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      A rare case of Waardenburg syndrome with unilateral hearing loss caused by nonsense variant c.772C>T (p.Arg259*) in the MITF gene in Yakut patient from the Eastern Siberia (Sakha Republic, Russia)

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          ABSTRACT

          Waardenburg syndrome (WS) is an orphan genetic disease with autosomal dominant pattern of inheritance characterised by varying degrees of hearing loss accompanied by skin, hair and iris pigmentation abnormalities. Four types of WS differing in phenotypic characteristics are now described. We performed a Sanger sequencing of coding regions of genes PAX3, MITF, SOX10 and SNAI2 in the patient with WS from a Yakut family living in the Sakha Republic. No changes were found in the PAX3, SOX10 and SNAI2 coding regions while a previously reported heterozygous transition c.772C>T (p.Arg259*) in exon 8 of the MITF gene was found in this patient. This patient presents rare phenotype of WS type 2: congenital unilateral hearing loss, unilateral heterochromia of irises, and absence of skin/hair depigmentation and dystopia canthorum. Audiological variability in WS type 2, caused by the c.772C>T (p.Arg259*) variant in the MITF gene, outlines the importance of molecular analysis and careful genotype–phenotype comparisons in order to optimally inform patients about the risk of hearing loss. The results of this study confirm the association of pathogenic variants in the MITF gene with WS type 2 and expanded data on the variability of audiological features of the WS.

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          Most cited references17

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          Waardenburg syndrome.

          Auditory-pigmentary syndromes are caused by physical absence of melanocytes from the skin, hair, eyes, or the stria vascularis of the cochlea. Dominantly inherited examples with patchy depigmentation are usually labelled Waardenburg syndrome (WS). Type I WS, characterised by dystopia canthorum, is caused by loss of function mutations in the PAX3 gene. Type III WS (Klein-Waardenburg syndrome, with abnormalities of the arms) is an extreme presentation of type I; some but not all patients are homozygotes. Type IV WS (Shah-Waardenburg syndrome with Hirschsprung disease) can be caused by mutations in the genes for endothelin-3 or one of its receptors, EDNRB. Type II WS is a heterogeneous group, about 15% of whom are heterozygous for mutations in the MITF (microphthalmia associated transcription factor) gene. All these forms show marked variability even within families, and at present it is not possible to predict the severity, even when a mutation is detected. Characterising the genes is helping to unravel important developmental pathways in the neural crest and its derivatives.
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            Microphthalmia-associated transcription factor as a regulator for melanocyte-specific transcription of the human tyrosinase gene.

            Tyrosinase is a rate-limiting enzyme in melanin biosynthesis and is specifically expressed in differentiated melanocytes. We have identified the enhancer element in the 5'-flanking region of the human tyrosinase gene that is responsible for its pigment cell-specific transcription and have termed it tyrosinase distal element (TDE) (positions -1861 to -1842). Transient expression assays showed that TDE confers efficient expression of a firefly luciferase reporter gene linked to the tyrosinase gene promoter in MeWo pigmented melanoma cells but not in HeLa cells, which do not express tyrosinase. TDE was specifically bound by nuclear proteins of MeWo and HeLa cells, the binding properties of which were indistinguishable in gel mobility shift assays. TDE contains the CATGTG motif in its center, and mutation analysis indicates that the CA dinucleotides of this motif are crucial for protein binding and pigment cell-specific enhancer function. The CATGTG motif is consistent with the consensus sequence recognized by a large family of transcription factors with a basic helix-loop-helix structure, which prompted us to examine the possible involvement of a ubiquitous transcription factor, USF, and a novel factor, microphthalmia-associated transcription factor (MITF), recently cloned as the human homolog of the mouse microphthalmia (mi) gene product. The mi phenotype is associated with a mutant mi locus and characterized by small eyes and loss of melanin pigments. Both USF and MITF are predicted to contain a basic helix-loop-helix structure and a leucine zipper structure. We provide evidence that USF binds to TDE, whereas we were unable to detect the DNA-binding activity of MITF. Transient coexpression assays showed that MITF specifically transactivates the promoter activity of the tyrosinase gene through the CATGTG motif of TDE but not the promoter of the ubiquitously expressed heme oxygenase gene, while USF is able to activate both promoters. These results indicate that MITF is a cell-type-specific factor that is capable of activating transcription of the tyrosinase gene.
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              A new syndrome combining developmental anomalies of the eyelids, eyebrows and nose root with pigmentary defects of the iris and head hair and with congenital deafness.

