Pathogenic variants in the paired-related homeobox 1 gene (PRRX1) cause craniosynostosis with incomplete penetrance

<p><strong>Purpose</strong></p> Studies previously implicated PRRX1 in craniofacial development, including demonstration of murine Prrx1 expression in the pre-osteogenic cells of the cranial sutures. We investigated the role of heterozygous missense and loss-of-function varia...

Descrizione completa

Dettagli Bibliografici
Autori principali: Tooze, RS, Miller, KA, Swagemakers, SMA, Calpena, E, McGowan, SJ, Boute, O, Collet, C, Johnson, D, Laffargue, F, de Leeuw, N, Morton, JV, Noons, P, Ockeloen, CW, Phipps, JM, Tan, TY, Timberlake, AT, Vanlerberghe, C, Wall, SA, Weber, A, Wilson, LC, Zackai, EH, Mathijssen, IMJ, Twigg, SRF, Wilkie, AOM
Natura: Journal article
Lingua:English
Pubblicazione: Elsevier 2023
_version_ 1826310304208781312
author Tooze, RS
Miller, KA
Swagemakers, SMA
Calpena, E
McGowan, SJ
Boute, O
Collet, C
Johnson, D
Laffargue, F
de Leeuw, N
Morton, JV
Noons, P
Ockeloen, CW
Phipps, JM
Tan, TY
Timberlake, AT
Vanlerberghe, C
Wall, SA
Weber, A
Wilson, LC
Zackai, EH
Mathijssen, IMJ
Twigg, SRF
Wilkie, AOM
author_facet Tooze, RS
Miller, KA
Swagemakers, SMA
Calpena, E
McGowan, SJ
Boute, O
Collet, C
Johnson, D
Laffargue, F
de Leeuw, N
Morton, JV
Noons, P
Ockeloen, CW
Phipps, JM
Tan, TY
Timberlake, AT
Vanlerberghe, C
Wall, SA
Weber, A
Wilson, LC
Zackai, EH
Mathijssen, IMJ
Twigg, SRF
Wilkie, AOM
author_sort Tooze, RS
collection OXFORD
description <p><strong>Purpose</strong></p> Studies previously implicated PRRX1 in craniofacial development, including demonstration of murine Prrx1 expression in the pre-osteogenic cells of the cranial sutures. We investigated the role of heterozygous missense and loss-of-function variants in PRRX1 associated with craniosynostosis. <p><strong>Methods</strong></p> Trio-based genome, exome or targeted sequencing were used to screen PRRX1 in patients with craniosynostosis; immunofluorescence analyses were used to assess nuclear localization of wild-type and mutant proteins. <p><strong>Results</strong></p> Genome sequencing identified 2 of 9 sporadically affected individuals with syndromic/multisuture craniosynostosis who were heterozygous for rare/undescribed variants in PRRX1. Exome or targeted sequencing of PRRX1 revealed a further 9/1449 patients with craniosynostosis harboring deletions or rare heterozygous variants within the homeodomain. By collaboration, seven additional individuals (four families) were identified with putatively pathogenic PRRX1 variants. Immunofluorescence analyses showed that missense variants within the PRRX1 homeodomain cause abnormal nuclear localization. Of patients with variants considered likely pathogenic, bicoronal or other multi-suture synostosis was present in 11/17 (65% of the cases). Pathogenic variants were inherited from unaffected relatives in many instances, yielding a 12.5% penetrance estimate for craniosynostosis. <p><strong>Conclusion</strong></p> This work supports a key role for PRRX1 in cranial suture development and shows that haploinsufficiency of PRRX1 is a relatively frequent cause of craniosynostosis.
first_indexed 2024-03-07T07:49:59Z
format Journal article
id oxford-uuid:707d9f49-2e4e-446d-ae1c-d4cbd3420d77
institution University of Oxford
language English
last_indexed 2024-03-07T07:49:59Z
publishDate 2023
publisher Elsevier
record_format dspace
spelling oxford-uuid:707d9f49-2e4e-446d-ae1c-d4cbd3420d772023-07-10T10:48:36ZPathogenic variants in the paired-related homeobox 1 gene (PRRX1) cause craniosynostosis with incomplete penetranceJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:707d9f49-2e4e-446d-ae1c-d4cbd3420d77EnglishSymplectic ElementsElsevier2023Tooze, RSMiller, KASwagemakers, SMACalpena, EMcGowan, SJBoute, OCollet, CJohnson, DLaffargue, Fde Leeuw, NMorton, JVNoons, POckeloen, CWPhipps, JMTan, TYTimberlake, ATVanlerberghe, CWall, SAWeber, AWilson, LCZackai, EHMathijssen, IMJTwigg, SRFWilkie, AOM<p><strong>Purpose</strong></p> Studies previously implicated PRRX1 in craniofacial development, including demonstration of murine Prrx1 expression in the pre-osteogenic cells of the cranial sutures. We investigated the role of heterozygous missense and