Joubert Syndrome Clinical Trial
Official title:
Assessment of the Prevalence and Mutational Spectrum of Genes AHI1, NPHP1 and CEP290 in Joubert Syndrome and Cerebello-oculo-renal Syndromes
Primary objective:
- assessment of the prevalence of AHI1 mutations in Joubert syndrome and
cerebello-oculo-renal syndromes (JS/CORS)
Secondary objective:
- assessment of the prevalence of CEP290 mutations and NPHP1 homozygous deletions in
JS/CORS
- caracterization of mutational spectrum of AHI1, NPHP1, CEP290 genes in JS/CORS.
- evaluation of genotype-phenotype correlation in JS/CORS.
Design: multicentric Aims of this study: to describe clinical and genetic basis of Joubert
syndrome and cerebello-oculo-renal syndromes.Joubert syndrome (JS) is characterized by
hypotonia, abnormal ocular movements and neonatal breathing dysregulation evolving into
developmental delay, ataxia, oculomotor apraxia with variable mental retardation. The
neuroradiological hallmark of JS is a complex midbrain-hindbrain malformation consisting of
vermis hypoplasia/dysplasia, a deepened interpeduncular fossa, and thickened, elongated and
mal-orientated superior cerebellar peduncles (Molar Tooth Sign, MTS). Other organs could be
involved in JS (kidneys :nephronophthisis or cystic dysplastic kidneys; eyes : Leber
Congenital Amaurosis, retinopathy, colobomas); liver : hepatic fibrosis; others:
polydactyly, tongue hamartomas, situs inversus). Several associated central nervous system
malformations were described : polymicrogyria, hydrocephalus, corpus callosum anomalies and
encephalocele. This pleiotropic involvement identifies a large spectrum of
cerebello-oculo-renal syndromes or JS Related Disorders (JSRD).
Joubert syndrome and cerebello-oculo-renal syndromes (JS/CORS) are autosomal recessive
conditions associated with a high risk of recurrence for further pregnancies (25%). In 2004
mutations in AHI1 gene (Abelson helper integration site gene) were identified in 7-11% JS
but the disease is caracterized by a wide genetic heterogeneity. At least five others genes
are involved in JS/CORS : NPHP1, which homozygous deletions are responsible for a small
percentage of JS (2%) and more recently CEP290 gene which exact mutations prevalence
remained to be evaluated.
Using molecular analysis of those three genes (sequencing of 29 coding exons of AHI1 and 54
exons of CEP290, searching for NPHP1 homozygous deletions by PCR analysis) we project to
study respective prevalence of mutations of those three genes and described associated
phenotypes in 65 JSCORS patients. This work will allowed to described genotype-phenotypes
correlation in JSCORS and to progress in the characterization of the underlying pathogenetic
mechanisms. It will be the first step before identification of novel disease genes.
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Observational Model: Family-Based, Time Perspective: Cross-Sectional
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