Usher syndrome is an autosomal recessive condition characterized by sensorineural hearing loss, variable vestibular dysfunction,
and visual impairment due to retinitis pigmentosa (RP). The seven proteins that have been identified for Usher syndrome type
1 (USH1) and type 2 (USH2) may interact in a large protein complex. In order to identify novel USH genes, we followed a candidate
strategy, assuming that mutations in proteins interacting with this “USH network” may cause Usher syndrome as well. The
DFNB31 gene encodes whirlin, a PDZ scaffold protein with expression in both hair cell stereocilia and retinal photoreceptor cells.
Whirlin represents an excellent candidate for USH2 because it binds to Usherin (USH2A) and VLGR1b (USH2C). Genotyping of microsatellite
markers specific for the
DFNB31 gene locus on chromosome 9q32 was performed in a German USH2 family that had been excluded for all known USH loci. Patients
showed common haplotypes. Sequence analysis of
DFNB31 revealed compound heterozygosity for a nonsense mutation, p.Q103X, in exon 1, and a mutation in the splice donor site of
exon 2, c.837+1G>A.
DFNB31 mutations appear to be a rare cause of Usher syndrome, since no mutations were identified in an additional 96 USH2 patients.
While mutations in the C-terminal half of whirlin have previously been reported in non-syndromic deafness (DFNB31), both alterations
identified in our USH2 family affect the long protein isoform. We propose that mutations causing Usher syndrome are probably
restricted to exons 1–6 that are specific for the long isoform and probably crucial for retinal function. We describe a novel
genetic subtype for Usher syndrome, which we named
USH2D and which is caused by mutations in whirlin. Moreover, this is the first case of USH2 that is allelic to non-syndromic deafness.