Cholestasis
Gene: PEX6
Comment when marking as ready: As discussed in the GMS Gastrohepatology Specialist Test Group webex call 14th Jan 2019: The Specialist Test Group agreed that there is enough evidence to rate this gene green based on unpublished data from patient cohort from USA (2,000 patients at Emory) that this is one of the Zellweger genes with significant prevalence.Created: 28 Jan 2019, 2:15 p.m.
Initial gene list and info collated by Miranda Durkie Sheffield Diagnostic Genetics Service December 2018 on behalf of the GMS Gastrohepatology specialist test group. Gene Symbol submitted: PEX6; Suggested intial gene rating: Green; Evidence for inclusion: none given; Evidence for exclusion: none given; Technical notes (e.g. non-coding/CNV mutations requiring coverage?): none givenCreated: 7 Jan 2019, 4:42 p.m.
For Peroxisome biogenesis disorder 4B (OMIM:614863), Falkenberg et al (PMID: 29220678) has identified Allelic Expression Imbalance (AEI) as a mechanism responsible for the condition. Affected patients (7 unrelated cases) were monoallelic for rs61753230 (c.2578C>T, p.Arg860Trp) and rs144286892 (c.∗442_445 delTAAA), with these variants being on the same chromosome (cis). It would appear that rs144286892 causes the over expression of the allele that it is on, resulting in over expression of rs61753230. The unaffected parents analysed were monoallelic for rs61753230 and biallelic for rs144286892, resulting in overexpression of both rs61753230 and wild type alleles (PMID: 29220678). Experimental evidence revealed that rs61753230 has a dominant-negative effect on the function of the PEX1- PEX6 complex in peroxisomal matrix protein import (PMID: 29220678).Created: 16 Jun 2022, 4:26 p.m. | Last Modified: 16 Jun 2022, 4:26 p.m.
Panel Version: 1.110
Comment on mode of inheritance: biallelic and monoallelic variants reported in Peroxisome biogenesis disorder 4B 614863, but this phenotype is not relevant to this panelCreated: 13 Aug 2018, 2:31 p.m.
Comment on phenotypes: Variants also associated with Peroxisome biogenesis disorder 4B 614863 and Heimler syndrome 2 616617Created: 13 Aug 2018, 2:30 p.m.
Mode of inheritance
BOTH monoallelic and biallelic, autosomal or pseudoautosomal
Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal
Phenotypes
Zellwegers syndrome
Gene: pex6 has been classified as Green List (High Evidence).
Source Other was added to PEX6. Mode of inheritance for gene PEX6 was changed from to BIALLELIC, autosomal or pseudoautosomal Added phenotypes Peroxisome biogenesis disorder 4A (Zellweger) 614862 for gene: PEX6 Publications for gene PEX6 were changed from to 10408779; 8670792; 8940266
Source Expert Review Green was added to PEX6. Rating Changed from Red List (low evidence) to Green List (high evidence)
gene: PEX6 was added gene: PEX6 was added to Cholestasis. Sources: NHS GMS Mode of inheritance for gene: PEX6 was set to