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Erschienen in: Child's Nervous System 6/2016

28.04.2016 | Original Paper

Variants in TNIP1, a regulator of the NF-kB pathway, found in two patients with neural tube defects

verfasst von: La Carpia Francesca, Rendeli Claudia, Clelia Molinario, Milillo Annamaria, Farroni Chiara, Cannelli Natalia, Ausili Emanuele, Paolucci Valentina, Neri Giovanni, Romagnoli Costantino, Sangiorgi Eugenio, Gurrieri Fiorella

Erschienen in: Child's Nervous System | Ausgabe 6/2016

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Abstract

Purpose

Neural tube defects (NTDs) occur in 1:1000 births. The etiology is complex, with the influence of environmental and genetic factors. Environmental factors, such as folate deficiency, diabetes, or hypoxia strongly contribute to the occurrence of NTD. Also, there is a strong genetic contribution to NTD, as highlighted by the number of genes so far identified in several different developmental pathways usually altered in NTD. Each gene identified so far accounts for a small percentage of all NTD cases, indicating a very high heterogeneity.

Methods

Exome sequencing was performed in seven sporadic patients with severe mielomeningocele. Novel coding variants shared by two or more patients were selected for further analysis.

Results

We identified in two unrelated patients two different variants in TNIP1, a gene not previously involved in NTD whose main role is downregulation of the NF-kB pathway. One variant, c.1089T>G (p.Phe363Leu), is de novo, whereas the c.1781C>T (p.Pro594Leu) is absent in the mother, but could not be tested in the father, as he was unavailable. The latter variant is a very rare variant in the ExAC database.

