A Novel Splice Site Variant in FOXN1 in A Patient with Abnormal Newborn Screening for Severe Combined Immunodeficiency and Congenital Lymphopenia

Author(s):  
Ori Scott ◽  
Jenny Garkaby ◽  
Jessica Willett-Pachul ◽  
Yehonatan Pasternak

Background: The Forkhead box protein N1 (FOXN1) is a key regulator of thymic epithelial development, and its complete deficiency leads to a nude-severe combined immunodeficiency (SCID) phenotype. More recently, heterozygous mutations in FOXN1 have been linked with a syndrome of congenital lymphopenia and a wide clinical spectrum, with most cases being caused by missense mutations. Aim: To broaden the genotypic and phenotypic spectrum of heterozygous FOXN1 deficiency. Methods: Case report of a patient with FOXN1 haploinsufficiency due to a novel splice-site mutation. Results: Our patient was identified at 3 weeks of life given an abnormal newborn screen (NBS) for SCID, and was found to have congenital lymphopenia preferentially affecting CD8+ T-cells. Her cellular and humoral function were both excellent, and she has remained entirely asymptomatic and thriving for the first 3 years of her life. The patient was found on whole exome sequencing to carry a heterozygous splice-site mutation in the FOXN1 gene, affecting the Forkhead domain. The mutation was also identified in her asymptomatic mother. Conclusion: Heterozygous FOXN1 mutations are an increasingly-recognized cause of congenital lymphopenia. Our experience suggests most patients remain clinically well, with main manifestation including T-lymphopenia, mostly affecting CD8+ cells. Identification of the same variant in an asymptomatic parent suggests age-dependent improvement in T-cell counts and an overall benign course, while provides impetus for diligent conservative management with regular follow-up.

2021 ◽  
Author(s):  
Peng Tu ◽  
Hairui Sun ◽  
Xiaohang Zhang ◽  
Qian Ran ◽  
suzhen Ran ◽  
...  

Abstract Background: Left ventricular non-compaction cardiomyopathy (LVNC) is a rare congenital heart defect (CHD), genetics defects have been found in patients with LVNC and their family members; and MYH7 is the most common genetic associated with LVNC. Methods: A trio (fetus and the parents) whole-exome sequencing (WES) was performed when the fetus was found with Ebstein's anomaly (EA), heart dilatation, perimembranous ventricular septal defects (VSD), mild seroperitoneum and single umbilical artery (SUA).Results: Whole-exome sequencing identified a maternal inherited heterozygous splice site mutation in MYH7 (NM_000257.3:c.732+1G>A). Subsequent Sanger sequencing confirmed that the mutation was heterozygous in the fetus, the old sister, the grandmother, and the mother. QPCR experiment using RNA from blood lymphocytes but were unable to amplify any product.Conclusion: This familial case underlines that the striking cardiac phenotypic of MYH7 mutation (the c.732+1G>A spice site variant) may be highly variable. The mechanistic studies which could uncover candidate genes modulating cardiac phenotype associated with LVNC/EA should be proceed.


2019 ◽  
Vol 109 (5) ◽  
pp. 603-611 ◽  
Author(s):  
Motoi Yamashita ◽  
Ryosuke Wakatsuki ◽  
Tamaki Kato ◽  
Tsubasa Okano ◽  
Shingo Yamanishi ◽  
...  

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1732-1732
Author(s):  
Shuhei Karakawa ◽  
Satoshi Okada ◽  
Miyuki Tsumura ◽  
Yoko Mizoguchi ◽  
Norioki Ohno ◽  
...  

