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Ron HA, Kane O, Guo R, Menello C, Engelhardt N, Pressley S, DiBoscio B, Steffensen M, Cuddapah S, Ng K, Ficicioglu C, Ahrens-Nicklas RC. Five-Year Outcomes of Patients with Pompe Disease Identified by the Pennsylvania Newborn Screen. Int J Neonatal Screen 2025; 11:16. [PMID: 40136631 PMCID: PMC11943203 DOI: 10.3390/ijns11010016] [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: 01/22/2025] [Revised: 02/13/2025] [Accepted: 02/17/2025] [Indexed: 03/27/2025] Open
Abstract
Pennsylvania started newborn screening for Pompe disease (PD) in 2016. As a result, the prevalence of PD has increased with early detection, primarily of late-onset Pompe disease (LOPD). No clear guidelines exist regarding if and when to initiate enzyme replacement therapy (ERT) in patients identified through a newborn screen (NBS). To help define the natural history and indications for starting ERT, we present the long-term follow-up data of 45 patients identified through NBS from 2016 to 2021. These patients were evaluated at regular intervals through our multi-disciplinary clinic at the Children's Hospital of Philadelphia (CHOP) with physical examinations, physical therapy evaluations, muscle biomarkers including creatine kinase (CK), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and hexosaminidase 4 levels (Hex4), as well as cardiac evaluation at certain points in time. We found that newborn screening of acid alpha-glucosidase (GAA) enzyme detected primarily LOPD. One case of infantile-onset PD (IOPD) was detected. Muscle biomarkers in LOPD were elevated at birth and showed a general downward trend over time. NBS GAA levels and initial CK levels helped to differentiate LOPD cases from unaffected infants (carriers, pseudodeficiency alleles), while Hex4 was not a meaningful discriminator. On repeat NBS, there was a significant difference between mean GAA levels for the unaffected vs. compound heterozygote groups and unaffected vs. homozygote groups for the common splice site pathogenic variant (c.-32-13T>G). Echocardiogram and electrocardiogram (EKG) are essentially normal at the first evaluation in LOPD. One LOPD patient was started on ERT at age 4.5 months. Continued data collection on these patients is critical for developing management guidelines, including timing of ERT and improved genotype-phenotype correlation.
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Affiliation(s)
- Hayley A. Ron
- Hackensack University Medical Center at Hackensack Meridian Health, Hackensack, NJ 07601, USA
| | - Owen Kane
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
| | - Rose Guo
- Cone Health, Greensboro, NC 27401, USA
| | - Caitlin Menello
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Nicole Engelhardt
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Shaney Pressley
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Brenda DiBoscio
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Madeline Steffensen
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Sanmati Cuddapah
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Kim Ng
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Can Ficicioglu
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Rebecca C. Ahrens-Nicklas
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA
- Section of Biochemical Genetics, Division of Genetics, Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
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2
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Quaglia A, Roberts EA, Torbenson M. Developmental and Inherited Liver Disease. MACSWEEN'S PATHOLOGY OF THE LIVER 2024:122-294. [DOI: 10.1016/b978-0-7020-8228-3.00003-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2025]
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3
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Pascoe JE, Zygmunt A, Ehsan Z, Gurbani N. Sleep in pediatric neuromuscular disorders. Semin Pediatr Neurol 2023; 48:101092. [PMID: 38065635 DOI: 10.1016/j.spen.2023.101092] [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: 08/14/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 12/18/2023]
Abstract
Sleep disordered breathing (SDB) is prevalent among children with neuromuscular disorders (NMD). The combination of respiratory muscle weakness, altered drive, and chest wall distortion due to scoliosis make sleep a stressful state in this population. Symptomatology can range from absent to snoring, nocturnal awakenings, morning headaches, and excessive daytime sleepiness. Sequelae of untreated SDB includes cardiovascular effects, metabolic derangements, and neurocognitive concerns which can be compounded by those innate to the NMD. The clinician should have a low threshold for obtaining polysomnography and recognize the nuances of individual disorders due to disproportionately impacted muscle groups such as hypoventilation in ambulating patients from diaphragm weakness. Non-invasive or invasive ventilation are the mainstay of treatment. In this review we explore the diagnosis and treatment of SDB in children with various NMD.
