Severe Developmental Phenotypes Research Articles

Structural perturbation of chromatin domains with multiple developmental regulators can severely impact gene regulation and development.

Chromatin domain boundaries delimited by CTCF motifs can restrict the range of enhancer action. However, disruption of domain structure often results in mild gene dysregulation and thus predicting the impact of boundary rearrangements on animal development remains challenging. Here, we tested whether structural perturbation of a chromatin domain with multiple developmental regulators can result in more acute gene dysregulation and severe developmental phenotypes. We targeted clusters of CTCF motifs in a domain of the mouse genome containing three FGF ligand genes - Fgf3, Fgf4, and Fgf15 - that regulate several developmental processes. Deletion of the 23.9kb cluster that defines the centromeric boundary of this domain resulted in ectopic interactions of the FGF genes with enhancers located across the deleted boundary that are active in the developing brain. This caused strong induction of FGF expression and perinatal lethality with encephalocele and orofacial cleft phenotypes. Heterozygous boundary deletion was sufficient to cause these fully penetrant phenotypes, and strikingly, loss of a single CTCF motif within the cluster also recapitulated ectopic FGF expression and caused encephalocele. However, such phenotypic sensitivity to perturbation of domain structure did not extend to all CTCF clusters of this domain, nor to all developmental processes controlled by these three FGF genes - for example, the ability to undergo lineage specification in the blastocyst and pre-implantation development were not affected. By tracing the impact of different chromosomal rearrangements throughout mouse development, we start to uncover the determinants of phenotypic robustness and sensitivity to perturbation of chromatin boundaries. Our data show how small sequence variants at certain domain boundaries can have a surprisingly outsized effect and must be considered as potential sources of gene dysregulation during development and disease.

SMARCA4 Loss and Mutated β-Catenin Induce Proliferative Lesions in the Murine Embryonic Cerebellum.

Almost all medulloblastomas (MB) of the Wingless/Int-1 (WNT) type are characterized by hotspot mutations in CTNNB1, and mouse models have convincingly demonstrated the tumor-initiating role of these mutations. Additional alterations in SMARCA4 are detected in ∼20% of WNT MB, but their functional role is mostly unknown. We, therefore, amended previously described brain lipid binding protein (Blbp)-cre::Ctnnb1(ex3)fl/wt mice by the introduction of floxed Smarca4 alleles. Unexpectedly, mutated and thereby stabilized β-catenin on its own induced severe developmental phenotypes in male and female Blbp-cre::Ctnnb1(ex3)fl/wt mice in our hands, including a thinned cerebral cortex, hydrocephalus, missing cerebellar layering, and cell accumulations in the brainstem and cerebellum. An additional loss of SMARCA4 even resulted in prenatal death for most mice. Respective Blbp-cre::Ctnnb1(ex3)fl/wt::Smarca4fl/rec mutants (male and female) developed large proliferative lesions in the cerebellum evolving from E13.5 to E16.5. Histological and molecular analysis of these lesions by DNA methylation profiling and single-cell RNA sequencing suggested an origin in early undifferentiated SOX2-positive cerebellar progenitors. Furthermore, upregulated WNT signaling, altered actin/cytoskeleton organization, and reduced neuronal differentiation were evident in mutant cells. In vitro, cells harboring alterations in both Ctnnb1 and Smarca4 were negatively selected and did not show tumorigenic potential after transplantation in adult female recipient mice. However, in cerebellar explant cultures, mutant cells displayed significantly increased proliferation, suggesting an important role of the embryonic microenvironment in the development of lesions. Altogether, these results represent an important first step toward the unraveling of tumorigenic mechanisms induced by aberrant WNT signaling and SMARCA4 deficiency.

