Helix-loop-helix Research Articles

Genome-Wide Analysis and Characterization of the PIF Gene Family Under Salt and Drought Stress in Common Beans (Phaseolus vulgaris L.)

The purpose of this study was to identify and describe members of the phytochrome-interacting factors (PIFs) gene family including the basic helix loop helix (bHLH) binding site in Phaseolus vulgaris plants, as well as to investigate their responses to salt and drought stress. Various tools of in silico approaches were used to identify five Pvul-PIF gene families in the P. vulgaris genome. This gene family contained 324 to 726 amino acids and has molecular weights ranging from 35.11 kDa to 77.67 kDa. The theoretical isoelectric points range from 6.03 (Pvul-PIF-3.3) to 8.30 (Pvul-PIF-3.2). Pvul-PIF proteins were shown to be clustered in three main groups with Arabidopsis thaliana, Populus trichocarpa, Solanum lycopersicum, Zea mays, Arachis hypogaea L., Oryza sativa, Vitis vinifera, Glycine max, and Phaseolus vulgaris species as a result of the phylogenetic study. Segmental duplication was detected between Pvul-PIF-3.2, Pvul-PIF-3.3 and Pvul-PIF-3.1 genes, Pvul-PIF-4.1 and Pvul-PIF-4.2 genes and Pvul-PIF-3.3 and Pvul-PIF-3.1 genes. When the expression patterns of the Pvul-PIF genes were examined, it was observed that they had different levels of expression under salt and drought stress and that they may be involved in specific biological and molecular processes in response to different abiotic and biotic stresses. The results of this research, which were established for the first time in response to salt and drought stress in P. vulgaris of the PIF gene family, will be a valuable source of knowledge and additional information in the fields of plant biotechnology, agricultural biotechnology, and molecular biology.

Targeting MYC with modular synthetic transcriptional repressors derived from bHLH DNA-binding domains.

Despite unequivocal roles in disease, transcription factors (TFs) remain largely untapped as pharmacologic targets due to the challenges in targeting protein-protein and protein-DNA interactions. Here we report a chemical strategy to generate modular synthetic transcriptional repressors (STRs) derived from the bHLH domain of MAX. Our synthetic approach yields chemically stabilized tertiary domain mimetics that cooperatively bind the MYC/MAX consensus E-box motif with nanomolar affinity, exhibit specificity that is equivalent to or beyond that of full-length TFs and directly compete with MYC/MAX protein for DNA binding. A lead STR directly inhibits MYC binding in cells, downregulates MYC-dependent expression programs at the proteome level and inhibits MYC-dependent cell proliferation. Co-crystallization and structure determination of a STR:E-box DNA complex confirms retention of DNA recognition in a near identical manner as full-length bHLH TFs. We additionally demonstrate structure-blind design of STRs derived from alternative bHLH-TFs, confirming that STRs can be used to develop highly specific mimetics of TFs targeting other gene regulatory elements.

Mechanism and treatment of α-amanitin poisoning.

Amanita poisoning has a high mortality rate. The α-amanitin toxin in Amanita is the main lethal toxin. There is no specific detoxification drug for α-amanitin, and the clinical treatment mainly focuses on symptomatic and supportive therapy. The pathogenesis of α-amanitin mainly includes: α-amanitin can inhibit the activity of RNA polymeraseII in the nucleus, including the inhibition of the largest subunit of RNA polymeraseII, RNApb1, bridge helix, and trigger loop. In addition, α-amanitin acts in vivo through the enterohepatic circulation and transport system. α-Amanitin can cause the cell death. The existing mechanisms of cell damage mainly focus on apoptosis, oxidative stress, and autophagy. In addition to the pathogenic mechanism, α-amanitin also has a role in cancer treatment, which is the focus of current research. The mechanism of action of α-amanitin on the body is still being explored.

Structural insight into the ligand binding mechanism of aryl hydrocarbon receptor

The aryl hydrocarbon receptor (AHR), a member of the basic helix–loop–helix (bHLH) Per–Arnt–Sim (PAS) family of transcription factors, plays important roles in regulating xenobiotic metabolism, cellular differentiation, stem cell maintenance, as well as immunity. More recently, AHR has gained significant interest as a drug target for the development of novel cancer immunotherapy drugs. Detailed understanding of AHR-ligand binding has been hampered for decades by the lack of a three-dimensional structure of the AHR PAS-B domain. Here, we present multiple crystal structures of the Drosophila AHR PAS-B domain, including its apo, ligand-bound, and AHR nuclear translocator (ARNT) PAS-B-bound forms. Together with biochemical and cellular assays, our data reveal structural features of the AHR PAS-B domain, provide insights into the mechanism of AHR ligand binding, and provide the structural basis for the future development of AHR-targeted therapeutics.