Abstract Abstract 1732 <Introduction> X-linked ectodermal dysplasia with immunodeficiency (XL-EDA-ID) is caused by hypomorphic mutations in the nuclear factor κB (NF-κB) essential modulator (NEMO) gene, also called IKBKG, and these mutations impair but do not abolish NF-κB signaling, resulting in distinct clinical and immunologic phenotypes. We presented the patient with XL-EDA-ID showing a novel splice-site mutation. In this report we precisely study the involvement of this mutation in the molecular pathogenesis of XL-EDA-ID. <Patient> The patient is 12 years old Japanese boy. He had conical-shaped teeth and hypodontia. He had suffered from recurrent bacterial infections and these pathogenic bacteria were mostly streptococcus pneumonia. The laboratory examination revealed that the number of white blood cell counts, the classification of lymphocytes, and the serum immunoglobulin levels were within normal range. However the specific antibodies against measles and streptococcus pneumonia were negative in spite of these infections. <Results> We identified a novel hemizygous mutation, 769-1 G>C, at the splicing acceptor site of exon 7 in the IKBKG gene. In order to clarify the effect of this mutation on mRNA, we performed a cloning analysis. Although various abnormal spliced NEMO (mutant NEMO) mRNAs were observed, a small amount of wild-type NEMO (WT NEMO) mRNA was also identified. The rate of WT and mutant was variable on the time of blood collection. Further we performed FACS and immunoblot analysis in order to evaluate the effect of this mutation at protein level. Two major bands which were presumed to be derived from WT and one mutant were detected in immunoblots using EBV transfected B cells, however the expression levels of these bands were markedly decreased compared to those of the healthy controls. The NEMO protein expression was confirmed to be decreased in various lineages of leukocytes. We generated WT and two representative mutant NEMO constructs and measured their NF-κB transcriptional activity using reporter assay. One mutant NEMO abolished NF-κB transcriptional activity, the other showed weak activity. However, neither of mutant NENO showed a dominant-negative effect against WT NEMO activity. CD14+ cells from the patient produced a lower level of TNF-α in response to IFN-γ stimulation, on the other hand CD3+ cells produced very little IFN-γ in response to IL-12. CD4+ T-cell proliferation was impaired in response to measles and mumps, but not rubella. <Conclusion> The hemizygous 769-1 G>C mutation was shown to cause the decreased expression of WT NEMO protein, resulting in the decrease in NF-κB activation and the development of XL-EDA-ID. Disclosures: No relevant conflicts of interest to declare.


2019 ◽  
Vol 57 (3) ◽  
pp. 187-194 ◽  
Author(s):  
Wenjing Wang ◽  
Jie Dong ◽  
Biaobang Chen ◽  
Jing Du ◽  
Yanping Kuang ◽  
...  

BackgroundAbnormal pronuclear formation during fertilisation and subsequent early embryonic arrest results in female infertility. In recent years, with the prevalence of assisted reproductive technology, a few genes have been identified that are involved in female infertility caused by abnormalities in oocyte development, fertilisation and embryonic development. However, the genetic factors responsible for multiple pronuclei formation during fertilisation and early embryonic arrest remain largely unknown.ObjectiveWe aim to identify genetic factors responsible for multiple pronuclei formation during fertilisation or early embryonic arrest.MethodsWhole-exome sequencing was performed in a cohort of 580 patients with abnormal fertilisation and early embryonic arrest. Effects of mutations were investigated in HEK293T cells by western blotting and immunoprecipitation, as well as minigene assay.ResultsWe identified a novel homozygous missense mutation (c.397T>G, p.C133G) and a novel homozygous donor splice-site mutation (c.546+5G>A) in the meiotic gene REC114. REC114 is involved in the formation of double strand breaks (DSBs), which initiate homologous chromosome recombination. We demonstrated that the splice-site mutation affected the normal alternative splicing of REC114, while the missense mutation reduced the protein level of REC114 in vitro and resulted in the loss of its function to protect its partner protein MEI4 from degradation.ConclusionsOur study has identified mutations in REC114 responsible for human multiple pronuclei formation and early embryonic arrest, and these findings expand our knowledge of genetic factors that are responsible for normal human female meiosis and fertility.


Blood ◽  
2008 ◽  
Vol 112 (5) ◽  
pp. 1872-1875 ◽  
Author(s):  
Taizo Wada ◽  
Masahiro Yasui ◽  
Tomoko Toma ◽  
Yuko Nakayama ◽  
Mika Nishida ◽  
...  

Abstract X-linked severe combined immunodeficiency (XSCID) is caused by mutations of the common gamma chain (γc) and usually characterized by the absence of T and natural killer (NK) cells. Here, we report an atypical case of XSCID presenting with autologous T and NK cells and Omenn syndrome-like manifestations. The patient carried a splice-site mutation (IVS1+5G>A) that caused most of the mRNA to be incorrectly spliced but produced normally spliced transcript in lesser amount, leading to residual γc expression and development of T and NK cells. The skin biopsy specimen showed massive infiltration of revertant T cells. Those T cells were found to have a second-site mutation and result in complete restoration of correct splicing. These findings suggest that the clinical spectrum of XSCID is quite broad and includes atypical cases mimicking Omenn syndrome, and highlight the importance of revertant mosaicism as a possible cause for variable phenotypic expression.


2016 ◽  
Vol 56 (3) ◽  
pp. 135-137 ◽  
Author(s):  
Fatma Bastaki ◽  
Madiha Mohamed ◽  
Pratibha Nair ◽  
Fatima Saif ◽  
Nafisa Tawfiq ◽  
...  