Conclusions

These findings suggest that TNIP1 is a new potential predisposing gene to spina bifida (SB) and its pathway needs to be investigated in human NTD in order to confirm its role and to plan appropriate counseling to families.
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Literatur
1.
Zurück zum Zitat Kibar Z, Capra V, Gros P (2007) Toward understanding the genetic basis of neural tube defects. Clin. Genet. 71:295–310CrossRefPubMed Kibar Z, Capra V, Gros P (2007) Toward understanding the genetic basis of neural tube defects. Clin. Genet. 71:295–310CrossRefPubMed
2.
Zurück zum Zitat Melvin EC, George TM, Worley G, Franklin A, Mackey J, Viles K, Shah N, Drake CR, Enterline DS, McLone D, Nye J, Oakes WJ, McLaughlin C, Walker ML, Peterson P, Brei T, Buran C, Aben J, Ohm B, Bermans I, Qumsiyeh M, Vance J, Pericak-Vance MASM, George TM, Worley G (2000) Genetic studies in neural tube defects. NTD collaborative group. Pediatr. Neurosurg. 32:1–9CrossRefPubMed Melvin EC, George TM, Worley G, Franklin A, Mackey J, Viles K, Shah N, Drake CR, Enterline DS, McLone D, Nye J, Oakes WJ, McLaughlin C, Walker ML, Peterson P, Brei T, Buran C, Aben J, Ohm B, Bermans I, Qumsiyeh M, Vance J, Pericak-Vance MASM, George TM, Worley G (2000) Genetic studies in neural tube defects. NTD collaborative group. Pediatr. Neurosurg. 32:1–9CrossRefPubMed
3.
Zurück zum Zitat Deak KL, Siegel DG, George TM, Gregory S, Ashley-Koch, Speer MC, NTD collaborative group (2008) Further evidence for a maternal genetic effect and a sex-influenced effect contributing to risk for human neural tube defects. Birth Defects Res A Clin Mol Teratol 82(10):662–669CrossRefPubMedPubMedCentral Deak KL, Siegel DG, George TM, Gregory S, Ashley-Koch, Speer MC, NTD collaborative group (2008) Further evidence for a maternal genetic effect and a sex-influenced effect contributing to risk for human neural tube defects. Birth Defects Res A Clin Mol Teratol 82(10):662–669CrossRefPubMedPubMedCentral
4.
Zurück zum Zitat Czeizel AE, Dudás I (1992) Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N. Engl. J. Med. 327(26):1832–1835CrossRefPubMed Czeizel AE, Dudás I (1992) Prevention of the first occurrence of neural-tube defects by periconceptional vitamin supplementation. N. Engl. J. Med. 327(26):1832–1835CrossRefPubMed
5.
Zurück zum Zitat Dheen ST, Tay SS, Boran J, Ting LW, Kumar SD, Fu J, Ling EA (2009) Recent studies on neural tube defects in embryos of diabetic pregnancy: an overview. Curr. Med. Chem. 16:2345–2354CrossRefPubMed Dheen ST, Tay SS, Boran J, Ting LW, Kumar SD, Fu J, Ling EA (2009) Recent studies on neural tube defects in embryos of diabetic pregnancy: an overview. Curr. Med. Chem. 16:2345–2354CrossRefPubMed
6.
Zurück zum Zitat Lynch SA (2005) Non-multifactorial neural tube defects. Am. J. Med. Genet. C: Semin. Med. Genet. 135C:69–76CrossRef Lynch SA (2005) Non-multifactorial neural tube defects. Am. J. Med. Genet. C: Semin. Med. Genet. 135C:69–76CrossRef
7.
Zurück zum Zitat Fleming A, Copp AJ (1998) Embryonic folate metabolism and mouse neural tube defects. Science 280:2107–2109CrossRefPubMed Fleming A, Copp AJ (1998) Embryonic folate metabolism and mouse neural tube defects. Science 280:2107–2109CrossRefPubMed
8.
Zurück zum Zitat Harris MJ, Juriloff DM (2010) An update to the list of mouse mutants with neural tube closure defects and advances toward a complete genetic perspective of neural tube closure. Birth Defects Res A Clin Mol Teratol 88:653–669CrossRefPubMed Harris MJ, Juriloff DM (2010) An update to the list of mouse mutants with neural tube closure defects and advances toward a complete genetic perspective of neural tube closure. Birth Defects Res A Clin Mol Teratol 88:653–669CrossRefPubMed
