Abstract

BackgroundMicrotia-atresia is characterized by abnormalities of the auricle (microtia) and aplasia or hypoplasia of the external auditory canal, often associated with middle ear abnormalities. To date, no causal genetic mutations or genes have been identified in microtia-atresia patients.MethodsWe designed a panel of 131 genes associated with external/middle or inner ear deformity. Targeted genomic capturing combined with next-generation sequencing (NGS) was utilized to screen for mutations in 40 severe microtia-atresia patients. Mutations detected by NGS were filtered and validated. And then mutations were divided into three categories—rare or novel variants, low-frequency variants and common variants—based on their frequency in the public database. The rare or novel mutations were prioritized by pathogenicity analysis. For the low-frequency variants and common variants, we used association studies to explore risk factors of severe microtia-atresia.ResultsSixty-five rare heterozygous mutations of 42 genes were identified in 27 (67.5%) severe microtia-atresia patients. Association studies to determine genes that were potentially pathogenic found that PLEC, USH2A, FREM2, DCHS1, GLI3, POMT1 and GBA genes were significantly associated with severe microtia-atresia. Of these, DCHS1 was strongly suggested to cause severe microtia-atresia as it was identified by both low-frequency and common variants association studies. A rare mutation (c.481C > T, p.R161C) in DCHS1 identified in one individual may be deleterious and may cause severe microtia-atresia.ConclusionWe identified several genes that were significantly associated with severe microtia-atresia. The findings provide new insights into genetic background of external ear deformities.

Highlights

  • Microtia-atresia is characterized by abnormalities of the auricle and aplasia or hypoplasia of the external auditory canal, often associated with middle ear abnormalities

  • Rare or novel variants Using the rigorous filtering pipeline, we identified 65 rare heterozygous mutations of 42 genes in 27 (67.5%) severe microtia-atresia patients (Additional file 2)

  • Because of limitations in the ability of in silico analysis to assess the pathogenicity of any mutation, we did not exclude mutations predicted to be benign or neutral by either SIFT or Polyphen-2. None of these mutations had been previously reported in microtia-atresia patients, and more than half (53.8%) of the variants were absent from population databases

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Summary

Introduction

Microtia-atresia is characterized by abnormalities of the auricle (microtia) and aplasia or hypoplasia of the external auditory canal, often associated with middle ear abnormalities. Severe microtia-atresia, one of the most frequent congenital craniofacial deformities, is characterized by abnormalities of the auricle (microtia) and aplasia or hypoplasia of the external auditory canal, often associated with middle ear abnormalities [1, 2]. The external ear consists of the auricle, the external auditory canal and the outer layer of the tympanic membrane, which derives from the space between the first and second branchial arch in the developing embryo [9]. The external ear begins its development during the fifth week, and the hillocks are first identifiable during the sixth week of embryogenesis. Any risk factor that affects external ear development will lead to microtia during embryonic development

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