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2026

Expanding the phenotypic and immunological landscape of Alazami syndrome: Evidence from seven new patients with LARP7 gene variants

Sharaf-Eldin W, Ghorab RM, Rafat K, Mahmoud H, Hassib N, Alahlafi A, Maroofian R, Gleeson JG, Essawi M, Zaki MS.

Eur J Pediatr. 2026 Mar 11;185(4):175. doi: 10.1007/s00431-026-06801-0. ABSTRACT Alazami syndrome is a neurodevelopmental disorder characterized by postnatal growth retardation, moderate to severe intellectual disability, and facial dysmorphology. It is caused by biallelic variants in the transcriptional regulator La ribonucleoprotein 7 (LARP7), where frameshift variants accounted for the majority of cases. The current study presents 7 new patients, including 3 males and 4 females from 3 unrelated families. Careful and thorough clinical examination identified novel oro-dental disease abnormalities, including a prominent premaxilla and enamel defects. The detected variants (c.1113_1116del, c.997 + 2T > C and c.518T > C) were not reported in the previous studies. The substitution c.518T > C represented the second missense variant to be identified in patients with Alazami syndrome. Male patients from the three families fulfilled ≥ 2 clinical warning signs of primary immunodeficiency. Lymphocyte subset counts and immunoglobulin levels were estimated in patients from two families. The values were within reference ranges, with only minor non-significant alterations in cytotoxic T-cell counts. A functional assay of B lymphocyte response was performed in one family, demonstrating impaired Streptococcus pneumoniae IgG antibody production following Pneumovax vaccination in the male patient, while his female sibling mounted an adequate response. In conclusion, the disease has a wide range of symptoms, which vary greatly among the affected patients. Our study expanded the clinical and molecular spectrum of the disorder and highlighted immunodeficiency as an underrecognized disease feature, potentially with a male sex predilection. PMID:41811398 | DOI:10.1007/s00431-026-06801-0

March 11, 2026
Genetic Neurologic DiseaseNeurogenomics

Bi-allelic variants in neuronal adhesion molecule astrotactin 1 gene ASTN1 cause diverse neurodevelopmental disorders

Levine JM, Calame DG, Sangermano R, Du H, Saad A, Lisfeld J, Bierhals T, Denecke J, Uctepe E, Celik MY, Yesilyurt A, Yildiz Er H, Yilmaz Gulec E, Mushiba A, Almontashiri N, Gawlinski P, Wiszniewski W, Karaca E, Alabdi L, Pehlivan D, Marafi D, Zaki MS, Alkuraya FS, Gleeson JG, Jhangiani SN, Gibbs RA, Posey JE, Bujakowska KM, Lupski JR.

Am J Hum Genet. 2026 Jan 15:S0002-9297(25)00482-3. doi: 10.1016/j.ajhg.2025.12.011. Online ahead of print. ABSTRACT ASTN1 encodes astrotactin 1, a neuronal-glial ligand in the developing brain that promotes neuronal migration along radial glia in brain structures with laminar organization, such as the cerebral cortex, hippocampus, and cerebellum. In mouse models, disruption of Astn1 results in neuronal migration deficits, a mild reduction in cerebellar volume, and balance and coordination deficits. In humans, bi-allelic ASTN1 variants have been identified in nine individuals with neurodevelopmental disorders (NDDs) with or without brain malformations. ASTN1 additionally interacts with astrotactin 2 (ASTN2) to implement neuronal migration; ASTN2 deletions associate with NDDs with reduced penetrance. Here, we describe eighteen individuals with NDDs from twelve unrelated families with bi-allelic, ultra-rare, predicted damaging variants in ASTN1 and one individual with heterozygous variants in both ASTN1 and ASTN2. We expand the clinical phenotypic descriptions of ASTN1-related NDDs, which range from mild to profound developmental delay or intellectual disability and can be associated with autism, attention-deficient hyperactivity disorder (ADHD), and epilepsy. Other recurrent abnormalities include dysmorphic facial features, hypotonia, spasticity, and ataxia. Additionally, we add to the neuroradiographic phenotype of this condition, which can be normal, mildly dysmorphic (a thin corpus callosum and cerebellar dysgenesis), or severely dysmorphic (polymicrogyria and lissencephaly). Remarkably, three genetic models of multilocus pathogenic variation (MPV), including tri-allelic, double heterozygous, and double homozygous due to distributive absence of heterozygosity (AOH), were observed. This ASTN1 allelic series characterizes the consequences of perturbations in radial-glia-guided neuronal migration in humans, the phenotypic spectrum of ASTN1-related NDDs, and the contribution of MPV to the genetic basis of NDDs. PMID:41544630 | DOI:10.1016/j.ajhg.2025.12.011

