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Orth P, Stahl PR, Tränkenschuh W, Baumhoer D, Kehl T, Lehnhof HP, Schneider G, Meese E, Madry H, Fischer U. A novel entity of massive multifocal osteolyses in the elderly. Bone Rep 2024; 21:101765. [PMID: 38681749 PMCID: PMC11052910 DOI: 10.1016/j.bonr.2024.101765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 04/03/2024] [Accepted: 04/16/2024] [Indexed: 05/01/2024] Open
Abstract
Osteolyses are common findings in elderly patients and most frequently represent malignant or locally aggressive bone tumors, infection, inflammatory and endocrine disorders, histiocytoses, and rare diseases such as Gorham-Stout syndrome. We here report on a novel entity of massive multifocal osteolyses in both shoulders, the right hip and left knee joint and the dens of an 83-year-old patient not relatable to any previously known etiopathology of bone disorders. The soft tissue mass is of myxoid stroma with an unspecific granulomatous inflammatory process, aggressively destroying extensive cortical and cancellous bone segments and encroaching on articulating bones in diarthrodial large joints. Radiological, nuclear medical, serological, histological, and immunohistochemical analyses were incapable of further classifying the disease pattern within the existing scheme of pathology. Quantitative polymerase chain reaction and next generation sequencing revealed that mutations are not suggestive of any known hereditary or acquired bone disease. Possible treatment options include radionuclide therapy for pain palliation and percutaneous radiation to arrest bone resorption while surgical treatment is inevitable for pathological fractures. This case study shall increase the awareness of the musculoskeletal community and motivate to collect further information on this rare but mutilating disorder.
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Affiliation(s)
- Patrick Orth
- Department of Orthopaedic Surgery, Saarland University Medical Center, D-66421 Homburg, Germany
- Center of Experimental Orthopaedics, Saarland University, D-66421 Homburg, Germany
| | - Phillip Rolf Stahl
- Department of Pathology, MSB Medical School Berlin, D-14197 Berlin, Germany
| | - Wolfgang Tränkenschuh
- Department of Pathology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Daniel Baumhoer
- Bone Tumor Reference Center, Institute of Pathology, University Hospital Basel, CH-4031 Basel, Switzerland
| | - Tim Kehl
- Center for Bioinformatics, Saarland Informatics Campus, D-66123 Saarbrücken, Germany
| | - Hans-Peter Lehnhof
- Center for Bioinformatics, Saarland Informatics Campus, D-66123 Saarbrücken, Germany
| | - Günther Schneider
- Department of Radiology, Saarland University Medical Center, D-66421 Homburg, Germany
| | - Eckart Meese
- Institute of Human Genetics, Saarland University, D-66421 Homburg, Germany
| | - Henning Madry
- Center of Experimental Orthopaedics, Saarland University, D-66421 Homburg, Germany
| | - Ulrike Fischer
- Institute of Human Genetics, Saarland University, D-66421 Homburg, Germany
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MacCarrick G, Aradhya S, Bailey M, Chu D, Hunt A, Izzo E, Krakow D, Mackenzie W, Poll S, Raggio C, Shediac R, White KK, McLaughlin HM, Seratti G. Clinical utility of comprehensive gene panel testing for common and rare causes of skeletal dysplasia and other skeletal disorders: Results from the largest cohort to date. Am J Med Genet A 2024:e63646. [PMID: 38702915 DOI: 10.1002/ajmg.a.63646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 04/03/2024] [Accepted: 04/18/2024] [Indexed: 05/06/2024]
Abstract
Molecular genetics enables more precise diagnoses of skeletal dysplasia and other skeletal disorders (SDs). We investigated the clinical utility of multigene panel testing for 5011 unrelated individuals with SD in the United States (December 2019-April 2022). Median (range) age was 8 (0-90) years, 70.5% had short stature and/or disproportionate growth, 27.4% had a positive molecular diagnosis (MDx), and 30 individuals received two MDx. Genes most commonly contributing to MDx were FGFR3 (16.9%), ALPL (13.0%), and COL1A1 (10.3%). Most of the 112 genes associated with ≥1 MDx were primarily involved in signal transduction (n = 35), metabolism (n = 23), or extracellular matrix organization (n = 17). There were implications associated with specific care/treatment options for 84.4% (1158/1372) of MDx-positive individuals; >50% were linked to conditions with targeted therapy approved or in clinical development, including osteogenesis imperfecta, achondroplasia, hypophosphatasia, and mucopolysaccharidosis. Forty individuals with initially inconclusive results became MDx-positive following family testing. Follow-up mucopolysaccharidosis enzyme activity testing was positive in 14 individuals (10 of these were not MDx-positive). Our findings showed that inclusion of metabolic genes associated with SD increased the clinical utility of a gene panel and confirmed that integrated use of comprehensive gene panel testing with orthogonal testing reduced the burden of inconclusive results.
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Affiliation(s)
- Gretchen MacCarrick
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | - Mitch Bailey
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Dorna Chu
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Abigail Hunt
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Emanuela Izzo
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Deborah Krakow
- David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, California, USA
| | - William Mackenzie
- Department of Orthopaedic Surgery, Nemours Children's Hospital, Wilmington, Delaware, USA
| | - Sarah Poll
- Invitae Corporation, San Francisco, California, USA
| | - Cathleen Raggio
- Department of Orthopedic Surgery, Hospital for Special Surgery, New York, New York, USA
| | - Renée Shediac
- BioMarin Pharmaceutical Inc, Novato, California, USA
| | - Klane K White
- Department of Pediatric Orthopedic Surgery, Children's Hospital Colorado, Aurora, Colorado, USA
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Cavarzere P, Pietrobelli A, Gandini A, Munari S, Baffico AM, Maffei M, Gaudino R, Guzzo A, Arrigoni M, Coviello D, Piacentini G, Antoniazzi F. Role of genetic investigation in the diagnosis of short stature in a cohort of Italian children. J Endocrinol Invest 2024; 47:1237-1250. [PMID: 38087044 DOI: 10.1007/s40618-023-02243-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/04/2023] [Indexed: 04/23/2024]
Abstract
BACKGROUND Short stature (SS) is defined as height more than 2 standard deviations below the mean for age and sex. Hypothyroidism, celiac disease, growth hormone deficiency, hormonal abnormalities, and genetic conditions are among its causes. A wide range of conditions often due to largely unknown genetic variants can elude conventional diagnostic workup. AIM We used next-generation sequencing (NGS) to better understand the etiology of SS in a cohort of Italian children. PATIENTS AND METHODS The study sample was 125 children with SS of unknown origin referred to our Institute between 2015 and 2021. All had undergone complete auxological and hormonal investigations to exclude common causes of SS. Genetic analysis was performed using a NGS panel of 104 genes. Clinical data were reviewed to clarify the pathogenicity of the variants detected. RESULTS In this cohort, 43 potentially causing variants were identified in 38 children. A syndromic genetic condition was diagnosed in 7: Noonan syndrome in 3, Leri-Weill syndrome in 3, and hypochondroplasia in 1. Moreover, 8 benign variants and other 37 like benign variants were found. In 88 children, 179 variants of uncertain significance (VUS) were identified. No variant was found in 16 children. CONCLUSION Genetic analysis is a useful tool in the diagnostic workup of patients with SS, in adapting management and treatment, and in identifying syndromes with mild atypical clinical features. The role of VUS should not be underestimated, particularly when multiple VUS with possible mutual worsening effects are present in the same child.
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Affiliation(s)
- P Cavarzere
- Pediatric Division, Department of Pediatrics, University Hospital of Verona (Full Member of European Reference Network Endo-ERN), Verona, Italy.
- Department of Pediatrics, Child and Mother's Hospital, Piazzale Stefani 1, 37126, Verona, Italy.
| | - A Pietrobelli
- Pediatric Division, Department of Pediatrics, University Hospital of Verona (Full Member of European Reference Network Endo-ERN), Verona, Italy
- Department Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
| | - A Gandini
- Department Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
| | - S Munari
- Pediatric Division, Department of Pediatrics, University Hospital of Verona (Full Member of European Reference Network Endo-ERN), Verona, Italy
| | - A M Baffico
- Laboratory of Human Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - M Maffei
- Laboratory of Human Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - R Gaudino
- Pediatric Division, Department of Pediatrics, University Hospital of Verona (Full Member of European Reference Network Endo-ERN), Verona, Italy
- Department Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
| | - A Guzzo
- Laboratory Unit, Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy
| | - M Arrigoni
- Pediatric Division, Department of Pediatrics, University Hospital of Verona (Full Member of European Reference Network Endo-ERN), Verona, Italy
| | - D Coviello
- Laboratory of Human Genetics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - G Piacentini
- Pediatric Division, Department of Pediatrics, University Hospital of Verona (Full Member of European Reference Network Endo-ERN), Verona, Italy
- Department Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
| | - F Antoniazzi
- Pediatric Division, Department of Pediatrics, University Hospital of Verona (Full Member of European Reference Network Endo-ERN), Verona, Italy
- Department Surgical Sciences, Dentistry, Gynecology and Pediatrics, Pediatric Clinic, University of Verona, Verona, Italy
- Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, Regional Center for the Diagnosis and Treatment of Children and Adolescents with Rare Skeletal Disorders, Pediatric Clinic, University of Verona, Verona, Italy
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Fernandez‐Luna JL, Hernández JL, Curiel‐Olmo S, Martínez‐Amador NA, Vega AI, Quirce R, Montes‐Moreno S, Gutierrez O, del Real A, Sañudo C, Riancho JA. Osteomesopyknosis associated with a novel ALOX5 variant that impacts the RANKL pathway. Mol Genet Genomic Med 2024; 12:e2471. [PMID: 38803233 PMCID: PMC11130582 DOI: 10.1002/mgg3.2471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 05/03/2024] [Accepted: 05/14/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Bone tissue homeostasis relies on the coordinated activity of the bone-forming osteoblasts and bone-resorbing osteoclasts. Osteomesopyknosis is considered a distinctive rare sclerosing skeletal disorder of unelucidated pathophysiology and presumably autosomal dominant transmission. However, the causal genes are unknown. METHODS We present a case report encompassing clinical assessments, imaging studies, and whole-exome sequencing analysis, complemented by functional in vitro experiments. RESULTS This new case of osteomesopyknosis was associated with a missense ALOX5 variant predicted to induce protein misfolding and proteasomal degradation. Transfection experiments demonstrated that the variant was associated with reduced protein levels restored by proteasomal inhibition with bortezomib. Likewise, gene expression analysis showed that the mutated gene was associated with a decreased RANKL/OPG ratio, which is a critical driver of osteoclast precursor differentiation. CONCLUSION Our data indicate impaired bone resorption as the underlying mechanism of this rare osteosclerosis, implicating ALOX5 pathogenic variants as potential etiological factors.
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Affiliation(s)
- Jose L. Fernandez‐Luna
- Unidad de Genética, Hospital UM ValdecillaSantanderSpain
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
- Centro de investigación biomédica en red de Enfermedades Raras (CIBERER)SantanderSpain
| | - José L. Hernández
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
- Servicio de Medicina Interna, Hospital UM ValdecillaSantanderSpain
- Departamento de Medicina y PsiquiatríaUniversidad de CantabriaSantanderSpain
| | - Soraya Curiel‐Olmo
- Unidad de Genética, Hospital UM ValdecillaSantanderSpain
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
| | | | - Ana I. Vega
- Unidad de Genética, Hospital UM ValdecillaSantanderSpain
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
| | - Remedios Quirce
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
- Servicio de Medicina NuclearHospital UM ValdecillaSantanderSpain
| | - Santiago Montes‐Moreno
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
- Servicio de Anatomía PatológicaHospital UM ValdecillaSantanderSpain
| | - Olga Gutierrez
- Unidad de Genética, Hospital UM ValdecillaSantanderSpain
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
| | - Alvaro del Real
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
- Departamento de Medicina y PsiquiatríaUniversidad de CantabriaSantanderSpain
| | - Carolina Sañudo
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
- Departamento de Medicina y PsiquiatríaUniversidad de CantabriaSantanderSpain
| | - Jose A. Riancho
- Instituto de Investigación Valdecilla (IDIVAL)SantanderSpain
- Centro de investigación biomédica en red de Enfermedades Raras (CIBERER)SantanderSpain
- Servicio de Medicina Interna, Hospital UM ValdecillaSantanderSpain
- Departamento de Medicina y PsiquiatríaUniversidad de CantabriaSantanderSpain
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Arnaud P, Mougin Z, Baujat G, Drouin-Garraud V, El Chehadeh S, Gouya L, Odent S, Jondeau G, Boileau C, Hanna N, Le Goff C. Pathogenic variants affecting the TB5 domain of the fibrillin-1 protein: not only in geleophysic/acromicric dysplasias but also in Marfan syndrome. J Med Genet 2024; 61:469-476. [PMID: 38458756 DOI: 10.1136/jmg-2023-109646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/18/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND Marfan syndrome (MFS) is a multisystem disease with a unique combination of skeletal, cardiovascular and ocular features. Geleophysic/acromicric dysplasias (GPHYSD/ACMICD), characterised by short stature and extremities, are described as 'the mirror image' of MFS. The numerous FBN1 pathogenic variants identified in MFS are located all along the gene and lead to the same final pathogenic sequence. Conversely, in GPHYSD/ACMICD, the 28 known heterozygous FBN1 pathogenic variants all affect exons 41-42 encoding TGFβ-binding protein-like domain 5 (TB5). METHODS Since 1996, more than 5000 consecutive probands have been referred nationwide to our laboratory for molecular diagnosis of suspected MFS. RESULTS We identified five MFS probands carrying distinct heterozygous pathogenic in-frame variants affecting the TB5 domain of FBN1. The clinical data showed that the probands displayed a classical form of MFS. Strikingly, one missense variant affects an amino acid that was previously involved in GPHYSD. CONCLUSION Surprisingly, pathogenic variants in the TB5 domain of FBN1 can lead to two opposite phenotypes: GPHYSD/ACMICD and MFS, suggesting the existence of different pathogenic sequences with the involvement of tissue specificity. Further functional studies are ongoing to determine the precise role of this domain in the physiopathology of each disease.
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Affiliation(s)
- Pauline Arnaud
- Département de Génétique, Assistance Publique - Hopitaux de Paris, Paris, France
- U1148 LVTS, INSERM, Paris, Île-de-France, France
- Centre de Référence Maladies Rares Syndrome de Marfan et apparentés, Hôpital Bichat, APHP, Paris, Île-de-France, France
| | | | - Genevieve Baujat
- Département de Génétique, AP-HP, Hôpital Necker-Enfants malades, AP-HP, Paris, Île-de-France, France
| | | | - Salima El Chehadeh
- Service de Génétique Médicale, Hôpital de Hautepierre, CHU de Strasbourg, Strasbourg, Grand Est, France
| | - Laurent Gouya
- Centre de Référence Maladies Rares Syndrome de Marfan et apparentés, Hôpital Bichat, APHP, Paris, Île-de-France, France
| | - Sylvie Odent
- Service de Génétique Clinique, CLAD Ouest, CHU Rennes, Rennes, Bretagne, France
- UMR 6290, IGDR, Rennes, Bretagne, France
| | - Guillaume Jondeau
- U1148 LVTS, INSERM, Paris, Île-de-France, France
- Centre de Référence Maladies Rares Syndrome de Marfan et apparentés, Hôpital Bichat, APHP, Paris, Île-de-France, France
| | - Catherine Boileau
- Département de Génétique, Assistance Publique - Hopitaux de Paris, Paris, France
- U1148 LVTS, INSERM, Paris, Île-de-France, France
| | - Nadine Hanna
- Département de Génétique, Assistance Publique - Hopitaux de Paris, Paris, France
- U1148 LVTS, INSERM, Paris, Île-de-France, France
- Centre de Référence Maladies Rares Syndrome de Marfan et apparentés, Hôpital Bichat, APHP, Paris, Île-de-France, France
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Nagayama S, Takahashi H, Hasegawa F, Hori A, Kizami S, Furukawa R, Horie K, Ogoyama M, Hata K, Fujiwara H. A novel variant in IFT122 associated with a severe phenotype of cranioectodermal dysplasia. Congenit Anom (Kyoto) 2024. [PMID: 38637985 DOI: 10.1111/cga.12569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/01/2024] [Accepted: 04/03/2024] [Indexed: 04/20/2024]
Abstract
A 27-year-old multiparous woman conceived her fetus naturally. Early second-trimester ultrasound showed short extremities with systemic subcutaneous edema. The pregnancy was artificially terminated at 19 weeks of gestation because of the abnormalities based on the parents' wishes. The parents desired whole-exome sequencing to detect a causative gene using the umbilical cord and the parents' saliva. Compound heterozygous variants (NC_000003.11(NM_052989.3):c.230 T > G/NC_000003.11(NM_052985.4):c.1178A > T) were identified. We described a fetus with a novel compound heterozygous variant in IFT122. The phenotype of this case was severer than of other types of cranioectodermal dysplasia.
