Curation NIID NOTCH2NLC

Gene NOTCH2NLC
Disease NIID
Inheritance AD
Score

12 + 2 = 14 / 18

Genetic + experimental = total
Classification
0
18
Refuted
Moderate
Definitive
Last Updated 08/14/2025
Pubs Reviewed 8
Publication Span 5.08 years
Publication Interval 5.08 years
Curator(s) Macayla Weiner, Laurel Hiatt
Description

Autosomal dominant NIID is caused by heterozygous GGC/CGG repeat expansions in the 5′ UTR of NOTCH2NLC (also reported as NBPF19/NOTCH2NLC). The association is supported by independent long-read sequencing and repeat-primed/GC-rich PCR studies in familial and sporadic NIID, segregation in affected families, expansion enrichment in disease cohorts compared with controls, and replicated clinical/pathologic findings including multisystem neurodegeneration, characteristic DWI corticomedullary-junction hyperintensity/white matter disease, and eosinophilic p62/ubiquitin-positive intranuclear inclusions. Reported functional observations include altered methylation/regulatory findings and patient tissue pathology.

Genetic evidence

Total: 12

Category
Type
Citation
Score
Details
Singular Evidence
Probands
6

A multicenter Chinese NIID cohort described 223 patients/probands with NOTCH2NLC 5′ UTR GGC repeat expansions (>60 repeats), skin-biopsy p62-positive intranuclear inclusions, and characteristic neurologic/MRI features; for familial NIID, only probands were included in the final analysis.

Collective Evidence
Segregation
1.5

In a five-generation Chinese Han NIID family, linkage mapped the disease locus to 1p13.3–q23.1 (maximum LOD 3.184), WES did not identify a causal coding variant, and long-read sequencing identified a NOTCH2NLC 5′ GGC expansion. RP-PCR/GC-PCR showed expanded alleles in affected family members, whereas unaffected relatives carried normal-range repeats; additional familial/sporadic NIID cases also carried expansions.

Statistics
Case-control data
6

Available genetic case-control support includes NOTCH2NLC GGC expansions in 7/127 genetically undiagnosed Taiwanese CMT patients, including 7/66 CMT2 cases (10.6%), and 0/200 controls (pmid:34675106), plus pathogenic expansions in 27/597 ET pedigrees and 3/412 sporadic ET cases with intermediate alleles enriched versus 1085 controls (pmid:36086903). PMID:35857137 and pmid:36570826 are case-control studies of methylation/perfusion phenotypes rather than primary genetic enrichment studies.

Experimental evidence

Total: 2

Category
Type
Citation
Score
Details
Function
Regulatory impact
1

SMRT/IPD analysis suggested the expanded CGG repeat in the 5′ UTR of NBPF19/NOTCH2NLC tended to be hypermethylated, but RNA-seq from NIID brains (n=3) versus controls (n=8) did not show a significant difference in NBPF19 expression.

Functional Alteration
Patient cells
1

In a Korean NOTCH2NLC-expanded NIID cohort/family study, skin biopsies from two patients confirmed intranuclear inclusions using H&E with ubiquitin and p62 immunostaining; patient/family DNA methylation profiling showed lower promoter methylation in affected offspring than an asymptomatic expanded-repeat father.

Maximum score caps apply at evidence type, category, and supercategory levels, so section totals may be lower than the raw sum of row scores.