Identification of genetic mechanisms of non-isolated auditory neuropathy with various phenotypes in Chinese families

Abstract Background Non-isolated auditory neuropathy (AN), or syndromic AN, is marked by AN along with additional systemic manifestations. The diagnostic process is challenging due to its varied symptoms and overlap with other syndromes. This study focuses on two mitochondrial function-related genes...

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Main Authors: Yang Cao, Xiaolong Zhang, Lan Lan, Danyang Li, Jin Li, Linyi Xie, Fen Xiong, Lan Yu, Xiaonan Wu, Hongyang Wang, Qiuju Wang
Format: Article
Language:English
Published: BMC 2025-01-01
Series:Orphanet Journal of Rare Diseases
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Online Access:https://doi.org/10.1186/s13023-025-03540-7
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author Yang Cao
Xiaolong Zhang
Lan Lan
Danyang Li
Jin Li
Linyi Xie
Fen Xiong
Lan Yu
Xiaonan Wu
Hongyang Wang
Qiuju Wang
author_facet Yang Cao
Xiaolong Zhang
Lan Lan
Danyang Li
Jin Li
Linyi Xie
Fen Xiong
Lan Yu
Xiaonan Wu
Hongyang Wang
Qiuju Wang
author_sort Yang Cao
collection DOAJ
description Abstract Background Non-isolated auditory neuropathy (AN), or syndromic AN, is marked by AN along with additional systemic manifestations. The diagnostic process is challenging due to its varied symptoms and overlap with other syndromes. This study focuses on two mitochondrial function-related genes which result in non-isolated AN, FDXR and TWNK, providing a summary and enrichment analysis of genes associated with non-isolated AN to elucidate the genotype-phenotype correlation and underlying mechanisms. Methods Seven independent Chinese Han patients with mutations in FDXR and TWNK underwent comprehensive clinical evaluations, genetic testing, and bioinformatics analyses. Diagnostic assessments included auditory brainstem response and distortion product otoacoustic emissions, supplemented by other examinations. Whole exome sequencing and Sanger sequencing validated genetic findings. Pathogenicity was assessed following American College of Medical Genetics and Genomics guidelines. Genes associated with non-isolated AN were summarized from prior reports, and functional enrichment analysis was conducted using Gene Ontology databases. Results A total of 11 variants linked to non-isolated AN were identified in this study, eight of which were novel. Patients’ age of hearing loss onset ranged from 2 to 25 years, averaging 11 years. Hearing loss varied from mild to profound, with 57.1%(4/7) of patients having risk factors and 71.4%(5/7) exhibiting additional systemic symptoms such as muscle weakness, ataxia, and high arches. Functional enrichment analysis revealed that genes associated with non-isolated AN predominantly involve mitochondrial processes, affecting the central and peripheral nervous, musculoskeletal, and visual systems. Conclusion This study identifies novel mutations in FDXR and TWNK that contribute to non-isolated AN through mitochondrial dysfunction. The findings highlight the role of mitochondrial processes in non-isolated AN, suggesting potential relevance as biomarkers for neurodegenerative diseases. Further research is required to explore these mechanisms and potential therapies. Graphical Abstract
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spelling doaj-art-6651eb17d6ca4aada079e9461bee67d42025-08-20T02:36:41ZengBMCOrphanet Journal of Rare Diseases1750-11722025-01-0120111710.1186/s13023-025-03540-7Identification of genetic mechanisms of non-isolated auditory neuropathy with various phenotypes in Chinese familiesYang Cao0Xiaolong Zhang1Lan Lan2Danyang Li3Jin Li4Linyi Xie5Fen Xiong6Lan Yu7Xiaonan Wu8Hongyang Wang9Qiuju Wang10Senior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolSenior Department of Otolaryngology Head and Neck Surgery, The 6th Medical Center of Chinese PLA General Hospital, Chinese PLA Medical SchoolAbstract Background Non-isolated auditory neuropathy (AN), or syndromic AN, is marked by AN along with additional systemic manifestations. The diagnostic process is challenging due to its varied symptoms and overlap with other syndromes. This study focuses on two mitochondrial function-related genes which result in non-isolated AN, FDXR and TWNK, providing a summary and enrichment analysis of genes associated with non-isolated AN to elucidate the genotype-phenotype correlation and underlying mechanisms. Methods Seven independent Chinese Han patients with mutations in FDXR and TWNK underwent comprehensive clinical evaluations, genetic testing, and bioinformatics analyses. Diagnostic assessments included auditory brainstem response and distortion product otoacoustic emissions, supplemented by other examinations. Whole exome sequencing and Sanger sequencing validated genetic findings. Pathogenicity was assessed following American College of Medical Genetics and Genomics guidelines. Genes associated with non-isolated AN were summarized from prior reports, and functional enrichment analysis was conducted using Gene Ontology databases. Results A total of 11 variants linked to non-isolated AN were identified in this study, eight of which were novel. Patients’ age of hearing loss onset ranged from 2 to 25 years, averaging 11 years. Hearing loss varied from mild to profound, with 57.1%(4/7) of patients having risk factors and 71.4%(5/7) exhibiting additional systemic symptoms such as muscle weakness, ataxia, and high arches. Functional enrichment analysis revealed that genes associated with non-isolated AN predominantly involve mitochondrial processes, affecting the central and peripheral nervous, musculoskeletal, and visual systems. Conclusion This study identifies novel mutations in FDXR and TWNK that contribute to non-isolated AN through mitochondrial dysfunction. The findings highlight the role of mitochondrial processes in non-isolated AN, suggesting potential relevance as biomarkers for neurodegenerative diseases. Further research is required to explore these mechanisms and potential therapies. Graphical Abstracthttps://doi.org/10.1186/s13023-025-03540-7Non-isolated auditory neuropathyHereditary deafnessFDXRTWNKSyndrome
spellingShingle Yang Cao
Xiaolong Zhang
Lan Lan
Danyang Li
Jin Li
Linyi Xie
Fen Xiong
Lan Yu
Xiaonan Wu
Hongyang Wang
Qiuju Wang
Identification of genetic mechanisms of non-isolated auditory neuropathy with various phenotypes in Chinese families
Orphanet Journal of Rare Diseases
Non-isolated auditory neuropathy
Hereditary deafness
FDXR
TWNK
Syndrome
title Identification of genetic mechanisms of non-isolated auditory neuropathy with various phenotypes in Chinese families
title_full Identification of genetic mechanisms of non-isolated auditory neuropathy with various phenotypes in Chinese families
title_fullStr Identification of genetic mechanisms of non-isolated auditory neuropathy with various phenotypes in Chinese families
title_full_unstemmed Identification of genetic mechanisms of non-isolated auditory neuropathy with various phenotypes in Chinese families
title_short Identification of genetic mechanisms of non-isolated auditory neuropathy with various phenotypes in Chinese families
title_sort identification of genetic mechanisms of non isolated auditory neuropathy with various phenotypes in chinese families
topic Non-isolated auditory neuropathy
Hereditary deafness
FDXR
TWNK
Syndrome
url https://doi.org/10.1186/s13023-025-03540-7
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