A Deep Intronic PKHD1 Variant Identified by SpliceAI in a Deceased Neonate With Autosomal Recessive Polycystic Kidney Disease

Felix Richter, Kayleigh D. Rutherford, Anisha J. Cooke, Malorie Meshkati, Vanessa Eddy-Abrams, Daniel Greene, Jordana Kosowsky, Yeaji Park, Surabhi Aggarwal, Rebecca J. Burke, Weili Chang, Jillian Connors, Peter J. Giannone, Thomas Hays, Divya Khattar, Mark Polak, Liana Senaldi, Matthew Smith-Raska, Shanthy Sridhar, Laurie SteinerJonathan R. Swanson, Kate A. Tauber, Mafalda Barbosa, Katherine F. Guttmann, Ernest Turro

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


The etiologies of newborn deaths in neonatal intensive care units usually remain unknown, even after genetic testing. Whole-genome sequencing, combined with artificial intelligence–based methods for predicting the effects of non-coding variants, provide an avenue for resolving these deaths. Using one such method, SpliceAI, we identified a maternally inherited deep intronic PKHD1 splice variant (chr6:52030169T>C), in trans with a pathogenic missense variant (p.Thr36Met), in a newborn who died of autosomal recessive polycystic kidney disease at age 2 days. We validated the deep intronic variant's impact in maternal urine–derived cells expressing PKHD1. Reverse transcription polymerase chain reaction followed by Sanger sequencing showed that the variant causes inclusion of 147 bp of the canonical intron between exons 29 and 30 of PKHD1 into the mRNA, including a premature stop codon. Allele-specific expression analysis at a heterozygous site in the mother showed that the mutant allele completely suppresses canonical splicing. In an unrelated healthy control, there was no evidence of transcripts including the novel splice junction. We returned a diagnostic report to the parents, who underwent in vitro embryo selection.

Original languageEnglish
Pages (from-to)829-833
Number of pages5
JournalAmerican Journal of Kidney Diseases
Issue number6
StateAccepted/In press - 2024

Bibliographical note

Publisher Copyright:
© 2024 National Kidney Foundation, Inc.


  • Deceased
  • Intronic
  • NICU
  • PKHD1
  • SpliceAI

ASJC Scopus subject areas

  • Nephrology


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