Insight into IKBKG/NEMO Locus: Report of New Mutations and Complex Genomic Rearrangements Leading to Incontinentia Pigmenti Disease

MI Conte, A Pescatore, M Paciolla, E Esposito… - Human …, 2014 - Wiley Online Library
MI Conte, A Pescatore, M Paciolla, E Esposito, MG Miano, MB Lioi, MA McAleer, G Giardino…
Human mutation, 2014Wiley Online Library
Incontinentia pigmenti (IP) is an X‐linked‐dominant M endelian disorder caused by mutation
in the IKBKG/NEMO gene, encoding for NEMO/IKK gamma, a regulatory protein of nuclear
factor kappaB (NF‐kB) signaling. In more than 80% of cases, IP is due to recurrent or
nonrecurrent deletions causing loss‐of‐function (L o F) of NEMO/IKK gamma. We review
how the local architecture of the IKBKG/NEMO locus with segmental duplication and a high
frequency of repetitive elements favor de novo aberrant recombination through different …
Abstract
Incontinentia pigmenti (IP) is an X‐linked‐dominant Mendelian disorder caused by mutation in the IKBKG/NEMO gene, encoding for NEMO/IKKgamma, a regulatory protein of nuclear factor kappaB (NF‐kB) signaling. In more than 80% of cases, IP is due to recurrent or nonrecurrent deletions causing loss‐of‐function (LoF) of NEMO/IKKgamma. We review how the local architecture of the IKBKG/NEMO locus with segmental duplication and a high frequency of repetitive elements favor de novo aberrant recombination through different mechanisms producing genomic microdeletion. We report here a new microindel (c.436_471delinsT, p.Val146X) arising through a DNA‐replication‐repair fork‐stalling‐and‐template‐switching and microhomology‐mediated‐end‐joining mechanism in a sporadic IP case. The LoF mutations of IKBKG/NEMO leading to IP include small insertions/deletions (indel) causing frameshift and premature stop codons, which account for 10% of cases. We here present 21 point mutations previously unreported, which further extend the spectrum of pathologic variants: 14/21 predict LoF because of premature stop codon (6/14) or frameshift (8/14), whereas 7/21 predict a partial loss of NEMO/IKKgamma activity (two splicing and five missense). We review how the analysis of IP‐associated IKBKG/NEMO hypomorphic mutants has contributed to the understanding of the pathophysiological mechanism of IP disease and has provided important information on affected NF‐kB signaling. We built a locus‐specific database listing all IKBKG/NEMO variants, accessible at http://IKBKG.lovd.nl.
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