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Affiliation(s)
- John E Pascoe
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States.
| | - Alexander Zygmunt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Zarmina Ehsan
- Division of Pulmonary and Sleep Medicine, Children's Mercy-Kansas City, Kansas City, MO, United States; Department of Pediatrics, University of Missouri-Kansas City School of Medicine, Kansas City, MO, United States
| | - Neepa Gurbani
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Taverna S, Cammarata G, Colomba P, Sciarrino S, Zizzo C, Francofonte D, Zora M, Scalia S, Brando C, Curto AL, Marsana EM, Olivieri R, Vitale S, Duro G. Pompe disease: pathogenesis, molecular genetics and diagnosis. Aging (Albany NY) 2020; 12:15856-15874. [PMID: 32745073 PMCID: PMC7467391 DOI: 10.18632/aging.103794] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 07/14/2020] [Indexed: 12/14/2022]
Abstract
Pompe disease (PD) is a rare autosomal recessive disorder caused by mutations in the GAA gene, localized on chromosome 17 and encoding for acid alpha-1,4-glucosidase (GAA). Currently, more than 560 mutations spread throughout GAA gene have been reported. GAA catalyzes the hydrolysis of α-1,4 and α-1,6-glucosidic bonds of glycogen and its deficiency leads to lysosomal storage of glycogen in several tissues, particularly in muscle. PD is a chronic and progressive pathology usually characterized by limb-girdle muscle weakness and respiratory failure. PD is classified as infantile and childhood/adult forms. PD patients exhibit a multisystemic manifestation that depends on age of onset. Early diagnosis is essential to prevent or reduce the irreversible organ damage associated with PD progression. Here, we make an overview of PD focusing on pathogenesis, clinical phenotypes, molecular genetics, diagnosis, therapies, autophagy and the role of miRNAs as potential biomarkers for PD.
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Affiliation(s)
- Simona Taverna
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Giuseppe Cammarata
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Paolo Colomba
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Serafina Sciarrino
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Carmela Zizzo
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Daniele Francofonte
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Marco Zora
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Simone Scalia
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Chiara Brando
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Alessia Lo Curto
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Emanuela Maria Marsana
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Roberta Olivieri
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Silvia Vitale
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
| | - Giovanni Duro
- Institute for Biomedical Research and Innovation (IRIB-CNR), National Research Council of Italy, Palermo, Italy
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Mazzarotto F, Olivotto I, Boschi B, Girolami F, Poggesi C, Barton PJR, Walsh R. Contemporary Insights Into the Genetics of Hypertrophic Cardiomyopathy: Toward a New Era in Clinical Testing? J Am Heart Assoc 2020; 9:e015473. [PMID: 32306808 PMCID: PMC7428545 DOI: 10.1161/jaha.119.015473] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Genetic testing for hypertrophic cardiomyopathy (HCM) is an established clinical technique, supported by 30 years of research into its genetic etiology. Although pathogenic variants are often detected in patients and used to identify at-risk relatives, the effectiveness of genetic testing has been hampered by ambiguous genetic associations (yielding uncertain and potentially false-positive results), difficulties in classifying variants, and uncertainty about genotype-negative patients. Recent case-control studies on rare variation, improved data sharing, and meta-analysis of case cohorts contributed to new insights into the genetic basis of HCM. In particular, although research into new genes and mechanisms remains essential, reassessment of Mendelian genetic associations in HCM argues that current clinical genetic testing should be limited to a small number of validated disease genes that yield informative and interpretable results. Accurate and consistent variant interpretation has benefited from new standardized variant interpretation guidelines and innovative approaches to improve classification. Most cases lacking a pathogenic variant are now believed to indicate non-Mendelian HCM, with more benign prognosis and minimal risk to relatives. Here, we discuss recent advances in the genetics of HCM and their application to clinical genetic testing together with practical issues regarding implementation. Although this review focuses on HCM, many of the issues discussed are also relevant to other inherited cardiac diseases.
