PPP3CA truncating variants clustered in the regulatory domain cause early-onset refractory epilepsy

Sugi Panneerselvam1, Julia Wang2, Wenmiao Zhu3

  • 1Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas, USA.

Clinical Genetics
|May 8, 2021
PubMed

Insights

New research identifies specific PPP3CA gene truncating variants in a regulatory domain region. These variants are linked to severe early-onset epilepsy, distinguishing them from other known loss-of-function or gain-of-function mutations.

Area of Science:

  • Genetics and Molecular Biology
  • Neuroscience
  • Developmental Biology

Background:

  • PPP3CA encodes the catalytic subunit of calcineurin, a crucial phosphatase involved in cellular signaling.
  • Known loss-of-function (LoF) variants in the catalytic domain are associated with epilepsy.
  • Gain-of-function (GoF) variants in the auto-inhibitory domain are linked to congenital abnormalities.

Purpose of the Study:

  • To investigate the clinical and molecular characteristics of novel de novo PPP3CA variants.
  • To differentiate the phenotypic impact of truncating variants in the regulatory domain from previously described LoF and GoF variants.

Main Methods:

  • Clinical evaluation of five new patients with de novo PPP3CA variants.
  • Analysis of variant locations, focusing on a specific 26-amino acid region in the regulatory domain (RD).
  • Comparison of seizure severity and associated neurodevelopmental features between different variant types.
  • Expression studies to assess the impact of a truncating variant on RNA and protein levels.

Main Results:

  • Five new patients with de novo PPP3CA variants were identified.
  • Frameshift and truncating variants were clustered within a 26-amino acid region of the RD.
  • Patients with truncating variants exhibited more severe, early-onset seizures compared to those with LoF missense variants.
  • Autism spectrum disorder was more prevalent in patients with LoF missense variants.
  • Expression studies indicated RNA expression but no detectable mutant protein for a truncating variant.

Conclusions:

  • PPP3CA truncating variants clustered in the RD represent a distinct class of pathogenic variants.
  • These variants are strongly associated with severe, early-onset refractory epilepsy.
  • The findings differentiate the clinical spectrum of PPP3CA-related disorders based on variant type and location.