Entry - #600105 - RETINITIS PIGMENTOSA 12; RP12 - OMIM
# 600105

RETINITIS PIGMENTOSA 12; RP12


Alternative titles; symbols

RETINITIS PIGMENTOSA WITH OR WITHOUT PARAARTERIOLAR PRESERVATION OF RETINAL PIGMENT EPITHELIUM
RP WITH OR WITHOUT PRESERVED PARAARTERIOLE RETINAL PIGMENT EPITHELIUM
RP WITH OR WITHOUT PPRPE


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
1q31.3 Retinitis pigmentosa-12 600105 AR 3 CRB1 604210
Clinical Synopsis
 
Phenotypic Series
 

INHERITANCE
- Autosomal recessive
HEAD & NECK
Eyes
- Retinitis pigmentosa
- Night blindness (before age 3 years)
- Concentric visual field loss
- Nystagmus
- Attenuation of retinal arterioles
- Bone spicule-type pigment deposits
MISCELLANEOUS
- Childhood onset
MOLECULAR BASIS
- Caused by mutation in the homolog of the Drosophila crumbs 1 gene (CRB1, 604210.0001)
Retinitis pigmentosa - PS268000 - 100 Entries
Location Phenotype Inheritance Phenotype
mapping key
Phenotype
MIM number
Gene/Locus Gene/Locus
MIM number
1p36.11 Retinitis pigmentosa 59 AR 3 613861 DHDDS 608172
1p36.11 ?Congenital disorder of glycosylation, type 1bb AR 3 613861 DHDDS 608172
1p34.1 Retinitis pigmentosa 76 AR 3 617123 POMGNT1 606822
1p31.3 Retinitis pigmentosa 87 with choroidal involvement AD 3 618697 RPE65 180069
1p31.3 Retinitis pigmentosa 20 AR 3 613794 RPE65 180069
1p22.1 Retinitis pigmentosa 19 AR 3 601718 ABCA4 601691
1p13.3 Retinitis pigmentosa 32 AR 3 609913 CLCC1 617539
1q21.2 Retinitis pigmentosa 18 AD 3 601414 PRPF3 607301
1q22 Retinitis pigmentosa 35 AR 3 610282 SEMA4A 607292
1q31.3 Retinitis pigmentosa-12 AR 3 600105 CRB1 604210
1q32.3 ?Retinitis pigmentosa 67 AR 3 615565 NEK2 604043
1q41 Retinitis pigmentosa 39 AR 3 613809 USH2A 608400
2p23.3 Retinitis pigmentosa 75 AR 3 617023 AGBL5 615900
2p23.3 ?Retinitis pigmentosa 58 AR 3 613617 ZNF513 613598
2p23.3 Retinitis pigmentosa 71 AR 3 616394 IFT172 607386
2p23.2 Retinitis pigmentosa 54 AR 3 613428 PCARE 613425
2p15 Retinitis pigmentosa 28 AR 3 606068 FAM161A 613596
2q11.2 Retinitis pigmentosa 33 AD 3 610359 SNRNP200 601664
2q13 Retinitis pigmentosa 38 AR 3 613862 MERTK 604705
2q31.3 Retinitis pigmentosa 26 AR 3 608380 CERKL 608381
2q37.1 Retinitis pigmentosa 96, autosomal dominant AD 3 620228 SAG 181031
2q37.1 Retinitis pigmentosa 47, autosomal recessive AR 3 613758 SAG 181031
3q11.2 Retinitis pigmentosa 55 AR 3 613575 ARL6 608845
3q12.3 Retinitis pigmentosa 56 AR 3 613581 IMPG2 607056
3q22.1 Retinitis pigmentosa 4, autosomal dominant or recessive AD, AR 3 613731 RHO 180380
3q25.1 Retinitis pigmentosa 61 3 614180 CLRN1 606397
3q26.2 Retinitis pigmentosa 68 AR 3 615725 SLC7A14 615720
4p16.3 Retinitis pigmentosa-40 AR 3 613801 PDE6B 180072
4p15.32 Retinitis pigmentosa 93 AR 3 619845 CC2D2A 612013
4p15.32 Retinitis pigmentosa 41 AR 3 612095 PROM1 604365
4p12 Retinitis pigmentosa 49 AR 3 613756 CNGA1 123825
4q32-q34 Retinitis pigmentosa 29 AR 2 612165 RP29 612165
5q32 Retinitis pigmentosa 43 AR 3 613810 PDE6A 180071
6p24.2 Retinitis pigmentosa 62 AR 3 614181 MAK 154235
6p21.31 Retinitis pigmentosa 14 AR 3 600132 TULP1 602280
6p21.1 Retinitis pigmentosa 48 AD 3 613827 GUCA1B 602275
6p21.1 Retinitis pigmentosa 7 and digenic form AD, AR, DD 3 608133 PRPH2 179605
6p21.1 Leber congenital amaurosis 18 AD, AR, DD 3 608133 PRPH2 179605
6q12 Retinitis pigmentosa 25 AR 3 602772 EYS 612424
6q14.1 Retinitis pigmentosa 91 AD 3 153870 IMPG1 602870
6q23 Retinitis pigmentosa 63 AD 2 614494 RP63 614494
