The third case of TNFRSF11A-associated dysosteosclerosis with a mutation producing elongating proteins

J Hum Genet. 2021 Apr;66(4):371-377. doi: 10.1038/s10038-020-00831-8. Epub 2020 Oct 9.

Abstract

Dysosteosclerosis (DOS) is a distinct form of sclerosing bone disease characterized by platyspondyly and progressive osteosclerosis. DOS is genetically heterogeneous. Three causal genes, SLC29A3, CSF1R, and TNFRSF11A are reported. TNFRSF11A-associated DOS has been identified in two patients; however, TNFRSF11A is also a causal gene for osteopetrosis, autosomal recessive 7 (OP-AR7). Whole-exome sequencing in a patient with sclerosing bone disease identified novel compound heterozygous variants (c.414_427 + 7del, c.1664del) in TNFRSF11A. We examined the impact of the two variants on five splicing isoforms of TNFRSF11A by RT-PCR. We found that c.1664del resulted in elongated proteins (p.S555Cfs*121, etc.), while c.414_427 + 7del generated two aberrant splicing products (p.A139Wfs*19 and p.E132Dfs*19) that lead to nonsense mediated mRNA decay (NMD). In the previous two cases of TNFRSF11A-associated DOS, their mutations produced truncated TNFRSF11A protein isoforms. The mutations in all three cases thus contrast with TNFRSF11A mutations reported in OP-AR7, which does not generated truncated or elongated TNFRSF11A proteins. Thus, we identified the third case of TNFRSF11A-associated DOS and reinforced the genotype-phenotype correlation that aberrant protein-producing TNFRSF11A mutations cause DOS.

Publication types

  • Case Reports

MeSH terms

  • Child, Preschool
  • Exome Sequencing
  • Female
  • Humans
  • Mutation*
  • Osteosclerosis / genetics
  • Osteosclerosis / metabolism
  • Osteosclerosis / pathology*
  • Prognosis
  • Receptor Activator of Nuclear Factor-kappa B / genetics*
  • Receptor Activator of Nuclear Factor-kappa B / metabolism*

Substances

  • Receptor Activator of Nuclear Factor-kappa B
  • TNFRSF11A protein, human

Supplementary concepts

  • Dysosteosclerosis