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Rodríguez-García ME, Cotrina-Vinagre FJ, Bellusci M, Hernández-Sánchez L, de Aragón AM, López-Laso E, Martín-Hernández E, Martínez-Azorín F. First splicing variant in HECW2 with an autosomal recessive pattern of inheritance and associated with NDHSAL. Hum Mutat 2022; 43:1361-1367. [PMID: 35753050 DOI: 10.1002/humu.24426] [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: 02/21/2022] [Revised: 06/06/2022] [Accepted: 06/21/2022] [Indexed: 11/07/2022]
Abstract
We report the clinical and genetic features of a Caucasian girl who presented a severe neurodevelopmental disorder with drug-resistant epilepsy, hypotonia, severe gastro-esophageal reflux and brain MRI anomalies. WES uncovered a novel variant in homozygosis (g.197092814_197092824delinsC) in HECW2 gene that encodes the E3 ubiquitin-protein ligase HECW2. This protein induces ubiquitination and is implicated in the regulation of several important pathways involved in neurodevelopment and neurogenesis. Furthermore, de novo heterozygous missense variants in this gene have been associated with NDHSAL. The homozygous variant of our patient disrupts the splice donor site of intron 22 and causes the elimination of exon 22 (r.3766_3917+1del) leading to an in-frame deletion of the protein (p.Leu1256_Trp1306del). Functional studies showed a two-fold increase of its RNA expression, while the protein expression level was reduced by 60%, suggesting a partial LOF mechanism of pathogenesis. Thus, this is the first patient with NDHSAL caused by an autosomal recessive splicing variant in HECW2. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- María Elena Rodríguez-García
- Grupo de Enfermedades Raras, Mitocondriales y Neuromusculares (ERMN) Instituto de Investigación Hospital 12 de Octubre (i+12), E-28041, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), E-28041, Madrid, Spain
| | - Francisco Javier Cotrina-Vinagre
- Grupo de Enfermedades Raras, Mitocondriales y Neuromusculares (ERMN) Instituto de Investigación Hospital 12 de Octubre (i+12), E-28041, Madrid, Spain
| | - Marcello Bellusci
- Unidad Pediátrica de Enfermedades Raras, Enfermedades Mitocondriales y Metabólicas Hereditarias, Hospital 12 de Octubre, E-28041, Madrid, Spain
| | - Laura Hernández-Sánchez
- Grupo de Enfermedades Raras, Mitocondriales y Neuromusculares (ERMN) Instituto de Investigación Hospital 12 de Octubre (i+12), E-28041, Madrid, Spain
| | | | - Eduardo López-Laso
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), E-28041, Madrid, Spain.,Unidad de Neurología Pediátrica, Hospital Universitario Reina Sofia IMIBIC, E-14004, Córdoba, Spain
| | - Elena Martín-Hernández
- Grupo de Enfermedades Raras, Mitocondriales y Neuromusculares (ERMN) Instituto de Investigación Hospital 12 de Octubre (i+12), E-28041, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), E-28041, Madrid, Spain.,Unidad Pediátrica de Enfermedades Raras, Enfermedades Mitocondriales y Metabólicas Hereditarias, Hospital 12 de Octubre, E-28041, Madrid, Spain
| | - Francisco Martínez-Azorín
- Grupo de Enfermedades Raras, Mitocondriales y Neuromusculares (ERMN) Instituto de Investigación Hospital 12 de Octubre (i+12), E-28041, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), E-28041, Madrid, Spain
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