7p21.1 ?Retinitis pigmentosa 85 AR 3 618345 AHR 600253
7p15.3 Retinitis pigmentosa 42 AD 3 612943 KLHL7 611119
7p14.3 ?Retinitis pigmentosa 9 AD 3 180104 RP9 607331
7q32.1 Retinitis pigmentosa 10 AD 3 180105 IMPDH1 146690
7q34 Retinitis pigmentosa 86 AR 3 618613 KIAA1549 613344
8p23.1 Retinitis pigmentosa 88 AR 3 618826 RP1L1 608581
8p11.21-p11.1 Retinitis pigmentosa 73 AR 3 616544 HGSNAT 610453
8q11.23-q12.1 Retinitis pigmentosa 1 AD, AR 3 180100 RP1 603937
8q22.1 Cone-rod dystrophy 16 AR 3 614500 CFAP418 614477
8q22.1 Retinitis pigmentosa 64 AR 3 614500 CFAP418 614477
9p21.1 Retinitis pigmentosa 31 AD 3 609923 TOPORS 609507
9q32 Retinitis pigmentosa 70 AD 3 615922 PRPF4 607795
10q11.22 ?Retinitis pigmentosa 66 AR 3 615233 RBP3 180290
10q22.1 Retinitis pigmentosa 92 AR 3 619614 HKDC1 617221
10q22.1 Retinitis pigmentosa 79 AD 3 617460 HK1 142600
10q23.1 Cone-rod dystrophy 15 AR 3 613660 CDHR1 609502
10q23.1 Macular dystrophy, retinal AR 3 613660 CDHR1 609502
10q23.1 Retinitis pigmentosa 65 AR 3 613660 CDHR1 609502
10q23.1 Retinitis pigmentosa 44 3 613769 RGR 600342
10q24.32 Retinitis pigmentosa 83 AD 3 618173 ARL3 604695
11p11.2 Retinitis pigmentosa 72 AR 3 616469 ZNF408 616454
11q12.3 Retinitis pigmentosa, concentric 3 613194 BEST1 607854
11q12.3 Retinitis pigmentosa-50 3 613194 BEST1 607854
11q12.3 Retinitis pigmentosa 7, digenic form AD, AR, DD 3 608133 ROM1 180721
14q11.2-q12 Retinitis pigmentosa 27 AD 3 613750 NRL 162080
14q24.1 Leber congenital amaurosis 13 AD, AR 3 612712 RDH12 608830
14q24.3 ?Retinitis pigmentosa 81 AR 3 617871 IFT43 614068
14q31.3 Retinitis pigmentosa 94, variable age at onset, autosomal recessive AR 3 604232 SPATA7 609868
14q31.3 Leber congenital amaurosis 3 AR 3 604232 SPATA7 609868
14q31.3 ?Retinitis pigmentosa 51 AR 3 613464 TTC8 608132
15q23 Retinitis pigmentosa 37 AD, AR 3 611131 NR2E3 604485
15q25.1 Retinitis pigmentosa 90 AR 3 619007 IDH3A 601149
16p13.3 Retinitis pigmentosa 80 AR 3 617781 IFT140 614620
16p12.3-p12.1 Retinitis pigmentosa 22 2 602594 RP22 602594
16q13 Retinitis pigmentosa 74 AR 3 616562 BBS2 606151
16q13 Retinitis pigmentosa with or without situs inversus AR 3 615434 ARL2BP 615407
16q21 Retinitis pigmentosa 45 AR 3 613767 CNGB1 600724
16q22.2 Retinitis pigmentosa 84 AR 3 618220 DHX38 605584
17p13.3 Retinitis pigmentosa 13 AD 3 600059 PRPF8 607300
17q23.2 Retinitis pigmentosa 17 AD 4 600852 RP17 600852
17q25.1 Retinitis pigmentosa 36 3 610599 PRCD 610598
17q25.3 Retinitis pigmentosa 30 3 607921 FSCN2 607643
17q25.3 Retinitis pigmentosa 57 AR 3 613582 PDE6G 180073
19p13.3 Retinitis pigmentosa 77 AR 3 617304 REEP6 609346
19p13.3 Retinitis pigmentosa 95 AR 3 620102 RAX2 610362
19p13.2 Retinitis pigmentosa 78 AR 3 617433 ARHGEF18 616432
19q13.42 Retinitis pigmentosa 11 AD 3 600138 PRPF31 606419
20p13 Retinitis pigmentosa 46 AR 3 612572 IDH3B 604526
20p11.23 Retinitis pigmentosa 69 AR 3 615780 KIZ 615757
20q11.21 Retinitis pigmentosa 89 AD 3 618955 KIF3B 603754
20q13.33 Retinitis pigmentosa 60 AD 3 613983 PRPF6 613979
Xp22.2 ?Retinitis pigmentosa 23 XLR 3 300424 OFD1 300170
Xp21.3-p21.2 ?Retinitis pigmentosa, X-linked recessive, 6 XL 2 312612 RP6 312612
Xp11.4 Retinitis pigmentosa 3 XL 3 300029 RPGR 312610
Xp11.3 Retinitis pigmentosa 2 XL 3 312600 RP2 300757
Xq26-q27 Retinitis pigmentosa 24 2 300155 RP24 300155
Xq28 Retinitis pigmentosa 34 2 300605 RP34 300605
Chr.Y Retinitis pigmentosa, Y-linked YL 2 400004 RPY 400004
Not Mapped Retinitis pigmentosa AR 268000 RP 268000

