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Three unrelated probands from targeted exon-enriched sequencing exhibited biallelic B9D1 variants including a nonsense c.391C>T (p.Gln131Ter), a missense c.181C>T (p.Arg61Trp), and a splice-donor c.341+2T>C with exon 4 deletion (PMID:21493627). A fourth prenatal case carried homozygous c.151T>C (p.Ser51Pro) (PMID:40565534). Affected fetuses uniformly showed occipital encephalocele, polycystic kidney dysplasia, postaxial polydactyly, and hepatic fibrosis consistent with autosomal recessive inheritance.
Functional assays demonstrate markedly reduced ciliogenesis in patient fibroblasts (PMID:21493627), and B9d1⁻/⁻ mice recapitulate key MKS features including polydactyly and kidney cysts with disrupted Hedgehog signaling (PMID:21763481). These combined genetic and experimental data support a Limited clinical validity classification for B9D1 in Meckel syndrome. Key take-home: inclusion of B9D1 in MKS diagnostic panels enhances prenatal diagnosis and genetic counseling.
Gene–Disease AssociationLimited4 unrelated probands with biallelic B9D1 variants in MKS context Genetic EvidenceLimitedFour probands with biallelic LoF and rare missense variants in B9D1 under autosomal recessive inheritance ([PMID:21493627], [PMID:40565534]) Functional EvidenceModeratePatient cell immunofluorescence and B9d1 knockout mouse models demonstrate compromised ciliogenesis and recapitulate MKS phenotypes ([PMID:21493627], [PMID:21763481]) |