1. Hypomorphic Recessive Variants in SUFU Impair the Sonic Hedgehog Pathway and Cause Joubert Syndrome with Cranio-facial and Skeletal Defects
- Author
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Antonella Casella, Jessica Rosati, Joel Victor Fluss, Roberta De Mori, Susanne Roosing, Barbara Illi, Danila Anello, Tommaso Biagini, Joseph G. Gleeson, Damir Musaev, Enrico Bertini, Tommaso Mazza, Enza Maria Valente, Rachel Schot, Valentina Stanley, Stefano D'Arrigo, Marta Romani, Maha S. Zaki, Silvia Tardivo, Sara Nuovo, Monia Ginevrino, Romina Alfonsi, Luisa Chiapparini, William B. Dobyns, G.M.S. Mancini, Mahmoud Y. Issa, Elisa Lorefice, Lucia Di Marcotullio, Alessia Micalizzi, Autumn Sa'na Leggins, and Clinical Genetics
- Subjects
Male ,0301 basic medicine ,hypomorphic variants ,Cerebellum ,Repressor Proteins/chemistry/genetics/metabolism ,Multiple/genetics/pathology ,Nerve Tissue Proteins/metabolism ,Cystic/genetics/pathology ,GLI3 ,Fibroblasts/metabolism/pathology ,Ciliopathies ,Sensory disorders Donders Center for Medical Neuroscience [Radboudumc 12] ,Joubert Syndrome ,Cohort Studies ,Craniofacial Abnormalities ,Retina/abnormalities/pathology ,Developmental ,polymicrogyria ,Eye Abnormalities ,Sonic hedgehog ,Hypertelorism ,congenital ataxia ,Child ,Cells, Cultured ,Genetics (clinical) ,Craniofacial Abnormalities/genetics/pathology ,Skin ,Genetics ,Primary cilium ,ddc:618 ,Cultured ,Sufu ,Cilium ,Gene Expression Regulation, Developmental ,Kidney Diseases, Cystic ,Joubert syndrome ,SUFU ,Sonic Hedgehog ,ciliopathies ,developmental defects ,molar tooth sign ,Abnormalities, Multiple ,Bone Diseases, Developmental ,Female ,Fibroblasts ,Hedgehog Proteins ,Humans ,Kruppel-Like Transcription Factors ,Nerve Tissue Proteins ,Repressor Proteins ,Retina ,Sequence Analysis, DNA ,Signal Transduction ,Zinc Finger Protein Gli3 ,Genes, Recessive ,Mutation, Missense ,Hedgehog signaling pathway ,medicine.anatomical_structure ,Kidney Diseases ,Abnormalities ,Bone Diseases ,medicine.symptom ,Multiple ,Sequence Analysis ,Kruppel-Like Transcription Factors/metabolism ,Developmental/genetics/pathology ,Eye Abnormalities/genetics/pathology ,animal structures ,Cells ,Biology ,Article ,Cystic ,03 medical and health sciences ,medicine ,Hedgehog Proteins/metabolism ,Recessive ,Skin/metabolism/pathology ,DNA ,medicine.disease ,Cerebellum/abnormalities/pathology ,030104 developmental biology ,Gene Expression Regulation ,Genes ,Mutation ,biology.protein ,Missense - Abstract
The Sonic Hedgehog (SHH) pathway is a key signaling pathway orchestrating embryonic development, mainly of the CNS and limbs. In vertebrates, SHH signaling is mediated by the primary cilium, and genetic defects affecting either SHH pathway members or ciliary proteins cause a spectrum of developmental disorders. SUFU is the main negative regulator of the SHH pathway and is essential during development. Indeed, Sufu knock-out is lethal in mice, and recessive pathogenic variants of this gene have never been reported in humans. Through whole-exome sequencing in subjects with Joubert syndrome, we identified four children from two unrelated families carrying homozygous missense variants in SUFU. The children presented congenital ataxia and cerebellar vermis hypoplasia with elongated superior cerebellar peduncles (mild “molar tooth sign”), typical cranio-facial dysmorphisms (hypertelorism, depressed nasal bridge, frontal bossing), and postaxial polydactyly. Two siblings also showed polymicrogyria. Molecular dynamics simulation predicted random movements of the mutated residues, with loss of the native enveloping movement of the binding site around its ligand GLI3. Functional studies on cellular models and fibroblasts showed that both variants significantly reduced SUFU stability and its capacity to bind GLI3 and promote its cleavage into the repressor form GLI3R. In turn, this impaired SUFU-mediated repression of the SHH pathway, as shown by altered expression levels of several target genes. We demonstrate that germline hypomorphic variants of SUFU cause deregulation of SHH signaling, resulting in recessive developmental defects of the CNS and limbs which share features with both SHH-related disorders and ciliopathies.
- Published
- 2017
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