@article {678, title = {Heterozygous Variants in KMT2E Cause a Spectrum of Neurodevelopmental Disorders and Epilepsy.}, journal = {Am J Hum Genet}, volume = {104}, year = {2019}, month = {2019 Jun 06}, pages = {1210-1222}, abstract = {

We delineate a KMT2E-related neurodevelopmental disorder on the basis of 38 individuals in 36 families. This study includes 31 distinct heterozygous variants in KMT2E (28 ascertained from Matchmaker Exchange and three previously reported), and four individuals with chromosome 7q22.2-22.23 microdeletions encompassing KMT2E (one previously reported). Almost all variants occurred de novo, and most were truncating. Most affected individuals with protein-truncating variants presented with mild intellectual disability. One-quarter of individuals met criteria for autism. Additional common features include macrocephaly, hypotonia, functional gastrointestinal abnormalities, and a subtle facial gestalt. Epilepsy was present in about one-fifth of individuals with truncating variants and was responsive to treatment with anti-epileptic medications in almost all. More than 70\% of the individuals were male, and expressivity was variable by sex; epilepsy was more common in females and autism more common in males. The four individuals with microdeletions encompassing KMT2E generally presented similarly to those with truncating variants, but the degree of developmental delay was greater. The group of four individuals with missense variants in KMT2E presented with the most severe developmental delays. Epilepsy was present in all individuals with missense variants, often manifesting as treatment-resistant infantile epileptic encephalopathy. Microcephaly was also common in this group. Haploinsufficiency versus gain-of-function or dominant-negative effects specific to these missense variants in KMT2E might explain this divergence in phenotype, but requires independent validation. Disruptive variants in KMT2E are an under-recognized cause of neurodevelopmental abnormalities.

}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2019.03.021}, author = {O{\textquoteright}Donnell-Luria, Anne H and Pais, Lynn S and Faundes, V{\'\i}ctor and Wood, Jordan C and Sveden, Abigail and Luria, Victor and Abou Jamra, Rami and Accogli, Andrea and Amburgey, Kimberly and Anderlid, Britt Marie and Azzarello-Burri, Silvia and Basinger, Alice A and Bianchini, Claudia and Bird, Lynne M and Buchert, Rebecca and Carr{\'e}, Wilfrid and Ceulemans, Sophia and Charles, Perrine and Cox, Helen and Culliton, Lisa and Curr{\`o}, Aurora and Demurger, Florence and Dowling, James J and Duban-Bedu, Benedicte and Dubourg, Christ{\`e}le and Eiset, Saga Elise and Escobar, Luis F and Ferrarini, Alessandra and Haack, Tobias B and Hashim, Mona and Heide, Solveig and Helbig, Katherine L and Helbig, Ingo and Heredia, Raul and H{\'e}ron, Delphine and Isidor, Bertrand and Jonasson, Amy R and Joset, Pascal and Keren, Boris and Kok, Fernando and Kroes, Hester Y and Lavillaureix, Alino{\"e} and Lu, Xin and Maas, Saskia M and Maegawa, Gustavo H B and Marcelis, Carlo L M and Mark, Paul R and Masruha, Marcelo R and McLaughlin, Heather M and McWalter, Kirsty and Melchinger, Esther U and Mercimek-Andrews, Saadet and Nava, Caroline and Pendziwiat, Manuela and Person, Richard and Ramelli, Gian Paolo and Ramos, Luiza L P and Rauch, Anita and Reavey, Caitlin and Renieri, Alessandra and Rie{\ss}, Angelika and Sanchez-Valle, Amarilis and Sattar, Shifteh and Saunders, Carol and Schwarz, Niklas and Smol, Thomas and Srour, Myriam and Steindl, Katharina and Syrbe, Steffen and Taylor, Jenny C and Telegrafi, Aida and Thiffault, Isabelle and Trauner, Doris A and van der Linden, Helio and van Koningsbruggen, Silvana and Villard, Laurent and Vogel, Ida and Vogt, Julie and Weber, Yvonne G and Wentzensen, Ingrid M and Widjaja, Elysa and Zak, Jaroslav and Baxter, Samantha and Banka, Siddharth and Rodan, Lance H} } @article {338, title = {Mutations in EBF3 Disturb Transcriptional Profiles and Cause Intellectual Disability, Ataxia, and Facial Dysmorphism.}, journal = {Am J Hum Genet}, volume = {100}, year = {2017}, month = {2017 Jan 05}, pages = {117-127}, abstract = {

From a GeneMatcher-enabled international collaboration, we identified ten individuals affected by intellectual disability, speech delay, ataxia, and facial dysmorphism and carrying a deleterious EBF3 variant detected by whole-exome sequencing. One 9-bp duplication and one splice-site, five missense, and two nonsense variants in EBF3 were found; the mutations occurred de novo in eight individuals, and the missense variant c.625C>T (p.Arg209Trp) was inherited by two affected siblings from their healthy mother, who is mosaic. EBF3 belongs to the early B cell factor family (also known as Olf, COE, or O/E) and is a transcription factor involved in neuronal differentiation and maturation. Structural assessment predicted that the five amino acid substitutions have damaging effects on DNA binding of EBF3. Transient expression of EBF3 mutant proteins in HEK293T cells revealed mislocalization of all but one mutant in the cytoplasm, as well as nuclear localization. By transactivation assays, all EBF3 mutants showed significantly reduced or no ability to activate transcription of the reporter gene CDKN1A, and in~situ subcellular fractionation experiments demonstrated that EBF3 mutant proteins were less tightly associated with chromatin. Finally, in RNA-seq and ChIP-seq experiments, EBF3 acted as a transcriptional regulator, and mutant EBF3 had reduced genome-wide DNA binding and gene-regulatory activity. Our findings demonstrate that variants disrupting EBF3-mediated transcriptional regulation cause intellectual disability and developmental delay and are present in \~{}0.1\% of individuals with unexplained neurodevelopmental disorders.

