A novel intronic variant in the ASAH1 gene enhances aberrant splicing, causing spinal muscular atrophy with progressive myoclonic epilepsy

Abstract Background Spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME) is a rare autosomal recessive disorder caused by ASAH1 gene variants. Although ASAH1 coding variants cause SMA-PME, the impact of noncoding variants, particularly noncanonical splice-site variants, is less clea...

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Main Authors: Jinli Bai, Ping Li, Hui Jiao, Yuwei Jin, Hong Wang, Qinglin Jiang, Fang Song, Xiaoyin Peng, Yujin Qu
Format: Article
Language:English
Published: BMC 2025-07-01
Series:Italian Journal of Pediatrics
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Online Access:https://doi.org/10.1186/s13052-025-02058-9
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author Jinli Bai
Ping Li
Hui Jiao
Yuwei Jin
Hong Wang
Qinglin Jiang
Fang Song
Xiaoyin Peng
Yujin Qu
author_facet Jinli Bai
Ping Li
Hui Jiao
Yuwei Jin
Hong Wang
Qinglin Jiang
Fang Song
Xiaoyin Peng
Yujin Qu
author_sort Jinli Bai
collection DOAJ
description Abstract Background Spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME) is a rare autosomal recessive disorder caused by ASAH1 gene variants. Although ASAH1 coding variants cause SMA-PME, the impact of noncoding variants, particularly noncanonical splice-site variants, is less clear. Methods Whole-exome sequencing (WES) was performed on the proband, and Sanger sequencing was used to confirm the carrier status of the variants in the core family members. Complementary DNA (cDNA) and minigene splicing assays were performed to validate the splicing effects. Results Two heterozygous ASAH1 variants were identified through WES: c.304dupA (p.Thr102Asnfs*14) and c.264 + 11A > G. Sanger sequencing confirmed that the variants were bi-parentally segregated in trans: c.304dupA was inherited from the father, and c.264 + 11A > G was inherited from the mother. The c.304dupA variant was classified as pathogenic according to the ACMG guidelines. However, the c.264 + 11A > G variant in intron 3 was reported for the first time, and its functional impact has not yet been fully elucidated. Complementary DNA (cDNA) and minigene splicing assays indicated that the c.264 + 11A > G variant generated two transcripts. Approximately 10% of the ASAH1 transcripts from the allele carrying c.264 + 11A > G were full length, whereas the remaining transcripts lacked exon 3. Exon skipping results from aberrant splicing, which potentially leads to a premature termination codon (PTC, p.Tyr59Ter). Conclusion To the best of our knowledge, the c.264 + 11A > G is the first likely pathogenic noncanonical splice-site variant identified in this gene. This drives the pathogenesis of SMA-PME through exon 3 skipping. Our findings provide new insights into the intricate splicing mechanisms of noncanonical splice-site variants, emphasizing the unique role of cDNA analysis and minigene splicing assays in the precise diagnosis and genetic counseling of SMA-PME cases.
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spelling doaj-art-813a6fa206294e5c82bedb4e580268a52025-08-20T03:42:56ZengBMCItalian Journal of Pediatrics1824-72882025-07-0151111010.1186/s13052-025-02058-9A novel intronic variant in the ASAH1 gene enhances aberrant splicing, causing spinal muscular atrophy with progressive myoclonic epilepsyJinli Bai0Ping Li1Hui Jiao2Yuwei Jin3Hong Wang4Qinglin Jiang5Fang Song6Xiaoyin Peng7Yujin Qu8Department of Medical Genetics, Capital Institute of PediatricsDepartment of Medical Genetics, Capital Institute of PediatricsDepartment of Neurology, Capital Center For Children’s Health, Capital Medical UniversityDepartment of Medical Genetics, Capital Institute of PediatricsDepartment of Medical Genetics, Capital Institute of PediatricsDepartment of Medical Genetics, Capital Institute of PediatricsDepartment of Medical Genetics, Capital Institute of PediatricsDepartment of Neurology, Capital Center For Children’s Health, Capital Medical UniversityDepartment of Medical Genetics, Capital Institute of PediatricsAbstract Background Spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME) is a rare autosomal recessive disorder caused by ASAH1 gene variants. Although ASAH1 coding variants cause SMA-PME, the impact of noncoding variants, particularly noncanonical splice-site variants, is less clear. Methods Whole-exome sequencing (WES) was performed on the proband, and Sanger sequencing was used to confirm the carrier status of the variants in the core family members. Complementary DNA (cDNA) and minigene splicing assays were performed to validate the splicing effects. Results Two heterozygous ASAH1 variants were identified through WES: c.304dupA (p.Thr102Asnfs*14) and c.264 + 11A > G. Sanger sequencing confirmed that the variants were bi-parentally segregated in trans: c.304dupA was inherited from the father, and c.264 + 11A > G was inherited from the mother. The c.304dupA variant was classified as pathogenic according to the ACMG guidelines. However, the c.264 + 11A > G variant in intron 3 was reported for the first time, and its functional impact has not yet been fully elucidated. Complementary DNA (cDNA) and minigene splicing assays indicated that the c.264 + 11A > G variant generated two transcripts. Approximately 10% of the ASAH1 transcripts from the allele carrying c.264 + 11A > G were full length, whereas the remaining transcripts lacked exon 3. Exon skipping results from aberrant splicing, which potentially leads to a premature termination codon (PTC, p.Tyr59Ter). Conclusion To the best of our knowledge, the c.264 + 11A > G is the first likely pathogenic noncanonical splice-site variant identified in this gene. This drives the pathogenesis of SMA-PME through exon 3 skipping. Our findings provide new insights into the intricate splicing mechanisms of noncanonical splice-site variants, emphasizing the unique role of cDNA analysis and minigene splicing assays in the precise diagnosis and genetic counseling of SMA-PME cases.https://doi.org/10.1186/s13052-025-02058-9Spinal muscular atrophy with progressive myoclonic epilepsyGenetic diagnosisIntronic variantAberrant splicing
spellingShingle Jinli Bai
Ping Li
Hui Jiao
Yuwei Jin
Hong Wang
Qinglin Jiang
Fang Song
Xiaoyin Peng
Yujin Qu
A novel intronic variant in the ASAH1 gene enhances aberrant splicing, causing spinal muscular atrophy with progressive myoclonic epilepsy
Italian Journal of Pediatrics
Spinal muscular atrophy with progressive myoclonic epilepsy
Genetic diagnosis
Intronic variant
Aberrant splicing
title A novel intronic variant in the ASAH1 gene enhances aberrant splicing, causing spinal muscular atrophy with progressive myoclonic epilepsy
title_full A novel intronic variant in the ASAH1 gene enhances aberrant splicing, causing spinal muscular atrophy with progressive myoclonic epilepsy
title_fullStr A novel intronic variant in the ASAH1 gene enhances aberrant splicing, causing spinal muscular atrophy with progressive myoclonic epilepsy
title_full_unstemmed A novel intronic variant in the ASAH1 gene enhances aberrant splicing, causing spinal muscular atrophy with progressive myoclonic epilepsy
title_short A novel intronic variant in the ASAH1 gene enhances aberrant splicing, causing spinal muscular atrophy with progressive myoclonic epilepsy
title_sort novel intronic variant in the asah1 gene enhances aberrant splicing causing spinal muscular atrophy with progressive myoclonic epilepsy
topic Spinal muscular atrophy with progressive myoclonic epilepsy
Genetic diagnosis
Intronic variant
Aberrant splicing
url https://doi.org/10.1186/s13052-025-02058-9
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