Kabuki syndrome genes KMT2D and KDM6A: functional analyses demonstrate critical roles in craniofacial, heart and brain development

PM Van Laarhoven, LR Neitzel… - Human molecular …, 2015 - academic.oup.com
PM Van Laarhoven, LR Neitzel, AM Quintana, EA Geiger, EH Zackai, DE Clouthier
Human molecular genetics, 2015academic.oup.com
Kabuki syndrome (KS) is a rare multiple congenital anomaly syndrome characterized by
distinctive facial features, global developmental delay, intellectual disability and
cardiovascular and musculoskeletal abnormalities. While mutations in KMT2D have been
identified in a majority of KS patients, a few patients have mutations in KDM6A. We analyzed
40 individuals clinically diagnosed with KS for mutations in KMT2D and KDM6A. Mutations
were detected in KMT2D in 12 and KDM6A in 4 cases, respectively. Observed mutations …
Abstract
Kabuki syndrome (KS) is a rare multiple congenital anomaly syndrome characterized by distinctive facial features, global developmental delay, intellectual disability and cardiovascular and musculoskeletal abnormalities. While mutations in KMT2D have been identified in a majority of KS patients, a few patients have mutations in KDM6A. We analyzed 40 individuals clinically diagnosed with KS for mutations in KMT2D and KDM6A. Mutations were detected in KMT2D in 12 and KDM6A in 4 cases, respectively. Observed mutations included single-nucleotide variations and indels leading to frame shifts, nonsense, missense or splice-site alterations. In two cases, we discovered overlapping chromosome X microdeletions containing KDM6A. To further elucidate the functional roles of KMT2D and KDM6A, we knocked down the expression of their orthologs in zebrafish. Following knockdown of kmt2d and the two zebrafish paralogs kdm6a and kdm6al, we analyzed morphants for developmental abnormalities in tissues that are affected in individuals with KS, including craniofacial structures, heart and brain. The kmt2d morphants exhibited severe abnormalities in all tissues examined. Although the kdm6a and kdm6al morphants had similar brain abnormalities, kdm6a morphants exhibited craniofacial phenotypes, whereas kdm6al morphants had prominent defects in heart development. Our results provide further support for the similar roles of KMT2D and KDM6A in the etiology of KS by using a vertebrate model organism to provide direct evidence of their roles in the development of organs and tissues affected in KS patients.
Oxford University Press