Abstract

We report the underlying genetic causes of prelingual hearing loss (HL) segregating in eight large consanguineous families, ascertained from the Punjab province of Pakistan. Exome sequencing followed by segregation analysis revealed seven potentially pathogenic variants, including four novel alleles c.257G>A, c.6083A>C, c.89A>G, and c.1249A>G of CLPP, CDH23, COL4A5, and LARS2, respectively. We also identified three previously reported HL-causing variants (c.4528C>T, c.35delG, and c.1219T>C) of MYO15A, GJB2, and TMPRSS3 segregating in four families. All identified variants were either absent or had very low frequencies in the control databases. Our in silico analyses and 3-dimensional (3D) molecular modeling support the deleterious impact of these variants on the encoded proteins. Variants identified in MYO15A, GJB2, TMPRSS3, and CDH23 were classified as “pathogenic” or “likely pathogenic”, while the variants in CLPP and LARS2 fall in the category of “uncertain significance” based on the American College of Medical Genetics and Genomics/Association for Molecular Pathology (ACMG/AMP) variant pathogenicity guidelines. This paper highlights the genetic diversity of hearing disorders in the Pakistani population and reports the identification of four novel mutations in four HL families.

Highlights

  • Hearing loss (HL) is an etiologically heterogeneous trait that can present itself at any age and degree of severity

  • Unlike genetic disorders caused by single-gene pathogenic variants, over 120 distinct autosomal genetic loci are already linked to just the nonsyndromic form of recessively inherited HL [3]

  • Advancements in molecular genetics screening and bioinformatics tools have been tremendously helpful in deciphering the causal variants for Mendelian disorders, including HL

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Summary

Introduction

Hearing loss (HL) is an etiologically heterogeneous trait that can present itself at any age and degree of severity. This condition affects 1 in 500 newborns and >360 million people worldwide [1,2]. Unlike genetic disorders caused by single-gene pathogenic variants (e.g., cystic fibrosis), over 120 distinct autosomal genetic loci are already linked to just the nonsyndromic form of recessively inherited HL [3]. The Pakistani population is ideal for genetic studies because of its rich anthropogeneological background, via successive waves of invasions due to its pivotal location at crossroads of South Asia, the Middle East, and Central Asia, as well as its high consanguinity. Specific clans and high consanguinity in Pakistan provide a unique genetic resource (62.7% of marriages are consanguineous, of which ~80% are between first cousins) [23]

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