Abstract
Constitutional SMARCB1 mutations at 22q11.23 have been found in ∼50% of familial and <10% of sporadic schwannomatosis cases1. We sequenced highly conserved regions along 22q from eight individuals with schwannomatosis whose schwannomas involved somatic loss of one copy of 22q, encompassing SMARCB1 and NF2, with a different somatic mutation of the other NF2 allele in every schwannoma but no mutation of the remaining SMARCB1 allele in blood and tumor samples. LZTR1 germline mutations were identified in seven of the eight cases. LZTR1 sequencing in 12 further cases with the same molecular signature identified 9 additional germline mutations. Loss of heterozygosity with retention of an LZTR1 mutation was present in all 25 schwannomas studied. Mutations segregated with disease in all available affected first-degree relatives, although four asymptomatic parents also carried an LZTR1 mutation. Our findings identify LZTR1 as a gene predisposing to an autosomal dominant inherited disorder of multiple schwannomas in ∼80% of 22q-related schwannomatosis cases lacking mutation in SMARCB1.
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Acknowledgements
We thank the patients for their participation in this study. A.P. is a recipient of a Children's Tumor Foundation Young Investigator Award (grant 2009-01-004). The study was supported in part by the Children's Tumor Foundation and by internal funds from the University of Alabama at Birmingham Medical Genomics Laboratory.
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The study was conceived and coordinated by A.P. and L.M.M. Patient phenotyping was performed by L.A., D.B.-V., A.B., J.O.B., A.L.B., M.S.D., H.F., K.G., S.H., C.K., C.L., R.N., K.A.R., J.M.S., P.S., J.A.W., A.Z. and B.R.K. Clinical data were collected by A.R.G. Design of the target enrichment library was performed by A.P. Paired-end next-generation sequencing was performed by M.R.C. and D.K.C. Detection of variants, filtering and annotation were performed by A.P., P.M., D.K.C. and L.M.M. NF2 and SMARCB1 mutation analyses and loss of heterozygosity studies were performed by A.B.P. Multiplex ligation-dependent probe amplification analyses were performed by C.F. LZTR1 mutation analyses and confirmatory tests were performed by J.X. and A.B.P. Prediction of protein structure and effects of missense mutations was performed by Y.F.L. and L.M.M. Analysis of mutational databases and statistical analyses were performed by J.X., Y.F.L. and L.M.M. The manuscript was written by A.P., J.X., A.B.P., Y.F.L. and L.M.M. All authors contributed to the manuscript.
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Piotrowski, A., Xie, J., Liu, Y. et al. Germline loss-of-function mutations in LZTR1 predispose to an inherited disorder of multiple schwannomas. Nat Genet 46, 182–187 (2014). https://doi.org/10.1038/ng.2855
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DOI: https://doi.org/10.1038/ng.2855
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