@article{ZahnleiterUebeEkicietal.2013,
  author    = {Zahnleiter, Diana and Uebe, Steffen and Ekici, Arif B. and Hoyer, Juliane and Wiesener, Antje and Wieczorek, Dagmar and Kunstmann, Erdmute and Reis, Andr{\´e} and Doerr, Helmuth-Guenther and Rauch, Anita and Thiel, Christian T.},
  title     = {Rare Copy Number Variants Are a Common Cause of Short Stature},
  series = {PLoS Genetics},
  volume    = {9},
  journal   = {PLoS Genetics},
  number    = {3},
  issn      = {1553-7404},
  doi       = {10.1371/journal.pgen.1003365},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-127645},
  pages     = {e1003365},
  year      = {2013},
  abstract  = {Human growth has an estimated heritability of about 80\%-90\%. Nevertheless, the underlying cause of shortness of stature remains unknown in the majority of individuals. Genome-wide association studies (GWAS) showed that both common single nucleotide polymorphisms and copy number variants (CNVs) contribute to height variation under a polygenic model, although explaining only a small fraction of overall genetic variability in the general population. Under the hypothesis that severe forms of growth retardation might also be caused by major gene effects, we searched for rare CNVs in 200 families, 92 sporadic and 108 familial, with idiopathic short stature compared to 820 control individuals. Although similar in number, patients had overall significantly larger CNVs \((p-value <1 x 10^{-7})\). In a gene-based analysis of all non-polymorphic CNVs >50 kb for gene function, tissue expression, and murine knock-out phenotypes, we identified 10 duplications and 10 deletions ranging in size from 109 kb to 14 Mb, of which 7 were de novo (p < 0.03) and 13 inherited from the likewise affected parent but absent in controls. Patients with these likely disease causing 20 CNVs were smaller than the remaining group (p < 0.01). Eleven (55\%) of these CNVs either overlapped with known microaberration syndromes associated with short stature or contained GWAS loci for height. Haploinsufficiency (HI) score and further expression profiling suggested dosage sensitivity of major growth-related genes at these loci. Overall 10\% of patients carried a disease-causing CNV indicating that, like in neurodevelopmental disorders, rare CNVs are a frequent cause of severe growth retardation.},
  language  = {en}
}
@article{HauerPoppTaheretal.2019,
  author    = {Hauer, Nadine N. and Popp, Bernt and Taher, Leila and Vogl, Carina and Dhandapany, Perundurai S. and B{\"u}ttner, Christian and Uebe, Steffen and Sticht, Heinrich and Ferrazzi, Fulvia and Ekici, Arif B. and De Luca, Alessandro and Klinger, Patrizia and Kraus, Cornelia and Zweier, Christiane and Wiesener, Antje and Abou Jamra, Rami and Kunstmann, Erdmute and Rauch, Anita and Wieczorek, Dagmar and Jung, Anna-Marie and Rohrer, Tilman R. and Zenker, Martin and Doerr, Helmuth-Guenther and Reis, Andr{\´e} and Thiel, Christian T.},
  title     = {Evolutionary conserved networks of human height identify multiple Mendelian causes of short stature},
  series = {European Journal of Human Genetics},
  volume    = {27},
  journal   = {European Journal of Human Genetics},
  doi       = {10.1038/s41431-019-0362-0},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227899},
  pages     = {1061-1071},
  year      = {2019},
  abstract  = {Height is a heritable and highly heterogeneous trait. Short stature affects 3\% of the population and in most cases is genetic in origin. After excluding known causes, 67\% of affected individuals remain without diagnosis. To identify novel candidate genes for short stature, we performed exome sequencing in 254 unrelated families with short stature of unknown cause and identified variants in 63 candidate genes in 92 (36\%) independent families. Based on systematic characterization of variants and functional analysis including expression in chondrocytes, we classified 13 genes as strong candidates. Whereas variants in at least two families were detected for all 13 candidates, two genes had variants in 6 (UBR4) and 8 (LAMA5) families, respectively. To facilitate their characterization, we established a clustered network of 1025 known growth and short stature genes, which yielded 29 significantly enriched clusters, including skeletal system development, appendage development, metabolic processes, and ciliopathy. Eleven of the candidate genes mapped to 21 of these clusters, including CPZ, EDEM3, FBRS, IFT81, KCND1, PLXNA3, RASA3, SLC7A8, UBR4, USP45, and ZFHX3. Fifty additional growth-related candidates we identified await confirmation in other affected families. Our study identifies Mendelian forms of growth retardation as an important component of idiopathic short stature.},
  language  = {en}
}
@article{HauerPoppSchoelleretal.2018,
  author    = {Hauer, Nadine N. and Popp, Bernt and Schoeller, Eva and Schuhmann, Sarah and Heath, Karen E. and Hisado-Oliva, Alfonso and Klinger, Patricia and Kraus, Cornelia and Trautmann, Udo and Zenker, Martin and Zweier, Christiane and Wiesener, Antje and Jamra, Rami Abou and Kunstmann, Erdmute and Wieczorek, Dagmar and Uebe, Steffen and Ferrazzi, Fulvia and B{\"u}ttner, Christian and Ekici, Arif B. and Rauch, Anita and Sticht, Heinrich and D{\"o}rr, Helmuth-G{\"u}nther and Reis, Andr{\´e} and Thiel, Christian T.},
  title     = {Clinical relevance of systematic phenotyping and exome sequencing in patients with short stature},
  series = {Genetics in Medicine},
  volume    = {20},
  journal   = {Genetics in Medicine},
  doi       = {10.1038/gim.2017.159},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-227888},
  pages     = {630-638},
  year      = {2018},
  abstract  = {Purpose Short stature is a common condition of great concern to patients and their families. Mostly genetic in origin, the underlying cause often remains elusive due to clinical and genetic heterogeneity. Methods We systematically phenotyped 565 patients where common nongenetic causes of short stature were excluded, selected 200 representative patients for whole-exome sequencing, and analyzed the identified variants for pathogenicity and the affected genes regarding their functional relevance for growth. Results By standard targeted diagnostic and phenotype assessment, we identified a known disease cause in only 13.6\% of the 565 patients. Whole-exome sequencing in 200 patients identified additional mutations in known short-stature genes in 16.5\% of these patients who manifested only part of the symptomatology. In 15.5\% of the 200 patients our findings were of significant clinical relevance. Heterozygous carriers of recessive skeletal dysplasia alleles represented 3.5\% of the cases. Conclusion A combined approach of systematic phenotyping, targeted genetic testing, and whole-exome sequencing allows the identification of the underlying cause of short stature in at least 33\% of cases, enabling physicians to improve diagnosis, treatment, and genetic counseling. Exome sequencing significantly increases the diagnostic yield and consequently care in patients with short stature.},
  language  = {en}
}