Abstract

Microcephaly (MCPH) is a developmental anomaly of the brain known by reduced cerebral cortex and underdeveloped intellectual disability without additional clinical symptoms. It is a genetically and clinically heterogenous disorder. Twenty-five genes (involved in spindle positioning, Wnt signaling, centriole biogenesis, DNA repair, microtubule dynamics, cell cycle checkpoints, and transcriptional regulation) causing MCPH have been identified so far. Pakistani population has contributed in the identification of many MCPH genes. WES of three large consanguineous families revealed three pathogenic variants of MCPH1, CENPJ, and CASK. One novel (c.1254delT) deletion variant of MCPH1 and one known (c.18delC) deletion variant of CENPJ were identified in family 1 and 2, respectively. In addition to this, we also identified a missense variant (c.1289G>A) of CASK in males individuals in family 3. Missense mutation in the CASK gene is frequent in the boys with intellectual disability and autistic traits which are the common features that are associated with FG Syndrome 4. The study reports novel and reported mutant alleles disrupting the working of genes vital for normal brain functioning. The findings of this study enhance our understanding about the genetic architecture of primary microcephaly in our local pedigrees and add to the allelic heterogeneity of 3 known MCPH genes. The data generated will help to develop specific strategies to reduce the high incidence rate of MCPH in Pakistani population.

Highlights

  • Primary microcephaly is a rare genetically heterogenous neurodevelopmental condition that affects the cerebral cortex, and the affected individual has a reduced brain weight than the individuals of the same age, ethnicity, and gender [1, 2]

  • We report three variants in MCPH1, CENPJ, and CASK genes segregating with MCPH

  • We report a novel deletion variant in MCPH1 and reported deletion and missense variants in CENPJ and CASK genes, respectively (Figure 1)

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Summary

Introduction

Primary microcephaly is a rare genetically heterogenous neurodevelopmental condition that affects the cerebral cortex, and the affected individual has a reduced brain weight than the individuals of the same age, ethnicity, and gender [1, 2]. The severe MCPH is defined as the occipitofrontal head circumference (OFC) of more than 3SD below the mean for gender, age, and ethnicity [4, 5] It is a recessive hereditary disorder, and most of the MCPH causing mutation occur in genes that are essential for maintaining proper cell cycle and integrity of the cellular genome [6]. And genetically microcephaly is a very heterogeneous disorder with over 900 OMIM phenotype entries and at last count 25 different types of genes with diverse form of linked variants [6, 7] Majority of these genes express during the proliferation of neural precursor cells (NPCs) in the ventricular zone of the cerebral cortex [8]. The variants of MCPH genes reported in this study will help in devising better molecular diagnostic strategies and providing genetic counselling to the affected families

Subjects and Approval of This Research Study
Sanger Sequencing
In Silico Analysis of the Identified Variants
Results and Discussion
IV-3 IV-4 IV-5
Conclusion
Ethical Approval
Conflicts of Interest
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