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Lecca M, Mauri L, Gana S, Del Longo A, Morelli F, Nicotra R, Plumari M, Galli J, Sirchia F, Valente EM, Cavallari U, Mazza M, Signorini S, Errichiello E. Novel molecular, structural and clinical findings in an Italian cohort of congenital cataract. Clin Genet 2024; 106:403-412. [PMID: 38840272 DOI: 10.1111/cge.14568] [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: 01/12/2024] [Revised: 05/16/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024]
Abstract
The current genetic diagnostic workup of congenital cataract (CC) is mainly based on NGS panels, whereas exome sequencing (ES) has occasionally been employed. In this multicentre study, we investigated by ES the detection yield, mutational spectrum and genotype-phenotype correlations in a CC cohort recruited between 2020 and mid-2022. The cohort consisted of 67 affected individuals from 51 unrelated families and included both non-syndromic (75%) and syndromic (25%) phenotypes, with extra-CC ocular/visual features present in both groups (48% and 76%, respectively). The functional effect of variants was predicted by 3D modelling and hydropathy properties changes. Variant clustering was used for the in-depth assessment of genotype-phenotype correlations. A diagnostic (pathogenic or likely pathogenic) variant was identified in 19 out of 51 probands/families (~37%). In a further 14 probands/families a candidate variant was identified: in 12 families a VUS was detected, of which 9 were considered plausibly pathogenic (i.e., 4 or 5 points according to ACMG criteria), while in 2 probands ES identified a single variant in an autosomal recessive gene associated with CC. Eighteen probands/families, manifesting primarily non-syndromic CC (15/18, 83%), remained unsolved. The identified variants (8 P, 12 LP, 10 VUS-PP, and 5 VUS), half of which were unreported in the literature, affected five functional categories of genes involved in transcription/splicing, lens formation/homeostasis (i.e., crystallin genes), membrane signalling, cell-cell interaction, and immune response. A phenotype-specific variant clustering was observed in four genes (KIF1A, MAF, PAX6, SPTAN1), whereas variable expressivity and potential phenotypic expansion in two (BCOR, NHS) and five genes (CWC27, KIF1A, IFIH1, PAX6, SPTAN1), respectively. Finally, ES allowed to detect variants in six genes not commonly included in commercial CC panels. These findings broaden the genotype-phenotype correlations in one of the largest CC cohorts tested by ES, providing novel insights into the underlying pathogenetic mechanisms and emphasising the power of ES as first-tier test.
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Affiliation(s)
- Mauro Lecca
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Lucia Mauri
- Medical Genetics Unit, Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Simone Gana
- Medical Genetics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Alessandra Del Longo
- Pediatric Ophthalmology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- European Reference Network on Eye Diseases (ERN-EYE), ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Federica Morelli
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Roberta Nicotra
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Massimo Plumari
- Medical Genetics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Jessica Galli
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
- Unit of Child Neurology and Psychiatry, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Fabio Sirchia
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Medical Genetics Unit, IRCCS San Matteo Foundation, Pavia, Italy
| | - Enza Maria Valente
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Medical Genetics Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Ugo Cavallari
- Medical Genetics Unit, Department of Laboratory Medicine, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Marco Mazza
- Pediatric Ophthalmology Unit, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
- European Reference Network on Eye Diseases (ERN-EYE), ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Sabrina Signorini
- Developmental Neuro-ophthalmology Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Edoardo Errichiello
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
- Medical Genetics Unit, IRCCS Mondino Foundation, Pavia, Italy
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Guven Y, Saracoglu HP, Aksakal SD, Kalayci T, Altunoglu U, Uyguner ZO, Eraslan S, Borklu E, Kayserili H. Nance-Horan Syndrome: characterization of dental, clinical and molecular features in three new families. BMC Oral Health 2023; 23:314. [PMID: 37221585 DOI: 10.1186/s12903-023-03029-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Accepted: 05/09/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Nance-Horan syndrome (NHS; MIM 302,350) is an extremely rare X-linked dominant disease characterized by ocular and dental anomalies, intellectual disability, and facial dysmorphic features. CASE PRESENTATION We report on five affected males and three carrier females from three unrelated NHS families. In Family 1, index (P1) showing bilateral cataracts, iris heterochromia, microcornea, mild intellectual disability, and dental findings including Hutchinson incisors, supernumerary teeth, bud-shaped molars received clinical diagnosis of NHS and targeted NHS gene sequencing revealed a novel pathogenic variant, c.2416 C > T; p.(Gln806*). In Family 2, index (P2) presenting with global developmental delay, microphthalmia, cataracts, and ventricular septal defect underwent SNP array testing and a novel deletion encompassing 22 genes including the NHS gene was detected. In Family 3, two half-brothers (P3 and P4) and maternal uncle (P5) had congenital cataracts and mild to moderate intellectual deficiency. P3 also had autistic and psychobehavioral features. Dental findings included notched incisors, bud-shaped permanent molars, and supernumerary molars. Duo-WES analysis on half-brothers showed a hemizygous novel deletion, c.1867delC; p.(Gln623ArgfsTer26). CONCLUSIONS Dental professionals can be the first-line specialists involved in the diagnosis of NHS due to its distinct dental findings. Our findings broaden the spectrum of genetic etiopathogenesis associated with NHS and aim to raise awareness among dental professionals.
