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      A novel missense variant in the SDR domain of the WWOX gene leads to complete loss of WWOX protein with early-onset epileptic encephalopathy and severe developmental delay.

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          Abstract

          The human WWOX (WW domain-containing oxidoreductase) gene, originally known as a tumor suppressor gene, has been shown to be important for brain function and development. In recent years, mutations in WWOX have been associated with a wide phenotypic spectrum of autosomal recessively inherited neurodevelopmental disorders. Whole exome sequencing was completed followed by Sanger sequencing to verify segregation of the identified variants. Functional WWOX analysis was performed in fibroblasts of one patient. Transcription and translation were assessed by quantitative real-time PCR and Western blotting. We report two related patients who presented with early epilepsy refractory to treatment, progressive microcephaly, profound developmental delay, and brain MRI abnormalities. Additionally, one of the patients showed bilateral optic atrophy. Whole exome sequencing revealed homozygosity for a novel missense variant affecting the evolutionary conserved amino acid Gln230 in the catalytic short-chain dehydrogenase/reductase (SDR) domain of WWOX in both girls. Functional studies showed normal levels of WWOX transcripts but absence of WWOX protein. To our knowledge, our patients are the first individuals presenting the more severe end of the phenotypic spectrum of WWOX deficiency, although they were only affected by a single missense variant of WWOX. This could be explained by the functional data indicating an impaired translation or premature degradation of the WWOX protein.

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          Author and article information

          Journal
          Neurogenetics
          Neurogenetics
          Springer Science and Business Media LLC
          1364-6753
          1364-6745
          August 2018
          : 19
          : 3
          Affiliations
          [1 ] Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany. j.johannsen@uke.de.
          [2 ] Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
          [3 ] Institute of Clinical Pharmacology, University Medical Center Göttingen, Göttingen, Germany.
          [4 ] Clinic of Radiotherapy and Radiation Oncology, University Medical Center Göttingen, Göttingen, Germany.
          [5 ] Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
          Article
          10.1007/s10048-018-0549-5
          10.1007/s10048-018-0549-5
          29808465
          0c5bd65e-ef52-4c6e-9222-e0348b473c95

          Epileptic encephalopathy,Missense variant,Protein loss,WWOX gene,WWOX protein

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