Abstract

BackgroundCRB1 mutations are reported as cause of severe congenital and early-onset retinal dystrophies (EORD) with different phenotypic manifestations, including Leber congenital amaurosis (LCA), retinitis pigmentosa (RP) and cone-rod dystrophies. Comprehensive mutational scanning of the whole gene has been only performed in few cohorts, mainly in LCA patients. Here, we aimed investigating the real prevalence of CRB1 mutations in the Spanish population by extensive screening of CRB1 mutations in a large cohort of LCA and EORP cases.MethodsThis report integrates data from previous studies on CRB1 defects in our Spanish cohort of LCA and early-onset RP (EORP) with new findings from a comprehensive mutational screening of the whole gene. The molecular tools used include mutation genotyping arrays, whole-genome homozygosity mapping, an optimized high-resolution melting (HRM) analysis and Sanger sequencing.ResultsA large clinically well-characterized cohort of 404 Spanish cases was studied, 114 of which suffered from LCA and 290 from EORP. This study reveals that 11% of Spanish patients carried mutations in CRB1, ranging from 9% of EORP to 14% of LCA cases. More than three quarters of the mutations identified herein have been first described in this Spanish cohort, 13 of them are unreported new variants and 13 had been previously reported in our previous studies.ConclusionsThis work provides a wide spectrum of CRB1 mutations in the Spanish EORD patients and evidences the major role of CRB1 as causal gene in the Spanish EORP patients. It is noteworthy that a high rate of private mutations only described in our cohort has been found so far. To our knowledge, this study represents the most complete mutational screening of CRB1 in a Spanish LCA and EORP cohort, allowing us to establish gene-specific frequencies and to provide a wide spectrum of CRB1 mutations in the Spanish population.

Highlights

  • CRB1 mutations are reported as cause of severe congenital and early-onset retinal dystrophies (EORD) with different phenotypic manifestations, including Leber congenital amaurosis (LCA), retinitis pigmentosa (RP) and cone-rod dystrophies

  • The prevalence of CRB1 mutations varies widely depending on the clinical phenotype and the cohort studied, ranging between 7% in EORD patients [6], 10% in LCA patients [7], 31% in RP patients with Coats-like exudative vasculopathy and 66% in RP patients with preserved para-arteriolar retinal pigment epithelium (PPRPE) [8]

  • A pathogenic CRB1 allele was identified in 2 additional patients but a second variant could not be identified by whole screening of this gene by Sanger sequencing and Multiplex Ligation-dependent Probe Amplification (MLPA) (Table 2)

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Summary

Introduction

CRB1 mutations are reported as cause of severe congenital and early-onset retinal dystrophies (EORD) with different phenotypic manifestations, including Leber congenital amaurosis (LCA), retinitis pigmentosa (RP) and cone-rod dystrophies. Mutations in the human Crumbs homolog 1 (CRB1, MIN #604210) gene lead to severe congenital and early-onset retinal dystrophies (EORD) with a wide range of clinical manifestations including Leber congenital amaurosis (LCA, MIN #613835), early-onset Retinitis Pigmentosa (EORP) with or without preserved para-arteriolar retinal pigment epithelium (PPRPE; MIN #600105), Coats-like exudative vasculopathy, and juvenile cone-rod dystrophies [1,2,3,4,5]. CRB1 is located in the apical region of retinal pigment epithelial (RPE) cells, rod and cone photoreceptor cells and Muller glial cells [13] In this way, the Drosophila Crumbs lossof-function (LOF) mutant leads to similar photoreceptor defects to those observed in patients carrying CRB1 mutations [11]. Both human and fly proteins seem to play an essential role in photoreceptor morphogenesis, including maintenance of the polarity of RPE cells [13,14]

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