Abstract

Xeroderma pigmentosum (XP) group D, a severe disease often typified by extreme sun sensitivity, can be caused by ERCC2 mutations. ERCC2 encodes an adenosine triphosphate (ATP)-dependent DNA helicase, namely XP group D protein (XPD). The XPD, one of ten subunits of the transcription factor TFIIH, plays a critical role in the nucleotide-excision repair (NER) pathway. Mutations in XPD that affect the NER pathway can lead to neurological degeneration and skin cancer, which are the most common causes of death in XP patients. Here, we present detailed phenotypic information on a Vietnamese family in which four members were affected by XP with extreme sun sensitivity. Genomic analysis revealed a compound heterozygous mutation of ERCC2 that affected family members and single heterozygous mutations in unaffected family members. We identified a novel, nonsense mutation in one allele of ERCC2 (c.1354C > T, p.Q452X) and a known missense mutation in the other allele (c.2048G > A, p.R683Q). Fibroblasts isolated from the compound heterozygous subject also failed to recover from UV-driven DNA damage, thus recapitulating aspects of XP syndrome in vitro. We describe a novel ERCC2 variant that leads to the breakdown of the NER pathway across generations of a family presenting with severe XP.

Highlights

  • Xeroderma pigmentosum (XP) syndrome, which is inherited in an autosomal recessive manner, is characterized by sun sensitivity and sunlight-induced ocular symptoms[1]

  • Genetic analysis has revealed a potential mechanism for this type of sun sensitivity in selected XP patients through variants in nucleotide-excision repair (NER) genes

  • ERCC2 (OMIM: 126340) encodes the XP group D protein (XPD), a DNA helicase and subunit of transcription factor TFIIH, which is involved in basal transcription and NER

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Summary

Materials and methods

Phenotypes of affected individuals Three patients (II-4, II-6, and II-10) were first recruited to the Medical University Center 3 in 2013. These patients were all siblings of a family living in Tay Ninh Province, Vietnam. Physicians recorded a detailed phenotypic analysis of each patient to include dermatology, ophthalmology, and neurology pathologies based on the XP Disease Severity Scoring System[2]. Written informed consent for undergoing a clinical assessment and detailed genetic analysis and being photographed for publication purposes under the University Medical Center ethics board (15 people, 3 generations). Cells were incubated in serum-free EdU (Invitrogen, Waltham, MA, USA) supplemented with DMEM immediately after the irradiation per the established protocol[13]. Fluorescence intensity was measured using an excitation wavelength of 540–570 nm (peak excitation was 570 nm) and emission wavelength of 580–610 nm (peak emission was 585 nm) with a Spectra Max 384 Plus Spectrophotometer (Molecular Devices, San Jose, CA, USA)

Results
Discussion
II-10 II-5 II-7 II-8 II-9 II-11 III-1 III-2 III-3
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