Mutation analysis and description of sixteen RSH/Smith-Lemli-Opitz syndrome patients: Polymerase chain reaction-based assays to simplify genotyping

We report the clinical and molecular data of 16 patients with RSH/Smith-Lem li-Opitz syndrome (RSH/SLOS) with varying phenotypic severity, for which we have identified mutations in both alleles. RSH/SLOS is an autosomal recess ive malformation syndrome caused by mutations in the gene encoding the ster ol Delta(7)-reductase. This protein catalyzes the reduction of 7-dehydrocho lesterol to cholesterol in the last step of cholesterol biosynthesis via th e Kandutsch-Russell pathway. In addition to previously reported mutations ( T93M, L109P, G147D, W151X, T154M, R242C, A247V, T289I, IVS8-1G-->C, Y408H, and E448K), we have identified six previously undescribed mutations (321G-- >C, W177R, R242H, Y318N, L341P, and C444Y). We also report rapid polymerase chain reaction (PCR)-based assays developed to detect four of the recurrin g mutations (T93M, W151X, V326L, and R404C) and six other RSH/SLOS mutation s (321G-->C, L109P, T154M, T289I, Y318N, and L341P). The purpose of this ar ticle is to correlate detailed clinical information with molecular data in order to improve our understanding of the genotype-phenotype correlation of RSH/SLOS and to report the development of PCR-based assays that will allow more rapid mutation analysis. Published 2000 Wiley-Liss, Inc.(dagger).