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Missense variants in ANKRD11 cause KBG syndrome by impairment of stability or transcriptional activity of the encoded protein

Elke de Boer 1 Charlotte Ockeloen 1, * Rosalie Kampen Juliet Hampstead Alexander Dingemans Dmitrijs Rots Lukas Lütje Tazeen Ashraf Rachel Baker Mouna Barat-Houari 2 Brad Angle Nicolas Chatron 3, 4 Anne-Sophie Denommé-Pichon 5 Orrin Devinsky Christèle Dubourg 6, 7 Frances Elmslie Houda Zghal Elloumi Laurence Faivre 5, 8 Sarah Fitzgerald-Butt David Geneviève 9 Jacqueline Goos Benjamin Helm Usha Kini Amaia Lasa-Aranzasti Gaetan Lesca Sally Lynch Irene Mathijssen Ruth Mcgowan Kristin Monaghan Sylvie Odent 6, 7 Rolph Pfundt Audrey Putoux 10 Jeroen van Reeuwijk Gijs Santen Erina Sasaki Arthur Sorlin 5 Peter van der Spek Alexander Stegmann Sigrid Swagemakers Irene Valenzuela Eléonore Viora-Dupont Antonio Vitobello Stephanie Ware Mathys Wéber Christian Gilissen Karen Low Simon Fisher Alexander J.M. Dingemans Jacqueline A.C. Goos Irene M.J. Mathijssen Gijs W.E. Santen Alexander P.A. Stegmann Sigrid M.A. Swagemakers Lisenka E.L.M. Vissers Maggie M.K. Wong 11 Tjitske Kleefstra 1 
Abstract : Purpose: Although haploinsufficiency of ANKRD11 is among the most common genetic causes of neurodevelopmental disorders, the role of rare ANKRD11 missense variation remains unclear. We characterized clinical, molecular, and functional spectra of ANKRD11 missense variants. Methods: We collected clinical information of individuals with ANKRD11 missense variants and evaluated phenotypic fit to KBG syndrome. We assessed pathogenicity of variants through in silico analyses and cell-based experiments. Results: We identified 20 unique, mostly de novo, ANKRD11 missense variants in 29 individuals, presenting with syndromic neurodevelopmental disorders similar to KBG syndrome caused by ANKRD11 protein truncating variants or 16q24.3 microdeletions. Missense variants significantly clustered in repression domain 2 at the ANKRD11 C-terminus. Of the 10 functionally studied missense variants, 6 reduced ANKRD11 stability. One variant caused decreased proteasome degradation and loss of ANKRD11 transcriptional activity. Conclusion: Our study indicates that pathogenic heterozygous ANKRD11 missense variants cause the clinically recognizable KBG syndrome. Disrupted transrepression capacity and reduced protein stability each independently lead to ANKRD11 loss-of-function, consistent with haploinsufficiency. This highlights the diagnostic relevance of ANKRD11 missense variants, but also poses diagnostic challenges because the KBG-associated phenotype may be mild and inherited pathogenic ANKRD11 (missense) variants are increasingly observed, warranting stringent variant classification and careful phenotyping.
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Contributor : Laurent Jonchère Connect in order to contact the contributor
Submitted on : Wednesday, September 28, 2022 - 2:35:35 PM
Last modification on : Thursday, December 1, 2022 - 2:02:09 PM



Elke de Boer, Charlotte Ockeloen, Rosalie Kampen, Juliet Hampstead, Alexander Dingemans, et al.. Missense variants in ANKRD11 cause KBG syndrome by impairment of stability or transcriptional activity of the encoded protein. Genetics in Medicine, 2022, ⟨10.1016/j.gim.2022.06.007⟩. ⟨hal-03790568⟩



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