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Hoogenboom A, Falix FA, van der Laan L, Kerkhof J, Alders M, Sadikovic B, van Haelst MM. Novel PUF60 variant suggesting an interaction between Verheij and Cornelia de Lange syndrome: phenotype description and review of the literature. Eur J Hum Genet 2024; 32:435-439. [PMID: 38273166 PMCID: PMC10999433 DOI: 10.1038/s41431-023-01527-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/08/2023] [Accepted: 12/14/2023] [Indexed: 01/27/2024] Open
Abstract
Verheij syndrome [VRJS; OMIM 615583] is a rare autosomal dominant neurodevelopmental disorder characterized by distinct clinical features, including growth retardation, intellectual disability, cardiac, and renal anomalies. VRJS is caused by deletions of chromosome 8q24.3 or pathogenic variants in the PUF60 gene. Recently, pathogenic PUF60 variants have been reported in some individuals with VRJS, contributing to the variability in the clinical presentation and severity of the condition. PUF60 encodes a protein involved in regulating gene expression and cellular growth. In this report, we describe a new case of VRJS with developmental delay, cardiac-, and renal abnormalities, caused by a heterozygous pathogenic PUF60 variant. Surprisingly, DNA methylation analysis revealed a pattern resembling the Cornelia de Lange syndrome (CdLS) episignature, suggesting a potential connection between PUF60 and CdLS-related genes. This case report further delineates the clinical and molecular spectrum of VRJS and supports further research to validate the interaction between VRJS and CdLS.
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Affiliation(s)
- Amarens Hoogenboom
- Medical University of Groningen (UMCG), Groningen, the Netherlands
- Department of pediatrics, Curaçao Medical Center (CMC), Willemstad, Curaçao
| | - Farah A Falix
- Department of pediatrics, Curaçao Medical Center (CMC), Willemstad, Curaçao
| | - Liselot van der Laan
- Department of Human Genetics, Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development, Amsterdam University Medical Centers (AUMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Jennifer Kerkhof
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
| | - Mariëlle Alders
- Department of Human Genetics, Amsterdam UMC, Amsterdam, the Netherlands
- Amsterdam Reproduction & Development, Amsterdam University Medical Centers (AUMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Bekim Sadikovic
- Department of Human Genetics, Amsterdam UMC, Amsterdam, the Netherlands
- Verspeeten Clinical Genome Centre, London Health Sciences Centre, London, ON, Canada
- Department of Pathology and Laboratory Medicine, Western University, London, ON, Canada
| | - Mieke M van Haelst
- Department of pediatrics, Curaçao Medical Center (CMC), Willemstad, Curaçao.
- Department of Human Genetics, Amsterdam UMC, Amsterdam, the Netherlands.
- Amsterdam Reproduction & Development, Amsterdam University Medical Centers (AUMC), University of Amsterdam, Amsterdam, The Netherlands.
- Emma Center for Personalized Medicine, Amsterdam UMC, Amsterdam, The Netherlands.
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Miao M, Wang J, Guo C, Su X, Sun L, Lu S. Identification of a novel de novo PUF60 variant causing Verheij syndrome in a fetus. Gene 2024; 897:148092. [PMID: 38110042 DOI: 10.1016/j.gene.2023.148092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 12/08/2023] [Accepted: 12/15/2023] [Indexed: 12/20/2023]
Abstract
Verheij syndrome (VRJS) is a craniofacial spliceosomopathy with a wide phenotypic spectrum. Haploinsufficiency of the poly-uridine binding splicing factor 60 gene (PUF60) and its loss-of-function (LOF) variants are involved in VRJS. We evaluated a human fetus with congenital heart defects and preaxial polydactyly. Clinical data were obtained from the medical record. Whole-exome sequencing (WES) was used to explore the potential genetic etiology, and the detected variant verified using Sanger sequencing. Functional studies were performed to validate the pathogenic effects of the variant. Using trio-WES, we identified a novel PUF60 variant (NM_078480.2; c.1678 T > A, p.*560Argext*204) in the pedigree. Bioinformatic analyses revealed that the variant is potentially pathogenic, and functional studies indicated that it leads to degradation of the elongated protein and subsequently PUF60 LOF, producing some VRJS phenotypes. These findings confirmed the pathogenicity of the variant. This study implicates PUF60 LOF in the etiopathogenesis of VRJS. It not only expands the PUF60 variant spectrum, and also provides a basis for genetic counseling and the diagnosis of VRJS. Although trio-WES is a well-established approach for identifying the genetic etiology of rare multisystemic conditions, functional studies could aid in verifying the pathogenicity of novel variants.
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Affiliation(s)
- Mingzhu Miao
- Department of Prenatal Diagnosis, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210036, China
| | - Jue Wang
- Department of Prenatal Diagnosis, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210036, China
| | - Chenyan Guo
- Department of Obstetrics, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210036, China
| | - Xiaotian Su
- Department of Bioinformatics, Berry Genomics Co., Ltd., Beijing, China
| | - Lizhou Sun
- Department of Obstetrics, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210036, China.
| | - Shoulian Lu
- Department of Prenatal Diagnosis, Jiangsu Province People's Hospital and Nanjing Medical University First Affiliated Hospital, Nanjing 210036, China.
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Grimes H, Ansari M, Ashraf T, Cueto-González AM, Calder A, Day M, Fernandez Alvarez P, Foster A, Lahiri N, Repetto GM, Scurr I, Varghese V, Low KJ. PUF60-related developmental disorder: A case series and phenotypic analysis of 10 additional patients with monoallelic PUF60 variants. Am J Med Genet A 2023; 191:2610-2622. [PMID: 37303278 DOI: 10.1002/ajmg.a.63313] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 05/11/2023] [Accepted: 05/18/2023] [Indexed: 06/13/2023]
Abstract
PUF60-related developmental disorder (also referred to as Verheij syndrome), resulting from haploinsufficiency of PUF60, is associated with multiple congenital anomalies affecting a wide range of body systems. These anomalies include ophthalmic coloboma, and congenital anomalies of the heart, kidney, and musculoskeletal system. Behavioral and intellectual difficulties are also observed. While less common than other features associated with PUF60-related developmental disorder, for instance hearing impairment and short stature, identification of specific anomalies such as ophthalmic coloboma can aid with diagnostic identification given the limited spectrum of genes linked with this feature. We describe 10 patients with PUF60 gene variants, bringing the total number reported in the literature, to varying levels of details, to 56 patients. Patients were recruited both via locally based exome sequencing from international sites and from the DDD study in the United Kingdom. Eight of the variants reported were novel PUF60 variants. The addition of a further patient with a reported c449-457del variant to the existing literature highlights this as a recurrent variant. One variant was inherited from an affected parent. This is the first example in the literature of an inherited variant resulting in PUF60-related developmental disorder. Two patients (20%) were reported to have a renal anomaly consistent with 22% of cases in previously reported literature. Two patients received specialist endocrine treatment. More commonly observed were clinical features such as: cardiac anomalies (40%), ocular abnormalities (70%), intellectual disability (60%), and skeletal abnormalities (80%). Facial features did not demonstrate a recognizable gestalt. Of note, but remaining of unclear causality, we describe a single pediatric patient with pineoblastoma. We recommend that stature and pubertal progress should be monitored in PUF60-related developmental disorder with a low threshold for endocrine investigations as hormone therapy may be indicated. Our study reports an inherited case with PUF60-related developmental disorder which has important genetic counseling implications for families.
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Affiliation(s)
- H Grimes
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - M Ansari
- South East Scotland Genetics Service, Western General Hospital, Edinburgh, UK
| | - T Ashraf
- Department of Clinical Genetics, Great Ormond Street Hospital, London, UK
| | - Anna Mª Cueto-González
- Department of Clinical and Molecular Genetics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
- Medicine Genetics Group, Vall Hebron Research Institute (VHIR), Vall d'Hebron Barcelona Hospital Campus, Autonomous University of Barcelona, Barcelona, Spain
| | - A Calder
- Department of Radiology, Great Ormond Street Hospital, London, UK
| | - M Day
- Exeter Genetics Laboratory, Royal Devon and Exeter NHS Trust, Exeter, UK
| | - P Fernandez Alvarez
- Department of Clinical and Molecular Genetics, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - A Foster
- Department of Clinical Genetics, West Midlands Regional Genetics Centre, Birmingham, UK
| | - N Lahiri
- Department of Clinical Genetics, St Georges University Hospital NHS Foundation Trust, London, UK
- Department of Clinical and Molecular Science, St Georges University of London, London, UK
| | - G M Repetto
- Centro de Genética y Genómica, Facultad de Medicina Clínica Alemana Universidad del Desarrollo, Santiago, Chile
| | - I Scurr
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - V Varghese
- All Wales Medical Genomics Services, University Hospital of Wales, Cardiff, UK
| | - Karen J Low
- Department of Clinical Genetics, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
- Centre for Academic Child Health, University of Bristol, Bristol, UK
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