TEXT

A number sign (#) is used with this entry because of evidence that retinitis pigmentosa-12 (RP12) is caused by homozygous or compound heterozygous mutations in the CRB1 gene (604210) on chromosome 1q31.

Homozygous or compound heterozygous mutation in CRB1 can also cause a more severe retinal dystrophy, Leber congenital amaurosis (LCA8; see 604210).

For a phenotypic description and a discussion of genetic heterogeneity of retinitis pigmentosa, see 268000.


Clinical Features

Heckenlively (1982) described 5 patients with retinitis pigmentosa of probable autosomal recessive inheritance who showed relative preservation of retinal pigment epithelium adjacent to and under retinal arterioles and hypermetropia (RP patients tend to be myopic). Affected sibs and parental consanguinity were noted.

Bleeker-Wagemakers et al. (1992) reported a consanguineous Dutch family of 90 members from a genetically isolated population in the north of the Netherlands. Affected members (approximately 40) presented with an early-onset form of retinitis pigmentosa, starting with night blindness before the age of 3 years. Nonrecordable electroretinograms (ERGs) and concentric visual field loss in the first decade were followed in most cases by macular involvement and decreased visual acuity before age 15. Visual acuity at age 30 was 0.2 or less. At funduscopy, pigmentary depositions and atrophy of retinal pigment epithelium (RPE) were seen. See also Humphries et al. (1992).

