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You Y, Wu W, Du Y, Hu J, Li B. Developmental epileptic encephalopathy caused by homozygosity of a c.172+1G>C variant in the WWOX gene. Mol Genet Genomic Med 2024; 12:e2500. [PMID: 39101447 PMCID: PMC11298992 DOI: 10.1002/mgg3.2500] [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: 02/24/2023] [Revised: 06/01/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Variations in the WWOX gene have been identified as the leading cause of several central nervous system disorders. However, most previous reports have focused on the description of clinical phenotype, neglecting functional verification. Herein, we presented a case of a patient with developmental epileptic encephalopathy (DEE) caused by WWOX gene variation. CASE PRESENTATION Our patient was a 13-month-old girl with abnormal facial features, including facial hypotonia, arched eyebrows, a broad nose, and a depressed nasal bridge. She also had sparse and yellow hair, a low anterior hairline, and a short neck. Before the age of 8 months, she was suffering from mild seizures. Her developmental delay gradually worsened, and she suffered infantile spasms. After treatment with vigabatrin, seizures subsided. WWOX gene homozygous variation c.172+1G>C was identified using whole exome sequencing. Further minigene assay confirmed that the variation site affected splicing, causing protein truncation and affecting its function. CONCLUSION Clinical phenotype and minigene results suggest that WWOX gene homozygous variation c.172+1G>C can cause severe DEE. We also concluded that vigabatrin can effectively treat seizures.
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Affiliation(s)
- Yang You
- Department of ImagingThe Fourth Hospital of Hebei Medical UniversityShijiazhuangHebeiP.R. China
| | - Wenjuan Wu
- Department of NeurologyHebei Medical University, Hebei Children's HospitalShijiazhuangHebeiP.R. China
| | - Yakun Du
- Department of NeurologyHebei Medical University, Hebei Children's HospitalShijiazhuangHebeiP.R. China
| | - Jintong Hu
- Department of NeurologyHebei Medical University, Hebei Children's HospitalShijiazhuangHebeiP.R. China
| | - Baoguang Li
- Department of NeurologyHebei Medical University, Hebei Children's HospitalShijiazhuangHebeiP.R. China
- Key Laboratory of Pediatric Epilepsy and Neurological Disorders of Hebei ProvinceShijiazhuangP.R. China
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Dong XS, Wen XJ, Zhang S, Wang DG, Xiong Y, Li ZM. Identification of compound heterozygous deletion of the WWOX gene in WOREE syndrome. BMC Med Genomics 2023; 16:291. [PMID: 37974179 PMCID: PMC10652538 DOI: 10.1186/s12920-023-01731-4] [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: 02/22/2023] [Accepted: 11/08/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND Biallelic loss-of-function variants in WWOX cause WWOX-related epileptic encephalopathy (WOREE syndrome), which has been reported in 60 affected individuals to date. In this study, we report on an affected individual with WOREE syndrome who presented with early-onset refractory seizures and global neurodevelopmental delay and died at the age of two and a half years. METHODS We present clinical and molecular findings in the affected individual, including biallelic pathogenic variants in the WWOX gene. We employed different molecular approaches, such as whole exome sequencing, quantitative real-time polymerase chain reaction (qPCR), and whole-genome sequencing, to identify the genetic variants. The breakpoints were determined through gap PCR and Sanger sequencing. RESULT Whole exome sequencing revealed homozygous exon 6 deletion in the WWOX gene in the proband. Quantitative real-time PCR confirmed that the parents were heterozygous carriers of exon 6 deletion. However, using whole-genome sequencing, we identified three larger deletions (maternal allele with exon 6-8 deletion and paternal allele with two deletions in proximity one in intron 5 and the other in exon 6) involving the WWOX gene in the proband, with deletion sizes of 13,261 bp, 53,904 bp, and 177,200 bp. The exact breakpoints were confirmed through gap PCR and Sanger sequencing. We found that the proband inherited the discontinuous deletion of intron 5 and exon 6 from the father, and the exons 6-8 deletion from the mother using gap PCR. CONCLUSION Our findings extend the variant spectrum of WOREE syndrome and support the critical role of the WWOX gene in neural development.
