1
|
Zhao J, Zhang S, Jiang Y, Liu Y, Wang J, Zhu Q. Mutation analysis of the WFS1 gene in a Chinese family with autosomal-dominant non-syndrome deafness. Sci Rep 2022; 12:22180. [PMID: 36564540 PMCID: PMC9789122 DOI: 10.1038/s41598-022-26850-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/21/2022] [Indexed: 12/24/2022] Open
Abstract
To analyse the pathogenic genes and mutations of a family with hereditary deafness. We recruited a three-generation family with NSHL. A detailed medical history inquiry and related examinations were performed. Next-generation sequencing (NGS) was used to confirm the gene mutation in the proband, and Sanger sequencing was used for verification. The effect of the WFS1 mutation on the function and structure of the wolframin protein was predicted by multiple computational software. From the Gene Expression Omnibus (GEO) database, we obtained GSE40585 dataset and performed enrichment analyses. The family clinically manifested as autosomal dominant NSHL. A novel WFS1 c.2421C>G (p.Ser807Arg) mutation was identified in four affected individuals in the pedigree . The p.Ser807Arg mutation is a highly conserved residue and causes an increase in protein stability. It had an important influence on not only amino acid size, charge and hydrophobicity but also protein intermolecular hydrogen bonding and spatial structure. There were differentially expressed genes (DEGs) in GSE40585 dataset. Enrichment analysis revealed that DEGs mainly functioned in amino acid metabolism, signal transduction and dephosphorylation. We reported a novel mutation c.2421C>G (p.Ser807Arg in WFS1. This study expands the mutation spectrum of WFS1.
Collapse
Affiliation(s)
- Jing Zhao
- grid.452209.80000 0004 1799 0194Department of Otolaryngology, The Third Hospital of Hebei Medical University, Hebei, China
| | - Siqi Zhang
- grid.452702.60000 0004 1804 3009Department of Otolaryngology, The Second Hospital of Hebei Medical University, Hebei, China
| | - Yuan Jiang
- grid.452702.60000 0004 1804 3009Department of Otolaryngology, The Second Hospital of Hebei Medical University, Hebei, China
| | - Yan Liu
- grid.452702.60000 0004 1804 3009Department of Otolaryngology, The Second Hospital of Hebei Medical University, Hebei, China
| | - Jiantao Wang
- grid.452702.60000 0004 1804 3009Department of Otolaryngology, The Second Hospital of Hebei Medical University, Hebei, China
| | - QingWen Zhu
- grid.452702.60000 0004 1804 3009Department of Otolaryngology, The Second Hospital of Hebei Medical University, Hebei, China
| |
Collapse
|
2
|
Porosk R, Terasmaa A, Mahlapuu R, Soomets U, Kilk K. Metabolomics of the Wolfram Syndrome 1 Gene (Wfs1) Deficient Mice. OMICS-A JOURNAL OF INTEGRATIVE BIOLOGY 2018; 21:721-732. [PMID: 29257731 DOI: 10.1089/omi.2017.0143] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Wolfram syndrome 1 is a rare autosomal recessive neurodegenerative disease characterized by diabetes insipidus, diabetes mellitus, optic atrophy, and deafness. Mutations in the WFS1 gene encoding the wolframin glycoprotein can lead to endoplasmic reticulum stress and unfolded protein responses in cells, but the pathophysiology at whole organism level is poorly understood. In this study, several organs (heart, liver, kidneys, and pancreas) and bodily fluids (trunk blood and urine) of 2- and 6-month old Wfs1 knockout (KO), heterozygote (HZ), and wild-type (WT) mice were analyzed by untargeted and targeted metabolomics using liquid chromatography-mass spectrometry. The key findings were significant perturbations in the metabolism of pancreas and heart before the onset of related clinical signs such as glycosuria that precedes hyperglycemia and thus implies a kidney dysfunction before the onset of classical diabetic nephropathy. The glucose use and gluconeogenesis in KO mice are intensified in early stages, but later the energetic needs are mainly covered by lipolysis. Furthermore, in young mice liver and trunk blood hypouricemia, which in time turns to hyperuricemia, was detected. In summary, we show that the metabolism in Wfs1-deficient mice markedly differs from the metabolism of WT mice in many aspects and discuss the future biological and clinical relevance of these observations.