Van den Born et al. (1994) observed clinical heterogeneity within the pedigree reported by Bleeker-Wagemakers et al. (1992). Only some affected members displayed retinitis pigmentosa with characteristic preserved paraarteriolar RPE (PPRPE).

Benayoun et al. (2009) studied a consanguineous family in which 4 of 9 offspring had severe early-onset RP. All patients had nystagmus, and visual acuity, which was poor from early childhood, deteriorated to light perception only by the end of the second decade of life. Both scotopic and photopic ERGs were completely extinct in all affected individuals as early as 4 years of age. Funduscopic findings included typical bone spicule-type pigment deposits, attenuation of the retinal arterioles, and pale appearance of the optic disc.


Mapping

Initially, Van Soest et al. (1994) analyzed all branches of the family reported by Bleeker-Wagemakers et al. (1992) jointly, and found linkage between the marker F13B (134580), located on 1q31-q32.1, and RP12 (as this form of the disorder was symbolized); maximum lod = 4.99 at 8% recombination. Analysis of linkage heterogeneity between 5 branches of the family yielded significant evidence for nonallelic genetic heterogeneity within this family, coinciding with the observed clinical differences. Multipoint analysis, carried out in the branches that showed linkage, favored the following order: 1cen--D1S158--(F13B, RP12)--D1S53--1qter; maximum lod = 9.17. The finding of a single founder allele associated with the disease phenotype supported this localization. The study demonstrated that even in a large family, apparently segregating for a single disease entity, genetic heterogeneity can be detected and resolved successfully.

In the large Dutch pedigree in which RP12 was mapped to 1q by van Soest et al. (1994), van Soest et al. (1996) constructed haplotypes for the target region on 1q and screened for key recombinants in the pedigree. The obligate RP12 region was reduced from 16 cM to 5cM between markers D1S533 and CACNL1A3 (114208). Both the latter gene and phosducin (171490) were excluded as candidate genes.

In 3 affected members of a consanguineous family with early-onset RP, Benayoun et al. (2009) performed genomewide homozygosity mapping but did not find a significant homozygous genomic interval shared by all 3 individuals. Haplotype analysis revealed that all 4 affected individuals shared the same combination of 2 different haplotypes linked to the CRB1 gene on chromosome 1q31.3, a combination that was not found in any of their unaffected sibs. A maximum 2-point lod score of 2.9 (theta = 0.0) was obtained for each of 3 CRB1-linked markers (D1S2757, D1S2840, and D1S413).

Possible Heterogeneity

Leutelt et al. (1995) studied a Pakistani pedigree segregating RP in which there were several consanguineous marriages. Linkage studies demonstrated close linkage between the disease locus and 6 genes on 1q, including F13B. However, analysis of individual nuclear families showed very close linkage without recombination in 3 branches, and several recombinants and negative lod scores throughout the fourth branch. The results were interpreted as indicating that 2 different mutations were segregating in the kindred. Parallel to the linkage heterogeneity, clear phenotypic differences were observed between the 'linked' and 'unlinked' parts of the pedigree. Patients in the linked branches showed RP with preserved paraarterial retinal pigment epithelium. Patients in branch 4, on the other hand, presented with a rather classic type of RP with high myopia.

Bessant et al. (2000) reported linkage analysis in 14 large families with autosomal recessive retinitis pigmentosa. Three of the 14 families showed evidence of linkage to the 1q31-q32.1 locus. Two of these families (18RP and RP112) were of Pakistani origin and 1 (RP23/91) was Spanish. Bessant et al. (2000) screened these families and the Pakistani family studied by Leutelt et al. (1995) for mutations in the RGS16 (602514) gene. No mutations in the coding sequence of the gene were identified. However, a polymorphism in intron 3 was found in homozygous state in all affected members of the family reported by Leutelt et al. (1995). This polymorphism was not found in homozygous state in controls. Bessant et al. (2000) concluded that while the RGS16 gene was less likely to be the cause of some cases of the RP12 phenotype, it could not be excluded.


Inheritance

The transmission pattern of RP12 in the families reported by Den Hollander et al. (1999) was consistent with autosomal recessive inheritance.


