Novel mutation in FOXC1 wing region causing Axenfeld-Rieger anomaly.
OBJECTIVE
To determine the possible molecular genetic defect underlying Axenfeld-Rieger anomaly (ARA) and to identify the pathogenic mutation causing this anterior segment dysgenesis in an Indian pedigree.


METHODS
The FOXC1 gene was amplified from genomic DNA of members of an ARA-affected family and control subjects using four novel sets of primers. The amplicons were directly sequenced, and the sequences were analyzed to identify the disease-causing mutation.


RESULTS
A heterozygous novel missense mutation was identified in the coding region of the FOXC1 gene in all three patients in this family. Consistent with the autosomal dominant inheritance pattern, the mutation segregated with the disease phenotype and was fully penetrant. The mutation was found in the wing region of the highly conserved forkhead domain of the FOXC1 gene and resulted in a very severe phenotype leading to blindness.


CONCLUSIONS
This is the first study to demonstrate that a mutation in the FOXC1 wing region can cause an anterior segment dysgenesis of the eye. This mutation resulted in blindness in the ARA-affected family, and the findings suggest that the FOXC1 wing region has a functional role in the normal development of the eye. Moreover, this is the first study from India to report the genetic etiology of Axenfeld-Rieger anomaly. Genotype-phenotype correlations of FOXC1 may help in establishing the disease prognosis and also in understanding the clinical and genetic heterogeneity associated with various anterior segment dysgenesis caused by this gene.
Panicker
Shirly G
SG
Prof. Brien Holden Eye Research Centre, Hyderabad Eye Research Foundation, L. V. Prasad Eye Institute, India. shirly@lvpeye.stph.net
Sampath
Srirangan
S
Mandal
Anil K
AK
Reddy
Aramati B M
AB
Ahmed
Niyaz
N
Hasnain
Seyed E
SE
D000328:Adult; D000869:Anterior Eye Segment / Q000002:abnormalities* / Q000473:pathology; D001766:Blindness / Q000208:ethnology / Q000235:genetics / Q000473:pathology; D004252:DNA Mutational Analysis; D004268:DNA-Binding Proteins; D005124:Eye Abnormalities / Q000208:ethnology / Q000235:genetics* / Q000473:pathology; D005260:Female; D051858:Forkhead Transcription Factors; D005838:Genotype; D005901:Glaucoma / Q000208:ethnology / Q000235:genetics* / Q000473:pathology; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D007429:Intraocular Pressure; D007498:Iris / Q000002:abnormalities* / Q000473:pathology; D008297:Male; D020125:Mutation, Missense; D010375:Pedigree; D010641:Phenotype; D016133:Polymerase Chain Reaction; D017422:Sequence Analysis, DNA; D014157:Transcription Factors / Q000235:genetics*
D004268:DNA-Binding Proteins; C112743:FOXC1 protein, human; D051858:Forkhead Transcription Factors; D014157:Transcription Factors