Cardiac-specific knockdown of Bhlhe40 attenuates angiotensin II (Ang II)-Induced atrial fibrillation in mice.

Atrial fibrosis and atrial inflammation are associated with the pathogenesis of atrial fibrillation (AF). Basic helix–loop–helix family member E40 (Bhlhe40) is an important transcription factor, which is involved in tumors, inflammation, apoptosis, viral infection, and hypoxia. However, its role and molecular mechanism in AF remain unclear. In this study, a mouse model of AF was induced by Ang II infusion. The atrial diameter was evaluated using echocardiography. Induction and duration of AF were measured by programmed electrical stimulation. Atrial structural remodeling was detected using routine histologic examinations. Our results showed that Bhlhe40 was significantly upregulated in angiotensin II (Ang II)-stimulated atrial cardiomyocytes and atrial tissues and in tissues from patients with AF. Cardiac-specific knockdown of Bhlhe40 in mice by a type 9 recombinant adeno-associated virus (rAAV9)-shBhlhe40 significantly ameliorated Ang II-induced atrial dilatation, atrial fibrosis, and atrial inflammation, as well as the inducibility and duration of AF. Mechanistically, cardiac-specific knockdown of Bhlhe40 attenuated Ang II-induced activation of NF-κB/NLRP3, TGF-1β/Smad2 signals, the increased expression of CX43, and the decreased expression of Kv4.3 in the atria. This is the first study to suggest that Bhlhe40 is a novel regulator of AF progression, and identifying Bhlhe40 may be a new therapeutic target for hypertrophic remodeling and heart failure.

RsTTG1, a WD40 Protein, Interacts with the bHLH Transcription Factor RsTT8 to Regulate Anthocyanin and Proanthocyanidin Biosynthesis in Raphanus sativus.

MBW complexes, consisting of MYB, basic helix–loop–helix (bHLH), and WD40 proteins, regulate multiple traits in plants, including anthocyanin and proanthocyanidin (PA) biosynthesis and the determination of epidermal cell fate. Here, a WD40 gene from Raphanus sativus, designated TRANSPARENT TESTA GLABRA 1 (RsTTG1), was cloned and functionally characterized. Heterologous expression of RsTTG1 in the Arabidopsis thaliana mutant ttg1-22 background restored accumulation of anthocyanin and PA in the mutant and rescued trichome development. In radish, RsTTG1 was abundantly expressed in all root and leaf tissues, independently of anthocyanin accumulation, while its MBW partners RsMYB1 and TRANSPARENT TESTA 8 (RsTT8) were expressed at higher levels in pigment-accumulating tissues. In yeast two-hybrid analysis, the full-length RsTTG1 protein interacted with RsTT8. Moreover, transient protoplast co-expression assays demonstrated that RsTTG1, which localized to both the cytoplasm and nucleus, moves from the cytoplasm to the nucleus in the presence of RsTT8. When co-expressed with RsMYB1 and RsTT8, RsTTG1 stably activated the promoters of the anthocyanin biosynthesis genes CHALCONE SYNTHASE (RsCHS) and DIHYDROFLAVONOL 4-REDUCTASE (RsDFR). Transient expression of RsTTG1 in tobacco leaves exhibited an increase in anthocyanin accumulation due to activation of the expression of anthocyanin biosynthesis genes when simultaneously expressed with RsMYB1 and RsTT8. These results indicate that RsTTG1 is a vital regulator of pigmentation and trichome development as a functional homolog of AtTTG1.

14-3-3 proteins regulate photomorphogenesis by facilitating light-induced degradation of PIF3.

