Key result
The R321N mutation attenuated Tinman DNA binding and cofactor interaction in vitro, and resulted in reproducible heart cell patterning defects in adult Drosophila.
Why the study?
Sequencing of human genome samples has unearthed genetic variants requiring functional testing to validate their clinical significance, including variants of unknown significance in NKX2.5.
The human NKX2.5 K158N variant is likely pathogenic due to deficient DNA binding and reduced cofactor interaction, suggesting later developmental or adult-onset cardiac defects.
Answers are grounded in this paper and cite their sources.
May support NKX2.5 K158N pathogenicity; leaves open human validation before clinical reclassification.
Sequencing of human genome samples has unearthed genetic variants for which functional testing is necessary to validate their clinical significance. We used the Drosophila system to analyze a variant of unknown significance in the human congenital heart disease gene NKX2.5 (also known as NKX2-5). We generated an R321N allele of the NKX2.5 ortholog tinman (tin) to model a human K158N variant and tested its function in vitro and in vivo. The R321N Tin isoform bound poorly to DNA in vitro and was deficient in activating a Tin-dependent enhancer in tissue culture. Mutant Tin also showed a significantly reduced interaction with a Drosophila T-box cardiac factor named Dorsocross1. We generated a tinR321N allele using CRISPR/Cas9, for which homozygotes were viable and had normal heart specification, but showed defects in the differentiation of the adult heart that were exacerbated by further loss of tin function. We propose that the human K158N variant is pathogenic through causing a deficiency in DNA binding and a reduced ability to interact with a cardiac co-factor, and that cardiac defects might arise later in development or adult life.
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Lovato et al. (2023) studied Congenital heart disease (NKX2.5 variant of unknown significance). Drosophila tinman (tin) R321N allele (model of human NKX2.5 K158N) vs. Wild-type tinman (tin) was evaluated on Protein function in vitro and heart structure in vivo. The R321N mutation attenuated Tinman DNA binding and cofactor interaction in vitro, and resulted in reproducible heart cell patterning defects in adult Drosophila.
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