Blood ◽  
2018 ◽  
Vol 132 (Supplement 1) ◽  
pp. 4512-4512
Author(s):  
Lisa J Crawford ◽  
David Campbell ◽  
Ken I Mills ◽  
Alexandra E Irvine

Abstract Background Proteasome inhibitors have provided significant therapeutic advance in the treatment of Multiple Myeloma (MM), however resistance and dose limiting side effects remain a clinical challenge. Recent research has focused on developing strategies to target other enzymes within the ubiquitin proteasome system, with the aim of overcoming resistance and toxicity. We have previously reported deregulated expression of the E3 ligase HUWE1 in MM and demonstrated that knockdown or inhibition of HUWE1 leads to a decrease in MYC activity (Blood 2016, 128:240; 2017, 130:3077). HUWE1 is a large HECT domain E3 ligase that is involved in the regulation of key proteins such as p53, MYC and MCL-1. Mutations in HUWE1 have recently been identified in MM patients, significantly associated with the t(11;14) subgroup (blood-2018-03-840132). A recurrently mutated splice site mutation in the DUF913 (domain of unknown function 913) of HUWE1 was identified in 18% of patients, the remainder are predominantly missense mutations distributed across the coding sequence (CDS). Other studies have demonstrated that point mutations in the dimerization interface of HUWE1, which acts to regulate its activity, result in hyper-activation of HUWE1 (eLife 2017;6:e21036; Sci Rep 2017;7:15050). While 7% of the mutations reported in MM patients are found in this region, the effect of the majority of mutations on the functional significance of HUWE1 has yet to be determined. The aim of this study was to analyse HUWE1 expression and activity in HUWE1 mutant MM cell lines. Methods HUWE1 mutational status was analysed in a publically available dataset of MM cell lines (www.keatslab.org). Inhibitors of HUWE1 (BI8622, BI8626; described in EMBO Mol Med 2014, 6:1525-1541) were purchased from Syngene. The effect of the inhibitors on HUWE1 mutant MM cell lines was assessed using CellTitre-glo. HUWE1 auto-ubiquitination activity was analysed using UbiQapture-Q and Western blotting. Results HUWE1 mutations were identified in 6 out of 69 MM cell lines. HUWE1 mutational status was confirmed in 5 cell lines (U266, XG-1, XG-2, KMS-27, H1112) by Sanger sequencing. In agreement with MM patient data, HUWE1 mutations were predominantly found in cell lines expressing the t(11;14) translocation (4/6 cell lines) and are distributed in a similar manner. H1112 cells harbor the recurrent splice site mutation observed in patients, whereas the other cell lines contain missense mutations across the CDS. HUWE1 protein expression in mutant cell lines was compared with expression in 5 MM cell lines expressing wild type (WT) HUWE1 (JJN3, MM.1S, ANBL-6, KMS-18, OPM-2). No significant difference in expression was observed in the majority of HUWE1 mutant cell lines, however, HUWE1 expression was significantly lower in the H1112 cell line (p=0.002) compared to HUWE1 WT cell lines. Accordingly, HUWE1 auto-ubiquitination activity was reduced only in H1112 cells. XG-2 and U266 displayed similar sensitivity to HUWE1 inhibitors as HUWE1 WT cell lines (IC50 12-18 µM vs 9-20 µM), while XG-1, H1112 and KMS-27 were less sensitive (IC50 20-33 µM). The effect of HUWE1 on substrate proteins (e.g. MYC) varies depending on tumor type. In HUWE1 WT MM cell lines, inhibition of HUWE1 leads to significantly decreased expression of MYC and MCL-1 in (p<0.01), through increased proteasomal degradation. A similar decrease in MYC and MCL-1 expression is observed in XG-2, and in MCL-1 in U266 cells (which lack expression of c-MYC). Conversely, no significant effect on MYC or MCL-1 expression was seen in XG-1 cells, while barely detectable levels of MYC and MCL-1 were observed in H1112 and KMS-27 cells, suggesting altered or absent HUWE1 activity in these cell lines. Conclusion HUWE1 has recently been identified as a mutational driver in t(11;14) MM, however, little is known about the functional consequence of HUWE1 mutations. Here we show that the H1112 cell line, representative of the most commonly occurring HUWE1 mutation in MM, leads to reduced expression and activity of HUWE1 and is associated with low expression of HUWE1 substrates MYC and MCL-1. Conversely, expression of HUWE1 and activity against selected substrates remains unchanged in XG-2 and U266 cells. Moreover, recent studies demonstrate that certain HUWE1 mutations lead to enhanced catalytic activity. In summary, the pathogenicity of HUWE1 mutations in MM is likely to depend on the type and location of the mutation. Disclosures No relevant conflicts of interest to declare.


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