REPORT

A Truncating Mutation of CEP135 Causes Primary

Microcephaly and Disturbed Centrosomal Function
Muhammad Sajid Hussain,1,2,3,4 Shahid Mahmood Baig,4 Sascha Neumann,2 Gudrun Nurnberg,1,3
Muhammad Farooq,4 Ilyas Ahmad,1,4 Thomas Alef,1 Hans Christian Hennies,1,5 Martin Technau,2
Janine Altmuller,1 Peter Frommolt,1,5 Holger Thiele,1 Angelika Anna Noegel,1,2,3,5,*
and Peter Nurnberg1,3,5,*

Autosomal-recessive primary microcephaly (MCPH) is a rare congenital disorder characterized by intellectual disability, reduced brain
and head size, but usually without defects in cerebral cortical architecture, and other syndromic abnormalities. MCPH is heterogeneous.
The underlying genes of the seven known loci code for centrosomal proteins. We studied a family from northern Pakistan with two
microcephalic children using homozygosity mapping and found suggestive linkage for regions on chromosomes 2, 4, and 9. We
sequenced two positional candidate genes and identified a homozygous frameshift mutation in the gene encoding the 135 kDa centro-
somal protein (CEP135), located in the linkage interval on chromosome 4, in both affected children. Post hoc whole-exome sequencing
corroborated this mutations identification as the causal variant. Fibroblasts obtained from one of the patients showed multiple and frag-
mented centrosomes, disorganized microtubules, and reduced growth rate. Similar effects were reported after knockdown of CEP135
through RNA interference; we could provoke them also by ectopic overexpression of the mutant protein. Our findings suggest an addi-
tional locus for MCPH at HSA 4q12 (MCPH8), further strengthen the role of centrosomes in the development of MCPH, and place
CEP135 among the essential components of this important organelle in particular for a normal neurogenesis.

Autosomal-recessive primary microcephaly (MCPH [MIM
251200]) is a neurodevelopmental disorder characterized
by reduced size of the cerebral cortex and mild to moderate
intellectual disability whereas the architecture of the brain
is largely normal. Head circumference is already reduced at
birth and usually more than 3 SD below the age- and sex-
matched population mean throughout the patients life-
time. Many patients have a receding forehead. MCPH is
heterogeneous; it has seven known loci, MCPH1
MCPH7,1 each of which is associated with an underlying
genetic defect: MCPH1 (MIM 251200) is associated with
mutations of MCPH1 (MIM 607117);2 MCPH2 with or
without cortical malformations (MIM 604317) is associ-
ated with mutations of WDR62 (MIM 613583);3,4
MCPH3 (MIM 604804) is associated with mutations of
CDK5RAP2 (MIM 608201);5 MCPH4 (MIM 604321) is asso-
ciated with mutations of CEP152 (MIM 613529);6 MCPH5
(MIM 608716) is associated with mutations of ASPM (MIM
605481);7 MCPH6 (MIM 608393) is associated with muta-
tions of CENPJ (MIM 609279);5 and MCPH7 (MIM 612703)
is associated with mutations of STIL (MIM 181590).8
Recently, a new locus at HSA 10q11.23-21.3 was described
in a consanguineous Turkish family, but the authors were
not able to find the disease-causing gene variant.9 The
MCPH-associated genes described to date have been impli-
cated in cell division and cell cycle regulation, and many of
the corresponding gene products are localized to the
centrosome. It has been speculated that they affect neural
progenitor cell number through disturbed microtubule
organization at the centrosome, resulting in altered cell
division and cortical development. Despite their similar
subcellular localization, the biological functions of these
genes may vary.1,3,4,10
We studied a consanguineous family from northern
Pakistan; the two affected children had primary micro-
cephaly at birth (Figures 1A and 1B). After informed
consent of the parents was obtained, pedigree information
was documented and clinical data and blood samples were
collected from the affected siblings, their father, and an
unaffected sibling. Each affected child had a sloping fore-
head. By 5 years of age they showed severe cognitive defi-
cits; their speech was not understandable. They were
unable to form sentences and even to say any clear words,
although their hearing was not impaired. Other abnormal-
ities were not apparent. Individual V-2 died at 11 years. The
head circumference of the affected individuals ranged
between
12 and
14.5 SD compared to the average pop-
ulation of the same age and sex. The parents were healthy
with normal head circumference. Ethical approval for this
study was obtained from the ethics review board at the
National Institute for Biotechnology and Genetic Engi-
neering in Faisalabad according to the Declaration of Hel-
sinki.