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Affiliation(s)
- Shiho Nagayama
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
| | - Hironori Takahashi
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
| | - Fuyuki Hasegawa
- Department of Clinical Genetics, National Center for Child Health and Development, Tokyo, Japan
| | - Asuka Hori
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Sho Kizami
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
| | - Rieko Furukawa
- Department of Radiology, Jichi Medical University, Shimotsuke, Japan
| | - Kenji Horie
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
| | - Manabu Ogoyama
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
| | - Kenichiro Hata
- Department of Maternal-Fetal Biology, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Molecular Biology, Gunma University, Maebashi, Japan
| | - Hiroyuki Fujiwara
- Department of Obstetrics and Gynecology, Jichi Medical University, Shimotsuke, Japan
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Dupre N, Riou MC, Isaac J, Ferre F, Cormier-Daire V, Kerner S, de La Dure-Molla M, Nowwarote N, Acevedo AC, Fournier BPJ. Root resorptions induced by genetic disorders: A systematic review. Oral Dis 2024. [PMID: 38566363 DOI: 10.1111/odi.14942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 03/08/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVES Root resorption in permanent teeth is a common pathological process that often follows dental trauma or orthodontic treatment. More rarely, root resorption is a feature of genetic disorders and can help with diagnosis. Thus, the present review aims to determine which genetic disorders could induce pathological root resorptions and thus which mutated genes could be associated with them. METHODS We conducted a systematic review following the PRISMA guidelines. Articles describing root resorptions in patients with genetic disorders were included from PubMed, Embase, Web of Science, and Google Scholar. We synthesized the genetic disorder, the type, severity, and extent of the resorptions, as well as the other systemic and oral symptoms and histological features. RESULTS The synthetic analysis included 25 studies among 937 identified records. We analyzed 21 case reports, three case series, and one cohort study. Overall, we highlighted 14 different pathologies with described root resorptions. Depending on the pathology, the sites of resorption, their extent, and their severity showed differences. CONCLUSION With 14 genetic pathologies suspected to induce root resorptions, our findings are significant and enrich a previous classification. Among them, three metabolic disorders, three calcium-phosphorus metabolism disorders, and osteolysis disorders were identified.
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Affiliation(s)
- Nicolas Dupre
- Reference Center for Oral and Dental Rare Diseases, APHP, ORARES, Rothschild Hospital, Paris, France
- Centre de Recherche Des Cordeliers, Laboratory of Molecular Oral Pathophysiology, Université Paris Cité, Sorbonne Université, INSERM, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
| | - Margot C Riou
- Reference Center for Oral and Dental Rare Diseases, APHP, ORARES, Rothschild Hospital, Paris, France
- Centre de Recherche Des Cordeliers, Laboratory of Molecular Oral Pathophysiology, Université Paris Cité, Sorbonne Université, INSERM, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
| | - Juliane Isaac
- Centre de Recherche Des Cordeliers, Laboratory of Molecular Oral Pathophysiology, Université Paris Cité, Sorbonne Université, INSERM, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
| | - François Ferre
- Centre de Recherche Des Cordeliers, Laboratory of Molecular Oral Pathophysiology, Université Paris Cité, Sorbonne Université, INSERM, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
| | - Valérie Cormier-Daire
- Reference Center for Skeletal Dysplasia, INSERM UMR1163, Institut Imagine, Necker Hospital, Université Paris Cité, Paris, France
| | - Stéphane Kerner
- Reference Center for Oral and Dental Rare Diseases, APHP, ORARES, Rothschild Hospital, Paris, France
- Centre de Recherche Des Cordeliers, Laboratory of Molecular Oral Pathophysiology, Université Paris Cité, Sorbonne Université, INSERM, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
- Department of Periodontics, School of Dentistry, Loma Linda University, Loma Linda, California, USA
- Post-Graduate Program in Periodontology and Implant Dentistry, EFP, Université Paris Cité, Paris, France
| | - Muriel de La Dure-Molla
- Reference Center for Oral and Dental Rare Diseases, APHP, ORARES, Rothschild Hospital, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
- Reference Center for Skeletal Dysplasia, INSERM UMR1163, Institut Imagine, Necker Hospital, Université Paris Cité, Paris, France
| | - Nunthawan Nowwarote
- Centre de Recherche Des Cordeliers, Laboratory of Molecular Oral Pathophysiology, Université Paris Cité, Sorbonne Université, INSERM, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
| | - Ana Carolina Acevedo
- Centre de Recherche Des Cordeliers, Laboratory of Molecular Oral Pathophysiology, Université Paris Cité, Sorbonne Université, INSERM, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
- Laboratory of Oral Histopathology, Faculty of Health Sciences, University of Brasilia, Brasilia, Brazil
- Oral Care Center for Inherited Diseases, University Hospital of Brasilia, Brasilia, Brazil
| | - Benjamin P J Fournier
- Reference Center for Oral and Dental Rare Diseases, APHP, ORARES, Rothschild Hospital, Paris, France
- Centre de Recherche Des Cordeliers, Laboratory of Molecular Oral Pathophysiology, Université Paris Cité, Sorbonne Université, INSERM, Paris, France
- Department of Periodontology, Oral Biology, Pediatric Dentistry, and Oral Surgery, Faculty of Odontology, Université Paris Cité, Paris, France
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8
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Li L, Jin X, Liu S, Fan H. Prenatal ultrasound findings and prenatal diagnosis of fetal skeletal dysplasia. JOURNAL OF CLINICAL ULTRASOUND : JCU 2024. [PMID: 38561934 DOI: 10.1002/jcu.23673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/26/2024] [Accepted: 03/10/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To analyze the value of prenatal ultrasound and molecular testing in diagnosing fetal skeletal dysplasia (SD). METHODS Clinical data, prenatal ultrasound data, and molecular results of pregnant women with fetal SD were collected in the ultrasound department of our clinic from May 2019 to December 2021. RESULTS A total of 40 pregnant women with fetal SD were included, with 82.5% exhibiting short limb deformity, followed by 25.0% with central nervous system malformations, 17.50% with facial malformations, 15% with cardiac malformations, and 12.5% with urinary system malformations. The genetic testing positive rate was 70.0% (28/40), with 92.8% (26/28) being single-gene disorders due to mutations in FGFR3, COL1A1, COL1A2, EVC2, FLNB, LBR, and TRPV4 genes. The most common SD subtypes were osteogenesis imperfecta (OI), thanatophoric dysplasia (TD), and achondroplasia (ACH). The gestational age (GA) at initial diagnosis for TD, OI, and ACH was 16.6, 20.9, and 28.3 weeks, respectively (p < 0.05), with no significant difference in femoral shortening between the three groups (p > 0.05). Of the OI cases, 5 out of 12 had a family history. CONCLUSION Short limb deformity is the most prevalent phenotype of SD. When fetal SD is suspected, detailed ultrasound screening should be conducted, combined with GA at initial diagnosis, family history, and molecular evidence, to facilitate more accurate diagnosis and enhance prenatal counseling and perinatal management.
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Affiliation(s)
- Lili Li
- Department of Ultrasound, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Xiaofei Jin
- Department of Ultrasound, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Suna Liu
- Department of Neonatal Disease Screening, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Hui Fan
- Department of Ultrasound, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
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Casareto L, Appelman-Dijkstra NM, Brandi ML, Chapurlat R, Cormier-Daire V, Hamdy NAT, Heath KE, Horn J, Mantovani G, Mohnike K, Sousa SB, Travessa A, Wekre LL, Zillikens MC, Sangiorgi L. ERN BOND: The key European network leveraging diagnosis, research, and treatment for rare bone conditions. Eur J Med Genet 2024; 68:104916. [PMID: 38296035 DOI: 10.1016/j.ejmg.2024.104916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/22/2023] [Accepted: 01/28/2024] [Indexed: 02/09/2024]
Abstract
There is no universally accepted definition for rare diseases: in Europe a disease is considered to be rare when affecting fewer than 1 in 2000 people. European Reference Networks (ERNs) have been the concrete response to address the unmet needs of rare disease patients and many pan-European issues in the field, reducing inequities, and significantly increasing accessibility to high-quality healthcare across Europe. ERNs are virtual networks, involving centres and patient representatives with the general scope to facilitate discussion on complex cases requiring highly specialised competences and trained expertise. ERN BOND - the European Reference Network on rare BONe Diseases - is one of these 24 approved networks with the specific ongoing mission to implement measures facilitating multidisciplinary, holistic, continuous, patient-centred, and participative care provision to patients, and supporting them in the full realisation of their fundamental human rights. ERN BOND includes in 2023 a total of 53 centres of expertise from 20 European countries. Its governing structure installed in March 2017 includes decision-making, operative and consultative committees, which comprise experts in the field and patient representatives ensuring patient's voice and perspectives are taken into account. Over the years, ERN BOND has worked hard to achieve its mission and valuably contribute to the advancement of diagnosis, management, treatment, and research in rare diseases. The network activities are mainly related to (i) the provision of care which collectively involves averagely 2800 patients diagnosed per year, (ii) the development of education for and training of the healthcare personnel consisting until now in the realisation of 7 thematic workshops and 19 webinars, (iii) the dissemination and exchange and spread of knowledge via network's website (https://ernbond.eu/), social media channels, and newsletters, (iv) the management of related data through a disease registry currently mapping over 2300 cases and recording over 600 reported cases, and (v) the enhancement of research which now include two clinical trials endorsed by the network. ERN BOND represents therefore an unprecedented move to improve the healthcare management of patients suffering from rare bone diseases through European collaborations. This network, through the support from the European Health Programme, will continue to pursue its efforts to achieve its goals, always maintaining the patients and their families at the centre of healthcare services.
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Affiliation(s)
- Lorena Casareto
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.
| | - Natasha M Appelman-Dijkstra
- Department of Internal Medicine, Division of Endocrinology and Leiden Center for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
| | - Maria Luisa Brandi
- Bone Metabolic Diseases Unit, Careggi University Hospital (AOU Careggi), Florence, Italy, Florence, Italy
| | - Roland Chapurlat
- National Reference Center for Fibrous Dysplasia of Bone/McCune-Albright syndrome, INSERM, UMR, 1033, Hospices Civils de Lyon, Lyon, France
| | - Valérie Cormier-Daire
- French reference center for skelatal dysplasia, Paris Cité University, Imagine Institute, Assistance Publique- Hôpitaux de Paris, Hôpital Necker-Enfants Malades, Paris, France
| | - Neveen A T Hamdy
- Department of Internal Medicine, Division of Endocrinology and Leiden Center for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
| | - Karen E Heath
- Skeletal dysplasia multidisciplinary Unit (UMDE) and Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, IdiPAZ and CIBERER, ISCIII, Madrid, Spain
| | - Joachim Horn
- Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Olso, Norway
| | - Giovanna Mantovani
- Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy; Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Klaus Mohnike
- Universitätsklinikum Magdeburg, University of Magdeburg, Magdeburg, Germany
| | | | - André Travessa
- Medical Genetics Department, Centro Hospitalar Universitário Lisboa Norte, and Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| | - Lena Lande Wekre
- Oslo University Hospital, Oslo, Norway; TRS National Resource Center for Rare Disorders, Sunnaas Rehabilitation Hospital, Norway
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Luca Sangiorgi
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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10
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Viakhireva I, Bychkov I, Markova T, Shatokhina O, Karandasheva K, Udalova V, Bekhtereva Y, Ryzhkova O, Skoblov M. The molecular complexity of COL2A1 splicing variants and their significance in phenotype severity. Bone 2024; 181:117013. [PMID: 38246255 DOI: 10.1016/j.bone.2024.117013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 12/25/2023] [Accepted: 01/05/2024] [Indexed: 01/23/2024]
Abstract
Pathogenic single nucleotide variants (SNVs) found in the COL2A1 gene are associated with a broad range of skeletal dysplasias due to their impact on the structure and function of the Col2a1 protein. However, the molecular mechanisms of some nucleotide variants detected during diagnostic testing remain unclear. The interpretation of missense and splicing variants caused by SNVs poses a significant challenge for clinicians. In this work, we analyzed 22 splicing variants in the COL2A1 gene which have been found in patients with COL2A1-associated skeletal dysplasias. Using a minigene system, we investigated the impact of these SNVs on splicing and gained insights into their molecular mechanisms and genotype-phenotype correlations for each patient. The results of our study are very useful for improving the accuracy of diagnosis and the management of patients with skeletal dysplasias caused by SNVs in the COL2A1 gene.
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Affiliation(s)
- I Viakhireva
- Research Centre for Medical Genetics, Moscow, Russian Federation.
| | - I Bychkov
- Research Centre for Medical Genetics, Moscow, Russian Federation
| | - T Markova
- Research Centre for Medical Genetics, Moscow, Russian Federation
| | - O Shatokhina
- Research Centre for Medical Genetics, Moscow, Russian Federation
| | - K Karandasheva
- Research Centre for Medical Genetics, Moscow, Russian Federation
| | - V Udalova
- LLC Genomed, Moscow, Russian Federation
| | | | - O Ryzhkova
- Research Centre for Medical Genetics, Moscow, Russian Federation
| | - M Skoblov
- Research Centre for Medical Genetics, Moscow, Russian Federation
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11
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McLuckey MN, Imel EA, Forbes-Amrhein MM. Osteopetrosis in the pediatric patient: what the radiologist needs to know. Pediatr Radiol 2024:10.1007/s00247-024-05899-4. [PMID: 38483591 DOI: 10.1007/s00247-024-05899-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 05/22/2024]
Abstract
Osteopetrosis describes several types of rare sclerosing bone dysplasias of varying clinical and radiographic severity. The classic autosomal dominant subtype emerges most often in adolescence but can present from infancy through adulthood. The autosomal recessive osteopetrosis, or "malignant infantile osteopetrosis," presents in infancy with a grimmer prognosis, though the autosomal dominant forms (often mislabeled as "benign") actually can have life-threatening consequences as well. Often osteopetrosis is detected due to skeletal findings on radiographs performed to evaluate injury or as an incidental finding during evaluation for illness. Given the varied phenotypic severity and presentations at different ages, radiologists play an integral role in the care of these patients both in diagnosis and in clinical evaluation and monitoring. A deeper understanding of the underlying genetic basis of the disease can aid in the radiologist in diagnosis and in anticipation of unique complications. An overview of current clinical management is also discussed.
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Affiliation(s)
- Morgan N McLuckey
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 550 N University Boulevard, Room 0063, Indianapolis, IN, 46202, USA.
| | - Erik A Imel
- Department of Medicine and Pediatrics, Indiana University School of Medicine, 1120 W. Michigan Street, Room 380, Indianapolis, IN, 46202, USA
| | - Monica M Forbes-Amrhein
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Riley Hospital for Children, 705 Riley Hospital Drive, Room 1053, Indianapolis, IN, 46202, USA
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12
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Reddy Y, Jamnik A, Thornberg D, Datcu AM, Lachmann E, Johnson M, Ramo B, McIntosh AL. The effect of antibiotic-impregnated calcium sulfate beads and Medical Optimization Clinic attendance on the acute surgical site infection rate in high-risk pediatric neuromuscular and syndromic scoliosis patients. Spine Deform 2024:10.1007/s43390-024-00837-8. [PMID: 38457028 DOI: 10.1007/s43390-024-00837-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Accepted: 02/01/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Neuromuscular and syndromic (NMS) scoliosis patients are at higher risk of acute surgical site infections (SSIs). Despite following POSNA's endorsed consensus-based guidelines for SSI prevention, our institutional rates of acute SSI have varied dramatically. This variability drove simultaneous strategies to lower SSI rates: the creation of a preoperative Medical Optimization Clinic (MOC) and use of antibiotic-impregnated (Abx-I) calcium sulfate beads. METHODS Patients undergoing index PSF at a single institution between 2016 and 2022 were retrospectively reviewed. Patients with ≥ 2 risk factors were included: (1) BMI < 18.5 or > 25; (2) incontinence; (3) instrumentation to pelvis; (4) non-verbal; (5) GMFCS IV/V. SSI was defined as deep infection within 90 days. We compared patients who attended MOC and received Abx-I (MOC + Abx-I) to those receiving neither intervention (control) nor a single intervention. RESULTS 282 patients were included. The overall infection rate was 4.26%. Higher GMFCS (p = 0.0147), non-verbal status (p = 0.0048), and longer fusions (p = 0.0298) were independently associated with infection rate. Despite the MOC + Abx-I group having larger Cobb angles (88° ± 26°), higher GMFCS levels (4.5 ± 0.9), ASA class (3 ± 0.4), and more frequent instrumentation to the pelvis (85%), they had the lowest infection rate (2.13%) when compared to the control (4.2%) or single intervention groups (5.7%, 4.6%) (p = 0.9). CONCLUSION The study examined the modern infection rate of NMS patients following the implementation of two interventions: MOC and Abx-I. Despite having higher risk factors (curves (88°), GMFCS level (4.5), ASA class (3), higher % instrumentation to the pelvis (85%)), the patients treated with both interventions demonstrated the lowest infection rate (2.13%).