14-3-3s are highly conserved phosphopeptide-binding proteins that play important roles in various developmental and signaling pathways in plants. However, although protein phosphorylation has been proven to be a key mechanism for regulating many pivotal components of the light signaling pathway, the role of 14-3-3 proteins in photomorphogenesis remains largely obscure. PHYTOCHROME-INTERACTING FACTOR3 (PIF3) is an extensively studied transcription factor repressing photomorphogenesis, and it is well-established that upon red (R) light exposure, photo-activated phytochrome B (phyB) interacts with PIF3 and induces its rapid phosphorylation and degradation. PHOTOREGULATORY PROTEIN KINASES (PPKs), a family of nuclear protein kinases, interact with phyB and PIF3 in R light and mediate multisite phosphorylation of PIF3 in vivo. Here, we report that two members of the 14-3-3 protein family, 14-3-3λ and κ, bind to a serine residue in the bHLH domain of PIF3 that can be phosphorylated by PPKs, and act as key positive regulators of R light-induced photomorphogenesis. Moreover, 14-3-3λ and κ preferentially interact with photo-activated phyB and promote the phyB-PIF3-PPK complex formation, thereby facilitating phyB-induced phosphorylation and degradation of PIF3 upon R light exposure. Together, our data demonstrate that 14-3-3λ and κ work in close concert with the phyB-PIF3 module to regulate light signaling in Arabidopsis.

Identification and Characterization of Trihelix Transcription Factors and Expression Changes during Flower Development in Pineapple

Trihelix transcription factors with helix–loop–helix–loop–helix characteristics are essential in plant growth, development, and response to adversity. Several potential functions of Trihelix have been studied in multiple plant species, but little is known about the features and functions of Trihelix genes in pineapple. In this study, 23 Trihelix members were identified and classified into 5 groups and were unevenly distributed in 17 chromosomes of pineapple. The results revealed that six fragment duplication events and one tandem duplication event were found through gene duplication analysis. Moreover, 4, 10, 21, and 23 homologous gene pairs were found between pineapple and Arabidopsis, grape, banana, and rice, respectively. The promoters of Trihelix have many cis-elements, especially in light and hormone response. The expression characteristics of AcTrihelix members showed obvious tissue specificities in different tissues. The expressions of AcTrihelix3, AcTrihelix8, AcTrihelix16, AcTrihelix19, AcTrihelix20, and AcTrihelix23 were maintained at high levels during the late stage of flower bud development. In floral organs, the expression of different members was very different. In conclusion, some AcTrihelix members may play important roles during the floral development of pineapple, and they provide resources for further studies of the function of Trihelix and the molecular mechanism during pineapple flower formation.

Dimmed gene knockout shortens larval growth and reduces silk yield in the silkworm, Bombyx mori.

The bHLH domain transcription factor, Bombyx mori-derived dimmed (Bmdimm), is directly regulated by the JH-BmMet/BmSRC-BmKr-h1 pathway and plays a key role in regulating the expression of FibH, which codes the main component of silk protein. However, the other roles of Bmdimm in silk protein synthesis remain unclear. Here, we established a Bmdimm knockout (KO) line containing a 7-bp deletion via CRISPR/Cas9 system, which led to the absence of the bHLH domain. The expression level of silk protein genes and silk yield decreased significantly in the Bmdimm KO line. Moreover, knocking out Bmdimm led to shortened larval stages and significant weight loss in larvae and adults. Bmdimm was found to be highly expressed in the silk gland, but it was also expressed in the fat body. The expression level of Bmkr-h1 in the fat body was significantly downregulated in the Bmdimm KO line. Exogenous JHA treatment upregulated Bmkr-h1 and rescued the phenotype of larval growth in the Bmdimm KO line. In conclusion, knocking out Bmdimm led to a shortened larval stage via the inhibition of Bmkr-h1 expression, then reduced silk yield. These findings help to elucidate the regulatory mechanism of fibroin synthesis and larval development in silkworms.

Genome-wide identification and transcriptional profiling of the basic helix-loop-helix gene family in tung tree (Vernicia fordii).

The basic helix-loop-helix (bHLH) transcription factor gene family is one of the largest gene families and is extensively involved in plant growth, development, biotic and abiotic stress responses. Tung tree (Vernicia fordii) is an economically important woody oil plant that produces tung oil rich in eleostearic acid. However, the characteristics of the bHLH gene family in the tung tree genome are still unclear. Hence, VfbHLHs were first searched at a genome-wide level, and their expression levels in various tissues or under low temperature were investigated systematically. In this study, we identified 104 VfbHLHs in the tung tree genome, and these genes were classified into 18 subfamilies according to bHLH domains. Ninety-eight VfbHLHs were mapped to but not evenly distributed on 11 pseudochromosomes. The domain sequences among VfbHLHs were highly conserved, and their conserved residues were also identified. To explore their expression, we performed gene expression profiling using RNA-Seq and RT-qPCR. We identified five, 18 and 28 VfbHLH genes in female flowers, male flowers and seeds, respectively. Furthermore, we found that eight genes (VfbHLH29, VfbHLH31, VfbHLH47, VfbHLH51, VfbHLH57, VfbHLH59, VfbHLH70, VfbHLH72) were significant differential expressed in roots, leaves and petioles under low temperature stress. This study lays the foundation for future studies on bHLH gene cloning, transgenes, and biological mechanisms.

