Renal Ciliopathies and Nephronophthisis

Gene: ADAMTS9

Amber List (moderate evidence)

ADAMTS9 (ADAM metallopeptidase with thrombospondin type 1 motif 9)
EnsemblGeneIds (GRCh38): ENSG00000163638
EnsemblGeneIds (GRCh37): ENSG00000163638
OMIM: 605421, Gene2Phenotype
ADAMTS9 is in 3 panels

2 reviews

Chirag Patel (Genetic Health Queensland)

I don't know

CLINGEN assessed as LIMITED (2022)

Bi-allelic variants in ADAMTS9 are associated with a nephronophthisis-related ciliopathy disease in humans. This is a recent association, first proposed in 2019 (Choi et al., 2019; PMID: 30609407) and currently does not have an official OMIM disease association. Patients in this study shared common phenotypes including proteinuria, end stage renal disease, gross morphological defects in the kidneys and extra-renal features including deafness, and short stature. In contrast, another study (PMID: 34750010) describes bi-allelic variants in ADAMTS9 being associated with Joubert syndrome-like presentation (complete with the neurological and ocular features) without the renal manifestations.

In total, three unrelated individuals harboring bi-allelic variants (missense as well as loss of function) in ADAMTS9 have been reported in the literature (consisting of the above two studies) presenting with renal and/or extra-renal symptoms. To date, four unique variants have been described associated with disease and were scored in the curation. However, these variants were not all assigned the default points owing to verified consanguinity, population frequency of the variants in databases such as gnomAD, or in silico predictions indicating the variant’s impact on the protein to be likely benign. Taken together, ADAMTS9 currently has limited genetic case-level data to establish a clear gene-disease relationship.

Functional studies performed with transgenic animal models (reviewed but not scored in the curation) have investigated the role of Adamts9 in development, particularly in the context of the cardiac, cartilage, bone development. However, there are currently no studies that have explored the role of this gene in the renal system. The first study linking ADAMTS9 to disease (PMID: 30609407) performed functional studies using patient-derived fibroblasts. These studies demonstrated that patient fibroblasts have reduced primary cilia, suggesting a role for ADAMTS9 in cilia formation. Further lines of evidence in mouse epithelial cells indicate a dysfunction in signaling pathways, such as Shh signaling, and impaired spheroid formation. However, these phenotypes have not been directly implicated in the human disease and such findings have also not been demonstrated in a relevant cell line of human origin, although it should be noted that overexpression of human ADAMTS9 was demonstrated to rescue spheroid formation, strongly suggesting a direct involvement of the protein in this process. In addition, a study (PMID: 30814516) has explored the role of Adamts9 in ciliary trafficking using mice models, but the genetic background of this model is not consistent with the human disease context. Therefore, in keeping with the gene curation SOP guidelines, this evidence has been either only reviewed or scored with reduced points. Default points were given to the morpholino-mediated knockdown of Adamts9 in zebrafish that caused curved body axis, hydrocephalus, and pronephric cysts (PMID: 30609407).

In summary, due to the limited genetic evidence as well as the absence of renal-specific experimental evidence, the causal relationship between the bi-allelic variants in ADAMTS9 and its associated disease ciliopathy cannot be unequivocally determined at this time. Therefore, this gene-disease relationship, based on our scoring of currently available information has been determined as limited.
Created: 25 Nov 2022, 1:36 a.m. | Last Modified: 25 Nov 2022, 1:36 a.m.
Panel Version: 1.14

Alison Yeung (Victorian Clinical Genetics Services)

Green List (high evidence)

Two families reported with functional evidence
Sources: Literature
Created: 16 Jan 2020, 11:09 p.m.

Mode of inheritance
BIALLELIC, autosomal or pseudoautosomal

Phenotypes
Nephronophthisis-Related Ciliopathy

Publications

Variants in this GENE are reported as part of current diagnostic practice

Details

Mode of Inheritance
BIALLELIC, autosomal or pseudoautosomal
Sources
  • Expert Review Amber
  • Literature
Phenotypes
  • Nephropathy-related ciliopathy, MONDO:0022409, ADAMTS9-related
OMIM
605421
Clinvar variants
Variants in ADAMTS9
Penetrance
unknown
Publications
Panels with this gene

History Filter Activity

27 Nov 2022, Gel status: 2

Set Phenotypes

Zornitza Stark (Victorian Clinical Genetics Services; Australian Genomics)

Phenotypes for gene: ADAMTS9 were changed from Nephronophthisis-Related Ciliopathy to Nephropathy-related ciliopathy, MONDO:0022409, ADAMTS9-related

25 Nov 2022, Gel status: 2

Entity classified by Genomics England curator

Chirag Patel (Genetic Health Queensland)

Gene: adamts9 has been classified as Amber List (Moderate Evidence).

16 Jan 2020, Gel status: 3

Entity classified by Genomics England curator

Zornitza Stark (Victorian Clinical Genetics Services; Australian Genomics)

Gene: adamts9 has been classified as Green List (High Evidence).

16 Jan 2020, Gel status: 3

Entity classified by Genomics England curator

Alison Yeung (Victorian Clinical Genetics Services)

Gene: adamts9 has been classified as Green List (High Evidence).

16 Jan 2020, Gel status: 1

Created, Added New Source, Set mode of inheritance, Set publications, Set Phenotypes, Set penetrance

Alison Yeung (Victorian Clinical Genetics Services)

gene: ADAMTS9 was added gene: ADAMTS9 was added to Renal Ciliopathies and Nephronophthisis. Sources: Literature Mode of inheritance for gene: ADAMTS9 was set to BIALLELIC, autosomal or pseudoautosomal Publications for gene: ADAMTS9 were set to PMID:30609407 Phenotypes for gene: ADAMTS9 were set to Nephronophthisis-Related Ciliopathy Penetrance for gene: ADAMTS9 were set to unknown Review for gene: ADAMTS9 was set to GREEN gene: ADAMTS9 was marked as current diagnostic