The full spectrum of holoprosencephaly-associated mutations within the ZIC2 gene in humans predicts loss-of-function as the predominant disease mechanism (original) (raw)

Holoprosencephaly due to mutations in ZIC2: Ala-nine tract expansion mutations may be caused by parental somatic recombination

Human Molecular Genetics

We report on the prevalence of mutations in the zinc finger transcription factor gene, ZIC2, in a group of 509 unrelated individuals with isolated holoprosencephaly (HPE) and normal chromosomes. Overall, we encountered 16 HPE patients (from 15 unrelated families) with ZIC2 mutations. Thus, ZIC2 mutation was the apparent cause of HPE in 3-4% of cases. Seven mutations were frameshifts that were predicted to result in loss of function, further supporting the idea that ZIC2 haploinsufficiency can result in HPE. One mutation, an alanine tract expansion which is caused by the expansion of an imperfect trinucleotide repeat, occurred in seven patients from six different families. In three of those families, the father was found to be apparently mosaic for the mutation. We hypothesize that this mutation can arise through errors in somatic recombination, an extremely unusual mutation mechanism. In addition, one mutation resulted in a single amino acid change and one mutation was an in-frame d...

Common genetic causes of holoprosencephaly are limited to a small set of evolutionarily conserved driver genes of midline development coordinated by TGFβ, hedgehog and FGF signaling

Human mutation, 2018

Next generation sequencing (NGS) promises to accelerate gene discovery in human disease. Here we applied targeted capture to examine 153 genes representative of all the major vertebrate developmental pathways among 333 probands to rank their relative significance as causes for holoprosencephaly (HPE). HPE involves a small number of genes damaged by gross chromosomal re-arrangements, micro-deletions, or clustered novel or de novo mutations. Yet the typical incomplete penetrance and variable expressivity remain unexplained. We now show that comparisons of variant transmission vs. non-transmission among 136 HPE Trios indicates some reported genes now lack confirmation, while novel genes are implicated. Furthermore, we demonstrate that variation of modest intrinsic effect can synergize with these driver mutations as gene modifiers. Overall, we establish a simple autosomal dominant with modifier pattern accounting for 25% of the molecular pathology. This article is protected by copyright...