CDKL5 variants: Improving our understanding of a rare neurologic disorder.

Objective: To provide new insights into the interpretation of genetic variants in a rare neurologic disorder, CDKL5 deficiency, in the contexts of population sequencing data and an updated characterization of the CDKL5 gene. Methods: We analyzed all known potentially pathogenic CDKL5 variants by com...

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Main Authors: Hector, R., Kalscheuer, V., Hennig, F., Leonard, H., Downs, Jennepher, Clarke, A., Benke, T., Armstrong, J., Pineda, M., Bailey, M., Cobb, S.
Format: Journal Article
Published: 2017
Online Access:http://hdl.handle.net/20.500.11937/73020
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author Hector, R.
Kalscheuer, V.
Hennig, F.
Leonard, H.
Downs, Jennepher
Clarke, A.
Benke, T.
Armstrong, J.
Pineda, M.
Bailey, M.
Cobb, S.
author_facet Hector, R.
Kalscheuer, V.
Hennig, F.
Leonard, H.
Downs, Jennepher
Clarke, A.
Benke, T.
Armstrong, J.
Pineda, M.
Bailey, M.
Cobb, S.
author_sort Hector, R.
building Curtin Institutional Repository
collection Online Access
description Objective: To provide new insights into the interpretation of genetic variants in a rare neurologic disorder, CDKL5 deficiency, in the contexts of population sequencing data and an updated characterization of the CDKL5 gene. Methods: We analyzed all known potentially pathogenic CDKL5 variants by combining data from large-scale population sequencing studies with CDKL5 variants from new and all available clinical cohorts and combined this with computational methods to predict pathogenicity. Results: The study has identified several variants that can be reclassified as benign or likely benign. With the addition of novel CDKL5 variants, we confirm that pathogenic missense variants cluster in the catalytic domain of CDKL5 and reclassify a purported missense variant as having a splicing consequence. We provide further evidence that missense variants in the final 3 exons are likely to be benign and not important to disease pathology. We also describe benign splicing and nonsense variants within these exons, suggesting that isoform hCDKL5_5 is likely to have little or no neurologic significance. We also use the available data to make a preliminary estimate of minimum incidence of CDKL5 deficiency. Conclusions: These findings have implications for genetic diagnosis, providing evidence for the reclassification of specific variants previously thought to result in CDKL5 deficiency. Together, these analyses support the view that the predominant brain isoform in humans (hCDKL5_1) is crucial for normal neurodevelopment and that the catalytic domain is the primary functional domain.
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spelling curtin-20.500.11937-730202018-12-13T09:34:00Z CDKL5 variants: Improving our understanding of a rare neurologic disorder. Hector, R. Kalscheuer, V. Hennig, F. Leonard, H. Downs, Jennepher Clarke, A. Benke, T. Armstrong, J. Pineda, M. Bailey, M. Cobb, S. Objective: To provide new insights into the interpretation of genetic variants in a rare neurologic disorder, CDKL5 deficiency, in the contexts of population sequencing data and an updated characterization of the CDKL5 gene. Methods: We analyzed all known potentially pathogenic CDKL5 variants by combining data from large-scale population sequencing studies with CDKL5 variants from new and all available clinical cohorts and combined this with computational methods to predict pathogenicity. Results: The study has identified several variants that can be reclassified as benign or likely benign. With the addition of novel CDKL5 variants, we confirm that pathogenic missense variants cluster in the catalytic domain of CDKL5 and reclassify a purported missense variant as having a splicing consequence. We provide further evidence that missense variants in the final 3 exons are likely to be benign and not important to disease pathology. We also describe benign splicing and nonsense variants within these exons, suggesting that isoform hCDKL5_5 is likely to have little or no neurologic significance. We also use the available data to make a preliminary estimate of minimum incidence of CDKL5 deficiency. Conclusions: These findings have implications for genetic diagnosis, providing evidence for the reclassification of specific variants previously thought to result in CDKL5 deficiency. Together, these analyses support the view that the predominant brain isoform in humans (hCDKL5_1) is crucial for normal neurodevelopment and that the catalytic domain is the primary functional domain. 2017 Journal Article http://hdl.handle.net/20.500.11937/73020 10.1212/NXG.0000000000000200 restricted
spellingShingle Hector, R.
Kalscheuer, V.
Hennig, F.
Leonard, H.
Downs, Jennepher
Clarke, A.
Benke, T.
Armstrong, J.
Pineda, M.
Bailey, M.
Cobb, S.
CDKL5 variants: Improving our understanding of a rare neurologic disorder.
title CDKL5 variants: Improving our understanding of a rare neurologic disorder.
title_full CDKL5 variants: Improving our understanding of a rare neurologic disorder.
title_fullStr CDKL5 variants: Improving our understanding of a rare neurologic disorder.
title_full_unstemmed CDKL5 variants: Improving our understanding of a rare neurologic disorder.
title_short CDKL5 variants: Improving our understanding of a rare neurologic disorder.
title_sort cdkl5 variants: improving our understanding of a rare neurologic disorder.
url http://hdl.handle.net/20.500.11937/73020