Collapse
Affiliation(s)
- Rando Porosk
- 1 Department of Biochemistry, Institute of Biomedicine and Translational Medicine, University of Tartu , Tartu, Estonia
| | - Anton Terasmaa
- 2 Department of Physiology, Institute of Biomedicine and Translational Medicine, University of Tartu , Tartu, Estonia
| | - Riina Mahlapuu
- 1 Department of Biochemistry, Institute of Biomedicine and Translational Medicine, University of Tartu , Tartu, Estonia
| | - Ursel Soomets
- 1 Department of Biochemistry, Institute of Biomedicine and Translational Medicine, University of Tartu , Tartu, Estonia
| | - Kalle Kilk
- 1 Department of Biochemistry, Institute of Biomedicine and Translational Medicine, University of Tartu , Tartu, Estonia
| |
Collapse
|
3
|
Tang XW, Wang J, Zou YF. No association between wolframin gene H611R polymorphism and mood disorders: evidence from 2,570 subjects. Nord J Psychiatry 2015; 69:132-7. [PMID: 25074416 DOI: 10.3109/08039488.2014.936503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND In the past few decades, a number of studies have investigated the association of the wolframin (WFS1) gene H611R polymorphism with mood disorders, but the findings are not always consistent. AIMS The objective of the present study is to assess the association between WFS1 gene H611R polymorphism and mood disorders by using a meta-analysis. METHODS A comprehensive literature search of PubMed, Excerpta Medica Database, Elsevier Science Direct and China National Knowledge Infrastructure databases was conducted to identify relevant articles, with the last report up to April 15, 2014. Pooled odds ratio (OR) with 95% confidence interval (CI) was estimated. RESULTS Seven studies including 1318 cases and 1252 controls were selected from potentially relevant articles. This meta-analysis showed that there was no significant association between WFS1 gene H611R polymorphism and mood disorders (R vs. H: OR = 0.93, 95% CI = 0.82-1.05, P = 0.22; HR+ RR vs. HH: OR = 0.98, 95% CI = 0.82-1.17, P = 0.80; RR vs. HH+ HR: OR = 0.84, 95% CI = 0.67-1.04, P = 0.11; RR vs. HH: OR = 0.86, 95% CI = 0.67-1.10, P = 0.24; HR vs. HH: OR = 1.03, 95% CI = 0.78-1.36, P = 0.83). In subgroup analyses by ethnicity, we did not detect any significant association of this polymorphism with mood disorders in Caucasian and Asian populations (P > 0.05). In subgroup analyses by types of mood disorders, we also did not detect any significant association of this polymorphism with bipolar disorder or major depressive disorder (P > 0.05). CONCLUSIONS The results of this meta-analysis suggest that there is no association between WFS1 gene H611R polymorphism and mood disorders.
Collapse
Affiliation(s)
- Xiao-Wu Tang
- Xiao-Wu Tang, Department of Medicine, HeFei Vocational and Technical College , ChaoHu 238000, Anhui , China
| | | | | |
Collapse
|
4
|
Qing J, Yan D, Zhou Y, Liu Q, Wu W, Xiao Z, Liu Y, Liu J, Du L, Xie D, Liu XZ. Whole-exome sequencing to decipher the genetic heterogeneity of hearing loss in a Chinese family with deaf by deaf mating. PLoS One 2014; 9:e109178. [PMID: 25289672 PMCID: PMC4188603 DOI: 10.1371/journal.pone.0109178] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Accepted: 08/13/2014] [Indexed: 01/12/2023] Open
Abstract
Inherited deafness has been shown to have high genetic heterogeneity. For many decades, linkage analysis and candidate gene approaches have been the main tools to elucidate the genetics of hearing loss. However, this associated study design is costly, time-consuming, and unsuitable for small families. This is mainly due to the inadequate numbers of available affected individuals, locus heterogeneity, and assortative mating. Exome sequencing has now become technically feasible and a cost-effective method for detection of disease variants underlying Mendelian disorders due to the recent advances in next-generation sequencing (NGS) technologies. In the present study, we have combined both the Deafness Gene Mutation Detection Array and exome sequencing to identify deafness causative variants in a large Chinese composite family with deaf by deaf mating. The simultaneous screening of the 9 common deafness mutations using the allele-specific PCR based universal array, resulted in the identification of the 1555A>G in the mitochondrial DNA (mtDNA) 12S rRNA in affected individuals in one branch of the family. We then subjected the mutation-negative cases to exome sequencing and identified novel causative variants in the MYH14 and WFS1 genes. This report confirms the effective use of a NGS technique to detect pathogenic mutations in affected individuals who were not candidates for classical genetic studies.
Collapse
Affiliation(s)
- Jie Qing
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Departments of Otolaryngology-Head and Neck Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Denise Yan
- Departments of Otolaryngology-Head and Neck Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Yuan Zhou
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiong Liu
- Departments of Otolaryngology-Head and Neck Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Weijing Wu
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zian Xiao
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yuyuan Liu
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jia Liu
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lilin Du
- Departments of Otolaryngology-Head and Neck Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| | - Dinghua Xie
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xue Zhong Liu
- Department of Otolaryngology-Head and Neck Surgery, Institute of Otology, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Departments of Otolaryngology-Head and Neck Surgery, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, United States of America
| |
Collapse
|
5
|
Genotypic classification of patients with Wolfram syndrome: insights into the natural history of the disease and correlation with phenotype. Genet Med 2013; 15:497-506. [PMID: 23429432 DOI: 10.1038/gim.2012.180] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 12/06/2012] [Indexed: 11/08/2022] Open
Abstract
PURPOSE Wolfram syndrome is a degenerative, recessive rare disease with an onset in childhood. It is caused by mutations in WFS1 or CISD2 genes. More than 200 different variations in WFS1 have been described in patients with Wolfram syndrome, which complicates the establishment of clear genotype-phenotype correlation. The purpose of this study was to elucidate the role of WFS1 mutations and update the natural history of the disease. METHODS This study analyzed clinical and genetic data of 412 patients with Wolfram syndrome published in the last 15 years. RESULTS (i) 15% of published patients do not fulfill the current -inclusion criterion; (ii) genotypic prevalence differences may exist among countries; (iii) diabetes mellitus and optic atrophy might not be the first two clinical features in some patients; (iv) mutations are nonuniformly distributed in WFS1; (v) age at onset of diabetes mellitus, hearing defects, and diabetes insipidus may depend on the patient's genotypic class; and (vi) disease progression rate might depend on genotypic class. CONCLUSION New genotype-phenotype correlations were established, disease progression rate for the general population and for the genotypic classes has been calculated, and new diagnostic criteria have been proposed. The conclusions raised could be important for patient management and counseling as well as for the development of treatments for Wolfram syndrome.