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Affiliation(s)
- Francesco Mazzarotto
- Cardiomyopathy UnitCareggi University HospitalFlorenceItaly
- Cardiovascular Research CenterRoyal Brompton and Harefield NHS Foundation TrustLondonUnited Kingdom
- National Heart and Lung InstituteImperial College LondonUnited Kingdom
- Department of Clinical and Experimental MedicineUniversity of FlorenceItaly
| | - Iacopo Olivotto
- Cardiomyopathy UnitCareggi University HospitalFlorenceItaly
- Department of Clinical and Experimental MedicineUniversity of FlorenceItaly
| | - Beatrice Boschi
- Cardiomyopathy UnitCareggi University HospitalFlorenceItaly
- Genetic UnitCareggi University HospitalFlorenceItaly
| | - Francesca Girolami
- Cardiomyopathy UnitCareggi University HospitalFlorenceItaly
- Department of Paediatric CardiologyMeyer Children's HospitalFlorenceItaly
| | - Corrado Poggesi
- Department of Clinical and Experimental MedicineUniversity of FlorenceItaly
| | - Paul J. R. Barton
- Cardiovascular Research CenterRoyal Brompton and Harefield NHS Foundation TrustLondonUnited Kingdom
- National Heart and Lung InstituteImperial College LondonUnited Kingdom
| | - Roddy Walsh
- Department of Clinical and Experimental CardiologyHeart CenterAcademic Medical CenterAmsterdamthe Netherlands
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Aung-Htut MT, Ham KA, Tchan MC, Fletcher S, Wilton SD. Novel Mutations Found in Individuals with Adult-Onset Pompe Disease. Genes (Basel) 2020; 11:genes11020135. [PMID: 32012848 PMCID: PMC7073677 DOI: 10.3390/genes11020135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/19/2019] [Accepted: 01/23/2020] [Indexed: 11/16/2022] Open
Abstract
Pompe disease, or glycogen storage disease II is a rare, progressive disease leading to skeletal muscle weakness due to deficiency of the acid α-1,4-glucosidase enzyme (GAA). The severity of disease and observed time of onset is subject to the various combinations of heterozygous GAA alleles. Here we have characterized two novel mutations: c.2074C>T and c.1910_1918del, and a previously reported c.1082C>G mutation of uncertain clinical significance. These mutations were found in three unrelated patients with adult-onset Pompe disease carrying the common c.-32-13T>G mutation. The c.2074 C>T nonsense mutation has obvious consequences on GAA expression but the c.1910_1918del (deletion of 3 amino acids) and c.1082C>G missense variants are more subtle DNA changes with catastrophic consequences on GAA activity. Molecular and clinical analyses from the three patients corresponded with the anticipated pathogenicity of each mutation.
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Affiliation(s)
- May T. Aung-Htut
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth 6150, Australia; (M.T.A.-H.); (K.A.H.); (S.F.)
- Perron Institute for Neurological and Translational Science and The University of Western Australia, Perth 6009, Australia
| | - Kristin A. Ham
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth 6150, Australia; (M.T.A.-H.); (K.A.H.); (S.F.)
| | - Michel C. Tchan
- Genetic Medicine, Westmead Hospital, Sydney 2145, Australia;
- Sydney Medical School, The University of Sydney, Sydney 2006, Australia
| | - Sue Fletcher
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth 6150, Australia; (M.T.A.-H.); (K.A.H.); (S.F.)
| | - Steve D. Wilton
- Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, Perth 6150, Australia; (M.T.A.-H.); (K.A.H.); (S.F.)
- Perron Institute for Neurological and Translational Science and The University of Western Australia, Perth 6009, Australia
- Correspondence:
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Abstract
Pompe disease is a rare and deadly muscle disorder. As a clinical entity, the disease has been known for over 75 years. While an optimist might be excited about the advances made during this time, a pessimist would note that we have yet to find a cure. However, both sides would agree that many findings in basic science-such as the Nobel prize-winning discoveries of glycogen metabolism, the lysosome, and autophagy-have become the foundation of our understanding of Pompe disease. The disease is a glycogen storage disorder, a lysosomal disorder, and an autophagic myopathy. In this review, we will discuss how these past discoveries have guided Pompe research and impacted recent therapeutic developments.
