title: Identification of presumed pathogenic KRT3 and KRT12 gene mutations associated with Meesmann corneal dystrophy.
abstract: OBJECTIVE
  To report potentially pathogenic mutations in the keratin 3 (KRT3) and keratin 12 (KRT12) genes in two individuals with clinically diagnosed Meesmann corneal dystrophy (MECD).
  
  
  METHODS
  Slit-lamp examination was performed on the probands and available family members to identify characteristic features of MECD. After informed consent was obtained, saliva samples were obtained as a source of genomic DNA, and screening of KRT3 and KRT12 was performed. Potentially pathogenic variants were screened for in 200 control chromosomes. PolyPhen-2, SIFT, and PANTHER were used to predict the functional impact of identified variants. Short tandem repeat genotyping was performed to confirm paternity.
  
  
  RESULTS
  Slit-lamp examination of the first proband demonstrated bilateral, diffusely distributed, clear epithelial microcysts, consistent with MECD. Screening of KRT3 revealed a heterozygous missense variant in exon 1, c.250C>T (p.(Arg84Trp)), which has a minor allele frequency of 0.0076 and was not identified in 200 control chromosomes. In silico analysis with PolyPhen-2 and PANTHER predicted the variant to be damaging to protein function; however, SIFT analysis predicted tolerance of the variant. The second proband demonstrated bilateral, diffusely distributed epithelial opacities that appeared gray-white on direct illumination and translucent on retroillumination. Neither parent demonstrated corneal opacities. Screening of KRT12 revealed a novel heterozygous insertion/deletion variant in exon 6, c.1288_1293delinsAGCCCT (p.(Arg430_Arg431delinsSerPro)). This variant was not present in either of the proband's parents or in 200 control chromosomes and was predicted to be damaging by PolyPhen-2, PANTHER, and SIFT. Haplotype analysis confirmed paternity of the second proband, indicating that the variant arose de novo.
  
  
  CONCLUSIONS
  We present a novel KRT12 mutation, representing the first de novo mutation and the first indel in KRT12 associated with MECD. In addition, we report a variant of uncertain significance in KRT3 in an individual with MECD. Although the potential pathogenicity of this variant is unknown, it is the first variant affecting the head domain of K3 to be reported in an individual with MECD and suggests that disease-causing variants associated with MECD may not be restricted to primary sequence alterations of either the helix-initiation or helix-termination motifs of K3 and K12.
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Judy L
authors.initials: JL
authors.lastname: Chen
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Benjamin R
authors.initials: BR
authors.lastname: Lin
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Gee
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Jessica A
authors.initials: JA
authors.lastname: Gee
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Duk-Won D
authors.initials: DW
authors.lastname: Chung
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Ricardo F
authors.initials: RF
authors.lastname: Frausto
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Sophie X
authors.initials: SX
authors.lastname: Deng
authors.affiliation: Stein Eye Institute, David Geffen School of Medicine at UCLA, Los Angeles, CA.
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Aldave
mesh_terms: D000595:Amino Acid Sequence; D019943:Amino Acid Substitution; D001483:Base Sequence; D002648:Child; D053559:Corneal Dystrophy, Juvenile Epithelial of Meesmann / Q000235:genetics* / Q000473:pathology; D004252:DNA Mutational Analysis; D005260:Female; D006579:Heterozygote; D006801:Humans; D054643:INDEL Mutation; D053551:Keratin-12 / Q000737:chemistry / Q000235:genetics*; D053558:Keratin-3 / Q000737:chemistry / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D009154:Mutation; D020125:Mutation, Missense; D010375:Pedigree; D020641:Polymorphism, Single Nucleotide
chemical_list: C507494:KRT12 protein, human; C479360:KRT3 protein, human; D053551:Keratin-12; D053558:Keratin-3