9.
Zurück zum Zitat Bosoi CM, Capra V, Allache R, Trinh VQ, De Marco P, Merello E, Drapeau P, Bassuk AG, Kibar Z (2011) Identification and characterization of novel rare mutations in the planar cell polarity gene PRICKLE1 in human neural tube defects. Hum. Mutat. 32(12):1371–1375CrossRefPubMedPubMedCentral Bosoi CM, Capra V, Allache R, Trinh VQ, De Marco P, Merello E, Drapeau P, Bassuk AG, Kibar Z (2011) Identification and characterization of novel rare mutations in the planar cell polarity gene PRICKLE1 in human neural tube defects. Hum. Mutat. 32(12):1371–1375CrossRefPubMedPubMedCentral
10.
Zurück zum Zitat Cai C, Shi O (2014) Genetic evidence in planar cell polarity signaling pathway in human neural tube defects. Front Med 8:68–78CrossRefPubMed Cai C, Shi O (2014) Genetic evidence in planar cell polarity signaling pathway in human neural tube defects. Front Med 8:68–78CrossRefPubMed
11.
Zurück zum Zitat Allache R, De Marco P, Merello E, Capra V, Kibar Z (2012) Role of the planar cell polarity gene CELSR1 in neural tube defects and caudal agenesis. Birth Defects Res Part A Clin Mol Teratol 94:176–181CrossRefPubMed Allache R, De Marco P, Merello E, Capra V, Kibar Z (2012) Role of the planar cell polarity gene CELSR1 in neural tube defects and caudal agenesis. Birth Defects Res Part A Clin Mol Teratol 94:176–181CrossRefPubMed
12.
Zurück zum Zitat De Marco P, Merello E, Rossi A, Piatelli G, Cama A, Kibar Z, Capra V (2012) FZD6 is a novel gene for human neural tube defects. Hum. Mutat. 33:384–390CrossRefPubMed De Marco P, Merello E, Rossi A, Piatelli G, Cama A, Kibar Z, Capra V (2012) FZD6 is a novel gene for human neural tube defects. Hum. Mutat. 33:384–390CrossRefPubMed
13.
Zurück zum Zitat Kibar Z, Torban E, McDearmid JR, Reynolds A, Berghout J, Mathieu M, Kirillova I, Merello E, Hayes JM, Wallingford JB, Drapeay P, Capra V, Gros P (2007) Mutations in VANGL1 associated with neural-tube defects. N. Engl. J. Med. 356:1432–1437CrossRefPubMed Kibar Z, Torban E, McDearmid JR, Reynolds A, Berghout J, Mathieu M, Kirillova I, Merello E, Hayes JM, Wallingford JB, Drapeay P, Capra V, Gros P (2007) Mutations in VANGL1 associated with neural-tube defects. N. Engl. J. Med. 356:1432–1437CrossRefPubMed
14.
Zurück zum Zitat Lei Y-P, Zhang T, Li H, Wu B, Jin L, Wang HY (2010) VANGL2 mutations in human cranial neural-tube defects. N. Engl. J. Med. 362:2232–2235CrossRefPubMed Lei Y-P, Zhang T, Li H, Wu B, Jin L, Wang HY (2010) VANGL2 mutations in human cranial neural-tube defects. N. Engl. J. Med. 362:2232–2235CrossRefPubMed
15.
Zurück zum Zitat Kibar Z, Salem S, Bosoi C, Pauwels E, De Marco P, Merello E, Bassuk AG, Capra V, Gros P (2011) Contribution of VANGL2 mutations to isolated neural tube defects. Clin. Genet. 80:76–82CrossRefPubMedPubMedCentral Kibar Z, Salem S, Bosoi C, Pauwels E, De Marco P, Merello E, Bassuk AG, Capra V, Gros P (2011) Contribution of VANGL2 mutations to isolated neural tube defects. Clin. Genet. 80:76–82CrossRefPubMedPubMedCentral
16.
Zurück zum Zitat Seo JH, Zilber Y, Babayeva S, Liu J, Kyriakopoulos P, De Marco P, Merello E, Capra V, Gros P, Torban E (2011) Mutations in the planar cell polarity gene, fuzzy, are associated with neural tube defects in humans. Hum. Mol. Genet. 20:4324–4333CrossRefPubMed Seo JH, Zilber Y, Babayeva S, Liu J, Kyriakopoulos P, De Marco P, Merello E, Capra V, Gros P, Torban E (2011) Mutations in the planar cell polarity gene, fuzzy, are associated with neural tube defects in humans. Hum. Mol. Genet. 20:4324–4333CrossRefPubMed
17.