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Affiliation(s)
- Lara Kohler
- Cell Biology and Physiology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Rosa Puertollano
- Cell Biology and Physiology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Nina Raben
- Cell Biology and Physiology Center, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
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8
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Quaglia A, Roberts EA, Torbenson M. Developmental and Inherited Liver Disease. MACSWEEN'S PATHOLOGY OF THE LIVER 2018:111-274. [DOI: 10.1016/b978-0-7020-6697-9.00003-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2025]
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9
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Zharkinbekova NA, Mukhambetova GA, Kaishibayeva GS, Zhiyenbayeva BS, Zhumagulova KB, Kaishibayev SN, Iglikova AE, Suleimanova SY. [First cases of Pompe's disease in Kazakhstan]. Zh Nevrol Psikhiatr Im S S Korsakova 2017; 117:85-87. [PMID: 28884723 DOI: 10.17116/jnevro20171178185-87] [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: 11/17/2022]
Abstract
The article presents the clinical observations of two newly diagnosed patients with Pompe disease in the Republic of Kazakhstan, confirmed by genetic research.
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Affiliation(s)
- N A Zharkinbekova
- Scientific-Practical Center Smagul Kaishibayev Institute of Neurology, Almaty, Kazakhstan
| | - G A Mukhambetova
- Scientific-Practical Center Smagul Kaishibayev Institute of Neurology, Almaty, Kazakhstan
| | - G S Kaishibayeva
- Scientific-Practical Center Smagul Kaishibayev Institute of Neurology, Almaty, Kazakhstan
| | - B S Zhiyenbayeva
- Scientific-Practical Center Smagul Kaishibayev Institute of Neurology, Almaty, Kazakhstan
| | - K B Zhumagulova
- Scientific-Practical Center Smagul Kaishibayev Institute of Neurology, Almaty, Kazakhstan
| | - S N Kaishibayev
- Scientific-Practical Center Smagul Kaishibayev Institute of Neurology, Almaty, Kazakhstan
| | - A E Iglikova
- Scientific-Practical Center Smagul Kaishibayev Institute of Neurology, Almaty, Kazakhstan
| | - S Yu Suleimanova
- Scientific-Practical Center Smagul Kaishibayev Institute of Neurology, Almaty, Kazakhstan
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10
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Chen MA, Weinstein DA. Glycogen storage diseases: Diagnosis, treatment and outcome. ACTA ACUST UNITED AC 2016. [DOI: 10.3233/trd-160006] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
| | - David A. Weinstein
- Glycogen Storage Disease Program, University of Florida College of Medicine, Gainesville, FL, USA
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11
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Al Jasmi F, Al Jumah M, Alqarni F, Al-Sanna'a N, Al-Sharif F, Bohlega S, Cupler EJ, Fathalla W, Hamdan MA, Makhseed N, Nafissi S, Nilipour Y, Selim L, Shembesh N, Sunbul R, Tonekaboni SH. Diagnosis and treatment of late-onset Pompe disease in the Middle East and North Africa region: consensus recommendations from an expert group. BMC Neurol 2015; 15:205. [PMID: 26471939 PMCID: PMC4608291 DOI: 10.1186/s12883-015-0412-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 08/18/2015] [Indexed: 01/30/2023] Open
Abstract
Background Pompe disease is a rare autosomal recessive disorder caused by a deficiency of the lysosomal enzyme alpha-glucosidase responsible for degrading glycogen. Late-onset Pompe disease has a complex multisystem phenotype characterized by a range of symptoms. Methods An expert panel from the Middle East and North Africa (MENA) region met to create consensus-based guidelines for the diagnosis and treatment of late-onset Pompe disease for the MENA region, where the relative prevalence of Pompe disease is thought to be high but there is a lack of awareness and diagnostic facilities. Results These guidelines set out practical recommendations and include algorithms for the diagnosis and treatment of late-onset Pompe disease. They detail the ideal diagnostic workup, indicate the patients in whom enzyme replacement therapy should be initiated, and provide guidance on appropriate patient monitoring. Conclusions These guidelines will serve to increase awareness of the condition, optimize patient diagnosis and treatment, reduce disease burden, and improve patient outcomes.
