Peroxisome biogenesis disorders (PBD) are a heterogeneous group of autosomal recessive neurodegenerative disorders that affect multiple organ systems. Approximately 80% of PBD patients are classified in the Zellweger syndrome spectrum (PBD-ZSS). Mutations in the PEX1, PEX6, PEX10, PEX12, or PEX26 genes are found in approximately 90% of PBD-ZSS patients. Here, we sequenced the coding regions and splice junctions of these five genes in 58 PBD-ZSS cases previously subjected to targeted sequencing of a limited number of PEX gene exons. In our cohort, 71 unique sequence variants were identified, including 18 novel mutations predicted to disrupt protein function and 2 novel silent variants. We identified 4 patients who had two deleterious mutations in one PEX gene and a third deleterious mutation in a second PEX gene. For two such patients, we conducted cell fusion complementation analyses to identify the defective gene responsible for aberrant peroxisome assembly. Overall, we provide empirical data to estimate the relative fraction of diseasecausing alleles that occur in the coding and splice junction sequences of these five PEX genes and the frequency of cases where mutations occur in multiple PEX genes. This information is beneficial for efforts aimed at establishing rapid and sensitive clinical diagnostics for PBD-ZSS patients and interpreting the results from these genetic tests. © 2008 Wiley-Liss, Inc.KEY WORDS: peroxisome biogenesis disorders, Zellweger syndrome, PBD-ZSS, neonatal adrenoleukodystrophy, infantile Refsum disease, PEX1, PEX6, PEX10, PEX12
INTRODUCTIONPeroxisomes are organelles present in almost all eukaryotic cells (Purdue and Lazarow, 2001;Schluter, et al., 2007;Wanders and Waterham, 2006). In humans, they are essential for the metabolism of branched chain and very long chain fatty acids, ether lipids, polyamines, amino acids, and glyoxylate (Schluter, et al., 2007;Steinberg, et al., 2006;Wanders and Waterham, 2006). During some of these metabolic processes, they generate and subsequently inactivate reactive oxygen species (Schrader and Fahimi, 2006).
E468 Yik et al.Based on genetic, bioinformatic, and proteomic analyses, it has been estimated that at least eighty-five proteins are associated with peroxisome structure and function in humans (Schluter, et al., 2007). Peroxisome matrix proteins are synthesized on free ribosomes in the cytosol prior to import into the peroxisome. Peroxins, encoded by a family of sixteen human PEX genes (Steinberg, et al., 2004), are involved in peroxisome biogenesis with functions ranging from membrane synthesis and matrix protein import to organelle division.Peroxisomal biogenesis disorders (PBD; MIM# 601539) are inherited in an autosomal recessive manner and are characterized by impaired peroxisome assembly (Wanders and Waterham, 2005;Weller, et al., 2003). Due to their heterogeneity, PBDs had been divided into four groups: Zellweger syndrome (ZS; MIM# 214100), neonatal adrenoleukodystrophy (NALD; MIM# 202370), infantile Refsum disease (IRD; MIM# 266510), and rhiz...