Aims Uveal melanoma (UM) is the most common malignant tumour of the eye. Diagnosis often occurs late in the course of disease, and prognosis is generally poor. Recently, recurrent somatic mutations were described, unravelling additional specific altered pathways in UM. Targeted next-generation sequencing (NGS) can now be applied to an accurate and fast identification of somatic mutations in cancer. The aim of the present study was to characterise the mutation pattern of five UM hepatic metastases with well-defined clinical and pathological features. Methods We analysed the UM mutation spectrum using targeted NGS on 409 cancer genes. Results Four previous reported genes were found to be recurrently mutated. All tumours presented mutually exclusive GNA11 or GNAQ missense mutations. BAP1 loss-of-function mutations were found in three UMs. SF3B1 missense mutations were found in the two UMs with no BAP1 mutations. We then searched for additional mutation targets. We identified the Arg505Cys mutation in the tumour suppressor FBXW7. The same mutation was previously described in different cancer types, and FBXW7 was recently reported to be mutated in UM exomes. Conclusions Further studies are required to confirm FBXW7 implication in UM tumorigenesis. Elucidating the molecular mechanisms underlying UM tumorigenesis holds the promise for novel and effective targeted UM therapies.

Wagner disease is a rare nonsyndromic autosomal-dominant vitreoretinopathy, associated with splice mutations specifically targeting VCAN exon 8. We report the extensive genetic analysis of two Wagner probands, previously found negative for disease-associated splice mutations. Next-generation sequencing (NGS), quantitative real-time PCR, and long-range PCR identified two deletions (3.4 and 10.5 kb) removing at least one exon–intron boundary of exon 8, and both correlating with an imbalance of VCAN mRNA isoforms. We showed that the 10.5-kb deletion occurred de novo, causing somatic mosaicism in the proband's mother who had an unusually mild asymmetrical phenotype. Therefore, exon 8 deletions are novel VCAN genetic defects responsible for Wagner disease, and VCAN mosaic mutations may be involved in the pathogenesis of Wagner disease with attenuated phenotype. NGS is then an effective screening tool for genetic diagnosis of Wagner disease, improving the chance of identifying all disease-causative variants as well as mosaic mutations in VCAN.

Neurofibromatosis type 1 (NF1) is an autosomal dominant disease with complete penetrance but high variable expressivity. NF1 is caused by loss-of-function mutations in the NF1 gene, a negative regulator of the RAS-MAPK pathway. The NF1 gene has one of the highest mutation rates in human disorders, which may explain the outbreak of independent de novo variants in the same family. Here, we report the co-occurrence of pathogenic variants in the NF1 and SPRED1 genes in six families with NF1 and Legius syndrome, using next-generation sequencing. In five of these families, we observed the co-occurrence of two independent NF1 variants. All NF1 variants were classified as pathogenic, according to the American College of Medical Genetics and Genomics and the Association for Molecular Pathology (ACMG-AMP) guidelines. In the sixth family, one sibling inherited a complete deletion of the NF1 gene from her mother and carried a variant of unknown significance in the SPRED1 gene. This variant was also present in her brother, who was diagnosed with Legius syndrome, a differential diagnosis of NF1. This work illustrates the complexity of molecular diagnosis in a not-so-rare genetic disease.

To report the clinical and molecular findings of a kindred with Wagner syndrome (WS) revealed by intraocular inflammatory features. Eight available family members underwent complete ophthalmologic examination, including laser flare cell meter measurements. Collagen, type II, alpha 1, versican (VCAN), frizzled family receptor 4, low density lipoprotein receptor-related protein 5, tetraspanin 12, and Norrie disease (pseudoglioma) genes were screened with direct sequencing. The index case was initially referred for unexplained severe and chronic postoperative bilateral uveitis following a standard cataract surgery procedure. Clinical examination of the proband revealed an optically empty vitreous with avascular vitreous strands and veils, features highly suggestive of WS. The systematic familial ophthalmologic examination identified three additional unsuspected affected family members who also presented with the WS phenotype, including uveitis for one of them. We identified a novel c.4004–6T>A nucleotide substitution at the acceptor splice site of intron 7 of the VCAN gene that segregated with the disease phenotype. We present a family with WS with typical WS features and intraocular inflammatory manifestations associated with a novel splice site VCAN mutation. Beyond the structural role in the retinal-vitreous architecture, versican is also emerging as a pivotal mediator of the inflammatory response, supporting uveitis predisposition as a clinical manifestation of WS.

Les vitréorétinopathies (VRPs) héréditaires constituent un groupe de maladies cécitantes englobant des formes exsudatives résultant d’un arrêt développemental de la vascularisation rétinienne, et des formes dégénératives associant des anomalies du vitré, de la vascularisation rétinienne et une dégénérescence choriorétinienne. L’analyse par séquençage haut-débit d’une cohorte de 182 patients-VRPs nous a permis d’élargir le spectre des anomalies moléculaires de ces pathologies et d’identifier pour la première fois des délétions hétérozygotes de l’exon 8 du gène VCAN dans la maladie de Wagner, une vitréorétinopathie autosomique dominante très sévère, non syndromique. VCAN code pour la versicane, qui joue un rôle prépondérant dans l’angiogenèse, la migration/prolifération/adhésion/différenciation cellulaire. Tous ces rôles sont sous la dépendance de quatre isoformes, produites par épissage alternatif des exons 7/8, et dont le rapport quantitatif est déséquilibré chez les patients atteints de la maladie de Wagner. Afin de mieux comprendre ces mécanismes, nous avons généré une délétion d’environ 10-kb incluant l’exon 8 de Vcan chez la souris grâce à la technologie Crispr/Cas9. Les analyses moléculaires de ces souris VcanΔ8, indiquent que le déséquilibre quantitatif d’expression des isoformes de la versicane dans les tissus oculaires est similaire à celui retrouvé à partir des fibroblastes des patients Wagner. L’exploration phénotypique ophtalmologique indique que les souris souris VcanΔ8 présentent dès 3 mois une altération de l’ERG similaire à celle observée chez les patients Wagner. Nous avons pu réaliser une analyse du transcriptome oculaire des souris VcanΔ8 par RNA-Seq dont les résultats indiquent des différences d'expression du gène Rp1l1, jouant un rôle au niveau du cil connecteur des photorécepteurs, et de gènes majeurs impliqués dans des voies de signalisation contrôlant l'inflammation choriorétinienne. Ces différentes pistes sont pertinentes pour expliquer en partie les processus physiopathogéniques de la maladie de Wagner. Nous avons également réalisé une étude d'expression des différents isoformes de la versicane au cours du développement oculaire à partir des souris sauvages et transgéniques. Le modèle murin VcanΔ8 offre, pour la première fois, un modèle oculaire qui semble reproduire le modèle humain de la maladie de Wagner. Par conséquent, il offre des perspectives prometteuses vers une meilleure compréhension des mécanismes physiopathologiques de la maladie de Wagner. Mais au-delà de la maladie de Wagner, ce modèle pourrait avoir des retombées dans d'autres processus pathologiques. En effet, la versicane est une glycoaminoglycane à chondroïtine sulfate qui suscite une attention toute particulière dans le domaine de la cancérogénèse car c'est une molécule qui semble fortement moduler le phénotype du microenvironnement de nombreuses tumeurs à pronostic défavorable.