ABSTRACT
Gap junctions are important structures in cell communication. Mutations in connexins,
the building blocks of gap junctions, are involved in several human disorders including
skin disease, peripheral neuropathy, cataracts, and deafness, the most common of all
sensory deficits. Mutations in five connexin-encoding genes-GJB1, GJB2, GJB3, GJB6, and GJA1-are linked to deafness. GJB2 is of particular importance since mutations in this gene are the most common cause
of congenital autosomal recessive nonsyndromic deafness. The severity of deafness
caused by mutations in GJB2 varies from mild to profound as a function of the type of mutation. Persons who segregate
two mutations of GJB2 that result in no protein product (also known as truncating mutations) are more likely
to have severe-to-profound hearing loss than are persons with one truncating mutation
and one missense mutation (a mutation that results in the generation of an abnormal
protein product). Persons carrying two missense mutations have the mildest degree
of GJB2-related deafness. Understanding these phenotype-genotype relationships and the limitations
of GJB2 mutation screening is of major importance for genetic counseling.
KEYWORDS
Connexins - deafness - DFNB1 - genotype-phenotype - clinical application
REFERENCES
- 1
Bruzzone R.
Connections with connexins: the molecular basis of direct intercellular signaling.
Eur J Biochem.
1996;
238
1-27
- 2
Sohl G, Willecke K.
An update on connexin genes and their nomenclature in mouse and man.
Cell Commun Adhes.
2003;
10
173-180
- 3
Willecke K, Eiberger J, Degen J et al..
Structural and functional diversity of connexin genes in the mouse and human genome.
Biol Chem.
2002;
383
725-737
- 4
Essenfelder G M, Larderet G, Waksman G, Lamartine J.
Gene structure and promoter analysis of the human GJB6 gene encoding connexin 30.
Gene.
2005;
350
33-40
- 5
Anderson C L, Zundel M A, Werner R.
Variable promoter usage and alternative splicing in five mouse connexin genes.
Genomics.
2005;
85
238-244
- 6
Harris A.
Emerging issues of connexin channels: biophysics fills the gap.
Q Rev Biophys.
2001;
34
325-472
, Erratum: Q Rev Biophys 2002;35:109
- 7
Cao F, Eckert R, Elfgang C et al..
A quantitative analysis of connexin-specific permeability differences of gap junctions
expressed in HeLa transfectants and Xenopus oocytes.
J Cell Sci.
1998;
111(Pt 1)
31-43
- 8
Van Laer L, Cryns K, Smith R J, Van Camp G.
Nonsyndromic hearing loss.
Ear Hear.
2003;
24
275-288
- 9
Mehl A L, Thomson V.
The Colorado newborn hearing screening project, 1992-1999: on the threshold of effective
population-based universal newborn hearing screening.
Pediatrics.
2002;
109
E7
- 10 Van Camp G, Smith R JH. Hereditary hearing loss home page. Available at: http://web.host.va.ac.be/hhh/
- 11
Johnstone B M, Patuzzi R, Syka J, Sykova E.
Stimulus-related potassium changes in the organ of Corti of guinea-pig.
J Physiol.
1989;
408
77-92
- 12
Beltramello M, Piazza V, Bukauskas F F, Pozzan T, Mammano F.
Impaired permeability to Ins(1,4,5)P3 in a mutant connexin underlies recessive hereditary
deafness.
Nat Cell Biol.
2005;
7
63-69
- 13
Forge A, Marziano N K, Casalotti S O, Becker D L, Jagger D.
The inner ear contains heteromeric channels composed of CX26 and CX30 and deafness-related
mutations in CX26 have a dominant negative effect on CX30.
Cell Commun Adhes.
2003;
10
341-346
- 14
Cohen-Salmon M, Ott T, Michel V et al..
Targeted ablation of connexin26 in the inner ear epithelial gap junction network causes
hearing impairment and cell death.
Curr Biol.
2002;
12
1106-1111
- 15
Teubner B, Michel V, Pesch J et al..
Connexin30 (Gjb6)-deficiency causes severe hearing impairment and lack of endocochlear
potential.
Hum Mol Genet.
2003;
12
13-21
- 16
Kelsell D P, Dunlop J, Stevens H P et al..
Connexin 26 mutations in hereditary non-syndromic sensorineural deafness.
Nature.
1997;
387
80-83
- 17
Denoyelle F, Marlin S, Weil D et al..
Clinical features of the prevalent form of childhood deafness, DFNB1, due to a connexin-26
gene defect: implications for genetic counselling.
Lancet.
1999;
353
1298-1303
- 18
Green G E, Scott D A, McDonald J M, Woodworth G G, Sheffield V C, Smith R J.
Carrier rates in the midwestern United States for GJB2 mutations causing inherited
deafness.
JAMA.
1999;
281
2211-2216
- 19
Morell R J, Kim H J, Hood L J et al..
Mutations in the connexin 26 gene (GJB2) among Ashkenazi Jews with nonsyndromic recessive
deafness.
N Engl J Med.
1998;
339
1500-1505
- 20
Van Laer L, Coucke P, Mueller R F et al..
A common founder for the 35delG GJB2 gene mutation in connexin 26 hearing impairment.
J Med Genet.
2001;
38
515-518
- 21
Abe S, Usami S, Shinkawa H, Kelley P M, Kimberling W J.
Prevalent connexin 26 gene (GJB2) mutations in Japanese.
J Med Genet.
2000;
37
41-43
- 22
del Castillo I, Villamar M, Moreno-Pelayo M A et al..
A deletion involving the connexin 30 gene in nonsyndromic hearing impairment.
N Engl J Med.
2002;
346
243-249
- 23
Del Castillo I, Moreno-Pelayo M A, Del Castillo F J et al..