Collapse
|
6
|
Gershon ES, Badner JA. Incorporation of molecular data and redefinition of phenotype: new approaches to genetic epidemiology of bipolar manic depressive illness and schizophrenia. DIALOGUES IN CLINICAL NEUROSCIENCE 2012. [PMID: 22034205 PMCID: PMC3181639 DOI: 10.31887/dcns.2001.3.1/esgershon] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Considerable advances have been made in identifying specific genetic components of bipolar manic depressive illness (BP) and schizophrenia (SZ), despite their complex inheritance. Meta-analysis of all published whole-genome linkage scans reveals overall support for illness genes in several chromosomal regions. In two of these regions, on the lonq arm of chromosome 13 and on the long arm of chromosome 22, the combined studies of BP and SZ are consistent with a common susceptibility locus for the two disorders. This lends some plausibility to the hypothesis of some shared genetic predispositions for BP and SZ. Other linkages are supported by multiple studies of specific chromosomal regions, most notably two regions on chromosome 6 in SZ. The velocardiofacial syndrome is associated with deletions very close to the linkage region on chromosome 22, and with psychiatric manifestations of both BP and SZ. Endophenotypes of SZ, previously demonstrated to be heritable, have been found to have chromosomal linkage in at least one study. These include eye-tracking abnormalities linked to the short arm of chromosome 6, and abnormality of the P50 cortical evoked potential linked to chromosome 15. Variants in specific genes have been associated with susceptibility to illness, and other genes have been associated with susceptibility to side effects of pharmacological treatment. These genetic findings may eventually be part of an integrated genetic, environmental, and interactive-factor epidemiology of the major mental illnesses.
Collapse
Affiliation(s)
- E S Gershon
- Department of Psychiatry, University of Chicago, Chicago, III, USA
| | | |
Collapse
|
7
|
Boutzios G, Livadas S, Marinakis E, Opie N, Economou F, Diamanti-Kandarakis E. Endocrine and metabolic aspects of the Wolfram syndrome. Endocrine 2011; 40:10-3. [PMID: 21725703 DOI: 10.1007/s12020-011-9505-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Wolfram syndrome (WS), also known as DIDMOAD (Diabetes Insipidus, Diabetes Mellitus, Optic Atrophy and Deafness), is a neurodegenerative disease with autosomal recessive inheritance with incomplete penetrance. DIDMOAD is a very rare disease with an estimated prevalence of 1 in 770,000 and it is believed to occur in 1 of 150 patients with juvenile-onset insulin-dependent diabetes mellitus. Additionally, WS may also present with different endocrine and metabolic abnormalities such as anterior and posterior pituitary gland dysfunction. This mini-review summarizes the variable presentation of WS and the need of screening for other metabolic and hormonal abnormalities, coexisting in this rare syndrome.
Collapse
Affiliation(s)
- Georgios Boutzios
- Third Department of Medicine, Medical School University of Athens, Sotiria Hospital Athens, Athens, Greece
| | | | | | | | | | | |
Collapse
|
8
|
Alimadadi A, Ebrahim-Habibi A, Abbasi F, Amoli MM, Sayahpour FA, Larijani B. Novel mutations of wolframin: a report with a look at the protein structure. Clin Genet 2010; 79:96-9. [DOI: 10.1111/j.1399-0004.2010.01511.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
9
|
Abstract
Wolfram syndrome (WS) (MIM 222300) is a rare multisystem neurodegenerative disorder of autosomal recessive inheritance, also known as DIDMOAD (diabetes insipidus, insulin-deficient diabetes mellitus, optic atrophy and deafness). A Wolfram gene (WFS1) has been mapped to chromosome 4p16.1 which encodes an endoplasmic reticulum (ER) membrane-embedded protein. ER localization suggests that WFS1 protein has physiological functions in membrane trafficking, secretion, processing and/or regulation of ER calcium omeostasis. Disturbances or overloading of these functions induce ER stress responses, including apoptosis. Most WS patients carry mutations in this gene, but some studies provided evidence for genetic heterogeneity, and the genotype-phenotype relationships are not clear. Here we review the data regarding the mechanisms and the mutations of WFS1 gene that relate to WS.
Collapse
Affiliation(s)
- L Rigoli
- Department of Pediatrics, University Hospital, Messina, Italy.
| | | | | |
Collapse
|
10
|
Kumar S. Wolfram syndrome: important implications for pediatricians and pediatric endocrinologists. Pediatr Diabetes 2010; 11:28-37. [PMID: 20015125 DOI: 10.1111/j.1399-5448.2009.00518.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Sharath Kumar
- Department of Pediatrics, Amrita Institute of Medical Sciences, Cochin, Kerala, India.
