NOTCH1: Review of its role in lymphatic development and study of seven families with rare pathogenic variants

Mol Genet Genomic Med. 2021 Jan;9(1):e1529. doi: 10.1002/mgg3.1529. Epub 2020 Nov 28.


Background: We developed a Next-Generation-Sequencing (NGS) protocol to screen the most frequent genetic variants related to lymphedema and a group of candidate genes. The aim of the study was to find the genetic cause of lymphedema in the analyzed patients.

Methods: We sequenced a cohort of 246 Italian patients with lymphatic malformations. In the first step, we analyzed genes known to be linked to lymphedema: 235 out of 246 patients tested negative for the most frequent variants and underwent testing for variants in a group of candidate genes, including the NOTCH1 gene, selected from the database of mouse models. We also performed in silico analysis to observe molecular interactions between the wild-type and the variant amino acids and other protein residues.

Results: Seven out of 235 probands, five with sporadic and two with familial lymphedema, were found to carry rare missense variants in the NOTCH1 gene.

Conclusions: Our results propose that NOTCH1 could be a novel candidate for genetic predisposition to lymphedema.

Keywords: NOTCH1; Next Generation Sequencing (NGS); genetic diagnosis; lymphedema.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Female
  • Humans
  • Lymphatic System / abnormalities
  • Lymphedema / genetics*
  • Lymphedema / pathology
  • Male
  • Middle Aged
  • Mutation, Missense
  • Pedigree
  • Receptor, Notch1 / genetics*


  • NOTCH1 protein, human
  • Receptor, Notch1