GJB2 Mutation Spectrum and Genotype-Phenotype Correlation in 1067 Han Chinese Subjects with Non-Syndromic Hearing Loss

Mutations in Gap Junction Beta 2 (GJB2) have been reported to be a major cause of non-syndromic hearing loss in many populations worldwide. The spectrums and frequencies of GJB2 variants vary substantially among different ethnic groups, and the genotypes among these populations remain poorly understood. In the present study, we carried out a systematic and extended mutational screening of GJB2 gene in 1067 Han Chinese subjects with non-syndromic hearing loss, and the resultant GJB2 variants were evaluated by phylogenetic, structural and bioinformatic analysis. A total of 25 (23 known and 2 novel) GJB2 variants were identified, including 6 frameshift mutations, 1 nonsense mutation, 16 missense mutations and 2 silent mutations. In this cohort, c.235delC is the most frequently observed pathogenic mutation. The phylogenetic, structural and bioinformatic analysis showed that 2 novel variants c.127G>T (p.V43L), c.293G>C (p.R98P) and 2 known variants c. 107T>C (p.L36P) and c.187G>T (p.V63L) are localized at highly conserved amino acids. In addition, these 4 mutations are absent in 203 healthy individuals, therefore, they are probably the most likely candidate pathogenic mutations. In addition, 66 (24 novel and 42 known) genotypes were identified, including 6 homozygotes, 20 compound heterozygotes, 18 single heterozygotes, 21 genotypes harboring only polymorphism(s) and the wild type genotype. Among these, 153 (14.34%) subjects were homozygous for pathogenic mutations, 63 (5.91%) were compound heterozygotes, and 157 (14.71%) carried single heterozygous mutation. Furthermore, 65.28% (141/216) of these cases with two pathogenic mutations exhibited profound hearing loss. These data suggested that mutations in GJB2 gene are responsible for approximately 34.96% of non-syndromic hearing loss in Han Chinese population from Zhejiang Province in eastern China. In addition, our results also strongly supported the idea that other factors such as alterations in regulatory regions, additional genes, and environmental factors may contribute to the clinical manifestation of deafness.

[1]  J. W. Askew,et al.  Novel mutations in the connexin 26 gene (GJB2) that cause autosomal recessive (DFNB1) hearing loss. , 1998, American journal of human genetics.

[2]  M Bitner-Glindzicz,et al.  Spectrum of GJB2 mutations causing deafness in the British Bangladeshi population , 2008, Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery.

[3]  G. Lucotte,et al.  The 35delG mutation in the connexin 26 gene (GJB2) associated with congenital deafness: European carrier frequencies and evidence for its origin in ancient Greece. , 2005, Genetic testing.

[4]  U. Kim,et al.  Molecular analysis of the GJB2, GJB6 and SLC26A4 genes in Korean deafness patients. , 2008, International journal of pediatric otorhinolaryngology.

[5]  B. Wu,et al.  GJB2 mutation spectrum in 2063 Chinese patients with nonsyndromic hearing impairment , 2009, Journal of Translational Medicine.

[6]  Shuan-Yow Li,et al.  Mutations of Cx26 gene (GJB2) for prelingual deafness in Taiwan , 2002, European Journal of Human Genetics.

[7]  Keehyun Park,et al.  Connexin26 Mutations Associated With Nonsyndromic Hearing Loss , 2000, The Laryngoscope.

[8]  H. Ostrer,et al.  Mutations in the connexin 26 gene (GJB2) among Ashkenazi Jews with nonsyndromic recessive deafness. , 1998, The New England journal of medicine.

[9]  G. Taylor,et al.  Congenital non-syndromal sensorineural hearing impairment due to connexin 26 gene mutations--molecular and audiological findings. , 1999, International journal of pediatric otorhinolaryngology.

[10]  F. Mammano,et al.  Coordinated control of connexin 26 and connexin 30 at the regulatory and functional level in the inner ear , 2008, Proceedings of the National Academy of Sciences.

[11]  B. Papsin,et al.  Ethnicity and mutations in GJB2 (connexin 26) and GJB6 (connexin 30) in a multi-cultural Canadian paediatric Cochlear Implant Program. , 2006, International journal of pediatric otorhinolaryngology.

[12]  D. Chan,et al.  GJB2‐associated hearing loss: Systematic review of worldwide prevalence, genotype, and auditory phenotype , 2014, The Laryngoscope.

[13]  Jing Zheng,et al.  Frequency and spectrum of mitochondrial 12S rRNA variants in 440 Han Chinese hearing impaired pediatric subjects from two otology clinics , 2011, Journal of Translational Medicine.

[14]  S. Leal,et al.  Low prevalence of Connexin 26 (GJB2) variants in Pakistani families with autosomal recessive non‐syndromic hearing impairment , 2004, Clinical genetics.