| |
Collapse
|
11
|
Wolfram syndrome 1 (Wfs1) mRNA expression in the normal mouse brain during postnatal development. Neurosci Res 2009; 64:213-30. [DOI: 10.1016/j.neures.2009.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2008] [Revised: 02/28/2009] [Accepted: 03/04/2009] [Indexed: 11/19/2022]
|
12
|
Must A, Kõks S, Vasar E, Tasa G, Lang A, Maron E, Väli M. Common Variations in 4p Locus are Related to Male Completed Suicide. Neuromolecular Med 2008; 11:13-9. [DOI: 10.1007/s12017-008-8056-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2008] [Accepted: 11/25/2008] [Indexed: 11/24/2022]
|
13
|
Serretti A, Mandelli L. The genetics of bipolar disorder: genome 'hot regions,' genes, new potential candidates and future directions. Mol Psychiatry 2008; 13:742-71. [PMID: 18332878 DOI: 10.1038/mp.2008.29] [Citation(s) in RCA: 131] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Bipolar disorder (BP) is a complex disorder caused by a number of liability genes interacting with the environment. In recent years, a large number of linkage and association studies have been conducted producing an extremely large number of findings often not replicated or partially replicated. Further, results from linkage and association studies are not always easily comparable. Unfortunately, at present a comprehensive coverage of available evidence is still lacking. In the present paper, we summarized results obtained from both linkage and association studies in BP. Further, we indicated new potential interesting genes, located in genome 'hot regions' for BP and being expressed in the brain. We reviewed published studies on the subject till December 2007. We precisely localized regions where positive linkage has been found, by the NCBI Map viewer (http://www.ncbi.nlm.nih.gov/mapview/); further, we identified genes located in interesting areas and expressed in the brain, by the Entrez gene, Unigene databases (http://www.ncbi.nlm.nih.gov/entrez/) and Human Protein Reference Database (http://www.hprd.org); these genes could be of interest in future investigations. The review of association studies gave interesting results, as a number of genes seem to be definitively involved in BP, such as SLC6A4, TPH2, DRD4, SLC6A3, DAOA, DTNBP1, NRG1, DISC1 and BDNF. A number of promising genes, which received independent confirmations, and genes that have to be further investigated in BP, have been also systematically listed. In conclusion, the combination of linkage and association approaches provided a number of liability genes. Nevertheless, other approaches are required to disentangle conflicting findings, such as gene interaction analyses, interaction with psychosocial and environmental factors and, finally, endophenotype investigations.
Collapse
Affiliation(s)
- A Serretti
- Institute of Psychiatry, University of Bologna, Bologna, Italy.
| | | |
Collapse
|
14
|
So J, Warsh JJ, Li PP. Impaired endoplasmic reticulum stress response in B-lymphoblasts from patients with bipolar-I disorder. Biol Psychiatry 2007; 62:141-7. [PMID: 17217928 DOI: 10.1016/j.biopsych.2006.10.014] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2006] [Revised: 10/11/2006] [Accepted: 10/12/2006] [Indexed: 01/19/2023]
Abstract
BACKGROUND Aberrant intracellular calcium (Ca2+) signaling in patients with bipolar-I disorder (BD-I) suggests disturbed endoplasmic reticulum (ER) function in BD. We examined whether the ER stress response is altered in BD-I patients and the relationship to basal intracellular Ca2+ levels ([Ca2+]B), in B lymphoblasts (BLCLs) from BD-I patients. METHODS Endoplasmic reticulum stress-induced X-box binding protein 1 (XBP1), C/EBP homologous protein (CHOP), and GRP78 expression in BLCLs from BD-I subjects stratified on elevated or normal [Ca2+]B and control subjects were determined by real-time quantitative reverse transcription polymerase chain reaction. The XBP1 -116C/G polymorphism, which impairs the XBP1 loop in the ER stress response, were genotyped with a TaqMan-based assay. RESULTS Compared with control subjects, thapsigargin- and tunicamycin-induced increases in XBP1 and CHOP but not GRP78 messenger RNA levels were significantly lower in BD-I patients. However, induction of these genes did not differ significantly in the two BD-I subgroups stratified on [Ca2+]B. Furthermore, the attenuated XBP1 induction cannot be explained solely by differences of XBP1 -116C/G genotype frequency. CONCLUSIONS Our findings suggest that the ER stress response is impaired in BD-I patients but irrespective of altered intracellular Ca2+ homeostasis as reflected in elevated [Ca2+]B. Moreover, an effect of XBP1 -116C/G polymorphism could not account for the attenuated XBP1 induction in bipolar-I disorder observed in this study.
Collapse
Affiliation(s)
- Jonathan So
- Laboratory of Cellular and Molecular Pathophysiology, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | | | | |
Collapse
|
15
|
Mathis S, Paquis V, Mesnage V, Balaboï I, Gil R, Gilbert B, Neau JP. Ataxie cérébelleuse révélant un syndrome de Wolfram. Rev Neurol (Paris) 2007; 163:197-204. [PMID: 17351539 DOI: 10.1016/s0035-3787(07)90391-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Wolfram syndrome is a genetic disease with recessive autosomic transmission, associating early-onset diabetes mellitus and bilateral optical atrophy. CASE REPORT We report the case of a 47-year-old patient for whom we diagnosed a Wolfram syndrome in view of a late neurological syndrome in association with ataxia and bilateral horizontal nystagmus. The brain resonance magnetic imaging revealed a major atrophy of the brainstem and cerebellum. CONCLUSION Wolfram syndrome is a rare pathology, with fatal consequences before the age of 50. The association of diabetes mellitus and optical atrophy, especially when there are other symptoms (ataxia, deafness, diabetes insipidus, neuropsychiatric manifestations or urinary tract disorders) should lead to this diagnosis and to carry out a genetic confirmation.