January 15, 2026
Genetic Neurologic DiseaseNeurogenomics

2025

A fin-loop-like structure in GPX4 underlies neuroprotection from ferroptosis

Lorenz SM, Wahida A, Bostock MJ, Seibt T, Santos Dias Mourão A, Levkina A, Trümbach D, Soudy M, Emler D, Rothammer N, Woo MS, Sonner JK, Novikova M, Henkelmann B, Aldrovandi M, Kaemena DF, Mishima E, Vermonden P, Zong Z, Chen D, Nakamura T, Ito J, Doll S, Proneth B, Bürkle E, Rizzollo F, Escamilla Ayala A, Napolitano V, Kolonko-Adamska M, Gaussmann S, Merl-Pham J, Hauck S, Pertek A, Orschmann T, van San E, Vanden Berghe T, Hass D, Maida A, Frenz JM, Pedrera L, Dolga A, Kraiger M, Hrabé de Angelis M, Fuchs H, Ebert G, Lenberg J, Friedman J, Scale C, Agostinis P, Zimprich A, Vogt-Weisenhorn D, Garrett L, Hölter SM, Wurst W, Glaab E, Lewerenz J, Popper B, Sieben C, Steinacker P, Zischka H, Garcia-Saez AJ, Tietze A, Ramesh SK, Ayton S, Vincendeau M, Friese MA, Wigby K, Sattler M, Mann M, Ingold I, Jayavelu AK, Popowicz GM, Conrad M.

Cell. 2025 Dec 4:S0092-8674(25)01310-8. doi: 10.1016/j.cell.2025.11.014. Online ahead of print. ABSTRACT Ferroptosis, driven by uncontrolled peroxidation of membrane phospholipids, is distinct from other cell death modalities because it lacks an initiating signal and is surveilled by endogenous antioxidant defenses. Glutathione peroxidase 4 (GPX4) is the guardian of ferroptosis, although its membrane-protective function remains poorly understood. Here, structural and functional analyses of a missense mutation in GPX4 (p.R152H), which causes early-onset neurodegeneration, revealed that this variant disrupts membrane anchoring without considerably impairing its catalytic activity. Spatiotemporal Gpx4 deletion or neuron-specific GPX4R152H expression in mice induced degeneration of cortical and cerebellar neurons, accompanied by progressive neuroinflammation. Patient induced pluripotent stem cell (iPSC)-derived cortical neurons and forebrain organoids displayed increased ferroptotic vulnerability, mirroring key pathological features, and were sensitive to ferroptosis inhibition. Neuroproteomics revealed Alzheimer’s-like signatures in affected brains. These findings highlight the necessity of proper GPX4 membrane anchoring, establish ferroptosis as a key driver of neurodegeneration, and provide the rationale for targeting ferroptosis as a therapeutic strategy in neurodegenerative disease. PMID:41349546 | DOI:10.1016/j.cell.2025.11.014

December 4, 2025
Gene ExpressionGenetic Neurologic DiseaseNeurogenomics

Expanding the Phenotype of Syndromic SLC30A9-Associated Disease

(NOT PUBLISHED – ONLINE PREPRINT) Wagner NE, AlAshwal SM, Lenberg J, Bird LM, Ceulemans S, Friedman J, Borooah S.

