Abstract

BackgroundInherited retinal dystrophies, including Retinitis Pigmentosa and Leber Congenital Amaurosis among others, are a group of genetically heterogeneous disorders that lead to variable degrees of visual deficits. They can be caused by mutations in over 100 genes and there is evidence for the presence of as yet unidentified genes in a significant proportion of patients. We aimed at identifying a novel gene for an autosomal recessive form of early onset severe retinal dystrophy in a patient carrying no previously described mutations in known genes.MethodsAn integrated strategy including homozygosity mapping and whole exome sequencing was used to identify the responsible mutation. Functional tests were performed in the medaka fish (Oryzias latipes) model organism to gain further insight into the pathogenic role of the ADAMTS18 gene in eye and central nervous system (CNS) dysfunction.ResultsThis study identified, in the analyzed patient, a homozygous missense mutation in the ADAMTS18 gene, which was recently linked to Knobloch syndrome, a rare developmental disorder that affects the eye and the occipital skull. In vivo gene knockdown performed in medaka fish confirmed both that the mutation has a pathogenic role and that the inactivation of this gene has a deleterious effect on photoreceptor cell function.ConclusionThis study reveals that mutations in the ADAMTS18 gene can cause a broad phenotypic spectrum of eye disorders and contribute to shed further light on the complexity of retinal diseases.

Highlights

  • Inherited retinal dystrophies, including Retinitis Pigmentosa and Leber Congenital Amaurosis among others, are a group of genetically heterogeneous disorders that lead to variable degrees of visual deficits

  • Patients were screened for the presence of previously described mutations in genes with a known pathogenic role in ARRP and Leber Congenital Amaurosis (LCA) using genotyping microchips based on the allele-specific primer extension (APEX) technique [8]

  • Fundus examination showed attenuated retinal vessels, macular dystrophy, and diffuse mid-peripheral retinal pigment epithelium (RPE) mottling with myriads of tiny white and black dots (Figure 1A)

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Summary

Introduction

Inherited retinal dystrophies, including Retinitis Pigmentosa and Leber Congenital Amaurosis among others, are a group of genetically heterogeneous disorders that lead to variable degrees of visual deficits. They can be caused by mutations in over 100 genes and there is evidence for the presence of as yet unidentified genes in a significant proportion of patients. Inherited retinal dystrophies (IRD) are a genetically heterogeneous group of disorders that represent the most frequent causes of genetic blindness in the western world [1,2] They include Retinitis Pigmentosa (RP) and Leber Congenital Amaurosis (LCA), among the others. We selected a subset of the latter patients, preferentially those with some evidence of belonging to consanguineous families, for homozygosity mapping genotyping followed by whole exome sequencing analysis, which has proven to be an effective strategy for the identification of novel autosomal-recessive retinal disease genes [9,10]

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