“…Furthermore, CRISPR/Cas9 offers the opportunity to test genetic modifiers and possible genetic interactions that determine disease severity in congenital hydrocephalus. For instance, X-linked hydrocephalus (XLH), which can result from mutations in the L1 cell adhesion molecule ( L1cam ) gene in mice (Dahme et al, 1997; Demyanenko et al, 1999), rats (Emmert et al, 2019) and humans (Adle-Biassette et al, 2013; Dahme et al, 1997; Rosenthal et al, 1992), varies in severity from hydrocephalus with multiple structural abnormalities and prenatal death to a milder phenotype with cognitive impairment or isolated symptoms even within the same family (Fryns et al, 1991; Serville et al, 1992). CRISPR/Cas9-generated rodent models of congenital hydrocephalus resulting from mutations in different hydrocephalus-related genes, such as L1cam and Ccdc39 , can be interbred to investigate epistatic interactions previously believed to affect mutation penetrance and ventricular size in other models of hydrocephalus (Weller and Gärtner, 2001; Zhang et al, 2006).…”