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通过全外显子组测序揭示儿科患者的遗传诊断:Wiedemann-Steiner 综合征的建模研究。

Uncovering a Genetic Diagnosis in a Pediatric Patient by Whole Exome Sequencing: A Modeling Investigation in Wiedemann-Steiner Syndrome.

机构信息

Medical Genetics, Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy.

Neuropsychiatry for Child and Adolescent Unit, Department of Woman and Child, Policlinico Riuniti, 71122 Foggia, Italy.

出版信息

Genes (Basel). 2024 Sep 1;15(9):1155. doi: 10.3390/genes15091155.

Abstract

Wiedemann-Steiner syndrome (WSS), a rare autosomal-dominant disorder caused by haploinsufficiency of the gene product, is part of a group of disorders called chromatinopathies. Chromatinopathies are neurodevelopmental disorders caused by mutations affecting the proteins responsible for chromatin remodeling and transcriptional regulation. The resulting gene expression dysregulation mediates the onset of a series of clinical features such as developmental delay, intellectual disability, facial dysmorphism, and behavioral disorders. The aim of this study was to investigate a 10-year-old girl who presented with clinical features suggestive of WSS. Clinical and genetic investigations were performed. Whole exome sequencing (WES) was used for genetic testing, performed using Illumina technology. The bidirectional capillary Sanger resequencing technique was used in accordance with standard methodology to validate a mutation discovered by WES in all family members who were available. Utilizing computational protein modeling for structural and functional studies as well as in silico pathogenicity prediction models, the effect of the mutation was examined. WES identified a de novo heterozygous missense variant in the gene KMT2A(NM_001197104.2): c.3451C>G, p.(Arg1151Gly), absent in the gnomAD database. The variant was classified as Likely Pathogenetic (LP) according to the ACMG criteria and was predicted to affect the CXXC-type zinc finger domain functionality of the protein. Modeling of the resulting protein structure suggested that this variant changes the protein flexibility due to a variation in the Gibbs free energy and in the vibrational entropy energy difference between the wild-type and mutated domain, resulting in an alteration of the DNA binding affinity. A novel and de novo mutation discovered by the NGS approach, enhancing the mutation spectrum in the gene, was characterized and associated with WSS. This novel gene variant is suggested to modify the CXXC-type zinc finger domain functionality by affecting protein flexibility and DNA binding.

摘要

威德曼-施泰因综合征(Wiedemann-Steiner syndrome,WSS)是一种罕见的常染色体显性遗传疾病,由基因产物的单倍不足引起,是一组称为染色质病的神经发育障碍的一部分。染色质病是由影响负责染色质重塑和转录调节的蛋白质的突变引起的。由此导致的基因表达失调介导了一系列临床特征的发生,如发育迟缓、智力残疾、面部畸形和行为障碍。本研究旨在研究一名 10 岁女孩,其临床表现提示为 WSS。进行了临床和遗传研究。使用 Illumina 技术进行全外显子组测序(WES)进行基因检测。根据标准方法,使用双向毛细管 Sanger 重测序技术验证在所有可用的家族成员中发现的 WES 突变。利用计算蛋白质建模进行结构和功能研究以及计算致病性预测模型,研究了突变的影响。WES 在 基因 KMT2A(NM_001197104.2)中发现了一个新的杂合错义变异:c.3451C>G,p.(Arg1151Gly),在 gnomAD 数据库中不存在。根据 ACMG 标准,该变异被归类为可能致病性(LP),并预测会影响蛋白质的CXXC 型锌指结构域功能。对产生的蛋白质结构进行建模表明,该变异由于野生型和突变结构域之间的吉布斯自由能和振动熵能差异的变化,导致蛋白质的灵活性发生变化,从而改变 DNA 结合亲和力。通过 NGS 方法发现了一种新的、新出现的突变,增强了 基因中的突变谱,并与 WSS 相关。该新的 基因变异被认为通过影响蛋白质的灵活性和 DNA 结合来改变 CXXC 型锌指结构域的功能。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/eb4b/11431573/3ec08ec4210c/genes-15-01155-g001.jpg

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