Fol. Biol. 2020, 66, 123-132

https://doi.org/10.14712/fb2020066040123

Phenotype Variability in Czech Patients Carrying PAX6 Disease-Causing Variants

J. Moravikova1, Z. Kozmik2, L. Hlavata1, M. Putzova3, P. Skalicka1,4, M. Michaelides5,6, F. Malinka1,7, Lubica Dudakova1, P. Liskova1,4

1Research Unit for Rare Diseases, Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
2Department of Transcriptional Regulation, Institute of Molecular Genetics, Czech Academy of Sciences, Prague, Czech Republic
3Biopticka laborator s.r.o., Pilsen, Czech Republic
4Department of Ophthalmology, First Faculty of Medicine, Charles University and General University Hospital in Prague, Czech Republic
5Moorfields Eye Hospital NHS Foundation Trust, London, UK
6UCL Institute of Ophthalmology, University College London, UK
7Department of Computer Science, Czech Technical University in Prague, Czech Republic

Received June 2020
Accepted August 2020

The aim of this study was to report PAX6 disease-causing variants in six Czech families, to describe the associated phenotypes, and to perform functional assessment of the splice site variants. Detailed ophthalmic examination was performed. The PAX6 coding region was directly sequenced in three probands. Two probands were analysed by exome sequencing and one by genome sequencing. The effect of two variants on pre-mRNA splicing was evaluated using an exon trapping assay. Six different heterozygous PAX6 variants were identified, with c.111_120del and c.1183+1G>T being novel. Both c.1183+1G>T and c.1032+1G>A were proved to cause aberrant splicing with exon skipping and subsequent frameshift. The phenotypic features were variable between and within families. One individual, aged 31 years, presented with mild unilateral ptosis accompanied by aniridia in the right eye, partial aniridia in the left eye, and bilateral congenital cataracts, without marked foveal hypoplasia. Bilateral microcornea, partial aniridia, congenital cataracts, and a large posterior segment coloboma were found in another proband, aged 32 years. One child, aged 8 years, had bilateral high myopia, optic nerve colobomas, anterior polar cataracts, but no iris defects. Another individual, aged 46 years, had bilateral congenital ptosis, iris hypoplasia, keratopathy with marked fibrovascular pannus, anterior polar cataract, and foveal hypoplasia combined with impaired glucose tolerance. However, his daughter, aged 11 years, showed classical features of aniridia. Our study extends the genetic spectrum of PAX6 disease-causing variants and confirms that the associated phenotypic features may be very broad and different to the ‘classical’ aniridia.

Funding

This work was supported by AZV 17-30500A. Institutional support was provided by UNCE 204064 and PROGRES Q26 programmes of Charles University. J. M. was supported by GAUK 250713/82318/2018 and SVV 260367/2017. M. M. is supported by grants from the National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology.

References

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