Exploring Genetic Variants in Ellis-Van Creveld Syndrome: Insights from a Consanguineous Family

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Maryam Khalid
Areej Munir
Abdullah Sajid
Ammar Mehfooz
Usama Khalil Qadri
Shahzeera Begum
Mohsan Aslam
Rehmatullah Zadran
Mehak Khalid
Waseem Ahmed

Abstract

Background: Ellis-Van Creveld Syndrome (EVC) is a rare genetic disorder characterized by skeletal abnormalities and developmental anomalies, presenting significant challenges in diagnosis and understanding its genetic underpinnings.


Objective: This study aimed to comprehensively investigate the clinical and molecular aspects of EVC within a consanguineous family from Pakistan, identifying the genetic variants involved.


Methods: A detailed clinical assessment was conducted on all family members, documenting phenotypic features such as polydactyly, syndactyly, dental abnormalities, and short stature. Pedigrees were constructed following established guidelines to depict familial relationships and inheritance patterns. Venous blood samples were collected for genomic DNA extraction using the Phenol-Chloroform Method. Microsatellite marker analysis was performed for linkage mapping, guided by the UCSC Genome Browser and Rutgers Combined Linkage-Physical Map. Mutation screening of the EVC and EVC2 genes was conducted using Sanger sequencing, with primers designed targeting exon-intron boundaries and coding exons. PCR amplification and sequencing were performed according to standard protocols. Data analysis was carried out using SPSS version 25.


Results: Clinical assessment revealed classical EVC phenotypes, including bilateral postaxial polydactyly in 80% of affected individuals and dental abnormalities in 70%. Microsatellite marker analysis identified linkage to the EVC/EVC2 locus on chromosome 4p16.2. However, Sanger sequencing of the 21 coding exons of EVC and the 22 exons of EVC2 did not detect any pathogenic mutations. Haplotype analysis confirmed the segregation of specific markers with affected individuals, suggesting the involvement of additional genetic factors.


Conclusion: The study's findings challenge the traditional understanding of EVC, highlighting the necessity for advanced genomic techniques such as whole-genome sequencing to fully elucidate its genetic contributors. These insights underscore the heterogeneous nature of EVC and emphasize the importance of comprehensive genetic screening for accurate diagnosis and personalized management of this rare genetic disorder.

Article Details

How to Cite
Khalid, M., Areej Munir, Abdullah Sajid, Ammar Mehfooz, Usama Khalil Qadri, Shahzeera Begum, Mohsan Aslam, Rehmatullah Zadran, Mehak Khalid, & Waseem Ahmed. (2024). Exploring Genetic Variants in Ellis-Van Creveld Syndrome: Insights from a Consanguineous Family. Journal of Health and Rehabilitation Research, 4(2), 1105–1110. https://doi.org/10.61919/jhrr.v4i2.964
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Articles
Author Biographies

Maryam Khalid, Isra University Islamabad Pakistan.

Department of Medical Lab Technology, Al Nafees Medical College, Isra University, Islamabad, Pakistan.

Areej Munir, Isra University Islamabad Pakistan.

Department of Medical Lab Technology, Al Nafees Medical College, Isra University, Islamabad, Pakistan.

Abdullah Sajid, Isra University Islamabad Pakistan.

Department of Medical Lab Technology, Al Nafees Medical College, Isra University, Islamabad, Pakistan.

Ammar Mehfooz, Isra University Islamabad Pakistan.

Department of Medical Lab Technology, Al Nafees Medical College, Isra University, Islamabad, Pakistan.

Usama Khalil Qadri, Shaheed Zulfiqar Ali Bhutto Medical University Islamabad Pakistan.

Department of Molecular Biology, Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Islamabad, Pakistan.

Shahzeera Begum, Isra University Islamabad Pakistan.

Department of Medical Lab Technology, Al Nafees Medical College, Isra University, Islamabad, Pakistan.

Mohsan Aslam, Isra University Islamabad Pakistan.

Department of Medical Lab Technology, Al Nafees Medical College, Isra University, Islamabad, Pakistan.

Rehmatullah Zadran, National Infectious Disease Laboratory Kabul Afghanistan.

WHO-Surveillance Department, National Infectious Disease Laboratory, Kabul, Afghanistan.

Mehak Khalid, MBBS MCPS-Gynaecologist.

MBBS MCPS-Gynaecologist.

Waseem Ahmed, Quaid-i-Azam University Islamabad Pakistan

Department of Biochemistry, Faculty of Biological Sciences, Quaid-I-Azam University, Islamabad, Pakistan.

References

Da Silva JD, Tkachenko N, Soares AR. Ellis-Van Creveld Syndrome. In: GeneReviews®. University of Washington, Seattle; 1993.

Aubert-Mucca M, Huber C, Baujat G, Michot C, Zarhrate M, Bras M, Boutaud L, Malan V, Attie-Bitach T, Cormier-Daire V, et al. Ellis-Van Creveld Syndrome: Clinical and Molecular Analysis of 50 Individuals. J Med Genet. 2023;60:337-45.

Piceci-Sparascio F, Micale L, Torres B, Guida V, Consoli F, Torrente I, Onori A, Frustaci E, D'Asdia MC, Petrizzelli F, et al. Clinical Variability in DYNC2H1-Related Skeletal Ciliopathies Includes Ellis-Van Creveld Syndrome. Eur J Hum Genet. 2023;31:479-84.

