Reverse genotyping: unveiling Alu element insertion as a new cause of Kabuki syndrome using DNA methylation signature

Abstract Kabuki syndrome type 1 (KS1) is a monogenic disorder arising from pathogenic variants within KMT2D and characterized by syndromic neurodevelopmental delay. We report the retrospective identification of a causative AluY insertion within KMT2D in a genetically unsolved individual with typical...

Full description

Saved in:
Bibliographic Details
Main Authors: Quentin Sabbagh, Nathalie Ruiz-Pallares, Cassandra Rastin, Jacques Puechberty, Thomas Guignard, Claire Jeandel, Fanny Merklen, Pascal Pujol, Jennifer Kerkhof, Bekim Sadikovic, Mouna Barat-Houari, David Geneviève
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Clinical Epigenetics
Subjects:
Online Access:https://doi.org/10.1186/s13148-025-01879-z
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850206470393561088
author Quentin Sabbagh
Nathalie Ruiz-Pallares
Cassandra Rastin
Jacques Puechberty
Thomas Guignard
Claire Jeandel
Fanny Merklen
Pascal Pujol
Jennifer Kerkhof
Bekim Sadikovic
Mouna Barat-Houari
David Geneviève
author_facet Quentin Sabbagh
Nathalie Ruiz-Pallares
Cassandra Rastin
Jacques Puechberty
Thomas Guignard
Claire Jeandel
Fanny Merklen
Pascal Pujol
Jennifer Kerkhof
Bekim Sadikovic
Mouna Barat-Houari
David Geneviève
author_sort Quentin Sabbagh
collection DOAJ
description Abstract Kabuki syndrome type 1 (KS1) is a monogenic disorder arising from pathogenic variants within KMT2D and characterized by syndromic neurodevelopmental delay. We report the retrospective identification of a causative AluY insertion within KMT2D in a genetically unsolved individual with typical KS1 features, after identification of a DNA methylation signature. This is the first documentation of Alu insertion as a molecular mechanism responsible for KS1. This study emphasizes the need for reanalyzing inconclusive sequencing data in individuals with gene-specific phenotypes and reinforces episignature as a reliable diagnostic tool when NGS approaches fail to provide conclusive results in individuals with rare diseases.
format Article
id doaj-art-6deddf5dcb9043ceac01c8242013eead
institution OA Journals
issn 1868-7083
language English
publishDate 2025-04-01
publisher BMC
record_format Article
series Clinical Epigenetics
spelling doaj-art-6deddf5dcb9043ceac01c8242013eead2025-08-20T02:10:49ZengBMCClinical Epigenetics1868-70832025-04-011711610.1186/s13148-025-01879-zReverse genotyping: unveiling Alu element insertion as a new cause of Kabuki syndrome using DNA methylation signatureQuentin Sabbagh0Nathalie Ruiz-Pallares1Cassandra Rastin2Jacques Puechberty3Thomas Guignard4Claire Jeandel5Fanny Merklen6Pascal Pujol7Jennifer Kerkhof8Bekim Sadikovic9Mouna Barat-Houari10David Geneviève11Department of Clinical Genetics, Centre de Référence « Anomalies du Développement et Syndromes Malformatifs », University Hospital of Montpellier, Inserm UMR1183, Montpellier UniversityDepartment of Molecular Genetics and Cytogenomics, University Hospital of Montpellier, Montpellier UniversityVerspeeten Clinical Genome Centre, London Health Sciences CentreDepartment of Clinical Genetics, Centre de Référence « Anomalies du Développement et Syndromes Malformatifs », University Hospital of Montpellier, Inserm UMR1183, Montpellier UniversityDepartment of Molecular Genetics and Cytogenomics, University Hospital of Montpellier, Montpellier UniversityDepartment of Paediatric Endocrinology, University Hospital of Montpellier, Montpellier UniversityDepartment of Otorhinolaryngology, University Hospital of Montpellier, Montpellier UniversityFrench Society for Predictive and Personalized Medicine (SFMPP)Verspeeten Clinical Genome Centre, London Health Sciences CentreVerspeeten Clinical Genome Centre, London Health Sciences CentreDepartment of Molecular Genetics and Cytogenomics, University Hospital of Montpellier, Montpellier UniversityDepartment of Clinical Genetics, Centre de Référence « Anomalies du Développement et Syndromes Malformatifs », University Hospital of Montpellier, Inserm UMR1183, Montpellier UniversityAbstract Kabuki syndrome type 1 (KS1) is a monogenic disorder arising from pathogenic variants within KMT2D and characterized by syndromic neurodevelopmental delay. We report the retrospective identification of a causative AluY insertion within KMT2D in a genetically unsolved individual with typical KS1 features, after identification of a DNA methylation signature. This is the first documentation of Alu insertion as a molecular mechanism responsible for KS1. This study emphasizes the need for reanalyzing inconclusive sequencing data in individuals with gene-specific phenotypes and reinforces episignature as a reliable diagnostic tool when NGS approaches fail to provide conclusive results in individuals with rare diseases.https://doi.org/10.1186/s13148-025-01879-zKabuki syndromeKMT2DEpigenetic signatureAlu elementMobile element insertion
spellingShingle Quentin Sabbagh
Nathalie Ruiz-Pallares
Cassandra Rastin
Jacques Puechberty
Thomas Guignard
Claire Jeandel
Fanny Merklen
Pascal Pujol
Jennifer Kerkhof
Bekim Sadikovic
Mouna Barat-Houari
David Geneviève
Reverse genotyping: unveiling Alu element insertion as a new cause of Kabuki syndrome using DNA methylation signature
Clinical Epigenetics
Kabuki syndrome
KMT2D
Epigenetic signature
Alu element
Mobile element insertion
title Reverse genotyping: unveiling Alu element insertion as a new cause of Kabuki syndrome using DNA methylation signature
title_full Reverse genotyping: unveiling Alu element insertion as a new cause of Kabuki syndrome using DNA methylation signature
title_fullStr Reverse genotyping: unveiling Alu element insertion as a new cause of Kabuki syndrome using DNA methylation signature
title_full_unstemmed Reverse genotyping: unveiling Alu element insertion as a new cause of Kabuki syndrome using DNA methylation signature
title_short Reverse genotyping: unveiling Alu element insertion as a new cause of Kabuki syndrome using DNA methylation signature
title_sort reverse genotyping unveiling alu element insertion as a new cause of kabuki syndrome using dna methylation signature
topic Kabuki syndrome
KMT2D
Epigenetic signature
Alu element
Mobile element insertion
url https://doi.org/10.1186/s13148-025-01879-z
work_keys_str_mv AT quentinsabbagh reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT nathalieruizpallares reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT cassandrarastin reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT jacquespuechberty reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT thomasguignard reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT clairejeandel reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT fannymerklen reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT pascalpujol reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT jenniferkerkhof reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT bekimsadikovic reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT mounabarathouari reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature
AT davidgenevieve reversegenotypingunveilingaluelementinsertionasanewcauseofkabukisyndromeusingdnamethylationsignature