Collapse
Affiliation(s)
- S Mathis
- Clinique Neurologique, CHU La Milétrie, Poitiers
| | | | | | | | | | | | | |
Collapse
|
16
|
Abstract
Genetic predisposition plays an important role in most common psychiatric disorders. The identification of a specific gene associated with a psychiatric illness can lead to improved management of the gene-associated disorder. Mutations in the wolframin gene are associated with mental illness. Many patients with the Wolfram syndrome (WS), who are homozygous or compound heterozygous for wolframin mutations, have severe psychiatric symptoms. In WS families, close blood relatives, who have a high probability of carrying a single wolframin mutation, had a statistically significant excess, over spouse controls, of psychiatric hospitalizations, attempted and completed suicides, and self-reports of mental illness. Since heterozygous carriers of wolframin mutations are relatively frequent in the population according to the general Hardy-Weinberg principle, such mutations might be responsible for the illnesses of many psychiatric patients. The hypothesis that heterozygous carriers of a wolframin mutation are predisposed to psychiatric illness was tested in subjects from 25 WS families. In all, 11 relatives who had psychiatric hospitalizations could be genotyped through mutation analysis. Eight of these carried the wolframin mutation transmitted in their family, significantly (one-sided P=0.0022) more than the 3.0 expected if there were no association between psychiatric hospitalizations and mutations at this locus. All eight mutation-positive subjects had been hospitalized for a major depression. This confirmation of the association is not influenced by confounders, undetected stratification, or genetic heterogeneity. The relative risk of psychiatric hospitalization for depression was estimated to be 7.1 (95% CI 1.9-26.6) for carriers of a single wolframin mutation compared to noncarriers.
Collapse
Affiliation(s)
- M Swift
- Disease Insight Research Foundation, Ardsley, NY 10502, USA.
| | | |
Collapse
|
17
|
Kato T. Mitochondrial dysfunction in bipolar disorder: from 31P-magnetic resonance spectroscopic findings to their molecular mechanisms. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2005; 63:21-40. [PMID: 15797464 DOI: 10.1016/s0074-7742(05)63002-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Affiliation(s)
- Tadafumi Kato
- Laboratory for Molecular Dynamics of Mental Disorders Brain Science Institute, RIKEN Saitama 351-0198, Japan
| |
Collapse
|
18
|
Medlej R, Wasson J, Baz P, Azar S, Salti I, Loiselet J, Permutt A, Halaby G. Diabetes mellitus and optic atrophy: a study of Wolfram syndrome in the Lebanese population. J Clin Endocrinol Metab 2004; 89:1656-61. [PMID: 15070927 DOI: 10.1210/jc.2002-030015] [Citation(s) in RCA: 98] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Wolfram syndrome (WFS) is a rare hereditary neurodegenerative disorder also known as DIDMOAD (diabetes insipidus, diabetes mellitus, optic atrophy, and deafness). WFS seems to be a heterogeneous disease that has not yet been fully characterized in terms of clinical features and pathophysiological mechanisms because the number of patients in most series was small. In this study we describe 31 Lebanese WFS patients belonging to 17 families; this, to our knowledge, is the largest number of patients reported in one series so far. Criteria for diagnosis of WFS were the presence of insulin-dependent diabetes mellitus and optic atrophy unexplained by any other disease. Central diabetes insipidus was found in 87% of the patients, and sensorineural deafness confirmed by audiograms was present in 64.5%. Other less frequent features included neurological and psychiatric abnormalities, urodynamic abnormalities, limited joint motility, cardiovascular and gastrointestinal autonomic neuropathy, hypergonadotropic hypogonadism in males, and diabetic microvascular disease. New features, not reported in previous descriptions, such as heart malformations and anterior pituitary dysfunction, were recognized in some of the patients and participated in the morbidity and mortality of the disease. Genetic analysis revealed WFS1 gene mutations in three families (23.5%), whereas no abnormalities were detected in mitochondrial DNA. In conclusion, WFS is a devastating disease for the patients and their families. More information about WFS will lead to a better understanding of this disease and hopefully to improvement in means of its prevention and treatment.
Collapse
Affiliation(s)
- R Medlej
- Departments of Endocrinology and Metabolism, Hôtel Dieu Hospital, Beirut, Lebanon
| | | | | | | | | | | | | | | |
Collapse
|
19
|
Larsen ZM, Johannesen J, Kristiansen OP, Nerup J, Pociot F. Evidence for linkage on chromosome 4p16.1 in Type 1 diabetes Danish families and complete mutation scanning of the WFS1 (Wolframin) gene. Diabet Med 2004; 21:218-22. [PMID: 15008830 DOI: 10.1046/j.1464-5491.2003.01088.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIMS To investigate whether the WFS1 gene, the gene for Wolfram syndrome, is a susceptibility gene for more common forms of diabetes in the Danish population. METHODS One hundred and fifty-two Danish Type 1 diabetes mellitus sib-pair families were genotyped for two microsatellite markers situated within 5 cM of the WFS1 gene and analysed for linkage and association using the sib-TDT. The entire coding region, the 5'UTR and 3'UTR of the WFS1 gene, were screened for mutations by direct sequencing in 29 selected Type 1 diabetes patients. Four of the identified mutations were tested for linkage and association in 255 Danish Type 1 diabetes families (including 103 simplex families). RESULTS Evidence for linkage to Type 1 diabetes was found as the second most frequent allele of the marker D4S394 were transmitted 137 times (T = 61%) and not transmitted 88 times to affected offspring (Puc = 0.0011). Twelve mutations were found in the coding region and three mutations in the 3'UTR. No evidence for linkage and association to Type 1 diabetes was found testing four of the identified amino acid substitutions. CONCLUSIONS Evidence of linkage to Type 1 diabetes was observed in the Danish family collection. However, no evidence of linkage and association was observed for any of the analysed polymorphisms, suggesting that other variations must be responsible for the observed evidence of linkage in the region.