Comparative physiological analyses and the genetic basis reveal heat stress responses mechanism among different Betula luminifera populations.

Betula luminifera is a subtropical fast-growing timber species with high economic value. However, along with global warming, heat stress become one of the main environmental variables that limit the productivity of B. luminifera, and the response of diverse geographic populations to high temperatures is still unclear. In order to offer a comprehensive understanding of the behavior of B. luminifera under heat stress, the physiological responses of six B. luminifera populations (across the core distribution area) were described in this work in an integrated viewpoint. The results showed that a multi-level physiological regulatory network may exist in B. luminifera, the first response was the activity of resistant enzymes [e.g., peroxidase (POD)] at a preliminary stage of 2 h heat stress, and then the proline (osmoregulation substance) content began to increase after 24 h of continuous high-temperature treatment. In addition, photosynthesis was stronlgly affected by heat stress, and the net photosynthetic rate (Pn) showed a downward trend under heat treatment in all six B. luminifera populations. Interestingly, although the physiological change patterns of the six B. luminifera populations were relatively consistent for the same parameter, there were obvious differences among different populations. Comprehensive analysis revealed that the physiological response of Rongshui (RS) was the most stable, and this was the representative B. luminifera population. Illumina RNA-seq analysis was applied to reveal the specific biological process of B. luminifera under heat stress using the RS population, and a total of 116,484 unigenes were obtained. The differentially expressed genes (DEGs) between different time periods under heat stress were enriched in 34 KEGG pathways, and the limonene and pinene degradation pathway was commonly enriched in all pairwise comparisons. Moreover, transcription factors including bHLH (basic helix–loop–helix), MYB, WRKY, and NAC (NAM, ATAF1/2, and CUC2) were identified. In this study, the physiological response and tolerance mechanisms of B. luminifera under high temperature stress were revealed, which can conducive to the basis of B. luminifera selection and resistance assessment for cultivation and breeding.

BES1/BZR1 Family Transcription Factors Regulate Plant Development via Brassinosteroid-Dependent and Independent Pathways.

The BES1/BZR1 family is a plant-specific small group of transcription factors possessing a non-canonical bHLH domain. Genetic and biochemical analyses within the last two decades have demonstrated that members of this family are key transcription factors in regulating the expression of brassinosteroid (BR) response genes. Several recent genetic and evolutionary studies, however, have clearly indicated that the BES1/BZR1 family transcription factors also function in regulating several aspects of plant development via BR-independent pathways, suggesting they are not BR specific. In this review, we summarize our current understanding of this family of transcription factors, the mechanisms regulating their activities, DNA binding motifs, and target genes. We selectively discuss a number of their biological functions via BR-dependent and particularly independent pathways, which were recently revealed by loss-of-function genetic analyses. We also highlight a few possible future directions.

PHYTOCHROME-INTERACTING FACTOR 4/HEMERA-mediated thermosensory growth requires the Mediator subunit MED14.

While moderately elevated ambient temperatures do not trigger stress responses in plants, they do substantially stimulate the growth of specific organs through a process known as thermomorphogenesis. The basic helix-loop-helix transcription factor PHYTOCHROME-INTERACTING FACTOR 4 (PIF4) plays a central role in regulating thermomorphogenetic hypocotyl elongation in various plant species, including Arabidopsis (Arabidopsis thaliana). Although it is well known that PIF4 and its co-activator HEMERA (HMR) promote plant thermosensory growth by activating genes involved in the biosynthesis and signaling of the phytohormone auxin, the detailed molecular mechanism of such transcriptional activation is not clear. In this report, we investigated the role of the Mediator complex in the PIF4/HMR-mediated thermoresponsive gene expression. Through the characterization of various mutants of the Mediator complex, a tail subunit named MED14 was identified as an essential factor for thermomorphogenetic hypocotyl growth. MED14 was required for the thermal induction of PIF4 target genes but had a marginal effect on the levels of PIF4 and HMR. Further transcriptomic analyses confirmed that the expression of numerous PIF4/HMR-dependent, auxin-related genes required MED14 at warm temperatures. Moreover, PIF4 and HMR physically interacted with MED14 and both were indispensable for the association of MED14 with the promoters of these thermoresponsive genes. While PIF4 did not regulate MED14 levels, HMR was required for the transcript abundance of MED14. Taken together, these results unveil an important thermomorphogenetic mechanism, in which PIF4 and HMR recruit the Mediator complex to activate auxin-related growth-promoting genes when plants sense moderate increases in ambient temperature.

