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Aubert-Mucca M, Huber C, Baujat G, Michot C, Zarhrate M, Bras M, Boutaud L, Malan V, Attie-Bitach T, Cormier-Daire V. Ellis-Van Creveld Syndrome: Clinical and Molecular Analysis of 50 Individuals. J Med Genet 2023; 60:337-345. [PMID: 35927022 DOI: 10.1136/jmg-2022-108435] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 07/09/2022] [Indexed: 11/03/2022]
Abstract
BACKGROUND Ellis-Van Creveld (EVC) syndrome is one of the entities belonging to the skeletal ciliopathies short rib-polydactyly subgroup. Major signs are ectodermal dysplasia, chondrodysplasia, polydactyly and congenital cardiopathy, with a high degree of variability in phenotypes ranging from lethal to mild clinical presentations. The EVC and EVC2 genes are the major genes causative of EVC syndrome. However, an increased number of genes involved in the ciliopathy complex have been identified in EVC syndrome, leading to a better understanding of its physiopathology, namely, WDR35, GLI1, DYNC2LI1, PRKACA, PRKACB and SMO. They all code for proteins located in the primary cilia, playing a key role in signal transduction of the Hedgehog pathways. METHODS The aim of this study was the analysis of 50 clinically identified EVC cases from 45 families to further define the phenotype and molecular bases of EVC. RESULTS Our detection rate in the cohort of 45 families was of 91.11%, with variants identified in EVC/EVC2 (77.8%), DYNC2H1 (6.7%), DYNC2LI1 (2.2%), SMO (2.2%) or PRKACB (2.2%). No distinctive feature was remarkable of a specific genotype-phenotype correlation. Interestingly, we identified a high proportion of heterozygous deletions in EVC/EVC2 of variable sizes (26.92%), mostly inherited from the mother, and probably resulting from recombinations involving Alu sequences. CONCLUSION We confirmed that EVC and EVC2 are the major genes involved in the EVC phenotype and highlighted the high prevalence of previously unreported CNVs (Copy Number Variation).
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Affiliation(s)
- Marion Aubert-Mucca
- Centre de Référence des Maladies Osseuses Constitutionnelles, Service de Médecine Génomique des Maladies Rares, Hôpital Universitaire Necker-Enfants Malades, Paris, France
| | - Céline Huber
- Université Paris Cité, INSERM UMR 1163, Imagine Institute, Paris, France
| | - Genevieve Baujat
- Centre de Référence des Maladies Osseuses Constitutionnelles, Service de Médecine Génomique des Maladies Rares, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Université Paris Cité, INSERM UMR 1163, Imagine Institute, Paris, France
| | - Caroline Michot
- Centre de Référence des Maladies Osseuses Constitutionnelles, Service de Médecine Génomique des Maladies Rares, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Université Paris Cité, INSERM UMR 1163, Imagine Institute, Paris, France
| | - Mohammed Zarhrate
- Genomics Core Facility, Institut Imagine-Structure Fédérative de Recherche Necker, INSERM U1163 et INSERM US24/CNRS UMS3633, Imagine Institute, Paris, France
| | - Marc Bras
- Bioinformatics Platform, Imagine Institute, Paris, France
| | - Lucile Boutaud
- Université Paris Cité, INSERM UMR 1163, Imagine Institute, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hopital Universitaire Necker-Enfants Malades, Paris, France
| | - Valérie Malan
- Université Paris Cité, INSERM UMR 1163, Imagine Institute, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hopital Universitaire Necker-Enfants Malades, Paris, France
| | - Tania Attie-Bitach
- Université Paris Cité, INSERM UMR 1163, Imagine Institute, Paris, France
- Service de Médecine Génomique des Maladies Rares, Hopital Universitaire Necker-Enfants Malades, Paris, France
| | | | - Valerie Cormier-Daire
- Centre de Référence des Maladies Osseuses Constitutionnelles, Service de Médecine Génomique des Maladies Rares, Hôpital Universitaire Necker-Enfants Malades, Paris, France
- Université Paris Cité, INSERM UMR 1163, Imagine Institute, Paris, France
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Schmidts M, Arts HH, Bongers EMHF, Yap Z, Oud MM, Antony D, Duijkers L, Emes RD, Stalker J, Yntema JBL, Plagnol V, Hoischen A, Gilissen C, Forsythe E, Lausch E, Veltman JA, Roeleveld N, Superti-Furga A, Kutkowska-Kazmierczak A, Kamsteeg EJ, Elçioğlu N, van Maarle MC, Graul-Neumann LM, Devriendt K, Smithson SF, Wellesley D, Verbeek NE, Hennekam RCM, Kayserili H, Scambler PJ, Beales PL, Knoers NVAM, Roepman R, Mitchison HM. Exome sequencing identifies DYNC2H1 mutations as a common cause of asphyxiating thoracic dystrophy (Jeune syndrome) without major polydactyly, renal or retinal involvement. J Med Genet 2013; 50:309-23. [PMID: 23456818 PMCID: PMC3627132 DOI: 10.1136/jmedgenet-2012-101284] [Citation(s) in RCA: 100] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 01/21/2013] [Indexed: 11/29/2022]
Abstract
