杂合性 ANKRD17 功能丧失变异导致伴有智力残疾、言语延迟和发育异常的综合征。

Heterozygous ANKRD17 loss-of-function variants cause a syndrome with intellectual disability, speech delay, and dysmorphism.

机构信息

Département de Génétique, Hôpital Necker-Enfants Malades, Assistance Publique Hôpitaux de Paris (AP-HP), and Institut Imagine, Paris 75015, France; Laboratory of embryology and genetics of human malformations, Institut National de la Santé et de la Recherche Médicale (INSERM) UMR 1163, Institut Imagine, Université de Paris, Paris 75015, France; Rosamund Stone Zander Translational Neuroscience Center, Department of Neurology, Boston Children's Hospital, Boston, MA 02115, USA.

Department of Medical Genetics, St George's University Hospitals NHS FT, London SW17 ORE, UK.

出版信息

Am J Hum Genet. 2021 Jun 3;108(6):1138-1150. doi: 10.1016/j.ajhg.2021.04.007. Epub 2021 Apr 27.

Abstract

ANKRD17 is an ankyrin repeat-containing protein thought to play a role in cell cycle progression, whose ortholog in Drosophila functions in the Hippo pathway as a co-factor of Yorkie. Here, we delineate a neurodevelopmental disorder caused by de novo heterozygous ANKRD17 variants. The mutational spectrum of this cohort of 34 individuals from 32 families is highly suggestive of haploinsufficiency as the underlying mechanism of disease, with 21 truncating or essential splice site variants, 9 missense variants, 1 in-frame insertion-deletion, and 1 microdeletion (1.16 Mb). Consequently, our data indicate that loss of ANKRD17 is likely the main cause of phenotypes previously associated with large multi-gene chromosomal aberrations of the 4q13.3 region. Protein modeling suggests that most of the missense variants disrupt the stability of the ankyrin repeats through alteration of core structural residues. The major phenotypic characteristic of our cohort is a variable degree of developmental delay/intellectual disability, particularly affecting speech, while additional features include growth failure, feeding difficulties, non-specific MRI abnormalities, epilepsy and/or abnormal EEG, predisposition to recurrent infections (mostly bacterial), ophthalmological abnormalities, gait/balance disturbance, and joint hypermobility. Moreover, many individuals shared similar dysmorphic facial features. Analysis of single-cell RNA-seq data from the developing human telencephalon indicated ANKRD17 expression at multiple stages of neurogenesis, adding further evidence to the assertion that damaging ANKRD17 variants cause a neurodevelopmental disorder.

摘要

ANKRD17 是一种含有锚蛋白重复序列的蛋白,被认为在细胞周期进程中发挥作用,其在果蝇中的同源物作为 Yorkie 的共因子在 Hippo 途径中发挥作用。在这里,我们描述了一种由从头杂合 ANKRD17 变体引起的神经发育障碍。该队列的 34 名个体来自 32 个家庭,其突变谱高度提示杂合不足是疾病的潜在机制,其中 21 个截断或必需剪接位点变体、9 个错义变体、1 个框内插入-缺失和 1 个微缺失(1.16 Mb)。因此,我们的数据表明,ANKRD17 的缺失很可能是先前与 4q13.3 区域的大的多基因染色体异常相关的表型的主要原因。蛋白建模表明,大多数错义变体通过改变核心结构残基来破坏锚蛋白重复的稳定性。我们队列的主要表型特征是不同程度的发育迟缓/智力残疾,特别是影响言语,此外还有生长不良、喂养困难、非特异性 MRI 异常、癫痫和/或异常脑电图、易患复发性感染(主要是细菌)、眼科异常、步态/平衡障碍和关节过度活动。此外,许多个体具有相似的发育不良的面部特征。对来自发育中的人类端脑的单细胞 RNA-seq 数据的分析表明,ANKRD17 在神经发生的多个阶段表达,进一步证明了破坏性 ANKRD17 变体导致神经发育障碍的说法。

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