Charité - Universitätsmedizin Berlin, Berlin 13353, Germany.
Charité - Universitätsmedizin Berlin, Berlin 13353, Germany; Berlin Institute of Health (BIH), Berlin 10117, Germany.
Am J Hum Genet. 2019 Sep 5;105(3):631-639. doi: 10.1016/j.ajhg.2019.07.002. Epub 2019 Jul 25.
Notch signaling is an established developmental pathway for brain morphogenesis. Given that Delta-like 1 (DLL1) is a ligand for the Notch receptor and that a few individuals with developmental delay, intellectual disability, and brain malformations have microdeletions encompassing DLL1, we hypothesized that insufficiency of DLL1 causes a human neurodevelopmental disorder. We performed exome sequencing in individuals with neurodevelopmental disorders. The cohort was identified using known Matchmaker Exchange nodes such as GeneMatcher. This method identified 15 individuals from 12 unrelated families with heterozygous pathogenic DLL1 variants (nonsense, missense, splice site, and one whole gene deletion). The most common features in our cohort were intellectual disability, autism spectrum disorder, seizures, variable brain malformations, muscular hypotonia, and scoliosis. We did not identify an obvious genotype-phenotype correlation. Analysis of one splice site variant showed an in-frame insertion of 12 bp. In conclusion, heterozygous DLL1 pathogenic variants cause a variable neurodevelopmental phenotype and multi-systemic features. The clinical and molecular data support haploinsufficiency as a mechanism for the pathogenesis of this DLL1-related disorder and affirm the importance of DLL1 in human brain development.
Notch 信号通路是大脑形态发生的既定发育途径。鉴于 Delta-like 1(DLL1)是 Notch 受体的配体,并且少数发育迟缓、智力障碍和脑畸形的个体存在包含 DLL1 的微缺失,我们假设 DLL1 不足会导致人类神经发育障碍。我们对神经发育障碍患者进行了外显子组测序。该队列是使用已知的 Matchmaker Exchange 节点(如 GeneMatcher)确定的。这种方法从 12 个无血缘关系的家庭中确定了 15 名具有杂合致病性 DLL1 变体(无义、错义、剪接位点和一个全基因缺失)的个体。我们队列中最常见的特征是智力障碍、自闭症谱系障碍、癫痫发作、可变脑畸形、肌肉张力减退和脊柱侧凸。我们没有发现明显的基因型-表型相关性。对一个剪接位点变体的分析显示,有 12 个 bp 的框内插入。总之,杂合 DLL1 致病性变体导致可变的神经发育表型和多系统特征。临床和分子数据支持单倍不足是该 DLL1 相关疾病发病机制的一种机制,并证实 DLL1 在人类大脑发育中的重要性。
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