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Novel Cysteine-Sparing Hypomorphic NOTCH3 A1604T Mutation Observed in a Family With Migraine and White Matter Lesions.

Authors :
Arnardottir S
Del Gaudio F
Klironomos S
Braune EB
Lombraña AA
Oliveira DV
Jin S
Karlström H
Lendahl U
Sjöstrand C
Source :
Neurology. Genetics [Neurol Genet] 2021 Apr 22; Vol. 7 (3), pp. e584. Date of Electronic Publication: 2021 Apr 22 (Print Publication: 2021).
Publication Year :
2021

Abstract

Objective: To conduct a clinical study of a family with neurologic symptoms and findings carrying a novel NOTCH3 mutation and to analyze the molecular consequences of the mutation.<br />Methods: We analyzed a family with complex neurologic symptoms by MRI and neurologic examinations. Exome sequencing of the NOTCH3 locus was conducted, and whole-genome sequencing was performed to identify COL4A1 , COL4A2 , and HTRA1 mutations. Cell lines expressing the normal or NOTCH3 <superscript>A1604T</superscript> receptors were analyzed to assess proteolytic processing, cell morphology, receptor routing, and receptor signaling.<br />Results: Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) is the most common hereditary form of cerebral small vessel disease (SVD) and caused by mutations in the NOTCH3 gene. Most CADASIL mutations alter the number of cysteine residues in the extracellular domain of the NOTCH3 receptor, but in this article, we describe a family in which some members carry a novel cysteine-sparing NOTCH3 mutation (c.4810 G>A, p.Ala1604Thr). Two of 3 siblings heterozygous for the NOTCH3 <superscript>A1604T</superscript> mutation presented with migraine and white matter lesions (WMLs), the latter of a type related to but distinct from what is normally observed in CADASIL. Two other members instead carried a novel COL4A1 missense mutation (c.4795 G>A; p.(Ala1599Thr)). The NOTCH3 <superscript>A1604T</superscript> receptor was aberrantly processed, showed reduced presence at the cell surface, and less efficiently activated Notch downstream target genes.<br />Conclusions: We identify a family with migraine and WML in which some members carry a cysteine-sparing hypomorphic NOTCH3 mutation. Although a causal relationship is not established, we believe that the observations contribute to the discussion on dysregulated Notch signaling in cerebral SVDs.<br /> (Copyright © 2021 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)

Details

Language :
English
ISSN :
2376-7839
Volume :
7
Issue :
3
Database :
MEDLINE
Journal :
Neurology. Genetics
Publication Type :
Academic Journal
Accession number :
33898742
Full Text :
https://doi.org/10.1212/NXG.0000000000000584