loss-of-function variants in PRRX1 associated with craniosynostosis. <p><strong>Methods</strong></p> Trio-based genome, exome or targeted sequencing were used to screen PRRX1 in patients with craniosynostosis; immunofluorescence analyses were used to assess nuclear localization of wild-type and mutant proteins. <p><strong>Results</strong></p> Genome sequencing identified 2 of 9 sporadically affected individuals with syndromic/multisuture craniosynostosis who were heterozygous for rare/undescribed variants in PRRX1. Exome or targeted sequencing of PRRX1 revealed a further 9/1449 patients with craniosynostosis harboring deletions or rare heterozygous variants within the homeodomain. By collaboration, seven additional individuals (four families) were identified with putatively pathogenic PRRX1 variants. Immunofluorescence analyses showed that missense variants within the PRRX1 homeodomain cause abnormal nuclear localization. Of patients with variants considered likely pathogenic, bicoronal or other multi-suture synostosis was present in 11/17 (65% of the cases). Pathogenic variants were inherited from unaffected relatives in many instances, yielding a 12.5% penetrance estimate for craniosynostosis. <p><strong>Conclusion</strong></p> This work supports a key role for PRRX1 in cranial suture development and shows that haploinsufficiency of PRRX1 is a relatively frequent cause of craniosynostosis.
spellingShingle Tooze, RS
Miller, KA
Swagemakers, SMA
Calpena, E
McGowan, SJ
Boute, O
Collet, C
Johnson, D
Laffargue, F
de Leeuw, N
Morton, JV
Noons, P
Ockeloen, CW
Phipps, JM
Tan, TY
Timberlake, AT
Vanlerberghe, C
Wall, SA
Weber, A
Wilson, LC
Zackai, EH
Mathijssen, IMJ
Twigg, SRF
Wilkie, AOM
Pathogenic variants in the paired-related homeobox 1 gene (PRRX1) cause craniosynostosis with incomplete penetrance
title Pathogenic variants in the paired-related homeobox 1 gene (PRRX1) cause craniosynostosis with incomplete penetrance
title_full Pathogenic variants in the paired-related homeobox 1 gene (PRRX1) cause craniosynostosis with incomplete penetrance
title_fullStr Pathogenic variants in the paired-related homeobox 1 gene (PRRX1) cause craniosynostosis with incomplete penetrance
title_full_unstemmed Pathogenic variants in the paired-related homeobox 1 gene (PRRX1) cause craniosynostosis with incomplete penetrance
title_short Pathogenic variants in the paired-related homeobox 1 gene (PRRX1) cause craniosynostosis with incomplete penetrance
title_sort pathogenic variants in the paired related homeobox 1 gene prrx1 cause craniosynostosis with incomplete penetrance
work_keys_str_mv AT toozers pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT millerka pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT swagemakerssma pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT calpenae pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT mcgowansj pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT bouteo pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT colletc pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT johnsond pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT laffarguef pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT deleeuwn pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT mortonjv pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT noonsp pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT ockeloencw pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT phippsjm pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT tanty pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT timberlakeat pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT vanlerberghec pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT wallsa pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT webera pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT wilsonlc pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT zackaieh pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT mathijssenimj pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT twiggsrf pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance
AT wilkieaom pathogenicvariantsinthepairedrelatedhomeobox1geneprrx1causecraniosynostosiswithincompletepenetrance