Expansion of NEUROD2 phenotypes to include developmental delay without seizures.

Expansion of NEUROD2 phenotypes to include developmental delay without seizures.
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DOI:
10.1002/ajmg.a.62064
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发表时间:
2021-04
期刊:
American journal of medical genetics. Part A
影响因子:
--
通讯作者:
Lakhani SA
Lakhani SA
中科院分区:
其他
文献类型:
--
作者:
Mis EK;Sega AG;Signer RH;Cartwright T;Ji W;Martinez-Agosto JA;Nelson SF;Palmer CGS;Lee H;Mitzelfelt T;Konstantino M;Undiagnosed Diseases Network;Jeffries L;Khokha MK;Marco E;Martin MG;Lakhani SA

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脑特异性转录因子神经元分化因子2(NEUROD2)的新生杂合变体最近与早发性癫痫性脑病和发育迟缓相关。在这里,我们报告了一个青少年发育迟缓没有癫痫谁被发现有一个新的从头杂合子NEUROD2错义变异,p。(Leu163Pro)。使用非洲爪蟾蝌蚪中神经元分化的体内测定的功能测试证明,NEUROD2的患者变体显示最小的蛋白质活性,强烈表明功能效应的丧失。相比之下,第二种罕见的NEUROD2变体,p。(Ala235Thr),在青少年发育迟缓,但缺乏父母的遗传研究,显示正常的体内NEUROD2活性。因此,我们提供了临床,遗传和功能的证据表明,NEUROD2变体可以导致发育迟缓,而不伴随早发性癫痫发作,并证明功能测试如何在确定变体致病性时补充遗传数据。
De novo heterozygous variants in the brain-specific transcription factor Neuronal Differentiation Factor 2 (NEUROD2) have been recently associated with early-onset epileptic encephalopathy and developmental delay. Here, we report an adolescent with developmental delay without seizures who was found to have a novel de novo heterozygous NEUROD2 missense variant, p.(Leu163Pro). Functional testing using an in vivo assay of neuronal differentiation in Xenopus laevis tadpoles demonstrated that the patient variant of NEUROD2 displays minimal protein activity, strongly suggesting a loss of function effect. In contrast, a second rare NEUROD2 variant, p.(Ala235Thr), identified in an adolescent with developmental delay but lacking parental studies for inheritance, showed normal in vivo NEUROD2 activity. We thus provide clinical, genetic, and functional evidence that NEUROD2 variants can lead to developmental delay without accompanying early-onset seizures, and demonstrate how functional testing can complement genetic data when determining variant pathogenicity.
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