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Affiliation(s)
| | - Fatma Al Jasmi
- Department of Pediatrics, College of Medicine and Health Science, United Arab Emirates University, P.O. Box 17666, Al-Ain, United Arab Emirates.
| | - Mohammed Al Jumah
- King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, NGHA, Riyadh, Kingdom of Saudi Arabia. .,Prince Mohammed Ben Abdulaziz Hospital, MOH, P.O. Box 22490, Riyadh, 11426, Kingdom of Saudi Arabia.
| | - Fatimah Alqarni
- Neurology Department, National Neurosciences Institute, King Fahad Medical City, P.O. Box 59046, Riyadh, 11525, Kingdom of Saudi Arabia.
| | - Nouriya Al-Sanna'a
- Johns Hopkins Aramco Healthcare, Pediatrics Services Division, Building 61/Room D-269, Dhahran, Kingdom of Saudi Arabia.
| | - Fawziah Al-Sharif
- Medical Genetics And Metabolic Consultant, MCH, PO Box 55954, Jeddah, 21544, Kingdom of Saudi Arabia.
| | - Saeed Bohlega
- Department of Neurosciences, MBC 76, King Faisal Specialist Hospital and Research Centre, P.O. Box 3354, Riyadh, 11211, Kingdom of Saudi Arabia.
| | - Edward J Cupler
- Department of Neuroscience, MBC J-76, King Faisal Specialist Hospital and Research Center, P.O. Box 40047, Jeddah, 21499, Kingdom of Saudi Arabia.
| | - Waseem Fathalla
- Department of Pediatrics, Division of Child Neurology, Mafraq Hospital, P.O. Box: 2951, Abu Dhabi, United Arab Emirates.
| | - Mohamed A Hamdan
- KidsHeart: American Fetal & Children's Heart Center, Dubai Healthcare City, P.O. Box 505193, Dubai, United Arab Emirates.
| | - Nawal Makhseed
- Pediatric Department, Jahra Hospital, Ministry of Health, P.O. Box 16586, Qadisiya, 35856, Kuwait.
| | - Shahriar Nafissi
- Department of Neurology, Tehran University of Medical Sciences, Shariati Hospital, North Karegar Street, Tehran, 14114, Iran.
| | - Yalda Nilipour
- Pediatric Pathology Research Center, Mofid Children Hospital, Shahid Beheshti Medical University (SBMU), Shariati Avenue, Tehran, 15468-155514, Iran.
| | - Laila Selim
- Pediatric Neurology and Neurometabolic Division, Cairo University Children Hospital (Abo el Reesh), 1-Aly Pasha Ibrahim Street, Near Sayeda Zeinab Metro Station, Cairo, Egypt.
| | - Nuri Shembesh
- Pediatrics and Pediatric Neurology, Benghazi University, P.O. Box 1565, Benghazi, Libya.
| | - Rawda Sunbul
- Department of Pediatrics, Qatif Central Hospital, P.O. Box 18476, Dammam, 31911, Eastern Province, Kingdom of Saudi Arabia.
| | - Seyed Hassan Tonekaboni
- Pediatric Neurology Research Center, Mofid Children Hospital, Shahid Beheshti Medical University (SBMU), Shariati Avenue, Tehran, 15468-155514, Iran.
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Musumeci O, Thieme A, Claeys KG, Wenninger S, Kley RA, Kuhn M, Lukacs Z, Deschauer M, Gaeta M, Toscano A, Gläser D, Schoser B. Homozygosity for the common GAA gene splice site mutation c.-32-13T>G in Pompe disease is associated with the classical adult phenotypical spectrum. Neuromuscul Disord 2015; 25:719-24. [DOI: 10.1016/j.nmd.2015.07.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 05/17/2015] [Accepted: 07/03/2015] [Indexed: 10/23/2022]
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13
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Lim JA, Li L, Raben N. Pompe disease: from pathophysiology to therapy and back again. Front Aging Neurosci 2014; 6:177. [PMID: 25183957 PMCID: PMC4135233 DOI: 10.3389/fnagi.2014.00177] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 07/04/2014] [Indexed: 11/13/2022] Open
Abstract
Pompe disease is a lysosomal storage disorder in which acid alpha-glucosidase (GAA) is deficient or absent. Deficiency of this lysosomal enzyme results in progressive expansion of glycogen-filled lysosomes in multiple tissues, with cardiac and skeletal muscle being the most severely affected. The clinical spectrum ranges from fatal hypertrophic cardiomyopathy and skeletal muscle myopathy in infants to relatively attenuated forms, which manifest as a progressive myopathy without cardiac involvement. The currently available enzyme replacement therapy (ERT) proved to be successful in reversing cardiac but not skeletal muscle abnormalities. Although the overall understanding of the disease has progressed, the pathophysiology of muscle damage remains poorly understood. Lysosomal enlargement/rupture has long been considered a mechanism of relentless muscle damage in Pompe disease. In past years, it became clear that this simple view of the pathology is inadequate; the pathological cascade involves dysfunctional autophagy, a major lysosome-dependent intracellular degradative pathway. The autophagic process in Pompe skeletal muscle is affected at the termination stage—impaired autophagosomal-lysosomal fusion. Yet another abnormality in the diseased muscle is the accelerated production of large, unrelated to ageing, lipofuscin deposits—a marker of cellular oxidative damage and a sign of mitochondrial dysfunction. The massive autophagic buildup and lipofuscin inclusions appear to cause a greater effect on muscle architecture than the enlarged lysosomes outside the autophagic regions. Furthermore, the dysfunctional autophagy affects the trafficking of the replacement enzyme and interferes with its delivery to the lysosomes. Several new therapeutic approaches have been tested in Pompe mouse models: substrate reduction therapy, lysosomal exocytosis following the overexpression of transcription factor EB and a closely related but distinct factor E3, and genetic manipulation of autophagy.