Standard procedures were used to extract DNA from the
blood samples for homozygosity mapping. Initially, we
excluded all known MCPH loci in the family, using STR
markers to demonstrate heterozygosity in the relevant
genomic regions. We then performed a genome-wide

1
Cologne Center for Genomics (CCG), University of Cologne, 50931 Cologne, Germany; 2Institute of Biochemistry I, Medical Faculty, University of
Cologne, 50931 Cologne, Germany; 3Center for Molecular Medicine Cologne (CMMC), University of Cologne, 50931 Cologne, Germany; 4Health Biotech-
nology Division, National Institute for Biotechnology and Genetic Engineering (NIBGE), Faisalabad 38000, Pakistan; 5Cologne Excellence Cluster on
Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50674 Cologne, Germany
*Correspondence: noegel@uni-koeln.de (A.A.N.), nuernberg@uni-koeln.de (P.N.)
DOI 10.1016/j.ajhg.2012.03.016. 2012 by The American Society of Human Genetics. All rights reserved.

The American Journal of Human Genetics 90, 871878, May 4, 2012 871
Figure 1. Identification of an MCPH-Causing Mutation in CEP135
(A) Clinical features of two siblings of a family from northern Pakistan presenting with microcephaly, sloping forehead, and retrogna-
thia. Informed consent to publish the photographs was obtained from the subjects parents.
(B) A simplified pedigree of the Pakistani family. Filled circles indicate individuals with MCPH. Their parents are second cousins. Only
the core family is shown. DNA was available for individuals IV-1, V-1, V-2, and V-3.
(C) G-banded chromosome 4 showing the position of the linkage interval at 4p14-4q12 along with the position of CEP135. The homo-
zygous region was delimited by the markers SNP_A-2154951 (rs12498424, physical position 40,631,476 bp) and SNP_A-1894332
(rs13134527, physical position 58,702,130 bp).
(D) Sequence chromatograms of a part of CEP135 exon 8 as obtained by Sanger sequencing. Traces of the male patient (V-1) and his
father (IV-1) show the mutation c.970delC in homozygous and heterozygous status, respectively. The mutant sequences are shown
along with a wild-type trace from a control individual.
(E) Schematic representation of the genomic structure of human CEP135. The 26 exons of CEP135 are drawn to scale, while introns show
just artificial lines. Black boxes represent untranslated regions. The position of mutation c.970delC in exon 8 is indicated.
(F) CEP135 structure as predicted by SMART (Simple Modular Architecture Research Tool) database. This software predicted six coiled-
coil domains (orange rods) which cover almost the entire region of the protein. The position of mutation p.Q324Sfs*2 in the fourth
coiled-coil domain is indicated.

linkage analysis using the Affymetrix GeneChip Human
Mapping 250K Sty Array. Data handling, evaluation, and
statistical analysis were performed as described previ-
ously.11 We observed three peaks on chromosomes 2, 4,
and 9 that were suggestive for linkage with maximum mul-
tipoint LOD scores of 2.07, 2.53, and 2.53, respectively
(Figure S1). The underlying common homozygous regions
defined a candidate region of 8.6 Mb on chromosome
2 (90,183,48498,795,792; hg19), a candidate region of
18.1 Mb on chromosome 4 (40,631,47658,702,130;
hg19), and a candidate region of 8.8 Mb on chromosome
9 (92,274,161101,122,314; hg19). Altogether these
regions include more than 200 annotated known and
predicted coding genes (UCSC Genome Bioinformatics,
hg19). The genes were prioritized with Endeavour and
GeneWanderer.12,13 Highly ranked genes were further
scrutinized manually with the NCBI, Ensembl, and UCSC
genome databases. Finally, we gave top priority to genes
that were very likely to have important functions related
to cell division or chromosome segregation and decided
to sequence the following two strong candidate genes
first: the cell division cycle-14 homolog B gene (CDC14B
[MIM 603505]) at cytoband 9q22.32-q31.1 and the gene
encoding the 135 kDa centrosomal protein (CEP135
[MIM 611423]) at HAS 4p14-q12 (Figure 1C).
