Mutations in REEP6 Cause Autosomal-Recessive Retinitis Pigmentosa

  • Am J Hum Genet. 2016 Dec 1;99(6):1305-1315. doi: 10.1016/j.ajhg.2016.10.008.
Gavin Arno  1 ,  Smriti A Agrawal  2 ,  Aiden Eblimit  2 ,  James Bellingham  3 ,  Mingchu Xu  2 ,  Feng Wang  2 ,  Christina Chakarova  3 ,  David A Parfitt  3 ,  Amelia Lane  3 ,  Thomas Burgoyne  3 ,  Sarah Hull  1 ,  Keren J Carss  4 ,  Alessia Fiorentino  3 ,  Matthew J Hayes  3 ,  Peter M Munro  3 ,  Ralph Nicols  5 ,  Nikolas Pontikos  3 ,  Graham E Holder  1 ,  UKIRDC ,  Chinwe Asomugha  6 ,  F Lucy Raymond  7 ,  Anthony T Moore  8 ,  Vincent Plagnol  9 ,  Michel Michaelides  1 ,  Alison J Hardcastle  3 ,  Yumei Li  2 ,  Catherine Cukras  10 ,  Andrew R Webster  1 ,  Michael E Cheetham  11 ,  Rui Chen  12
Affiliations
  • 1. UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK; Moorfields Eye Hospital, London EC1V 2PD, UK.
  • 2. Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030-3411, USA; Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030-3411, USA.
  • 3. UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK.
  • 4. NIHR BioResource - Rare Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Department of Haematology, University of Cambridge, NHS Blood and Transplant Centre, Cambridge CB2 0PT, UK.
  • 5. Department of Ophthalmology, Baylor College of Medicine, Houston, TX 77030-3411, USA.
  • 6. Department of Molecular Physiology and Biophysics, Baylor College of Medicine, Houston, TX 77030-3411, USA.
  • 7. NIHR BioResource - Rare Diseases, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, Cambridge CB2 0QQ, UK; Department of Medical Genetics, Cambridge Institute for Medical Research, University of Cambridge, Cambridge CB2 0XY, UK.
  • 8. UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK; Moorfields Eye Hospital, London EC1V 2PD, UK; Ophthalmology Department, UCSF School of Medicine, Koret Vision Center, San Francisco, CA 94133-0644, USA.
  • 9. UCL Genetics Institute, University College London, London WC1E 6BT, UK.
  • 10. National Eye Institute, NIH, Bethesda, MD 20892, USA.
  • 11. UCL Institute of Ophthalmology, 11-43 Bath Street, London EC1V 9EL, UK. Electronic address: [email protected].
  • 12. Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030-3411, USA; Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX 77030-3411, USA. Electronic address: [email protected].
Abstract

Retinitis pigmentosa (RP) is the most frequent form of inherited retinal dystrophy. RP is genetically heterogeneous and the genes identified to date encode proteins involved in a wide range of functional pathways, including photoreceptor development, phototransduction, the retinoid cycle, cilia, and outer segment development. Here we report the identification of biallelic mutations in Receptor Expression Enhancer Protein 6 (REEP6) in seven individuals with autosomal-recessive RP from five unrelated families. REEP6 is a member of the REEP/Yop1 family of proteins that influence the structure of the endoplasmic reticulum but is relatively unstudied. The six variants identified include three frameshift variants, two missense variants, and a genomic rearrangement that disrupts exon 1. Human 3D Organoid optic cups were used to investigate REEP6 expression and confirmed the expression of a retina-specific isoform REEP6.1, which is specifically affected by one of the frameshift mutations. Expression of the two missense variants (c.383C>T [p.Pro128Leu] and c.404T>C [p.Leu135Pro]) and the REEP6.1 frameshift mutant in cultured cells suggest that these changes destabilize the protein. Furthermore, CRISPR-Cas9-mediated Gene Editing was used to produce Reep6 knock-in mice with the p.Leu135Pro RP-associated variant identified in one RP-affected individual. The homozygous knock-in mice mimic the clinical phenotypes of RP, including progressive photoreceptor degeneration and dysfunction of the rod photoreceptors. Therefore, our study implicates REEP6 in retinal homeostasis and highlights a pathway previously uncharacterized in retinal dystrophy.