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Paediatric or syndromic cardiomyopathy v7.37 NEB Achchuthan Shanmugasundram Classified gene: NEB as Red List (low evidence)
Paediatric or syndromic cardiomyopathy v7.37 NEB Achchuthan Shanmugasundram Added comment: Comment on list classification: There is only patient reported in a large cohort study (UK 100,000 genomes project) with unspecified cardiomyopathy and homozygous NEB variant. No further phenotypic information was reported in the publication (PMID:39472908).

All other reported cases did not have confirmed cardiomyopathy (despite some cardiac involvement in a few cases) or had Nemaline myopathy and cardiomyopathy with variants in other genes (e.g. ACTA1).

There is no functional evidence to suggest the association of NEB with cardiomyopathy.

Hence, this gene should be rated red.
Paediatric or syndromic cardiomyopathy v7.37 NEB Achchuthan Shanmugasundram Gene: neb has been classified as Red List (Low Evidence).
Paediatric or syndromic cardiomyopathy v7.36 NEB Achchuthan Shanmugasundram Added comment: Comment on phenotypes: OMIM phenotype accessed on 28 August 2025.
Paediatric or syndromic cardiomyopathy v7.36 NEB Achchuthan Shanmugasundram Phenotypes for gene: NEB were changed from Nemaline myopathy 2, autosomal recessive, OMIM:256030 to Nemaline myopathy 2, autosomal recessive, OMIM:256030
Paediatric or syndromic cardiomyopathy v7.35 NEB Achchuthan Shanmugasundram gene: NEB was added
gene: NEB was added to Paediatric or syndromic cardiomyopathy. Sources: Literature
Mode of inheritance for gene: NEB was set to BIALLELIC, autosomal or pseudoautosomal
Publications for gene: NEB were set to 23650303; 26321576; 28131200; 29070751; 29070751; 39472908
Phenotypes for gene: NEB were set to Nemaline myopathy 2, autosomal recessive, OMIM:256030
Review for gene: NEB was set to RED
Added comment: Biallelic variants in NEB are reported to cause Nemaline myopathy 2 (MIM #256030), which is a skeletal muscle disorder with a wide range of severity and age-of-onset. The most common clinical presentation is early-onset (in infancy or childhood) muscle weakness predominantly affecting proximal limb muscles. The OMIM record (MIM #256030) does not list any cardiac presentations as part of the phenotype.

Cardiac involvement has only been reported in very few cases with NEB-related nemaline myopathy in the literature. However, there is no evidence available to suggest that these patients presented with cardiomyopathy (PMIDs: 28131200 (2016); 29070751 (2017, Article in Japanese); 29070751 (2020).

Although a 9-year-old male patient with nemaline myopathy with dilated cardiomyopathy reported in PMID:23650303 (2013), the patient harboured a novel heterozygous ACTA1 variant, which is causative of the disease.

PMID:39472908 (2024) reported paediatric and adult probands with diverse cardiomyopathies from the UK 100,000 genomes project cohort, of which one male patient with unspecified cardiomyopathy was identified with a homozygous splice donor variant in NEB gene (c.2415+1G>A). However, no further information on patient phenotypes was provided in the patient.

Nebulin is primarily expressed in skeletal muscles and expressed at very low levels in heart. In addition, no cardiac phenotype was reported in NEB knockout mouse models (PMID: 26321576, 2015), suggesting that the any cardiac failure in patients with NEB-related Nemaline myopathy may be secondary to respiratory failure.
Sources: Literature
Paediatric or syndromic cardiomyopathy v0.16 NEBL Ivone Leong reviewed gene: NEBL: Rating: RED; Mode of pathogenicity: ; Publications: ; Phenotypes: ; Mode of inheritance:
Paediatric or syndromic cardiomyopathy v0.15 NEBL Ivone Leong Source NHS GMS was added to NEBL.
Paediatric or syndromic cardiomyopathy v0.1 NEBL Ivone Leong gene: NEBL was added
gene: NEBL was added to Cardiomyopathies - including childhood onset. Sources: Expert Review Red,South West GLH
Mode of inheritance for gene: NEBL was set to MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted