Pediatric Endocrinology, University Children's Hospital, Hoppe-Seyler-Strasse 1, 72076, Tübingen, Germany.
Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.
Clin Epigenetics. 2020 Oct 19;12(1):152. doi: 10.1186/s13148-020-00945-y.
Pathogenic CDKN1C gain-of-function variants on the maternal allele were initially reported as a cause of IMAGe syndrome characterized by intrauterine growth retardation, metaphyseal dysplasia, primary adrenal insufficiency and genital anomalies. Recently, a maternally inherited CDKN1C missense mutation (p.Arg279Leu) was identified in several members of a single family clinically diagnosed with Silver-Russell syndrome (SRS) but without adrenal insufficiency. Thereafter, two half siblings from UK with familial SRS were described who carried the same mutation. This specific amino acid change is located within a narrow functional region containing the mutations previously associated with IMAGe syndrome.
Here, we describe a third familial case with maternally inherited SRS due to a missense variant affecting the same amino acid position 279 but leading to a different amino acid substitution (p. (Arg279Ser)). The two affected family members (mother and son) presented with the complete SRS phenotype (both Netchine-Harbison CSS score 5 of 6) but without body asymmetry or adrenal insufficiency.
In comparison with loss-of-function genomic IGF2 mutations, CDKN1C gain-of-function mutations are a less frequent cause of SRS and seem to affect a cluster of few amino acids.
最初报道母源等位基因上致病性 CDKN1C 功能获得性变异是 IMAGe 综合征的一个原因,其特征为宫内生长迟缓、干骺端发育不良、原发性肾上腺功能不全和生殖器异常。最近,在一个单一家庭的几个成员中发现了一个母系遗传的 CDKN1C 错义突变(p.Arg279Leu),这些成员被临床诊断为 Silver-Russell 综合征(SRS),但没有肾上腺功能不全。此后,描述了来自英国的两个具有家族性 SRS 的半同胞,他们携带相同的突变。这种特定的氨基酸变化位于一个狭窄的功能区域内,该区域包含先前与 IMAGe 综合征相关的突变。
在这里,我们描述了第三个具有母系遗传 SRS 的家族病例,其原因是错义变异影响相同的氨基酸位置 279,但导致不同的氨基酸取代(p.(Arg279Ser))。两个受影响的家庭成员(母亲和儿子)表现出完整的 SRS 表型(均为 Netchine-Harbison CSS 评分 5 分中的 6 分),但没有身体不对称或肾上腺功能不全。
与缺失功能的 IGF2 基因突变相比,CDKN1C 功能获得性突变是 SRS 的一个不太常见的原因,似乎影响了少数几个氨基酸簇。