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Affiliation(s)
- Yashas Reddy
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, 1015, Walnut Street, Philadelphia, PA, 19107, United States
| | - Adam Jamnik
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, United States
| | - David Thornberg
- Scottish Rite for Children, Dept of Orthopedics, 2222 Welborn St, Dallas, TX, 75219, United States
| | - Anne-Marie Datcu
- School of Medicine, Texas A&M University, 8447 Riverside Parkway, Byran, TX, 77807, United States
| | - Emily Lachmann
- Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX, 75390, United States
| | - Megan Johnson
- Scottish Rite for Children, Dept of Orthopedics, 2222 Welborn St, Dallas, TX, 75219, United States
| | - Brandon Ramo
- Scottish Rite for Children, Dept of Orthopedics, 2222 Welborn St, Dallas, TX, 75219, United States
| | - Amy L McIntosh
- Sidney Kimmel Medical College, Thomas Jefferson University Hospital, 1015, Walnut Street, Philadelphia, PA, 19107, United States.
- Scottish Rite for Children, Dept of Orthopedics, 2222 Welborn St, Dallas, TX, 75219, United States.
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13
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Koparir A, Lekszas C, Keseroglu K, Rose T, Rappl L, Rad A, Maroofian R, Narendran N, Hasanzadeh A, Karimiani EG, Boschann F, Kornak U, Klopocki E, Özbudak EM, Vona B, Haaf T, Liedtke D. Zebrafish as a model to investigate a biallelic gain-of-function variant in MSGN1, associated with a novel skeletal dysplasia syndrome. Hum Genomics 2024; 18:23. [PMID: 38448978 PMCID: PMC10916241 DOI: 10.1186/s40246-024-00593-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/29/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND/OBJECTIVES Rare genetic disorders causing specific congenital developmental abnormalities often manifest in single families. Investigation of disease-causing molecular features are most times lacking, although these investigations may open novel therapeutic options for patients. In this study, we aimed to identify the genetic cause in an Iranian patient with severe skeletal dysplasia and to model its molecular function in zebrafish embryos. RESULTS The proband displays short stature and multiple skeletal abnormalities, including mesomelic dysplasia of the arms with complete humero-radio-ulna synostosis, arched clavicles, pelvic dysplasia, short and thin fibulae, proportionally short vertebrae, hyperlordosis and mild kyphosis. Exome sequencing of the patient revealed a novel homozygous c.374G > T, p.(Arg125Leu) missense variant in MSGN1 (NM_001105569). MSGN1, a basic-Helix-Loop-Helix transcription factor, plays a crucial role in formation of presomitic mesoderm progenitor cells/mesodermal stem cells during early developmental processes in vertebrates. Initial in vitro experiments show protein stability and correct intracellular localization of the novel variant in the nucleus and imply retained transcription factor function. To test the pathogenicity of the detected variant, we overexpressed wild-type and mutant msgn1 mRNA in zebrafish embryos and analyzed tbxta (T/brachyury/ntl). Overexpression of wild-type or mutant msgn1 mRNA significantly reduces tbxta expression in the tailbud compared to control embryos. Mutant msgn1 mRNA injected embryos depict a more severe effect, implying a gain-of-function mechanism. In vivo analysis on embryonic development was performed by clonal msgn1 overexpression in zebrafish embryos further demonstrated altered cell compartments in the presomitic mesoderm, notochord and pectoral fin buds. Detection of ectopic tbx6 and bmp2 expression in these embryos hint to affected downstream signals due to Msgn1 gain-of-function. CONCLUSION In contrast to loss-of-function effects described in animal knockdown models, gain-of-function of MSGN1 explains the only mildly affected axial skeleton of the proband and rather normal vertebrae. In this context we observed notochord bending and potentially disruption of pectoral fin buds/upper extremity after overexpression of msgn1 in zebrafish embryos. The latter might result from Msgn1 function on mesenchymal stem cells or on chondrogenesis in these regions. In addition, we detected ectopic tbx6 and bmp2a expression after gain of Msgn1 function in zebrafish, which are interconnected to short stature, congenital scoliosis, limb shortening and prominent skeletal malformations in patients. Our findings highlight a rare, so far undescribed skeletal dysplasia syndrome associated with a gain-of-function mutation in MSGN1 and hint to its molecular downstream effectors.
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Affiliation(s)
- Asuman Koparir
- Institute of Human Genetics, Julius-Maximilians-Universität Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany
| | - Caroline Lekszas
- Institute of Human Genetics, Julius-Maximilians-Universität Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany
| | - Kemal Keseroglu
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Thalia Rose
- Institute of Human Genetics, Julius-Maximilians-Universität Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany
| | - Lena Rappl
- Institute of Human Genetics, Julius-Maximilians-Universität Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany
| | - Aboulfazl Rad
- Cellular and Molecular Research Centre, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Reza Maroofian
- Department of Neuromuscular Disorders, UCL Queen Square Institute of Neurology, London, WC1N 3BG, UK
| | - Nakul Narendran
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Atefeh Hasanzadeh
- Cellular and Molecular Research Centre, Sabzevar University of Medical Sciences, Sabzevar, 009851, Iran
| | | | - Felix Boschann
- Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Uwe Kornak
- Institute for Medical Genetics and Human Genetics, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Eva Klopocki
- Institute of Human Genetics, Julius-Maximilians-Universität Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany
| | - Ertuğrul M Özbudak
- Division of Developmental Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Barbara Vona
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
- Institute for Auditory Neuroscience and InnerEarLab, University Medical Center Göttingen, Göttingen, Germany
| | - Thomas Haaf
- Institute of Human Genetics, Julius-Maximilians-Universität Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany
| | - Daniel Liedtke
- Institute of Human Genetics, Julius-Maximilians-Universität Würzburg, Biozentrum, Am Hubland, 97074, Würzburg, Germany.
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14
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Liu L, Shi Y, Fan X, Yao Y, Wu W, Tian Y, Wu H, Li Z, Wang Y, Xu C. The health-care utilization and economic burden in patients with genetic skeletal disorders. Orphanet J Rare Dis 2024; 19:99. [PMID: 38438867 PMCID: PMC10913423 DOI: 10.1186/s13023-024-03102-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 02/21/2024] [Indexed: 03/06/2024] Open
Abstract
BACKGROUND Most genetic skeletal disorders (GSD) were complex, disabling and life-threatening without effective diagnostic and treatment methods. However, its impacts on health system have not been well studied. The study aimed to systematically evaluate the health-care utilization and economic burden in GSD patients. METHODS The patients were derived from 2018 Nationwide Inpatient Sample and Nationwide Readmissions Database. GSD patients were extracted based on International Classification of Diseases-10th revision codes. RESULTS A total of 25,945 (0.12%) records regarding GSD were extracted from all 21,400,282 records in NIS database. GSD patients were likely to have significantly longer length of stay (6.50 ± 0.08 vs. 4.63 ± 0.002, P < 0.001), higher total charges ($85,180.97 ± 1,239.47 vs. $49,884.26 ± 20.99, P < 0.001), suffering more procedure, diagnosis and transferring records in comparison to patients with common conditions. GSD patients had a significantly higher 30-day all-cause readmission rate based on Nationwide Readmissions Database. CONCLUSIONS The heavy health-care utilization and economic burden emphasized the urgency for policy leaders, scientific and pharmaceutical researchers, health care providers and employers to identify innovative ways and take effective measurements immediately, and eventually to help improve the care, management, and treatment of these devastating diseases.
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Affiliation(s)
- Luna Liu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Shandong First Medical University, Ministry of Education, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, 250021, Jinan, Shandong, China
| | - Yingzhou Shi
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Shandong First Medical University, Ministry of Education, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, 250021, Jinan, Shandong, China
| | - Xiude Fan
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Shandong First Medical University, Ministry of Education, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, 250021, Jinan, Shandong, China
- Shandong Institute of Endocrine and Metabolic Diseases, 250021, Jinan, Shandong, China
- Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, 250021, Jinan, Shandong, China
| | - Yangyang Yao
- Department of Pediatric Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong, China
| | - Wanhong Wu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Shandong First Medical University, Ministry of Education, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, 250021, Jinan, Shandong, China
| | - Yang Tian
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Shandong First Medical University, Ministry of Education, Jinan, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, 250021, Jinan, Shandong, China
| | - Huixiao Wu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Shandong First Medical University, Ministry of Education, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, 250021, Jinan, Shandong, China
- Shandong Institute of Endocrine and Metabolic Diseases, 250021, Jinan, Shandong, China
- Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, 250021, Jinan, Shandong, China
| | - Zongyue Li
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Shandong First Medical University, Ministry of Education, Jinan, China
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong, China
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, 250021, Jinan, Shandong, China
- Shandong Institute of Endocrine and Metabolic Diseases, 250021, Jinan, Shandong, China
- Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, 250021, Jinan, Shandong, China
| | - Yanzhou Wang
- Department of Pediatric Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong, China
| | - Chao Xu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, 250021, Jinan, Shandong, China.
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Shandong First Medical University, Ministry of Education, Jinan, China.
- Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, 250021, Jinan, Shandong, China.
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, 250021, Jinan, Shandong, China.
- Shandong Institute of Endocrine and Metabolic Diseases, 250021, Jinan, Shandong, China.
- Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, 250021, Jinan, Shandong, China.
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15
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Singh S, Jacob P, Patil SJ, Muranjan M, Shah H, Girisha KM, Bhavani GS. Indian patients with CHST3-related chondrodysplasia with congenital joint dislocations. Am J Med Genet A 2024; 194:e63422. [PMID: 37876363 DOI: 10.1002/ajmg.a.63422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 09/13/2023] [Accepted: 09/20/2023] [Indexed: 10/26/2023]
Abstract
CHST3-related chondrodysplasia with congenital joint dislocations (CDCJD, #MIM 143095), is a rare genetic skeletal disorder caused by biallelic loss of function variants in CHST3. CHST3 is critical for the sulfation of chondroitin sulfate. This study delineates the clinical presentation of nine individuals featuring the key symptoms of CDCJD; congenital joint (knee and elbow) dislocations, short trunk short stature progressive vertebral anomalies, and metacarpal shortening. Additional manifestations include irregular distal femoral epiphysis, supernumerary carpal ossification centers, bifid humerus, club foot, and cardiac abnormalities. Sanger sequencing was carried out to investigate molecular etiology in eight patients and exome sequencing in one. Genetic testing revealed five homozygous variants in CHST3 (four were novel and one was previously reported). All these variants are located on sulfotransferase domain of CHST3 protein and were classified as pathogenic/ likely pathogenic. We thus report on nine individuals with CHST3-related chondrodysplasia with congenital joint dislocations from India and suggest monitoring the health of cardiac valves in this condition.
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Affiliation(s)
- Swati Singh
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Prince Jacob
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Siddaramappa J Patil
- Division of Medical Genetics, Mazumdar Shaw Medical Center, Narayana Hrudayalaya Hospitals, Bangalore, Karnataka, India
| | - Mamta Muranjan
- Department of Pediatrics, Genetic Division, Seth GS Medical College, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Hitesh Shah
- Department of Pediatric Orthopedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Gandham SriLakshmi Bhavani
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
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16
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Ahmed HA, Elhossini R, Aglan M, Amr K. Aggrecan-related bone disorders; a novel heterozygous ACAN variant associated with spondyloepimetaphyseal dysplasia expanding the phenotypic spectrum and review of literature. J Genet Eng Biotechnol 2024; 22:100341. [PMID: 38494255 PMCID: PMC10860877 DOI: 10.1016/j.jgeb.2023.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
BACKGROUND Spondyloepimetaphyseal dysplasias (SEMD) are a large group of skeletal disorders represented by abnormalities of vertebrae in addition to epiphyseal and metaphyseal areas of bones. Several genes have been identified underlying different forms. ACAN gene mutations were found to cause Aggrecan-related bone disorders (spondyloepimetaphyseal dysplasias,spondyloepiphyseal dysplasias, familial osteochondritis dissecans and short stature syndromes). This study aims to find the disease causing variant in Egyptian patient with SEMD using whole exome sequencing. METHODS Whole-exome sequencing was performed for an Egyptian male patient who presented with short stature, clinical and radiological features suggestive of unclassified SEMD. RESULTS The study identified a novel de novo heterozygous ACAN gene variant (c.7378G>A; p.Gly2460Arg) in G3 domain. Mutations in ACAN gene have been more commonly associated with short stature than SEMD. The phenotype of our patient was intermediate in severity between spondyloepiphyseal dysplasia presentation; Kimberley type(SEDK) and Spondyloepimetaphyseal dysplasias Aggrecan (SEMDAG) CONCLUSIONS: Whole exome sequencing revealed a novel de novo ACAN gene variant in patient with SEDK. The clinical and skeletal phenotype of our patient was much severe than those reported originally and showed more metaphyseal involvement. To the best of our knowledge, two previous studies reported a heterozygous variant in ACAN with spondyloepiphyseal dysplasia presentation; Kimberley type.
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Affiliation(s)
- Hoda A Ahmed
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Egypt.
| | - R Elhossini
- Department of Clinical Genetics, Human Genetics and Genome Research Institute, National Research Centre, Egypt
| | - M Aglan
- Department of Clinical Genetics, Human Genetics and Genome Research Institute, National Research Centre, Egypt
| | - Khalda Amr
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Egypt
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Molin AN, Contentin R, Angelozzi M, Karvande A, Kc R, Haseeb A, Voskamp C, de Charleroy C, Lefebvre V. Skeletal growth is enhanced by a shared role for SOX8 and SOX9 in promoting reserve chondrocyte commitment to columnar proliferation. Proc Natl Acad Sci U S A 2024; 121:e2316969121. [PMID: 38346197 PMCID: PMC10895259 DOI: 10.1073/pnas.2316969121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 12/26/2023] [Indexed: 02/15/2024] Open
Abstract
SOX8 was linked in a genome-wide association study to human height heritability, but roles in chondrocytes for this close relative of the master chondrogenic transcription factor SOX9 remain unknown. We undertook here to fill this knowledge gap. High-throughput assays demonstrate expression of human SOX8 and mouse Sox8 in growth plate cartilage. In situ assays show that Sox8 is expressed at a similar level as Sox9 in reserve and early columnar chondrocytes and turned off when Sox9 expression peaks in late columnar and prehypertrophic chondrocytes. Sox8-/- mice and Sox8fl/flPrx1Cre and Sox9fl/+Prx1Cre mice (inactivation in limb skeletal cells) have a normal or near normal skeletal size. In contrast, juvenile and adult Sox8fl/flSox9fl/+Prx1Cre compound mutants exhibit a 15 to 20% shortening of long bones. Their growth plate reserve chondrocytes progress slowly toward the columnar stage, as witnessed by a delay in down-regulating Pthlh expression, in packing in columns and in elevating their proliferation rate. SOX8 or SOX9 overexpression in chondrocytes reveals not only that SOX8 can promote growth plate cell proliferation and differentiation, even upon inactivation of endogenous Sox9, but also that it is more efficient than SOX9, possibly due to greater protein stability. Altogether, these findings uncover a major role for SOX8 and SOX9 in promoting skeletal growth by stimulating commitment of growth plate reserve chondrocytes to actively proliferating columnar cells. Further, by showing that SOX8 is more chondrogenic than SOX9, they suggest that SOX8 could be preferred over SOX9 in therapies to promote cartilage formation or regeneration in developmental and degenerative cartilage diseases.
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Affiliation(s)
- Arnaud N. Molin
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
| | - Romain Contentin
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
| | - Marco Angelozzi
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
| | - Anirudha Karvande
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
| | - Ranjan Kc
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
| | - Abdul Haseeb
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
| | - Chantal Voskamp
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
| | - Charles de Charleroy
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
| | - Véronique Lefebvre
- Department of Surgery, Division of Orthopaedic Surgery, The Children’s Hospital of Philadelphia, Philadelphia, PA19104
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Ouedraogo ZG, Janel C, Janin A, Millat G, Langlais S, Pontier B, Biard M, Lepage M, Francannet C, Laffargue F, Creveaux I. Relevance of Extending FGFR3 Gene Analysis in Osteochondrodysplasia to Non-Coding Sequences: A Case Report. Genes (Basel) 2024; 15:225. [PMID: 38397214 PMCID: PMC10888313 DOI: 10.3390/genes15020225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 01/31/2024] [Accepted: 02/07/2024] [Indexed: 02/25/2024] Open
Abstract
Skeletal dysplasia, also called osteochondrodysplasia, is a category of disorders affecting bone development and children's growth. Up to 552 genes, including fibroblast growth factor receptor 3 (FGFR3), have been implicated by pathogenic variations in its genesis. Frequently identified causal mutations in osteochondrodysplasia arise in the coding sequences of the FGFR3 gene: c.1138G>A and c.1138G>C in achondroplasia and c.1620C>A and c.1620C>G in hypochondroplasia. However, in some cases, the diagnostic investigations undertaken thus far have failed to identify the causal anomaly, which strengthens the relevance of the diagnostic strategies being further refined. We observed a Caucasian adult with clinical and radiographic features of achondroplasia, with no common pathogenic variant. Exome sequencing detected an FGFR3(NM_000142.4):c.1075+95C>G heterozygous intronic variation. In vitro studies showed that this variant results in the aberrant exonization of a 90-nucleotide 5' segment of intron 8, resulting in the substitution of the alanine (Ala359) for a glycine (Gly) and the in-frame insertion of 30 amino acids. This change may alter FGFR3's function. Our report provides the first clinical description of an adult carrying this variant, which completes the phenotype description previously provided in children and confirms the recurrence, the autosomal-dominant pathogenicity, and the diagnostic relevance of this FGFR3 intronic variant. We support its inclusion in routinely used diagnostic tests for osteochondrodysplasia. This may increase the detection rate of causal variants and therefore could have a positive impact on patient management. Finally, FGFR3 alteration via non-coding sequence exonization should be considered a recurrent disease mechanism to be taken into account for new drug design and clinical trial strategies.
