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Journal article

Homozygous SMAD6 variants in two unrelated patients with craniosynostosis and radioulnar synostosis

Abstract:

Background

SMAD6 encodes an intracellular inhibitor of the bone morphogenetic protein (BMP) signalling pathway. Until now, rare heterozygous loss-of-function variants in SMAD6 were demonstrated to increase the risk of disparate clinical disorders including cardiovascular disease, craniosynostosis and radioulnar synostosis. Only two unrelated patients harbouring biallelic SMAD6 variants presenting a complex cardiovascular phenotype and facial dysmorphism have been described.

Cases

Here, we present the first two patients with craniosynostosis harbouring homozygous SMAD6 variants. The male probands, both born to healthy consanguineous parents, were diagnosed with metopic synostosis and bilateral or unilateral radioulnar synostosis. Additionally, one proband had global developmental delay. Echocardiographic evaluation did not reveal cardiac or outflow tract abnormalities.

Molecular analyses

The novel missense (c.[584T>G];[584T>G], p.[(Val195Gly)];[(Val195Gly)]) and missense/splice-site variant (c.[817G>A];[817G>A], r.[(817g>a,817delins[a;817+2_817+228])];[(817g>a,817delins[a;817+2_817+228])], p.[(Glu273Lys,Glu273Serfs*72)];[(Glu273Lys,Glu273Serfs*72)]) both locate in the functional MH1 domain of the protein and have not been reported in gnomAD database. Functional analyses of the variants showed reduced inhibition of BMP signalling or abnormal splicing, respectively, consistent with a hypomorphic mechanism of action.

Conclusion

Our data expand the spectrum of variants and phenotypic spectrum associated with homozygous variants of SMAD6 to include craniosynostosis.
Publication status:
Published
Peer review status:
Peer reviewed

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Files:
Publisher copy:
10.1136/jmg-2023-109151

Authors


More by this author
Role:
Author
ORCID:
0000-0002-9668-0535
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
RDM
Sub department:
Weatherall Insti. of Molecular Medicine
Oxford college:
Somerville College
Role:
Author
ORCID:
0000-0001-9711-7595
More by this author
Institution:
University of Oxford
Division:
MSD
Department:
RDM
Sub department:
Weatherall Insti. of Molecular Medicine
Role:
Author
ORCID:
0009-0001-8897-7777


Publisher:
BMJ Publishing Group
Journal:
Journal of Medical Genetics More from this journal
Volume:
61
Issue:
4
Pages:
363-368
Place of publication:
England
Publication date:
2024-01-30
Acceptance date:
2023-11-29
DOI:
EISSN:
1468-6244
ISSN:
0022-2593
Pmid:
38290823


Language:
English
Pubs id:
1614758
Local pid:
pubs:1614758
Deposit date:
2024-05-22

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