Gass Jennifer M, Head Barbara B, Shields Sally M, Stevenson Roger E, Louie Raymond J
J.C. Self Research Institute of Human Genetics, Greenwood Genetic Center, Greenwood, South Carolina, USA.
Maternal-Fetal Medicine Division, Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA.
Birth Defects Res. 2020 Aug;112(13):1028-1034. doi: 10.1002/bdr2.1699. Epub 2020 Apr 29.
Hydrocephalus is characterized by increased cerebrospinal fluid within the brain, a causally heterogeneous disorder estimated to affect 1 per 1,000 live births, with the most severe cases often leading to fetal demise. The large number of known genetic and environmental factors that contribute to hydrocephalus makes the differential diagnosis challenging.
Three consecutive pregnancies of an unrelated couple were found by ultrasound to carry fetuses with hydrocephaly. DNA from two affected fetuses and the parents were subjected to whole exome sequencing. Heterozygous alterations in the TRAPPC12 gene were identified in the parents and compound heterozygous alterations were present in the two affected fetuses. The variant from the father (c.954del) leads to a premature termination of the transcript; the variant from the mother (c.1677+5G>A) affects a splice site which leads to aberrant splicing of the TRAPPC12 transcript.
Compound heterozygous variants in TRAPPC12, which encodes a protein involved in Golgi trafficking and mitosis, may disrupt normal brain embryogenesis leading to hydrocephalus and recurrent pregnancy loss.
脑积水的特征是脑内脑脊液增多,这是一种病因异质性疾病,估计每1000例活产中就有1例受影响,最严重的病例常导致胎儿死亡。导致脑积水的已知遗传和环境因素众多,这使得鉴别诊断具有挑战性。
一对无血缘关系的夫妇连续三次怀孕,经超声检查发现胎儿患有脑积水。对两名患病胎儿及其父母的DNA进行了全外显子组测序。在父母中鉴定出TRAPPC12基因的杂合改变,在两名患病胎儿中存在复合杂合改变。来自父亲的变异(c.954del)导致转录本提前终止;来自母亲的变异(c.1677+5G>A)影响一个剪接位点,导致TRAPPC12转录本异常剪接。
TRAPPC12基因中的复合杂合变异可能会破坏正常的脑胚胎发育,导致脑积水和复发性流产。TRAPPC12基因编码一种参与高尔基体运输和有丝分裂的蛋白质。