Prevalence and evolutionary origins of the del(GJB6-D13S1830) mutation in the DFNB1
locus in hearing-impaired subjects: a multicenter study.
Am J Hum Genet.
2003;
73
1452-1458
- 24
Roux A F, Pallares-Ruiz N, Vielle A et al..
Molecular epidemiology of DFNB1 deafness in France.
BMC Med Genet.
2004;
5
5
- 25
Gualandi E, Ravani A, Berto A et al..
Occurrence of del(GIB6-D13S1830) mutation in Italian non-syndromic hearing loss patients
carrying a single GJB2 mutated allele.
Acta Otolaryngol Suppl.
2004;
29-34
- 26
del Castillo F J, Rodriguez-Ballesteros M, Alvarez A et al..
A novel deletion involving the connexin-30 gene, del(GJB6-d13s1854), found in trans
with mutations in the GJB2 gene (connexin-26) in subjects with DFNB1 non-syndromic
hearing impairment.
J Med Genet.
2005;
42
588-594
- 27
Liu X Z, Xia X J, Xu L R et al..
Mutations in connexin31 underlie recessive as well as dominant non-syndromic hearing
loss.
Hum Mol Genet.
2000;
9
63-67
- 28
Mhatre A N, Weld E, Lalwani A K.
Mutation analysis of Connexin 31 (GJB3) in sporadic non-syndromic hearing impairment.
Clin Genet.
2003;
63
154-159
- 29
Xia J H, Liu C Y, Tang B S et al..
Mutations in the gene encoding gap junction protein beta-3 associated with autosomal
dominant hearing impairment.
Nat Genet.
1998;
20
370-373
- 30
Richard G, Smith L E, Bailey R A et al..
Mutations in the human connexin gene GJB3 cause erythrokeratodermia variabilis.
Nat Genet.
1998;
20
366-369
- 31
Liu X Z, Xia X J, Adams J et al..
Mutations in GJA1 (connexin 43) are associated with non-syndromic autosomal recessive
deafness.
Hum Mol Genet.
2001;
10
2945-2951
- 32
Paznekas W A, Boyadjiev S A, Shapiro R E et al..
Connexin 43 (GJA1) mutations cause the pleiotropic phenotype of oculodentodigital
dysplasia.
Am J Hum Genet.
2003;
72
408-418
- 33
Richard G, White T W, Smith L E et al..
Functional defects of CX26 resulting from a heterozygous missense mutation in a family
with dominant deaf-mutism and palmoplantar keratoderma.
Hum Genet.
1998;
103
393-399
- 34
Uyguner O, Tukel T, Baykal C et al..
The novel R75Q mutation in the GJB2 gene causes autosomal dominant hearing loss and
palmoplantar keratoderma in a Turkish family.
Clin Genet.
2002;
62
306-309
- 35
Denoyelle F, Lina-Granade G, Plauchu H et al..
Connexin 26 gene linked to a dominant deafness.
Nature.
1998;
393
319-320
- 36
Hamelmann C, Amedofu G K, Albrecht K et al..
Pattern of connexin 26 (GJB2) mutations causing sensorineural hearing impairment in
Ghana.
Hum Mutat.
2001;
18
84-85
- 37
Morle L, Bozon M, Alloisio N et al..
A novel C202F mutation in the connexin26 gene (GJB2) associated with autosomal dominant
isolated hearing loss.
J Med Genet.
2000;
37
368-370
- 38
Martin P E, Coleman S L, Casalotti S O, Forge A, Evans W H.
Properties of connexin26 gap junctional proteins derived from mutations associated
with non-syndromal hereditary deafness.
Hum Mol Genet.
1999;
8
2369-2376
- 39
Grifa A, Wagner C A, D'Ambrosio L et al..
Mutations in GJB6 cause nonsyndromic autosomal dominant deafness at DFNA3 locus.
Nat Genet.
1999;
23
16-18
- 40
Azaiez H, Chamberlin G P, Fischer S M et al..
GJB2: the spectrum of deafness-causing allele variants and their phenotype.
Hum Mutat.
2004;
24
305-311
- 41
Cryns K, Orzan E, Murgia A et al..
A genotype-phenotype correlation for GJB2 (connexin 26) deafness.
J Med Genet.
2004;
41
147-154
- 42
Kelley P M, Harris D J, Comer B C et al..
Novel mutations in the connexin 26 gene (GJB2) that cause autosomal recessive (DFNB1)
hearing loss.
Am J Hum Genet.
1998;
62
792-799
- 43
Griffith A J, Chowdhry A A, Kurima K et al..
Autosomal recessive nonsyndromic neurosensory deafness at DFNB1 not associated with
the compound-heterozygous GJB2 (connexin 26) genotype M34T/167delT.
Am J Hum Genet.
2000;
67
745-749
- 44
Feldmann D, Denoyelle F, Loundon N et al..
Clinical evidence of the nonpathogenic nature of the M34T variant in the connexin
26 gene.
Eur J Hum Genet.
2004;
12
279-284
- 45
White T W, Deans M R, Kelsell D P, Paul D L.
Connexin mutations in deafness.
Nature.
1998;
394
630-631
- 46
Cucci R A, Prasad S, Kelley P M et al..
The M34T allele variant of connexin 26.
Genet Test.
2000;
4
335-344
- 47
Bauer P W, Geers A E, Brenner C, Moog J S, Smith R J.
The effect of GJB2 allele variants on performance after cochlear implantation.
Laryngoscope.
2003;
113
2135-2140
Richard J.H SmithM.D.
Department of Otolaryngology
120 Hawkins Drive, Iowa City, Iowa 52240
Email: Richard-smith@uiowa.edu