Human IP3 receptor triple knockout stem cells remain pluripotent despite altered mitochondrial metabolism

Inositol 1,4,5-trisphosphate receptors (IP3Rs) are ER Ca2+-release channels that control a broad set of cellular processes. Animal models lacking IP3Rs in different combinations display severe developmental phenotypes. Given the importance of IP3Rs in human diseases, we investigated their role in human induced pluripotent stem cells (hiPSC) by developing single IP3R and triple IP3R knockouts (TKO). Genome edited TKO-hiPSC lacking all three IP3R isoforms, IP3R1, IP3R2, IP3R3, failed to generate Ca2+ signals in response to agonists activating GPCRs, but retained stemness and pluripotency. Steady state metabolite profiling and flux analysis of TKO-hiPSC indicated distinct alterations in tricarboxylic acid cycle metabolites consistent with a deficiency in their pyruvate utilization via pyruvate dehydrogenase, shifting towards pyruvate carboxylase pathway. These results demonstrate that IP3Rs are not essential for hiPSC identity and pluripotency but regulate mitochondrial metabolism. This set of knockout hiPSC is a valuable resource for investigating IP3Rs in human cell types of interest.

Triplications of chromosome 1p36.3, including the genes GABRD and SKI, are associated with a developmental disorder and a facial gestalt.

Triplication of chromosomal region 1p36.3 is a rare genomic rearrangement. In this report, we delineate the phenotypic spectrum associated with 1p36.3 triplications. We describe four patients with microtriplications of variable size, but with a strong phenotypic overlap, and compare them to previously described patients with an isolated triplication or duplication of this region. The 1p36.3 triplication syndrome is associated with a distinct phenotype, characterized by global developmental delay, moderate intellectual disability, seizures, behavioral problems, and specific facial dysmorphic features, including ptosis, hypertelorism, and arched eyebrows. The de novo occurrence of these microtriplications demonstrates the reduced reproductive fitness associated with this genotype, in contrast to 1p36.3 duplications which are mostly inherited and can be associated with similar facial features but with a less severe developmental phenotype. The shared triplicated region encompasses four disease-related genes of which GABRD and SKI are most likely to contribute to the phenotype.

Cyp21a2 Knockout Tadpoles Survive Metamorphosis Despite Low Corticosterone.

Corticosteroids are so vital for organ maturation that reduced corticosteroid signaling during postembryonic development causes death in terrestrial vertebrates. Indeed, death occurs at metamorphosis in frogs lacking proopiomelanocortin (pomc) or the glucocorticoid receptor (GR; nr3c1). Some residual corticosteroids exist in pomc mutants to activate the wild-type (WT) GR and mineralocorticoid receptor (MR), and the elevated corticosteroids in GR mutants may activate MR. Thus, we expected a more severe developmental phenotype in tadpoles with inactivation of 21-hydroxylase, which should eliminate all interrenal corticosteroid biosynthesis. Using CRISPR/Cas9 in Xenopus tropicalis, we produced an 11-base pair deletion in cyp21a2, the gene encoding 21-hydroxylase. Growth and development were delayed in cyp21a2 mutant tadpoles, but unlike the other frog models, they survived metamorphosis. Consistent with an absence of 21-hydroxylase, mutant tadpoles had a 95% reduction of aldosterone in tail tissue, but they retained some corticosterone (∼40% of WT siblings), an amount, however, too low for survival in pomc mutants. Decreased corticosteroid signaling was evidenced by reduced expression of corticosteroid-response gene, klf9, and by impaired negative feedback in the hypothalamus-pituitary-interrenal axis with higher messenger RNA expression levels of crh, pomc, star, and cyp11b2 and an approximately 30-fold increase in tail content of progesterone. In vitro tail-tip culture showed that progesterone can transactivate the frog GR. The inadequate activation of GR by corticosterone in cyp21a2 mutants was likely compensated for by sufficient corticosteroid signaling from other GR ligands to allow survival through the developmental transition from aquatic to terrestrial life.

