TBX6 null variants and a common hypomorphic allele in congenital scoliosis.

Wu, N and Ming, X and Xiao, J and Wu, Z and Chen, X and Shinawi, M and Shen, Y and Yu, G and Liu, J and Xie, H and Gucev, Z S and Liu, S and Yang, N and Al-Kateb, H and Chen, J and Zhang, J and Hauser, N and Zhang, T and Tasic, V and Liu, P and Su, X and Pan, X and Liu, C and Wang, L and Shen, J and Shen, J and Chen, Y and Zhang, T and Zhang, J and Choy, K W and Wang, J and Wang, Q and Li, S and Zhou, W and Guo, J and Wang, Y and Zhang, C and Zhao, Hong and An, Yu and Zhao, Yu and Wang, J and Liu, Z and Zuo, Y and Tian, Y and Weng, X and Sutton, V R and Wang, H and Ming, Y and Kulkarni, S and Zhong, T P and Giampietro, P F and Dunwoodie, Sally L and Cheung, S W and Zhang, X and Jin, L and Lupski, J R and Qiu, G and Zhang, F (2015) TBX6 null variants and a common hypomorphic allele in congenital scoliosis. The New England Journal of Medicine, 372 (4). pp.341-50. ISSN 1533-4406 (OA)

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Link to published document: http://dx.doi.org/10.1056/NEJMoa1406829

Abstract

BACKGROUND

Congenital scoliosis is a common type of vertebral malformation. Genetic susceptibility has been implicated in congenital scoliosis.

METHODS

We evaluated 161 Han Chinese persons with sporadic congenital scoliosis, 166 Han Chinese controls, and 2 pedigrees, family members of which had a 16p11.2 deletion, using comparative genomic hybridization, quantitative polymerase-chain-reaction analysis, and DNA sequencing. We carried out tests of replication using an additional series of 76 Han Chinese persons with congenital scoliosis and a multicenter series of 42 persons with 16p11.2 deletions.

RESULTS

We identified a total of 17 heterozygous TBX6 null mutations in the 161 persons with sporadic congenital scoliosis (11%); we did not observe any null mutations in TBX6 in 166 controls (P<3.8×10(-6)). These null alleles include copy-number variants (12 instances of a 16p11.2 deletion affecting TBX6) and single-nucleotide variants (1 nonsense and 4 frame-shift mutations). However, the discordant intrafamilial phenotypes of 16p11.2 deletion carriers suggest that heterozygous TBX6 null mutation is insufficient to cause congenital scoliosis. We went on to identify a common TBX6 haplotype as the second risk allele in all 17 carriers of TBX6 null mutations (P<1.1×10(-6)). Replication studies involving additional persons with congenital scoliosis who carried a deletion affecting TBX6 confirmed this compound inheritance model. In vitro functional assays suggested that the risk haplotype is a hypomorphic allele. Hemivertebrae are characteristic of TBX6-associated congenital scoliosis.

CONCLUSIONS

Compound inheritance of a rare null mutation and a hypomorphic allele of TBX6 accounted for up to 11% of congenital scoliosis cases in the series that we analyzed. (Funded by the National Basic Research Program of China and others.).

Item Type: Article
Subjects: R Medicine > R Medicine (General)
Depositing User: Repository Administrator
Date Deposited: 05 Feb 2016 01:20
Last Modified: 09 May 2016 06:58
URI: https://eprints.victorchang.edu.au/id/eprint/332

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