A deep intronic DLG4 variant resulting in DLG4-related synaptopathy

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The rare autosomal dominant brain disorder DLG4-related synaptopathy is caused by de novo variants in DLG4 (encoding PSD-95), the majority of which are predicted to be protein-truncating. In addition to splice site variants, a number of synonymous and missense DLG4 variants are predicted to exert their effect through altered RNA splicing, although the pathogenicity of these variants is uncertain without functional RNA studies. Here, we describe a young boy with a deep intronic DLG4 variant (c.2105+235C>T) identified using whole genome sequencing. By using reverse-transcription PCR on RNA derived from peripheral blood, we demonstrate that DLG4 mRNA expression is detectable in blood and the deep intronic variant gives rise to two alternative DLG4 transcripts, one of which includes a pseudoexon. Both alternative transcripts are out-of-frame and predicted to result in protein-truncation, thereby establishing the genetic diagnosis for the proband. This adds to the evidence concerning the pathogenic potential of deep intronic variants and underlines the importance of functional studies, even in cases where reported tissue-specific gene expression might suggest otherwise.
OriginalsprogEngelsk
TidsskriftClinical Genetics
Vol/bind105
Udgave nummer1
Sider (fra-til)77-80
Antal sider4
ISSN0009-9163
DOI
StatusUdgivet - 2024

Bibliografisk note

Funding Information:
We are deeply grateful to the family, who has provided detailed clinical information. AML is supported by a grant from SHINE syndrome foundation ( www.shinesyndrome.org ), Jascha Foundation (grant number 2022‐0011), and collaborative research grant of Rigshospitalet and Odense University hospital (OUH) (grant number A3948). WKC is supported by a grant from SFARI at the Simons Foundation.

Publisher Copyright:
© 2023 The Authors. Clinical Genetics published by John Wiley & Sons Ltd.

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