Collapse
Affiliation(s)
- Z M Larsen
- Steno Diabetes Centre, Gentofte, Denmark
| | | | | | | | | |
Collapse
|
20
|
Cryns K, Sivakumaran TA, Van den Ouweland JMW, Pennings RJE, Cremers CWRJ, Flothmann K, Young TL, Smith RJH, Lesperance MM, Van Camp G. Mutational spectrum of the WFS1 gene in Wolfram syndrome, nonsyndromic hearing impairment, diabetes mellitus, and psychiatric disease. Hum Mutat 2003; 22:275-87. [PMID: 12955714 DOI: 10.1002/humu.10258] [Citation(s) in RCA: 130] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
WFS1 is a novel gene and encodes an 890 amino-acid glycoprotein (wolframin), predominantly localized in the endoplasmic reticulum. Mutations in WFS1 underlie autosomal recessive Wolfram syndrome and autosomal dominant low frequency sensorineural hearing impairment (LFSNHI) DFNA6/14. In addition, several WFS1 sequence variants have been shown to be significantly associated with diabetes mellitus and this gene has also been implicated in psychiatric diseases. Wolfram syndrome is highly variable in its clinical manifestations, which include diabetes insipidus, diabetes mellitus, optic atrophy, and deafness. Wolfram syndrome mutations are spread over the entire coding region, and are typically inactivating, suggesting that a loss of function causes the disease phenotype. In contrast, only non-inactivating mutations have been found in DFNA6/14 families, and these mutations are mainly located in the C-terminal protein domain. In this paper, we provide an overview of the currently known disease-causing and benign allele variants of WFS1 and propose a potential genotype-phenotype correlation for Wolfram syndrome and LFSNHI.
Collapse
Affiliation(s)
- Kim Cryns
- Department of Medical Genetics, University of Antwerp, Antwerp, Belgium
| | | | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Serretti A, Cusin C, Cristina S, Lorenzi C, Lilli R, Lattuada E, Grieco G, Costa A, Santorelli F, Barale F, Smeraldi E, Nappi G. Psychiatr Genet 2003; 13:121-126. [DOI: 10.1097/00041444-200306000-00012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
|
22
|
Sequeira A, Kim C, Seguin M, Lesage A, Chawky N, Desautels A, Tousignant M, Vanier C, Lipp O, Benkelfat C, Rouleau G, Turecki G. Wolfram syndrome and suicide: Evidence for a role of WFS1 in suicidal and impulsive behavior. Am J Med Genet B Neuropsychiatr Genet 2003; 119B:108-13. [PMID: 12707947 DOI: 10.1002/ajmg.b.20011] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
There is evidence suggesting that subjects affected with the Wolfram syndrome (WFS) and normal carriers present an increased risk of psychiatric disorders, particularly depression and suicidal behavior. We investigated a possible role of the gene involved in WFS (WFS1) in the neurobiology of suicide and the potential modulatory effect on traits associated to suicidal behavior. Genetic variation at WFS1 (H611R, R456H, and I333V) was investigated in 111 suicide victims and 129 normal controls. Possible effects on psychopathology and behavioral traits were investigated in a subsample of suicide cases (N = 31) for whom phenotyping was carried out by means of structured psychiatric interviews and questionnaires adapted for psychological autopsies. We found a significantly higher frequency of the 611R/611R genotype in suicide completers as compared to controls (chi(2) = 19.21, df=2, P = 0.001). Suicide completers with this genotype had higher scores on measures of impulsivity (t = -3.15, df = 15.3, P = 0.006); novelty seeking (NS) (t = -3.35, df = 13.8, P = 0.005); and conversely, lower scores of persistence (t = 2.4, df = 16.6, P = 0.028). Scores of impulsivity and NS remained higher in subjects with the associated genotype after adjusting for age, gender, and psychopathology. These results suggest a role for WFS1 in the pathophysiology of impulsive suicide, and are consistent with previous clinical reports suggesting an increased risk of suicidal behavior in WFS homozygotes and heterozygotes. However, these findings are preliminary and should be confirmed in independent samples.
