1. Mutations in EXTL3 Cause Neuro-immuno-skeletal Dysplasia Syndrome
- Author
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Talia Hartley, Machteld M. Oud, Paul Tuijnenburg, Chela James, Hywel Williams, Taco W. Kuijpers, Machiel H. Jansen, Hans G. Brunner, Maja Hempel, Rui Li, Louise Ocaka, Polona Le Quesne Stabej, PL Beales, Catherine M. Cale, Steven T. Pals, Ronald J.A. Wanders, Zemin Ren, Naomi van Vlies, Davor Lessel, Heleen H. Arts, Rosalind Jane Davies, Christine Hall, Patricia Dias, Lucie Dupuis, Sacha Ferdinandusse, Tim M. Strom, E. Graham Davies, Chiara Bacchelli, Hartmut Engels, Jan-Maarten Cobben, René Santer, Jessika Johannsen, Marielle Alders, Sérgio B. Sousa, Ronald Roepman, Roberto Mendoza-Londono, Ingo Müller, Kai Lehmberg, Laboratory Genetic Metabolic Diseases, ARD - Amsterdam Reproduction and Development, Human Genetics, Paediatric Metabolic Diseases, Pathology, ANS - Cellular & Molecular Mechanisms, Paediatric Genetics, Paediatric Infectious Diseases / Rheumatology / Immunology, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, ACS - Pulmonary hypertension & thrombosis, MUMC+: DA Klinische Genetica (5), Klinische Genetica, and RS: FHML non-thematic output
- Subjects
0301 basic medicine ,DNA Copy Number Variations ,Mutation, Missense ,HEPARAN-SULFATE PROTEOGLYCANS ,COPY-NUMBER VARIATION ,030105 genetics & heredity ,Biology ,N-Acetylglucosaminyltransferases ,Osteochondrodysplasias ,Article ,CLASSIFICATION ,Cell Line ,Glycosaminoglycan ,Pathogenesis ,03 medical and health sciences ,chemistry.chemical_compound ,EXOME SEQUENCE DATA ,Cell Line, Tumor ,Genetics ,medicine ,Missense mutation ,Humans ,BIOSYNTHESIS ,Genetics (clinical) ,Alleles ,Glycosaminoglycans ,Severe combined immunodeficiency ,Neurodevelopmental disorders Donders Center for Medical Neuroscience [Radboudumc 7] ,IDENTIFICATION ,TUMOR SUPPRESSORS EXT1 ,Heparan sulfate ,medicine.disease ,Molecular biology ,Phenotype ,GENE ,Musculoskeletal Abnormalities ,Haematopoiesis ,Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11] ,030104 developmental biology ,chemistry ,Dysplasia ,DE-NOVO MUTATIONS ,Immunology ,MORPHOGENESIS ,Exostosin ,Extl3 ,Heparan Sulfate ,Neuro-immuno-skeletal Dysplasia ,T Cell Scid ,Severe Combined Immunodeficiency ,Chondroitin ,Genome-Wide Association Study - Abstract
Contains fulltext : 169755.pdf (Publisher’s version ) (Open Access) EXTL3 regulates the biosynthesis of heparan sulfate (HS), important for both skeletal development and hematopoiesis, through the formation of HS proteoglycans (HSPGs). By whole-exome sequencing, we identified homozygous missense mutations c.1382C>T, c.1537C>T, c.1970A>G, and c.2008T>G in EXTL3 in nine affected individuals from five unrelated families. Notably, we found the identical homozygous missense mutation c.1382C>T (p.Pro461Leu) in four affected individuals from two unrelated families. Affected individuals presented with variable skeletal abnormalities and neurodevelopmental defects. Severe combined immunodeficiency (SCID) with a complete absence of T cells was observed in three families. EXTL3 was most abundant in hematopoietic stem cells and early progenitor T cells, which is in line with a SCID phenotype at the level of early T cell development in the thymus. To provide further support for the hypothesis that mutations in EXTL3 cause a neuro-immuno-skeletal dysplasia syndrome, and to gain insight into the pathogenesis of the disorder, we analyzed the localization of EXTL3 in fibroblasts derived from affected individuals and determined glycosaminoglycan concentrations in these cells as well as in urine and blood. We observed abnormal glycosaminoglycan concentrations and increased concentrations of the non-sulfated chondroitin disaccharide D0a0 and the disaccharide D0a4 in serum and urine of all analyzed affected individuals. In summary, we show that biallelic mutations in EXTL3 disturb glycosaminoglycan synthesis and thus lead to a recognizable syndrome characterized by variable expression of skeletal, neurological, and immunological abnormalities.
- Published
- 2017