Department of Human Genetics, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, 6500 HB Nijmegen, the Netherlands; CAPES Foundation, Ministry of Education of Brazil, Brasília, Brazil.
Department of Pediatrics, Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA.
Am J Hum Genet. 2021 Jul 1;108(7):1342-1349. doi: 10.1016/j.ajhg.2021.05.010. Epub 2021 Jun 17.
EDEM3 encodes a protein that converts ManGlcNAc isomer B to ManGlcNAc. It is involved in the endoplasmic reticulum-associated degradation pathway, responsible for the recognition of misfolded proteins that will be targeted and translocated to the cytosol and degraded by the proteasome. In this study, through a combination of exome sequencing and gene matching, we have identified seven independent families with 11 individuals with bi-allelic protein-truncating variants and one individual with a compound heterozygous missense variant in EDEM3. The affected individuals present with an inherited congenital disorder of glycosylation (CDG) consisting of neurodevelopmental delay and variable facial dysmorphisms. Experiments in human fibroblast cell lines, human plasma, and mouse plasma and brain tissue demonstrated decreased trimming of ManGlcNAc isomer B to ManGlcNAc, consistent with loss of EDEM3 enzymatic activity. In human cells, ManGlcNAc to ManGlcNAc conversion is also diminished with an increase of GlcManGlcNAc. Furthermore, analysis of the unfolded protein response showed a reduced increase in EIF2AK3 (PERK) expression upon stimulation with tunicamycin as compared to controls, suggesting an impaired unfolded protein response. The aberrant plasma N-glycan profile provides a quick, clinically available test for validating variants of uncertain significance that may be identified by molecular genetic testing. We propose to call this deficiency EDEM3-CDG.
EDEM3 编码一种蛋白,可将 ManGlcNAc 异构物 B 转化为 ManGlcNAc。它参与内质网相关降解途径,负责识别错误折叠的蛋白质,这些蛋白质将被靶向并转移到细胞质中,并被蛋白酶体降解。在这项研究中,我们通过外显子组测序和基因匹配相结合,鉴定了 7 个独立的家系,其中 11 名个体存在 EDEM3 基因的双等位基因蛋白截断变异,1 名个体存在复合杂合错义变异。受影响的个体表现出遗传性糖基化缺陷(CDG),包括神经发育迟缓和可变的面部畸形。在人成纤维细胞系、人血浆和鼠血浆和脑组织中的实验表明,ManGlcNAc 异构物 B 向 ManGlcNAc 的修剪减少,与 EDEM3 酶活性丧失一致。在人细胞中,ManGlcNAc 向 ManGlcNAc 的转化也随着 GlcManGlcNAc 的增加而减少。此外,未折叠蛋白反应的分析表明,与对照组相比,在用衣霉素刺激时,EIF2AK3(PERK)的表达增加减少,表明未折叠蛋白反应受损。异常的血浆 N-糖链谱为验证通过分子遗传学检测可能发现的不确定意义的变异提供了一种快速、临床可用的测试方法。我们建议将这种缺陷称为 EDEM3-CDG。