}, keywords = {Adolescent, Adult, Amino Acid Substitution, Ataxia, Child, Child, Preschool, Chromatin, Cyclin-Dependent Kinase Inhibitor p21, Developmental Disabilities, Exome, Face, Female, Gene Expression Regulation, Genes, Reporter, HEK293 Cells, Humans, Intellectual Disability, Language Development Disorders, Male, Models, Molecular, Mosaicism, Mutation, Neurodevelopmental Disorders, Protein Transport, Syndrome, Transcription Factors, Transcription, Genetic}, issn = {1537-6605}, doi = {10.1016/j.ajhg.2016.11.012}, author = {Harms, Frederike Leonie and Girisha, Katta M and Hardigan, Andrew A and Kort{\"u}m, Fanny and Shukla, Anju and Alawi, Malik and Dalal, Ashwin and Brady, Lauren and Tarnopolsky, Mark and Bird, Lynne M and Ceulemans, Sophia and Bebin, Martina and Bowling, Kevin M and Hiatt, Susan M and Lose, Edward J and Primiano, Michelle and Chung, Wendy K and Juusola, Jane and Akdemir, Zeynep C and Bainbridge, Matthew and Charng, Wu-Lin and Drummond-Borg, Margaret and Eldomery, Mohammad K and El-Hattab, Ayman W and Saleh, Mohammed A M and B{\'e}zieau, St{\'e}phane and Cogn{\'e}, Benjamin and Isidor, Bertrand and K{\"u}ry, S{\'e}bastien and Lupski, James R and Myers, Richard M and Cooper, Gregory M and Kutsche, Kerstin} } @article {214, title = {Truncating mutations in the last exon of NOTCH3 cause lateral meningocele syndrome.}, journal = {Am J Med Genet A}, volume = {167A}, year = {2015}, month = {2015 Feb}, pages = {271-81}, abstract = {

Lateral meningocele syndrome (LMS, OMIM\%130720), also known as Lehman syndrome, is a very rare skeletal disorder with facial anomalies, hypotonia and meningocele-related neurologic dysfunction. The characteristic lateral meningoceles represent the severe end of the dural ectasia spectrum and are typically most severe in the lower spine. Facial features of LMS include hypertelorism and telecanthus, high arched eyebrows, ptosis, midfacial hypoplasia, micrognathia, high and narrow palate, low-set ears and a hypotonic appearance. Hyperextensibility, hernias and scoliosis reflect a connective tissue abnormality, and aortic dilation, a high-pitched nasal voice, wormian bones and osteolysis may be present. Lateral meningocele syndrome has phenotypic overlap with Hajdu-Cheney syndrome. We performed exome resequencing in five unrelated individuals with LMS and identified heterozygous truncating NOTCH3 mutations. In an additional unrelated individual Sanger sequencing revealed a deleterious variant in the same exon 33. In total, five novel de novo NOTCH3 mutations were identified in six unrelated patients. One had a 26 bp deletion (c.6461_6486del, p.G2154fsTer78), two carried the same single base pair insertion (c.6692_93insC, p.P2231fsTer11), and three individuals had a nonsense point mutation at c.6247A > T (pK2083*), c.6663C > G (p.Y2221*) or c.6732C > A, (p.Y2244*). All mutations cluster into the last coding exon, resulting in premature termination of the protein and truncation of the negative regulatory proline-glutamate-serine-threonine rich PEST domain. Our results suggest that mutant mRNA products escape nonsense mediated decay. The truncated NOTCH3 may cause gain-of-function through decreased clearance of the active intracellular product, resembling NOTCH2 mutations in the clinically related Hajdu-Cheney syndrome and contrasting the NOTCH3 missense mutations causing CADASIL.

}, keywords = {Abnormalities, Multiple, Child, Child, Preschool, DNA Mutational Analysis, Exome, Exons, Facies, High-Throughput Nucleotide Sequencing, Humans, Magnetic Resonance Imaging, Male, Meningocele, Mutation, Phenotype, Receptor, Notch3, Receptors, Notch, Young Adult}, issn = {1552-4833}, doi = {10.1002/ajmg.a.36863}, author = {Gripp, Karen W and Robbins, Katherine M and Sobreira, Nara L and Witmer, P Dane and Bird, Lynne M and Avela, Kristiina and M{\"a}kitie, Outi and Alves, Daniela and Hogue, Jacob S and Zackai, Elaine H and Doheny, Kimberly F and Stabley, Deborah L and Sol-Church, Katia} }