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. 2024 Sep 20:10.1002/ana.27077.
doi: 10.1002/ana.27077. Online ahead of print.

Loss-of-Function Variants in CUL3 Cause a Syndromic Neurodevelopmental Disorder

Patrick R Blackburn  1 Frédéric Ebstein  2   3 Tzung-Chien Hsieh  4 Marialetizia Motta  5 Francesca Clementina Radio  5 Johanna C Herkert  6 Tuula Rinne  7 Isabelle Thiffault  8   9 Michele Rapp  10 Mariel Alders  11 Saskia Maas  11 Bénédicte Gerard  12 Thomas Smol  13 Catherine Vincent-Delorme  14 Benjamin Cogné  3   15 Bertrand Isidor  3   15 Marie Vincent  3   15 Ruxandra Bachmann-Gagescu  16   17 Anita Rauch  16 Pascal Joset  18 Giovanni Battista Ferrero  19 Andrea Ciolfi  5 Thomas Husson  20   21 Anne-Marie Guerrot  21 Carlos Bacino  22 Colleen Macmurdo  23 Stephanie S Thompson  23 Jill A Rosenfeld  22   24 Laurence Faivre  25   26 Frederic Tran Mau-Them  26   27 Wallid Deb  3   15 Virginie Vignard  3   15 Pankaj B Agrawal  28   29 Jill A Madden  28   29 Alice Goldenberg  21 François Lecoquierre  21 Michael Zech  30   31   32 Holger Prokisch  30   31   32 Ján Necpál  33   34 Robert Jech  35 Juliane Winkelmann  36   37   38   39 Monika Turčanová Koprušáková  40 Vassiliki Konstantopoulou  41 John R Younce  42 Marwan Shinawi  43   44 Chloe Mighton  45   46 Charlotte Fung  47   48 Chantal F Morel  47   49 Jordan Lerner-Ellis  50   51   52 Stephanie DiTroia  53 Magalie Barth  54   55 Dominique Bonneau  54 Ingrid Krapels  56   57 Alexander P A Stegmann  56   57 Vyne van der Schoot  56   57 Theresa Brunet  58   59 Cornelia Bußmann  60 Cyril Mignot  61 Giuseppe Zampino  62   63 Saskia B Wortmann  64 Johannes A Mayr  64 René G Feichtinger  64 Thomas Courtin  65 Claudia Ravelli  66 Boris Keren  61 Alban Ziegler  55   67 Linda Hasadsri  68 Pavel N Pichurin  69 Eric W Klee  69   70   71 Katheryn Grand  72 Pedro A Sanchez-Lara  72 Elke Krüger  2 Stéphane Bézieau  3   15 Hannah Klinkhammer  4   73 Peter Michael Krawitz  4 Evan E Eichler  74   75 Marco Tartaglia  5 Sébastien Küry  3   15 Tianyun Wang  76   77   78   79
Affiliations

Loss-of-Function Variants in CUL3 Cause a Syndromic Neurodevelopmental Disorder

Patrick R Blackburn et al. Ann Neurol. .

Abstract

Objective: De novo variants in cullin-3 ubiquitin ligase (CUL3) have been strongly associated with neurodevelopmental disorders (NDDs), but no large case series have been reported so far. Here, we aimed to collect sporadic cases carrying rare variants in CUL3, describe the genotype-phenotype correlation, and investigate the underlying pathogenic mechanism.

Methods: Genetic data and detailed clinical records were collected via multicenter collaboration. Dysmorphic facial features were analyzed using GestaltMatcher. Variant effects on CUL3 protein stability were assessed using patient-derived T-cells.

Results: We assembled a cohort of 37 individuals with heterozygous CUL3 variants presenting a syndromic NDD characterized by intellectual disability with or without autistic features. Of these, 35 have loss-of-function (LoF) and 2 have missense variants. CUL3 LoF variants in patients may affect protein stability leading to perturbations in protein homeostasis, as evidenced by decreased ubiquitin-protein conjugates in vitro. Notably, we show that 4E-BP1 (EIF4EBP1), a prominent substrate of CUL3, fails to be targeted for proteasomal degradation in patient-derived cells.

Interpretation: Our study further refines the clinical and mutational spectrum of CUL3-associated NDDs, expands the spectrum of cullin RING E3 ligase-associated neuropsychiatric disorders, and suggests haploinsufficiency via LoF variants is the predominant pathogenic mechanism. ANN NEUROL 2024.

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Conflict of interest statement

Potential Conflicts of Interest

Nothing to report.

Update of

  • Loss-of-function variants in CUL3 cause a syndromic neurodevelopmental disorder.
    Blackburn PR, Ebstein F, Hsieh TC, Motta M, Radio FC, Herkert JC, Rinne T, Thiffault I, Rapp M, Alders M, Maas S, Gerard B, Smol T, Vincent-Delorme C, Cogné B, Isidor B, Vincent M, Bachmann-Gagescu R, Rauch A, Joset P, Ferrero GB, Ciolfi A, Husson T, Guerrot AM, Bacino C, Macmurdo C, Thompson SS, Rosenfeld JA, Faivre L, Mau-Them FT, Deb W, Vignard V, Agrawal PB, Madden JA, Goldenberg A, Lecoquierre F, Zech M, Prokisch H, Necpál J, Jech R, Winkelmann J, Koprušáková MT, Konstantopoulou V, Younce JR, Shinawi M, Mighton C, Fung C, Morel C, Ellis JL, DiTroia S, Barth M, Bonneau D, Krapels I, Stegmann S, van der Schoot V, Brunet T, Bußmann C, Mignot C, Courtin T, Ravelli C, Keren B, Ziegler A, Hasadsri L, Pichurin PN, Klee EW, Grand K, Sanchez-Lara PA, Krüger E, Bézieau S, Klinkhammer H, Krawitz PM, Eichler EE, Tartaglia M, Küry S, Wang T. Blackburn PR, et al. medRxiv [Preprint]. 2023 Jun 16:2023.06.13.23290941. doi: 10.1101/2023.06.13.23290941. medRxiv. 2023. Update in: Ann Neurol. 2024 Sep 20. doi: 10.1002/ana.27077. PMID: 37398376 Free PMC article. Updated. Preprint.

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