Skip to main content
American Journal of Human Genetics logoLink to American Journal of Human Genetics
. 1996 Sep;59(3):529–539.

Germ-line mutations in the neurofibromatosis 2 gene: correlations with disease severity and retinal abnormalities.

D M Parry 1, M M MacCollin 1, M I Kaiser-Kupfer 1, K Pulaski 1, H S Nicholson 1, M Bolesta 1, R Eldridge 1, J F Gusella 1
PMCID: PMC1914910  PMID: 8751853

Abstract

Neurofibromatosis 2 (NF2) features bilateral vestibular schwannomas, other benign neural tumors, and cataracts. Patients in some families develop many tumors at an early age and have rapid clinical progression, whereas in other families, patients may not have symptoms until much later and vestibular schwannomas may be the only tumors. The NF2 gene has been cloned from chromosome 22q; most identified germ-line mutations result in a truncated protein and severe NF2. To look for additional mutations and clinical correlations, we used SSCP analysis to screen DNA from 32 unrelated patients. We identified 20 different mutations in 21 patients (66%): 10 nonsense mutations, 2 frameshifts, 7 splice-site mutations, and 1 large in-frame deletion. Clinical information on 47 patients from the 21 families included ages at onset and at diagnosis, numbers of meningiomas, spinal and skin tumors, and presence of cataracts and retinal abnormalities. We compared clinical findings in patients with nonsense or frameshift mutations to those with splice-site mutations. When each patient was considered as an independent random event, the two groups differed (P < or = .05) for nearly every variable. Patients with nonsense or frameshift mutations were younger at onset and at diagnosis and had a higher frequency and mean number of tumors, supporting the correlation between nonsense and frameshift mutations and severe NF2. When each family was considered as an independent random event, statistically significant differences between the two groups were observed only for mean ages at onset and at diagnosis. A larger data set is needed to resolve these discrepancies. We observed retinal hamartomas and/or epiretinal membranes in nine patients from five families with four different nonsense mutations. This finding, which may represent a new genotype-phenotype correlation, merits further study.