Am J Med Genet A. 2025 Nov 26:e70007. doi: 10.1002/ajmga.70007. Online ahead of print. ABSTRACT SLC30A9 mutations are linked to Birk-Landau-Perez syndrome, which is characterized by neurodevelopmental and renal disease, thought to result from impaired zinc homeostasis. In this report, we describe a patient with a homozygous likely pathogenic SLC30A9 variant with atypical chorio-retinal degeneration, suggesting retinal involvement in SLC30A9-associated diseases. The patient has bilateral sensorineural hearing loss, developmental delay, intellectual disability, abnormal balance, and Tourette syndrome. Ophthalmic manifestations include vascular attenuation, optic disc pallor, and pigmentation. In addition, the patient is noted to have high myopia. Our case highlights the importance of broad genetic testing in diagnosing rare multi-systemic disorders. Further research into the molecular mechanisms by which SLC30A9 results in photoreceptor disease is essential to understand its role in retinal degeneration and to develop potential therapeutic strategies. PMID:41293997 | DOI:10.1002/ajmga.70007

November 26, 2025
Genetic Neurologic DiseaseNeurogenomicsPhenotyping

A phenotypic brain organoid atlas and biobank for neurodevelopmental disorders

Wang L, Nakamura Y, Li J, Sievert D, Liu Y, Nguyen T, Jetti PS, Thai E, Zhou RY, Weng J, Meave N, Yadavilli M, Howarth R, Camey K, Banka N, Owusu-Hammond C, Barrows C, Kingsmore SF, Zaki MS, Mukamel E, Gleeson JG.

Cell Stem Cell. 2025 Nov 3:S1934-5909(25)00374-1. doi: 10.1016/j.stem.2025.10.006. Online ahead of print. ABSTRACT Thousands of genes are associated with neurodevelopmental disorders (NDDs), yet mechanisms and targeted treatments remain elusive. To fill these gaps, we present a California Institute of Regenerative Medicine (CIRM)-initiated NDD biobank of 352 publicly available genetically diverse patient-derived induced pluripotent stem cells (iPSCs), along with clinical details, brain imaging, and genomic data, representing four major categories of disease: microcephaly (MIC), polymicrogyria (PMG), epilepsy (EPI), and intellectual disability (ID). From 35 representative patients, we studied over 6,000 brain organoids for histology and single-cell transcriptomics. Compared with an organoid library from ten neurotypicals, patients showed distinct cellular defects linked to underlying clinical disease categories. MIC showed defects in cell survival and excessive TTR+ cells, PMG showed intermediate progenitor cell junction defects, EPI showed excessive astrogliosis, and ID showed excessive generation of TTR+ cells. Our organoid atlas demonstrates both conserved and divergent NDD category-specific phenotypes, bridging genotype and phenotype. This NDD iPSC biobank can support future disease modeling and therapeutic approaches. PMID:41187745 | DOI:10.1016/j.stem.2025.10.006

November 3, 2025
Genetic Neurologic DiseaseNeurogenomicsPhenotyping

Splicing and frameshift variants in QSER1 may be involved in developmental phenotypes

Fischer MC, Reis LM, Lenberg J, Friedman J, Seese SE, Muheisen S, Writzl K, Golob B, Peterlin B, Semina EV.

HGG Adv. 2025 Oct 25:100539. doi: 10.1016/j.xhgg.2025.100539. Online ahead of print. ABSTRACT Human development is a complex process that requires precise control of gene expression through regulatory proteins. Recently, heterozygous variants in PRR12, encoding a proline-rich regulatory protein, were found to cause a variable phenotype involving developmental delay/cognitive impairment, neuropsychiatric diagnoses, structural eye anomalies, congenital heart and kidney defects, and poor growth. QSER1, encoding glutamine- and serine-rich protein 1, represents a paralog of PRR12 that shares 28% overall identity at the protein level and stronger conservation (43%) in the C-terminal region. QSER1 deficiency in human embryonic stem cells causes hypermethylation of many key transcription factor genes, implicating it in the development of multiple organs. Here we present three unrelated individuals with neurodevelopmental phenotypes, variable other multisystem anomalies, and heterozygous variants in QSER1. This includes two novel de novo frameshift alleles (p.(Lys1565Argfs*36) and p.(Phe896fs*28)), and one ultra-rare canonical splice site variant resulting in a combination of abnormal transcripts, frameshift (p.(Glu1393Glyfs*26)) and in-frame deletion of a conserved amino acid (p.(Glu1393del)), supported by in silico predictions and minigene assays. In situ hybridization revealed dynamic and broad expression of qser1 in zebrafish embryos, including a strong presence in the developing brain. These data suggest a possible role for QSER1/qser1 in vertebrate development and human disease. PMID:41139957 | DOI:10.1016/j.xhgg.2025.100539

October 25, 2025
Genetic Neurologic DiseaseNeurogenomicsPhenotyping

Sequencing Analysis Demonstrates That a Complex Genetic Architecture Contributes to Risk for Spina Bifida

Strain M, Garrett ME, Bucklan M, Jasien JM, Worley G, Gleeson JG, Ashley-Koch AE.