CASK loss of function differentially regulates neuronal maturation and synaptic function in human induced cortical excitatory neurons

SummaryLoss-of-function (LOF) mutations in CASK cause severe developmental phenotypes, including microcephaly with pontine and cerebellar hypoplasia, X-linked intellectual disability, and autism. Unraveling the pathological mechanisms of CASK-related disorders has been challenging owing to limited human cellular models to study the dynamic roles of this molecule during neuronal maturation and synapse development. Here, we investigate cell-autonomous functions of CASK in cortical excitatory induced neurons (iNs) generated from CASK knockout (KO) isogenic human embryonic stem cells (hESCs) using gene expression, morphometrics, and electrophysiology. While immature CASK KO iNs show robust neuronal outgrowth, mature CASK KO iNs display severe defects in synaptic transmission and synchronized network activity without compromising neuronal morphology and synapse numbers. In the developing human cortical excitatory neurons, CASK functions to promote both structural integrity and establishment of cortical excitatory neuronal networks. These results lay the foundation for future studies identifying suppressors of such phenotypes relevant to human patients.

MEDB-12. Severe developmental abnormalities and proliferative cerebellar lesions induced by combined activity of Wnt signalling and loss of SMARCA4

Almost all medulloblastomas (MB) of the WNT subgroup are characterized by hotspot mutations in CTNNB1, and mouse models have convincingly demonstrated the tumor-initiating role of these mutations as well as the tumor origin in the dorsal brain stem. Around 20 % of WNT MB additionally carry SMARCA4mutations, but the functional role of these alterations is mostly unknown. We therefore amended previously described Blbp-cre::Ctnnb1(ex3)Fl/+mice by the introduction of a floxed Smarca4 allele. In contrast to existing literature, Blbp-cre::Ctnnb1(ex3)Fl/+ mice had a maximum life span of only 17 days, even after breeding into two different genetic backgrounds (C57BL/6J and 129S2/Sv). The mice displayed a severe developmental phenotype including a thinned cerebral cortex, hydrocephalus, missing cerebellar foliation and layering as well as non-proliferative cell accumulations in brain stem and cerebellum. An additional homozygous loss of SMARCA4 even resulted in prenatal death for most mice and caused big proliferative lesions in the cerebellum at embryonal day 14.5. These lesions appear to originate from SOX2-positive progenitor cells in the cerebellar ventricular zone. In a next experiment, cells isolated from this region will be characterized in vitro and will be transplanted orthotopically to evaluate their neoplastic potential in vivo. Altogether, we hope to elucidate how a loss of SMARCA4 and mutations of Ctnnb1 cooperate during hindbrain development and tumor formation within this region.

Novel regulation of the transcription factor ZHX2 by N-terminal methylation

ABSTRACT N-terminal methylation (Nα-methylation) by the methyltransferase NRMT1 is an important post-translational modification that regulates protein–DNA interactions. Accordingly, its loss impairs functions that are reliant on such interactions, including DNA repair and transcriptional regulation. The global loss of Nα-methylation results in severe developmental and premature aging phenotypes, but given over 300 predicted substrates, it is hard to discern which physiological substrates contribute to each phenotype. One of the most striking phenotypes in NRMT1 knockout (Nrmt1−/− ) mice is early liver degeneration. To identify the disrupted signaling pathways leading to this phenotype and the NRMT1 substrates involved, we performed RNA-sequencing analysis of control and Nrmt1−/− adult mouse livers. We found both a significant upregulation of transcripts in the cytochrome P450 (CYP) family and downregulation of transcripts in the major urinary protein (MUP) family. Interestingly, transcription of both families is inversely regulated by the transcription factor zinc fingers and homeoboxes 2 (ZHX2). ZHX2 contains a non-canonical NRMT1 consensus sequence, indicating that its function could be directly regulated by Nα-methylation. We confirmed misregulation of CYP and MUP mRNA and protein levels in Nrmt1−/− livers and verified NRMT1 can methylate ZHX2 in vitro. In addition, we used a mutant of ZHX2 that cannot be methylated to directly demonstrate Nα-methylation promotes ZHX2 transcription factor activity and target promoter occupancy. Finally, we show Nrmt1−/− mice also exhibit early postnatal de-repression of ZHX2 targets involved in fetal liver development. Taken together, these data implicate ZHX2 misregulation as a driving force behind the liver phenotype seen in Nrmt1−/− mice.