Molecular Genetics

Den Hollander et al. (1999) cloned a protein homologous to the protein 'crumbs' (CRB) of Drosophila melanogaster that they denoted CRB1 (crumbs homolog-1; 604210). In 10 unrelated RP12 patients, they identified a homozygous AluY insertion disrupting the open reading frame (604210.0001), 5 homozygous missense mutations, and 4 compound heterozygous mutations in the CRB1 gene (see, e.g., 604210.0002-604210.0005). The similarity to CRB of Drosophila suggested a role for CRB1 in cell-cell interaction and possibly in the maintenance of cell polarity in the retina. The distinct RPE abnormalities observed in RP12 patients suggested that CRB1 mutations trigger a novel mechanism of photoreceptor degeneration.

Den Hollander et al. (2001) identified CRB1 mutations (see, e.g., 604210.0006-604210.0009) in 5 of 9 patients who had RP with Coats-like exudative vasculopathy (see 300216), 1 of whom had PPRPE. Coats-like exudative vasculopathy is a relatively rare complication of RP that may progress to partial or total retinal detachment. Den Hollander et al. (2001) suggested that given that 4 of 5 patients had developed the complication in one eye and that not all sibs with RP had the complication, CRB1 mutations should be considered an important risk factor for the Coats-like reaction, although its development may require additional genetic or environmental factors.

In affected members of a consanguineous family with early-onset retinitis pigmentosa, Benayoun et al. (2009) identified compound heterozygosity for a G1103R mutation (604210.0011) and a 10-bp deletion (604210.0012) in the CRB1 gene. Each mutation had previously been identified in homozygosity in a family diagnosed with Leber congenital amaurosis (LCA8; see 604210).


REFERENCES

  1. Benayoun, L., Spiegel, R., Auslender, N., Abbasi, A. H., Rizel, L., Hujeirat, Y., Salama, I., Garzozi, H. J., Allon-Shalev, S., Ben-Yosef, T. Genetic heterogeneity in two consanguineous families segregating early onset retinal degeneration: the pitfalls of homozygosity mapping. Am. J. Med. Genet. 149A: 650-656, 2009. [PubMed: 19140180, related citations] [Full Text]

  2. Bessant, D. A. R., Payne, A. M., Snow, B. E., Antinolo, G., Mehdi, S. Q., Bird, A. C., Siderovski, D. P., Bhattacharya, S. S. Importance of the autosomal recessive retinitis pigmentosa locus on 1q31-q32.1 (RP12) and mutation analysis of the candidate gene RGS16 (RGS-r). (Letter) J. Med. Genet. 37: 384-387, 2000. [PubMed: 10905894, related citations] [Full Text]

  3. Bleeker-Wagemakers, L. M., Gal, A., Kumar-Singh, R., van den Born, L. I., Li, Y., Schwinger, E., Sandkuijl, L. A., Bergen, A. A. B., Kenna, P., Humphries, P., Farrar, G. J. Evidence for nonallelic genetic heterogeneity in autosomal recessive retinitis pigmentosa. Genomics 14: 811-812, 1992. [PubMed: 1427914, related citations] [Full Text]

  4. den Hollander, A. I., Heckenlively, J. R., van den Born, L. I., de Kok, Y. J. M., van der Velde-Visser, S. D., Kellner, U., Jurklies, B., van Schooneveld, M. J., Blankenagel, A., Rohrschneider, K., Wissinger, B., Cruysberg, J. R. M., Deutman, A. F., Brunner, H. G., Apfelstedt-Sylla, E., Hoyng, C. B., Cremers, F. P. M. Leber congenital amaurosis and retinitis pigmentosa with Coats-like exudative vasculopathy are associated with mutations in the Crumbs homologue 1 (CRB1) gene. Am. J. Hum. Genet. 69: 198-203, 2001. Note: Erratum: Am. J. Hum. Genet. 69: 1160 only, 2001. [PubMed: 11389483, images, related citations] [Full Text]