All exons and the intron-exon boundaries of CEP135
and CDC14B were sequenced in the two affected individ-
uals. The PCR products (primers are listed in Table S1)

872 The American Journal of Human Genetics 90, 871878, May 4, 2012
were sequenced bidirectionally with a BigDye Terminator
v1.1 cycle sequencing kit on an ABI3730xl automated
DNA sequencer. Sequences were analyzed with DNASTAR
(Lasergene) and Mutation Surveyor (SoftGenetics). We
found no mutation in CDC14B but a homozygous single
base-pair (bp) deletion (c.970delC) in exon 8 of CEP135.
We found the homozygous 1 bp deletion in both affected
children, but not in the unaffected child, whereas the
father was heterozygous for this mutation (Figure 1D),
which is compatible with recessive inheritance. Moreover,
the mutation is unlikely to be a polymorphism, as it is not
listed in dbSNP, and we could not find it when testing 384
healthy Pakistani controls with pyrosequencing. For this
purpose, PCR primers (listed in Table S2) were designed
by the PSQ Assay Design program v.1.0.6 (QIAGEN,
Hilden, Germany). Pyrosequencing was done according
to the manufacturers instructions on a PSQ HS96A instru-
ment (QIAGEN) with the use of PyroMark Gold Q96
Reagents (QIAGEN). The data were analyzed by Pyro
Q-CpG v.1.0.9 analysis software (QIAGEN).
In an attempt to identify a second independent muta-
tion of CEP135, we sequenced CEP135 in patients from
seven other families affected with MCPH from northern
Pakistan in which all known MCPH-associated genes
were previously excluded. No CEP135 mutation was found
in any of these families. Therefore, we decided to perform
whole-exome sequencing of the affected boy (individual
V-1) of the family presented in Figure 1B in order to
demonstrate that there were no other mutations in rele-
vant genes that might also explain the phenotype. We
fragmented 1 mg of DNA using sonification technology
(Covaris, Woburn, MA, USA). The fragments were end re-
paired and adaptor ligated. After size selection, the library
was subjected to the enrichment process. We chose the Seq-
Cap EZ Human Exome Library v2.0 kit from NimbleGen
(Roche NimbleGen, Madison, WI, USA) and analyzed the
sample on an Illumina HiSeq 2000 sequencing instrument.
About 10 Gb of sequence were produced for this sample by
loading it individually on one lane of a flow cell and gener-
ating paired-end reads of 2 3 100 bp. This resulted in a very
high coverage; i.e., > 303 for nearly 92% of the target
sequences, which comprised about 44 Mb. Primary data
were filtered according to signal purity by the Illumina
Realtime Analysis (RTA) software v1.8. Subsequently, the
reads were mapped to the human genome reference build
hg19 via the ELANDv2 alignment algorithm on a multi-
node compute cluster. With the use of CASAVA v1.8, PCR
duplicates were filtered out, and the output was converted
into BAM format. Variant calling was performed with the
use of SAMtools (version 0.1.7) for indel detection.14
Scripts developed in-house at the Cologne Center for
Genomics were applied to detect protein changes, affected
splice sites, and overlaps with known variants. In partic-
ular, we filtered the variants for high-quality unknown
variants in the linkage intervals (dbSNP build 132 or the
1000 Genomes database; in-house variation database; and
public Exome Variant Server, NHLBI Exome Sequencing
The American Journal of Human Genetics 90, 871878, May 4, 2012 873
Project, Seattle) (Table S3). Only three other homozygous
variants resisted our filter criteria in addition to CEP135
c.970delC. None of these could be assumed to be relevant
for the phenotype (Table S4). Likewise, we could not find
deleterious mutations in any of the seven known MCPH-
associated genes, even when allowing for compound
heterozygosity during filtering.
The deletion c.970delC of CEP135 results in a frameshift,
changing glutamine at position 324 into serine, immedi-
ately followed by a premature termination codon
(p.Gln324Serfs*2). This truncating mutation is obviously
incompatible with a normal function of CEP135 if one
considers the size of the protein and the position of
the mutation (Figures 1E and 1F). CEP135 consists of 26
exons, and its open reading frame codes for a polypeptide
of 1,140 amino acids.