Characterization of Fly POLR1D Mutations in a Clinically Relevant Residue Associated with Treacher Collins Syndrome (TCS)

Treacher Collins Syndrome (TCS) is an extreme craniofacial disorder caused by mutations in genes important for RNA polymerase I (Pol I) transcription. Pol I is a multi‐subunit complex that transcribes ribosomal DNA (rDNA) to synthesize ribosomal RNA (rRNA). Two Pol I subunits often mutated in TCS are POLR1D and POLR1C which form a heterodimer that is important for Pol I complex assembly. Using fruit flies (D. melanogaster) as a model system, we mapped a fly POLR1D mutation that displays a severe developmental arrest phenotype in a clinically relevant residue where in a TCS patient this residue is mutated from a glycine residue to a bulky, negatively charged glutamic acid residue. In the fly mutant collection, this glycine residue is mutated to a bulkier but positively charged arginine residue. We used a simple in vitro co‐expression system to examine the biochemical impact of these mutations on fly and human POLR1D and POLR1C heterodimer formation in vitro. We also complement our in vitro work with a chimeric yeast (S. cerevisiae) model in vivo where together we found that in the same mutated residue, there is a defect that impacts heterodimer formation and Pol I and III complex integrity. Our results show that fly POLR1D is a suitable model system for human TCS mutants.

CELSR1 Risk Alleles in Familial Bicuspid Aortic Valve and Hypoplastic Left Heart Syndrome.

Whole-genome sequencing in families enables deciphering of congenital heart disease causes. A shared genetic basis for familial bicuspid aortic valve (BAV) and hypoplastic left heart syndrome (HLHS) was postulated. Whole-genome sequencing was performed in affected members of 6 multiplex BAV families, an HLHS cohort of 197 probands and 546 relatives, and 813 controls. Data were filtered for rare, predicted-damaging variants that cosegregated with familial BAV and disrupted genes associated with congenital heart disease in humans and mice. Candidate genes were further prioritized by rare variant burden testing in HLHS cases versus controls. Modifier variants in HLHS proband-parent trios were sought to account for the severe developmental phenotype. In 5 BAV families, missense variants in 6 ontologically diverse genes for structural (SPTBN1, PAXIP1, and FBLN1) and signaling (CELSR1, PLXND1, and NOS3) proteins fulfilled filtering metrics. CELSR1, encoding cadherin epidermal growth factor laminin G seven-pass G-type receptor, was identified as a candidate gene in 2 families and was the only gene demonstrating rare variant enrichment in HLHS probands (P=0.003575). HLHS-associated CELSR1 variants included 16 missense, one splice site, and 3 noncoding variants predicted to disrupt canonical transcription factor binding sites, most of which were inherited from a parent without congenital heart disease. Filtering whole-genome sequencing data for rare, predicted-damaging variants inherited from the other parent revealed 2 cases of CELSR1 compound heterozygosity, one case of CELSR1-CELSR3 synergistic heterozygosity, and 4 cases of CELSR1-MYO15A digenic heterozygosity. CELSR1 is a susceptibility gene for familial BAV and HLHS, further implicating planar cell polarity pathway perturbation in congenital heart disease.

Case report : a novel ASXL3 gene variant in a Sudanese boy

BackgroundBainbridge-Ropers syndrome (BRPS) [OMIM#615485] is a neurodevelopmental disorder, characterized by delayed psychomotor development with generalized hypotonia, moderate to severe intellectual disability, poor or absent speech, feeding difficulties, growth failure, dysmorphic craniofacial features and minor skeletal features. The aim of this study was to investigate the genetic etiology of a Sudanese boy with severe developmental delay, intellectual disability, and craniofacial phenotype using trio-based whole-exome sequencing. To our knowledge, no patients with ASXL3 gene variant c.3043C>T have been reported detailedly in literature.Case presentationThe patient (male, 3 years 6 months) was the first born of a healthy non-consanguineous couple originating from Sudan, treated for “psychomotor retardation” for more than 8 months in Yiwu. The patient exhibited severely delayed milestones in physiological and intellectual developmental stages, language impairment, poor eye-contact, lack of subtle motions of fingers, fear of claustrophobic space, hypotonia, clinodactyly, autistic features. Peripheral blood samples were collected from the patient and his parents. Trio-based whole-exome sequencing(Trio-WES) identified a de novo heterozygous ASXL3 gene variant c.3043C>T;p.Q1015X. Sanger sequencing verified variants of this family.ConclusionTrio-WES analysis identified a de novo nonsense variant (c.3043C>T) of ASXL3 gene in a Sudanese boy. To our knowledge, the patient with this variant has not been reported previously in literature. This study presents a new case for ASXL3 gene variants, which expanded the mutational and phenotypic spectrum.