  5. den Hollander, A. I., ten Brink, J. B., de Kok, Y. J. M., van Soest, S., van den Born, L. I., van Driel, M. A., van de Pol, D. J. R., Payne, A. M., Bhattacharya, S. S., Kellner, U., Hoyng, C. B., Westerveld, A., Brunner, H. G., Bleeker-Wagemakers, E. M., Deutman, A. F., Heckenlively, J. R., Cremers, F. P. M., Bergen, A. A. B. Mutations in a human homologue of Drosophila crumbs cause retinitis pigmentosa (RP12). Nature Genet. 23: 217-221, 1999. [PubMed: 10508521, related citations] [Full Text]

  6. Heckenlively, J. R. Preserved para-arteriole retinal pigment epithelium (PPRPE) in retinitis pigmentosa. Brit. J. Ophthal. 66: 26-30, 1982. [PubMed: 7055539, related citations] [Full Text]

  7. Humphries, P., Kenna, P., Farrar, G. J. On the molecular genetics of retinitis pigmentosa. Science 256: 804-808, 1992. [PubMed: 1589761, related citations] [Full Text]

  8. Leutelt, J., Oehlmann, R., Younus, F., van den Born, L. I., Weber, J. L., Denton, M. J., Mehdi, S. Q., Gal, A. Autosomal recessive retinitis pigmentosa locus maps on chromosome 1q in a large consanguineous family from Pakistan. Clin. Genet. 47: 122-124, 1995. [PubMed: 7634534, related citations] [Full Text]

  9. van den Born, L. I., van Soest, S., van Schooneveld, M. J., Riemslag, F. C., de Jong, P. T., Bleeker-Wagemakers, E. M. Autosomal recessive retinitis pigmentosa with preserved para-arteriolar retinal pigment epithelium. Am. J. Ophthal. 118: 430-439, 1994. [PubMed: 7943119, related citations] [Full Text]

  10. van Soest, S., te Nijenhuis, S., van den Born, L. I., Bleeker-Wagemakers, E. M., Sharp, E., Sandkuijl, L. A., Westerveld, A., Bergen, A. A. B. Fine mapping of the autosomal recessive retinitis pigmentosa locus (RP12) on chromosome 1q; exclusion of the phosducin gene (PDC). Cytogenet. Cell Genet. 73: 81-85, 1996. [PubMed: 8646891, related citations] [Full Text]

  11. van Soest, S., van den Born, L. I., Gal, A., Farrar, G. J., Bleeker-Wagemakers, L. M., Westerveld, A., Humphries, P., Sandkuijl, L. A., Bergen, A. A. B. Assignment of a gene for autosomal recessive retinitis pigmentosa (RP12) to chromosome 1q31-q32.1 in an inbred and genetically heterogeneous disease population. Genomics 22: 499-504, 1994. [PubMed: 8001962, related citations] [Full Text]


Marla J. F. O'Neill - updated : 10/18/2010
Anne M. Stumpf - updated : 2/9/2009
Ada Hamosh - updated : 9/21/2001
Michael J. Wright - updated : 7/20/2001
Victor A. McKusick - updated : 9/29/1999
Alan F. Scott - updated : 6/8/1995
Creation Date:
Victor A. McKusick : 9/12/1994
carol : 01/04/2024
carol : 05/06/2022
carol : 11/29/2018
carol : 11/28/2018
carol : 08/21/2012
carol : 3/31/2011
carol : 10/18/2010
alopez : 2/18/2009
alopez : 2/9/2009
wwang : 10/4/2007
carol : 9/13/2006
alopez : 9/21/2001
terry : 9/21/2001
alopez : 7/27/2001
terry : 7/20/2001
alopez : 9/30/1999
terry : 9/29/1999
dkim : 7/7/1998
jamie : 1/17/1997
mark : 9/29/1996
joanna : 9/17/1996
marlene : 8/15/1996
joanna : 12/8/1995
mimadm : 9/23/1995
carol : 9/12/1994

# 600105

RETINITIS PIGMENTOSA 12; RP12


Alternative titles; symbols

RETINITIS PIGMENTOSA WITH OR WITHOUT PARAARTERIOLAR PRESERVATION OF RETINAL PIGMENT EPITHELIUM
RP WITH OR WITHOUT PRESERVED PARAARTERIOLE RETINAL PIGMENT EPITHELIUM
RP WITH OR WITHOUT PPRPE


