PPP2R1A neurodevelopmental disorder is associated with congenital heart defects. Issue 11 (15th August 2022)

• Record Type: Journal Article
• Authors: Baker, Elizabeth K.; Solivio, Beulah; Pode‐Shakked, Ben; Cross, Laura Ann; Sullivan, Bonnie; Raas‐Rothschild, Annick; Chorin, Odelia; Barel, Ortal; Bar‐Yosef, Omer; Husami, Ammar; Hopkin, Robert J.; Prada, Carlos E.; Stottmann, Rolf W.; Weaver, Kathryn Nicole
• Is Part Of: American journal of medical genetics. Volume 188:Issue 11(2022)
• Page Start: 3262
• Page End: 3277
• Publication Date: 2022-08-15
• Subjects: congenital heart defects -- neurodevelopmental disorder -- PPP2R1A -- protein phosphatase 2A; Medical genetics -- Periodicals; 616.14205
• DOI: 10.1002/ajmg.a.62946
• Languages: English
• ISSNs: 1552-4825

Abstract

Abstract: Protein phosphatase 2A (PP2A) is a heterotrimeric serine/threonine phosphatase that regulates numerous biological processes. PPP2R1A encodes the scaffolding "Aα" subunit of PP2A. To date, nearly 40 patients have been previously reported with 19 different pathogenic PPP2R1A variants, with phenotypes including intellectual disability, developmental delay, epilepsy, infant agenesis/dysgenesis of the corpus callosum, and dysmorphic features. Apart from a single case, severe congenital heart defects (CHD) have not been described. We report four new unrelated individuals with pathogenic heterozygous PPP2R1A variants and CHD and model the crystal structure of several variants to investigate mechanisms of phenotype disparity. Individuals 1 and 2 have a previously described variant (c.548G>A, p.R183Q) and similar phenotypes with severe ventriculomegaly, agenesis/dysgenesis of the corpus callosum, and severe CHD. Individual 3 also has a recurrent variant (c.544C>T, p.R182W) and presented with agenesis of corpus callosum, ventriculomegaly, mild pulmonic stenosis, and small patent foramen ovale. Individual 4 has a novel variant (c.536C>A, p.P179H), ventriculomegaly, and atrial septal defect. To conclude, we propose expansion of the phenotype of PPP2R1A neurodevelopmental disorder to include CHD. Further, the R183Q variant has now been described in three individuals, all with severe neurologic abnormalities, severe CHD, and early death suggesting that this variant may be particularly deleterious.