BACKGROUND Jeune asphyxiating thoracic dystrophy (JATD) is a rare, often lethal, recessively inherited chondrodysplasia characterised by shortened ribs and long bones, sometimes accompanied by polydactyly, and renal, liver and retinal disease. Mutations in intraflagellar transport (IFT) genes cause JATD, including the IFT dynein-2 motor subunit gene DYNC2H1. Genetic heterogeneity and the large DYNC2H1 gene size have hindered JATD genetic diagnosis. AIMS AND METHODS To determine the contribution to JATD we screened DYNC2H1 in 71 JATD patients JATD patients combining SNP mapping, Sanger sequencing and exome sequencing. RESULTS AND CONCLUSIONS We detected 34 DYNC2H1 mutations in 29/71 (41%) patients from 19/57 families (33%), showing it as a major cause of JATD especially in Northern European patients. This included 13 early protein termination mutations (nonsense/frameshift, deletion, splice site) but no patients carried these in combination, suggesting the human phenotype is at least partly hypomorphic. In addition, 21 missense mutations were distributed across DYNC2H1 and these showed some clustering to functional domains, especially the ATP motor domain. DYNC2H1 patients largely lacked significant extra-skeletal involvement, demonstrating an important genotype-phenotype correlation in JATD. Significant variability exists in the course and severity of the thoracic phenotype, both between affected siblings with identical DYNC2H1 alleles and among individuals with different alleles, which suggests the DYNC2H1 phenotype might be subject to modifier alleles, non-genetic or epigenetic factors. Assessment of fibroblasts from patients showed accumulation of anterograde IFT proteins in the ciliary tips, confirming defects similar to patients with other retrograde IFT machinery mutations, which may be of undervalued potential for diagnostic purposes.
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Affiliation(s)
- Miriam Schmidts
- Molecular Medicine Unit, Birth Defects Research Centre, University College London (UCL) Institute of Child Health, London, UK
| | - Heleen H Arts
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
| | - Ernie M H F Bongers
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
| | - Zhimin Yap
- Molecular Medicine Unit, Birth Defects Research Centre, University College London (UCL) Institute of Child Health, London, UK
| | - Machteld M Oud
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
| | - Dinu Antony
- Molecular Medicine Unit, Birth Defects Research Centre, University College London (UCL) Institute of Child Health, London, UK
| | - Lonneke Duijkers
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Department of Physiology, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands
| | - Richard D Emes
- School of Veterinary Medicine and Science, University of Nottingham, Nottingham, Leicestershire, UK
| | - Jim Stalker
- The Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK
| | - Jan-Bart L Yntema
- Department of Paediatrics, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Vincent Plagnol
- Department of Genetics, Environment and Evolution, UCL Genetics Institute (UGI), University College London, London, UK
| | - Alexander Hoischen
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
| | - Christian Gilissen
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
| | - Elisabeth Forsythe
- Molecular Medicine Unit, Birth Defects Research Centre, University College London (UCL) Institute of Child Health, London, UK
| | - Ekkehart Lausch
- Division of Pediatric Genetics, Center for Pediatrics and Adolescent Medicine, University Hospital Freiburg, Freiburg, Germany
| | - Joris A Veltman
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
| | - Nel Roeleveld
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
- Department of Epidemiology, Biostatistics and HTA, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Evidence Based Practice, Radboud University, Nijmegen, The Netherlands
| | - Andrea Superti-Furga
- Department of Pediatrics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | | | - Erik-Jan Kamsteeg
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
| | - Nursel Elçioğlu
- Department of Pediatric Genetics, Marmara University Hospital, Istanbul, Turkey
| | - Merel C van Maarle
- Department of Clinical Genetics, Center for Human and Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Koenraad Devriendt
- Laboratory for Genetics of Human Development, Department of Human Genetics, KU Leuven University, Leuven, Belgium
| | - Sarah F Smithson
- Department of Clinical Genetics, St. Michael's Hospital, Bristol, UK
| | - Diana Wellesley
- Faculty of Medicine, University of Southampton and Essex Clinical Genetics Service, Princess Anne Hospital, Southampton, UK
| | - Nienke E Verbeek
- Department of Medical Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Raoul C M Hennekam
- Department of Pediatrics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Hulya Kayserili
- Istanbul Medical Faculty, Medical Genetics Department, Istanbul University, Istanbul, Turkey
| | - Peter J Scambler
- Molecular Medicine Unit, Birth Defects Research Centre, University College London (UCL) Institute of Child Health, London, UK
| | - Philip L Beales
- Molecular Medicine Unit, Birth Defects Research Centre, University College London (UCL) Institute of Child Health, London, UK
| | - Nine VAM Knoers
- Department of Medical Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - Ronald Roepman
- Department of Human Genetics, Radboud University Medical Centre, Nijmegen, The Netherlands
- Nijmegen Centre for Molecular Life Sciences, Radboud University, Nijmegen, The Netherlands
- Institute for Genetic and Metabolic Disease, Radboud University, Nijmegen, The Netherlands
| | - Hannah M Mitchison
- Molecular Medicine Unit, Birth Defects Research Centre, University College London (UCL) Institute of Child Health, London, UK
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