[15]  Xiao-Hu Xu,et al.  GJB2 gene mutations in newborns with non-syndromic hearing impairment in Northern China , 2004, Hearing Research.

[16]  D. Choo,et al.  Molecular analysis of the mitochondrial 12S rRNA and tRNASer(UCN) genes in paediatric subjects with non-syndromic hearing loss , 2004, Journal of Medical Genetics.

[17]  O. Posukh,et al.  Carrier frequency of GJB2 gene mutations c.35delG, c.235delC and c.167delT among the populations of Eurasia , 2010, Journal of Human Genetics.

[18]  A. Kenneson,et al.  GJB2 (connexin 26) variants and nonsyndromic sensorineural hearing loss: A HuGE review , 2002, Genetics in Medicine.

[19]  L. Lan,et al.  Phenotype-genotype correlation in 295 Chinese deaf subjects with biallelic causative mutations in the GJB2 gene. , 2011, Genetic testing and molecular biomarkers.

[20]  F. Telischi,et al.  The prevalence of connexin 26 (GJB2) mutations in the Chinese population , 2002, Human Genetics.

[21]  W. Park,et al.  Prevalence of p.V37I Variant of GJB2 in Mild or Moderate Hearing Loss in a Pediatric Population and the Interpretation of Its Pathogenicity , 2013, PloS one.

[22]  M. Khullar,et al.  High frequency of heterozygosity in GJB2 mutations among patients with non-syndromic hearing loss , 2008, The Journal of Laryngology & Otology.

[23]  C. Morton,et al.  Newborn hearing screening--a silent revolution. , 2006, The New England journal of medicine.

[24]  Richard J. H. Smith,et al.  Forty-six genes causing nonsyndromic hearing impairment: which ones should be analyzed in DNA diagnostics? , 2009, Mutation research.

[25]  Toshikazu Yamaguchi,et al.  Simultaneous Screening of Multiple Mutations by Invader Assay Improves Molecular Diagnosis of Hereditary Hearing Loss: A Multicenter Study , 2012, PloS one.

[26]  G. Xing,et al.  A systematic review and meta-analysis of 235delC mutation of GJB2 gene , 2012, Journal of Translational Medicine.

[27]  A. Yılmaz Bioinformatic Analysis of GJB2 Gene Missense Mutations , 2014, Cell Biochemistry and Biophysics.

[28]  A. Dror,et al.  Hearing Impairment: A Panoply of Genes and Functions , 2010, Neuron.

[29]  S. Girirajan,et al.  Contribution of connexin26 (GJB2) mutations and founder effect to non-syndromic hearing loss in India , 2003, Journal of medical genetics.

[30]  Chien-Hao Huang,et al.  Mutation spectrum of the connexin 26 (GJB2) gene in Taiwanese patients with prelingual deafness , 2003, Genetics in Medicine.

[31]  N. Blin,et al.  Loss of function mutations of the GJB2 gene detected in patients with DFNB1-associated hearing impairment , 2006, Neurobiology of Disease.

[32]  Hong-Joon Park,et al.  Carrier frequency of GJB2 (connexin-26) mutations causing inherited deafness in the Korean population , 2008, Journal of Human Genetics.

[33]  Y. You,et al.  Comprehensive molecular etiology analysis of nonsyndromic hearing impairment from typical areas in China , 2009, Journal of Translational Medicine.

[34]  Vickie Thomson,et al.  The Colorado newborn hearing screening project, 1992-1999: on the threshold of effective population-based universal newborn hearing screening. , 2002, Pediatrics.

[35]  X. Estivill,et al.  Connexin-26 mutations in sporadic and inherited sensorineural deafness , 1998, The Lancet.

[36]  A. Pandya,et al.  Evidence of a founder effect for the 235delC mutation of GJB2 (connexin 26) in east Asians , 2003, Human Genetics.

[37]  Satoshi Iwasaki,et al.  Clinical features of patients with GJB2 (connexin 26) mutations: severity of hearing loss is correlated with genotypes and protein expression patterns , 2005, Journal of Human Genetics.

[38]  M. Tekin,et al.  GJB2 Mutations in Mongolia: Complex Alleles, Low Frequency, and Reduced Fitness of the Deaf , 2010, Annals of human genetics.

[39]  F. Moreno,et al.  A deletion involving the connexin 30 gene in nonsyndromic hearing impairment. , 2002, The New England journal of medicine.

[40]  K Cryns,et al.  A genotype-phenotype correlation for GJB2 (connexin 26) deafness , 2004, Journal of Medical Genetics.

[41]  S. Nishio,et al.  A large cohort study of GJB2 mutations in Japanese hearing loss patients , 2010, Clinical genetics.

[42]  E. Rappaport,et al.  Homozygosity for the V37I Connexin 26 mutation in three unrelated children with sensorineural hearing loss , 2002, Clinical genetics.