidence for the gene-disease assertion. We report a collection of 21 de novo variants in genes of unknown clinical significance ascertained via clinical testing, of which eight of 21 (38%) are predicted to cause loss of function. These genes were subjected to ClinGen scoring to assess the strength of gene-disease relationships. Using a cutoff for moderate high or strong, 10 of 21 genes now have sufficient evidence to qualify as likely pathogenic or pathogenic variants. Sharing such cases with phenotypic data is imperative to strengthen available genetic evidence to ultimately upgrade clinical validity classifications and facilitate accurate molecular diagnosis.
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Affiliation(s)
- Isabelle Thiffault
- Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri.,Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals, Kansas City, Missouri.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
| | - Maxime Cadieux-Dion
- Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri.,Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals, Kansas City, Missouri
| | - Emily Farrow
- Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.,Department of Pediatrics, Children's Mercy Hospitals, Kansas City, Missouri
| | - Raymond Caylor
- Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri.,Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals, Kansas City, Missouri
| | - Neil Miller
- Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri
| | - Sarah Soden
- Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri.,Department of Pediatrics, Children's Mercy Hospitals, Kansas City, Missouri
| | - Carol Saunders
- Center for Pediatric Genomic Medicine, Children's Mercy Hospital, Kansas City, Missouri.,Department of Pathology and Laboratory Medicine, Children's Mercy Hospitals, Kansas City, Missouri.,University of Missouri-Kansas City School of Medicine, Kansas City, Missouri
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13
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García M, Barreda-Bonis AC, Jiménez P, Rabanal I, Ortiz A, Vallespín E, Del Pozo Á, Martínez-San Millán J, González-Casado I, Moreno JC. Central Hypothyroidism and Novel Clinical Phenotypes in Hemizygous Truncation of TBL1X. J Endocr Soc 2018; 3:119-128. [PMID: 30591955 PMCID: PMC6300407 DOI: 10.1210/js.2018-00144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2018] [Accepted: 11/20/2018] [Indexed: 12/28/2022] Open
Abstract
Transducin β-like 1 X-linked (TBL1X) gene encodes a subunit of the nuclear corepressor-silencing mediator for retinoid and thyroid hormone receptor complex (NCoR-SMRT) involved in repression of thyroid hormone action in the pituitary and hypothalamus. TBL1X defects were recently associated with central hypothyroidism and hearing loss. The current study aims to describe the clinical and genetic characterization of a male diagnosed with central hypothyroidism through thyroid hormone profiling, TRH test, brain MRI, audiometry, and psychological evaluation. Next-generation sequencing of known genes involved in thyroid disorders was implemented. The 6-year-old boy was diagnosed with central hypothyroidism [free T4: 10.42 pmol/L (normal: 12 to 22 pmol/L); TSH: 1.57 mIU/L (normal: 0.7 to 5.7 mIU/L)], with a mildly reduced TSH response to TRH. He was further diagnosed with attention-deficit/hyperactivity disorder (ADHD) at 7 years, alternating episodes of encopresis and constipation, and frequent headaches. MRI showed a normal pituitary but detected a Chiari malformation type I (CMI). At 10 years, audiometry identified poor hearing threshold at high frequencies. Sequencing revealed a nonsense hemizygous mutation in TBL1X [c.1015C>T; p.(Arg339Ter)] largely truncating its WD-40 repeat domain involved in nuclear protein-protein interactions. In conclusion, to our knowledge, we identified the first severely truncating TBL1X mutation in a patient with central hypothyroidism, hypoacusia, and novel clinical features like ADHD, gastrointestinal dysmotility, and CMI. Given the relevance of TBL1X and NCoR-SMRT for the regulation of transcriptional programs at different tissues (pituitary, cochlea, brain, fossa posterior, and cerebellum), severe mutations in TBL1X may lead to a distinct syndrome with a phenotypic spectrum wider than previously reported.