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Affiliation(s)
- Zangbéwendé Guy Ouedraogo
- Service de Biochimie et Génétique Moléculaire, CHU Gabriel Montpied, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.J.); (S.L.); (M.L.)
- Université Clermont Auvergne, CNRS, Inserm, iGReD, 63001 Clermont-Ferrand, France
| | - Caroline Janel
- Service de Biochimie et Génétique Moléculaire, CHU Gabriel Montpied, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.J.); (S.L.); (M.L.)
| | - Alexandre Janin
- Unité Fonctionnelle Cardiogénétique, Moléculaire, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, 69677 Bron, France; (A.J.); (G.M.)
- CNRS UMR5261, INSERM U1315, Pathophysiology and Genetics of Neuron and Muscle, Institut Neuromyogène, Université Claude Bernard Lyon 1, 69008 Lyon, France
| | - Gilles Millat
- Unité Fonctionnelle Cardiogénétique, Moléculaire, Centre de Biologie et Pathologie Est, Hospices Civils de Lyon, 69677 Bron, France; (A.J.); (G.M.)
- CNRS UMR5261, INSERM U1315, Pathophysiology and Genetics of Neuron and Muscle, Institut Neuromyogène, Université Claude Bernard Lyon 1, 69008 Lyon, France
| | - Sarah Langlais
- Service de Biochimie et Génétique Moléculaire, CHU Gabriel Montpied, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.J.); (S.L.); (M.L.)
| | - Bénédicte Pontier
- Service de Génétique Médicale, CHU Estaing, CHU Clermont-Ferrand, 63100 Clermont-Ferrand, France; (B.P.); (C.F.); (F.L.)
| | - Marie Biard
- Service de Radiologie Pédiatrique, CHU Estaing, CHU Clermont-Ferrand, 63100 Clermont-Ferrand, France;
| | - Mathis Lepage
- Service de Biochimie et Génétique Moléculaire, CHU Gabriel Montpied, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.J.); (S.L.); (M.L.)
| | - Christine Francannet
- Service de Génétique Médicale, CHU Estaing, CHU Clermont-Ferrand, 63100 Clermont-Ferrand, France; (B.P.); (C.F.); (F.L.)
| | - Fanny Laffargue
- Service de Génétique Médicale, CHU Estaing, CHU Clermont-Ferrand, 63100 Clermont-Ferrand, France; (B.P.); (C.F.); (F.L.)
| | - Isabelle Creveaux
- Service de Biochimie et Génétique Moléculaire, CHU Gabriel Montpied, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France; (C.J.); (S.L.); (M.L.)
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Lacarrubba-Flores MDJ, da Costa Silveira K, Silveira C, Carvalho BS, Cavalcanti DP. A mesomelic skeletal dysplasia, Kantaputra-like, not related to HOXD cluster region, and with phenotypic gender differences. Am J Med Genet A 2024; 194:328-336. [PMID: 37846940 DOI: 10.1002/ajmg.a.63444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/30/2023] [Accepted: 10/06/2023] [Indexed: 10/18/2023]
Abstract
Mesomelic skeletal dysplasia is a heterogeneous group of skeletal disorders that has grown since the molecular basis of these conditions is in the process of research and discovery. Here, we report a Brazilian family with eight affected members over three generations with a phenotype similar to mesomelic Kantaputra dysplasia. This family presents marked shortening of the upper limbs with hypotrophy of the lower limbs and clubfeet without synostosis. Array-based CNV analysis and exome sequencing of four family members failed to show any region or gene candidate. Interestingly, males were more severely affected than females in this family, suggesting that gender differences could play a role in the phenotypic expressivity of this condition.
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Affiliation(s)
- Maria Dora Jazmin Lacarrubba-Flores
- Skeletal Dysplasias Group, Department of Translational Medicine-Area of Medical Genetics, Medical Sciences Faculty, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Karina da Costa Silveira
- Skeletal Dysplasias Group, Department of Translational Medicine-Area of Medical Genetics, Medical Sciences Faculty, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Cynthia Silveira
- Skeletal Dysplasias Group, Department of Translational Medicine-Area of Medical Genetics, Medical Sciences Faculty, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Benilton S Carvalho
- Department of Statistics, Institute of Mathematics, Statistics and Scientific Computing, University of Campinas (UNICAMP), São Paulo, Brazil
| | - Denise Pontes Cavalcanti
- Skeletal Dysplasias Group, Department of Translational Medicine-Area of Medical Genetics, Medical Sciences Faculty, State University of Campinas (UNICAMP), São Paulo, Brazil
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Liu J, Lin X, Sun L, Zhang Q, Jiang Y, Wang O, Xing X, Xia W, Li M. Safety and Efficacy of Denosumab in Children With Osteogenesis Imperfecta-the First Prospective Comparative Study. J Clin Endocrinol Metab 2024:dgad732. [PMID: 38198649 DOI: 10.1210/clinem/dgad732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Indexed: 01/12/2024]
Abstract
CONTEXT Denosumab is a potential therapeutic agent for osteogenesis imperfecta (OI), but its efficacy and safety remain unclear in children with OI. OBJECTIVE We aimed to investigate the effects of denosumab on bone mineral density (BMD), spinal morphometry, and safety in children with OI compared with zoledronic acid. METHODS In this prospective study, 84 children or adolescents with OI were randomized to receive denosumab subcutaneous injection every 6 months or zoledronic acid intravenous infusion once. Changes of BMD and its Z-score, vertebral shape, serum levels of calcium and bone turnover biomarkers were assessed during the 1-year treatment. RESULTS After 12 months of treatment, BMD at the lumbar spine, femoral neck, and total hip significantly increased by 29.3%, 27.8%, and 30.2% in the denosumab group, and by 32.2%, 47.1%, and 41.1% in the zoledronic acid group (all P < .001 vs baseline). Vertebral height and projection area significantly increased after denosumab and zoledronic acid treatment. Rebound hypercalcemia was found to be a common and serious side effect of denosumab, of which 14.3% reached hypercalcemic crisis. Rebound hypercalcemia could be alleviated by switching to zoledronic acid treatment. CONCLUSION Treatment with denosumab or zoledronic acid is beneficial in increasing BMD and improving the spinal morphometry of children with OI. However, denosumab should be used with caution in pediatric patients with OI because of its common and dangerous side effect of rebound hypercalcemia. The appropriate dosage and dosing interval of denosumab need to be further explored in children with OI.
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Affiliation(s)
- Jiayi Liu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaoyun Lin
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Lei Sun
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Qian Zhang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yan Jiang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Ou Wang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Xiaoping Xing
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Weibo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Mei Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health and Family Planning Commission, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
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Jin J, Rothämel P, Büchel J, Kammer B, Brunet T, Pattathu J, Flemmer AW, Nussbaum C, Schroepf S. Case Report: Stüve-Wiedemann syndrome-a rare cause of persistent pulmonary hypertension of the newborn. Front Pediatr 2024; 11:1329404. [PMID: 38239591 PMCID: PMC10794634 DOI: 10.3389/fped.2023.1329404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Persistent pulmonary hypertension of the newborn (PPHN) is a life-threatening condition characterized by hypoxemia due to elevated pulmonary vascular resistance. PPHN commonly arises secondary to various underlying conditions, including infection, meconium aspiration, and respiratory distress syndrome. Management includes pulmonary vasodilators, mechanical ventilation, oxygen supplementation, vasopressors, and volume replacement. Stüve-Wiedemann syndrome (SWS), a rare genetic disorder characterized by bone dysplasia, respiratory distress, hyperthermia, and swallowing difficulties, may present with pulmonary hypertension, indicating a poor prognosis. Case description A term female neonate presented with secondary respiratory failure and severe PPHN of unknown etiology on the second day of life, necessitating intubation. Clinical findings included facial dysmorphia, camptodactyly, skeletal anomalies, and generalized muscular hypotonia. High-frequency oscillation ventilation and surfactant administration yielded marginal improvement. On the third day of life, a severe pulmonary hypertensive crisis necessitated inhaled and systemic pulmonary vasodilators along with volume and catecholamine therapy. Whole exome sequencing revealed a homozygous mutation in the leukemia inhibitory factor receptor (LIFR) gene, consistent with Stüve-Wiedemann syndrome. Discussion/conclusion The case underscores the importance of considering and prompting evaluation of rare genetic causes in the differential diagnosis of PPHN, especially when other abnormalities are present and conventional therapies prove inadequate. Therapeutic strategies must account for the different pathophysiology of primary PPHN including vascular remodeling, as seen in SWS, which may not respond to pulmonary vasodilators typically employed in secondary PPHN due to vasoconstriction. In this case, the patient responded well to treatment for primary PPHN, but the use of high-frequency oscillation ventilation and surfactant was not helpful.
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Affiliation(s)
- Jessica Jin
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Paula Rothämel
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Johanna Büchel
- Clinic and Outpatient Clinic for Obstetrics and Gynecology, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Birgit Kammer
- Department of Pediatric Radiology, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Theresa Brunet
- Institute of Human Genetics, Klinikum Rechts der Isar, University Hospital, Technical University of Munich, Munich, Germany
| | - Joseph Pattathu
- Department of Pediatric Cardiology and Pediatric Intensive Care, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Andreas W. Flemmer
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Claudia Nussbaum
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
| | - Sebastian Schroepf
- Division of Neonatology, Department of Pediatrics, Dr. von Hauner Children’s Hospital, University Hospital, Ludwig-Maximilians-Universität, Munich, Germany
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de La Dure-Molla M, Gaucher C, Dupré N, Bloch Zupan A, Berdal A, Chaussain C. [The tooth: A marker of developmental abnormalities]. Med Sci (Paris) 2024; 40:16-23. [PMID: 38299898 DOI: 10.1051/medsci/2023190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024] Open
Abstract
Tooth formation results from specific epithelial-mesenchymal interactions, which summarize a number of developmental processes. Tooth anomalies may thus reflect subclinical diseases of the kidney, bone and more broadly of the mineral metabolism, skin or nervous system. Odontogenesis starts from the 3rd week of intrauterine life by the odontogenic orientation of epithelial cells by a first PITX2 signal. The second phase is the acquisition of the number, shape, and position of teeth. It depends on multiple transcription and growth factors (BMP, FGF, SHH, WNT). These ecto-mesenchymal interactions guide cell migration, proliferation, apoptosis and differentiation ending in the formation of the specific dental mineralized tissues. Thus, any alteration will have consequences on the tooth structure or shape. Resulting manifestations will have to be considered in the patient phenotype and the multidisciplinary care, but also may contribute to identify the altered genetic circuity.
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Affiliation(s)
- Muriel de La Dure-Molla
- Centre de référence maladies rares orales et dentaires, O-Rares, hôpital Rothschild, AP-HP, Paris ; université Paris Cité, UFR d'odontologie, Inserm, UMR1163, bases moléculaires et physiopathologiques des ostéochondrodysplasies, institut imagine, Paris ; FHU DDS Paris-Net, filière TETECOU, European Reference Network CRANIO
| | - Céline Gaucher
- FHU DDS Paris-Net, université Paris Cité, Inserm, AP-HP ; laboratoire BRIO URP2496, UFR d'odontologie, université Paris Cité, France ; Service de médecine bucco-dentaire, hôpital Henri Mondor, AP-HP ; Service de médecine génomique des maladies rares de système et d'organe, hôpital Cochin, AP-HP, Centre-Université Paris Cité, Montrouge, France
| | - Nicolas Dupré
- FHU DDS Paris-Net, université Paris Cité, Inserm, APHP ; équipe « Physiopathologie orale moléculaire », Centre de recherche des Cordeliers, Inserm U1138, université Paris Cité, Sorbonne université. UFR d'odontologie université Paris Cité. Centre de référence maladies rares O-Rares, hôpital Rothschild, AP-HP, Paris ; filière TETECOU, European Reference Network CRANIO, Paris
| | - Agnès Bloch Zupan
- Université de Strasbourg, institut de génétique et de biologie moléculaire et cellulaire (IGBMC), Inserm U1258, CNRS- UMR7104, Illkirch ; faculté de chirurgie dentaire Robert Frank ; institut d'études avancées (USIAS) ; Hôpitaux universitaires de Strasbourg (HUS), pôle de médecine et chirurgie bucco-dentaires, hôpital civil, centre de référence des maladies rares orales et dentaires O-Rares, filière santé maladies rares TETE COU, European Reference Network CRANIO, Strasbourg
| | - Ariane Berdal
- FHU DDS Paris-Net, université Paris Cité, Inserm AP-HP, équipe « Physiopathologie orale moléculaire », centre de recherche des Cordeliers, Inserm U1138, université Paris Cité, Sorbonne université. UFR d'odontologie, université Paris Cité. centre de référence maladies Rares O-Rares, hôpital Rothschild, AP-HP, Paris, filière TETECOU, European Reference Network CRANIO, Paris
| | - Catherine Chaussain
- FHU DDS Paris-Net, université Paris Cité, Inserm, AP-HP ; laboratoire BRIO URP2496, UFR d'odontologie ; AP-HP, hôpital Bretonneau ; centre de référence maladies Rares du métabolisme du calcium, phosphate et magnésium, filière OSCAR, European Reference Network BOND, Paris
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Elbaseet HM, Ibrahim AH, Oyoun NA, Abdelzaher MA, Khaled M. Management of Combined Fracture Neck of Femur and Femoral Deformity in Osteogenesis Imperfecta Patient: A Case Report. Strategies Trauma Limb Reconstr 2024; 19:56-59. [PMID: 38752190 PMCID: PMC11091891 DOI: 10.5005/jp-journals-10080-1611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 03/30/2024] [Indexed: 05/18/2024] Open
Abstract
Osteogenesis imperfecta (OI) patients usually sustain repeated fractures from trivial trauma and also have skeletal deformities that affect walking. The bone fragility and repeated fractures produce deformities of the long bones especially in femur and tibia. However, neck of femur (NOF) fractures in OI are rarely described. A 11-year-old male patient known to have OI (Sillence type IV) sustained a NOF fracture after a fall. He also had proximal femoral anterolateral bowing proximally and over an intramedullary (IM) rod inserted 4 years back. He was treated by corrective osteotomy and stabilisation with an IM telescoping nail for the deformed femur and the Wagner technique for the NOF fracture. One year after operation, the patient had recovered satisfactory functional outcome with union of the NOF fracture and correction of the femoral deformity. Conclusion The method of the Wagner technique can achieve stable fixation for femoral neck fractures and introduces the least interference with concurrent telescoping nail insertion. How to cite this article Elbaseet HM, Ibrahim AH, Abol Oyoun N, et al. Management of Combined Fracture Neck of Femur and Femoral Deformity in Osteogenesis Imperfecta Patient: A Case Report. Strategies Trauma Limb Reconstr 2024;19(1):56-59.
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Affiliation(s)
- Hesham Mohamed Elbaseet
- Pediatric Orthopedic Unit, Department of Orthopedic Surgery and Traumatology, Assiut University, Egypt
| | - AbdelKhalek Hafez Ibrahim
- Pediatric Orthopedic Unit, Department of Orthopedic Surgery and Traumatology, Assiut University, Egypt
| | - Nariman Abol Oyoun
- Pediatric Orthopedic Unit, Department of Orthopedic Surgery and Traumatology, Assiut University, Egypt
| | | | - Mohamed Khaled
- Pediatric Orthopedic Unit, Department of Orthopedic Surgery and Traumatology, Assiut University, Egypt
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Storoni S, Verdonk SJE, Micha D, Jak PMC, Bugiani M, Eekhoff EMW, van den Aardweg JG. Bronchial obstruction in osteogenesis imperfecta can be detected by forced oscillation technique. Front Med (Lausanne) 2023; 10:1301873. [PMID: 38179272 PMCID: PMC10764585 DOI: 10.3389/fmed.2023.1301873] [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: 09/25/2023] [Accepted: 12/05/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Respiratory insufficiency is a leading cause of death in individuals with osteogenesis imperfecta (OI). However, evaluating pulmonary function in OI presents challenges. Commonly used pulmonary function tests such as spirometry and body plethysmography are sometimes difficult to perform for OI patients, and reference intervals are not always applicable. The forced oscillation technique (FOT) is a patient-friendly method for detecting respiratory abnormalities that requires no effort from the patient. Objective This study investigates the feasibility of FOT in the evaluation of respiratory function in the clinical management of OI patients. Methods Twelve OI patients, comprising eight with Sillence OI I, two with OI IV, and two with OI III, underwent spirometry, body plethysmography, and FOT, both pre-and post-administration of salbutamol. Results FOT measurements exhibited consistent trends that aligned with spirometry and body plethysmography findings. The resistance at 8 Hz decreased after the administration of salbutamol, indicating that FOT is able to detect bronchial obstruction and its alleviation by medication (p < 0.05). The resonant frequency during expiration was higher than during inspiration in nearly all patients, suggesting obstructive disease. The technique gives insight into both inspiratory and expiratory impairment of pulmonary ventilation. The main FOT parameters showed a relatively high repeatability in duplicate measurements. Conclusion Bronchial obstruction can be detected by FOT in patients with OI during quiet breathing, making it an easily executable alternative to other lung function measurements. The technique can detect the bronchodilator effect of sympathomimetic medication. It has the potential to provide information on expiratory flow limitation, pulmonary restriction, and reduced lung compliance.
