Study of the Pathophysiology of RNU4ATAC and RTTN Associated Syndromes

Official title

Study of the Consequences of Mutations of the RNU4ATAC and RTTN Genes by Transcriptomic, Biochemical and Cellular Approaches in Order to Determine the Pathophysiology of Their Associated Syndromes: Microcephalic Osteodysplastic Primordial Dwarfism Type I/III, Roifman Syndrome and Lowry-Wood Syndrome

Overview

In the human genome, about 750 genes contain one intron excised by the minor spliceosome. These genes are named U12 genes, and these introns, minor or U12 introns. The minor spliceosome comprises its own set of snRNAs, among which U4atac. Its non-coding gene, RNU4ATAC, has been found mutated in Taybi-Linder (TALS), Roifman (RFMN) and Lowry-Wood syndromes (LWS). These rare developmental disorders associate ante- and post-natal growth retardation, microcephaly, skeletal dysplasia, intellectual disability, retinal dystrophy and immunodeficiency. Their physiopathological mechanisms remain unsolved: the number of U12 genes involved, their identity and function, or the cellular mechanisms impacted by the splicing defect, are still unknown. The hypothesis of the study is that U12 genes coding for primary cilia components are particularly sensitive to minor splicing defects caused by RNU4ATAC mutations. Indeed, a child showing signs of TALS but negative for RNU4ATAC was found to carry a homozygous variant in the RTTN gene, coding for the rotatin protein located at the centrosome and the base of the primary cilia and playing a role in maintaining these structures. In addition, bi-allelic RNU4ATAC mutations were identified in five patients presenting with traits suggestive of the Joubert syndrome (JBTS), a well-characterized ciliopathy. These patients also present with traits typical of TALS/RFMN/LWS. To better understand the causes of these pathologies, a cohort of patients with syndromes associated with bi-allele mutations of the RNU4ATAC or RTTN gene will be gathered, in order to conduct studies on the cells of these patients. Blood samples will be taken, as well as skin biopsies, if possible. These samples will be used to create induced pluripotent stem cell lines. Blood samples will also be collected from the parents of RNU4ATAC patients, to eliminate in transcriptomic analyses expression variations due to differences in genetic background. Biopsies of skin, muscle and brain tissue will be collected on foetuses carrying two-allele RNU4ATAC or RTTN mutations whose parents have had a miscarriage or have chosen to have a medical abortion. The biological samples collected will be used to study the transcription level of U12 genes, the splicing of their pre-messenger RNA, their main cellular functions, and the structural characteristics of tissues and cells.

Interventions

• Other Blood samples
  Blood samples of 5 ml to 15 ml depending on their weight
• Other Skin biopsies
  Biopsies of fragment of skin 2 to 3 mm long by 1 mm wide and 1 mm deep will preferably be taken on the inside of the arm, in the upper third, between the bend of the elbow and the hollow of the armpit under strict sterility conditions.
• Other Fetal samples
  Skin, muscle, brain and bone biopsies will be collected from fetuses in the autopsy room after the medical termination of pregnancy or miscarriage

Primary outcome measures

• Identification of RNU4ATAC mutations consequences at the cellular level [Time frame: 5 years]

Secondary outcome measures (2)

• Minor splicing anomalies [Time frame: 5 years]
• Understanding of neuronal differentiation anomalies [Time frame: 5 years]

Eligibility criteria

Inclusion criteria

TALS, RFMN, LWS or other pathology patients

• Woman or man
• All ages
• Presence of bi-allelic mutations of RNU4ATAC or RTTN
• Written consent of parents or legal guardian(s)
• Affiliation to a Social Security scheme

Healthy participants (Parent of the patient)

• Woman or man
• Major
• Presence of mono-allelic mutations of RNU4ATAC
• Written consent of the participant
• Affiliation to a Social Security scheme

Parents having recourse to a medical termination of pregnancy or having had a spontaneous miscarriage (for fetus samples)

• Woman or man
• Major
• Presence of bi-allelic mutations of RNU4ATAC or RTTN in the fetus
• Written parental consent
• Affiliation to a Social Security scheme

Exclusion criteria

Subject participating in another research including an exclusion period still in progress.

Criteria are shown verbatim from the registry (in English). Final eligibility is always assessed by the study center.

Healthy volunteers: Yes

Study design

Allocation

Non-randomized

Model

Single group

Masking

Open label

Primary purpose

Other

Study locations

France · 6 centers

• Centre de référence des anomalies du développement et syndromes malformatifs du Sud-Ouest — Bordeaux
• Centre de référence anomalies du développement de Lyon, Hôpital Femme Mère Enfant — Bron
• Centre de référence des anomalies du développement et syndromes malformatifs de l'Est, CHU — Dijon
• Centre de référence des anomalies du développement et syndromes malformatifs de l'inter ré — Lille
• Unité Fonctionelle d'embryo-fœtopathologie, Hôpital Necker-Enfants Malades — Paris
• Centre de référence des anomalies du développement et syndromes malformatifs de l'Ouest, H — Rennes

Identifiers

NCT: NCT06111950 · 69HCL20_0599

Primary sources (government registries)

• ClinicalTrials.gov (US NIH)

View this study on ClinicalTrials.gov ↗