Evidence map›Paper›PMID 41888561›Full record

ArticleEuropean journal of human genetics : EJHG2026

Non-coding structural variants disrupting conserved PITX2 enhancer loci in Axenfeld-Rieger syndrome.

Lucas A Mitchell, Joshua Schmidt, Emmanuelle Souzeau, Lachlan S W Knight, Giorgina Maxwell, Andrew Dubowsky, Ridia Lim, Edward Formaini, Matthew Welland, Cas Simons and 4 more

Abstract read
In one paragraph

Article in European journal of human genetics : EJHG, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Advances in genomic medicine: from diagnosis to patient perspectives.European journal of human genetics : EJHG · 2026
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

14 authors.

Lucas A MitchellGarvan Institute of Medical Research, Sydney, NSW, Australia.ORCID 0000-0001-5160-3299
Joshua SchmidtGarvan Institute of Medical Research, Sydney, NSW, Australia.
Emmanuelle SouzeauDepartment of Ophthalmology, Flinders University, Adelaide, SA, Australia.
Lachlan S W KnightDepartment of Ophthalmology, Flinders University, Adelaide, SA, Australia.ORCID 0000-0002-7633-5486
Giorgina MaxwellDepartment of Ophthalmology, Flinders University, Adelaide, SA, Australia.ORCID 0000-0002-4837-2204
Andrew DubowskySA Pathology, Adelaide, SA, Australia.ORCID 0000-0002-9585-1136
Ridia LimSydney Eye Hospital, Sydney, NSW, Australia.
Edward FormainiCentre for Population Genomics, Garvan Institute of Medical Research, University of New South Wales, Sydney, NSW, Australia.ORCID 0009-0008-1592-2338
Matthew WellandCentre for Population Genomics, Garvan Institute of Medical Research, University of New South Wales, Sydney, NSW, Australia.
Cas SimonsCentre for Population Genomics, Garvan Institute of Medical Research, University of New South Wales, Sydney, NSW, Australia.
Daniel G MacArthurCentre for Population Genomics, Garvan Institute of Medical Research, University of New South Wales, Sydney, NSW, Australia.
Janey L WiggsDepartment of Ophthalmology, Harvard Medical School, Boston, MA, USA.
Jamie E Craig *Department of Ophthalmology, Flinders University, Adelaide, SA, Australia.ORCID 0000-0001-9955-9696
Owen M Siggs *Garvan Institute of Medical Research, Sydney, NSW, Australia. o.siggs@garvan.org.au.ORCID 0000-0003-2840-4851

Funding

Department of Health | National Health and Medical Research Council (NHMRC) 2024/GNT2039978
6 · The paper itself

Abstract

Axenfeld-Rieger Syndrome (ARS) is an autosomal dominant condition with both ocular and non-ocular manifestations. ARS is primarily caused by coding variants at the PITX2 or FOXC1 loci, yet many cases still remain undiagnosed. Here we used whole-genome sequencing to identify two families with non-coding structural variants associated with a typical presentation of PITX2-associated ARS: one family with a 450 kb deletion removing a series of conserved enhancer elements distal to PITX2, and the second family with a 12.54 Mb inversion displacing the PITX2 gene from these same enhancer elements. Neither variant disrupted the PITX2 gene itself, and therefore both were expected to reduce PITX2 expression by disrupting its proximity or access to enhancer elements. PITX2 enhancer-disrupting inversions are an emerging genetic mechanism for the development of ARS, which should be carefully considered in the context of ARS and other conditions without a conclusive genetic diagnosis.

Indexed as

Anterior Eye SegmentEnhancer Elements, GeneticEye AbnormalitiesHomeodomain ProteinsTranscription FactorsEye Diseases, HereditaryHomeobox Protein PITX2HumansPedigreeHomeobox Protein PITX2Homeodomain ProteinsTranscription Factors

Identifiers

PMID41888561
PMCPMC13172411

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.