Mutations of the Histone Linker H1-4: An Expanded Cohort and Functional Characterization of Frameshift Mutant H1.4 in Neurons

Background: Rahman syndrome (RMNS) is a rare genetic disorder characterized by mild to severe intellectual disability, hypotonia, anxiety, autism spectrum disorder, vision problems, brittle bones, and dysmorphic facies. De novo heterozygous mutations in H1-4 (HIST1H1E) encoding the linker histone H1.4 are found in patients with RMNS; however, the underlying mechanisms causing the pronounced neurological manifestations are not understood. The majority of reported mutations in H1-4 are small insertions or deletions that create a shared frameshift, resulting in an H1.4 protein that is both truncated and possessing an abnormal C-terminal tail.Methods: Seven Rahman syndrome subjects with C-terminal frameshift mutations as well as three patients with heterozygous null mutations in H1-4 were described in detail. Lymphoblastoid cells from these patients were used to identify transcriptional abnormalities in RMNS. Wildtype or mutant frameshifted human H1.4 protein was exogenously expressed in primary rat hippocampal neurons, and neuronal structure and function were assessed using immunohistochemistry and multi-electrode array recordings. Results: Individuals with heterozygous null variants in the H1-4 gene lack several key RMNS phenotypes, supporting the hypothesis that RMNS is due to a gain-of-function of the frameshift mutant H1.4 protein. In cultured rat hippocampal neurons, H1.4 was localized to the nucleus, though the frameshift mutant H1.4 had a distinct subnuclear distribution and enlarged nuclei. Overexpression of frameshift mutant H1.4 had minimal effects on dendritic morphology; however, it significantly reduced neuronal firing rate relative to neurons overexpressing wildtype human H1.4. Limitations: Given the small number of RMNS cases worldwide, the true breadth of phenotypes remains unknown. Though our data do not show robust differential expression of any genes, larger cohorts for clinical and molecular studies will be needed to gain reliable data.Conclusions: These data are the first to characterize the consequence of frameshift mutant H1.4 in neurons. These data provide new insights into the breadth of phenotypes and causes of neurological dysfunction in RMNS and highlight the need for future studies on the function of histone H1.4 in neurons.