Prenatal Whole Exome Sequencing Reveals a Novel CDH1 Mutation Associated With Blepharo-Cheilo-Dontic Syndrome
Abstract Background: The cleft lip with or without palate (CL/P) is the most prevalent congenital craniofacial abnormality. This study aims to provide molecular diagnosis for patients with CL/P in a Chinese family, and then offer suggestions for future pregnancy for this family.Methods: Karyotyping, single nucleotide polymorphism array analysis, whole-exome sequencing (WES), and Sanger sequencing were applied to identify the underlying genetic cause for the clinical phenotypes. The functional effect of the identified mutation was evaluated through immunofluorescent analysis of the expression of wild or mutant protein that was transiently expressed. Non-invasive prenatal testing (NIPT) and ultrasound testing were conducted for a new pregnancy of this family. Results: A novel missense mutation (c.1418T>A/p.(Val473Asp)) in CDH1 was identified in the family members affected with CL/P. Functional analysis showed that this mutation changed the subcellular localization of the protein. The NIPT and ultrasound testing respectively revealed the new pregnancy carried no CDH1 mutation and facial dysmorphic features, and a healthy baby was delivered.Conclusion: The affected family members were diagnosed with a syndromic CL/P called Blepharo-Cheilo-Dontic(BCD) Syndrome. This study identified a novel CDH1 mutation for CL/P, expanded the mutation spectrum, and contributed to the genetic diagnosis and counseling of this disorder. This study also provided an example of the application of NIPT for BCD Syndrome.