Collapse
Affiliation(s)
- Adolfo Sequeira
- McGill Group for Suicide Studies, Douglas Hospital, McGill University, Montreal, Canada
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
23
|
Martorell L, Zaera MG, Valero J, Serrano D, Figuera L, Joven J, Labad A, Vilella E, Nunes V. The WFS1 (Wolfram syndrome 1) is not a major susceptibility gene for the development of psychiatric disorders. Psychiatr Genet 2003; 13:29-32. [PMID: 12605098 DOI: 10.1097/00041444-200303000-00005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Wolfram syndrome is a neurodegenerative disorder that is inherited in an autosomal recessive mode and characterized by the presence of diabetes mellitus and optic atrophy. Patients and heterozygote carriers are at an increased risk of suffering psychiatric disorders. Mutations in the Wolfram gene (WFS1 ) (4p16.1) are responsible for the development of the disease, and mRNA and protein expression of WFS1 have recently been found in areas of the rat brain that can be related to the psychiatric symptoms. OBJECTIVE To test the hypothesis that WFS1 mutations in heterozygote carriers or other variants of WFS1 can predispose to mental illness. METHODS Stage 1: Exons 2, 4 and 8 of that harbour mutations in Spanish Wolfram syndrome families were examined by Single Strand Conformation Polymorphism and sequencing analysis in 43 patients with affective disorder to identify variants and mutations. Stage 2: two variants identified in stage 1 were analysed in 152 psychiatric patients (118 schizophrenia and 34 affective disorder) and 177 control subjects. RESULTS Six variants (I333V Ile-->Val, F341, N500, R708, K774, K811) and a WFS1 mutation (R818C, Arg-->Cys) were found in the 43 patients analysed in stage 1 of the study. In stage 2, the R818C mutation was not found in the group of psychiatric patients but it was present in one control subject. The association study conducted with the I333V variant did not find significant differences in allele or genotype frequencies between patients and control subjects. CONCLUSIONS Our results suggest that WFS1 is not a major susceptibility gene for the development of psychiatric disorders in our population.
Collapse
Affiliation(s)
- Lourdes Martorell
- Departament de Formació i Investigació, Hospital Psiquiàtric Universitari Institut Pere Mata, Ctra. de l'Institut Pere Mata s/n, Reus, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Kato T, Iwamoto K, Washizuka S, Mori K, Tajima O, Akiyama T, Nanko S, Kunugi H, Kato N. No association of mutations and mRNA expression of WFS1/wolframin with bipolar disorder in humans. Neurosci Lett 2003; 338:21-4. [PMID: 12565131 DOI: 10.1016/s0304-3940(02)01334-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Association of WFS1 (wolframin) and bipolar disorder has been suggested by psychiatric manifestations in patients or non-symptomatic carriers of Wolfram disease and linkage of bipolar disorder with 4p16, the locus of WFS1. Five studies of WFS1 in bipolar disorder did not support this association, although possible association of several missense mutations has not been excluded yet. In this study, four such mutations were genotyped in 184 patients with bipolar disorder and 207 controls. None had the A559T and A602V mutations, and no association of G576S and H611R with bipolar disorder was found. We also quantified the expression levels of WFS1 mRNA in the postmortem brains of patients with bipolar disorder, depression, schizophrenia, and controls. There was no significant difference of the expression levels. These results did not support the pathophysiological significance of WFS1 in bipolar disorder.
Collapse
Affiliation(s)
- Tadafumi Kato
- Laboratory for Molecular Dynamics of Mental Disorders, Brain Science Institute, RIKEN, Hirosawa 2-1, Wako, Saitama 351-0198, Japan.
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Crawford J, Zielinski MA, Fisher LJ, Sutherland GR, Goldney RD. Is there a relationship between Wolfram syndrome carrier status and suicide? AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 114:343-6. [PMID: 11920861 DOI: 10.1002/ajmg.10256] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Wolfram syndrome (WFS) is a rare, autosomal recessive neurodegenerative disorder. An increased risk of psychiatric disorders and suicide has been reported for heterozygote carriers. In this study we investigated whether mutations in the WFS gene are associated with suicide in the general population. The gene for WFS (WFS1) has recently been mapped to chromosome 4p16.1, and its genomic structure has been characterized. We screened the entire WFS1 ORF in a panel of 100 completed suicides, 60 blood donors not known to have psychiatric illness, and 100 donors with a negative history of depression or suicidal behavior. We did not find evidence of an increased incidence of WFS carriers in the suicide panel and concluded that WFS1 carrier status is not a significant contributor to suicide in the general population. Screening of this highly polymorphic gene resulted in the detection of 33 variants, 13 of which cause amino acid changes. Seven of these changes have not been previously reported and six were unique to our suicide panel.
Collapse
Affiliation(s)
- Joanna Crawford
- Department of Cytogenetics and Molecular Genetics, Women's and Children's Hospital, North Adelaide, Australia.
| | | | | | | | | |
Collapse
|
26
|
Gershon ES, Badner JA. Progress toward discovery of susceptibility genes for bipolar manic-depressive illness and schizophrenia. CNS Spectr 2001; 6:965-8, 977. [PMID: 15311192 DOI: 10.1017/s1092852900001073] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
The inconsistency in linkage results that has bedeviled psychiatric genetics has been observed to occur regularly in common diseases with complex inheritance. Nonetheless, in two such instances--noninsulin-dependent diabetes mellitus (NIDDM) and inflammatory bowel disease (IBD)--susceptibility genes have been discovered based on the follow-ups of linkage findings. In bipolar illness disorder (BPD) and schizophrenia (SZ), there are some linkage reports with replication of other studies similar to the situation in NIDDM and IBD before the successful positional cloning efforts. Two of the regions with linkage reports, BPD and SZ, on the long arms of chromosomes 13 and 22, show linkage to the same markers in both diseases. This lends some plausibility to the hypothesis of some shared genetic predispositions for both disorders. Cytogenetic evidence offers another positional approach to susceptibility genes. The velocardiofacial syndrome is associated with deletions very close to the linkage region on chromosome 22, and with psychiatric manifestations of both BPD and SZ. Endophenotypes of SZ, previously demonstrated to the be heritable, have been found to have chromosomal linkage in at least one study. These include eye-tracking abnormalities linked to 6p, and an abnormality of the P50 cortical evoked potential linked to chromosome 15. Variants in specific genes have been associated with susceptibility to the psychiatric illnesses. These genetic findings may contribute to etiologic subcategorization of BPD and SZ, and the development of new treatment approaches. A table of genetic terms is included for review
Collapse
Affiliation(s)
- E S Gershon
- Department of Psychiatry, University of Chicago, Chicago, Ill, USA.