Zurück zum Zitat Shi Y, Ding Y, Lei YP, Yang XY, Xie GM, Wen J, Cai CQ, Li H, Chen Y, Zhang T, Wu BL, Jin L, Chen YG, Wang HY (2012) Identification of novel rare mutations of DACT1 in human neural tube defects. Hum. Mutat. 33:1450–1455CrossRefPubMed Shi Y, Ding Y, Lei YP, Yang XY, Xie GM, Wen J, Cai CQ, Li H, Chen Y, Zhang T, Wu BL, Jin L, Chen YG, Wang HY (2012) Identification of novel rare mutations of DACT1 in human neural tube defects. Hum. Mutat. 33:1450–1455CrossRefPubMed
18.
Zurück zum Zitat Narisawa A, Komatsuzaki S, Kikuchi A, Niihori T, Aoki Y, Fujiwara K, Tanemura M, Hata A, Suzuki Y, Relton CL, Grinham J, Leung KY, Partridge D, Robinson A, Stone V, Gustavsson P, Stanier P, Copp AJ, Greene ND, Tominaga T, Matsubara Y, Kure S (2012) Mutations in genes encoding the glycine cleavage system predispose to neural tube defects in mice and humans. Hum. Mol. Genet. 21:1496–1503CrossRefPubMedPubMedCentral Narisawa A, Komatsuzaki S, Kikuchi A, Niihori T, Aoki Y, Fujiwara K, Tanemura M, Hata A, Suzuki Y, Relton CL, Grinham J, Leung KY, Partridge D, Robinson A, Stone V, Gustavsson P, Stanier P, Copp AJ, Greene ND, Tominaga T, Matsubara Y, Kure S (2012) Mutations in genes encoding the glycine cleavage system predispose to neural tube defects in mice and humans. Hum. Mol. Genet. 21:1496–1503CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Ulloa F, Martí E (2010) Wnt won the war: antagonistic role of wnt over Shh controls dorso-ventral patterning of the vertebrate neural tube. Dev. Dyn. 239:69–76PubMed Ulloa F, Martí E (2010) Wnt won the war: antagonistic role of wnt over Shh controls dorso-ventral patterning of the vertebrate neural tube. Dev. Dyn. 239:69–76PubMed
20.
Zurück zum Zitat Murdoch JN, Copp AJ (2010) The relationship between sonic hedgehog signaling, cilia, and neural tube defects. Birth Defects Res A Clin Mol Teratol 88:633–652CrossRefPubMedPubMedCentral Murdoch JN, Copp AJ (2010) The relationship between sonic hedgehog signaling, cilia, and neural tube defects. Birth Defects Res A Clin Mol Teratol 88:633–652CrossRefPubMedPubMedCentral
21.
Zurück zum Zitat Kirillova I, Novikova I, Augé J, Audollent S, Esnault D, Encha-Razavi F, Lazjuk G, Attie-Bitach T, Vekemans M (2000) Expression of the sonic hedgehog gene in human embryos with neural tube defects. Teratology 61:347–354CrossRefPubMed Kirillova I, Novikova I, Augé J, Audollent S, Esnault D, Encha-Razavi F, Lazjuk G, Attie-Bitach T, Vekemans M (2000) Expression of the sonic hedgehog gene in human embryos with neural tube defects. Teratology 61:347–354CrossRefPubMed
22.
Zurück zum Zitat Patterson VL, Damrau C, Paudyal A, Reeve B, Grimes DT, Stewart ME, Williams DJ, Siggers P, Greenfield A, Murdoch JN (2009) Mouse hitchhiker mutants have spina bifida, dorso-ventral patterning defects and polydactyly: identification of Tulp3 as a novel negative regulator of the sonic hedgehog pathway. Hum. Mol. Genet. 18:1719–1739CrossRefPubMedPubMedCentral Patterson VL, Damrau C, Paudyal A, Reeve B, Grimes DT, Stewart ME, Williams DJ, Siggers P, Greenfield A, Murdoch JN (2009) Mouse hitchhiker mutants have spina bifida, dorso-ventral patterning defects and polydactyly: identification of Tulp3 as a novel negative regulator of the sonic hedgehog pathway. Hum. Mol. Genet. 18:1719–1739CrossRefPubMedPubMedCentral
23.
Zurück zum Zitat Li Q, Estepa G, Memet S, Marnet S, Israel A, Verma M (2000) Complete lack of NF-κB activity in IKK1 and IKK2 double-deficient mice: additional defect in neurulation. Genes Dev. 14:1729–1733PubMedPubMedCentral Li Q, Estepa G, Memet S, Marnet S, Israel A, Verma M (2000) Complete lack of NF-κB activity in IKK1 and IKK2 double-deficient mice: additional defect in neurulation. Genes Dev. 14:1729–1733PubMedPubMedCentral
