TY - JOUR
T1 - De novo mutations in NALCN cause a syndrome characterized by congenital contractures of the limbs and face, hypotonia, and developmental delay
AU - Chong, Jessica X.
AU - McMillin, Margaret J.
AU - Shively, Kathryn M.
AU - Beck, Anita E.
AU - Marvin, Colby T.
AU - Armenteros, Jose R.
AU - Buckingham, Kati J.
AU - Nkinsi, Naomi T.
AU - Boyle, Evan A.
AU - Berry, Margaret N.
AU - Bocian, Maureen
AU - Foulds, Nicola
AU - Uzielli, Maria Luisa Giovannucci
AU - Haldeman-Englert, Chad
AU - Hennekam, Raoul C M
AU - Kaplan, Paige
AU - Kline, Antonie D.
AU - Mercer, Catherine L.
AU - Nowaczyk, Malgorzata J M
AU - Klein Wassink-Ruiter, Jolien S.
AU - McPherson, Elizabeth W.
AU - Moreno, Regina A.
AU - Scheuerle, Angela E.
AU - Shashi, Vandana
AU - Stevens, Cathy A.
AU - Carey, John C.
AU - Monteil, Arnaud
AU - Lory, Philippe
AU - Tabor, Holly K.
AU - Smith, Joshua D.
AU - Shendure, Jay
AU - Nickerson, Deborah A.
AU - Bamshad, Michael J.
N1 - Funding Information:
We thank the families for their participation and support; Christa Poel, Karynne Patterson, and Ian Glass for technical assistance; and J. David Spafford for helpful comments. Our work was supported in part by grants from the NIH, the National Heart, Lung, and Blood Institute (NHLBI), and the National Human Genome Research Institute (NHGRI) (1U54HG006493 to M.B., D.N., and J.S.; 1RC2HG005608 to M.B., D.N., and J.S.; 5R000HG004316 to H.K.T.), by the National Institute of Child Health and Human Development (1R01HD048895 to M.J.B. and 5K23HD057331 to A.E.B), by the Life Sciences Discovery Fund (2065508 and 0905001), and by the Washington Research Foundation. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NHGRI, NHLBI, or NIH.
Publisher Copyright:
© 2015 The American Society of Human Genetics.
PY - 2015/3/5
Y1 - 2015/3/5
N2 - Freeman-Sheldon syndrome, or distal arthrogryposis type 2A (DA2A), is an autosomal-dominant condition caused by mutations in MYH3 and characterized by multiple congenital contractures of the face and limbs and normal cognitive development. We identified a subset of five individuals who had been putatively diagnosed with "DA2A with severe neurological abnormalities" and for whom congenital contractures of the limbs and face, hypotonia, and global developmental delay had resulted in early death in three cases; this is a unique condition that we now refer to as CLIFAHDD syndrome. Exome sequencing identified missense mutations in the sodium leak channel, non-selective (NALCN) in four families affected by CLIFAHDD syndrome. We used molecular-inversion probes to screen for NALCN in a cohort of 202 distal arthrogryposis (DA)-affected individuals as well as concurrent exome sequencing of six other DA-affected individuals, thus revealing NALCN mutations in ten additional families with "atypical" forms of DA. All 14 mutations were missense variants predicted to alter amino acid residues in or near the S5 and S6 pore-forming segments of NALCN, highlighting the functional importance of these segments. In vitro functional studies demonstrated that NALCN alterations nearly abolished the expression of wild-type NALCN, suggesting that alterations that cause CLIFAHDD syndrome have a dominant-negative effect. In contrast, homozygosity for mutations in other regions of NALCN has been reported in three families affected by an autosomal-recessive condition characterized mainly by hypotonia and severe intellectual disability. Accordingly, mutations in NALCN can cause either a recessive or dominant condition characterized by varied though overlapping phenotypic features, perhaps based on the type of mutation and affected protein domain(s).
AB - Freeman-Sheldon syndrome, or distal arthrogryposis type 2A (DA2A), is an autosomal-dominant condition caused by mutations in MYH3 and characterized by multiple congenital contractures of the face and limbs and normal cognitive development. We identified a subset of five individuals who had been putatively diagnosed with "DA2A with severe neurological abnormalities" and for whom congenital contractures of the limbs and face, hypotonia, and global developmental delay had resulted in early death in three cases; this is a unique condition that we now refer to as CLIFAHDD syndrome. Exome sequencing identified missense mutations in the sodium leak channel, non-selective (NALCN) in four families affected by CLIFAHDD syndrome. We used molecular-inversion probes to screen for NALCN in a cohort of 202 distal arthrogryposis (DA)-affected individuals as well as concurrent exome sequencing of six other DA-affected individuals, thus revealing NALCN mutations in ten additional families with "atypical" forms of DA. All 14 mutations were missense variants predicted to alter amino acid residues in or near the S5 and S6 pore-forming segments of NALCN, highlighting the functional importance of these segments. In vitro functional studies demonstrated that NALCN alterations nearly abolished the expression of wild-type NALCN, suggesting that alterations that cause CLIFAHDD syndrome have a dominant-negative effect. In contrast, homozygosity for mutations in other regions of NALCN has been reported in three families affected by an autosomal-recessive condition characterized mainly by hypotonia and severe intellectual disability. Accordingly, mutations in NALCN can cause either a recessive or dominant condition characterized by varied though overlapping phenotypic features, perhaps based on the type of mutation and affected protein domain(s).
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U2 - 10.1016/j.ajhg.2015.01.003
DO - 10.1016/j.ajhg.2015.01.003
M3 - Article
C2 - 25683120
AN - SCOPUS:84924237317
VL - 96
SP - 462
EP - 473
JO - American Journal of Human Genetics
JF - American Journal of Human Genetics
SN - 0002-9297
IS - 3
ER -