Biallelic Variants in TMEM17 Cause Meckel-Gruber Syndrome Within the Ciliopathy Spectrum

Luba M Pardo1, Javier Martini1, Emir Zonic1

  • 1CENTOGENE GmbH, Rostock, Germany.

Clinical Genetics
|October 7, 2025
PubMed

Insights

Biallelic variants in TMEM17 cause severe Meckel-Gruber syndrome (MGS) and other primary ciliopathies. This study upgrades the TMEM17 gene-disease association, expanding the known phenotype spectrum and suggesting genotype-phenotype correlations.

Area of Science:

  • Genetics
  • Molecular Biology
  • Developmental Biology

Background:

  • TMEM17 is crucial for ciliary function, with prior reports linking homozygous variants to Joubert and Oral-Facial-Digital syndromes.
  • The role of TMEM17 variants in other primary ciliopathies, particularly severe forms, requires further investigation.

Purpose of the Study:

  • To determine if biallelic TMEM17 variants contribute to primary ciliopathies.
  • To evaluate the gene-disease relationship (GDR) for TMEM17 based on ClinGen recommendations.

Main Methods:

  • Queried a Biodatabank to identify patients with potential TMEM17-related ciliopathies.
  • Evaluated identified cases for novel homozygous TMEM17 variants and associated phenotypes.
  • Assessed the gene-disease relationship using established clinical guidelines.

Main Results:

  • Identified four unrelated families with Meckel-Gruber syndrome (MGS) and novel homozygous TMEM17 variants (c.4del, c.366dup, c.368C>G).
  • A fifth family presented with MGS phenotype in three fetuses, with parents as heterozygote carriers of c.4del.
  • Phenotypes included severe prenatal manifestations like encephalocele, polycystic kidney dysplasia, and polydactyly, leading to early lethality.

Conclusions:

  • Strengthened the TMEM17 gene-disease association from 'limited' to 'moderate'.
  • Expanded the phenotypic spectrum of TMEM17 ciliopathies to include MGS with prenatal onset and early lethality.
  • Loss-of-function TMEM17 variants are implicated in severe ciliopathies, suggesting a genotype-phenotype correlation.

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