24.
Zurück zum Zitat Bassuk AG, Kibar Z (2009) Genetic basis of neural tube defects. Semin. Pediatr. Neurol. 16:101–110CrossRefPubMed Bassuk AG, Kibar Z (2009) Genetic basis of neural tube defects. Semin. Pediatr. Neurol. 16:101–110CrossRefPubMed
25.
Zurück zum Zitat Chen X, Shen Y, Gao Y, Zhao H, Sheng X, Zou J, Lip V, Xie H, Guo J, Shao H, Bao Y, Shen J, Niu B, Gusella JF, Wu BL, Zhang T (2013) Detection of copy number variants reveals Association of Cilia Genes with neural tube defects. PLoS One 8(1):e54492CrossRefPubMedPubMedCentral Chen X, Shen Y, Gao Y, Zhao H, Sheng X, Zou J, Lip V, Xie H, Guo J, Shao H, Bao Y, Shen J, Niu B, Gusella JF, Wu BL, Zhang T (2013) Detection of copy number variants reveals Association of Cilia Genes with neural tube defects. PLoS One 8(1):e54492CrossRefPubMedPubMedCentral
26.
Zurück zum Zitat Abdelhamed ZA, Wheway G, Szymanska K, Natarajan S, Toomes C, Inglehearn C, Johonson CA (2013) Variable expressivity of ciliopathy neurological phenotypes that encompass Meckel-Gruber syndrome and Joubert syndrome is caused by complex de-regulated ciliogenesis, Shh and wnt signalling defects. Hum. Mol. Genet. 22:1358–1372CrossRefPubMedPubMedCentral Abdelhamed ZA, Wheway G, Szymanska K, Natarajan S, Toomes C, Inglehearn C, Johonson CA (2013) Variable expressivity of ciliopathy neurological phenotypes that encompass Meckel-Gruber syndrome and Joubert syndrome is caused by complex de-regulated ciliogenesis, Shh and wnt signalling defects. Hum. Mol. Genet. 22:1358–1372CrossRefPubMedPubMedCentral
27.
Zurück zum Zitat Caspary T, Larkins CE, Anderson KV (2007) The graded response to sonic hedgehog depends on cilia architecture. Dev. Cell 12:767–778CrossRefPubMed Caspary T, Larkins CE, Anderson KV (2007) The graded response to sonic hedgehog depends on cilia architecture. Dev. Cell 12:767–778CrossRefPubMed
28.
Zurück zum Zitat Weatherbee SD, Niswander L, Anderson KV (2009) A mouse model for Meckel syndrome reveals Mks1 is required for ciliogenesis and hedgehog signaling. Hum. Mol. Genet. 18:4565–4575CrossRefPubMedPubMedCentral Weatherbee SD, Niswander L, Anderson KV (2009) A mouse model for Meckel syndrome reveals Mks1 is required for ciliogenesis and hedgehog signaling. Hum. Mol. Genet. 18:4565–4575CrossRefPubMedPubMedCentral
29.
Zurück zum Zitat Veltman JA, Brunner HG (2012) De novo mutations in human genetic disease. Nat. Rev. Genet. 13:565–575CrossRefPubMed Veltman JA, Brunner HG (2012) De novo mutations in human genetic disease. Nat. Rev. Genet. 13:565–575CrossRefPubMed
30.
Zurück zum Zitat Lemay P, Guyot M-C, Tremblay E, Dionne-Laport A, Spiegelman D, Henrion E, Diallo O, De Marco P, Merello E, Massicotte C, Desilets V, Michaud JL, Rouleau GA, Capra V, Kibar Z (2015) Loss-of-function de novo mutations play an important role in severe human neural tube defects. J Med Genet 52:493–497CrossRefPubMed Lemay P, Guyot M-C, Tremblay E, Dionne-Laport A, Spiegelman D, Henrion E, Diallo O, De Marco P, Merello E, Massicotte C, Desilets V, Michaud JL, Rouleau GA, Capra V, Kibar Z (2015) Loss-of-function de novo mutations play an important role in severe human neural tube defects. J Med Genet 52:493–497CrossRefPubMed
31.
Zurück zum Zitat McGreevy EM, Vijayraghavan D, Davidson L, Hildebrand JD (2015) Shroom3 functions downstream of planar cell polarity to regulate myosin II distribution and cellular organization during neural tube closure. Biol Open 4:186–196CrossRefPubMedPubMedCentral McGreevy EM, Vijayraghavan D, Davidson L, Hildebrand JD (2015) Shroom3 functions downstream of planar cell polarity to regulate myosin II distribution and cellular organization during neural tube closure. Biol Open 4:186–196CrossRefPubMedPubMedCentral