Solving the theta enigma: polymerase Ɵ deficiency causes developmental defects.

Solving the theta enigma: polymerase Ɵ deficiency causes developmental defects.

Disruption of the integrin-linked kinase (ILK) pseudokinase domain affects kidney development in mice

Disruption of the integrin-linked kinase (ILK) pseudokinase domain affects kidney development in mice

A Conditional Mutation in SCD1 Reveals Linkage Between PIN Protein Trafficking, Auxin Transport, Gravitropism, and Lateral Root Initiation.

Auxin is transported in plants with distinct polarity, defined by transport proteins of the PIN-formed (PIN) family. Components of the complex trafficking machinery responsible for polar PIN protein localization have been identified by genetic approaches, but severe developmental phenotypes of trafficking mutants complicate dissection of this pathway. We utilized a temperature sensitive allele of Arabidopsis thaliana SCD1 (stomatal cytokinesis defective1) that encodes a RAB-guanine nucleotide exchange factor. Auxin transport, lateral root initiation, asymmetric auxin-induced gene expression after gravitropic reorientation, and differential gravitropic growth were reduced in the roots of the scd1-1 mutant relative to wild type at the restrictive temperature of 25°C, but not at the permissive temperature of 18°C. In scd1-1 at 25°C, PIN1- and PIN2-GFP accumulated in endomembrane bodies. Transition of seedlings from 18 to 25°C for as little as 20 min resulted in the accumulation of PIN2-GFP in endomembranes, while gravitropism and root developmental defects were not detected until hours after transition to the non-permissive temperature. The endomembrane compartments that accumulated PIN2-GFP in scd1-1 exhibited FM4-64 signal colocalized with ARA7 and ARA6 fluorescent marker proteins, consistent with PIN2 accumulation in the late or multivesicular endosome. These experiments illustrate the power of using a temperature sensitive mutation in the gene encoding SCD1 to study the trafficking of PIN2 between the endosome and the plasma membrane. Using the conditional feature of this mutation, we show that altered trafficking of PIN2 precedes altered auxin transport and defects in gravitropism and lateral root development in this mutant upon transition to the restrictive temperature.

The Ldb1 Transcriptional Co‐Regulator is Required for Establishment, Development, and Survival of the Pancreatic Endocrine Lineage