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Affiliation(s)
- Yeliz Guven
- Department of Pedodontics, Faculty of Dentistry, Istanbul University, Vezneciler, Istanbul, Turkey.
| | | | - Sermin Dicle Aksakal
- Department of Pedodontics, Faculty of Dentistry, Istanbul University, Vezneciler, Istanbul, Turkey
| | - Tugba Kalayci
- Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Umut Altunoglu
- Department of Medical Genetics, Koc University School of Medicine (KUSoM), Sarıyer, Istanbul, Turkey
- Genetic Diseases Evaluation Center, Koc University Hospital, Zeytinburnu, Istanbul, Turkey
| | - Zehra Oya Uyguner
- Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Serpil Eraslan
- Genetic Diseases Evaluation Center, Koc University Hospital, Zeytinburnu, Istanbul, Turkey
| | - Esra Borklu
- Genetic Diseases Evaluation Center, Koc University Hospital, Zeytinburnu, Istanbul, Turkey
| | - Hulya Kayserili
- Department of Medical Genetics, Koc University School of Medicine (KUSoM), Sarıyer, Istanbul, Turkey
- Genetic Diseases Evaluation Center, Koc University Hospital, Zeytinburnu, Istanbul, Turkey
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Disatham J, Brennan L, Jiao X, Ma Z, Hejtmancik JF, Kantorow M. Changes in DNA methylation hallmark alterations in chromatin accessibility and gene expression for eye lens differentiation. Epigenetics Chromatin 2022; 15:8. [PMID: 35246225 PMCID: PMC8897925 DOI: 10.1186/s13072-022-00440-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/16/2022] [Indexed: 12/13/2022] Open
Abstract
Background Methylation at cytosines (mCG) is a well-known regulator of gene expression, but its requirements for cellular differentiation have yet to be fully elucidated. A well-studied cellular differentiation model system is the eye lens, consisting of a single anterior layer of epithelial cells that migrate laterally and differentiate into a core of fiber cells. Here, we explore the genome-wide relationships between mCG methylation, chromatin accessibility and gene expression during differentiation of eye lens epithelial cells into fiber cells. Results Whole genome bisulfite sequencing identified 7621 genomic loci exhibiting significant differences in mCG levels between lens epithelial and fiber cells. Changes in mCG levels were inversely correlated with the differentiation state-specific expression of 1285 genes preferentially expressed in either lens fiber or lens epithelial cells (Pearson correlation r = − 0.37, p < 1 × 10–42). mCG levels were inversely correlated with chromatin accessibility determined by assay for transposase-accessible sequencing (ATAC-seq) (Pearson correlation r = − 0.86, p < 1 × 10–300). Many of the genes exhibiting altered regions of DNA methylation, chromatin accessibility and gene expression levels in fiber cells relative to epithelial cells are associated with lens fiber cell structure, homeostasis and transparency. These include lens crystallins (CRYBA4, CRYBB1, CRYGN, CRYBB2), lens beaded filament proteins (BFSP1, BFSP2), transcription factors (HSF4, SOX2, HIF1A), and Notch signaling pathway members (NOTCH1, NOTCH2, HEY1, HES5). Analysis of regions exhibiting cell-type specific alterations in DNA methylation revealed an overrepresentation of consensus sequences of multiple transcription factors known to play key roles in lens cell differentiation including HIF1A, SOX2, and the MAF family of transcription factors. Conclusions Collectively, these results link DNA methylation with control of chromatin accessibility and gene expression changes required for eye lens differentiation. The results also point to a role for DNA methylation in the regulation of transcription factors previously identified to be important for lens cell differentiation. Supplementary Information The online version contains supplementary material available at 10.1186/s13072-022-00440-z.