CEP135 is a conserved a-helical protein which is present
at the centrosome throughout the cell cycle. Electron-
microscopic studies showed its association with the
pericentriolar material, an electron-dense material sur-
rounding the centrioles. Reducing CEP135 amounts in
cells via RNA interference caused a disorganization of
interphase and mitotic spindles, leading to the hypothesis
that CEP135 has a role in maintaining the structure and
organization of the centrosome and of microtubules.15
More recently the protein was identified as a centriolar
component; it functions in centriole biogenesis and
presumably has a scaffolding role.16 Centrioles are core
components of animal centrosomes and act as basal bodies
to assemble cilia and flagella.17
To unravel the effect of the mutation on the cellular
level, we analyzed control and patient fibroblasts. Biopsies
were taken from the affected individual V-1 (Figure 1B) and
healthy individuals. Tissues were cleaned with antiseptic
agent (Betaisodona, Mundipharma) and incubated over-
night with Dispase II (1.5 U/ml, Roche) diluted in PBS,
pH 6.8, at 4 C to separate the intact epidermis from the
dermis. The dermis was incubated in Dulbeccos modified
Eagles medium (DMEM) at 37 C. After one week, fibro-
blasts were detected. The pool of fibroblasts was increased
by additional culturing. Primary fibroblasts established
from the patient grew very slowly. To enhance growth,
DMEM with 15% fetal bovine serum was used. Patient
and wild-type primary fibroblasts were then cultured on
12 mm coverslips and fixed with 3% paraformaldehyde.
For staining of microtubules, cells were incubated for
15 min in tubulin stabilization buffer, which is composed
of Hanks buffer (137 mM NaCl, 5 mM KCl, 1.1 mM
Na2HPO4, 0.4 mM KH2PO4, 5 mM Glucose, 4 mM
NaHCO3) containing 1 mM MES, pH 6.8, 2 mM EGTA,
and 2 mM MgCl2. Permeabilization was done by 0.5%
Triton X-100 in 13 tubulin stabilization buffer for 4 min
at room temperature. For g-tubulin detection, the cells
were fixed with prechilled methanol for 10 min at
20 C.
Subsequently, the fixed cells were treated three times with
tubulin stabilization buffer. Blocking was done for 15 min
with blocking buffer (13 PBG: PBS containing 5% BSA and

0.45% fish gelatin). Primary antibodies were diluted in
blocking buffer and incubated overnight at 4 C. The
following antibodies were used: mouse monoclonal anti
g-tubulin (Sigma-Aldrich, GTU-88; 1:300), rabbit poly-
clonal anti-pericentrin (Abcam, ab4448; 1:300), and rat
monoclonal anti a-tubulin (YL 1/2 1:20).18 After incuba-
tion, samples were treated with 13 PBS three times for
5 min followed by secondary antibody incubation
(1:1,000 diluted in blocking buffer) for one hour at room
temperature. Alexa Fluor 568 goat anti-mouse IgG (Invitro-
gen, A11004), Alexa Fluor 647 donkey anti-mouse IgG
(Invitrogen, A31571), and Alexa Fluor 488 goat anti-rat
IgG (Invitrogen, A11006) were used as secondary anti-
bodies. DNA was detected with DAPI (Sigma-Aldrich,
D9564). Finally, the cells were mounted on glass slides
with Gelvatol. Images were taken with a confocal micro-
scope (Leica, LSM TCS SP5).
Control primary fibroblasts had oval nuclei surrounded
by organized microtubules and a single centrosome in
874 The American Journal of Human Genetics 90, 871878, May 4, 2012
Figure 2. Centrosome, Microtubule, and
Nuclear Shape Defects in CEP135 Microce-
phalic Patient Cells
(A) Immunofluorescence staining and
confocal microscopy images of wild-type
primary fibroblasts with well-organized
microtubules and a single centrosome de-
tected by g-tubulin. g-tubulin (turquoise)
and a-tubulin (green) antibodies were
used. DAPI (blue) was used for DNA stain-
ing. Scale bar, 5 mm.
(B) Abnormality of centrosome number
in CEP135 patient primary fibroblasts.