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Affiliation(s)
- Jeong-A Lim
- Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health Bethesda, MD, USA
| | - Lishu Li
- Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health Bethesda, MD, USA
| | - Nina Raben
- Laboratory of Muscle Stem Cells and Gene Regulation, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), National Institutes of Health Bethesda, MD, USA
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Herzog A, Hartung R, Reuser AJJ, Hermanns P, Runz H, Karabul N, Gökce S, Pohlenz J, Kampmann C, Lampe C, Beck M, Mengel E. A cross-sectional single-centre study on the spectrum of Pompe disease, German patients: molecular analysis of the GAA gene, manifestation and genotype-phenotype correlations. Orphanet J Rare Dis 2012; 7:35. [PMID: 22676651 PMCID: PMC3479421 DOI: 10.1186/1750-1172-7-35] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Accepted: 06/07/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Pompe disease (Glycogen storage disease type II, GSD II, acid alpha-glucosidase deficiency, acid maltase deficiency, OMIM # 232300) is an autosomal-recessive lysosomal storage disorder due to a deficiency of acid alpha-glucosidase (GAA, acid maltase, EC 3.2.1.20, Swiss-Prot P10253). Clinical manifestations are dominated by progressive weakness of skeletal muscle throughout the clinical spectrum. In addition, the classic infantile form is characterised by hypertrophic cardiomyopathy. METHODS In a cross-sectional single-centre study we clinically assessed 3 patients with classic infantile Pompe disease and 39 patients with non-classic presentations, measured their acid alpha-glucosidase activities and analysed their GAA genes. RESULTS Classic infantile patients had nearly absent residual enzyme activities and a typical clinical course with hypertrophic cardiomyopathy until the beginning of therapy. The disease manifestations in non-classic patients were heterogeneous. There was a broad variability in the decline of locomotive and respiratory function. The age of onset ranged from birth to late adulthood and correlated with enzyme activities. Molecular analysis revealed as many as 33 different mutations, 14 of which are novel. All classic infantile patients had two severe mutations. The most common mutation in the non-classic group was c.-32-13T>G. It was associated with a milder course in this subgroup. CONCLUSIONS Disease manifestation strongly correlates with the nature of the GAA mutations, while the variable progression in non-classic Pompe disease is likely to be explained by yet unknown modifying factors. This study provides the first comprehensive dataset on the clinical course and the mutational spectrum of Pompe disease in Germany.