EP14.02-007 Hes1 Protein Expression and Its Significance in Resected Small Cell Lung Cancers

Small cell lung cancer (SCLC) is a highly aggressive malignancy prone to early recurrence and metastasis. Preclinical studies have found that Hes1, as a transcription repressor of the basic helix-loop-helix (BHLH) family, can not only prevent the proliferation and migration of SCLC tumor cells, but also inhibit the neuroendocrine transcription factor ASCL1. However, the prognostic implication of Hes1 protein on surgically resected SCLCs remains unclear. The current study aims to analyze the expression pattern and prognostic value of Hes1 protein in SCLC.

30P Hes1 protein expression and its significance in resected small cell lung cancers

Small cell lung cancer (SCLC) is a highly aggressive malignancy prone to early recurrence and metastasis. Preclinical studies have found that Hes1, as a transcription repressor of the basic helix-loop-helix (BHLH) family, can not only prevent the proliferation and migration of SCLC tumor cells, but also inhibit the neuroendocrine transcription factor ASCL1. However, the prognostic implication of Hes1 protein on surgically resected SCLCs remains unclear. The current study aims to analyze the expression pattern and prognostic value of Hes1 protein in SCLC.

Unravelling the characterization of hypoxia‐inducible factor‐1α ( HIF‐1α ) and antioxidant enzymes in clam Cyclina sinensis in response to hypoxia

Aquatic hypoxia has negative or detrimental effects on clams. To cope with hypoxia stress, a complex series of physiological and biochemical strategies can be employed in clams. Hypoxia-inducible factor-1α (HIF-1α) and antioxidant enzymes are commonly found in aquatic animals as an adaptation against hypoxia. In the present study, we cloned the HIF-1α sequence in clam Cyclina sinensis, and it consists of 2654 base pairs (bp) carrying a single open-reading frame that encompasses 2235 bp of the coding region. The predicted C. sinensis HIF-1α protein (744 amino acids) has the conserved HLH-PAS domain, which contained one N-terminal basic helix–loop–helix (bHLH) domain and two Per-ARNT-Sim A/B (PAS) domains, followed by PAS-associated C-terminal (PAC) domain. HIF-1α is expressed predominantly in gills. Exposed to hypoxia, the transcript level of HIF-1α was significantly up-regulated in response to hypoxia, and then, the transcript level declined continuously with the time elapsed. The antioxidant enzymes (SOD, CAT and GSH-PX) in gills were increased initially and then decreased after acute hypoxia exposure. Our study indicates that the HIF-1α gene and antioxidant enzymes may play an important role in cope with acute hypoxia exposure.

Salt Dependence of DNA Binding Activity of Human Transcription Factor Dlx3.

Distal-less 3 (Dlx3) is a homeobox-containing transcription factor and plays a crucial role in the development and differentiation process. Human Dlx3 consists of two transactivation domains and a homeobox domain (HD) that selectively binds to the consensus site (5′-TAATT-3′) of the DNA duplex. Here, we performed chemical shift perturbation experiments on Dlx3-HD in a complex with a 10-base-paired (10-bp) DNA duplex under various salt conditions. We also acquired the imino proton spectra of the 10-bp DNA to monitor the changes in base-pair stabilities during titration with Dlx3-HD. Our study demonstrates that Dlx3-HD selectively recognizes its consensus DNA sequences through the α3 helix and L1 loop regions with a unique dynamic feature. The dynamic properties of the binding of Dlx3-HD to its consensus DNA sequence can be modulated by varying the salt concentrations. Our study suggested that this unique structural and dynamic feature of Dlx3-HD plays an important role in target DNA recognition, which might be associated with tricho-dento-osseous syndrome.