Interphase cell showing supernumerary
centrosomes. In this figure three centro-
somes were observed as detected by
g-tubulin (turquoise). Scale bar, 5 mm.
(C) Disorganized microtubule network in
patient fibroblasts. Scale bar, 20 mm.
(D) Control primary fibroblast showing
a well-shaped ellipsoid nucleus. Scale bar,
5 mm.
(E) Mutant fibroblast with a dysmorphic
nucleus. Scale bar, 10 mm.
(F) Graphical representation showing
the number of CEP135 mutant primary
fibroblasts with dysmorphic nuclei. About
20% of mutant fibroblasts harbored
misshapen nuclei whereas in control fibro-
blasts this number was only ~3%. Three
hundred cells of each, wild-type and
mutant, were counted. Error bars represent
SEM, p 3.44 3 10
03 (Students t test).
the vicinity of the nucleus during
interphase (Figure 2A). In the
patients primary fibroblasts, the
centrosome number was increased in
more than 18% of the cells (Table
S5). In such cells we found 3, 4, or
5 centrosomes per cell (Figures 2B
and S2). Furthermore, centrosomes
appeared fragmented (Figure S2). The microtubule network
was frequently disorganized (~55% of the cells), which was
accompanied by cell shape changes (Figures 2C and S3;
Table S5). We also observed misshapen and fragmented
nuclei (Figure 2E and S4). Statistical analysis showed
that ~20% of the mutant cells harbored misshapen nuclei
as compared to ~3% in control fibroblasts (Figure 2F; Table
S5). Another prominent aspect of the patients primary
fibroblasts was the complete loss of centrosomes. Approx-
imately 22% of mutant primary fibroblasts were without
centrosomes as detected with g-tubulin, whereas this was
never observed in control cells (Table S5; Figure S3). Most
cells with misshapen nuclei were also devoid of centro-
somes (Figure S4).
For ectopic expression of wild-type and mutant
(c.970delC) CEP135 fused to green fluorescent protein
(GFP), we used COS-7 cells. Gateway Technology (Invitro-
gen) was employed to clone wild-type (NM_025009.3)
CEP135 cDNA. The CEP135 mutation (c.970delC) was

introduced into the full-length cDNA with the use of the
QuikChange II Site-Directed Mutagenesis Kit (Stratagene)
(primers are listed in Table S6) in an attempt to reproduce
the patients situation. Entry clones in pENTR/TEV/
D-TOPO were transformed into Gateway destination
vector pcDNA-DEST53, which has an N-terminal cycle-3
GFP tag. Both wild-type and mutant plasmids (10 mg/ml)
were used for transfection of COS-7 cells. The Gene Pulser
II (Bio-Rad) device was used for electroporation. 72 hr
after transfection, the cells were subjected to immuno-
fluorescence.
When we analyzed the localization of the proteins and
their effect on centrosomes and microtubule organization,
we observed wild-type GFP-tagged CEP135 at the centro-
some where it colocalized with the centrosomal protein
pericentrin. We also detected it in some spots outside of
the centrosome that were not positive for pericentrin
(Figure 3A). By contrast, we did not detect the mutant
protein on the centrosome; instead, in a few cells we
observed a diffuse cytoplasmic staining (Figure 3B). Over-
The American Journal of Human Genetics 90, 871878, May 4, 2012 875
Figure 3. Distribution of GFP-Tagged
Wild-Type and Mutant CEP135
(A) N-terminally GFP-tagged human
CEP135 (GFP-CEP135) was transiently
expressed in COS-7 cells. GFP-CEP135
is present in dots of variable size and
number. A single centrosome was detected
by pericentrin-specific antibodies (tur-
quoise). Scale bar, 5 mm.
(B) COS-7 cell transfected with GFP-tagged
mutant CEP135 (GFP-CEP135-mut), where
diffuse staining was detected. Scale bar,
5 mm.
(C) Abnormal microtubule network in
COS-7 expressing wild-type CEP135. Scale
bar, 5 mm.
(D) COS-7 cells expressing GFP-CEP135-
mut have a disorganized microtubule
network. Microtubules appeared broken
and concentrated near the nucleus. Scale
bar, 5 mm.
expression of both wild-type and
mutant GFP-tagged CEP135 in HaCaT
cells led to the presence of abnormal
microtubule networks. The severity
of the disorganization was more
pronounced in cells expressing the
mutant protein (Figure 3C and 3D).
