Graduate College of Tianjin Medical University, No. 22 Qixiangtai Road, Heping District, Tianjin 300070, China; Tianjin Children's Hospital (Children's Hospital of Tianjin University), No. 238 Longyan Road, Beichen District, Tianjin 300134, China.
Tianjin Children's Hospital (Children's Hospital of Tianjin University), No. 238 Longyan Road, Beichen District, Tianjin 300134, China; Department of Neurology, Tianjin Children's Hospital, No. 238 Longyan Road, eichen District, Tianjin 300134, China.
Clin Chim Acta. 2022 Jul 1;532:137-144. doi: 10.1016/j.cca.2022.05.023. Epub 2022 Jun 8.
Missense variants in MED12 are associated with MED12-related disorders. We aimed to clarify the molecular level changes and underlying pathogenic mechanism of a female patient in our study.
We reported a Chinese girl with clinical characteristics similar to MED12-related disorders. Trio whole exome sequencing (WES) was performed to identify related pathogenic variant(s) and RNA sequencing (RNA-seq) was subsequently applied to evaluate the effect of identified variant(s) on mRNA splicing. Moreover, X-chromosome inactivation (XCI) assay based on AR and RP2 was performed to reveal the XCI pattern of the female patient.
The proband manifested mainly as mental retardation and language impairment. Trio WES revealed a novel heterozygous variant c.3354 + 5 G > A in intron 23 of MED12. RNA-seq identified two aberrant transcripts. XCI assay on AR revealed a homozygous result, while XCI based on RP2 showed random pattern in peripheral blood.
In conclusion, we identified a novel variant c.3354 + 5 G > A by WES combined with RNA-seq, which extends the spectrum of MED12 variants and provide a basis for further genetic counseling. According to the result of two aberrant transcripts by RNA-seq, we speculate that our patient's milder clinical feature may be the consequence of multiple different transcripts.
错义变异 MED12 与 MED12 相关疾病有关。我们旨在阐明本研究中一位女性患者的分子水平变化和潜在致病机制。
我们报道了一名具有与 MED12 相关疾病相似临床特征的中国女孩。进行了三人体外全基因组测序 (WES) 以鉴定相关致病变异,并随后进行 RNA 测序 (RNA-seq) 以评估鉴定变异对 mRNA 剪接的影响。此外,还进行了基于 AR 和 RP2 的 X 染色体失活 (XCI) 检测,以揭示女性患者的 XCI 模式。
先证者主要表现为智力低下和语言障碍。三人体外全基因组测序 (WES) 显示 MED12 基因 23 号内含子中的杂合性变异 c.3354+5G>A。RNA-seq 鉴定出两种异常转录本。AR 上的 XCI 检测呈纯合结果,而基于 RP2 的 XCI 在外周血中呈随机模式。
总之,我们通过 WES 结合 RNA-seq 鉴定出一个新的变异 c.3354+5G>A,扩展了 MED12 变异谱,并为进一步的遗传咨询提供了依据。根据 RNA-seq 的两种异常转录本,我们推测我们患者的较轻临床特征可能是多种不同转录本的结果。