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Affiliation(s)
- Silvia Storoni
- Department of Internal Medicine Section Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit, Amsterdam, Netherlands
- Amsterdam Rare Bone Disease Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Sara J. E. Verdonk
- Department of Internal Medicine Section Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit, Amsterdam, Netherlands
- Amsterdam Rare Bone Disease Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Dimitra Micha
- Amsterdam Rare Bone Disease Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
- Department of Human Genetics, Amsterdam UMC Location Vrije Universiteit, Amsterdam, Netherlands
| | - Patrick M. C. Jak
- Department of Respiratory Medicine, Amsterdam University Medical Center, Location AMC, Amsterdam, Netherlands
| | - Marianna Bugiani
- Department of Pathology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, Netherlands
| | - Elisabeth M. W. Eekhoff
- Department of Internal Medicine Section Endocrinology and Metabolism, Amsterdam UMC Location Vrije Universiteit, Amsterdam, Netherlands
- Amsterdam Rare Bone Disease Center, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Joost G. van den Aardweg
- Department of Respiratory Medicine, Amsterdam University Medical Center, Location AMC, Amsterdam, Netherlands
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25
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Peng Y, Zhou L, Chen J, Huang X, Pang J, Liu J, Tang W, Yang S, Liang C, Xie W. Clinical features and genetic analysis of a case series of skeletal ciliopathies in a prenatal setting. BMC Med Genomics 2023; 16:318. [PMID: 38062428 PMCID: PMC10704717 DOI: 10.1186/s12920-023-01753-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 11/24/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Short-rib polydactyly syndrome (SRPS) refers to a group of lethal skeletal dysplasias that can be difficult to differentiate between subtypes or from other non-lethal skeletal dysplasias such as Ellis-van Creveld syndrome and Jeune syndrome in a prenatal setting. We report the ultrasound and genetic findings of four unrelated fetuses with skeletal dysplasias. METHODS Systemic prenatal ultrasound examination was performed in the second or third trimester. Genetic tests including GTG-banding, single nucleotide polymorphism (SNP) array and exome sequencing were performed with amniocytes or aborted fetal tissues. RESULTS The major and common ultrasound anomalies for the four unrelated fetuses included short long bones of the limbs and narrow thorax. No chromosomal abnormalities and pathogenic copy number variations were detected. Exome sequencing revealed three novel variants in the DYNC2H1 gene, namely NM_001080463.2:c.6809G > A p.(Arg2270Gln), NM_001080463.2:3133C > T p.(Gln1045Ter), and NM_001080463.2:c.337C > T p.(Arg113Trp); one novel variant in the IFT172 gene, NM_015662.3:4540-5 T > A; and one novel variant in the WDR19 gene, NM_025132.4:c.2596G > C p.(Gly866Arg). The genotypes of DYNC2H1, IFT172 and WDR19 and the phenotypes of the fetuses give hints for the diagnosis of short-rib thoracic dysplasia (SRTD) with or without polydactyly 3, 10, and 5, respectively. CONCLUSION Our findings expand the mutation spectrum of DYNC2H1, IFT172 and WDR19 associated with skeletal ciliopathies, and provide useful information for prenatal diagnosis and genetic counseling on rare skeletal disorders.
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Affiliation(s)
- Ying Peng
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road.
| | - Lin Zhou
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road
| | - Jing Chen
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road
| | - Xiaoliang Huang
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road
| | - Jialun Pang
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road
| | - Jing Liu
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road
| | - Wanglan Tang
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road
| | - Shuting Yang
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road
| | - Changbiao Liang
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road
| | - Wanqin Xie
- Prenatal Diagnosis Center, National Health Commission Key Laboratory of Birth Defects for Research and Prevention, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410008, Hunan, China, No. 53 Xiangchun Road.
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26
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Indermaur M, Casari D, Kochetkova T, Willie BM, Michler J, Schwiedrzik J, Zysset P. Tensile Mechanical Properties of Dry Cortical Bone Extracellular Matrix: A Comparison Among Two Osteogenesis Imperfecta and One Healthy Control Iliac Crest Biopsies. JBMR Plus 2023; 7:e10826. [PMID: 38130764 PMCID: PMC10731133 DOI: 10.1002/jbm4.10826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/22/2023] [Accepted: 09/14/2023] [Indexed: 12/23/2023] Open
Abstract
Osteogenesis imperfecta (OI) is a genetic, collagen-related bone disease that increases the incidence of bone fractures. Still, the origin of this brittle mechanical behavior remains unclear. The extracellular matrix (ECM) of OI bone exhibits a higher degree of bone mineralization (DBM), whereas compressive mechanical properties at the ECM level do not appear to be inferior to healthy bone. However, it is unknown if collagen defects alter ECM tensile properties. This study aims to quantify the tensile properties of healthy and OI bone ECM. In three transiliac biopsies (healthy n = 1, OI type I n = 1, OI type III n = 1), 23 microtensile specimens (gauge dimensions 10 × 5 × 2 μm3) were manufactured and loaded quasi-statically under tension in vacuum condition. The resulting loading modulus and ultimate strength were extracted. Interestingly, tensile properties in OI bone ECM were not inferior compared to controls. All specimens revealed a brittle failure behavior. Fracture surfaces were graded according to their mineralized collagen fibers (MCF) orientation into axial, mixed, and transversal fracture surface types (FST). Furthermore, tissue mineral density (TMD) of the biopsy cortices was extracted from micro-computed tomogra[hy (μCT) images. Both FST and TMD are significant factors to predict loading modulus and ultimate strength with an adjusted R 2 of 0.556 (p = 2.65e-05) and 0.46 (p = 2.2e-04), respectively. The influence of MCF orientation and DBM on the mechanical properties of the neighboring ECM was further verified with quantitative polarized Raman spectroscopy (qPRS) and site-matched nanoindentation. MCF orientation and DBM were extracted from the qPRS spectrum, and a second mechanical model was developed to predict the indentation modulus with MCF orientation and DBM (R 2 = 67.4%, p = 7.73e-07). The tensile mechanical properties of the cortical bone ECM of two OI iliac crest biopsies are not lower than the one from a healthy and are primarily dependent on MCF orientation and DBM. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Michael Indermaur
- ARTORG Center for Biomedical EngineeringUniversity of BernBernSwitzerland
| | - Daniele Casari
- ARTORG Center for Biomedical EngineeringUniversity of BernBernSwitzerland
- Swiss Federal Laboratories for Material Science and TechnologyThunSwitzerland
| | - Tatiana Kochetkova
- Swiss Federal Laboratories for Material Science and TechnologyThunSwitzerland
| | - Bettina M. Willie
- Research Centre, Shriners Hospital for Children‐Canada, Department of Pediatric SurgeryMcGill UniversityMontrealQCCanada
| | - Johann Michler
- Swiss Federal Laboratories for Material Science and TechnologyThunSwitzerland
| | - Jakob Schwiedrzik
- Swiss Federal Laboratories for Material Science and TechnologyThunSwitzerland
| | - Philippe Zysset
- ARTORG Center for Biomedical EngineeringUniversity of BernBernSwitzerland
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27
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Moen J. The Reponic Classification of Insulin. Can J Diabetes 2023; 47:680-681. [PMID: 37211042 DOI: 10.1016/j.jcjd.2023.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Affiliation(s)
- Joshua Moen
- College of Education and Health Sciences, Touro University, Vallejo, California, United States.
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28
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Aurégan JC, Bosser C, Bachy-Razzouk M, Bensidhoum M, Hoc T. In Vivo Assessment of Skin Surface Pattern: Exploring Its Potential as an Indicator of Bone Biomechanical Properties. Bioengineering (Basel) 2023; 10:1338. [PMID: 38135929 PMCID: PMC10741173 DOI: 10.3390/bioengineering10121338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 11/14/2023] [Accepted: 11/18/2023] [Indexed: 12/24/2023] Open
Abstract
The mechanical properties of bone tissue are the result of a complex process involving collagen-crystal interactions. The mineral density of the bone tissue is correlated with bone strength, whereas the characteristics of collagen are often associated with the ductility and toughness of the bone. From a clinical perspective, bone mineral density alone does not satisfactorily explain skeletal fragility. However, reliable in vivo markers of collagen quality that can be easily used in clinical practice are not available. Hence, the objective of the present study is to examine the relationship between skin surface morphology and changes in the mechanical properties of the bone. An experimental study was conducted on healthy children (n = 11), children with osteogenesis imperfecta (n = 13), and women over 60 years of age (n = 22). For each patient, the skin characteristic length (SCL) of the forearm skin surface was measured. The SCL quantifies the geometric patterns formed by wrinkles on the skin's surface, both in terms of size and elongation. The greater the SCL, the more deficient was the organic collagen matrix. In addition, the bone volume fraction and mechanical properties of the explanted femoral head were determined for the elderly female group. The mean SCL values of the healthy children group were significantly lower than those of the elderly women and osteogenesis imperfecta groups. For the aged women group, no significant differences were indicated in the elastic mechanical parameters, whereas bone toughness and ductility decreased significantly as the SCL increased. In conclusion, in bone collagen pathology or bone aging, the SCL is significantly impaired. This in vivo skin surface parameter can be a non-invasive tool to improve the estimation of bone matrix quality and to identify subjects at high risk of bone fracture.
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Affiliation(s)
- Jean-Charles Aurégan
- B3OA, UMR CNRS 7052, Inserm U1271 Université de Paris, 10 avenue de Verdun, 75010 Paris, France; (J.-C.A.); (M.B.-R.); (M.B.)
- Orthopedics Department, Université Paris-Saclay, AP-HP, Hôpital Antoine Béclère, 157, Rue de la Porte-de-Trivaux, 92140 Clamart, France
| | - Catherine Bosser
- HealthDataSciences, 45, Chemin du Barthélémy, 69260 Charbonnières-les-Bains, France
| | - Manon Bachy-Razzouk
- B3OA, UMR CNRS 7052, Inserm U1271 Université de Paris, 10 avenue de Verdun, 75010 Paris, France; (J.-C.A.); (M.B.-R.); (M.B.)
- Orthopedics Department, Sorbonne Université, AP-HP, Hôpital Trousseau, 26, Avenue du Docteur-Arnold-Netter, 75012 Paris, France
| | - Morad Bensidhoum
- B3OA, UMR CNRS 7052, Inserm U1271 Université de Paris, 10 avenue de Verdun, 75010 Paris, France; (J.-C.A.); (M.B.-R.); (M.B.)
| | - Thierry Hoc
- B3OA, UMR CNRS 7052, Inserm U1271 Université de Paris, 10 avenue de Verdun, 75010 Paris, France; (J.-C.A.); (M.B.-R.); (M.B.)
- Mechanical Department, École Centrale de Lyon, MSGMGC, 36, Avenue Guy-de-Collongue, 69134 Ecully, France
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29
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Gourgas O, Lemire G, Eaton AJ, Alshahrani S, Duker AL, Li J, Carroll RS, Mackenzie S, Nikkel SM, Bober MB, Boycott KM, Murshed M. Specific heterozygous variants in MGP lead to endoplasmic reticulum stress and cause spondyloepiphyseal dysplasia. Nat Commun 2023; 14:7054. [PMID: 37923733 PMCID: PMC10624854 DOI: 10.1038/s41467-023-41651-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 09/13/2023] [Indexed: 11/06/2023] Open
Abstract
Matrix Gla protein (MGP) is a vitamin K-dependent post-translationally modified protein, highly expressed in vascular and cartilaginous tissues. It is a potent inhibitor of extracellular matrix mineralization. Biallelic loss-of-function variants in the MGP gene cause Keutel syndrome, an autosomal recessive disorder characterized by widespread calcification of various cartilaginous tissues and skeletal and vascular anomalies. In this study, we report four individuals from two unrelated families with two heterozygous variants in MGP, both altering the cysteine 19 residue to phenylalanine or tyrosine. These individuals present with a spondyloepiphyseal skeletal dysplasia characterized by short stature with a short trunk, diffuse platyspondyly, midface retrusion, progressive epiphyseal anomalies and brachytelephalangism. We investigated the cellular and molecular effects of one of the heterozygous deleterious variants (C19F) using both cell and genetically modified mouse models. Heterozygous 'knock-in' mice expressing C19F MGP recapitulate most of the skeletal anomalies observed in the affected individuals. Our results suggest that the main underlying mechanism leading to the observed skeletal dysplasia is endoplasmic reticulum stress-induced apoptosis of the growth plate chondrocytes. Overall, our findings support that heterozygous variants in MGP altering the Cys19 residue cause autosomal dominant spondyloepiphyseal dysplasia, a condition distinct from Keutel syndrome both clinically and molecularly.
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Affiliation(s)
- Ophélie Gourgas
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - Gabrielle Lemire
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
- Broad Center for Mendelian Genomics, Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Alison J Eaton
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
- University of Alberta, Edmonton, AB, Canada
| | - Sultanah Alshahrani
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Jingjing Li
- Department of Medicine, McGill University, Montreal, QC, Canada
| | | | | | | | | | - Kym M Boycott
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
- Department of Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Monzur Murshed
- Department of Medicine, McGill University, Montreal, QC, Canada.
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, QC, Canada.
- Shriners Hospitals for Children - Canada, Montreal, QC, Canada.
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30
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Peláez Chomba MS, Vásquez Gómez GR, Sullcahuaman Allende YC, Mendoza Fernández JC, Purizaca Rosillo ND, Zevallos A, Cruzate Cabrejos VL. Case Report: A prenatal diagnosis of osteogenesis imperfecta in a patient with a novel pathogenic variant in COL1A2. F1000Res 2023; 12:603. [PMID: 37829592 PMCID: PMC10565417 DOI: 10.12688/f1000research.131094.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/23/2023] [Indexed: 10/14/2023] Open
Abstract
Osteogenesis imperfecta is considered a rare genetic condition which is characterized by bone fragility. In 85% of cases, it is caused by mutations in COL1A1 and COL1A2 genes which are essential to produce type I collagen. We report the case of a female neonate delivered to a 27-year-old women at San Bartolomé Teaching Hospital with a family history of clavicle fracture. A prenatal control with ultrasound was performed to the mother at 29 weeks. A fetus with altered morphology and multiple fractures was found. Therefore, a prenatal diagnosis of osteogenesis imperfecta was performed. The neonate was born with a respiratory distress syndrome and an acyanotic congenital heart disease. Therefore, she remained in NICU until her death. We highlight the importance of prenatal diagnosis, genetic counseling and a multidisciplinary evaluation in this type of pathologies and report a new probably pathogenic variant in the COL1A2 gene detected by exomic sequencing in amniotic fluid.
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Affiliation(s)
- Melissa Sindy Peláez Chomba
- Departamento de Gineco Obstetricia, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Lima, Cercado de Lima 15001, Peru
| | - Guillermo Raúl Vásquez Gómez
- Departamento de Gineco Obstetricia, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Lima, Cercado de Lima 15001, Peru
| | - Yasser Ciro Sullcahuaman Allende
- Instituto de Investigación Genómica, IGENOMICA, Lima, Lima, San Borja 15037, Peru
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Lima, San Martin de Porres 15102, Peru
| | - Julio Cesar Mendoza Fernández
- Unidad Funcional de Genética y Biología Molecular, Instituto Nacional de Enfermedades Neoplásicas, Lima, Lima, Surquillo 15038, Peru
| | | | - Alejandra Zevallos
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Lima, Chorrillos 15067, Peru
| | - Vicente Leandro Cruzate Cabrejos
- Departamento de Gineco Obstetricia, Hospital Nacional Docente Madre Niño San Bartolomé, Lima, Lima, Cercado de Lima 15001, Peru
- Escuela Profesional de Medicina Humana, Universidad Privada San Juan Bautista, Lima, Lima, Chorrillos 15067, Peru
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31
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Liu W, Cao J, Shi X, Li Y, Qiao F, Wu Y. Genetic testing and diagnostic strategies of fetal skeletal dysplasia: a preliminary study in Wuhan, China. Orphanet J Rare Dis 2023; 18:336. [PMID: 37875969 PMCID: PMC10599061 DOI: 10.1186/s13023-023-02955-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 10/16/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Fetal skeletal dysplasia is a diverse group of degenerative diseases of bone and cartilage disorders that can lead to movement disorder and even death. This study aims to evaluate the diagnostic yield of sonographic examination and genetic testing for fetal skeletal dysplasia. METHODS From September 2015 to April 2021, the study investigated 24 cases with suspected short-limb fetuses, which were obtained from Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology. To identify the causative gene, multiple approaches (including karyotype analysis, copy number variations and whole exome sequencing) were performed on these fetuses. And further segregation analysis of the candidate variant was performed in parents by using Sanger sequencing. RESULTS ① Out of 24 cases, likely pathogenic variants in FGFR3, FBN2, COL1A2, CUL7 and DYNC2H1 were detected in 6 cases; pathogenic variants in FGFR3, IMPAD1 and GORAB were identified in other 6 cases; and variants in WNT1, FBN1, OBSL1, COL1A1, DYNC2H1 and NEK1, known as Variant of Undetermined Significance, were found in 4 cases. There were no variants detected in the rest 8 cases by the whole exome sequencing. ② Of 24 cases, 12 (50%) were found to carry variants (pathogenic or likely pathogenic) in seven genes with 12 variants. Four fetuses (16.7%) had variants of uncertain significance. CONCLUSION Genetic testing combining with ultrasound scanning enhances the accurate diagnosis of fatal skeletal dysplasia in utero, and then provides appropriate genetic counseling.
