The genetic landscape of crystallins in congenital cataract

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RESEARCH

The genetic landscape of crystallins in congenital cataract Vanita Berry1,2*  , Alex Ionides2, Nikolas Pontikos1,2, Michalis Georgiou1,2, Jing Yu4, Louise A. Ocaka5, Anthony T. Moore2,3, Roy A. Quinlan6 and Michel Michaelides1,2*

Abstract  Background:  The crystalline lens is mainly composed of a large family of soluble proteins called the crystallins, which are responsible for its development, growth, transparency and refractive index. Disease-causing sequence variants in the crystallins are responsible for nearly 50% of all non-syndromic inherited congenital cataracts, as well as causing cataract associated with other diseases, including myopathies. To date, more than 300 crystallin sequence variants causing cataract have been identified. Methods:  Here we aimed to identify the genetic basis of disease in five multi-generation British families and five sporadic cases with autosomal dominant congenital cataract using whole exome sequencing, with identified variants validated using Sanger sequencing. Following bioinformatics analysis, rare or novel variants with a moderate to damaging pathogenicity score, were filtered out and tested for segregation within the families. Results:  We have identified 10 different heterozygous crystallin variants. Five recurrent variants were found: familyA, with a missense variant (c.145C>T; p.R49C) in CRYAA​ associated with nuclear cataract; family-B, with a deletion in CRYBA1 (c.272delGAG; p.G91del) associated with nuclear cataract; and family-C, with a truncating variant in CRYGD (c.470G>A; W157*) causing a lamellar phenotype; individuals I and J had variants in CRYGC​ (c.13A>C; T5P) and in CRYGD (c.418C>T; R140*) causing unspecified congenital cataract and nuclear cataract, respectively. Five novel disease-causing variants were also identified: family D harboured a variant in CRYGC​ (c.179delG; R60Qfs*) responsible for a nuclear phenotype; family E, harboured a variant in CRYBB1 (c.656G>A; W219*) associated with lamellar cataract; individual F had a variant in CRYGD (c.392G>A; W131*) associated with nuclear cataract; and individuals G and H had variants in CRYAA​ (c.454delGCC; A152del) and in CRYBB1 (c.618C>A; Y206*) respectively, associated with unspecified congenital cataract. All novel variants were predicted to be pathogenic and to be moderately or highly damaging. Conclusions:  We report five novel variants and five known variants. Some are rare variants that have been reported previously in small ethnic groups but here we extend this to the wider population and record a broader phenotypic spectrum for these variants. Keywords:  Autosomal dominant congenital cataract, Next generation sequencing, Crystallins

*Correspondence: [email protected]; [email protected] 1 Department of Genetics, UCL Institute of Ophthalmology, University College London, 11‑43 Bath Street, London EC1V 9EL, UK Full list of author information is available at the end of the article

Background Familial cataract is a clinically and genetically heterogeneous disease with an