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Affiliation(s)
- Marta García
- Thyroid Molecular Laboratory, Institute for Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | | | - Paula Jiménez
- Thyroid Molecular Laboratory, Institute for Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
| | - Ignacio Rabanal
- Pediatric Otorhinolaryngology, La Paz University Hospital, Madrid, Spain
| | - Arancha Ortiz
- Child and Adolescent Psychiatry, La Paz University Hospital, Madrid, Spain
| | - Elena Vallespín
- Functional and Structural Genomics, Institute for Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain
| | - Ángela Del Pozo
- Bioinformatics Unit, Institute for Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Madrid, Spain
| | | | | | - José C Moreno
- Thyroid Molecular Laboratory, Institute for Medical and Molecular Genetics (INGEMM), La Paz University Hospital, Autonomous University of Madrid, Madrid, Spain
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14
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Lemattre C, Thevenon J, Duffourd Y, Nambot S, Haquet E, Vuadelle B, Genevieve D, Sarda P, Bruel AL, Kuentz P, Wells CF, Faivre L, Willems M. TBL1XR1 mutations in Pierpont syndrome are not restricted to the recurrent p.Tyr446Cys mutation. Am J Med Genet A 2018; 176:2813-2818. [PMID: 30365874 DOI: 10.1002/ajmg.a.40510] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 07/02/2018] [Accepted: 07/23/2018] [Indexed: 02/02/2023]
Abstract
Pierpont syndrome is a rare and sporadic syndrome, including developmental delay, facial characteristics, and abnormal extremities. Recently, a recurrent de novo TBL1XR1 variant (c.1337A > G; p.Tyr446Cys) has been identified in eight patients by whole-exome sequencing. A dominant-negative effect of this mutation is strongly suspected, since patients with TBL1XR1 deletion and other variants predicting loss of function do not share the same phenotype. We report two patients with typical Pierpont-like syndrome features. Exome sequencing allowed identifying a de novo heterozygous missense TBL1XR1 variant in both patients, different from those already reported: p.Cys325Tyr and p.Tyr446His. The localization of these mutations and clinical features of Pierpont-like syndrome suggest that their functional consequences are comparable with the recurrent mutation previously described, and provided additional data to understand molecular mechanisms of TBL1XR1 anomalies.
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Affiliation(s)
- C Lemattre
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - J Thevenon
- Equipe GAD, UMR1231, Université de Bourgogne Franche Comté, Dijon, France.,Département de Génétique et Procréation, Hôpital Couple-Enfant, CHU, Grenoble, France
| | - Y Duffourd
- Equipe GAD, UMR1231, Université de Bourgogne Franche Comté, Dijon, France.,Orphanomix, SATT Grand Est, Dijon, France.,UF Innovation en Diagnostic Génomique des Maladies Rares, Centre Hospitalier Universitaire de Dijon, Dijon, France.,Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, Hôpital d'enfants, CHU, Dijon, France
| | - S Nambot
- Equipe GAD, UMR1231, Université de Bourgogne Franche Comté, Dijon, France
| | - E Haquet
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, Montpellier, France
| | | | - D Genevieve
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - P Sarda
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - A L Bruel
- Equipe GAD, UMR1231, Université de Bourgogne Franche Comté, Dijon, France
| | - P Kuentz
- Equipe GAD, UMR1231, Université de Bourgogne Franche Comté, Dijon, France.,Laboratoire de Biologie Moléculaire, CHRU Saint-Jacques, Besançon, France
| | - C F Wells
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, Montpellier, France
| | - L Faivre
- Equipe GAD, UMR1231, Université de Bourgogne Franche Comté, Dijon, France.,Centre de Référence Anomalies du Développement et Syndromes Malformatifs et FHU TRANSLAD, Hôpital d'enfants, CHU, Dijon, France
| | - M Willems
- Département de Génétique Médicale, Hôpital Arnaud de Villeneuve, Montpellier, France
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15
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Zaghlula M, Glaze DG, Enns GM, Potocki L, Schwabe AL, Suter B. Current clinical evidence does not support a link between TBL1XR1 and Rett syndrome: Description of one patient with Rett features and a novel mutation in TBL1XR1, and a review of TBL1XR1 phenotypes. Am J Med Genet A 2018; 176:1683-1687. [PMID: 29777588 DOI: 10.1002/ajmg.a.38689] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 02/28/2018] [Accepted: 03/04/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Manar Zaghlula
- Graduate Program in Translational Biology and Molecular Medicine, Baylor College of Medicine, Houston, Texas.,Texas Children's Hospital, Jan and Dan Duncan Neurological Research Institute, Houston, Texas
| | - Daniel G Glaze
- Department of Neurology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Hospital, Houston, Texas
| | - Gregory M Enns
- Departments of Pediatrics and Pathology, Stanford University, Stanford, California
| | - Lorraine Potocki
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Hospital, Houston, Texas.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Aloysia L Schwabe
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Hospital, Houston, Texas.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Bernhard Suter
- Department of Neurology, Baylor College of Medicine, Houston, Texas.,Department of Pediatrics, Baylor College of Medicine, Houston, Texas.,Texas Children's Hospital, Houston, Texas
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