PUBLICATION
            Identification of Variants in RET and IHH Pathway Members in a Large Family With History of Hirschsprung Disease
- Authors
 - Sribudiani, Y., Chauhan, R.K., Alves, M.M., Petrova, L., Brosens, E., Harrison, C., Wabbersen, T., de Graaf, B.M., Rügenbrink, T., Burzynski, G., Brouwer, R.W.W., IJcken, W.F.J.V., Maas, S.M., de Klein, A., Osinga, J., Eggen, B.J.L., Burns, A.J., Brooks, A.S., Shepherd, I.T., Hofstra, R.M.W.
 - ID
 - ZDB-PUB-180331-4
 - Date
 - 2018
 - Source
 - Gastroenterology 155(1): 118-129.e6 (Journal)
 - Registered Authors
 - Shepherd, Iain T.
 - Keywords
 - ENS, family study, genetic causes of HSCR, neural development
 - MeSH Terms
 - 
    
        
        
            
                
- Family
 - Genetic Variation
 - Genetic Predisposition to Disease
 - Signal Transduction
 - Hedgehog Proteins/genetics*
 - Adaptor Proteins, Signal Transducing/genetics*
 - Hirschsprung Disease/genetics*
 - Zebrafish
 - COS Cells
 - Humans
 - Pedigree
 - Nerve Tissue Proteins/genetics*
 - Chlorocebus aethiops
 - Netherlands
 - Animals
 - Glial Cell Line-Derived Neurotrophic Factor/genetics*
 - Zinc Finger Protein Gli3/genetics*
 - Morpholinos
 - Protein Isoforms
 - HEK293 Cells
 - Male
 - Sequence Analysis, DNA
 - Proto-Oncogene Proteins c-ret/genetics*
 - Female
 
 - PubMed
 - 29601828 Full text @ Gastroenterology
 
            Citation
        
        
            Sribudiani, Y., Chauhan, R.K., Alves, M.M., Petrova, L., Brosens, E., Harrison, C., Wabbersen, T., de Graaf, B.M., Rügenbrink, T., Burzynski, G., Brouwer, R.W.W., IJcken, W.F.J.V., Maas, S.M., de Klein, A., Osinga, J., Eggen, B.J.L., Burns, A.J., Brooks, A.S., Shepherd, I.T., Hofstra, R.M.W. (2018) Identification of Variants in RET and IHH Pathway Members in a Large Family With History of Hirschsprung Disease. Gastroenterology. 155(1):118-129.e6.
        
    
                
                    
                        Abstract
                    
                    
                
                
            
        
        
    
        
            
            
 
    
    
        
    
Background & aims Hirschsprung disease (HSCR) is an inherited congenital disorder characterized by absence of enteric ganglia in the distal part of the gut. Variants in ret proto-oncogene (RET) have been associated with up to 50% of familial and 35% of sporadic cases. We searched for variants that affect disease risk in a large, multi-generational family with history of HSCR in a linkage region previously associated with the disease (4q31.3-q32.3) and exome wide.
Methods We performed exome sequencing analyses of a family in the Netherlands with 5 members diagnosed with HSCR and 2 members diagnosed with functional constipation. We initially focused on variants in genes located in 4q31.3-q32.3. However, we also performed an exome-wide analysis in which known HSCR or HSCR-associated gene variants predicted to be deleterious were prioritized for further analysis. Candidate genes were expressed in HEK293, COS-7, and Neuro-2a cells and analyzed by luciferase and immunoblot assays. Morpholinos were designed to target exons of candidate genes and injected into 1-cell stage zebrafish embryos. Embryos were allowed to develop and stained for enteric neurons.
Results Within the linkage region, we identified 1 putative splice variant in the LPS responsive beige-like anchor protein gene (LRBA). Functional assays could not confirm its predicted effect on mRNA splicing or on expression of the mab-21 like 2 gene (MAB21L2), which is embedded in LRBA. Zebrafish that developed following injection of the lrba morpholino had a shortened body axis and subtle gut morphological defects, but no significant reduction in number of enteric neurons compared with controls. Outside the linkage region, members of 1 branch of the family carried a previously unidentified RET variant or an in-frame deletion in the glial cell line derived neurotrophic factor gene (GDNF), which encodes a ligand of RET. This deletion was located 6 base pairs before the last codon. We also found variants in the indian hedgehog gene (IHH) and its mediator, the transcription factor GLI family zinc finger 3 (GLI3). When expressed in cells, the RET-P399L variant disrupted protein glycosylation and had altered phosphorylation following activation by GDNF. The deletion in GDNF prevented secretion of its gene product, reducing RET activation, and the IHH-Q51K variant reduced expression of the transcription factor GLI1. Injection of morpholinos that target ihh reduced the number of enteric neurons to 13%±1.4% of control zebrafish.
Conclusions In a study of a large family with history of HSCR, we identified variants in LRBA, RET, the gene encoding the RET ligand (GDNF), IHH, and a gene encoding a mediator of IHH signaling (GLI3). These variants altered functions of the gene products when expressed in cells and knockout of ihh reduced the number of enteric neurons in the zebrafish gut.
            
    
                
                    
                        Genes / Markers
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Expression
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Phenotype
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Mutations / Transgenics
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Human Disease / Model
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Sequence Targeting Reagents
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Fish
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Orthology
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Engineered Foreign Genes
                    
                    
                
                
            
        
        
    
        
            
            
        
        
    
    
    
                
                    
                        Mapping