Abstract

Laterality defects (LDs) or asymmetrically positioned organs are a group of rare developmental disorders caused by environmental and/or genetic factors. However, the exact molecular pathophysiology of LD is not yet fully characterised. In this context, studying Arab population presents an ideal opportunity to discover the novel molecular basis of diseases owing to the high rate of consanguinity and genetic disorders. Therefore, in the present study, we studied the molecular basis of LD in Arab patients, using next-generation sequencing method. We discovered an extremely rare novel missense variant in MYO1D gene (Pro765Ser) presenting with visceral heterotaxy and left isomerism with polysplenia syndrome. The proband in this index family has inherited this homozygous variant from her heterozygous parents following the autosomal recessive pattern. This is the first report to show MYO1D genetic variant causing left–right axis defects in humans, besides previous known evidence from zebrafish, frog and Drosophila models. Moreover, our multilevel bioinformatics-based structural (protein variant structural modelling, divergence, and stability) analysis has suggested that Ser765 causes minor structural drifts and stability changes, potentially affecting the biophysical and functional properties of MYO1D protein like calmodulin binding and microfilament motor activities. Functional bioinformatics analysis has shown that MYO1D is ubiquitously expressed across several human tissues and is reported to induce severe phenotypes in knockout mouse models. In conclusion, our findings show the expanded genetic spectrum of LD, which could potentially pave way for the novel drug target identification and development of personalised medicine for high-risk families.

Highlights

  • Laterality defects (LDs) are a group of developmental diseases that affect internal organ positioning in the body

  • At the age of 10 months, the proband underwent thorough palliative cardiac procedures in the form of ductal stenting in the neonatal period followed by Kawashima cavo-pulmonary shunt in addition to left pulmonary artery (LPA) balloon dilatation procedure

  • Variant filtration was based on its rare frequency, deleterious potential, autosomal recessive mode of inheritance, and functional relevance to disease (LD, primary ciliary dyskinesia (PCD), congenital heart disease, and heterotaxy)

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Summary

Introduction

Laterality defects (LDs) are a group of developmental diseases that affect internal organ positioning in the body. Human LDs can be divided into three categories: [1] situs solitus (SS) with normally expected organ arrangement; [2] situs inversus (SI) characterised by complete mirror image of organs; and [3] situs ambiguus (SA) with organ arrangement falling along a spectrum of various anomalies between SS and SI, including congenital heart defects (CHDs). Defective left–right (LR) patterning of internal organs is associated with multiple congenital diseases affecting the cardiovascular system, kidneys, liver, and biliary tract [2, 3]. According to the National Birth Defects Prevention Study [4], the estimated prevalence of LD is 1.1 per 10,000 in the United States. Despite the rare likelihood of LD, its incidence is excepted to be higher among the Arab population due to their high rate of consanguinity and genetic disorders [5]

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