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Affiliation(s)
- Xing-Sheng Dong
- Prenatal Diagnosis Center, Zhongshan Boai Hospital Affiliated to Southern Medical University, Zhongshan, Guangdong, China
| | - Xiao-Jun Wen
- Reproductive Medicine Center, Zhongshan Boai Hospital Affiliated to Southern Medical University, Zhongshan, Guangdong, China
| | - Sheng Zhang
- Department of Pediatrics, Zhongshan Boai Hospital Affiliated to Southern Medical University, Zhongshan, Guangdong, China
| | - De-Gang Wang
- Prenatal Diagnosis Center, Zhongshan Boai Hospital Affiliated to Southern Medical University, Zhongshan, Guangdong, China
| | - Yi Xiong
- Prenatal Diagnosis Center, Zhongshan Boai Hospital Affiliated to Southern Medical University, Zhongshan, Guangdong, China
| | - Zhi-Ming Li
- Prenatal Diagnosis Center, Zhongshan Boai Hospital Affiliated to Southern Medical University, Zhongshan, Guangdong, China.
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Yang X, Mao Y, Wang XK, Ma DN, Xu Z, Gong N, Henning B, Zhang X, He G, Shi YY, Eichler EE, Li ZQ, Takahashi E, Li WD. Population genetics of marmosets in Asian primate research centers and loci associated with epileptic risk revealed by whole-genome sequencing. Zool Res 2023; 44:837-847. [PMID: 37501399 PMCID: PMC10559097 DOI: 10.24272/j.issn.2095-8137.2022.514] [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: 04/23/2023] [Accepted: 07/26/2023] [Indexed: 07/29/2023] Open
Abstract
The common marmoset ( Callithrix jacchus) has emerged as a valuable nonhuman primate model in biomedical research with the recent release of high-quality reference genome assemblies. Epileptic marmosets have been independently reported in two Asian primate research centers. Nevertheless, the population genetics within these primate centers and the specific genetic variants associated with epilepsy in marmosets have not yet been elucidated. Here, we characterized the genetic relationships and risk variants for epilepsy in 41 samples from two epileptic marmoset pedigrees using whole-genome sequencing. We identified 14 558 184 single nucleotide polymorphisms (SNPs) from the 41 samples and found higher chimerism levels in blood samples than in fingernail samples. Genetic analysis showed fourth-degree of relatedness among marmosets at the primate centers. In addition, SNP and copy number variation (CNV) analyses suggested that the WW domain-containing oxidoreductase ( WWOX) and Tyrosine-protein phosphatase nonreceptor type 21 ( PTPN21) genes may be associated with epilepsy in marmosets. Notably, KCTD18-like gene deletion was more common in epileptic marmosets than control marmosets. This study provides valuable population genomic resources for marmosets in two Asian primate centers. Genetic analyses identified a reasonable breeding strategy for genetic diversity maintenance in the two centers, while the case-control study revealed potential risk genes/variants associated with epilepsy in marmosets.
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Affiliation(s)
- XiangYu Yang
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, China
- WLA Laboratories, World Laureates Association, Shanghai 201203, China
| | - YaFei Mao
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
- Department of Genome Sciences, University of Washington School of Medicine, Seattle WA 98195, USA
| | - Xuan-Kai Wang
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Dong-Ni Ma
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
- WLA Laboratories, World Laureates Association, Shanghai 201203, China
| | - Zhen Xu
- Institute of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
| | - Neng Gong
- Institute of Neuroscience, Key Laboratory of Primate Neurobiology, CAS Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai 200031, China
| | - Barbara Henning
- Department of Genome Sciences, University of Washington School of Medicine, Seattle WA 98195, USA
| | - Xu Zhang
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
- WLA Laboratories, World Laureates Association, Shanghai 201203, China
| | - Guang He
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Yong-Yong Shi
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
- Affiliated Hospital of Qingdao University & Biomedical Sciences Institute of Qingdao University, Qingdao Branch of SJTU Bio-X Institutes, Qingdao University, Qingdao, Shandong 266003, China
| | - Evan E Eichler
- Department of Genome Sciences, University of Washington School of Medicine, Seattle WA 98195, USA
- Howard Hughes Medical Institute, University of Washington, Seattle WA 98195, USA
| | - Zhi-Qiang Li
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
- Affiliated Hospital of Qingdao University & Biomedical Sciences Institute of Qingdao University, Qingdao Branch of SJTU Bio-X Institutes, Qingdao University, Qingdao, Shandong 266003, China. E-mail:
| | - Eiki Takahashi
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
- Department of Biomedicine, Graduate School of Medical Sciences, Kyushu University, Fukuoka 812-8582, Japan. E-mail:
| | - Wei-Dong Li
- Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, and Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai 200240, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, China
- WLA Laboratories, World Laureates Association, Shanghai 201203, China
- Global Institute of Future Technology, Shanghai Jiao Tong University, Shanghai 200240, China. E-mail:
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Chong SC, Cao Y, Fung ELW, Kleppe S, Gripp KW, Hertecant J, El-Hattab AW, Suleiman J, Clark G, von Allmen G, Rodziyevska O, Lewis RA, Rosenfeld JA, Dong J, Wang X, Miller MJ, Bi W, Liu P, Scaglia F. Expansion of the clinical and molecular spectrum of WWOX-related epileptic encephalopathy. Am J Med Genet A 2023; 191:776-785. [PMID: 36537114 DOI: 10.1002/ajmg.a.63074] [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: 06/12/2022] [Revised: 11/21/2022] [Accepted: 11/27/2022] [Indexed: 02/14/2023]
Abstract
WWOX biallelic loss-of-function pathogenic single nucleotide variants (SNVs) and copy number variants (CNVs) including exonic deletions and duplications cause WWOX-related epileptic encephalopathy (WOREE) syndrome. This disorder is characterized by refractory epilepsy, axial hypotonia, peripheral hypertonia, progressive microcephaly, and premature death. Here we report five patients with WWOX biallelic predicted null variants identified by exome sequencing (ES), genome sequencing (GS), and/or chromosomal microarray analysis (CMA). SNVs and intragenic deletions of one or more exons were commonly reported in WOREE syndrome patients which made the genetic diagnosis challenging and required a combination of different diagnostic technologies. These patients presented with severe, developmental and epileptic encephalopathy (DEE), and other cardinal features consistent with WOREE syndrome. This report expands the clinical phenotype associated with this condition, including failure to thrive in most patients and epilepsy that responded to a ketogenic diet in three patients. Dysmorphic features and abnormal prenatal findings were not commonly observed. Additionally, recurrent pancreatitis and sensorineural hearing loss each were observed in single patients. In summary, these phenotypic features broaden the clinical spectrum of WOREE syndrome.
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Affiliation(s)
- Shuk Ching Chong
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China.,Joint BCM-CUHK Center of Medical Genetics, Chinese University of Hong Kong, Hong Kong, China
| | - Ye Cao
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China.,Joint BCM-CUHK Center of Medical Genetics, Chinese University of Hong Kong, Hong Kong, China.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, China
| | - Eva L W Fung
- Department of Paediatrics, The Chinese University of Hong Kong, Hong Kong, China
| | - Soledad Kleppe
- Unidad de Metabolismo, Hospital de Niños Ricardo Gutiérrez, Buenos Aires, Argentina
| | - Karen W Gripp
- Division of Medical Genetics, A. I. du Pont Hospital for Children/Nemours, Wilmington, Delaware, USA
| | - Jozef Hertecant
- Division of Genetic and Metabolic Disorders, Departments of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates
| | - Ayman W El-Hattab
- Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Jehan Suleiman
- Division of Neurology, Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates.,Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Gary Clark
- Neurology and Developmental Neuroscience, Baylor College of Medicine, Neurology Service, Texas Children's Hospital, Houston, Texas, USA
| | - Gretchen von Allmen
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, Texas, USA
| | - Olga Rodziyevska
- Division of Child Neurology, Department of Pediatrics, McGovern Medical School, Houston, Texas, USA
| | - Richard A Lewis
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Department of Ophthalmology, Baylor College of Medicine, Houston, Texas, USA.,Texas Children's Hospital, Houston, Texas, USA
| | - Jill A Rosenfeld
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA
| | - Jie Dong
- Baylor Genetics, Houston, Texas, USA
| | | | - Xia Wang
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Baylor Genetics, Houston, Texas, USA
| | - Marcus J Miller
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Baylor Genetics, Houston, Texas, USA.,Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Weimin Bi
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Baylor Genetics, Houston, Texas, USA
| | - Pengfei Liu
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Baylor Genetics, Houston, Texas, USA
| | - Fernando Scaglia
- Joint BCM-CUHK Center of Medical Genetics, Chinese University of Hong Kong, Hong Kong, China.,Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.,Department of Obstetrics and Gynecology, The Chinese University of Hong Kong, Hong Kong, China.,Texas Children's Hospital, Houston, Texas, USA
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