Full text

PDF
529

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Allen J. C., Eldridge R., Young D. Early-onset neuroma: genetic, clinical and nosologic aspects. Birth Defects Orig Artic Ser. 1974;10(10):171–184. [PubMed] [Google Scholar]
  2. Anderson M. A., Gusella J. F. Use of cyclosporin A in establishing Epstein-Barr virus-transformed human lymphoblastoid cell lines. In Vitro. 1984 Nov;20(11):856–858. doi: 10.1007/BF02619631. [DOI] [PubMed] [Google Scholar]
  3. Arai E., Ikeuchi T., Nakamura Y. Characterization of the translocation breakpoint on chromosome 22q12.2 in a patient with neurofibromatosis type 2 (NF2). Hum Mol Genet. 1994 Jun;3(6):937–939. doi: 10.1093/hmg/3.6.937. [DOI] [PubMed] [Google Scholar]
  4. Bijlsma E. K., Merel P., Fleury P., van Asperen C. J., Westerveld A., Delattre O., Thomas G., Hulsebos T. J. Family with neurofibromatosis type 2 and autosomal dominant hearing loss: identification of carriers of the mutated NF2 gene. Hum Genet. 1995 Jul;96(1):1–5. doi: 10.1007/BF00214177. [DOI] [PubMed] [Google Scholar]
  5. Bourn D., Carter S. A., Evans D. G., Goodship J., Coakham H., Strachan T. A mutation in the neurofibromatosis type 2 tumor-suppressor gene, giving rise to widely different clinical phenotypes in two unrelated individuals. Am J Hum Genet. 1994 Jul;55(1):69–73. [PMC free article] [PubMed] [Google Scholar]
  6. Bourn D., Carter S. A., Mason S., Gareth D., Evans R., Strachan T. Germline mutations in the neurofibromatosis type 2 tumour suppressor gene. Hum Mol Genet. 1994 May;3(5):813–816. doi: 10.1093/hmg/3.5.813. [DOI] [PubMed] [Google Scholar]
  7. Bouzas E. A., Parry D. M., Eldridge R., Kaiser-Kupfer M. I. Familial occurrence of combined pigment epithelial and retinal hamartomas associated with neurofibromatosis 2. Retina. 1992;12(2):103–107. doi: 10.1097/00006982-199212020-00005. [DOI] [PubMed] [Google Scholar]
  8. Caspari R., Friedl W., Mandl M., Möslein G., Kadmon M., Knapp M., Jacobasch K. H., Ecker K. W., Kreissler-Haag D., Timmermanns G. Familial adenomatous polyposis: mutation at codon 1309 and early onset of colon cancer. Lancet. 1994 Mar 12;343(8898):629–632. doi: 10.1016/s0140-6736(94)92634-4. [DOI] [PubMed] [Google Scholar]
  9. Chen F., Kishida T., Yao M., Hustad T., Glavac D., Dean M., Gnarra J. R., Orcutt M. L., Duh F. M., Glenn G. Germline mutations in the von Hippel-Lindau disease tumor suppressor gene: correlations with phenotype. Hum Mutat. 1995;5(1):66–75. doi: 10.1002/humu.1380050109. [DOI] [PubMed] [Google Scholar]
  10. Cotlier E. Café-au-lait spots of the fundus in neurofibromatosis. Arch Ophthalmol. 1977 Nov;95(11):1990–1992. doi: 10.1001/archopht.1977.04450110084007. [DOI] [PubMed] [Google Scholar]
  11. Davies D. R., Armstrong J. G., Thakker N., Horner K., Guy S. P., Clancy T., Sloan P., Blair V., Dodd C., Warnes T. W. Severe Gardner syndrome in families with mutations restricted to a specific region of the APC gene. Am J Hum Genet. 1995 Nov;57(5):1151–1158. [PMC free article] [PubMed] [Google Scholar]
  12. Evans D. G., Bourn D., Wallace A., Ramsden R. T., Mitchell J. D., Strachan T. Diagnostic issues in a family with late onset type 2 neurofibromatosis. J Med Genet. 1995 Jun;32(6):470–474. doi: 10.1136/jmg.32.6.470. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Evans D. G., Huson S. M., Donnai D., Neary W., Blair V., Newton V., Harris R. A clinical study of type 2 neurofibromatosis. Q J Med. 1992 Aug;84(304):603–618. [PubMed] [Google Scholar]
