Abstract
Background:
Only 15 point mutations in NFIX gene have been reported so far, nine of them cause the Marshall-Smith syndrome (MSS) and the remaining mutations lead to an overgrowth disorder with a less severe phenotype, defined as Sotos-like.
Methods:
The clinical findings in three patients with MSS and two patients with a Sotos-like phenotype are presented. Analysis of the NFIX gene was performed both by conventional or next-generation sequencing.
Results:
Five de novo mutations in NFIX gene were identified, four of them not previously reported. Two frameshift mutations and a donor-splice one caused MSS, while two missense mutations in the DNA binding/dimerisation domain entailed an overgrowth syndrome with some clinical features resembling Sotos syndrome, accompanied by a marfanoid habitus, very low BMI, long narrow face, or arachnodactyly.
Conclusion:
Marshall-Smith mutations are scattered through exons 6–10 of NFIX gene, while most point mutations causing an overgrowth syndrome are clustered in exon 2. Clinical features of this overgrowth syndrome may well be considered an intermediate phenotype between Sotos and Marfan syndromes.
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References
Adam MP, Hennekam RC, Keppen LD, et al. Marshall-Smith syndrome: natural history and evidence of an osteochondrodysplasia with connective tissue abnormalities. Am J Med Genet A 2005;137:117–24.
Malan V, Rajan D, Thomas S, et al. Distinct effects of allelic NFIX mutations on nonsense-mediated mRNA decay engender either a Sotos-like or a Marshall-Smith syndrome. Am J Hum Genet 2010;87:189–98.
Yoneda Y, Saitsu H, Touyama M, et al. Missense mutations in the DNA-binding/dimerization domain of NFIX cause Sotos-like features. J Hum Genet 2012;57:207–11.
Priolo M, Grosso E, Mammì C, et al. A peculiar mutation in the DNA-binding/dimerization domain of NFIX causes Sotos-like overgrowth syndrome: a new case. Gene 2012;511:103–5.
Klaassens M, Morrogh D, Rosser EM, et al. Malan syndrome: Sotos-like overgrowth with de novo NFIX sequence variants and deletions in six new patients and a review of the literature. Eur J Hum Genet 2015;23:610–5.
Stefancsik R, Sarkar S. Relationship between the DNA binding domains of SMAD and NFI/CTF transcription factors defines a new superfamily of genes. DNA Seq 2003;14:233–9.
Gründer A, Qian F, Ebel TT, et al. Genomic organization, splice products and mouse chromosomal localization of genes for transcription factor Nuclear Factor One. Gene 2003;304:171–81.
Singh SK, Wilczynska KM, Grzybowski A, et al. The unique transcriptional activation domain of nuclear factor-I-X3 is critical to specifically induce marker gene expression in astrocytes. J Biol Chem 2011;286:7315–26.
Adzhubei IA, Schmidt S, Peshkin L, et al. A method and server for predicting damaging missense mutations. Nat Methods 2010;7:248–9.
Kent WJ, Sugnet CW, Furey TS, et al. The human genome browser at UCSC. Genome Res 2002;12:996–1006.
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The authors appreciate the collaboration of the patients and their families for participating in this study.
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Martinez, F., Marín-Reina, P., Sanchis-Calvo, A. et al. Novel mutations of NFIX gene causing Marshall-Smith syndrome or Sotos-like syndrome: one gene, two phenotypes. Pediatr Res 78, 533–539 (2015). https://doi.org/10.1038/pr.2015.135
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DOI: https://doi.org/10.1038/pr.2015.135
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