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Ocular Developmental Abnormalities and Glaucoma Associated with Interstitial 6p25 Duplications and Deletions

¹ From the Department of Molecular Genetics, Institute of Ophthalmology, London, United Kingdom; the ² Department of Biology, and ⁵ Institute of Child Health, University College, London, United Kingdom; ³ The Sanger Centre, Wellcome Trust Genome Campus, Hinxton Hall, United Kingdom; ⁴ Moorfields Eye Hospital, London, United Kingdom; the ⁶ Eye Unit, Southampton General Hospital, Southampton, United Kingdom; and the ⁷ Departments of Ophthalmology and Medical Genetics, University of Alberta, Edmonton, Alberta, Canada.

PURPOSE. Mutations in the forkhead transcription factor gene FOXC1 on 6p25 cause a range of ocular developmental abnormalities, with associated glaucoma. However, FOXC1 mutations have not been found in all similarly affected pedigrees mapping to this interval. This study was undertaken to investigate the potential role of 6p25 rearrangements in causing such phenotypes.

METHODS. Two large families with autosomal dominant iris hypoplasia and early-onset glaucoma, 21 probands with Axenfeld-Rieger phenotypes not attributable to PITX2 mutations, and 7 individuals with documented 6p25 cytogenetic rearrangements, were investigated by genotyping and fluorescence in situ hybridization, with markers and probes from the 6p25 region.

RESULTS. Interstitial 6p25 duplications were present in the unrelated families with iris hypoplasia, whereas an interstitial 6p25 deletion was identified in one Axenfeld-Rieger pedigree. Larger cytogenetic rearrangements, leading to trisomy or monosomy of the 6p25 region, resulted in microcornea and Rieger syndrome phenotypes, respectively. All the rearrangements encompassed FOXC1, increasing or decreasing the number of FOXC1 copies present, and appeared to correlate with the phenotypes observed.

CONCLUSIONS. These findings represent the first example of both interstitial duplications and deletions cosegregating with a human developmental disorder that is attributable to altered dose of transcription factor. The data presented provide additional evidence for the pathogenicity of altered gene dosage of FOXC1 and suggest that a common mechanism is responsible for rearrangements of 6p25.

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