  14. Evans D. G., Huson S. M., Donnai D., Neary W., Blair V., Teare D., Newton V., Strachan T., Ramsden R., Harris R. A genetic study of type 2 neurofibromatosis in the United Kingdom. I. Prevalence, mutation rate, fitness, and confirmation of maternal transmission effect on severity. J Med Genet. 1992 Dec;29(12):841–846. doi: 10.1136/jmg.29.12.841. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Font R. L., Moura R. A., Shetlar D. J., Martinez J. A., McPherson A. R. Combined hamartoma of sensory retina and retinal pigment epithelium. Retina. 1989;9(4):302–311. doi: 10.1097/00006982-198909040-00011. [DOI] [PubMed] [Google Scholar]
  16. Good W. V., Erodsky M. C., Edwards M. S., Hoyt W. F. Bilateral retinal hamartomas in neurofibromatosis type 2. Br J Ophthalmol. 1991 Mar;75(3):190–190. doi: 10.1136/bjo.75.3.190. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Jacoby L. B., MacCollin M., Louis D. N., Mohney T., Rubio M. P., Pulaski K., Trofatter J. A., Kley N., Seizinger B., Ramesh V. Exon scanning for mutation of the NF2 gene in schwannomas. Hum Mol Genet. 1994 Mar;3(3):413–419. doi: 10.1093/hmg/3.3.413. [DOI] [PubMed] [Google Scholar]
  18. Kaiser-Kupfer M. I., Freidlin V., Datiles M. B., Edwards P. A., Sherman J. L., Parry D., McCain L. M., Eldridge R. The association of posterior capsular lens opacities with bilateral acoustic neuromas in patients with neurofibromatosis type 2. Arch Ophthalmol. 1989 Apr;107(4):541–544. doi: 10.1001/archopht.1989.01070010555030. [DOI] [PubMed] [Google Scholar]
  19. Kanter W. R., Eldridge R., Fabricant R., Allen J. C., Koerber T. Central neurofibromatosis with bilateral acoustic neuroma: genetic, clinical and biochemical distinctions from peripheral neurofibromatosis. Neurology. 1980 Aug;30(8):851–859. doi: 10.1212/wnl.30.8.851. [DOI] [PubMed] [Google Scholar]
  20. Kaye L. D., Rothner A. D., Beauchamp G. R., Meyers S. M., Estes M. L. Ocular findings associated with neurofibromatosis type II. Ophthalmology. 1992 Sep;99(9):1424–1429. doi: 10.1016/s0161-6420(92)31789-0. [DOI] [PubMed] [Google Scholar]
  21. Kilpatrick T. J., Hjorth R. J., Gonzales M. F. A case of neurofibromatosis 2 presenting with a mononeuritis multiplex. J Neurol Neurosurg Psychiatry. 1992 May;55(5):391–393. doi: 10.1136/jnnp.55.5.391. [DOI] [PMC free article] [PubMed] [Google Scholar]
  22. Kluwe L., Mautner V. F. A missense mutation in the NF2 gene results in moderate and mild clinical phenotypes of neurofibromatosis type 2. Hum Genet. 1996 Feb;97(2):224–227. doi: 10.1007/BF02265270. [DOI] [PubMed] [Google Scholar]
  23. Kluwe L., Pulst S. M., Köppen J., Mautner V. F. A 163-bp deletion in the neurofibromatosis 2 (NF2) gene associated with variant phenotypes [corrected]. Hum Genet. 1995 Apr;95(4):443–446. doi: 10.1007/BF00208973. [DOI] [PubMed] [Google Scholar]
  24. Landau K., Dossetor F. M., Hoyt W. F., Muci-Mendoza R. Retinal hamartoma in neurofibromatosis 2. Arch Ophthalmol. 1990 Mar;108(3):328–329. doi: 10.1001/archopht.1990.01070050026011. [DOI] [PubMed] [Google Scholar]
  25. Landau K., Yaşargil G. M. Ocular fundus in neurofibromatosis type 2. Br J Ophthalmol. 1993 Oct;77(10):646–649. doi: 10.1136/bjo.77.10.646. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Lee D. K., Abbott M. L. Familial central nervous system neoplasia. Case report of a family with von Recklinghausen's neurofibromatosis. Arch Neurol. 1969 Feb;20(2):154–160. doi: 10.1001/archneur.1969.00480080054006. [DOI] [PubMed] [Google Scholar]
  27. Lekanne Deprez R. H., Bianchi A. B., Groen N. A., Seizinger B. R., Hagemeijer A., van Drunen E., Bootsma D., Koper J. W., Avezaat C. J., Kley N. Frequent NF2 gene transcript mutations in sporadic meningiomas and vestibular schwannomas. Am J Hum Genet. 1994 Jun;54(6):1022–1029. [PMC free article] [PubMed] [Google Scholar]
