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GLI2 – Culler-Jones syndrome

GLI2 heterozygous variants have been identified in patients with Culler-Jones syndrome, also known as postaxial polydactyly–anterior pituitary anomalies–facial dysmorphism syndrome. A novel missense variant c.527A>G (p.Tyr176Cys) was detected in a patient presenting with anosmia [PMID:36936162]. Additionally, a truncating variant c.3493delC (p.Gln1165SerfsTer52) co-segregated with disease in an Italian family [PMID:30629636]. Overall, these represent 2 probands with segregation in 1 family supporting a limited evidence base.

Functional studies demonstrate that the truncating GLI2 mutant exerts a dominant-negative effect on Hedgehog signaling, consistent with loss-of-function pathogenicity [PMID:30629636]. No conflicting evidence has been reported. Although current case numbers are limited, these findings support inclusion of GLI2 sequencing in the diagnostic evaluation of patients with pituitary anomalies and polydactyly. Key take-home: GLI2 heterozygous variants underlie Culler-Jones syndrome and warrant consideration in clinical genetic testing.

References

  • Frontiers in Endocrinology • 2023 • Case report: A case of Culler-Jones syndrome caused by a novel mutation of GLI2 gene and literature review. PMID:36936162
  • PloS one • 2019 • A novel truncating variant of GLI2 associated with Culler-Jones syndrome impairs Hedgehog signalling. PMID:30629636

Evidence Based Scoring (AI generated)

Gene–Disease Association

Limited

2 probands (one novel missense, one truncating variant), segregation in 1 family

Genetic Evidence

Limited

Case-level evidence from 2 unrelated probands with GLI2 variants and co-segregation in one pedigree

Functional Evidence

Moderate

Cell-based assays show dominant-negative impairment of Hedgehog signaling by the truncating GLI2 variant