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.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Clin+Genet
2016 ; 89
(3
): 359-66
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Mutations in RIT1 cause Noonan syndrome - additional functional evidence and
expanding the clinical phenotype
#MMPMID25959749
Koenighofer M
; Hung CY
; McCauley JL
; Dallman J
; Back EJ
; Mihalek I
; Gripp KW
; Sol-Church K
; Rusconi P
; Zhang Z
; Shi GX
; Andres DA
; Bodamer OA
Clin Genet
2016[Mar]; 89
(3
): 359-66
PMID25959749
show ga
RASopathies are a clinically heterogeneous group of conditions caused by
mutations in 1 of 16 proteins in the RAS-mitogen activated protein kinase
(RAS-MAPK) pathway. Recently, mutations in RIT1 were identified as a novel cause
for Noonan syndrome. Here we provide additional functional evidence for a causal
role of RIT1 mutations and expand the associated phenotypic spectrum. We
identified two de novo missense variants p.Met90Ile and p.Ala57Gly. Both variants
resulted in increased MEK-ERK signaling compared to wild-type, underscoring
gain-of-function as the primary functional mechanism. Introduction of p.Met90Ile
and p.Ala57Gly into zebrafish embryos reproduced not only aspects of the human
phenotype but also revealed abnormalities of eye development, emphasizing the
importance of RIT1 for spatial and temporal organization of the growing organism.
In addition, we observed severe lymphedema of the lower extremity and genitalia
in one patient. We provide additional evidence for a causal relationship between
pathogenic mutations in RIT1, increased RAS-MAPK/MEK-ERK signaling and the
clinical phenotype. The mutant RIT1 protein may possess reduced GTPase activity
or a diminished ability to interact with cellular GTPase activating proteins;
however the precise mechanism remains unknown. The phenotypic spectrum is likely
to expand and includes lymphedema of the lower extremities in addition to nuchal
hygroma.