  28. MacCollin M., Mohney T., Trofatter J., Wertelecki W., Ramesh V., Gusella J. DNA diagnosis of neurofibromatosis 2. Altered coding sequence of the merlin tumor suppressor in an extended pedigree. JAMA. 1993 Nov 17;270(19):2316–2320. doi: 10.1001/jama.270.19.2316. [DOI] [PubMed] [Google Scholar]
  29. MacCollin M., Ramesh V., Jacoby L. B., Louis D. N., Rubio M. P., Pulaski K., Trofatter J. A., Short M. P., Bove C., Eldridge R. Mutational analysis of patients with neurofibromatosis 2. Am J Hum Genet. 1994 Aug;55(2):314–320. [PMC free article] [PubMed] [Google Scholar]
  30. Martuza R. L., Eldridge R. Neurofibromatosis 2 (bilateral acoustic neurofibromatosis). N Engl J Med. 1988 Mar 17;318(11):684–688. doi: 10.1056/NEJM198803173181106. [DOI] [PubMed] [Google Scholar]
  31. Mori M., Morisaki S., Hazama R., Tsujihata M., Nagataki S., Yonekura M., Moriyama T., Mori K. [A family of von Recklinghausen's neurofibromatosis complicated by mononeuritis multiplex, bilateral acoustic neurinomas, and falx and spinal meningiomas]. No To Shinkei. 1985 Apr;37(4):403–408. [PubMed] [Google Scholar]
  32. Mérel P., Hoang-Xuan K., Sanson M., Bijlsma E., Rouleau G., Laurent-Puig P., Pulst S., Baser M., Lenoir G., Sterkers J. M. Screening for germ-line mutations in the NF2 gene. Genes Chromosomes Cancer. 1995 Feb;12(2):117–127. doi: 10.1002/gcc.2870120206. [DOI] [PubMed] [Google Scholar]
  33. Mérel P., Hoang-Xuan K., Sanson M., Moreau-Aubry A., Bijlsma E. K., Lazaro C., Moisan J. P., Resche F., Nishisho I., Estivill X. Predominant occurrence of somatic mutations of the NF2 gene in meningiomas and schwannomas. Genes Chromosomes Cancer. 1995 Jul;13(3):211–216. doi: 10.1002/gcc.2870130311. [DOI] [PubMed] [Google Scholar]
  34. Narod S. A., Parry D. M., Parboosingh J., Lenoir G. M., Ruttledge M., Fischer G., Eldridge R., Martuza R. L., Frontali M., Haines J. Neurofibromatosis type 2 appears to be a genetically homogeneous disease. Am J Hum Genet. 1992 Sep;51(3):486–496. [PMC free article] [PubMed] [Google Scholar]
  35. Olschwang S., Tiret A., Laurent-Puig P., Muleris M., Parc R., Thomas G. Restriction of ocular fundus lesions to a specific subgroup of APC mutations in adenomatous polyposis coli patients. Cell. 1993 Dec 3;75(5):959–968. doi: 10.1016/0092-8674(93)90539-3. [DOI] [PubMed] [Google Scholar]
  36. Parry D. M., Eldridge R., Kaiser-Kupfer M. I., Bouzas E. A., Pikus A., Patronas N. Neurofibromatosis 2 (NF2): clinical characteristics of 63 affected individuals and clinical evidence for heterogeneity. Am J Med Genet. 1994 Oct 1;52(4):450–461. doi: 10.1002/ajmg.1320520411. [DOI] [PubMed] [Google Scholar]
  37. Parry D. M., Kaiser-Kupfer M. I., Sherman J. L., Pikus A., Eldridge R. Neurofibromatosis 2 (bilateral acoustic or central neurofibromatosis), a treatable cause of deafness. Recommendations for screening and follow-up based on study of one large kindred. Ann N Y Acad Sci. 1991;630:305–307. doi: 10.1111/j.1749-6632.1991.tb19615.x. [DOI] [PubMed] [Google Scholar]
  38. Ragge N. K., Baser M. E., Klein J., Nechiporuk A., Sainz J., Pulst S. M., Riccardi V. M. Ocular abnormalities in neurofibromatosis 2. Am J Ophthalmol. 1995 Nov;120(5):634–641. doi: 10.1016/s0002-9394(14)72210-x. [DOI] [PubMed] [Google Scholar]
  39. Rouleau G. A., Merel P., Lutchman M., Sanson M., Zucman J., Marineau C., Hoang-Xuan K., Demczuk S., Desmaze C., Plougastel B. Alteration in a new gene encoding a putative membrane-organizing protein causes neuro-fibromatosis type 2. Nature. 1993 Jun 10;363(6429):515–521. doi: 10.1038/363515a0. [DOI] [PubMed] [Google Scholar]