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Affiliation(s)
- Wanlu Liu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Jing Cao
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Xinwei Shi
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Yuqi Li
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Fuyuan Qiao
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
| | - Yuanyuan Wu
- Department of Obstetrics and Gynecology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jiefang Avenue, Wuhan, 430030 China
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32
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Botor M, Auguściak-Duma A, Lesiak M, Sieroń Ł, Dziedzic-Kowalska A, Witecka J, Asman M, Madetko-Talowska A, Bik-Multanowski M, Galicka A, Sieroń AL, Gawron K. Analysis of miRNAs in Osteogenesis imperfecta Caused by Mutations in COL1A1 and COL1A2: Insights into Molecular Mechanisms and Potential Therapeutic Targets. Pharmaceuticals (Basel) 2023; 16:1414. [PMID: 37895885 PMCID: PMC10609877 DOI: 10.3390/ph16101414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 09/29/2023] [Accepted: 10/01/2023] [Indexed: 10/29/2023] Open
Abstract
Osteogenesis imperfecta (OI) is a group of connective tissue disorders leading to abnormal bone formation, mainly due to mutations in genes encoding collagen type I (Col I). Osteogenesis is regulated by a number of molecules, including microRNAs (miRNAs), indicating their potential as targets for OI therapy. The goal of this study was to identify and analyze the expression profiles of miRNAs involved in bone extracellular matrix (ECM) regulation in patients diagnosed with OI type I caused by mutations in COL1A1 or COL1A2. Primary skin fibroblast cultures were used for DNA purification and sequence analysis, followed by analysis of miRNA expression. Sequencing analysis revealed mutations of the COL1A1 or COL1A2 genes in all OI patients, including four previously unreported. Amongst the 40 miRNAs analyzed, 9 were identified exclusively in OI cells and 26 in both OI patients and the controls. In the latter case, the expression of six miRNAs (hsa-miR-10b-5p, hsa-miR-19a-3p, hsa-miR-19b-3p, has-miR-204-5p, has-miR-216a-5p, and hsa-miR-449a) increased, while four (hsa-miR-129-5p, hsa-miR-199b-5p, hsa-miR-664a-5p, and hsa-miR-30a-5p) decreased significantly in OI cells in comparison to their expression in the control cells. The identified mutations and miRNA expression profiles shed light on the intricate processes governing bone formation and ECM regulation, paving the way for further research and potential therapeutic advancements in OI and other genetic diseases related to bone abnormality management.
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Affiliation(s)
- Malwina Botor
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (A.A.-D.); (M.L.); (Ł.S.); (A.L.S.)
| | - Aleksandra Auguściak-Duma
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (A.A.-D.); (M.L.); (Ł.S.); (A.L.S.)
| | - Marta Lesiak
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (A.A.-D.); (M.L.); (Ł.S.); (A.L.S.)
| | - Łukasz Sieroń
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (A.A.-D.); (M.L.); (Ł.S.); (A.L.S.)
| | - Agata Dziedzic-Kowalska
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (A.A.-D.); (M.L.); (Ł.S.); (A.L.S.)
| | - Joanna Witecka
- Department of Parasitology, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, 41-200 Sosnowiec, Poland;
| | - Marek Asman
- Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, 41-808 Zabrze, Poland;
| | - Anna Madetko-Talowska
- Department of Medical Genetics, Jagiellonian University Medical College, 30-663 Krakow, Poland; (A.M.-T.); (M.B.-M.)
| | - Mirosław Bik-Multanowski
- Department of Medical Genetics, Jagiellonian University Medical College, 30-663 Krakow, Poland; (A.M.-T.); (M.B.-M.)
| | - Anna Galicka
- Department of Medical Chemistry, Medical University of Bialystok, 15-222 Bialystok, Poland;
| | - Aleksander L. Sieroń
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (A.A.-D.); (M.L.); (Ł.S.); (A.L.S.)
| | - Katarzyna Gawron
- Department of Molecular Biology and Genetics, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, Poland; (A.A.-D.); (M.L.); (Ł.S.); (A.L.S.)
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Moy N, Flynn D, Henriquez J, Connelly LB, Vale L, Paolucci F. Interventions for improving clinical outcomes and health-related quality-of-life for people living with skeletal dysplasias: an evidence gap map. Qual Life Res 2023; 32:2751-2762. [PMID: 37294397 PMCID: PMC10474209 DOI: 10.1007/s11136-023-03431-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/25/2023] [Indexed: 06/10/2023]
Abstract
PURPOSE Skeletal dysplasias are rare genetic disorders that are characterized by abnormal development of bone and cartilage. There are multiple medical and non-medical treatments for specific symptoms of skeletal dysplasias e.g. pain, as well as corrective surgical procedures to improve physical functioning. The aim of this paper was to develop an evidence-gap map of treatment options for skeletal dysplasias, and their impact on patient outcomes. METHODS We conducted an evidence-gap map to identify the available evidence on the impact of treatment options on people with skeletal dysplasias on clinical outcomes (such as increase in height), and dimensions of health-related quality of life. A structured search strategy was applied to five databases. Two reviewers independently assessed articles for inclusion in two stages: titles and abstracts (stage 1), and full text of studies retained at stage 2. RESULTS 58 studies fulfilled our inclusion criteria. The included studies covered 12 types of skeletal dysplasia that are non-lethal with severe limb deformities that could result in significant pain and numerous orthopaedic interventions. Most studies reported on the effect of surgical interventions (n = 40, 69%), followed by the effect of treatments on dimensions of health quality-of-life (n = 4, 6.8%) and psychosocial functioning (n = 8, 13.8%). CONCLUSION Most studies reported on clinical outcomes from surgery for people living with Achondroplasia. Consequently, there are gaps in the literature on the full range of treatment options (including no active treatment), outcomes and the lived experience of people living with other skeletal dysplasias. More research is warranted to examine the impact of treatments on health-related quality-of-life of people living with skeletal dysplasias, including their relatives to enable them to make preference- and valued based decisions about treatment.
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Affiliation(s)
- Naomi Moy
- Department of Sociology and Business Law, University of Bologna, Bologna, Italy
| | - Darren Flynn
- Department of Midwifery, Nursing and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Josefa Henriquez
- Department of Sociology and Business Law, University of Bologna, Bologna, Italy
| | - Luke B Connelly
- Department of Sociology and Business Law, University of Bologna, Bologna, Italy
- Centre for the Business and Economics of Health, The University of Queensland, Brisbane, Australia
| | - Luke Vale
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Francesco Paolucci
- Department of Sociology and Business Law, University of Bologna, Bologna, Italy.
- Newcastle Business School, Faculty of Business and Law, University of Newcastle, Callaghan, Australia.
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Mutlu H, Elçioğlu N, Kiliç E. Autosomal recessive otospondylo-mega-epiphyseal dysplasia: comprehensive clinical review of a pediatric cohort. Clin Dysmorphol 2023; 32:151-155. [PMID: 37646720 DOI: 10.1097/mcd.0000000000000467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
Autosomal recessive otospondylo-mega-epiphyseal dysplasia (OSMEDB) is characterized by short stature with short limbs, dysmorphic facial features, and hearing loss, which is caused by biallelic, loss-of-function, variants in the COL11A2 gene. Geno-phenotypic data from the medical records of eight affected individuals from five unrelated families was abstracted, recorded in an Excel spreadsheet and analyzed using simple frequency analysis. Either short femora or short extremities with or without other ultrasonographic abnormalities were demonstrated in five patients antenatally. The mean height was -2.29 SDS. Pectus deformity, including either chest asymmetry or pectus excavatum, was present in five patients. Bilateral hearing loss was verified in all patients. Severe speech delay and learning disabilities were present in two patients whose deafness was realized after the age of 12 months. Four novel loss-of-function variants in COL11A2 were found in this cohort. We present novel geno-phenotypic findings in a pediatric cohort with OSMEDB. The age of manifestation of short stature was variable, ranging from birth to middle childhood, and the severity of short stature varied even within the same family. Hearing loss may not be evident in the neonatal period and manifest later in OSMEDB. Intermittent hearing tests should be performed for early intervention of neurolinguistic delay and learning disabilities.
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Affiliation(s)
- Hatice Mutlu
- Division of Pediatric Genetics, Department of Pediatrics, Ankara University School of Medicine, Cebeci/ANKARA
| | - Nursel Elçioğlu
- Department of Pediatric Genetics, Marmara University School of Medicine, İstanbul; Eastern Mediterranean University Medical School, Mersin
| | - Esra Kiliç
- Department of Pediatric Genetics, Ankara Bilkent City Hospital, Ankara, Turkey
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Billich N, O'Brien K, Fredwall SO, Lee M, Savarirayan R, Davidson ZE. A scoping review of nutrition issues and management strategies in individuals with skeletal dysplasia. Genet Med 2023; 25:100920. [PMID: 37330695 DOI: 10.1016/j.gim.2023.100920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 06/11/2023] [Accepted: 06/12/2023] [Indexed: 06/19/2023] Open
Abstract
PURPOSE Skeletal dysplasia are heterogeneous conditions affecting the skeleton. Common nutrition issues include feeding difficulties, obesity, and metabolic complications. This systematic scoping review aimed to identify key nutrition issues, management strategies, and gaps in knowledge regarding nutrition in skeletal dysplasia. METHODS The databases Ovid MEDLINE, Ovid EMBASE, Ebsco CINAHL, Scopus, and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews were searched. Reference lists and citing literature for included studies were searched. Eligible studies included participants with skeletal dysplasia and described: anthropometry, body composition, nutrition-related biochemistry, clinical issues, dietary intake, measured energy or nutrition requirements, or nutrition interventions. RESULTS The literature search identified 8509 references from which 138 studies were included (130 observational, 3 intervention, 2 systematic reviews, and 3 clinical guidelines). Across 17 diagnoses identified, most studies described osteogenesis imperfecta (n = 50) and achondroplasia or hypochondroplasia (n = 47). Nutrition-related clinical issues, biochemistry, obesity, and metabolic complications were most commonly reported, and few studies measured energy requirements (n = 5). CONCLUSION Nutrition-related comorbidities are documented in skeletal dysplasia; yet, evidence to guide management is scarce. Evidence describing nutrition in rarer skeletal dysplasia conditions is lacking. Advances in skeletal dysplasia nutrition knowledge is needed to optimize broader health outcomes.
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Affiliation(s)
- Natassja Billich
- Murdoch Children's Research Institute, Parkville, VIC, Australia; The University of Queensland, St Lucia, QLD, Australia.
| | - Katie O'Brien
- Royal Children's Hospital, Parkville, VIC, Australia; Monash University, Clayton, VIC, Australia
| | - Svein O Fredwall
- Murdoch Children's Research Institute, Parkville, VIC, Australia; TRS National Resource Centre for Rare Disorders, Sunnaas Rehabiliation Hospital, Nesodden, Norway
| | | | - Ravi Savarirayan
- Murdoch Children's Research Institute, Parkville, VIC, Australia; University of Melbourne, Parkville, VIC, Australia
| | - Zoe E Davidson
- Murdoch Children's Research Institute, Parkville, VIC, Australia; Monash University, Clayton, VIC, Australia
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Nayır Büyükşahin H, Emiralioglu N, Simşek Kiper PÖ, Sunman B, Güzelkaş I, Alboğa D, Akgül Erdal M, Boduroglu K, Utine GE, Yalcın E, Doğru D, Kiper N, Ozcelik U. Evaluation of polysomnography findings in children with genetic skeletal disorders. J Sleep Res 2023; 32:e13914. [PMID: 37128177 DOI: 10.1111/jsr.13914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 03/30/2023] [Accepted: 04/05/2023] [Indexed: 05/03/2023]
Abstract
Children with genetic skeletal disorders have variable conditions that can lead to sleep-disordered breathing, and polysomnography is the gold standard for diagnosing this condition. We aimed to review polysomnography findings, to assess the severity of sleep apnea, and to investigate the clinical variables predictive of sleep-disordered breathing in these patients. We retrospectively collected the medical records of patients with genetic skeletal disorders who underwent polysomnography for 5 years. Twenty-seven children with various genetic skeletal disorders, including achondroplasia (14), Crouzon syndrome (3), acromesomelic dysplasia Maroteaux type (3), Apert syndrome (2), osteopetrosis (1), Jeune dysplasia (1), Desbuquois dysplasia (1), acrodysostosis (1), and spondyloepiphyseal dysplasia (1) were enrolled. The median age at the first polysomnography was 58 (1st-3rd quartile: 31-113) months. The overall sleep-disordered breathing results were: 19 (70.3%) had obstructive sleep apneas (OSA) (4 mild, 6 moderate, 9 severe), 2 (7.4%) had central apneas, 4 (14.8%) had nocturnal hypoventilation. There was a significant correlation between non-ambulatory status with both total AHI and OSA (p < 0.001, rho: -0.66/p = 0.04, rho: 0.38, respectively). Nine patients received positive airway pressure titration, and the oAHI values of all returned to the normal range. These patients were started with positive airway pressure treatment. Our cohort showed that the majority of the patients with skeletal dysplasia had sleep apnea syndrome characterised mainly by OSA, highlighting the importance of polysomnography screening for sleep disorders. Positive airway pressure therapy represents an effective treatment for sleep-disordered breathing in those patients.
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Affiliation(s)
- Halime Nayır Büyükşahin
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nagehan Emiralioglu
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Pelin Özlem Simşek Kiper
- Division of Genetics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Birce Sunman
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ismail Güzelkaş
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Didem Alboğa
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Akgül Erdal
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Koray Boduroglu
- Division of Genetics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Gülen Eda Utine
- Division of Genetics, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ebru Yalcın
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Deniz Doğru
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nural Kiper
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ugur Ozcelik
- Division of Pulmonology, Department of Pediatrics, Hacettepe University Faculty of Medicine, Ankara, Turkey
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Merchant N, Dauber A. Shedding New Light: Novel Therapies for Achondroplasia and Growth Disorders. Pediatr Clin North Am 2023; 70:951-961. [PMID: 37704353 DOI: 10.1016/j.pcl.2023.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/15/2023]
Abstract
Achondroplasia is the most common form of disproportionate severe short stature. Management of achondroplasia requires a multidisciplinary approach and has been largely symptomatic for medical complications and psychosocial implications. Increased understanding of genetic and molecular mechanisms of achondroplasia has led to the development of novel disease-modifying drugs. The current drugs under investigation target the growth plate to stimulate chondrocyte growth and development. These include analogs of C-type natriuretic peptide (CNP), FGFR3-selective tyrosine kinase inhibitors, anti-FGFR3 antibodies, aptamers against FGF2, and soluble forms of FGFR3. Long-term data on the effects of these therapies on medical comorbidities are pending at this time.
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Affiliation(s)
- Nadia Merchant
- Division of Endocrinology, Children's National Hospital, Washington, DC 20010, USA; Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA.
| | - Andrew Dauber
- Division of Endocrinology, Children's National Hospital, Washington, DC 20010, USA; Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC 20037, USA
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Ashwal E, Sgro J, Shannon P, Chong K, Glanc P, Chitayat D. Lung Hypoplasia in Fetuses with Skeletal Dysplasia Determined by Fetal Lung Weight: Which Ultrasound Measurement/Ratio Has the Highest Detection Rate. Fetal Diagn Ther 2023; 51:23-29. [PMID: 37778334 DOI: 10.1159/000534209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 08/11/2023] [Indexed: 10/03/2023]
Abstract
INTRODUCTION To determine lung hypoplasia in cases with fetal skeletal dysplasia based on the total lung weight at autopsy as the most accountable surrogate marker for pulmonary hypoplasia. METHODS This retrospective cohort study included all pregnancies with antenatal diagnosis of skeletal dysplasia (2012-2018). We included only cases in which information on fetal biometry was available within 2 weeks before delivery and had autopsy and skeletal X-rays + molecular analysis using extracted fetal DNA. We compared the predictive accuracy of fetal sonographic body-proportional ratios (BPRs) including: (1) thoracic circumference-to-abdominal circumference ratio, (2) the femur length-to-abdominal circumference (FL/AC) ratio, (3) head circumference-to-abdominal circumference ratio, and (4) foot length-to-femur length ratio. Lung hypoplasia was defined as total lung weight below -2 SD from the expected mean for gestational age. RESULTS Fifty three pregnancies with antenatal diagnosis of skeletal dysplasia underwent autopsy included. Lung hypoplasia was determined in 34 (64.1%). Median of gestational age at last sonographic assessment was 21.3 (19.9-24.9) weeks. FL/AC ratio demonstrated the highest area under the curve of 0.817 (95% CI: 0.685-0.949; p < 0.0001). FL/AC ≤0.1550 demonstrated the highest detection rate of 88.2% along with the highest negative predictive value of 75%. CONCLUSION Using a novel, more practical approach to predict lung hypoplasia in skeletal dysplasia, fetal sonographic BPRs and, specifically, FL/AC ratio demonstrate a high detection rate of lung hypoplasia.
