Abstract
RASopathies are a group of developmental disorders caused by mutations in genes that regulate the RAS/MAPK pathway and include Noonan syndrome (NS), Costello syndrome, cardiofaciocutaneous syndrome and other related disorders. Whole exome sequencing studies recently identified LZTR1, PPP1CB and MRAS as new causative genes in RASopathies. However, information on the phenotypes of LZTR1 mutation-positive patients and functional properties of the mutations are limited. To identify variants of LZTR1, PPP1CB, and MRAS, we performed a targeted next-generation sequencing and reexamined previously analyzed exome data in 166 patients with suspected RASopathies. We identified eight LZTR1 variants, including a de novo variant, in seven probands who were suspicious for NS and one known de novo PPP1CB variant in a patient with NS. One of the seven probands had two compound heterozygous LZTR1 variants, suggesting autosomal recessive inheritance. All probands with LZTR1 variants had cardiac defects, including hypertrophic cardiomyopathy and atrial septal defect. Five of the seven probands had short stature or intellectual disabilities. Immunoprecipitation of endogenous LZTR1 followed by western blotting showed that LZTR1 bound to the RAF1–PPP1CB complex. Cells transfected with a small interfering RNA against LZTR1 exhibited decreased levels of RAF1 phosphorylated at Ser259. These are the first results to demonstrate LZTR1 in association with the RAF1–PPP1CB complex as a component of the RAS/MAPK pathway.
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Acknowledgements
The authors thank the patients, their family members, and the doctors who participated in this study. We are grateful to Jun-ichi Miyazaki of Osaka University for supplying the pCAGGS expression vector. We thank Daiju Oba, Ayumi Nishiyama, Shingo Takahara, Aya Shibui-Inoue, Yu Katata and Koki Nagai who contributed to the routine diagnostic work, and Yoko Tateda, Kumi Kato, and Riyo Takahashi for their technical assistance.
Funding
This study was supported in part by the Grants-in-Aid by the Practical Research Project for Rare/Intractable Diseases from the Japan Agency for Medical Research and Development, AMED to Y.A. (18ek0109241h0002), and the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Numbers 17H04223 to Y.A. and 18K15657 to T.A.
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Umeki, I., Niihori, T., Abe, T. et al. Delineation of LZTR1 mutation-positive patients with Noonan syndrome and identification of LZTR1 binding to RAF1–PPP1CB complexes. Hum Genet 138, 21–35 (2019). https://doi.org/10.1007/s00439-018-1951-7
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DOI: https://doi.org/10.1007/s00439-018-1951-7