
CLINICAL NEXT GENERATION SEQUENCING REVEALS AN
H3F3A GENE AS A NEW POTENTIAL GENE CANDIDATE
FOR MICROCEPHALY ASSOCIATED WITH SEVERE
DEVELOPMENTAL DELAY, INTELLECTUAL DISABILITY
AND GROWTH RETARDATION Maver A1, Čuturilo G2,3, Ruml Stojanović J3, Peterlin B1,* *Corresponding Author: Professor Borut Peterlin, Clinical Institute of Genomic Medicine, University
Medical Center Ljubljana, Šlajmerjeva 4, 1000 Ljubljana, Slovenia. Tel: +38615401137. E-mail:
borut.peterlin@kclj.si page: 65
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RESULTS
Exome analysis. Initially, we focused the search for
causative variants in the proband to panels of genes, possibly
associated with the clinical condition, including 1607
genes in an expanded developmental delay panel, 611
genes in an undiagnosed metabolic disorders panel and
155 genes in an intellectual disability panel. This initial
search failed to reveal any causative variants.
Subsequently, we performed the search for candidate
de novo and biallelic variants in novel genes. This revealed
the presence of a heterozygous de novo missense variant
in the H3F3A gene (NM_002107.4: c.185T>G) detected
in the proband and absent in the parents. This variant is
predicted to result in a p.(Leu62Arg) amino acid substitution
in the Histone H3 protein.
The identified variant was absent in all populations
of the gnomAD project and was also not detected in our
in-house database of 3000 exomes. Furthermore, we observed
a depletion of the overall rate of missense variants
in the H3F3A gene in the gnomAD database, indicating an
evolutionary constraint against missense variation in this
gene, with only five missense variants in H3F3A observed
in the gnomAD database populations (Z score for missense
variant constraint in gnomAD dataset equaled 3.2).
The identified variant affects a highly conserved
leucine residue at position 62 of the Histone H3 protein
and the GERP rejected substitution score indicated high
conservation rate (GERP RS score 4.97) of the variant
nucleotide position across species. The substitution of the
aliphatic hydrophobic leucine residue with a positively
charged hydrophilic arginine residue affects the polarity
at position 62 and thus predicted to affect the physicochemical
properties of the affected protein domain in the
proximity of the DNA binding site. All the utilized tools
for in silico prediction of the variant’s effect on protein
function predict its damaging effect in consensus, including
MutationTaster, SIFT, Polyphen2, MetaSVM, CADD
and REVEL (Figure 2).
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