RT Journal Article T1 Pathogenic variants in E3 ubiquitin ligase RLIM/RNF12 lead to a syndromic X-linked intellectual disability and behavior disorder. A1 Frints, Suzanna G M A1 Ozanturk, Aysegul A1 Rodríguez Criado, Germán A1 Grasshoff, Ute A1 de Hoon, Bas A1 Field, Michael A1 Manouvrier-Hanu, Sylvie A1 E Hickey, Scott A1 Kammoun, Molka A1 Gripp, Karen W A1 Bauer, Claudia A1 Schroeder, Christopher A1 Toutain, Annick A1 Mihalic Mosher, Theresa A1 Kelly, Benjamin J A1 White, Peter A1 Dufke, Andreas A1 Rentmeester, Eveline A1 Moon, Sungjin A1 Koboldt, Daniel C A1 van Roozendaal, Kees E P A1 Hu, Hao A1 Haas, Stefan A A1 Ropers, Hans-Hilger A1 Murray, Lucinda A1 Haan, Eric A1 Shaw, Marie A1 Carroll, Renee A1 Friend, Kathryn A1 Liebelt, Jan A1 Hobson, Lynne A1 De Rademaeker, Marjan A1 Geraedts, Joep A1 Fryns, Jean-Pierre A1 Vermeesch, Joris A1 Raynaud, Martine A1 Riess, Olaf A1 Gribnau, Joost A1 Katsanis, Nicholas A1 Devriendt, Koen A1 Bauer, Peter A1 Gecz, Jozef A1 Golzio, Christelle A1 Gontan, Cristina A1 Kalscheuer, Vera M AB RLIM, also known as RNF12, is an X-linked E3 ubiquitin ligase acting as a negative regulator of LIM-domain containing transcription factors and participates in X-chromosome inactivation (XCI) in mice. We report the genetic and clinical findings of 84 individuals from nine unrelated families, eight of whom who have pathogenic variants in RLIM (RING finger LIM domain-interacting protein). A total of 40 affected males have X-linked intellectual disability (XLID) and variable behavioral anomalies with or without congenital malformations. In contrast, 44 heterozygous female carriers have normal cognition and behavior, but eight showed mild physical features. All RLIM variants identified are missense changes co-segregating with the phenotype and predicted to affect protein function. Eight of the nine altered amino acids are conserved and lie either within a domain essential for binding interacting proteins or in the C-terminal RING finger catalytic domain. In vitro experiments revealed that these amino acid changes in the RLIM RING finger impaired RLIM ubiquitin ligase activity. In vivo experiments in rlim mutant zebrafish showed that wild type RLIM rescued the zebrafish rlim phenotype, whereas the patient-specific missense RLIM variants failed to rescue the phenotype and thus represent likely severe loss-of-function mutations. In summary, we identified a spectrum of RLIM missense variants causing syndromic XLID and affecting the ubiquitin ligase activity of RLIM, suggesting that enzymatic activity of RLIM is required for normal development, cognition and behavior. YR 2018 FD 2018-05-04 LK http://hdl.handle.net/10668/12425 UL http://hdl.handle.net/10668/12425 LA en DS RISalud RD Apr 9, 2025