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TBX6 Null Variants and a Common Hypomorphic Allele in Congenital Scoliosis
Open accessAbstract
BACKGROUND: Congenital scoliosis is a common type of vertebral malformation. Genetic susceptibility has been implicated in congenital scoliosis. METHODS: We evaluated 161 Han Chinese persons with sporadic congenital scoliosis, 166 Han Chinese controls, and 2 pedigrees, family members of which had a 16p11.2 deletion, using comparative genomic hybridization, quantitative polymerase-chain-reaction analysis, and DNA sequencing. We carried out tests of replication using an additional series of 76 Han Chinese persons with congenital scoliosis and a multicenter series of 42 persons with 16p11.2 deletions. RESULTS: We identified a total of 17 heterozygous TBX6 null mutations in the 161 persons with sporadic congenital scoliosis (11%); we did not observe any null mutations in TBX6 in 166 controls (P<3.8×10(-6)). These null alleles include copy-number variants (12 instances of a 16p11.2 deletion affecting TBX6) and single-nucleotide variants (1 nonsense and 4 frame-shift mutations). However, the discordant intrafamilial phenotypes of 16p11.2 deletion carriers suggest that heterozygous TBX6 null mutation is insufficient to cause congenital scoliosis. We went on to identify a common TBX6 haplotype as the second risk allele in all 17 carriers of TBX6 null mutations (P<1.1×10(-6)). Replication studies involving additional persons with congenital scoliosis who carried a deletion affecting TBX6 confirmed this compound inheritance model. In vitro functional assays suggested that the risk haplotype is a hypomorphic allele. Hemivertebrae are characteristic of TBX6-associated congenital scoliosis. CONCLUSIONS: Compound inheritance of a rare null mutation and a hypomorphic allele of TBX6 accounted for up to 11% of congenital scoliosis cases in the series that we analyzed. (Funded by the National Basic Research Program of China and others.).
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Metadata
- Authors
- Wu, N., Ming, X., Xiao, J., Wu, Z., Chen, X., Shinawi, M., Shen, Y., Yu, G., Liu, J., Xie, H., Gucev, Z. S., Liu, S., Yang, N., Al-Kateb, H., Chen, J., Zhang, J., Hauser, N., Zhang, T., Tasic, V., Liu, P., Su, X., Pan, X., Liu, C., Wang, L., Shen, J., Shen, J., Chen, Y., Zhang, T., Zhang, J., Choy, K. W., Wang, J., Wang, Q., Li, S., Zhou, W., Guo, J., Wang, Y., Zhang, C., Zhao, H., An, Y., Zhao, Y., Wang, J., Liu, Z., Zuo, Y., Tian, Y., Weng, X., Sutton, V. R., Wang, H., Ming, Y., Kulkarni, S., Zhong, T. P., Giampietro, P. F., Dunwoodie, S. L., Cheung, S. W., Zhang, X., Jin, L., Lupski, J. R., Qiu, G., & Zhang, F.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2015-01-22
- Volume
- 372
- Issue
- 4
- Pages
- 341-350
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2059707376
- Cited by
- 300
- References
- 40
- FWCI
- 22.42
- Type
- journal article
- Language
- en
- Open access
- bronze
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- Wu, N., Ming, X., Xiao, J., Wu, Z., Chen, X., Shinawi, M., Shen, Y., Yu, G., Liu, J., Xie, H., Gucev, Z. S., Liu, S., Yang, N., Al-Kateb, H., Chen, J., Zhang, J., Hauser, N., Zhang, T., Tasic, V., . . . Zhang, F. (2015). TBX6 Null Variants and a Common Hypomorphic Allele in Congenital Scoliosis. New England Journal of Medicine. https://doi.org/10.1056/nejmoa1406829
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