ORPHA: 791;   DO: 0110358;  


Phenotype-Gene Relationships

Location Phenotype Phenotype
MIM number
Inheritance Phenotype
mapping key
Gene/Locus Gene/Locus
MIM number
1q31.3 Retinitis pigmentosa-12 600105 Autosomal recessive 3 CRB1 604210

TEXT

A number sign (#) is used with this entry because of evidence that retinitis pigmentosa-12 (RP12) is caused by homozygous or compound heterozygous mutations in the CRB1 gene (604210) on chromosome 1q31.

Homozygous or compound heterozygous mutation in CRB1 can also cause a more severe retinal dystrophy, Leber congenital amaurosis (LCA8; see 604210).

For a phenotypic description and a discussion of genetic heterogeneity of retinitis pigmentosa, see 268000.


Clinical Features

Heckenlively (1982) described 5 patients with retinitis pigmentosa of probable autosomal recessive inheritance who showed relative preservation of retinal pigment epithelium adjacent to and under retinal arterioles and hypermetropia (RP patients tend to be myopic). Affected sibs and parental consanguinity were noted.

Bleeker-Wagemakers et al. (1992) reported a consanguineous Dutch family of 90 members from a genetically isolated population in the north of the Netherlands. Affected members (approximately 40) presented with an early-onset form of retinitis pigmentosa, starting with night blindness before the age of 3 years. Nonrecordable electroretinograms (ERGs) and concentric visual field loss in the first decade were followed in most cases by macular involvement and decreased visual acuity before age 15. Visual acuity at age 30 was 0.2 or less. At funduscopy, pigmentary depositions and atrophy of retinal pigment epithelium (RPE) were seen. See also Humphries et al. (1992).

Van den Born et al. (1994) observed clinical heterogeneity within the pedigree reported by Bleeker-Wagemakers et al. (1992). Only some affected members displayed retinitis pigmentosa with characteristic preserved paraarteriolar RPE (PPRPE).

Benayoun et al. (2009) studied a consanguineous family in which 4 of 9 offspring had severe early-onset RP. All patients had nystagmus, and visual acuity, which was poor from early childhood, deteriorated to light perception only by the end of the second decade of life. Both scotopic and photopic ERGs were completely extinct in all affected individuals as early as 4 years of age. Funduscopic findings included typical bone spicule-type pigment deposits, attenuation of the retinal arterioles, and pale appearance of the optic disc.


Mapping

Initially, Van Soest et al. (1994) analyzed all branches of the family reported by Bleeker-Wagemakers et al. (1992) jointly, and found linkage between the marker F13B (134580), located on 1q31-q32.1, and RP12 (as this form of the disorder was symbolized); maximum lod = 4.99 at 8% recombination. Analysis of linkage heterogeneity between 5 branches of the family yielded significant evidence for nonallelic genetic heterogeneity within this family, coinciding with the observed clinical differences. Multipoint analysis, carried out in the branches that showed linkage, favored the following order: 1cen--D1S158--(F13B, RP12)--D1S53--1qter; maximum lod = 9.17. The finding of a single founder allele associated with the disease phenotype supported this localization. The study demonstrated that even in a large family, apparently segregating for a single disease entity, genetic heterogeneity can be detected and resolved successfully.

In the large Dutch pedigree in which RP12 was mapped to 1q by van Soest et al. (1994), van Soest et al. (1996) constructed haplotypes for the target region on 1q and screened for key recombinants in the pedigree. The obligate RP12 region was reduced from 16 cM to 5cM between markers D1S533 and CACNL1A3 (114208). Both the latter gene and phosducin (171490) were excluded as candidate genes.