Cells transfected with GFP-tagged
mutant CEP135 also harbored mul-
tiple centrosomes (up to 5), which
then resulted in multipolar spindle
formation. This phenotype was not
observed in the cells that overex-
pressed the wild-type protein. Inter-
estingly, the GFP-tagged CEP135 was
detected on microtubules (Figure 4).
These findings of a disorganized
microtubule network and multiple centrosomes in cells
transfected with GFP-tagged CEP135 resembled those
observed in mutant primary fibroblast cells.
The CEP135 mutation c.970delC is thought to lead to a
truncation of the protein due to the introduction of a
premature stop codon (p.Gln324Serfs*2). Alternatively,
it might also trigger nonsense-mediated mRNA decay
(NMD).19 We designed RT-PCR experiments to investigate
this (Table S7). The PAXgene Blood RNA system (QIAGEN)
was used to extract RNA from patient and control blood
samples, and cDNA was synthesized with SuperScript III
reverse transcriptase enzyme (Invitrogen). When primers
were used to amplify a nearly full-length CEP135 cDNA
of ~3.4 kb, no PCR product was obtained with the patients
RNA, but only with the control sample, suggesting
pronounced degradation of mutant CEP135 mRNA
(Figure S5A). In contrast, a smaller PCR product of only
385 bp, generated with primers just flanking the site of
mutation, was easily obtained from both control and
mutant RNA (Figure S5B). A contamination of the mutant
Figure 4. Centrosomal and Spindle Abnormalities in COS-7 Cells Transiently Expressing Wild-Type and Mutant CEP135
(A) A GFP-CEP135-expressing cell at metaphase showing bipolar spindles with two centrosomes.
(B) GFP-CEP135-mut-expressing cell with supernumerary centrosomes, which result in multipolar spindle formation. Centrosomes
were detected by pericentrin-specific antibodies (turquoise). Scale bar, 5 mm.

sample with wild-type RNA was excluded by sequencing
of the PCR product. One explanation to reconcile these
apparently contradictory results might be an incomplete
decay of the mutant mRNA. To verify this hypothesis, we
performed quantitative real-time PCR with cDNAs from
patient V-1 and his mother (IV-2), along with two different
control samples. GAPDH and CEP135 gene-specific primers
(Table S8), 10 mM each, were mixed with SYBR Green
PCR Master Mix (QIAGEN) and the respective cDNA. An
ANXA7 plasmid was used for calibration. Thermal cycler
conditions were 95 C for 15 min, 41 cycles of 94 C for
30 s, 57 C for 45 s, and 68 C for 40 s. A DNA Engine
Opticon 2 (MJ Research, Bio-Rad) was used. The data
were analyzed with MJ Opticon Monitor software (version
3.1). We found a dramatic reduction in the CEP135 mRNA
level in the patient as compared to the controls (Figure S6).
The mothers CEP135 mRNA level was twice as high as that
of the affected son but still significantly reduced when
compared to the controls. These data corroborate the
notion of a partial NMD effect caused by the mutation
c.970delC.
