CICS-UBI, Health Sciences Research Centre, University of Beira Interior, 6200-506 Covilhã, Portugal.
Serviço de Endocrinologia, Diabetes e Metabolismo, Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, 1649-028 Lisboa, Portugal.
Int J Mol Sci. 2024 Nov 10;25(22):12061. doi: 10.3390/ijms252212061.
Kallmann syndrome is a rare disorder characterized by hypogonadotropic hypogonadism and an impaired sense of smell (anosmia or hyposmia) caused by congenital defects in the development of the gonadotropin-releasing hormone (GnRH) and olfactory neurons. Mutations in several genes have been associated with Kallmann syndrome. However, genetic testing of this disorder often reveals variants of uncertain significance (VUS) that remain uninterpreted without experimental validation. The aim of this study was to analyze the functional consequences of a heterozygous missense VUS in the gene (c.4354G>T, p.Val1452Leu), in a patient with Kallmann syndrome with reversal of hypogonadism. The variant, located in the first nucleotide of exon 19, was analyzed using minigene assays to determine its effect on ribonucleic acid (RNA) splicing. These showed that the variant generates two different transcripts: a full-length transcript with the missense change (p.Val1452Leu), and an abnormally spliced transcript lacking exon 19. The latter results in an in-frame deletion (p.Val1452_Lys1511del) that disrupts the helicase C-terminal domain of the CHD7 protein. The variant was reclassified as likely pathogenic. These findings demonstrate that missense variants can exert more extensive effects beyond simple amino acid substitutions and underscore the critical role of functional analyses in VUS reclassification and genetic diagnosis.
卡尔曼综合征是一种罕见的疾病,其特征是促性腺激素释放激素(GnRH)和嗅觉神经元发育先天性缺陷导致的促性腺激素低下性性腺功能减退症和嗅觉丧失(嗅觉缺失或嗅觉减退)。几种基因突变与卡尔曼综合征有关。然而,对该疾病的基因检测经常显示出意义未明的变异(VUS),如果没有实验验证,这些变异仍然无法解释。本研究旨在分析患有卡尔曼综合征并伴有性腺功能减退逆转的患者中 基因(c.4354G>T,p.Val1452Leu)杂合错义 VUS 的功能后果。该变体位于外显子 19 的第一个核苷酸,通过 minigene 测定法分析其对核糖核酸(RNA)剪接的影响。结果表明,该变体产生两种不同的转录本:一种是具有错义改变的全长转录本(p.Val1452Leu),另一种是异常剪接的转录本,缺失外显子 19。后者导致无义缺失(p.Val1452_Lys1511del),破坏 CHD7 蛋白的解旋酶 C 端结构域。该变体被重新归类为可能致病。这些发现表明,错义变异可以产生比简单氨基酸取代更广泛的影响,并强调了功能分析在 VUS 重新分类和遗传诊断中的关键作用。