Polycomb group (PcG) proteins are key epigenetic regulators of gene transcription. Multiple neurodevelopmental disorders have been associated with pathogenic variants in genes encoding PcG proteins. RYBP is a core component of the non-canonical Polycomb Repressor Complex 1; however, its role in disease is unclear. Functional consequences of RYBP variants were assessed through in vitro cellular studies and in vivo Drosophila melanogaster studies. We describe seven individuals with heterozygous de novo variants in RYBP and clinical findings including severe developmental delay, dysmorphisms and multiple congenital anomalies. We show that all the single nucleotide variants in RYBP localize to the N-terminal domain of the gene, which encodes the zinc finger domain and ubiquitin binding moiety. In vitro studies demonstrate that the RYBP c.132C>G p.(Cys44Trp) variant causes reduced protein expression but does not affect binding of YY1, RING1B or ubiquitin. In vivo overexpression studies in Drosophila melanogaster show a dramatic functional difference from human RYBP and variant forms affecting the C44 amino acid residue. DNA methylation studies suggest a possible episignature that may be associated with RYBP-related disorder. Heterozygous de novo variants in RYBP are associated with an identifiable syndromic neurodevelopmental disorder with multiple congenital anomalies.
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