CEP135 was identified as a centrosomal component
by proteomic analysis and shown to be present in the
pericentriolar matrix, around the centriolar surface, and
within the proximal lumen of the centrioles.16,20 In
Chlamydomonas, the CEP135 ortholog Bld10p localizes
to the cartwheel, a 9-fold symmetrical structure that
presumably functions as the scaffold for the centriole-
microtubule assembly and is responsible for achieving
the 9-fold symmetry.21 Bld10p mutants (bld10) show aber-
rant interphase microtubules and mitotic spindles, defects
in cell division, and a significant reduction of the growth
rate.22 Knockdown of CEP135 in CHO cells also led to
a reduced growth rate.15 In mutant primary fibroblast cells,
we have observed strongly reduced growth as well, which
did not allow the acquisition of further data. The two
known interaction partners of CEP135, the 50 kDa subunit
of the dynactin complex (p50) and C-Nap1, have their
binding sites in the C-terminal domain of CEP135. A trun-
cation of CEP135 releases p50 and C-Nap1 and causes
decomposition of functional centrosomes and premature
centrosome splitting, respectively.23,24 Knockdown of
CEP135 leads to disorganized interphase and mitotic
spindle microtubules with bipolar and multipolar orienta-
tion.15 A role in procentriole formation has been uncov-
ered wherein CEP135 and CPAP, also known as CENPJ
(MCPH6 protein), form a core structure within the prox-
imal lumen of both parental and nascent centrioles.16
The phenotype of multiple centrosomes has also been
described in different patient and animal cells carrying
mutations in genes responsible for MCPH. Approximately
25% of the cells of lymphoblastoid cell lines carrying
a mutation in MCPH1 harbored supernumerary centro-
somes.25 An aberrant centrosome number was also
observed in Mcph1 null DT40 cells after ionizing radiation
treatment.26 Mutant centrosomal protein CEP152 is the
cause of primary microcephaly MCPH4 and of Seckel
syndrome.6,27 Fibroblast cells of patients with Seckel syn-
drome associated with CEP152 mutations also harbored
multiple centrosomes of variable size.27 Cdk5rap2 mutant
mouse embryonic fibroblasts had supernumerary centro-
somes resulting in bipolar and multipolar spindles.28
A similar phenotype was seen in mouse neuronal progen-
itors mutated in the MCPH3-associated gene ortholog
Cdk5rap2.29 We have identified multiple centrosomes
in primary CEP135 patient fibroblasts as well as in cells

876 The American Journal of Human Genetics 90, 871878, May 4, 2012
transfected with a plasmid encoding the mutant protein.
The abnormal centrosome number supports CEP135s
role in centriole biogenesis, whereas a disorganization of
the microtubule network points to its role at the centro-
some as microtubule-organizing center.
In summary, we have shown a truncating mutation
of CEP135 to cause autosomal-recessive primary micro-
cephaly in a Pakistani family. We suggest designation of
the corresponding locus at 4q12 MCPH8. The correspond-
ing protein, CEP135, is a centrosomal component and
further strengthens the role of centrosomes in the cause
of MCPH. In 18% and 22% of mutant fibroblasts, we
observed either the presence of multiple centrosomes or
a complete loss of centrosomes, respectively. Centrosome
amplification most likely affects mitotic progression and
mitotic spindle orientation and leads to multipolar spin-
dles, which result in the loss of progenitor cells. This has
been observed in MCPH1 and CEP152 mutant human cells
as well as in Cdk5rap2 mutant mouse cells.2528 These
events can also affect the polarity of cell division in the
neural progenitor cells, leading to an altered number of
neural progenitor cells or an altered fate, which may be
the cause of reduced neuron production.
Supplemental Data
Supplemental Data include six figures and eight tables and can be
found with this article online at http://www.cell.com/AJHG/.
Acknowledgments
We are grateful to all family members for their participation in this
study. We wish to thank Ursula Euteneuer and Ludwig Eichinger
for helpful discussion and Ingelore Bamann, Martina Munck,
and Alexandra Herzog for technical assistance. P.N. is a founder,
CEO, and shareholder of ATLAS Biolabs GmbH. ATLAS Biolabs
GmbH is a service provider for genomic analyses. This work was
supported by grants from the Higher Education Commission
(HEC) of Pakistan, the German Academic Exchange Service
(DAAD), and the Center for Molecular Medicine Cologne
(CMMC).
Received: November 17, 2011
Revised: March 7, 2012
Accepted: March 15, 2012
Published online: April 19, 2012
Web Resources
The URLs for the data presented herein are as follows:
Endeavour, http://homes.esat.kuleuven.be/~bioiuser/endeavour/
tool/endeavourweb.php
Ensembl Genome Browser, http://www.ensembl.org
Exome Variant Server, http://snp.gs.washington.edu/EVS/
GeneWanderer, http://compbio.charite.de/genewanderer/
GeneWanderer
Marshfield genetic map, http://www.bli.uzh.ch/BLI/Projects/
genetics/maps/marsh.html
NCBI Map Viewer, http://www.ncbi.nlm.nih.gov/mapview/
The American Journal of Human Genetics 90, 871878, May 4, 2012 877
Online Mendelian Inheritance in Man (OMIM), http://www.
omim.org
SMART database, http://smart.embl-heidelberg.de/
UCSC Genome Browser, http://genome.ucsc.edu
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