  40. Rouleau G. A., Wertelecki W., Haines J. L., Hobbs W. J., Trofatter J. A., Seizinger B. R., Martuza R. L., Superneau D. W., Conneally P. M., Gusella J. F. Genetic linkage of bilateral acoustic neurofibromatosis to a DNA marker on chromosome 22. Nature. 1987 Sep 17;329(6136):246–248. doi: 10.1038/329246a0. [DOI] [PubMed] [Google Scholar]
  41. Ruttledge M. H., Narod S. A., Dumanski J. P., Parry D. M., Eldridge R., Wertelecki W., Parboosingh J., Faucher M. C., Lenoir G. M., Collins V. P. Presymptomatic diagnosis for neurofibromatosis 2 with chromosome 22 markers. Neurology. 1993 Sep;43(9):1753–1760. doi: 10.1212/wnl.43.9.1753. [DOI] [PubMed] [Google Scholar]
  42. Sainz J., Figueroa K., Baser M. E., Mautner V. F., Pulst S. M. High frequency of nonsense mutations in the NF2 gene caused by C to T transitions in five CGA codons. Hum Mol Genet. 1995 Jan;4(1):137–139. doi: 10.1093/hmg/4.1.137. [DOI] [PubMed] [Google Scholar]
  43. Sanson M., Marineau C., Desmaze C., Lutchman M., Ruttledge M., Baron C., Narod S., Delattre O., Lenoir G., Thomas G. Germline deletion in a neurofibromatosis type 2 kindred inactivates the NF2 gene and a candidate meningioma locus. Hum Mol Genet. 1993 Aug;2(8):1215–1220. doi: 10.1093/hmg/2.8.1215. [DOI] [PubMed] [Google Scholar]
  44. Sato N., Funayama N., Nagafuchi A., Yonemura S., Tsukita S., Tsukita S. A gene family consisting of ezrin, radixin and moesin. Its specific localization at actin filament/plasma membrane association sites. J Cell Sci. 1992 Sep;103(Pt 1):131–143. doi: 10.1242/jcs.103.1.131. [DOI] [PubMed] [Google Scholar]
  45. Schachat A. P., Shields J. A., Fine S. L., Sanborn G. E., Weingeist T. A., Valenzuela R. E., Brucker A. J. Combined hamartomas of the retina and retinal pigment epithelium. Ophthalmology. 1984 Dec;91(12):1609–1615. doi: 10.1016/s0161-6420(84)34094-5. [DOI] [PubMed] [Google Scholar]
  46. Sivalingam A., Augsburger J., Perilongo G., Zimmerman R., Barabas G. Combined hamartoma of the retina and retinal pigment epithelium in a patient with neurofibromatosis type 2. J Pediatr Ophthalmol Strabismus. 1991 Nov-Dec;28(6):320–322. doi: 10.3928/0191-3913-19911101-08. [DOI] [PubMed] [Google Scholar]
  47. Thomas P. K., King R. H., Chiang T. R., Scaravilli F., Sharma A. K., Downie A. W. Neurofibromatous neuropathy. Muscle Nerve. 1990 Feb;13(2):93–101. doi: 10.1002/mus.880130202. [DOI] [PubMed] [Google Scholar]
  48. Trofatter J. A., MacCollin M. M., Rutter J. L., Murrell J. R., Duyao M. P., Parry D. M., Eldridge R., Kley N., Menon A. G., Pulaski K. A novel moesin-, ezrin-, radixin-like gene is a candidate for the neurofibromatosis 2 tumor suppressor. Cell. 1993 Mar 12;72(5):791–800. doi: 10.1016/0092-8674(93)90406-g. [DOI] [PubMed] [Google Scholar]
  49. Twist E. C., Ruttledge M. H., Rousseau M., Sanson M., Papi L., Merel P., Delattre O., Thomas G., Rouleau G. A. The neurofibromatosis type 2 gene is inactivated in schwannomas. Hum Mol Genet. 1994 Jan;3(1):147–151. doi: 10.1093/hmg/3.1.147. [DOI] [PubMed] [Google Scholar]
  50. Watson C. J., Gaunt L., Evans G., Patel K., Harris R., Strachan T. A disease-associated germline deletion maps the type 2 neurofibromatosis (NF2) gene between the Ewing sarcoma region and the leukaemia inhibitory factor locus. Hum Mol Genet. 1993 Jun;2(6):701–704. doi: 10.1093/hmg/2.6.701. [DOI] [PubMed] [Google Scholar]
  51. Young D. F., Eldridge R., Gardner W. J. Bilateral acoustic neuroma in a large kindred. JAMA. 1970 Oct 12;214(2):347–353. [PubMed] [Google Scholar]
  52. van Heyningen V. Genetics. One gene--four syndromes. Nature. 1994 Jan 27;367(6461):319–320. doi: 10.1038/367319a0. [DOI] [PubMed] [Google Scholar]

Articles from American Journal of Human Genetics are provided here courtesy of American Society of Human Genetics

RESOURCES