Role of Methoprene-tolerant in the regulation of oogenesis in Dipetalogaster maxima

Juvenile hormone (JH) signalling, via its receptor Methoprene-tolerant (Met), controls metamorphosis and reproduction in insects. Met belongs to a superfamily of transcription factors containing the basic Helix Loop Helix (bHLH) and Per Arnt Sim (PAS) domains. Since its discovery in 1986, Met has been characterized in several insect species. However, in spite of the importance as vectors of Chagas disease, our knowledge on the role of Met in JH signalling in Triatominae is limited. In this study, we cloned and sequenced the Dipetalogaster maxima Met transcript (DmaxMet). Molecular modelling was used to build the structure of Met and identify the JH binding site. To further understand the role of the JH receptor during oogenesis, transcript levels were evaluated in two main target organs of JH, fat body and ovary. Functional studies using Met RNAi revealed significant decreases of transcripts for vitellogenin (Vg) and lipophorin (Lp), as well as their receptors. Lp and Vg protein amounts in fat body, as well as Vg in hemolymph were also decreased, and ovarian development was impaired. Overall, these studies provide additional molecular insights on the roles of JH signalling in oogenesis in Triatominae; and therefore are relevant for the epidemiology of Chagas´ disease.

An order-to-disorder structural switch regulates HIF-1 transcription through S247 phosphorylation in the HIF1α PAS-B domain

Hypoxia-inducible factor 1 (HIF-1), a transcriptional activator that mediates cellular responses to hypoxic stress, is essential for tumor progression. It is a heterodimer comprising HIF1α and HIF1β, with multiple interfaces among their PAS-A, PAS-B, and bHLH domains. HIF1β is also known as aryl hydrocarbon receptor nuclear translocator (ARNT). Casein kinase 1δ–dependent phosphorylation of the solvent-front residue S247 on the HIF1α PAS-B domain interrupts HIF1α–ARNT complex formation and reduces HIF-1 transcription activity. However, S247 is involved in neither HIF1α–ARNT complex formation nor stabilization of the relative orientation between the HIF1α PAS-A and PAS-B domains. To uncover the underlying allosteric mechanism, we conducted Gaussian accelerated molecular dynamics simulations and identified two distinct conformations of the pS247-carrying HIF1α PAS-B domain: H291-in and H291-out. The H291-in structure can associate with the HIF1α PAS-A domain and form a V-shaped pouch to accommodate the ARNT PAS-A domain, but it cannot associate with the ARNT PAS-B domain. By contrast, the H291-out structure can bind to the ARNT PAS-B domain, but its association with the HIF1α PAS-A domain leads to an unsuitable relative orientation to accommodate the ARNT PAS-A domain. Both conformations were also collected in parallel simulations of the unphosphorylated PAS-B domain. Both structures manage to associate with the ARNT PAS-B and HIF1α PAS-A domains; thus, they are adequate for HIF1α–ARNT complex formation. The domain–domain contact pattern in a phosphorylated variant is shuffled by an order-to-disorder structural switch, triggered by the newly formed K251–pS247 interaction.

The recurrent TCF4 missense variant p.(Arg389Cys) causes a neurodevelopmental disorder overlapping with but not typical for Pitt-Hopkins syndrome.

TCF4 haploinsufficiency by deletions, truncating variants or loss-of-function missense variants within the DNA-binding and protein interacting bHLH domain causes Pitt-Hopkins syndrome (PTHS). This neurodevelopmental disorder (NDD) is characterized by severe intellectual disability (ID), epilepsy, hyperbreathing and a typical facial gestalt. Only few aberrations of the N-terminus of TCF4 were associated with milder or atypical phenotypes. By personal communication and searching databases we assembled six cases with the novel, recurrent, de novo missense variant c.1165C > T, p.(Arg389Cys) in TCF4. This variant was identified by diagnostic exome or panel sequencing and is located upstream of the bHLH domain. All six individuals presented with moderate to severe ID with language impairment. Microcephaly occurred in two individuals, epilepsy only in one, and no breathing anomalies or myopia were reported. Facial gestalt showed some aspects of PTHS but was rather non-specific in most individuals. Interestingly, the variant is located within the AD2 activation domain next to a highly conserved coactivator-recruitment motif and might alter interaction with coactivator proteins independently from the bHLH domain. Our findings of a recurrent missense variant outside the bHLH domain in six individuals with an ID phenotype overlapping with but not typical for PTHS delineate a novel genotype-phenotype correlation for TCF4-related NDDs.