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Affiliation(s)
- Andreas Herzog
- Center for Pediatric and Adolescent Medicine, University Medical Center, Mainz, Germany
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15
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DeSena HC, Brumund MR, Superneau D, Snyder CS. Ventricular Fibrillation in a Patient with Pompe Disease: A Cautionary Tale. CONGENIT HEART DIS 2011; 6:397-401. [DOI: 10.1111/j.1747-0803.2010.00471.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Papadimas GK, Spengos K, Konstantinopoulou A, Vassilopoulou S, Vontzalidis A, Papadopoulos C, Michelakakis H, Manta P. Adult Pompe disease: clinical manifestations and outcome of the first Greek patients receiving enzyme replacement therapy. Clin Neurol Neurosurg 2011; 113:303-7. [PMID: 21216089 DOI: 10.1016/j.clineuro.2010.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2010] [Revised: 11/29/2010] [Accepted: 12/09/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Pompe disease is an autosomal recessive lysosomal disorder caused by α-glucosidase deficiency. A specific treatment for the disease with enzyme replacement therapy is currently available. The aim of the present study is to describe the clinical manifestations and the effect of treatment in the first Greek patients with the adult form of the disease. METHODS Five Greek patients with adult onset Pompe disease aged between 40 and 73 years received 20 mg/kg Myozyme intravenously at two weekly intervals over a different period. Clinical and functional parameters were longitudinally registered. RESULTS Proximal muscle weakness and respiratory insufficiency were the most common manifestations of the disease, but their severity was different even among patients with similar genotype. The effect of treatment varied with most patients experiencing some improvement in muscle strength and fatigability, while the most severely affected patient did not benefit and stopped therapy. CONCLUSION No clear genotype-phenotype correlation emerges from our study. The different effect of treatment on our patients seems to be mainly related to their pre-treatment condition and can be reliably assessed only on a long term basis.
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Affiliation(s)
- G K Papadimas
- Department of Neurology, University of Athens, School of Medicine, Eginition Hospital, Athens, Greece.
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17
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Amarinthnukrowh P, Tongkobpetch S, Kongpatanayothin A, Suphapeetiporn K, Shotelersuk V. p.D645E of Acid α-Glucosidase Is the Most Common Mutation in Thai Patients with Infantile-Onset Pompe Disease. Genet Test Mol Biomarkers 2010; 14:835-7. [DOI: 10.1089/gtmb.2010.0038] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Pramuk Amarinthnukrowh
- Center of Excellence for Medical Genetics, Bangkok, Thailand
- Molecular Genetics Diagnostic Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Siraprapa Tongkobpetch
- Center of Excellence for Medical Genetics, Bangkok, Thailand
- Molecular Genetics Diagnostic Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Apichai Kongpatanayothin
- Division of Cardiology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Kanya Suphapeetiporn
- Center of Excellence for Medical Genetics, Bangkok, Thailand
- Molecular Genetics Diagnostic Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Vorasuk Shotelersuk
- Center of Excellence for Medical Genetics, Bangkok, Thailand
- Molecular Genetics Diagnostic Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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18
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Silent exonic mutation in the acid-alpha-glycosidase gene that causes glycogen storage disease type II by affecting mRNA splicing. J Hum Genet 2009; 54:493-6. [PMID: 19609281 DOI: 10.1038/jhg.2009.66] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Glycogen-storage disease type II (GSDII) is an autosomal recessive disorder caused by a deficiency of acid alpha-glucosidase (GAA). The residual GAA activity is largely related to the severity of the clinical course. Most patients with infantile-onset GSDII do not show any enzyme activity, whereas patients with the late-onset forms of GSDII show various degrees of GAA activity. We performed a molecular genetic study on a Japanese boy with childhood-onset GSDII. The patient was a compound heterozygote for a newly discovered splice-site c.546G>T mutation and a recurrent missense p.R600C mutation, which usually causes the fatal infantile form in a homozygous state. The c.546G>T mutation, which did not alter the amino-acid sequence, was positioned at the last base of exon 2. cDNA-sequencing analysis revealed that c.546G>T was a leaky splice mutation, leading to the production of a normally spliced transcript, which was responsible for the low-level (approximately 10%) expression of the active enzyme in the patient's fibroblasts.
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19
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Pompe disease in a Brazilian series: clinical and molecular analyses with identification of nine new mutations. J Neurol 2009; 256:1881-90. [DOI: 10.1007/s00415-009-5219-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2008] [Revised: 04/01/2009] [Accepted: 06/11/2009] [Indexed: 10/20/2022]
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20
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Burghaus L, Liu W, Neuen-Jacob E, Gempel K, Haupt WF. Glykogenose Typ II (M. Pompe). DER NERVENARZT 2006; 77:181-2, 185-6. [PMID: 16228159 DOI: 10.1007/s00115-005-2005-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Late-onset Pompe's disease, a generalized lysosomal glycogen storage disease caused by acid maltase deficiency, usually presents as a slowly progressive muscular weakness of proximal muscles in lower limbs, followed by involvement of respiratory muscles. In the case presented here, however, respiratory failure was the first and selective symptom which caused the uncommon appearance of a patient entering our outpatient clinic on foot carrying his own artificial respirator. Intercostal muscle biopsy eventually led to the diagnosis.