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Affiliation(s)
- Eran Ashwal
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada
| | - Jonathan Sgro
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Patrick Shannon
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Karen Chong
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Phyllis Glanc
- Department of Medical Imaging, The Sunnybrook Health Science Center, University of Toronto, Toronto, Ontario, Canada
| | - David Chitayat
- Division of Clinical and Metabolic Genetics, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
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Sałacińska K, Pinkier I, Rutkowska L, Chlebna-Sokół D, Jakubowska-Pietkiewicz E, Michałus I, Kępczyński Ł, Salachna D, Wieczorek-Cichecka N, Piotrowicz M, Chilarska T, Jamsheer A, Matusik P, Wilk M, Petriczko E, Giżewska M, Stecewicz I, Walczak M, Rybak-Krzyszkowska M, Lewiński A, Gach A. NGS analysis of collagen type I genes in Polish patients with Osteogenesis imperfecta: a nationwide multicenter study. Front Endocrinol (Lausanne) 2023; 14:1149982. [PMID: 37810882 PMCID: PMC10556695 DOI: 10.3389/fendo.2023.1149982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/18/2023] [Indexed: 10/10/2023] Open
Abstract
Osteogenesis imperfecta (OI) is a rare genetic disorder of the connective tissue. It presents with a wide spectrum of skeletal and extraskeletal features, and ranges in severity from mild to perinatal lethal. The disease is characterized by a heterogeneous genetic background, where approximately 85%-90% of cases have dominantly inherited heterozygous pathogenic variants located in the COL1A1 and COL1A2 genes. This paper presents the results of the first nationwide study, performed on a large cohort of 197 Polish OI patients. Variants were identified using a next-generation sequencing (NGS) custom gene panel and multiplex ligation probe amplification (MLPA) assay. The following OI types were observed: 1 (42%), 2 (3%), 3 (35%), and 4 (20%). Collagen type I pathogenic variants were reported in 108 families. Alterations were observed in α1 and α2 in 70% and 30% of cases, respectively. The presented paper reports 97 distinct causative variants and expands the OI database with 38 novel pathogenic changes. It also enabled the identification of the first glycine-to-tryptophan substitution in the COL1A1 gene and brought new insights into the clinical severity associated with variants localized in "lethal regions". Our results contribute to a better understanding of the clinical and genetic aspects of OI.
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Affiliation(s)
- Kinga Sałacińska
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Iwona Pinkier
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Lena Rutkowska
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Danuta Chlebna-Sokół
- Department of Bone Metabolic Diseases, University Centre of Paediatric, Medical University of Lodz, Lodz, Poland
| | | | - Izabela Michałus
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Łukasz Kępczyński
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Dominik Salachna
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | | | - Małgorzata Piotrowicz
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Tatiana Chilarska
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Aleksander Jamsheer
- Department of Medical Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Paweł Matusik
- Department of Pediatrics, Pediatric Obesity and Metabolic Bone Diseases, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Wilk
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Elżbieta Petriczko
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Maria Giżewska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Iwona Stecewicz
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | - Mieczysław Walczak
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Disorders and Cardiology of Developmental Age, Pomeranian Medical University, Szczecin, Poland
| | | | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Agnieszka Gach
- Department of Genetics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
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Robinson ME, Rauch D, Glorieux FH, Rauch F. Standardized growth charts for children with osteogenesis imperfecta. Pediatr Res 2023; 94:1075-1082. [PMID: 36922619 DOI: 10.1038/s41390-023-02550-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/06/2023] [Accepted: 02/17/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND Osteogenesis imperfecta (OI) is associated with short stature, which is mild, severe and moderate in OI types I, III and IV, respectively. Standardized OI type- and sex-specific growth charts across all pediatric ages do not exist. METHODS We assessed 573 individuals with OI (type I, III or IV), each with at least one height measurement between ages 3 months and 20 years (total 6523 observations). Analogous to the Centers for Disease Control pediatric growth charts, we generated OI type- and sex-specific growth charts for infants (ages 3-36 months) as well as children and adolescents (ages 2-20 years). Growth curves were fitted to the data using the LMS method and percentiles were smoothed. RESULTS Age was associated with a decline in height z-scores (p < 0.001 for all OI types), which was more pronounced in females. Height multiplier curves were produced to predict adult height in children with OI. Among individuals with OI type I, those with COL1A1 pathogenic variants leading to haploinsufficiency were taller than those with COL1A1 or COL1A2 pathogenic variants not leading to haploinsufficiency. CONCLUSION Our standardized OI type- and sex-specific growth charts can be used to assess the growth of individuals with OI from infancy to adulthood. IMPACT Standardized osteogenesis imperfecta (OI) type- and sex-specific growth charts across all pediatric ages do not exist. Our study is the first to generate OI type- and sex-specific growth charts across all pediatric ages. Our height multiplier curves can be utilized to predict adult height in children with OI.
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Affiliation(s)
- Marie-Eve Robinson
- Shriners Hospital for Children - Canada, McGill University, Montreal, QC, Canada.
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada.
| | - Damian Rauch
- Shriners Hospital for Children - Canada, McGill University, Montreal, QC, Canada
| | - Francis H Glorieux
- Shriners Hospital for Children - Canada, McGill University, Montreal, QC, Canada
| | - Frank Rauch
- Shriners Hospital for Children - Canada, McGill University, Montreal, QC, Canada
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Conor Rork W, Hertz AG, Wiese AD, Kostick KM, Nguyen D, Schneider SC, Shepherd WS, Cho H, Murali CN, Lee B, Reid Sutton V, Storch EA. A qualitative exploration of patient perspectives on psychosocial burdens and positive factors in adults with osteogenesis imperfecta. Am J Med Genet A 2023; 191:2267-2275. [PMID: 37317786 PMCID: PMC10525007 DOI: 10.1002/ajmg.a.63323] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 05/11/2023] [Accepted: 05/26/2023] [Indexed: 06/16/2023]
Abstract
Osteogenesis imperfecta (OI) is a pleiotropic, heritable connective tissue disorder associated with a wide range of health implications, including frequent bone fracture. While progress has been made to understand the spectrum of these physical health implications, the impact of OI on psychosocial well-being, as well as protective factors that buffer against adverse psychosocial outcomes, remain understudied. This present study relies on a qualitative approach to assess patient perspectives on both protective and adverse psychosocial factors specific to OI in 15 adults with varying disease status. Semi-structured interviews were conducted, subsequently coded, and themes extracted. Themes concerning psychosocial burdens (i.e., negative affective and behavioral impacts of disease status) and protective factors were identified from cooperatively-coded transcripts (two coders per transcript). Participants reported experiencing an increase in negative affect and disease-related distress after fracturing a bone and during recovery. Fear and concern specific to the uncertainty of future bone fractures and negative self-image was common. In contrast to these negative impacts, participants additionally described positive orientations toward their disease and attributed positive traits to their lived experience with a chronic disease. While limited due to small sample size and lack of ethno-racial diversity, findings highlight a need for continued research on the relationship between OI disease status and psychosocial outcomes, as well as the development of psychological interventions designed for OI populations. Findings have relevant clinical applications for healthcare providers working with those diagnosed with OI.
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Affiliation(s)
- W. Conor Rork
- Vagelos College of Physicians and Surgeons, Columbia University, New York, New York
| | - Alyssa G. Hertz
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Andrew D. Wiese
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Kristin M. Kostick
- Center for Medical Ethics & Health Policy, Baylor College of Medicine, Houston, Texas
| | - Dianne Nguyen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Sophie C. Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Whitney S. Shepherd
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Hannah Cho
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | | | - Chaya N. Murali
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston, Texas
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston, Texas
| | - V. Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
- Texas Children’s Hospital, Houston, Texas
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
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Ohata Y, Kitaoka T, Ishimi T, Yamada C, Nakano Y, Yamamoto K, Takeyari S, Nakayama H, Fujiwara M, Kubota T, Ozono K. Association of trabecular bone score and bone mineral apparent density with the severity of bone fragility in children and adolescents with osteogenesis imperfecta: A cross-sectional study. PLoS One 2023; 18:e0290812. [PMID: 37643181 PMCID: PMC10464990 DOI: 10.1371/journal.pone.0290812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Accepted: 08/16/2023] [Indexed: 08/31/2023] Open
Abstract
Osteogenesis imperfecta (OI) is a hereditary skeletal disease characterized by bone fragility. Areal bone mineral density (BMD), evaluated by dual-energy X-ray absorptiometry (DXA), is used to assess bone brittleness. The height-adjusted BMD Z-score (BMDHAZ) is calculated in children and adolescents with OI to reduce the confounding factor of short stature. However, even with the BMDHAZ, severity evaluation in children and adolescents with OI is challenging because certain abnormalities in bone quality cannot be accurately assessed by BMD analysis. The trabecular bone scores (TBS) and bone mineral apparent density (BMAD), which represent the structural integrity of bone and bone-size-associated BMD, respectively, are associated with fracture risk. Recently, age- and sex-specific reference ranges have been reported, enabling the calculation of Z-scores for children. To evaluate which density measurements show the highest correlation with fracture risk, we analyzed the associations between the Z-scores of TBS, BMAD, and BMDHAZ, fracture rate, and genetic variants. We retrospectively reviewed 42 participants with OI aged 5 to 20 years who underwent DXA. COL1A1/2 pathogenic variants were detected in 41 of the 42 participants. In participants with nonsense and frameshift variants (n = 17) resulting in haploinsufficiency and mild phenotype, the TBS Z-score was negatively correlated with fracture rate (FR) (r = -0.50, p = 0.042). In participants with glycine substitution (n = 9) causing the severe phenotype, the BMAD Z-scores were negatively correlated with FR (r = -0.74, p = 0.022). No correlation between the BMDHAZ and FR was observed in both groups. These findings suggest that the TBS and BMAD are useful in assessing children and adolescents with OI with specific genetic variants.
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Affiliation(s)
- Yasuhisa Ohata
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Taichi Kitaoka
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takeshi Ishimi
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Chieko Yamada
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yukako Nakano
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Kenichi Yamamoto
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Shinji Takeyari
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Hirofumi Nakayama
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- The 1st. Department of Oral and Maxillofacial Surgery, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Makoto Fujiwara
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Takuo Kubota
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Keiichi Ozono
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Costantini A, Guasto A, Cormier-Daire V. TGF-β and BMP Signaling Pathways in Skeletal Dysplasia with Short and Tall Stature. Annu Rev Genomics Hum Genet 2023; 24:225-253. [PMID: 37624666 DOI: 10.1146/annurev-genom-120922-094107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
The transforming growth factor β (TGF-β) and bone morphogenetic protein (BMP) signaling pathways play a pivotal role in bone development and skeletal health. More than 30 different types of skeletal dysplasia are now known to be caused by pathogenic variants in genes that belong to the TGF-β superfamily and/or regulate TGF-β/BMP bioavailability. This review describes the latest advances in skeletal dysplasia that is due to impaired TGF-β/BMP signaling and results in short stature (acromelic dysplasia and cardiospondylocarpofacial syndrome) or tall stature (Marfan syndrome). We thoroughly describe the clinical features of the patients, the underlying genetic findings, and the pathomolecular mechanisms leading to disease, which have been investigated mainly using patient-derived skin fibroblasts and mouse models. Although no pharmacological treatment is yet available for skeletal dysplasia due to impaired TGF-β/BMP signaling, in recent years advances in the use of drugs targeting TGF-β have been made, and we also discuss these advances.
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Affiliation(s)
- Alice Costantini
- Paris Cité University, INSERM UMR 1163, Institut Imagine, Paris, France; , ,
- Department of Molecular Medicine and Surgery and Center for Molecular Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Alessandra Guasto
- Paris Cité University, INSERM UMR 1163, Institut Imagine, Paris, France; , ,
| | - Valérie Cormier-Daire
- Paris Cité University, INSERM UMR 1163, Institut Imagine, Paris, France; , ,
- Reference Center for Skeletal Dysplasia, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
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Zheng C, Liu H, Zhao P, Lu W, Song S, He T, Fan J, Wang D, Yang P, Jie Q, Zheng HF, Luo Z, Yang L. Targeting sulfation-dependent mechanoreciprocity between matrix and osteoblasts to mitigate bone loss. Sci Transl Med 2023; 15:eadg3983. [PMID: 37611084 DOI: 10.1126/scitranslmed.adg3983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2022] [Accepted: 08/04/2023] [Indexed: 08/25/2023]
Abstract
Sulfation is a widespread modification of biomolecules that has been incompletely explored to date. Through cross-phenotype meta-analysis of bone mineral density in up to 426,824 genotyped human participants along with phenotypic characterization of multiple mutant mouse lines, we identified a causative role for sulfate transporter solute carrier family 26 member A2 (SLC26A2) deficiency in osteoporosis. Ablation of SLC26A2 in osteoblasts caused severe bone loss and accumulation of immature bone cells and elicited peculiar pericellular matrix (PCM) production characterized by undersulfation coupled with decreased stiffness. These altered chemophysical properties of the PCM disrupted the formation of focal adhesions in osteoblasts. Bulk RNA sequencing and functional assays revealed that the mechanoreciprocal inhibition of focal adhesion kinase (FAK) and Yes1-associated transcriptional regulator (YAP)/WW domain containing transcription regulator 1 (TAZ) signaling impinged osteoblast maturation upon SLC26A2 deficiency. Moreover, pharmacological abrogation of the Hippo kinases and forced wheel-running ameliorated SLC26A2-deficient osteoporosis by promoting YAP/TAZ activity. Analysis of mouse single-cell RNA sequencing data suggested coordination among sulfate metabolism, focal adhesion, and YAP/TAZ activity during osteoblast-to-osteocyte transition. In addition to the SLC26A2-deficient setting, altered FAK and YAP/TAZ signaling was also observed in bone cells of ovariectomized mice and patients with osteoporosis, and pharmacological enforcing of YAP/TAZ activity ameliorated bone loss in ovariectomized mice. Collectively, these data unveil a role for sulfation in the developmental mechanoreciprocity between matrix and osteoblasts, which could be leveraged to prevent bone loss.
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Affiliation(s)
- Chao Zheng
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - He Liu
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Pianpian Zhao
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou 310030, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China
| | - Weiguang Lu
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Shiju Song
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Ting He
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Jing Fan
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Di Wang
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
| | - Pengfei Yang
- Key Laboratory for Space Bioscience and Biotechnology, Institute of Special Environmental Biophysics, School of Life Sciences, Northwestern Polytechnical University, Xi'an 710072, China
| | - Qiang Jie
- Department of Orthopedic Surgery, Hong Hui Hospital, Xi'an Jiaotong University, College of Medicine, Xi'an 710049, China
- Research Center for Skeletal Developmental Deformity and Injury repair, College of Life Science and Medicine, Northwest University, Xi'an 710069, China
| | - Hou-Feng Zheng
- Diseases & Population (DaP) Geninfo Lab, School of Life Sciences, Westlake University, Hangzhou 310030, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou 310024, China
| | - Zhuojing Luo
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
- Medical Research Institute, Northwestern Polytechnical University, Xi'an 710072, China
| | - Liu Yang
- Institute of Orthopedic Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, China
- Medical Research Institute, Northwestern Polytechnical University, Xi'an 710072, China
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Yan L, Cao J, Zhang Y, Liu Y, Zou J, Lou B, Zhuang D, Li H. Prenatal diagnosis to identify compound heterozygous variants in PKDCC that causes rhizomelic limb shortening with dysmorphic features in a fetus from China. BMC Med Genomics 2023; 16:190. [PMID: 37592254 PMCID: PMC10433562 DOI: 10.1186/s12920-023-01631-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/11/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND Rhizomelic limb shortening with dysmorphic features (RLSDF) has already been a disorder of the rare autosomal recessive skeletal dysplasia, just having a few reported cases. RLSDF is caused by protein kinase domain containing, cytoplasmic(PKDCC)gene variants. In this study, we describe the clinical features and potential RLSDF molecular etiology in a fetus from China. METHODS Genomic DNA (gDNA) extracted from the fetal muscle tissue and parents' peripheral blood was subjected to chromosomal microarray analysis (CMA) and trio-based whole exome sequencing (Trio-WES). The candidate pathogenic variants were verified by using Sanger sequencing. RESULTS Trio-WES identified two compound heterozygous variants in PKDCC, c.346delC (p.Pro117Argfs*113) and c.994G > T (p.Glu332Ter), inherited from the father and mother, respectively. Both variants are classified as pathogenic according to American College of Medical Genetics and Genomics guidelines. CONCLUSIONS We reported the first prenatal case of RLSDF caused by PKDCC in the Chinese population. Our findings extended the variation spectrum of PKDCC and emphasized the necessity of WES for the early diagnosis of skeletal dysplasia and other ultrasound structural abnormalities in fetuses.
