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A novel USP27X missense variant identified in an individual with intellectual disability

Abstract

X-linked intellectual disability (XLID) is a group of neurodevelopmental disorders with genetic heterogeneity. Mutation of USP27X, a deubiquitinase encoding gene, is associated with X-linked intellectual developmental disorder-105 (XLID105), which is characterized by different combinations of impaired intellectual development (ID), developmental delay (DD), autism spectrum, attention deficit hyperactivity disorder and anxiety. Now only fourteen genetically diagnosed individuals have been reported. Here we describe a three-year boy with mild abnormal facial features, DD, severe speech delay and cognitive impairment, and ventricular septal defect. In addition, an increased nuchal translucency was observed during the fetal period. Trio whole-exome sequencing identified a novel missense variant, c.257 C > T (p.Thr86Met), in the USP27X gene (NM_001145073), which is inherited from his healthy mother and assessed to be a variant of uncertain significance. Further in vitro function study shows that this variant is detrimental to the expression and deubiquitination activity of USP27X. Our study provides more pathogenic evidences for this variant identified, and link this variant to the XLID-105 disease. In conclusion, our report expands the clinical and genetic spectrum of USP27X. Clinical trial registration: ChiCTR2000034358.

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Fig. 1: Pedigree analysis and Sanger validation of the missense variant, c.257 C > T, in USP27X gene.
Fig. 2: Location of USP27X variants.
Fig. 3: Impacts of USP27X variants on the expression and function of the USP27X protein.

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The data underlying this article will be shared on reasonable request to the corresponding author.

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Acknowledgements

The authors would like to acknowledge the patient and his family for their consent in participating in our study.

Funding

This work was supported by the grants of the Hubei Provincial Natural Science Foundation Project (No.2023AFB893). Construction Project of Clinical Medical Research Center for Neurodevelopment Disorders in Children in Hubei Province (No. HST2020-19). Wuhan Children’s Imaging Clinical Medical Research Center (No. WK2022-38); Wuhan Children’s Neurological Disease Clinical Medical Research Center (No. WK2014-160).

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Contributions

Sukun Luo, Meng Zhang and Xuelian He designed the research. Yufeng Huang, Li Tan and Hongmin Zhu performed the clinical study. Sukun Luo, Xiankai Zhang and Peiwei Zhao performed expression and function experiments of USP27X variants, and analyzed data with structural modeling. Sukun Luo and Meng Zhang drafted the manuscript. Xuelian He revised the manuscript and approved the final version. All authors reviewed and approved the manuscript.

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Correspondence to Xuelian He.

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The authors declare no competing interests.

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This study has been approved by the institutional review board of Wuhan Children’s Hospital, Tongji Medical College, Huazhong University of Science & Technology.

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Written informed consent was obtained from the patients’ parents.

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Luo, S., Zhang, M., Zhang, X. et al. A novel USP27X missense variant identified in an individual with intellectual disability. J Hum Genet 70, 489–494 (2025). https://doi.org/10.1038/s10038-025-01359-5

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