Louie KW, Mishina Y, Zhang H. Molecular and Cellular Pathogenesis of Ellis-Van Creveld Syndrome: Lessons From Targeted and Natural Mutations in Animal Models. J Dev Biol. 2020;8:25.

Tukachinsky H, Lopez LV, Salic A. A Mechanism for Vertebrate Hedgehog Signaling: Recruitment to Cilia and Dissociation of SuFu-Gli Protein Complexes. J Cell Biol. 2010;191:415-28.

Caparrós-Martín JA, De Luca A, Cartault F, Aglan M, Temtamy S, Otaify GA, Mehrez M, Valencia M, Vázquez L, Alessandri JL, et al. Specific Variants in WDR35 Cause a Distinctive Form of Ellis-Van Creveld Syndrome by Disrupting the Recruitment of the EvC Complex and SMO Into the Cilium. Hum Mol Genet. 2015;24:4126-37.

Niceta M, Margiotti K, Digilio MC, Guida V, Bruselles A, Pizzi S, Ferraris A, Memo L, Laforgia N, Dentici ML, et al. Biallelic Mutations in DYNC2LI1 Are a Rare Cause of Ellis-Van Creveld Syndrome. Clin Genet. 2018;93:632-9.

Palencia-Campos A, Aoto PC, Machal EMF, Rivera-Barahona A, Soto-Bielicka P, Bertinetti D, Baker B, Vu L, Piceci-Sparascio F, Torrente I, et al. Ellis-Van Creveld Syndrome and Profound Deafness Resulted by Sequence Variants in the EVC2 and TMC1 Genes in a Consanguineous Family and EVC Syndrome by a Compound Heterozygous Variant in the EVC Gene in a Non-Consanguineous Family. J Med Genet. 2017;54:207-17.

Badano JL, Mitsuma N, Beales PL, Katsanis N. The Ciliopathies: An Emerging Class of Human Genetic Disorders. Annu Rev Genomics Hum Genet. 2006;7:125–48.

Ruiz-Perez VL, Blair HJ, Rodriguez-Andres ME, Blanco MJ, Wilson A, Liu YN, Miles C, Peters H, Goodship JA. EVC Is a Positive Mediator of Ihh-Regulated Bone Growth That Localizes at the Base of Chondrocyte Cilia. Development. 2007;134:2903-12.

Ruiz-Perez VL, Goodship JA. Ellis-Van Creveld Syndrome and Weyers Acrodental Dysostosis Are Caused by Cilia-Mediated Diminished Response to Hedgehog Ligands. Am J Med Genet C Semin Med Genet. 2009;15:341-45.

Ruiz-Perez VL, Ide SE, Strom TM, Lorenz B, Wilson D, Woods K, King L, Francomano C, Freisinger P, Spranger S, et al. Mutations in a New Gene in Ellis-Van Creveld Syndrome and Weyers Acrodental Dysostosis. Nat Genet. 2000;24:283-6.

Dorn KV, Hughes CE, Rohatgi RA. Smoothened-Evc2 Complex Transduces the Hedgehog Signal at Primary Cilia. Dev Cell. 2012;23:823-35.

Suda T, Udagawa N, Nakamura I. Modulation of Osteoclast Differentiation by Local Factors. Bone. 1995;17:87–91.

Bennett RL, Steinhaus KA, Uhrich SB, O'Sullivan CK, Resta RG, Lochner-Doyle D, Markel DS, Vincent V, Hamanishi J. Recommendations for Standardized Human Pedigree Nomenclature. J Genet Couns. 1995;4:267-79.

Sambrook J, Fritsch EF, Maniatis T. Molecular Cloning: A Laboratory Manual. 2nd ed. Cold Spring Harbor Laboratory Press; 1989.

Matise TC, Chen F, Chen W, Francisco M, Hansen M, He C, Hyland FC, Kennedy GC, Kong X, Murray SS, et al. A Second-Generation Combined Linkage–Physical Map of the Human Genome. Genome Res. 2007;17:1783-6.

Rozen S, Skaletsky H. Primer3 on the WWW for General Users and for Biologist Programmers. Bioinformatics Methods and Protocols. 1999;365-86.

Mac Kusick V. Ellis-Van Creveld Syndrome and the Amish. Nat Genet. 2000;24:203-4.

Horigome H, Hamada H, Sohda S, Oyake Y, Kurosaki Y. Prenatal Ultrasonic Diagnosis of a Case of Ellis-Van Creveld Syndrome With a Single Atrium. Pediatr Radiol. 1997;27:942-4.

Venkat-Raman N, Sebire N, Murphy K. Increased First-Trimester Fetal Nuchal Translucency Thickness in Association With Chondroectodermal Dysplasia (Ellis-Van Creveld). Ultrasound Obstet Gynecol. 2005;25:412-4.

Waldrigues A, Grohmann L, Takahashi T, Reis H. Ellis-Van Creveld: An Inbred Kindred With 5 Cases. Rev Bras Pesqui Med. 1997;10:193-8.

Blackburn M, Belliveau R. Ellis-Van Creveld Syndrome: A Report of Previously Undescribed Anomalies in Two Siblings. Am J Dis Child. 1971;122:267-70.

Digilio M, Marino B, Ammirati A, Borgaza U, Giannotti A, Dallapiccola B. Cardiac Malformations in Patients With Oral-Facial-Skeletal Syndromes: Clinical Similarities With Heterotaxia. Am J Med Genet. 1999;84:350-6.