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De Novo Heterozygous POLR2A Variants Cause a Neurodevelopmental Syndrome with Profound Infantile-Onset Hypotonia

Authors: Haijes, H; Koster, M; Rehmann, H; Li, D; Hakonarson, H; Cappuccio, G; Hancarova, M; +37 Authors

De Novo Heterozygous POLR2A Variants Cause a Neurodevelopmental Syndrome with Profound Infantile-Onset Hypotonia

Abstract

The RNA polymerase II complex (pol II) is responsible for transcription of all ∼21,000 human protein-encoding genes. Here, we describe sixteen individuals harboring de novo heterozygous variants in POLR2A, encoding RPB1, the largest subunit of pol II. An iterative approach combining structural evaluation and mass spectrometry analyses, the use of S. cerevisiae as a model system, and the assessment of cell viability in HeLa cells allowed us to classify eleven variants as probably disease-causing and four variants as possibly disease-causing. The significance of one variant remains unresolved. By quantification of phenotypic severity, we could distinguish mild and severe phenotypic consequences of the disease-causing variants. Missense variants expected to exert only mild structural effects led to a malfunctioning pol II enzyme, thereby inducing a dominant-negative effect on gene transcription. Intriguingly, individuals carrying these variants presented with a severe phenotype dominated by profound infantile-onset hypotonia and developmental delay. Conversely, individuals carrying variants expected to result in complete loss of function, thus reduced levels of functional pol II from the normal allele, exhibited the mildest phenotypes. We conclude that subtle variants that are central in functionally important domains of POLR2A cause a neurodevelopmental syndrome characterized by profound infantile-onset hypotonia and developmental delay through a dominant-negative effect on pol-II-mediated transcription of DNA.

Countries
Netherlands, Netherlands, Netherlands, Netherlands, Germany, Netherlands, United Kingdom, Denmark, Italy
Keywords

STRUCTURAL BASIS, Male, Heterozygote, Adolescent, POLR2A, EMC OR-01, RNA-POLYMERASE-II, 610, PROTEIN, Saccharomyces cerevisiae, Hypotonie, RPB1, ELONGATION COMPLEX, INITIATION, All institutes and research themes of the Radboud University Medical Center, desert Z score, infantile-onset hypotonia, POLR2A; RNA polymerase II complex; RPB1; de novo variants; desert Z score; desert regions; dominant-negative effect; haplo-insufficiency; infantile-onset hypotonia; neurodevelopmental syndrome, Genetics, PROGRAM, CELL-CYCLE, Humans, Genetics(clinical), TRANSCRIPTION, Age of Onset, Child, MUTATION, de novo variants, RNA polymerase II complex, RNS-Polymerase II, haplo-insufficiency, Radboudumc 7: Neurodevelopmental disorders DCMN: Donders Center for Medical Neuroscience, DNA-Directed RNA Polymerases, dominant-negative effect, neurodevelopmental syndrome, De-Novo-Synthese, Phenotype, Neurodevelopmental Disorders, Child, Preschool, Mutation, Muscle Hypotonia, Female, desert regions, LARGEST SUBUNIT, HeLa Cells

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
57
Top 1%
Top 10%
Top 10%
Green
hybrid