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Case Reports
. 2006 May 1;15(9):1413-22.
doi: 10.1093/hmg/ddl064. Epub 2006 Mar 16.

Mutations in SOX2 cause anophthalmia-esophageal-genital (AEG) syndrome

Kathleen A Williamson  1 , Ann M Hever, Joe Rainger, R Curtis Rogers, Alex Magee, Zdenek Fiedler, Wee Teik Keng, Freddie H Sharkey, Niolette McGill, Clare J Hill, Adele Schneider, Mario Messina, Peter D Turnpenny, Judy A Fantes, Veronica van Heyningen, David R FitzPatrick
Affiliations
Case Reports

Mutations in SOX2 cause anophthalmia-esophageal-genital (AEG) syndrome

Kathleen A Williamson et al. Hum Mol Genet. .

Erratum in

  • Hum Mol Genet. 2006 Jun 15;15(12):2030

Abstract

We report heterozygous, loss-of-function SOX2 mutations in three unrelated individuals with Anophthalmia-Esophageal-Genital (AEG) syndrome. One previously reported case [Rogers, R.C. (1988) Unknown cases. Proceedings of the Greenwood Genetic Center. 7, 57.] has a 2.7 Mb deletion encompassing SOX2 and associated with a cryptic translocation t(3;7)(q28;p21.3). The deletion and translocation breakpoints on chromosome 3q are >8.6 Mb apart and both chromosome rearrangements have occurred de novo. Another published case [Petrackova et al. (2004) Association of oesophageal atresia, anophthalmia and renal duplex. Eur. J. Pediatr., 163, 333-334.] has a de novo nonsense mutation, Q55X. A previously unreported case with severe bilateral microphthalmia and oesophageal atresia has a de novo missense mutation, R74P, that alters a highly evolutionarily conserved residue within the high mobility group domain, which is critical for DNA-binding of SOX2. In a yeast one-hybrid assay, this mutation abolishes Sox2-induced activation of the chick delta-crystallin DC5 enhancer. Four other reported AEG syndrome cases were extensively screened and do not have detectable SOX2 mutations. Two of these cases have unilateral eye malformations. SOX2 mutations are known to cause severe bilateral eye malformations but this is the first report implicating loss of function mutations in this transcription factor in oesophageal malformations. SOX2 is expressed in the developing foregut in mouse and zebrafish embryos and an apparently normal pattern of expression is maintained in Shh-/- mouse embryos, suggesting either that Sox2 acts upstream of Shh or functions in a different pathway. Three-dimensional reconstructions of the major morphological events in the developing foregut and eye from Carnegie Stages 12 and 13 human embryos are presented and compared with the data from model organisms. SOX2, with NMYC and CHD7, is now the third transcriptional regulator known to be critical for normal oesophageal development in humans.

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