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Affiliation(s)
- Lulu Yan
- The Central Laboratory of Birth Defects Prevention and Control, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, 315000, China
| | - Juan Cao
- Department of Obstetrics, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, 315000, China
| | - Yuxin Zhang
- The Central Laboratory of Birth Defects Prevention and Control, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, 315000, China
| | - Yingwen Liu
- The Central Laboratory of Birth Defects Prevention and Control, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, 315000, China
| | - Jinghui Zou
- Department of Obstetrics, Ningbo Medical Center Lihuili Hospital, Ningbo, Zhejiang, 315000, China
| | - Biying Lou
- Ningbo University School of Medicine, Ningbo, Zhejiang, 315000, China
| | - Danyan Zhuang
- The Central Laboratory of Birth Defects Prevention and Control, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, 315000, China
| | - Haibo Li
- The Central Laboratory of Birth Defects Prevention and Control, Ningbo Women and Children's Hospital, Ningbo, Zhejiang, 315000, China.
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46
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Miantti Ghellere Bonfim LC, S Guerini I, G Zambon M, A Lopes M. Blue Sclerae and Differential Diagnosis in Chest Pain: A Case Report. Cureus 2023; 15:e43542. [PMID: 37719560 PMCID: PMC10501879 DOI: 10.7759/cureus.43542] [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] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Osteogenesis imperfecta (OI) constitutes a complex connective tissue disorder extending beyond its hallmark bone fragility. This case report explores the intricate diagnostic journey involving an elderly patient with acute chest pain, blue sclerae, and multiple fractures. Despite a thorough cardiac evaluation yielding normal results, the complex medical history and phenotypic markers directed attention toward musculoskeletal factors, underlining the importance of comprehensive diagnostic approaches in hereditary conditions like OI.
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Affiliation(s)
| | - Isadora S Guerini
- Department of Medicine, Western Parana State University, Francisco Beltrão, BRA
| | - Marjorie G Zambon
- Department of Medicine, Mackenzie Evangelical University Hospital, Curitiba, BRA
| | - Marcela A Lopes
- Department of Critical Care, Hospital da Cidade, Salvador, BRA
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47
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Otaify GA, Elhossini RM, Abdel-Ghafar SF, Sayed IM, Abdel-Salam GMH, Aglan MS, Abdel-Hamid MS. CHST3-related skeletal dysplasia in 14 patients: Identification of 8 novel variants and further expansion of the phenotypic spectrum. Am J Med Genet A 2023; 191:2100-2112. [PMID: 37183573 DOI: 10.1002/ajmg.a.63246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 04/01/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023]
Abstract
Biallelic variants in CHST3 gene result in congenital dislocation of large joints, club feet, short stature, rhizomelia, kypho-scoliosis, platyspondyly, epiphyseal dysplasia, flared metaphysis, in addition to minor cardiac lesions and hearing loss. Herein, we describe 14 new patients from 11 unrelated Egyptian families with CHST3-related skeletal dysplasia. All patients had spondyloepiphyseal changes that were progressive with age in addition to bifid distal ends of humeri which can be considered a diagnostic key in patients with CHST3 variants. They also shared peculiar facies with broad forehead, broad nasal tip, long philtrum and short neck. Rare unusual associated findings included microdontia, teeth spacing, delayed eruption, prominent angulation of the lumbar-sacral junction and atrial septal defect. Mutational analysis revealed 10 different homozygous CHST3 (NM_004273.5) variants including 7 missense, two frameshift and one nonsense variant. Of them, the c.384_391dup (p.Pro131Argfs*88) was recurrent in two families. Eight of these variants were not described before. Our study presents the largest series of patients with CHST3-related skeletal dysplasia from the same ethnic group. Furthermore, it reinforces that lethal cardiac involvement is a critical clinical finding of the disorder. Therefore, we believe that our study expands the phenotypic and mutational spectrum, and also highlights the importance of performing echocardiography in patients harboring CHST3 variants.
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Affiliation(s)
- Ghada A Otaify
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Rasha M Elhossini
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Sherif F Abdel-Ghafar
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Inas M Sayed
- Orodental Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Ghada M H Abdel-Salam
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Mona S Aglan
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
| | - Mohamed S Abdel-Hamid
- Medical Molecular Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo, Egypt
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48
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Sharova M, Markova T, Sumina M, Petukhova M, Bulakh M, Ryzhkova O, Nagornova T, Ionova S, Marakhonov A, Dadali E, Kutsev S. Rare IFT140-Associated Phenotype of Cranioectodermal Dysplasia and Features of Diagnostic Journey in Patients with Suspected Ciliopathies. Genes (Basel) 2023; 14:1553. [PMID: 37628605 PMCID: PMC10454909 DOI: 10.3390/genes14081553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/21/2023] [Accepted: 07/26/2023] [Indexed: 08/27/2023] Open
Abstract
Here we present a patient with a cranioectodermal phenotype associated with pathogenic variants in the IFT140 gene. Most frequently, pathogenic variants in IFT140 correspond to the phenotype of Mainzer-Saldino syndrome. Only four patients have previously been described with this cranioectodermal phenotype and variants in IFT140. In comparison to other IFT140-cranioectodermal patients, our proband had similar skeletal features among with early onset end-stage renal failure that required kidney transplantation but did not have common ophthalmological features such as retinopathy, optic nerve atrophy, or nystagmus. Following exome sequencing, a splicing variant and exons 27-30 tandem duplication were suspected and further validated. The two other patients with Mainzer-Saldino syndrome that we described displayed a typical clinical picture but a special diagnostic journey. In both cases, at first only one pathogenic variant was detected following panel or exome NGS sequencing. Further WGS was performed for one of them where tandem duplication was found. Screening the third patient for the same tandem duplication was successful and revealed the presence of this duplication. Thus, we suggest that the description of the clinical feature polymorphism in a rare IFT140-cranioectodermal phenotype is extremely important for providing genetic counseling for families, as well as the formation of the correct diagnostic path for patients with a variant in IFT140.
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Affiliation(s)
| | | | - Maria Sumina
- State Healthcare Institution of Sverdlovsk Region “Clinical and Diagnostic Center “Mother’s and Child Health Protection”, 620067 Ekaterinburg, Russia
| | | | - Maria Bulakh
- Research Centre for Medical Genetics, 115522 Moscow, Russia
| | - Oxana Ryzhkova
- Research Centre for Medical Genetics, 115522 Moscow, Russia
| | | | - Sofya Ionova
- Research Centre for Medical Genetics, 115522 Moscow, Russia
| | | | - Elena Dadali
- Research Centre for Medical Genetics, 115522 Moscow, Russia
| | - Sergey Kutsev
- Research Centre for Medical Genetics, 115522 Moscow, Russia
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49
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Deveza LA, Zankl A, Hunter DJ. Investigation of a family affected by early-onset osteoarthritis - proposal of a clinical pathway and bioinformatics pipeline for the investigation of cases of familial OA. BMC Musculoskelet Disord 2023; 24:570. [PMID: 37443051 DOI: 10.1186/s12891-023-06691-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/03/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Familial cases of early-onset osteoarthritis (OA) are rare although the exact prevalence is unknown. Early recognition of underlying OA-associated disorders is vital for targeted treatment, when available, and genetic counselling, in case of skeletal dysplasias. Currently, there is no clear guidance on how best to investigate families affected by early-onset OA. METHODS We investigated a family with multiple members affected by early-onset OA (age at onset ≤ 40 years). Clinical and demographic characteristics were collected, followed by laboratory investigations screening for a range of potential OA-associated disorders, and whole genome sequencing in selected individuals. RESULTS Seventeen members of the family were included (7 affected and 10 non-affected). There was an even split between the two sexes and two participants were under 18 years old. No pattern of abnormality was seen in the laboratory investigation that could explain the OA phenotype in the family. Whole-genome sequencing was perfomed in one participant and analysed for likely pathogenic variants in genes known to be associated with skeletal dysplasias. A heterozygous variant in the COL2A1 gene was identified (p.Arg519Cys). Confirmatory tests were performed in five additional participants (four affected and one unaffected). CONCLUSION The methodology used in this study, including the clinical pathway and bioinformatics pipeline, could be applied to other families affected by early-onset OA.
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Affiliation(s)
- Leticia A Deveza
- Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine, University of Sydney, Camperdown, Australia.
- Rheumatology Department, Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia.
| | - Andreas Zankl
- Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine, University of Sydney, Camperdown, Australia
- Department of Clinical Genetics, The Children's Hospital at Westmead, Hawkesbury Road, Westmead, NSW, Australia
- Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia
- Bone Biology Division and Kinghorn Centre for Clinical Genomics, Garvan Institute of Medical Research, Darlinghurst, NSW, Australia
| | - David J Hunter
- Sydney Musculoskeletal Health, Kolling Institute, Faculty of Medicine, University of Sydney, Camperdown, Australia
- Rheumatology Department, Royal North Shore Hospital, Reserve Road, St Leonards, NSW, 2065, Australia
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50
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Guo L, Salian S, Xue JY, Rath N, Rousseau J, Kim H, Ehresmann S, Moosa S, Nakagawa N, Kuroda H, Clayton-Smith J, Wang J, Wang Z, Banka S, Jackson A, Zhang YM, Wei ZJ, Hüning I, Brunet T, Ohashi H, Thomas MF, Bupp C, Miyake N, Matsumoto N, Mendoza-Londono R, Costain G, Hahn G, Di Donato N, Yigit G, Yamada T, Nishimura G, Ansel KM, Wollnik B, Hrabě de Angelis M, Mégarbané A, Rosenfeld JA, Heissmeyer V, Ikegawa S, Campeau PM. Null and missense mutations of ERI1 cause a recessive phenotypic dichotomy in humans. Am J Hum Genet 2023; 110:1068-1085. [PMID: 37352860 PMCID: PMC10357479 DOI: 10.1016/j.ajhg.2023.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 06/25/2023] Open
Abstract
ERI1 is a 3'-to-5' exoribonuclease involved in RNA metabolic pathways including 5.8S rRNA processing and turnover of histone mRNAs. Its biological and medical significance remain unclear. Here, we uncover a phenotypic dichotomy associated with bi-allelic ERI1 variants by reporting eight affected individuals from seven unrelated families. A severe spondyloepimetaphyseal dysplasia (SEMD) was identified in five affected individuals with missense variants but not in those with bi-allelic null variants, who showed mild intellectual disability and digital anomalies. The ERI1 missense variants cause a loss of the exoribonuclease activity, leading to defective trimming of the 5.8S rRNA 3' end and a decreased degradation of replication-dependent histone mRNAs. Affected-individual-derived induced pluripotent stem cells (iPSCs) showed impaired in vitro chondrogenesis with downregulation of genes regulating skeletal patterning. Our study establishes an entity previously unreported in OMIM and provides a model showing a more severe effect of missense alleles than null alleles within recessive genotypes, suggesting a key role of ERI1-mediated RNA metabolism in human skeletal patterning and chondrogenesis.
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Affiliation(s)
- Long Guo
- Department of Laboratory Animal Science, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an 710061, China; National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710061, China; Center of Medical Genetics, Northwest Women's and Children's Hospital, the Affiliated Northwest Women's and Children's Hospital of Xi'an Jiaotong University Health Science Center, Xi'an 710003, China.
| | - Smrithi Salian
- Department of Pediatrics, CHU Sainte Justine Research Center, University of Montreal, 3175 Cote-Sainte-Catherine, Montreal, QC H3T 1C5, Canada
| | - Jing-Yi Xue
- Department of Laboratory Animal Science, School of Basic Medical Sciences, Xi'an Jiaotong University, Xi'an 710061, China; Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan
| | - Nicola Rath
- Research Unit Molecular Immune Regulation, Helmholtz Zentrum München, German Research Center for Environmental Health, D-81377 Munich, Germany
| | - Justine Rousseau
- Department of Pediatrics, CHU Sainte Justine Research Center, University of Montreal, 3175 Cote-Sainte-Catherine, Montreal, QC H3T 1C5, Canada
| | - Hyunyun Kim
- Department of Pediatrics, CHU Sainte Justine Research Center, University of Montreal, 3175 Cote-Sainte-Catherine, Montreal, QC H3T 1C5, Canada
| | - Sophie Ehresmann
- Molecular Biology Program, Université de Montréal, Montréal, QC H3T 1J4, Canada
| | - Shahida Moosa
- Division of Molecular Biology and Human Genetics, Stellenbosch University and Medical Genetics, Tygerberg Hospital, Tygerberg 7505, South Africa
| | - Norio Nakagawa
- Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan; Department of Pediatrics, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Hiroshi Kuroda
- Department of Pediatrics, Kyoto City Hospital, Kyoto 604-8845, Japan
| | - Jill Clayton-Smith
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University Foundation NHS Trust, Health Innovation Manchester, M13 9WL Manchester, UK; Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, M13 9PL Manchester, UK
| | - Juan Wang
- Department of Ultrasound, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004, China
| | - Zheng Wang
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan
| | - Siddharth Banka
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University Foundation NHS Trust, Health Innovation Manchester, M13 9WL Manchester, UK; Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, M13 9PL Manchester, UK
| | - Adam Jackson
- Manchester Centre for Genomic Medicine, St Mary's Hospital, Manchester University Foundation NHS Trust, Health Innovation Manchester, M13 9WL Manchester, UK; Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, M13 9PL Manchester, UK
| | - Yan-Min Zhang
- Shaanxi Institute for Pediatric Diseases, Xi'an Children's Hospital, Affiliated Children's Hospital of Xi'an Jiaotong University, Xi'an 710082, China
| | - Zhen-Jie Wei
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan
| | - Irina Hüning
- Institute of Human Genetics, University of Lübeck, 23538 Lübeck, Germany
| | - Theresa Brunet
- Institute of Human Genetics, School of Medicine, Technical University Munich, 80333 Munich, Germany; Department of Paediatric Neurology and Developmental Medicine, Hauner Children's Hospital, Ludwig Maximilian University of Munich, 80539 Munich, Germany
| | - Hirofumi Ohashi
- Division of Medical Genetics, Saitama Children's Hospital, Saitama 330-8777, Japan
| | - Molly F Thomas
- Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Caleb Bupp
- Spectrum Health, Grand Rapids, MI 49503, USA
| | - Noriko Miyake
- Department of Human Genetics, Research Institute, National Center for Global Health and Medicine, Tokyo 162-8655, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
| | - Roberto Mendoza-Londono
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Program in Genetics and Genome Biology, SickKids Research Institute, and Department of Paediatrics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | - Gregory Costain
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A4, Canada
| | - Gabriele Hahn
- Institute for Radiological Diagnostics, Universitätsklinikum Carl Gustav Carus Dresden, Technische Universität, 01307 Dresden, Germany
| | - Nataliya Di Donato
- Institute for Clinical Genetics, University Hospital, TU Dresden, 01069 Dresden, Germany
| | - Gökhan Yigit
- Institute of Human Genetics, University Medical Center Göttingen, 37075 Göttingen, Germany; DZHK (German Center for Cardiovascular Research), partner site Göttingen, 37075 Göttingen, Germany
| | - Takahiro Yamada
- Department of Medical Ethics and Medical Genetics, Kyoto University School of Public Health, Kyoto 606-8501, Japan
| | - Gen Nishimura
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan
| | - K Mark Ansel
- Department of Microbiology and Immunology, University of California San Francisco, San Francisco, CA 94143, USA
| | - Bernd Wollnik
- Institute of Human Genetics, University Medical Center Göttingen, 37075 Göttingen, Germany; DZHK (German Center for Cardiovascular Research), partner site Göttingen, 37075 Göttingen, Germany; Cluster of Excellence "Multiscale Bioimaging: from Molecular Machines to Networks of Excitable Cells" (MBExC), University of Göttingen, 37075 Göttingen, Germany
| | - Martin Hrabě de Angelis
- Institute of Experimental Genetics, German Mouse Clinic, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), 85764 Neuherberg, Germany; Chair of Experimental Genetics, TUM School of Life Sciences, Technische Universität München, 85354 Freising, Germany; German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - André Mégarbané
- Department of Human Genetics, Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, 1102-2801, Lebanon and Institut Jerome Lejeune, 75015 Paris, France
| | - Jill A Rosenfeld
- Department of Molecular & Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA; Baylor Genetics Laboratories, Houston, TX 77021, USA
| | - Vigo Heissmeyer
- Research Unit Molecular Immune Regulation, Helmholtz Zentrum München, German Research Center for Environmental Health, D-81377 Munich, Germany; Institute for Immunology, Biomedical Center, Faculty of Medicine, Ludwig-Maximilians-Universität in Munich, 82152 Planegg-Martinsried, Germany
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo 108-8639, Japan
| | - Philippe M Campeau
- Department of Pediatrics, CHU Sainte Justine Research Center, University of Montreal, 3175 Cote-Sainte-Catherine, Montreal, QC H3T 1C5, Canada.
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