Pancreatic islets are comprised of hormone secreting cell types that are vital regulators of glucose metabolism. Specifically, the pancreatic β cell is indispensable for glucose control and its dysfunction is central to diabetes mellitus. β cell development is regulated by transcription factor (TF) cascades, mediating differentiation of progenitors into mature insulin producing β cells. Our prior studies show that TF, Islet1 (Isl1), interacts with a transcriptional co‐regulator, Ldb1, to regulate β cell maturation from embryonic day (E) 18.5 onward. However, Ldb1 is also expressed in early stages of pancreas development, before Isl1 is present (as early as E10.5). The earlier Ldb1+ cell types include Pdx1+ multipotent progenitor cells (MPCs) and endocrine progenitors expressing the TF Neurogenin3 (Ngn3). MPC progeny will populate the entire pancreas (endocrine and exocrine), while Ngn3+ endocrine progenitors (Isl1−) are fated to become islet cells. Our hypothesis is that Ldb1 has Isl1 independent roles in maintaining progenitor identity in these requisite populations during early pancreatic development. To test this we generated a whole pancreas knockout of Ldb1 (Ldb1Δpanc) and observed severe developmental and postnatal phenotypes. At E13.5, Ldb1Δpanc mice exhibit disorganized progenitor pools, suggesting early defects in endocrine identity. At E15.5, Ldb1Δpanc mice had a significant reduction of Ngn3+ progenitors and Pdx1HI immunoreactivity, a mark of presumptive β cells. Ldb1Δpanc mice die by postnatal day 7 (P7) with severe hyperglycemia and hypoinsulinemia due to drastic islet hormone cell reduction. Interestingly, total pancreatic mass remained unchanged in Ldb1Δpanc neonates, suggesting that Ldb1 impacts are islet specific in the pancreas. Considering these observations, we generated a new model of Ldb1 loss specifically in Ngn3+ islet progenitors, termed Ldb1Δendo. We confirmed loss of Ldb1 in endocrine clusters and observed postnatal hyperglycemia, with a reduction of islet cells in neonates, similar to that seen in Ldb1Δpanc mice. Chromatin immunoprecipitation in vivo and in vitro highlights that Ldb1 imparts control on Pdx1 through occupation of the Pdx1 Area I–II regulatory domains, and that Ngn3 control also occurs via direct occupation. We are now further assessing the developmental phenotype, examining markers of proliferation, apoptosis, and altered cell identity through lineage tracing in the Ldb1Δendo model. Concomitantly, our published work revealed that Ldb1 and Isl1 interact in complex with the single stranded DNA binding protein co‐regulator, SSBP3, which helps stabilize this transcriptional complex. To examine the functional relationship between SSBP3, Isl1, and Ldb1 in vivo, we developed a new SSBP3 floxed mouse model in order to generate pancreas wide loss of SSBP3 (SSBP3Δpanc). We observed preliminary reductions in key islet mRNAs along with hyperglycemia in neonates at P1. Our work provides insight into the transcriptional complexes dictating how islet progenitors adopt their cell fate. Enhancing our understanding of this differentiation process can contribute to therapeutic β and islet cell generation strategies to help the growing diabetic population.Support or Funding InformationNIH‐NIDDK R01DK111483‐01NIH‐F31DK120217NIH‐NIGMS T32GM008111

The Second Site Modifier, Sympathy for the ligule, Encodes a Homolog of Arabidopsis ENHANCED DISEASE RESISTANCE4 and Rescues the Liguleless narrow Maize Mutant.

Liguleless narrow1 encodes a plasma membrane-localized receptor-like kinase required for normal development of maize (Zea mays) leaves, internodes, and inflorescences. The semidominant Lgn-R mutation lacks kinase activity, and phenotypic severity is dependent on inbred background. We created near isogenic lines and assayed the phenotype in multiple environments. Lgn-R plants that carry the B73 version of Sympathy for the ligule (Sol-B) fail to grow under hot conditions, but those that carry the Mo17 version (Sol-M) survive at hot temperatures and are significantly taller at cool temperatures. To identify Sol, we used recombinant mapping and analyzed the Lgn-R phenotype in additional inbred backgrounds. We identified amino acid sequence variations in GRMZM2G075262 that segregate with severity of the Lgn-R phenotypes. This gene is expressed at high levels in Lgn-R B73, but expression drops to nonmutant levels with one copy of Sol-M An EMS mutation solidified the identity of SOL as a maize homolog of Arabidopsis (Arabidopsis thaliana) ENHANCED DISEASE RESISTANCE4 (EDR4). SOL, like EDR4, is induced in response to pathogen-associated molecular patterns such as flg22. Integrated transcriptomic and phosphoproteomic analyses suggest that Lgn-R plants constitutively activate an immune signaling cascade that induces temperature-sensitive responses in addition to defects in leaf development. We propose that aspects of the severe Lgn-R developmental phenotype result from constitutive defense induction and that SOL potentially functions in repressing this response in Mo17 but not B73. Identification of LGN and its interaction with SOL provides insight into the integration of developmental control and immune responses.