Birth Defects Res. 2025 Oct;117(10):e2533. doi: 10.1002/bdr2.2533. ABSTRACT BACKGROUND: Spina bifida (SB), a common neural tube defects (NTDs), has a complex genetic architecture that remains incompletely understood. Although prior studies have identified rare, deleterious single nucleotide variants (SNVs) in SB, broader contributions to risk remain unclear. Here, we investigated shared genetic risk among 256 SB probands compared with 395 ancestry-matched controls using an unbiased sequencing approach. METHODS: We performed an exome-wide association study (ExWAS) of 46,887 SNVs with minor allele frequencies (MAF) > 0.001 to identify single-variant associations, followed by gene-based burden tests to assess the cumulative effect of SNVs within genes, using all variants and then restricting to rare variants (MAF < 0.05). Both burden tests were repeated in 510 unaffected parents to evaluate excess mutational burden relative to controls. RESULTS: Across all analyses, 16 genes were associated with SB: SRCIN1, PDE4DIP, XCL2, CTAGE10P, GLB1L3, PMS2P4, HSPA4, GLB1L2, FAM90A1, PLA1A, HLA-A, SPIRE2, TVP23B, CHD5, FOXA2, and PIF1. ExWAS identified 11 significant SNVs, nine of which were common (MAF > 0.05). The unrestricted burden test identified seven genes; four remained significant when restricted to rare variants, and two additional genes emerged only in that subset. Five burden-associated genes were not detected in the ExWAS, suggesting cumulative variant effects. Four burden-associated genes also showed enrichment in parents, supporting inherited risk. Three of these showed suggestive transmission disequilibrium (p values ≤ 0.10) and one was attributed to multiple SNVs. CONCLUSION: These results provide new insight into the multifactorial genetic landscape of SB and highlight the importance of unbiased approaches in constructing genetic models of NTD. PMID:41013918 | DOI:10.1002/bdr2.2533

October 11, 2025
Gene ExpressionNeurogenomicsNTDs

ACTB deletions or single-nucleotide loss-of-function variants: expansion and further delineation of the phenotype and review of the literature

Lesieur-Sebellin M, Wigby K, Schaefer E, Gouronc A, Chatron N, Poulat AL, Putoux A, Goldenberg A, Quibeuf M, Chambon P, Rondeau S, Barcia G, Levy J, Piard J, Kuentz P, Doco-Fenzy M, Bednarek N, Caumes R, Bouquillon S, Le Caignec C, Patat O, Khau Van Kien P, Chiesa J, Delplancq G, Bacrot S, Brisset S, Ginglinger E, Cantagrel V, Lenberg J, Friedman JR, Rio M, Scheidecker S, Malan V.

J Med Genet. 2025 Oct 8:jmg-2025-110631. doi: 10.1136/jmg-2025-110631. Online ahead of print. ABSTRACT BACKGROUND: Pathogenic gain-of-function or dominant-negative effect missense variations in ACTB are associated with a neurodevelopmental disorder characterised by intellectual disability (ID), seizures, sensorineural hearing loss, cerebral, renal and ocular abnormalities and dysmorphic features (Baraitser-Winter cerebrofrontofacial syndrome). ACTB encodes beta-actin, a highly conserved protein involved in cell motility, structure and integrity. Deletions including ACTB, and, more rarely, single-nucleotide loss-of-function variants in ACTB have been described in patients with a distinct phenotype including developmental delay, ID, microcephaly, growth restriction, cardiac and renal abnormalities and dysmorphic features. METHODS: We collected 14 individuals and 1 fetus carrying a heterozygous deletion including ACTB, and 4 individuals with a heterozygous truncating variant. Genotypic and phenotypic data were analysed. Furthermore, a comprehensive review of all cases reported to date was also undertaken. RESULTS: Twelve out of 17 individuals presented with ID, and 3 out of 17 with learning disabilities. Speech delay and behavioural abnormalities were observed in 15 out of 17 and 12 out of 17 individuals, respectively, motor delay in 9 out of 17 and growth restriction in 9 out of 18. Most of the individuals (13/18) had recognisable dysmorphic features. 11 anomalies were de novo, except for 1 deletion inherited from the mother. The size of the deletion varied from 125 kb to 1.6 Mb and could result from a fork stalling and template switching. CONCLUSION: This study allowed us to better characterise the phenotype associated with the haploinsufficiency of ACTB, underlying the high prevalence of neurodevelopmental disorders (ID, speech and motor delay, behavioural abnormalities) and growth restriction in this recognisable syndrome. PMID:41062261 | DOI:10.1136/jmg-2025-110631