| | | |
Collapse
|
27
|
Kato T. The other, forgotten genome: mitochondrial DNA and mental disorders. Mol Psychiatry 2001; 6:625-33. [PMID: 11673790 DOI: 10.1038/sj.mp.4000926] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2000] [Revised: 03/20/2001] [Accepted: 03/23/2001] [Indexed: 01/08/2023]
Abstract
This paper summarizes recent research on mitochondrial DNA (mtDNA)--which might be described as the "other, forgotten genome". Recent studies suggest the possible pathophysiological significance of mtDNA in schizophrenia and neurodegenerative and mood disorders. Decreased activity of the mitochondrial electron transport chain has been implicated in both Parkinson's and Alzheimer's disease and while age-related accumulation of mtDNA deletions has been suggested as a possible cause, there is no concrete evidence that particular mtDNA polymorphisms are responsible. In schizophrenia, the activity and/or mRNA expression of complex IV are involved, but the direction of the alteration is not the same and there is no evidence linking schizophrenia with mtDNA. In bipolar disorder, there is some evidence of parent-of-origin effects and association with mtDNA polymorphisms but further investigation is needed to elucidate the role of mtDNA in mental disorders.
Collapse
Affiliation(s)
- T Kato
- Laboratory for Molecular Dynamics of Mental Disorders, Brain Science Institute, RIKEN, Hirosawa 2-1, Wako, Saitama, 351-0198, Japan.
| |
Collapse
|
28
|
Abstract
Alteration of monoaminergic neurotransmission is implicated in the pathophysiology of bipolar disorder (manic-depressive illness). Candidate genes participating in monoaminergic neurotransmission, especially serotonin transporter and monoamine oxidase A, may be associated with bipolar disorder. And the regulating regions of these genes and the molecules participating in intracellular signal transduction are now under investigation. To date, 13 whole genome positional cloning studies have been performed and many candidate loci identified. Using patients from a pedigree in which schizophrenia, depression or bipolar disorder have been linked with a balanced translocation at 1 and 11, candidate pathogenetic genes were cloned as DISC1 (disrupted in schizophrenia-1) and DISC2. Recently, pathogenetic mutations have been identified in two genetic diseases frequently co-morbid with mood disorder; WFS1 for Wolfram syndrome and ATP2A2 (SERCA2) for Darier's disease. Transmission of bipolar disorder may be characterized by anticipation and parent-of-origin effect, and extended CTG repeat at SEF2-1B gene was identified from a bipolar patient. However, its pathogenetic role was not supported by subsequent studies. Association of bipolar disorder with mitochondrial DNA has also been suggested. The role of genomic imprinting is also possible because linkage to 18p11 is limited to paternally transmitted pedigrees. These results warrant further study of molecular genetics of bipolar disorder.
Collapse
Affiliation(s)
- T Kato
- Laboratory for Molecular Dynamics of Mental Disorders, Brain Science Institute, RIKEN, 2-1 Hirosawa, Wako-shi, 351-0198, Saitama, Japan.
| |
Collapse
|
29
|
Khanim F, Kirk J, Latif F, Barrett TG. WFS1/wolframin mutations, Wolfram syndrome, and associated diseases. Hum Mutat 2001; 17:357-67. [PMID: 11317350 DOI: 10.1002/humu.1110] [Citation(s) in RCA: 123] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Wolfram syndrome (WS) is the inherited association of juvenile-onset insulin-dependant diabetes mellitus and progressive bilateral optic atrophy. A nuclear gene, WFS1/wolframin, was identified that segregated with disease status and demonstrated an autosomal recessive mode of inheritance. Mutation analysis of the WFS1 gene in WS patients has identified mutations in 90% of patients. Most were compound heterozygotes with private mutations distributed throughout the gene with no obvious hotspots. The private nature of the mutations in WS patients and the low frequencies make it difficult to determine the biological or clinical relevance of these mutations. Mutation screening in patients with psychiatric disorders or diabetes mellitus has also been performed to test the hypothesis that heterozygous carriers of WFS1 gene mutations are at an increased risk following the observation that WS first-degree relatives have a higher frequency of these disorders. Most studies showed no association, however two missense mutations were identified that demonstrated significant association with psychiatric disorders and diabetes mellitus. Population association studies and functional studies of these variants will need to be performed to confirm these preliminary results. The elucidation of functions and functional pathways for the WFS1 gene product and variants will shed light on the effect of such disparate mutations on gene function and their role in the resulting clinical phenotype in WS and associated disorders.
Collapse
Affiliation(s)
- F Khanim
- Medical and Molecular Genetics, Division of Reproductive and Child Health, The University of Birmingham, Birmingham, UK
| | | | | | | |
Collapse
|