Broadening the phenotypic and molecular spectrum of FINCA syndrome: Biallelic NHLRC2 variants in 15 novel individuals.

TitleBroadening the phenotypic and molecular spectrum of FINCA syndrome: Biallelic NHLRC2 variants in 15 novel individuals.
Publication TypeJournal Article
Year of Publication2023
AuthorsSczakiel, HL, Zhao, M, Wollert-Wulf, B, Danyel, M, Ehmke, N, Stoltenburg, C, Damseh, N, Al-Ashhab, M, Balci, TB, Osmond, M, Andrade, A, Schallner, J, Porrmann, J, McDonald, K, Liao, M, Oppermann, H, Platzer, K, Dierksen, N, Mojarrad, M, Eslahi, A, Bakaeean, B, Calame, DG, Lupski, JR, Firoozfar, Z, Seyedhassani, SMohammad, Mohammadi, SAhmad, Anwaar, N, Rahman, F, Seelow, D, Janz, M, Horn, D, Maroofian, R, Boschann, F
JournalEur J Hum Genet
Volume31
Issue8
Pagination905-917
Date Published2023 Aug
ISSN1476-5438
KeywordsDisease Progression, Fibrosis, HEK293 Cells, Humans, Intellectual Disability, Movement Disorders, Phenotype, Seizures, Syndrome
Abstract

FINCA syndrome [MIM: 618278] is an autosomal recessive multisystem disorder characterized by fibrosis, neurodegeneration and cerebral angiomatosis. To date, 13 patients from nine families with biallelic NHLRC2 variants have been published. In all of them, the recurrent missense variant p.(Asp148Tyr) was detected on at least one allele. Common manifestations included lung or muscle fibrosis, respiratory distress, developmental delay, neuromuscular symptoms and seizures often followed by early death due to rapid disease progression.Here, we present 15 individuals from 12 families with an overlapping phenotype associated with nine novel NHLRC2 variants identified by exome analysis. All patients described here presented with moderate to severe global developmental delay and variable disease progression. Seizures, truncal hypotonia and movement disorders were frequently observed. Notably, we also present the first eight cases in which the recurrent p.(Asp148Tyr) variant was not detected in either homozygous or compound heterozygous state.We cloned and expressed all novel and most previously published non-truncating variants in HEK293-cells. From the results of these functional studies, we propose a potential genotype-phenotype correlation, with a greater reduction in protein expression being associated with a more severe phenotype.Taken together, our findings broaden the known phenotypic and molecular spectrum and emphasize that NHLRC2-related disease should be considered in patients presenting with intellectual disability, movement disorders, neuroregression and epilepsy with or without pulmonary involvement.

DOI10.1038/s41431-023-01382-0
Alternate JournalEur J Hum Genet
PubMed ID37188825
PubMed Central IDPMC10400545
Grant ListR35 NS105078 / NS / NINDS NIH HHS / United States
U01 HG011758 / HG / NHGRI NIH HHS / United States
T32 GM007526 / GM / NIGMS NIH HHS / United States
UM1 HG006542 / HG / NHGRI NIH HHS / United States

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