Noonan Syndrome in South Africa: Clinical and Molecular Profiles.

Noonan Syndrome (NS) is a common autosomal dominant multisystem disorder, caused by mutations in more than 10 genes in the Ras/MAPK signaling pathway. Differential mutation frequencies are observed across populations. Clinical expressions of NS are highly variable and include short stature, distinctive craniofacial dysmorphism, cardiovascular abnormalities, and developmental delay. Little is known about phenotypic specificities and molecular characteristics of NS in Africa. The present study has investigated patients with NS in Cape Town (South Africa). Clinical features were carefully documented in a total of 26 patients. Targeted Next-Generation Sequencing (NGS) was performed on 16 unrelated probands, using a multigene panel comprising 14 genes: PTPN11, SOS1, RIT1, A2ML1, BRAF, CBL, HRAS, KRAS, MAP2K1, MAP2K2, NRAS, RAF1, SHOC2, and SPRED1. The median age at diagnosis was 4.5 years (range: 1 month−51 years). Individuals of mixed-race ancestry were most represented (53.8%), followed by black Africans (30.8%). Our cohort revealed a lower frequency of pulmonary valve stenosis (34.6%) and a less severe developmental milestones phenotype. Molecular analysis found variants predicted to be pathogenic in 5 / 16 cases (31.2%). Among these mutations, two were previously reported: MAP2K1-c.389A>G (p.Tyr130Cys) and PTPN11 - c.1510A>G (p.Met504Val); three are novel: CBL-c.2520T>G (p.Cys840Trp), PTPN11- c.1496C>T (p.Ser499Phe), and MAP2K1- c.200A>C (p.Asp67Ala). Molecular dynamic simulations indicated that novel variants identified impact the stability and flexibility of their corresponding proteins. Genotype-phenotype correlations showed that clinical features of NS were more typical in patients with variants in MAP2K1. This first application of targeted NGS for the molecular diagnosis of NS in South Africans suggests that, while there is no major phenotypic difference compared to other populations, the distribution of genetic variants in NS in South Africans may be different.

OR28-2 The Ldb1 Transcriptional Co-regulator Is Required for Establishment, Development, and Survival of the Pancreatic Endocrine Lineage

Pancreatic islets are comprised of hormone-secreting cell types that are vital regulators of glucose homeostasis. Specifically, the pancreatic β-cell is indispensable for glucose metabolism and its dysfunction is central to diabetes mellitus. β-cell development is regulated by transcription factor (TF) cascades, mediating differentiation of embryonic progenitors into mature insulin-producing β-cells. Our prior studies showed that the pancreatic TF, Islet-1 (Isl1), interacts with a broadly-expressed transcriptional co-regulator, Ldb1, to regulate β-cell maturation during late embryogenesis and postnatal function (i.e embryonic day (E) 18.5 onward). However, Ldb1 is also expressed early in development, before Isl1 is present (i.e. as early as E10.5). The earlier Ldb1+cell types include Pdx1+multipotent progenitor cells (MPCs) and early endocrine progenitors expressing the TF Neurogenin-3 (Ngn3). MPC progeny will populate the entire pancreas (endocrine and exocrine), while Ngn3+endocrine progenitors (Isl1-) are fated to become the islet cells. Our hypothesis is that Ldb1 has Isl1-independent roles in maintaining progenitor identity and survival in these requisite populations during early pancreatic development. To test this, we generated a whole pancreas knockout of Ldb1, termed Ldb1∆panc, and observed severe developmental and postnatal phenotypes. At E13.5, Ldb1∆pancmice exhibited disorganized progenitor pools, suggesting early defects in endocrine identity. At E15.5 Ldb1∆pancmice had a significant reduction of Ngn3+endocrine progenitors, and Pdx1HI/insulin immunoreactivity as marks of presumptive β-cells. Ldb1∆pancmice died by postnatal day 7 with severe hyperglycemia and hypoinsulinemia due to a drastic islet hormone+cell reduction. Interestingly, total pancreatic mass remained unchanged in Ldb1∆pancneonates, suggesting that Ldb1 impacts are islet-specific in the pancreas. Considering these observations, we generated a new model of Ldb1 loss specifically in Ngn3+islet progenitors, termed Ldb1∆endo. We confirmed loss of Ldb1 in endocrine clusters and observed postnatal hyperglycemia, with a reduction of islet cells in Ldb1∆endoneonates, similar to Ldb1∆pancmice. Chromatin immunoprecipitation experiments highlight that Ldb1 likely imparts control on Pdx1 levels through occupation of the Pdx1 Area I-II regulatory domains. We are now further assessing the developmental phenotype, specifically examining markers of proliferation, apoptosis, and altered cell identity through lineage tracing in the Ldb1∆endomodel. Our work provides insight into how islet cells arise and the factors required for endocrine progenitors to adopt islet cell fates. This knowledge will not only enhance our understanding of this vital cell population but can contribute to novel cell-based therapeutics for helping the growing diabetic population. Unless otherwise noted, all abstracts presented at ENDO are embargoed until the date and time of presentation. For oral presentations, the abstracts are embargoed until the session begins. s presented at a news conference are embargoed until the date and time of the news conference. The Endocrine Society reserves the right to lift the embargo on specific abstracts that are selected for promotion prior to or during ENDO.

