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Chu KY, Wang YL, Chou YR, Chen JT, Wang YP, Simmer JP, Hu JCC, Wang SK. Synergistic Mutations of LRP6 and WNT10A in Familial Tooth Agenesis. J Pers Med 2021; 11:jpm11111217. [PMID: 34834569 PMCID: PMC8621929 DOI: 10.3390/jpm11111217] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 11/13/2021] [Accepted: 11/13/2021] [Indexed: 02/07/2023] Open
Abstract
Familial tooth agenesis (FTA), distinguished by developmental failure of selected teeth, is one of the most prevalent craniofacial anomalies in humans. Mutations in genes involved in WNT/β-catenin signaling, including AXIN2 WNT10A, WNT10B, LRP6, and KREMEN1, are known to cause FTA. However, mutational interactions among these genes have not been fully explored. In this study, we characterized four FTA kindreds with LRP6 pathogenic mutations: p.(Gln1252*), p.(Met168Arg), p.(Ala754Pro), and p.(Asn1075Ser). The three missense mutations were predicted to cause structural destabilization of the LRP6 protein. Two probands carrying both an LRP6 mutant allele and a WNT10A variant exhibited more severe phenotypes, suggesting mutational synergism or digenic inheritance. Biallelic LRP6 mutations in a patient with many missing teeth further supported the dose-dependence of LRP6-associated FTA. Analysis of 21 FTA cases with 15 different LRP6 loss-of-function mutations revealed high heterogeneity of disease severity and a distinctive pattern of missing teeth, with maxillary canines being frequently affected. We hypothesized that various combinations of sequence variants in WNT-related genes can modulate WNT signaling activities during tooth development and cause a wide spectrum of tooth agenesis severity, which highlights the importance of exome/genome analysis for the genetic diagnosis of FTA in this era of precision medicine.
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Affiliation(s)
- Kuan-Yu Chu
- Department of Dentistry, School of Dentistry, National Taiwan University, Taipei City 100, Taiwan; (K.-Y.C.); (Y.-L.W.); (J.-T.C.); (Y.-P.W.)
- Department of Pediatric Dentistry, National Taiwan University Children’s Hospital, Taipei City 100, Taiwan
| | - Yin-Lin Wang
- Department of Dentistry, School of Dentistry, National Taiwan University, Taipei City 100, Taiwan; (K.-Y.C.); (Y.-L.W.); (J.-T.C.); (Y.-P.W.)
- Department of Pediatric Dentistry, National Taiwan University Children’s Hospital, Taipei City 100, Taiwan
| | - Yu-Ren Chou
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei City 106, Taiwan;
| | - Jung-Tsu Chen
- Department of Dentistry, School of Dentistry, National Taiwan University, Taipei City 100, Taiwan; (K.-Y.C.); (Y.-L.W.); (J.-T.C.); (Y.-P.W.)
| | - Yi-Ping Wang
- Department of Dentistry, School of Dentistry, National Taiwan University, Taipei City 100, Taiwan; (K.-Y.C.); (Y.-L.W.); (J.-T.C.); (Y.-P.W.)
| | - James P. Simmer
- Department of Biologic and Materials Sciences, University of Michigan School of Dentistry, Ann Arbor, MI 48108, USA; (J.P.S.); (J.C.-C.H.)
| | - Jan C.-C. Hu
- Department of Biologic and Materials Sciences, University of Michigan School of Dentistry, Ann Arbor, MI 48108, USA; (J.P.S.); (J.C.-C.H.)
| | - Shih-Kai Wang
- Department of Dentistry, School of Dentistry, National Taiwan University, Taipei City 100, Taiwan; (K.-Y.C.); (Y.-L.W.); (J.-T.C.); (Y.-P.W.)
- Department of Pediatric Dentistry, National Taiwan University Children’s Hospital, Taipei City 100, Taiwan
- Correspondence: ; Tel.: +886-2-23123456 (ext. 70251)
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