Bi-Allelic Mutations In Klhl7 Cause A Crisponi/Ciss1-Like Phenotype Associated With Early-Onset Retinitis Pigmentosa
Tarih
2016Yazar
Angius, Andrea
Uva, Paolo
Buers, Insa
Oppo, Manuela
Puddu, Alessandro
Onano, Stefano
Persico, Ivana
Loi, Angela
Marcia, Loredana
Hoehne, Wolfgang
Cuccuru, Gianmauro
Fotia, Giorgio
Deiana, Manila
Marongiu, Mara
Atalay, Hatice Tuba
Inan, Sibel
El Assy, Osama
Smit, Leo M. E.
Okur, Ilyas
Boduroglu, Koray
Utine, Gulen Eda
Kilic, Esra
Zampino, Giuseppe
Crisponi, Giangiorgio
Crisponi, Laura
Rutsch, Frank
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Crisponi syndrome (CS)/cold-induced sweating syndrome type 1 (CISS1) is a very rare autosomal-recessive disorder characterized by a complex phenotype with high neonatal lethality, associated with the following main clinical features: hyperthermia and feeding difficulties in the neonatal period, scoliosis, and paradoxical sweating induced by cold since early childhood. CS/CISS1 can be caused by mutations in cytokine receptor-like factor 1 (CRLF1). However, the physiopathological role of CRLF1 is still poorly understood. A subset of CS/CISS1 cases remain yet genetically unexplained after CRLF1 sequencing. In five of them, exome sequencing and targeted Sanger sequencing identified four homozygous disease-causing mutations in kelch-like family member 7 (KLHL7), affecting the Kelch domains of the protein. KLHL7 encodes a BTB-Kelch-related protein involved in the ubiquitination of target proteins for proteasome-mediated degradation. Mono-allelic substitutions in other domains of KLHL7 have been reported in three families affected by a late-onset form of autosomal-dominant retinitis pigmentosa. Retinitis pigmentosa was also present in two surviving children reported here carrying bi-allelic KLHL7 mutations. KLHL7 mutations are thus associated with a more severe phenotype in recessive than in dominant cases. Although these data further support the pathogenic role of KLHL7 mutations in a CS/CISS1-like phenotype, they do not explain all their clinical manifestations and highlight the high phenotypic heterogeneity associated with mutations in KLHL7.