@article {201, title = {TBX6 null variants and a common hypomorphic allele in congenital scoliosis.}, journal = {N Engl J Med}, volume = {372}, year = {2015}, month = {2015 Jan 22}, pages = {341-50}, abstract = {

BACKGROUND: Congenital scoliosis is a common type of vertebral malformation. Genetic susceptibility has been implicated in congenital scoliosis.

METHODS: We evaluated 161 Han Chinese persons with sporadic congenital scoliosis, 166 Han Chinese controls, and 2 pedigrees, family members of which had a 16p11.2 deletion, using comparative genomic hybridization, quantitative polymerase-chain-reaction analysis, and DNA sequencing. We carried out tests of replication using an additional series of 76 Han Chinese persons with congenital scoliosis and a multicenter series of 42 persons with 16p11.2 deletions.

RESULTS: We identified a total of 17 heterozygous TBX6 null mutations in the 161 persons with sporadic congenital scoliosis (11\%); we did not observe any null mutations in TBX6 in 166 controls (P<3.8{\texttimes}10(-6)). These null alleles include copy-number variants (12 instances of a 16p11.2 deletion affecting TBX6) and single-nucleotide variants (1 nonsense and 4 frame-shift mutations). However, the discordant intrafamilial phenotypes of 16p11.2 deletion carriers suggest that heterozygous TBX6 null mutation is insufficient to cause congenital scoliosis. We went on to identify a common TBX6 haplotype as the second risk allele in all 17 carriers of TBX6 null mutations (P<1.1{\texttimes}10(-6)). Replication studies involving additional persons with congenital scoliosis who carried a deletion affecting TBX6 confirmed this compound inheritance model. In vitro functional assays suggested that the risk haplotype is a hypomorphic allele. Hemivertebrae are characteristic of TBX6-associated congenital scoliosis.

CONCLUSIONS: Compound inheritance of a rare null mutation and a hypomorphic allele of TBX6 accounted for up to 11\% of congenital scoliosis cases in the series that we analyzed. (Funded by the National Basic Research Program of China and others.).

}, keywords = {Adolescent, Asian Continental Ancestry Group, Child, Child, Preschool, Chromosomes, Human, Pair 16, DNA Copy Number Variations, Female, Genetic Predisposition to Disease, Genotype, Humans, Male, Mutation, Pedigree, Phenotype, Radiography, Scoliosis, Sequence Deletion, Spine, T-Box Domain Proteins}, issn = {1533-4406}, doi = {10.1056/NEJMoa1406829}, author = {Wu, N and Ming, X and Xiao, J and Wu, Z and Chen, X and Shinawi, M and Shen, Y and Yu, G and Liu, J and Xie, H and Gucev, Z S and Liu, S and Yang, N and Al-Kateb, H and Chen, J and Zhang, J and Hauser, N and Zhang, T and Tasic, V and Liu, P and Su, X and Pan, X and Liu, C and Wang, L and Shen, J and Shen, J and Chen, Y and Zhang, T and Zhang, J and Choy, K W and Wang, J and Wang, Q and Li, S and Zhou, W and Guo, J and Wang, Y and Zhang, C and Zhao, Hong and An, Yu and Zhao, Yu and Wang, J and Liu, Z and Zuo, Y and Tian, Y and Weng, X and Sutton, V R and Wang, H and Ming, Y and Kulkarni, S and Zhong, T P and Giampietro, P F and Dunwoodie, S L and Cheung, S W and Zhang, X and Jin, L and Lupski, J R and Qiu, G and Zhang, F} }