Supplemental Data. De Novo Truncating Mutations in WASF1. Cause Intellectual Disability with Seizures

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The American Journal of Human Genetics, Volume 13 Supplemental Data De Novo Truncating Mutations in WASF1 Cause Intellectual Disability with Seizures Yoko Ito, Keren J. Carss, Sofia T. Duarte, Taila Hartley, Boris Keren, Manju A. Kurian, Isabelle Marey, Perinne Charles, Carla Mendonça, Caroline Nava, Rolph Pfundt, Alba Sanchis-Juan, Hans van Bokhoven, Anthony van Essen, Conny van Ravenswaaij-Arts, NIHR BioResource, Care4Rare Canada Consortium, Kym M. Boycott, Kristin D. Kernohan, Sarah Dyack, and F. Lucy Raymond

Figure S1. Clinical phenotype of affected individuals. (A-B) Facial phenotype of P3 with midface hypoplasia. (C-D) Facial phenotype of P4 with strabismus. (E) Foot morphology of P1 showing pes planus and bilateral short 4th toes. (F) Hand morphology of P3 with arachnodactyly. (G) Normal hand morphology of P4. 1

Pl A 'O -.m - C I: I I I c... ' -------- I I LL c:::;_::.. GAAAAITACCTITICGTATTGCTTCCAC.TAC.C WASFl P3 'O C c... WASFl 'O C c... LL 'O C c... LL I& 11(1(1(( P2 WASFl P4. ' WASFl 2

P5 Mother Father Proband Figure S2. Confirmation of WASF1 mutations. P1, P2 and P5 have 6:g.11422797G>A; P3 has 6:g.11421847G>A; P4 has 6:g.11422831delinsCCTGGC. A) Integrated Genomics Viewer plots show high-throughput sequencing reads in four affected individuals. B) Sanger confirmations of P1, P3, P4 and P5 trios. 3

A Cells With Lamellipodia Only Cells With Both Lamellipodia and Filopodia Cells With B P1 P2 Control 4

Figure S3. Morphology of fibroblasts. Range in actin morphology in fibroblasts derived from individuals with the c.1516c>t variant. Actin was visualized in PDGF-induced fibroblasts by staining with phalloidin. (A) Representative cells from P1, P2, and control fibroblasts showing the diversity in cell phenotype. Scale bars are 1µm. (B) Field of view image of phalloidin-stained cells. Scale bars are 1µm. 5

Table S1. Method details. Individual Sequencing Alignment Data Variant callers P1 SureSelect All Exon 5 Mb library preparation (Agilent) followed by sequencing on an Illumina HiSeq 2. P2 and P5 P3 P4 MedExome library preparation (Roche), followed by Illumina NextSeq high output sequencing. TruSeq DNA PCR-Free library preparation (Illumina), followed by whole genome sequencing on an Illumina HiSeq X Ten. SureSelectXT Human All Exon 5Mb library preparation (Agilent), followed by sequencing on an Illumina HiSeq 2. Burrows-Wheeler Aligner. 1 Burrows-Wheeler Aligner. Isaac aligner. 3 Burrows-Wheeler Aligner. 1bps paired-end reads with a median coverage of targeted regions of 14X. 15bps paired-end reads with a median coverage of targeted regions of 142X. 15bps paired-end reads with a median coverage genomewide of 36X. Short reads with a median coverage genome-wide of 75X. SAMtools. 2 Structural variants considered No Genome No Analyzer Toolkit. Isaac variant caller, Canvas, and Manta. 3 5 Yes Genome Yes Analyzer Toolkit. 6

Table S2: Variants of unknown significance in individuals with WASF1 mutations. Genomic coordinates refer to GRCh37. NR = none reported. XLID = X-linked intellectual disability. Individual Gene Variant (HGVSg) Variant (HGVSc) Variant (HGVSp) Predicted Consequence CADD (phred scaled) Genotype Inheritance gnomad frequency In ClinVar Confirmed by Sanger sequencing Disease associated with gene Comments P1 ATP5J 21:g.271199 T>C ENST493. 3:c.116T>C ENSP28497 1.3:p.Iso39Thr Missense 15 Het De novo No Yes NR Gene not constrained for LOF or missense variation in ExAC. Encodes a subunit of the H+ ATP synthase complex, Iso39 is poorly conserved between species. P1 SLC38A4 12:g.47163175 C>T ENST266579. 8:c.1136C>T ENSP26657 9.4:p.Arg446Ter Stop Gain NA Het De novo No Yes NR Unlikely candidate because expressed predominantly in the liver. P1 ZNF175 19:g.5291449 A>G ENST262259. 6:c.1865A>G ENSP26225 9.2:p.Lys622Arg Missense 4.46 Het De novo 4/277122 No Yes NR Unlikely candidate because at least 4 LOF variants ocr before this c.1865a>g variant in the gnomad database; one of these variants (rs746669166) ocrs at an allele frequency of.25%. Gene not constrained for LOF or missense 7

variation in ExAC. P1 CROCC 1:g.17281987C >T 1:g.17296892C >T ENST375541.9:c.3646C>T ENST375541.9:c.5596C>T ENSP36469 1.4:p.Arg1216Trp ENSP36469 1.4:p.Arg1866Cys Missense Missense 14.33 Het 21.4 Het Inherited from mother Inherited from father 2/18958 No No 35/25599 4 No No NR Structural component of ciliary rootlets; unlikely candidate because CROCC is a frequently mutated gene with a z- missense score of -.97 in the ExAC database. P2 CDCA7L 7:g.2195644C >T ENST46877. 3:c.133G>A ENSP38398 6.3:p.Asp45Asn Missense 19 Het De novo No No NR Gene not constrained for LOF or missense variation in ExAC. No outcome in GeneMatcher. P3 ACSL4 X:g.18912393 C>T ENST348. 2:c.1135G>A ENSP33978 7.2:p.Asp379Asn Missense 29 Hemi Inherited from 3/ unaffected 174894 heterozygous mother No No XLID Female carriers of pathogenic ACSL4 variants have skewed X-inactivation. 8

Supplemental references 1. Li, H., and Durbin, R. (29). Fast and acrate short read alignment with Burrows-Wheeler transform. Bioinformatics 25, 1754 176. 2. Li, H., Handsaker, B., Wysoker, A., Fennell, T., Ruan, J., Homer, N., Marth, G., Abecasis, G., and Durbin, R. (29). The Sequence Alignment/Map format and SAMtools. Bioinformatics 25, 278 279. 3. Raczy, C., Petrovski, R., Saunders, C.T., Chorny, I., Kruglyak, S., Margulies, E.H., Chuang, H.Y., Källberg, M., Kumar, S. a., Liao, A., et al. (213). Isaac: Ultra-fast whole-genome secondary analysis on Illumina sequencing platforms. Bioinformatics 29, 241 243. 4. Chen, X., Schulz-Trieglaff, O., Shaw, R., Barnes, B., Schlesinger, F., Källberg, M., Cox, A.J., Kruglyak, S., and Saunders, C.T. (215). Manta: rapid detection of structural variants and indels for germline and cancer sequencing applications. Bioinformatics 32, 122 1222. 5. Roller, E., Ivakhno, S., Lee, S., Royce, T., and Tanner, S. (216). Canvas: versatile and scalable detection of copy number variants. Bioinformatics 32, 2375 2377. 9