Nakayama Tojo, Al-Maawali Almundher, El-Quessny Malak, Rajab Anna, Khalil Samir, Stoler Joan M, Tan Wen-Hann, Nasir Ramzi, Schmitz-Abe Klaus, Hill R Sean, Partlow Jennifer N, Al-Saffar Muna, Servattalab Sarah, LaCoursiere Christopher M, Tambunan Dimira E, Coulter Michael E, Elhosary Princess C, Gorski Grzegorz, Barkovich A James, Markianos Kyriacos, Poduri Annapurna, Mochida Ganeshwaran H
Division of Genetics and Genomics, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Manton Center for Orphan Disease Research, Boston Children's Hospital, Boston, MA 02115, USA; Department of Pediatrics, Harvard Medical School, Boston, MA 02115, USA.
Division of Genetics and Genomics, Department of Medicine, Boston Children's Hospital, Boston, MA 02115, USA; Manton Center for Orphan Disease Research, Boston Children's Hospital, Boston, MA 02115, USA; Department of Genetics, College of Medicine and Health Science, Sultan Qaboos University, Muscat 123, Oman.
Am J Hum Genet. 2015 May 7;96(5):709-19. doi: 10.1016/j.ajhg.2015.03.003. Epub 2015 Apr 9.
Despite recent advances in understanding the genetic bases of microcephaly, a large number of cases of microcephaly remain unexplained, suggesting that many microcephaly syndromes and associated genes have yet to be identified. Here, we report mutations in PYCR2, which encodes an enzyme in the proline biosynthesis pathway, as the cause of a unique syndrome characterized by postnatal microcephaly, hypomyelination, and reduced cerebral white-matter volume. Linkage mapping and whole-exome sequencing identified homozygous mutations (c.355C>T [p.Arg119Cys] and c.751C>T [p.Arg251Cys]) in PYCR2 in the affected individuals of two consanguineous families. A lymphoblastoid cell line from one affected individual showed a strong reduction in the amount of PYCR2. When mutant cDNAs were transfected into HEK293FT cells, both variant proteins retained normal mitochondrial localization but had lower amounts than the wild-type protein, suggesting that the variant proteins were less stable. A PYCR2-deficient HEK293FT cell line generated by genome editing with the clustered regularly interspaced short palindromic repeat (CRISPR)-Cas9 system showed that PYCR2 loss of function led to decreased mitochondrial membrane potential and increased susceptibility to apoptosis under oxidative stress. Morpholino-based knockdown of a zebrafish PYCR2 ortholog, pycr1b, recapitulated the human microcephaly phenotype, which was rescued by wild-type human PYCR2 mRNA, but not by mutant mRNAs, further supporting the pathogenicity of the identified variants. Hypomyelination and the absence of lax, wrinkly skin distinguishes this condition from that caused by previously reported mutations in the gene encoding PYCR2's isozyme, PYCR1, suggesting a unique and indispensable role for PYCR2 in the human CNS during development.
尽管在理解小头畸形的遗传基础方面取得了最新进展,但仍有大量小头畸形病例无法得到解释,这表明许多小头畸形综合征及相关基因尚未被发现。在此,我们报告脯氨酸生物合成途径中的一种酶——PYCR2发生突变,是导致一种独特综合征的原因,该综合征的特征为出生后小头畸形、髓鞘形成不足以及脑白质体积减小。连锁图谱分析和全外显子组测序在两个近亲家庭的患病个体中鉴定出PYCR2的纯合突变(c.355C>T [p.Arg119Cys]和c.751C>T [p.Arg251Cys])。来自一名患病个体的淋巴母细胞系显示PYCR2的量大幅减少。当将突变cDNA转染到HEK293FT细胞中时,两种变异蛋白均保持正常的线粒体定位,但量比野生型蛋白少,这表明变异蛋白稳定性较低。用成簇规律间隔短回文重复序列(CRISPR)-Cas9系统进行基因组编辑产生的PYCR2缺陷型HEK293FT细胞系表明,PYCR2功能丧失导致线粒体膜电位降低以及在氧化应激下对细胞凋亡的易感性增加。基于吗啉代的斑马鱼PYCR2直系同源基因pycr1b的敲低模拟了人类小头畸形表型,野生型人类PYCR2 mRNA可挽救该表型,而突变mRNA则不能,这进一步支持了所鉴定变异的致病性。髓鞘形成不足以及缺乏松弛、起皱的皮肤将这种情况与先前报道的编码PYCR2同功酶PYCR1的基因突变所导致的情况区分开来,这表明PYCR2在人类中枢神经系统发育过程中具有独特且不可或缺的作用。