Metabolism and Biological Activities of 4-Methyl-Sterols.

4,4-Dimethylsterols and 4-methylsterols are sterol biosynthetic intermediates (C4-SBIs) acting as precursors of cholesterol, ergosterol, and phytosterols. Their accumulation caused by genetic lesions or biochemical inhibition causes severe cellular and developmental phenotypes in all organisms. Functional evidence supports their role as meiosis activators or as signaling molecules in mammals or plants. Oxygenated C4-SBIs like 4-carboxysterols act in major biological processes like auxin signaling in plants and immune system development in mammals. It is the purpose of this article to point out important milestones and significant advances in the understanding of the biogenesis and biological activities of C4-SBIs.

GRIN2A-related disorders: genotype and functional consequence predict phenotype.

Alterations of the N-methyl-d-aspartate receptor (NMDAR) subunit GluN2A, encoded by GRIN2A, have been associated with a spectrum of neurodevelopmental disorders with prominent speech-related features, and epilepsy. We performed a comprehensive assessment of phenotypes with a standardized questionnaire in 92 previously unreported individuals with GRIN2A-related disorders. Applying the criteria of the American College of Medical Genetics and Genomics to all published variants yielded 156 additional cases with pathogenic or likely pathogenic variants in GRIN2A, resulting in a total of 248 individuals. The phenotypic spectrum ranged from normal or near-normal development with mild epilepsy and speech delay/apraxia to severe developmental and epileptic encephalopathy, often within the epilepsy-aphasia spectrum. We found that pathogenic missense variants in transmembrane and linker domains (misTMD+Linker) were associated with severe developmental phenotypes, whereas missense variants within amino terminal or ligand-binding domains (misATD+LBD) and null variants led to less severe developmental phenotypes, which we confirmed in a discovery (P = 10-6) as well as validation cohort (P = 0.0003). Other phenotypes such as MRI abnormalities and epilepsy types were also significantly different between the two groups. Notably, this was paralleled by electrophysiology data, where misTMD+Linker predominantly led to NMDAR gain-of-function, while misATD+LBD exclusively caused NMDAR loss-of-function. With respect to null variants, we show that Grin2a+/- cortical rat neurons also had reduced NMDAR function and there was no evidence of previously postulated compensatory overexpression of GluN2B. We demonstrate that null variants and misATD+LBD of GRIN2A do not only share the same clinical spectrum (i.e. milder phenotypes), but also result in similar electrophysiological consequences (loss-of-function) opposing those of misTMD+Linker (severe phenotypes; predominantly gain-of-function). This new pathomechanistic model may ultimately help in predicting phenotype severity as well as eligibility for potential precision medicine approaches in GRIN2A-related disorders.