In 3 affected members of a consanguineous family with early-onset RP, Benayoun et al. (2009) performed genomewide homozygosity mapping but did not find a significant homozygous genomic interval shared by all 3 individuals. Haplotype analysis revealed that all 4 affected individuals shared the same combination of 2 different haplotypes linked to the CRB1 gene on chromosome 1q31.3, a combination that was not found in any of their unaffected sibs. A maximum 2-point lod score of 2.9 (theta = 0.0) was obtained for each of 3 CRB1-linked markers (D1S2757, D1S2840, and D1S413).

Possible Heterogeneity

Leutelt et al. (1995) studied a Pakistani pedigree segregating RP in which there were several consanguineous marriages. Linkage studies demonstrated close linkage between the disease locus and 6 genes on 1q, including F13B. However, analysis of individual nuclear families showed very close linkage without recombination in 3 branches, and several recombinants and negative lod scores throughout the fourth branch. The results were interpreted as indicating that 2 different mutations were segregating in the kindred. Parallel to the linkage heterogeneity, clear phenotypic differences were observed between the 'linked' and 'unlinked' parts of the pedigree. Patients in the linked branches showed RP with preserved paraarterial retinal pigment epithelium. Patients in branch 4, on the other hand, presented with a rather classic type of RP with high myopia.

Bessant et al. (2000) reported linkage analysis in 14 large families with autosomal recessive retinitis pigmentosa. Three of the 14 families showed evidence of linkage to the 1q31-q32.1 locus. Two of these families (18RP and RP112) were of Pakistani origin and 1 (RP23/91) was Spanish. Bessant et al. (2000) screened these families and the Pakistani family studied by Leutelt et al. (1995) for mutations in the RGS16 (602514) gene. No mutations in the coding sequence of the gene were identified. However, a polymorphism in intron 3 was found in homozygous state in all affected members of the family reported by Leutelt et al. (1995). This polymorphism was not found in homozygous state in controls. Bessant et al. (2000) concluded that while the RGS16 gene was less likely to be the cause of some cases of the RP12 phenotype, it could not be excluded.


Inheritance

The transmission pattern of RP12 in the families reported by Den Hollander et al. (1999) was consistent with autosomal recessive inheritance.


Molecular Genetics

Den Hollander et al. (1999) cloned a protein homologous to the protein 'crumbs' (CRB) of Drosophila melanogaster that they denoted CRB1 (crumbs homolog-1; 604210). In 10 unrelated RP12 patients, they identified a homozygous AluY insertion disrupting the open reading frame (604210.0001), 5 homozygous missense mutations, and 4 compound heterozygous mutations in the CRB1 gene (see, e.g., 604210.0002-604210.0005). The similarity to CRB of Drosophila suggested a role for CRB1 in cell-cell interaction and possibly in the maintenance of cell polarity in the retina. The distinct RPE abnormalities observed in RP12 patients suggested that CRB1 mutations trigger a novel mechanism of photoreceptor degeneration.

Den Hollander et al. (2001) identified CRB1 mutations (see, e.g., 604210.0006-604210.0009) in 5 of 9 patients who had RP with Coats-like exudative vasculopathy (see 300216), 1 of whom had PPRPE. Coats-like exudative vasculopathy is a relatively rare complication of RP that may progress to partial or total retinal detachment. Den Hollander et al. (2001) suggested that given that 4 of 5 patients had developed the complication in one eye and that not all sibs with RP had the complication, CRB1 mutations should be considered an important risk factor for the Coats-like reaction, although its development may require additional genetic or environmental factors.

In affected members of a consanguineous family with early-onset retinitis pigmentosa, Benayoun et al. (2009) identified compound heterozygosity for a G1103R mutation (604210.0011) and a 10-bp deletion (604210.0012) in the CRB1 gene. Each mutation had previously been identified in homozygosity in a family diagnosed with Leber congenital amaurosis (LCA8; see 604210).


REFERENCES

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Contributors:
Marla J. F. O'Neill - updated : 10/18/2010
Anne M. Stumpf - updated : 2/9/2009
Ada Hamosh - updated : 9/21/2001
Michael J. Wright - updated : 7/20/2001
Victor A. McKusick - updated : 9/29/1999
Alan F. Scott - updated : 6/8/1995

Creation Date:
Victor A. McKusick : 9/12/1994

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