32.
Zurück zum Zitat Eubanks JD, Cheruvu VK (2009) Prevalence of sacral spina bifida occulta and its relationship to age, sex, race, and the sacral table angle: an anatomic, osteologic study of three thousand one hundred specimens. Spine (Phila Pa 1976) 34:1539–1543CrossRef Eubanks JD, Cheruvu VK (2009) Prevalence of sacral spina bifida occulta and its relationship to age, sex, race, and the sacral table angle: an anatomic, osteologic study of three thousand one hundred specimens. Spine (Phila Pa 1976) 34:1539–1543CrossRef
33.
Zurück zum Zitat Fidas A, MacDonald HL, Elton RA, Wild SR, Chrisholm GD, Scott R (1987) Prevalence and patterns of spina bifida occulta in 2707 normal adults. Clin. Radiol. 38:537–542CrossRefPubMed Fidas A, MacDonald HL, Elton RA, Wild SR, Chrisholm GD, Scott R (1987) Prevalence and patterns of spina bifida occulta in 2707 normal adults. Clin. Radiol. 38:537–542CrossRefPubMed
34.
Zurück zum Zitat Flores AM, Gurevich I, Zhang C, Ramirez VP, Devens TR, Aneskievich BJ (2011) TNIP1 is a corepressor of agonist-bound PPARs. Arch. Biochem. Biophys. 516:58–66CrossRefPubMedPubMedCentral Flores AM, Gurevich I, Zhang C, Ramirez VP, Devens TR, Aneskievich BJ (2011) TNIP1 is a corepressor of agonist-bound PPARs. Arch. Biochem. Biophys. 516:58–66CrossRefPubMedPubMedCentral
35.
Zurück zum Zitat Oshima S, Turer EE, Callahan JA, Chai S, Advincula R, Barrera J, Shifrin N, Lee B, Benedict Yen TS, Woo T, Malynn BA, Ma A (2009) ABIN-1 is a ubiquitin sensor that restricts cell death and sustains embryonic development. Nature 457:906–909CrossRefPubMedPubMedCentral Oshima S, Turer EE, Callahan JA, Chai S, Advincula R, Barrera J, Shifrin N, Lee B, Benedict Yen TS, Woo T, Malynn BA, Ma A (2009) ABIN-1 is a ubiquitin sensor that restricts cell death and sustains embryonic development. Nature 457:906–909CrossRefPubMedPubMedCentral
36.
Zurück zum Zitat Correa RG, Tergaonkar V, Ng JK, Dubova I, Izpisua-Belmonte JC, Verma IM (2004) Characterization of NF- κ B/I κ B proteins in zebra fish and their involvement in notochord development. Mol. Cell. Biol. 24(12):5257–5268CrossRefPubMedPubMedCentral Correa RG, Tergaonkar V, Ng JK, Dubova I, Izpisua-Belmonte JC, Verma IM (2004) Characterization of NF- κ B/I κ B proteins in zebra fish and their involvement in notochord development. Mol. Cell. Biol. 24(12):5257–5268CrossRefPubMedPubMedCentral
37.
Zurück zum Zitat Ruland J, Duncan GS, Elia A, del Barco BI, Nguyen L, Plyte S, Millar DG, Bouchard D, Wakeham A, Ohashi PS, Mak TW (2001) Bcl10 is a positive regulator of antigen receptor-induced activation of NF-kappaB and neural tube closure. Cell 104:33–42CrossRefPubMed Ruland J, Duncan GS, Elia A, del Barco BI, Nguyen L, Plyte S, Millar DG, Bouchard D, Wakeham A, Ohashi PS, Mak TW (2001) Bcl10 is a positive regulator of antigen receptor-induced activation of NF-kappaB and neural tube closure. Cell 104:33–42CrossRefPubMed
Metadaten
Titel
Variants in TNIP1, a regulator of the NF-kB pathway, found in two patients with neural tube defects
verfasst von
La Carpia Francesca
Rendeli Claudia
Clelia Molinario
Milillo Annamaria
Farroni Chiara
Cannelli Natalia
Ausili Emanuele
Paolucci Valentina
Neri Giovanni
Romagnoli Costantino
Sangiorgi Eugenio
Gurrieri Fiorella
Publikationsdatum
28.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Child's Nervous System / Ausgabe 6/2016
Print ISSN: 0256-7040
Elektronische ISSN: 1433-0350
DOI
https://doi.org/10.1007/s00381-016-3087-1

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