Deletions in the CDKL5 5′ untranslated region lead to CDKL5 deficiency disorder

Isabel Haviland, Ralph D. Hector, Lindsay C. Swanson, Aubrie Soucy Verran, Emma Sherrill, Zoë Frazier, Anne Marie M. Denny, Jenna Lucash, Bo Zhang, Holly A. Dubbs, Eric D. Marsh, Judith L. Weisenberg, Helen Leonard, Milena Crippa, Francesca Cogliati, Silvia Russo, Bernhard Suter, Rajsekar Rajaraman, Alan K. Percy, John M. SchreiberScott Demarest, Timothy A. Benke, Maya Chopra, Timothy W. Yu, Heather E. Olson

Research output: Contribution to journalArticlepeer-review

Abstract

Pathogenic variants in the cyclin-dependent kinase-like 5 (CDKL5) gene are associated with CDKL5 deficiency disorder (CDD), a severe X-linked developmental and epileptic encephalopathy. Deletions affecting the 5′ untranslated region (UTR) of CDKL5, which involve the noncoding exon 1 and/or alternatively spliced first exons (exons 1a–e), are uncommonly reported. We describe genetic and phenotypic characteristics for 15 individuals with CDKL5 partial gene deletions affecting the 5′ UTR. All individuals presented characteristic features of CDD, including medically refractory infantile-onset epilepsy, global developmental delay, and visual impairment. We performed RNA sequencing on fibroblast samples from three individuals with small deletions involving exons 1 and/or 1a/1b only. Results demonstrated reduced CDKL5 mRNA expression with no evidence of expression from alternatively spliced first exons. Our study broadens the genotypic spectrum for CDD by adding to existing evidence that deletions affecting the 5′ UTR of the CDKL5 gene are associated with the disorder. We propose that smaller 5′ UTR deletions may require additional molecular testing approaches such as RNA sequencing to determine pathogenicity.

Original languageEnglish
Article numbere63843
JournalAmerican Journal of Medical Genetics, Part A
Volume197
Issue number1
DOIs
StatePublished - Jan 2025

Keywords

  • 5′ UTR
  • CDKL5
  • alternatively spliced exons
  • developmental and epileptic encephalopathy
  • exon 1
  • genotypic spectrum

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