{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,19]],"date-time":"2023-10-19T04:33:22Z","timestamp":1697690002544},"reference-count":36,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,5,21]],"date-time":"2013-05-21T00:00:00Z","timestamp":1369094400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["American J of Med Genetics Pt A"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label \/><jats:p>The objective of our study was to characterize the influence of multiple mutations in the <jats:italic>MECP2<\/jats:italic> gene in a cohort of individuals with Rett syndrome. Further analysis demonstrated that nearly all resulted from de novo <jats:italic>in cis<\/jats:italic> mutations, where the disease severity was indistinguishable from single mutations. Our methods involved enrolling participants in the RTT Natural History Study (NHS). After providing informed consent through their parents or principal caretakers, additional molecular assessments were performed in the participants and their parents to assess the presence and location of more than one mutation in each. Clinical severity was assessed at each visit in those participants in the NHS. Non\u2010contiguous <jats:italic>MECP2<\/jats:italic> gene variations were detected in 12 participants and contiguous mutations involving a deletion and insertion in three participants. Thirteen of 15 participants had mutations that were <jats:italic>in cis<\/jats:italic>; four (of 13) had three <jats:italic>MECP2<\/jats:italic> mutations; two (of 15) had mutations that were both <jats:italic>in cis<\/jats:italic> and <jats:italic>in trans<\/jats:italic> (i.e., on different alleles). Clinical severity did not appear different from NHS participants with a single similar mutation. Mutations <jats:italic>in cis<\/jats:italic> were identified in most participants; two individuals had mutations both <jats:italic>in cis<\/jats:italic> and <jats:italic>in trans<\/jats:italic>. The presence of multiple mutations was not associated with greater severity. Nevertheless, multiple mutations will require greater thought in the future, if genetic assignment to drug treatment protocols is considered. \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajmg.a.35979","type":"journal-article","created":{"date-parts":[[2013,5,22]],"date-time":"2013-05-22T01:48:51Z","timestamp":1369187331000},"page":"1638-1646","source":"Crossref","is-referenced-by-count":3,"title":["Detection of rarely identified multiple mutations in <i>MECP2<\/i> gene do not contribute to enhanced severity in rett syndrome"],"prefix":"10.1002","volume":"161","author":[{"given":"Christopher A.","family":"Chapleau","sequence":"first","affiliation":[{"name":"Department of Pharmacy, Civitan International Research Center The University of Alabama at Birmingham Birmingham Alabama"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Lane","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Civitan International 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