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Affiliation(s)
- Joshua Disatham
- Department of Biomedical Science, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Lisa Brennan
- Department of Biomedical Science, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA
| | - Xiaodong Jiao
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Zhiwei Ma
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - J Fielding Hejtmancik
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marc Kantorow
- Department of Biomedical Science, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, FL, USA.
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Idriss LT, Hussain M, Khan M, Ahmad T, Muhammad K, Baig M, Khan MM, Inamullah. Mapping of global research output in congenital cataracts from 1903 to 2021. Medicine (Baltimore) 2021; 100:e27756. [PMID: 35049169 PMCID: PMC9191315 DOI: 10.1097/md.0000000000027756] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/27/2021] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND AND AIM Globally, congenital cataract remains one of the main causes of visual loss in children. This study was designed to plot the overall research output and evaluate some key bibliometric indicators in congenital cataracts research. METHODS Publications on congenital cataracts were retrieved from the Web of Science Core Collection database. The published literature was searched using the keywords "congenital cataract" OR "congenital cataracts" in the title filed with document types and language restrictions. The data were exported into HistCite to analyze; publication year, top authors, countries, institutions, journals, keywords, and most cited studies. VOSviewer software was used to construct network visualization mapping. RESULTS A total of 1427 publications (1903-2021) published in English language were included in this study. Over the past few decades, the total number of publications in congenital cataracts was found to be increased. The most productive year was 2016 (n = 72), while the most cited year was 1941 (1268 citations). The Investigative Ophthalmology & Visual Science (Impact Factor: 4.799) was the most attractive journal with 161 publications, and the Molecular Vision (Impact Factor : 2.367) was the most cited journal with 1915 citations and 161.723 citations per year. The most productive country was the United States of America (USA) (n = 325), while the most active institute was Sun Yat-sen University, China (n = 36). The most prolific author was Yao K (n = 27). The most studied Web of Science category was ophthalmology (n = 852). The most widely used keyword was congenital (n = 1427). The most cited paper in congenital cataracts was "Congenital cataract following German measles in the mother, cited 1268 times. The USA and author keyword congenital cataract had the highest total link strength. CONCLUSION These findings provide useful insights, current status, and trends in clinical research in congenital cataracts. This study can be used to identify future research areas and standard bibliography references for better diagnosis and disease control.
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Affiliation(s)
- Lujain Talaat Idriss
- Department of Ophthalmology, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Maryam Hussain
- Department of Biotechnology and Genetic Engineering, Hazara University Mansehra, Mansehra, Khyber Pakhtunkhwa, Islamic Republic of Pakistan
| | - Muhammad Khan
- Department of Biotechnology and Genetic Engineering, Hazara University Mansehra, Mansehra, Khyber Pakhtunkhwa, Islamic Republic of Pakistan
| | - Tauseef Ahmad
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
| | - Khushi Muhammad
- Department of Biotechnology and Genetic Engineering, Hazara University Mansehra, Mansehra, Khyber Pakhtunkhwa, Islamic Republic of Pakistan
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muhammad Mumtaz Khan
- Department of Microbiology, University of Haripur, Haripur, Khyber Pakhtunkhwa, Islamic Republic of Pakistan
| | - Inamullah
- Department of Biotechnology and Genetic Engineering, Hazara University Mansehra, Mansehra, Khyber Pakhtunkhwa, Islamic Republic of Pakistan
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Identification of Differentially Methylated CpG Sites in Fibroblasts from Keloid Scars. Biomedicines 2020; 8:biomedicines8070181. [PMID: 32605309 PMCID: PMC7400180 DOI: 10.3390/biomedicines8070181] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 06/20/2020] [Accepted: 06/24/2020] [Indexed: 12/12/2022] Open
Abstract
As a part of an abnormal healing process of dermal injuries and irritation, keloid scars arise on the skin as benign fibroproliferative tumors. Although the etiology of keloid scarring remains unsettled, considerable recent evidence suggested that keloidogenesis may be driven by epigenetic changes, particularly, DNA methylation. Therefore, genome-wide scanning of methylated cytosine-phosphoguanine (CpG) sites in extracted DNA from 12 keloid scar fibroblasts (KF) and 12 control skin fibroblasts (CF) (six normal skin fibroblasts and six normotrophic fibroblasts) was conducted using the Illumina Human Methylation 450K BeadChip in two replicates for each sample. Comparing KF and CF used a Linear Models for Microarray Data (Limma) model revealed 100,000 differentially methylated (DM) CpG sites, 20,695 of which were found to be hypomethylated and 79,305 were hypermethylated. The top DM CpG sites were associated with TNKS2, FAM45B, LOC723972, GAS7, RHBDD2 and CAMKK1. Subsequently, the most functionally enriched genes with the top 100 DM CpG sites were significantly (p ≤ 0.05) associated with SH2 domain binding, regulation of transcription, DNA-templated, nucleus, positive regulation of protein targeting to mitochondrion, nucleoplasm, Swr1 complex, histone exchange, and cellular response to organic substance. In addition, NLK, CAMKK1, LPAR2, CASP1, and NHS showed to be the most common regulators in the signaling network analysis. Taken together, these findings shed light on the methylation status of keloids that could be implicated in the underlying mechanism of keloid scars formation and remission.
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Jiang X, Jin X, Zhang N, Zhang H. A family of fuchs endothelial corneal dystrophy and anterior polar cataract with an analysis of whole exome sequencing. Ophthalmic Genet 2020; 41:263-270. [PMID: 32367751 DOI: 10.1080/13816810.2020.1759109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
PURPOSE Our aim was to introduce a family affected by this rare phenotype, and perform the whole exome sequencing (WES) to explore the potential candidate genes causing the disorders. METHODS A five-generation family including five patients affected by FECD with APC, and nine patients suffered from only FECD was recruited from the First Affiliated Hospital of Harbin Medical University. All participants received ophthalmic examinations. Eight family members were selected to perform WES with a bioinformatics analysis and genome-wide linkage analysis. The candidate genes were identified by polymerase chain reaction (PCR) and Sanger sequencing. RESULTS Patients in this family had FECD as the common feature. The proband (a 65-year-old female) was affected by FECD and APC in both eyes, with epithelial bullae in the left eye. Slit-lamp, specular, and confocal microscope and OCT images showed guttae more serious in the central cornea than the peripheral area, confirming the diagnosis of FECD. In this family, most corneal guttae was bilateral with an almost equal degree of progression in the Descemet membrane, APC was found around the age of 10, perhaps even earlier. According to the analysis of bioinformatics analysis, two candidate genes were found and confirmed by PCR and Sanger sequencing, but could not achieve genotype-phenotype co-segregation in the family. CONCLUSION We introduced a family of FECD with APC, with no known causative gene found by WES, inferring that there may be a novel gene-locus in the non-coding regions of genome, which needs further study by WGS. The contribution of this study was to exclude the possibility of the rare phenotype pathogenic site in exome and narrow the scope of pathogenic genes.
