Abstract
A variant in a transcription factor gene, POU4F3, is responsible for autosomal dominant nonsyndromic hereditary hearing loss, DFNA15. To date, 14 variants, including a whole deletion of POU4F3, have been reported to cause HL in various ethnic groups. In the present study, genetic screening for POU4F3 variants was carried out for a large series of Japanese hearing loss (HL) patients to clarify the prevalence and clinical characteristics of DFNA15 in the Japanese population. Massively parallel DNA sequencing of 68 target candidate genes was utilized in 2,549 unrelated Japanese HL patients (probands) to identify genomic variations responsible for HL. The detailed clinical features in patients with POU4F3 variants were collected from medical charts and analyzed. Novel 12 POU4F3 likely pathogenic variants (six missense variants, three frameshift variants, and three nonsense variants) were successfully identified in 15 probands (2.5%) among 602 families exhibiting autosomal dominant HL, whereas no variants were detected in the other 1,947 probands with autosomal recessive or inheritance pattern unknown HL. To obtain the audiovestibular configuration of the patients harboring POU4F3 variants, we collected audiograms and vestibular symptoms of the probands and their affected family members. Audiovestibular phenotypes in a total of 24 individuals from the 15 families possessing variants were characterized by progressive HL, with a large variation in the onset age and severity with or without vestibular symptoms observed. Pure-tone audiograms indicated the most prevalent configuration as mid-frequency HL type followed by high-frequency HL type, with asymmetry observed in approximately 20% of affected individuals. Analysis of the relationship between age and pure-tone average suggested that individuals with truncating variants showed earlier onset and slower progression of HL than did those with non-truncating variants. The present study showed that variants in POU4F3 were a common cause of autosomal dominant HL.
Highlights
Hearing loss (HL) is the most common sensory impairment, and is divided into prelingual HL (HL starts before speech development) and postlingual HL (HL occurs after speech development)
The present study showed that variants in POU4F3 were a common cause of autosomal dominant HL
Targeted deletion of both alleles of Pou4f3 is responsible for profound deafness and balance impairment in mice because of complete cochlear and vestibular hair cell losses followed by a partial secondary loss of spiral and vestibular ganglion neurons [4, 5]
Summary
Hearing loss (HL) is the most common sensory impairment, and is divided into prelingual HL (HL starts before speech development) and postlingual HL (HL occurs after speech development). 36 causative genes for ADNSHL have been identified [2]. One form of ADNSHL, DFNA15 (MIM# 602459), is caused by variants in the POU4F3 gene, which was first identified in a large Israeli Jewish family [3]. Pou4f3 is reported to be essential for the final differentiation and survival of hair cells [6, 7]. Targeted deletion of both alleles of Pou4f3 is responsible for profound deafness and balance impairment in mice because of complete cochlear and vestibular hair cell losses followed by a partial secondary loss of spiral and vestibular ganglion neurons [4, 5]
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