Detection and validation of novel mutations inMERTKin a simplex case of retinal degeneration using WGS and hiPSC–RPEs model

Abstract

Inherited retinal degenerations (IRDs) are a group of genetically heterogeneous conditions with a broad phenotypic heterogeneity. Here, we report detection and validation of the underlying cause of progressive retinal degeneration in a nuclear family of European descent with a single affected individual. Whole genome sequencing of the proband and her unaffected sibling identified a novel intron 8 donor splice site variant (c.1296 + 1G>A) and a novel 731 base pair deletion encompassing exon 9 (Chr2:g.112751488_112752218 del) resulting in c.1297_1451del; p.K433_G484fsTer3 in the Mer tyrosine kinase protooncogene (MERTK), which is highly expressed in the retinal pigment epithelium (RPE). The proband carried both variants in the heterozygous state, which segregated with disease in the pedigree. These MERTK variants are predicted to result in the defective splicing of exon 8 and loss of exon 9 respectively. To evaluate the impact of these novel variants, peripheral blood mononuclear cells of the proband and her parents were reprogrammed to humaninduced pluripotent stem cell (hiPSC) lines, which were subsequently differentiated to hiPSC–RPE. Analysis of the proband's hiPSC–RPE revealed the absence of both MERTK transcript and its respective protein as well as abnormal phagocytosis when compared with the parental hiPSC–RPE. In summary, whole genome sequencing identified novel compound heterozygous variants in MERTK as the underlying cause of progressive retinal degeneration in a simplex case. Further, analysis using an hiPSC–RPE model established the functional impact of novel MERTK mutations and revealed the potential mechanism underlying pathology in the proband.

Next-generation whole exome sequencing to delineate the genetic basis of primary congenital glaucoma

“…It is worth noting that we have successfully applied linkage coupled with whole exome 26 , 27 , and whole genome 28 , 29 , sequencing approaches to delineate pathogenic variants responsible for ocular dystrophies. Likewise, a similar approach to delineate the genetic basis of extraocular diseases has been adopted by our group 30 , 31 , and many other groups 32 , 33 .…”