SMC1A中的合子后镶嵌现象及首例患有科妮莉亚·德朗热综合征的女性病例报告
Postzygotic mosaicism in SMC1A and the first reported case of a female with Cornelia de Lange syndrome.
作者信息
Gil-Salvador Marta, Trujillano Laura, Lucia-Campos Cristina, Del Rincón Julia, Pamplona Pilar, Arnedo María, Puisac Beatriz, Marcos-Alcalde Íñigo, Gómez-Puertas Paulino, Ramos Feliciano J, Pié Juan, Latorre-Pellicer Ana
机构信息
Unit of Clinical Genetics and Functional Genomics, Department of Pharmacology and Physiology, School of Medicine, University of Zaragoza, CIBERER and IIS-Aragon, 50009, Zaragoza, Spain.
Department of Clinical and Molecular Genetics Medicine Genetics Group, VHIR, University Hospital Vall d'Hebron, 08035, Barcelona, Spain.
出版信息
Sci Rep. 2025 Jul 1;15(1):20772. doi: 10.1038/s41598-025-07268-z.
Postzygotic mosaicism (PZM) has been increasingly recognized in Cornelia de Lange syndrome (CdLS). However, it has been scarcely described when the genetic cause resides in SMC1A, an X-linked cohesin member implicated in approximately 5% of cases. Here, we report the first female patient with classic CdLS harboring a PZM variant in SMC1A and provide a comprehensive characterization of mosaicism in this gene. The identified PZM variant [SMC1A:NM_006306.3:c.2369 = /G > A; p.(Arg790Gln)], was detected in blood and buccal swab-derived DNA at around 30% allele frequency. Molecular dynamics simulations suggest that this mutation disrupts the elbow domain of SMC1A, potentially impairing cohesin function. Further delineation of phenotypes and genotypes associated with PZM variants in SMC1A reveals that, similar to constitutive variants, mosaic mutations are predominantly missense and distributed throughout the gene. Moreover, the phenotype of patients carrying mosaic variants is clinically indistinguishable from those with constitutive mutations, and purifying selection of the pathogenic variant in blood is suggested, as previously observed in NIPBL-related CdLS. However, this process may be more complex in SMC1A due to its X-linked nature. Our findings underscore the importance of high-sensitivity sequencing techniques for detecting mosaicism and highlight the complexity of X-linked mosaic variants in disease expressivity. Further functional studies and larger cohorts are crucial to improve genotype-phenotype correlations and diagnostics in CdLS.
合子后嵌合体(PZM)在Cornelia de Lange综合征(CdLS)中越来越受到认可。然而,当遗传病因存在于SMC1A时,这种情况却鲜有描述,SMC1A是一种X连锁的黏连蛋白成员,约5%的病例与之相关。在此,我们报告了首例患有经典CdLS且在SMC1A中携带PZM变异的女性患者,并对该基因的嵌合体进行了全面表征。所鉴定的PZM变异[SMC1A:NM_006306.3:c.2369 = /G > A; p.(Arg790Gln)]在血液和口腔拭子来源的DNA中以约30%的等位基因频率被检测到。分子动力学模拟表明,该突变破坏了SMC1A的肘部结构域,可能损害黏连蛋白功能。对与SMC1A中PZM变异相关的表型和基因型的进一步描述表明,与组成型变异相似,嵌合突变主要为错义突变且分布于整个基因。此外,携带嵌合变异患者的表型在临床上与携带组成型突变的患者无法区分,并且正如之前在与NIPBL相关的CdLS中所观察到的那样,提示血液中致病变异存在纯化选择。然而,由于其X连锁性质,这一过程在SMC1A中可能更为复杂。我们的研究结果强调了高灵敏度测序技术在检测嵌合体方面的重要性,并突出了X连锁嵌合变异在疾病表现中的复杂性。进一步的功能研究和更大规模的队列对于改善CdLS中的基因型-表型相关性及诊断至关重要。