️ Episode 182: Genotypic, Functional, and Phenotypic Characterization in CTNNB1 Neurodevelopmental Syndrome

In this episode of PaperCast Base by Base, we explore a large cross-sectional cohort study that integrates genetics, cellular functional assays, and deep phenotyping to map the landscape of CTNNB1 neurodevelopmental syndrome. The authors analyze variant types across 127 individuals from 20 countries, probe Wnt/β-catenin signaling consequences in vitro, and connect genotypes to clinical trajectories and everyday function.

Study Highlights:
The cohort revealed 88 distinct CTNNB1 variants with a strong enrichment for predicted loss-of-function changes, and functional luciferase assays confirmed reduced Wnt/β-catenin pathway activity for most variants. A subset of truncating variants showed dominant-negative behavior, while a rare missense change (G575R) behaved as a gain-of-function with increased protein stability and signaling. Systematic clinical assessments documented frequent motor impairment, hypotonia, dysmorphic features, visual issues such as strabismus, and developmental delays including later independent walking. Missense variants tended to associate with comparatively milder phenotypes, with earlier walking and better communication, social, and feeding skills than frameshift, nonsense, splice, or deletion variants.

Conclusion:
By combining genomic curation, mechanistic assays, and standardized clinical measures, this study refines the natural history of CTNNB1 syndrome and highlights therapeutic avenues that may upregulate CTNNB1 expression while cautioning about variant-specific effects.

Reference:
Zakelj N, Gosar D, Miroševič Š, Sanders SJ, Ljungdahl A, Kohani S, Huang S, Leong LI, An Y, Teo MJ, Moultrie F, Jerala R, Lainšek D, Forstnerič V, Sušjan P, Lisowski L, Perez-Iturralde A, Orazem Mrak J, Chan HYE, Osredkar D. Genotypic, functional, and phenotypic characterization in CTNNB1 neurodevelopmental syndrome. Human Genetics and Genomics Advances. 2025;6:100483. https://doi.org/10.1016/j.xhgg.2025.100483

License:
This episode is based on an open-access article published under the Creative Commons Attribution 4.0 International License (CC BY 4.0) – https://creativecommons.org/licenses/by/4.0/

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