CPAMD8 loss-of-function underlies non-dominant congenital glaucoma with variable anterior segment dysgenesis and abnormal extracellular matrix



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Bonet Fernández, Juan Manuel and Aroca Aguilar, José Daniel and Corton Pérez, Marta and Ramírez Sebastián, Ana Isabel and Alexandre Moreno, Susana and García Antón, María Teresa and Salazar Corral, Juan José and Ferre Fernández, Jesús José and Atienzar Aroca, Raquel and Villaverde Montero, Cristina and Iancu, Ionut and Tamayo Durán, Alejandra and Méndez Hernández, Carmen Dora and Morales Fernández, Laura and Rojas López, Blanca and Ayuso García, Carmen and Coca Prados, Miguel and Martínez de la Casa, José María and García Feijoo, Julián and Escribano, Julio (2020) CPAMD8 loss-of-function underlies non-dominant congenital glaucoma with variable anterior segment dysgenesis and abnormal extracellular matrix. Human Genetics . ISSN 0340-6717

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Abnormal development of the ocular anterior segment may lead to a spectrum of clinical phenotypes ranging from primary congenital glaucoma (PCG) to variable anterior segment dysgenesis (ASD). The main objective of this study was to identify the genetic alterations underlying recessive congenital glaucoma with ASD (CG-ASD). Next-generation DNA sequencing identified rare biallelic CPAMD8 variants in four patients with CG-ASD and in one case with PCG. CPAMD8 is a gene of unknown function and recently associated with ASD. Bioinformatic and in vitro functional evaluation of the variants using quantitative reverse transcription PCR and minigene analysis supported a loss-of-function pathogenic mechanism. Optical and electron microscopy of the trabeculectomy specimen from one of the CG-ASD cases revealed an abnormal anterior chamber angle, with altered extracellular matrix, and apoptotic trabecular meshwork cells. The CPAMD8 protein was immunodetected in adult human ocular fluids and anterior segment tissues involved in glaucoma and ASD (i.e., aqueous humor, non-pigmented ciliary epithelium, and iris muscles), as well as in periocular mesenchyme-like cells of zebrafish embryos. CRISPR/Cas9 disruption of this gene in F0 zebrafish embryos (96 hpf) resulted in varying degrees of gross developmental abnormalities, including microphthalmia, pharyngeal maldevelopment, and pericardial and periocular edemas. Optical and electron microscopy examination of these embryos showed iridocorneal angle hypoplasia (characterized by altered iris stroma cells, reduced anterior chamber, and collagen disorganized corneal stroma extracellular matrix), recapitulating some patients’ features. Our data support the notion that CPAMD8 loss-of-function underlies a spectrum of recessive CG-ASD phenotypes associated with extracellular matrix disorganization and provide new insights into the normal and disease roles of this gene.

Item Type:Article
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Received: 27 Januaury 2020; Accepted: 03 April 2020; Published: 09 April 2020

Uncontrolled Keywords:CPAMD8; Genetics; Congenital glaucoma; Ocular anterior segment; Extracellular matrix
Subjects:Medical sciences > Medicine > Medical genetics
Medical sciences > Medicine > Ophtalmology
Medical sciences > Optics > Eyes anatomy
Medical sciences > Optics > Imaging systems
ID Code:60052
Deposited On:26 Apr 2020 16:48
Last Modified:27 Apr 2021 16:11

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