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                Author and article information

                Journal
                Int J Circumpolar Health
                Int J Circumpolar Health
                ZICH
                zich20
                International Journal of Circumpolar Health
                Taylor & Francis
                1239-9736
                2242-3982
                2019
                18 June 2019
                : 78
                : 1
                : 1630219
                Affiliations
                [a ]Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems , Yakutsk, Russia
                [b ]Laboratory of Molecular Biology, M.K. Ammosov North-Eastern Federal University , Yakutsk, Russia
                [c ]Department of Professional Pathology, Republican Hospital №2 - Center for Emergency Medical Aid , Yakutsk, Russia
                [d ]Genomics Core Facility, Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences , Novosibirsk, Russia
                [e ]Novosibirsk State University , Novosibirsk, Russia
                [f ]Laboratory of Human Molecular Genetics, Ufa Federal Research Center of Russian Academy of Sciences, Institute of Biochemistry and Genetics , Ufa, Russia
                [g ]Department of Genetics and Fundamental Medicine, Bashkir State University , Ufa, Russia
                [h ]Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences , Novosibirsk, Russia
                [i ]Department of Pediatrics and Child Surgery, M.K. Ammosov North-Eastern Federal University , Yakutsk, Russia
                [j ]Laboratory of monitoring the children health and medico-environmental research, Yakut Science Centre of Complex Medical Problems , Yakutsk, Russia
                [k ]Department of Public Health and Nursing, Faculty on Medicine and Health Sciences, NTNU The Norwegian University of Science and Technology , Trondheim, Norway
                Author notes
                CONTACT Nikolay A. Barashkov barashkov2004@ 123456mail.ru Head of Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems , Sergelyahskoe shosse, 4, Yakutsk677000, Russia
                Author information
                http://orcid.org/0000-0002-6984-7934
                http://orcid.org/0000-0001-6866-9462
                http://orcid.org/0000-0002-8659-0886
                http://orcid.org/0000-0001-9181-0487
                Article
                1630219
                10.1080/22423982.2019.1630219
                6586136
                31213145
                a67d3b9d-2b88-4748-a4cc-434761612412
                © 2019 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 02 April 2019
                : 31 May 2019
                : 03 June 2019
                Page count
                Figures: 1, Tables: 1, References: 18, Pages: 5
                Funding
                Funded by: Ministry of Education and Science of the Russian Federation 10.13039/501100003443
                Award ID: #6.1766.2017
                Funded by: NEFU 10.13039/501100002965
                Award ID: #0794-2017-0019
                Award ID: FSRG-2017-0019
                Funded by: Russian Foundation for Basic Research 10.13039/501100002261
                Award ID: #18-013-00738_А
                Funded by: Russian Foundation for Basic Research 10.13039/501100002261
                Award ID: #18-05-600035_Arctica
                Funded by: Russian Foundation for Basic Research 10.13039/501100002261
                Award ID: #17-29-06-016_ofi_m
                Funded by: Russian Foundation for Basic Research 10.13039/501100002261
                Award ID: #18-015-00212_А
                This work was supported by the Ministry of Education and Science of the Russian Federation (the Project #6.1766.2017); NEFU in Yakutsk (the Project #0794-2017-0019, FSRG-2017-0019); Russian Foundation for Basic Research (grants #17-29-06-016_ofi_m, #18-015-00212_А, #18-013-00738_А, #18-05-600035_Arctica) and the Program “Genome of Yakutia” YSC CMP (BRK 0556-2017-0003)
                Categories
                Case Report

                Medicine
                waardenburg syndrome,mitf,sakha republic,eastern siberia,russia
                Medicine
                waardenburg syndrome, mitf, sakha republic, eastern siberia, russia

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