Loss of function in ROBO1 is associated with tetralogy of Fallot and septal defects

BACKGROUND: Congenital heart disease (CHD) is a common birth defect affecting approximately 1% of newborns. Great progress has been made in elucidating the genetic aetiology of CHD with advances in genomic technology, which we leveraged in recovering a new pathway affecting heart development in huma...

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Bibliographic Details
Main Authors: Kruszka, P, Tanpaiboon, P, Neas, K, Crosby, K, Berger, S, Martinez, A, Addissie, Y, Pongprot, Y, Sittiwangkul, R, Silvilairat, S, Makonkawkeyoon, K, Yu, L, Wynn, J, Bennett, J, Mefford, H, Reynolds, W, Liu, X, Mommersteeg, M, Chung, W, Lo, C, Muenke, M
Format: Journal article
Language:English
Published: BMJ Publishing Group 2017
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Summary:BACKGROUND: Congenital heart disease (CHD) is a common birth defect affecting approximately 1% of newborns. Great progress has been made in elucidating the genetic aetiology of CHD with advances in genomic technology, which we leveraged in recovering a new pathway affecting heart development in humans previously known to affect heart development in an animal model. METHODS: Four hundred and sixteen individuals from Thailand and the USA diagnosed with CHD and/or congenital diaphragmatic hernia were evaluated with chromosomal microarray and whole exome sequencing. The DECIPHER Consortium and medical literature were searched for additional patients. Murine hearts from ENU-induced mouse mutants and transgenic mice were evaluated using both episcopic confocal histopathology and troponin I stained sections. RESULTS: Loss of function ROBO1 variants were identified in three families; each proband had a ventricular septal defect, and one proband had tetralogy of Fallot. Additionally, a microdeletion in an individual with CHD was found in the medical literature. Mouse models showed perturbation of the Slit-Robo signalling pathway, causing septation and outflow tract defects and craniofacial anomalies. Two probands had variable facial features consistent with the mouse model. CONCLUSION: Our findings identify Slit-Robo as a significant pathway in human heart development and CHD.