Claudin-11, a tight junction protein, is indispensable in the formation of the radial component of myelin. Here, we report de novo stop-loss variants in the gene encoding claudin-11, CLDN11, in three unrelated individuals presenting with an early-onset spastic movement disorder, expressive speech disorder and eye abnormalities including hypermetropia. Brain MRI showed a myelin deficit with a discrepancy between T1-weighted and T2-weighted images and some progress in myelination especially involving the central and peripheral white matter. Exome sequencing identified heterozygous stop-loss variants c.622T>C, p.(*208Glnext*39) in two individuals and c.622T>G, p.(*208Gluext*39) in one individual, all occurring de novo. At the RNA level, the variant c.622T>C did not lead to a loss of expression in fibroblasts, indicating this transcript is not subject to nonsense-mediated decay and most likely translated into an extended protein. Extended claudin-11 is predicted to form an alpha helix not incorporated into the cytoplasmic membrane, possibly perturbing its interaction with intracellular proteins. Our observations suggest that stop-loss variants in CLDN11 expand the genetically heterogeneous spectrum of hypomyelinating leukodystrophies.
GrantsGerman Network for Mitochondrial Disorders (mitoNET) intramural fortune program Deutsche Forschungsgemeinschaft (DFG, German Research foundation) Canadian Institutes of Health Research National Ataxia Foundation Genome British Columbia Genome Canada (ABC4DE Project) Michael Smith Foundation for Health Foundation Research Scholar Award Foundation Metakids salary award Rubicon fellowship from the Netherlands Organization for Scientific Research (NWO and ZONMW) German Bundesministerium fur Bildung und Forschung (BMBF) through the Juniorverbund in der Systemmedizin "mitOmics"