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Affiliation(s)
- Xue Jiang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University , Harbin, P.R. China
| | - Xin Jin
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University , Harbin, P.R. China
| | - Nan Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University , Harbin, P.R. China
| | - Hong Zhang
- Department of Ophthalmology, The First Affiliated Hospital of Harbin Medical University , Harbin, P.R. China
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Wei M, Qi A, Mo H, Wu K, Ma X, Wang B. A novel NHS mutation in a Chinese family with Nance‑Horan Syndrome. Mol Med Rep 2019; 19:4419-4424. [PMID: 30942463 DOI: 10.3892/mmr.2019.10106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 11/15/2018] [Indexed: 11/06/2022] Open
Abstract
Nance‑Horan syndrome (NHS) is a rare X‑linked disorder with various clinical manifestations. The present study aimed to identify the pathogenic mutation causing NHS in a three‑generation Chinese family with 4 individuals presenting primarily with congenital cataracts. The genomic DNA of 5 individuals was collected, and family history and clinical information were recorded. Whole exome sequencing was performed on the proband, and candidate mutations were filtered by a series of screening processes and validated by Sanger sequencing. The identified pathogenic mutation was confirmed by co‑segregation analysis. Finally, a novel frameshift mutation (NM_001291867.1: c.302dupA; p.Ala102fs) was identified in the NHS actin remodeling regulator (NHS) gene, which co‑segregated with congenital cataracts in this family. Carrier females exhibited similar but milder clinical symptoms compared with the affected male. These clinical symptoms were consistent with the phenotypic features of the NHS‑associated disease, NHS. In summary, the present study identified a novel NHS mutation in a Chinese family with atypical NHS; the results broaden the known pathogenic mutation spectrum of NHS and will aid in the genetic counseling of patients with NHS. The data from the present study also suggest that genetic analysis may be required for the diagnosis of this disease.
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Affiliation(s)
- Meirong Wei
- Department of Ophthalmology, Liuzhou Maternal and Child Healthcare Hospital, Liuzhou, Guangxi 545001, P.R. China
| | - Anhui Qi
- Graduate School of Peking Union Medical College, Beijing 100730, P.R. China
| | - Haiming Mo
- Department of Ophthalmology, Liuzhou Maternal and Child Healthcare Hospital, Liuzhou, Guangxi 545001, P.R. China
| | - Kailin Wu
- Department of Ophthalmology, Liuzhou Maternal and Child Healthcare Hospital, Liuzhou, Guangxi 545001, P.R. China
| | - Xu Ma
- Center for Genetics, National Research Institute for Family Planning, Beijing 100081, P.R. China
| | - Binbin Wang
- Graduate School of Peking Union Medical College, Beijing 100730, P.R. China
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Ling C, Sui R, Yao F, Wu Z, Zhang X, Zhang S. Whole exome sequencing identified a novel truncation mutation in the NHS gene associated with Nance-Horan syndrome. BMC MEDICAL GENETICS 2019; 20:14. [PMID: 30642278 PMCID: PMC6332535 DOI: 10.1186/s12881-018-0725-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 11/21/2018] [Indexed: 11/10/2022]
Abstract
Background Nance-Horan syndrome (NHS) is an X-linked inheritance disorder characterized by bilateral congenital cataracts, and facial and dental dysmorphism. This disorder is caused by mutations in the NHS gene. However, NHS may be difficult to detect in individuals with subtle facial dysmorphism and dental abnormalities in whom congenital cataracts are the primary clinical manifestations. Methods In this study, we present a three-generation family with NHS. Whole exome sequencing was performed to determine the potential pathogenic variant in the proband. Further validation was explored with Sanger sequencing in 9 of the available individuals of the family and additional 200 controls. Results A novel truncation mutation in gene NHS (c.C4449G, p.Tyr1483Ter) was found in the proband, who presented with a long-narrow face, prominent nose and large anteverted pinnae ear, screw-driver like incisors, mild mulberry like molars, one missing maxillary second molar and malocclusion. We found this mutation was detected in 2 male patients and 4 female carriers in the family. However, the mutation was never detected in the control subjects. Conclusions In conclusion, we identified a novel truncation mutation in the NHS gene, which might associate with NHS. Our review on the NHS studies illustrated that NHS has significantly clinical heterogeneity. And NHS mutations in the NHS-affected individuals typically result in premature truncation of the protein. And the new mutation revealed in this study would highlight the understanding of the causative mutations of NHS. Electronic supplementary material The online version of this article (10.1186/s12881-018-0725-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chao Ling
- Laboratory of Clinical Genetics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Ruifang Sui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Fengxia Yao
- Laboratory of Clinical Genetics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Zhihong Wu
- Central Research Laboratory, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
| | - Xue Zhang
- Laboratory of Clinical Genetics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China. .,McKusick-Zhang Center for Genetic Medicine, State Key Laboratory of Medical Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, 100005, China.
| | - Shuyang Zhang
- Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China
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