Undiagnosed rare disease clinic identifies a novel UBE3A variant in two sisters with Angelman syndrome: The end of a diagnostic odyssey

IF 1.3 4区 医学 Q3 PEDIATRICS
Rebecca Bruns, Khurram Liaqat, Abdul Nasir, Kayla Treat, Vinaya S. Murthy, Lili Mantcheva, Wilfredo Torres, Erin Conboy, Francesco Vetrini
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引用次数: 0

Abstract

Angelman syndrome (AS, MIM #105830) is a neurodevelopmental disorder characterized by severe intellectual disability, profound developmental delay, movement or balance problems, an excessively cheerful disposition, and seizures. AS results from inadequate expression of the maternal UBE3A gene (MIM #601623), which encodes an E3 ligase in the ubiquitin-proteasome pathway. Here we present the case of two sisters with features consistent with AS who had negative methylation analyses. An autism/intellectual disability expanded panel revealed a maternally inherited novel UBE3A (NM_001354506.2) variant c.2443C>T p.(Pro815Ser) in both patients that was initially classified as a variant of uncertain significance. The patients were enrolled in Indiana University's Undiagnosed Rare Disease Clinic (URDC) to further investigate the variant. Additional data, including deep phenotyping, familial segregation analysis, and in silico studies, suggest that the variant is likely pathogenic. 3D modeling studies based on the available crystal structure revealed that the Pro815Ser variant can introduce more flexibility into the protein and alter its enzymatic activity. Recent literature confirms the pathogenic nature of the variant. Reanalysis of the UBE3A variant has heightened existing knowledge of AS and has offered this family an end to their diagnostic odyssey.

Abstract Image

未确诊罕见病诊所在两姐妹安杰尔曼综合征患者中发现新型 UBE3A 变异:诊断奥德赛的终点。
安杰尔曼综合征(Angelman syndrome,AS,MIM #105830)是一种神经发育障碍性疾病,其特征是严重的智力障碍、极度发育迟缓、运动或平衡障碍、性格过于开朗和癫痫发作。AS 是母体 UBE3A 基因(MIM #601623)表达不足所致,该基因编码泛素-蛋白酶体通路中的 E3 连接酶。在这里,我们介绍了两个姐妹的病例,她们的特征与 AS 一致,但甲基化分析结果均为阴性。自闭症/智力障碍扩展面板显示,这两名患者均存在母系遗传的新型 UBE3A (NM_001354506.2) 变异 c.2443C>T p.(Pro815Ser),该变异最初被归类为意义不确定的变异。印第安纳大学未确诊罕见病诊所(URDC)对这两名患者进行了登记,以进一步研究该变异。其他数据,包括深度表型分析、家族遗传分析和硅学研究表明,该变异体很可能是致病的。根据现有晶体结构进行的三维建模研究显示,Pro815Ser 变体可为蛋白质带来更多的灵活性,并改变其酶活性。最近的文献证实了该变异体的致病性。对 UBE3A 变异的重新分析提高了人们对强直性脊柱炎的认识,也为这个家庭的诊断之路画上了句号。
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来源期刊
Congenital Anomalies
Congenital Anomalies PEDIATRICS-
自引率
0.00%
发文量
49
审稿时长
>12 weeks
期刊介绍: Congenital Anomalies is the official English language journal of the Japanese Teratology Society, and publishes original articles in laboratory as well as clinical research in all areas of abnormal development and related fields, from all over the world. Although contributions by members of the teratology societies affiliated with The International Federation of Teratology Societies are given priority, contributions from non-members are welcomed.
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