October 8, 2025
Genetic Neurologic DiseaseNeurogenomicsPhenotyping

Clinical Genetic Testing in Schizophrenia: A Systematic Review and Meta-Analysis

Brah HS, Sran N, Sanghani S, Valmadrid L, Gandarilla I, Fakhouri S, Longmire E, Heskett KM, Kendall KM, Raznahan A, Baribeau D, Fan CC, Besterman AD.

Biol Psychiatry. 2025 Sep 30:S0006-3223(25)01485-4. doi: 10.1016/j.biopsych.2025.09.010. Online ahead of print. ABSTRACT BACKGROUND: Genetic testing may provide important diagnostic information for individuals with schizophrenia, but the frequency with which clinically significant variants are identified across different testing approaches has not been systematically evaluated. METHODS: We conducted a systematic review and meta-analysis searching MEDLINE, EMBASE, and APA PsycINFO (January 2007-June 2023) for studies reporting results of clinical genetic testing in schizophrenia. Two independent reviewers performed abstract/title screening, full-text review, and data extraction following PRISMA guidelines. A random-effects model was used to estimate the pooled and platform-specific proportions of individuals with pathogenic or likely pathogenic variants, with heterogeneity assessed using the I2 statistic. RESULTS: Analysis of 31 studies (20,476 participants) showed that 6% (95% CI: 4% to 7%) of individuals with schizophrenia had a clinically significant genetic variant identified. Detection rates were 6% (95% CI: 4% to 8%) for chromosomal microarray, 5% (95% CI: -0.02% to 12%) for exome sequencing, and 7% (95% CI: 2% to 12%) for genome sequencing. Substantial heterogeneity was observed across studies (I2 = 95.9%). Geographic representation was limited, with no studies from Latin America, South Asia, or Africa. CONCLUSIONS: Genetic testing identifies clinically informative variants in approximately 6% of individuals with schizophrenia. However, substantial heterogeneity across studies and limited geographic representation underscore the need for more standardized testing approaches and broader population sampling in future genetic research on schizophrenia. PMID:41038604 | DOI:10.1016/j.biopsych.2025.09.010

September 30, 2025
Genetic DiagnosticsGenetic Neurologic DiseaseNeurogenomics

A comparative view of human and mouse telencephalon inhibitory neuron development

Chung C, Girgiss J, Gleeson JG. A comparative view of human and mouse telencephalon inhibitory neuron development. Development. 2025 Jan 1

Development. 2025 Jan 1;152(1):dev204306. doi: 10.1242/dev.204306. Epub 2025 Jan 2. ABSTRACT Human GABAergic inhibitory neurons (INs) in the telencephalon play crucial roles in modulating neural circuits, generating cortical oscillations, and maintaining the balance between excitation and inhibition. The major IN subtypes are based on their gene expression profiles, morphological diversity and circuit-specific functions. Although previous foundational work has established that INs originate in the ganglionic eminence regions in mice, recent studies have questioned origins in humans and non-human primates. We review the origins of INs in mice and compare with recent findings from primary human prenatal brain tissue culture experiments and lineage analysis from somatic variants in neurotypical human cadavers and human brain organoids. Together, these studies suggest potential primate- or human-specific processes that may have been overlooked in mouse models and could have implications for brain disorders. PMID:39745314 | DOI:10.1242/dev.204306

January 1, 2025
Neurogenomics

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