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Affiliation(s)
- L Burghaus
- Klinik und Poliklinik für Neurologie der Universität zu Köln
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21
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Affiliation(s)
- Priya Sunil Kishnani
- Division of Medical Genetics Department of Pediatrics, Duke University Medical School, Durham, North Carolina 27710, USA.
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22
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Van Rompay AR, Johansson M, Karlsson A. Substrate specificity and phosphorylation of antiviral and anticancer nucleoside analogues by human deoxyribonucleoside kinases and ribonucleoside kinases. Pharmacol Ther 2003; 100:119-39. [PMID: 14609716 PMCID: PMC7126524 DOI: 10.1016/j.pharmthera.2003.07.001] [Citation(s) in RCA: 112] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Structural analogues of nucleosides, nucleoside analogues (NA), are used in the treatment of cancer and viral infections. Antiviral NAs inhibit replication of the viral genome, whereas anticancer NAs inhibit cellular DNA replication and repair. NAs are inactive prodrugs that are dependent on intracellular phosphorylation to their pharmacologically active triphosphate form. The deoxyribonucleoside kinases (dNK) and ribonucleoside kinases (rNK) catalyze the first phosphorylation step, converting deoxyribonucleosides and ribonucleosides to their corresponding monophosphate form. The dNKs have been studied intensively, whereas the rNKs have not been as thoroughly investigated. This overview is focused on the substrate specificity, tissue distribution, and subcellular location of the mammalian dNKs and rNKs and their role in the activation of NAs.
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Key Words
- antiviral therapy
- anticancer therapy
- chemotherapy
- nucleoside analogue
- deoxyribonucleoside kinase
- ribonucleoside kinase
- adk, adenosine kinase
- aids, aquired immunodeficiency syndrome
- arac, 1-β-d-arabinofuranosylcytosine (cytarabine)
- arag, 9-β-d-arabinofuranosylguanine (nelarabine)
- azt, 3′-azido-2′,3′-dideoxythymidine (zidovudine)
- cafda, 2-chloro-2′-fluoro-9-β-d-arabinofuranosyladenine (clofarabine)
- cda, 2-chloro-2′-deoxyadenosine (cladribine)
- dck, deoxycytidine kinase
- ddc, 2′,3′-dideoxycytidine (zalcitabine)
- ddi, 2′,3′-dideoxyinosine (didanosine)
- dgk, deoxyguanosine kinase
- dfdc, 2′,2′-difluorodeoxycytidine (gemcitabine)
- dnk, deoxyribonucleoside kinase
- d4t, 2′,3′-didehydro-3′-deoxythymidine (stavudine)
- f-araa, 2-fluoro-9-β-d-arabinofuranosyladenine (fludarabine)
- fda, food and drug administration
- fiau, 1-(2′-deoxy-2′-fluoro-β-d-arabinofuranosyl)-5-iodouracil (fialuridine)
- hbv, hepatitis b virus
- mtdna, mitochondrial dna
- hiv, human immunodeficiency virus
- na, nucleoside analogue
- ndpk, nucleoside diphosphate kinase
- nmpk, nucleoside monophosphate kinase
- 5′-nt, 5′-nucleotidase
- rnk, ribonucleoside kinase
- rr, ribonucleotide reductase
- rt, reverse transcriptase
- tk1, thymidine kinase 1
- tk2, thymidine kinase 2
- uck1, uridine-cytidine kinase 1
- uck2, uridine-cytidine kinase 2
- 3tc, 2′-deoxy-3′-thiacytidine (lamivudine)
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Affiliation(s)
- An R Van Rompay
- Department of Nephrology-Hypertension, University of Antwerp, 2610 Antwerp, Belgium
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23
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Fernandez-Hojas R, Huie ML, Navarro C, Dominguez C, Roig M, Lopez-Coronas D, Teijeira S, Anyane-Yeboa K, Hirschhorn R. Identification of six novel mutations in the acid alpha-glucosidase gene in three Spanish patients with infantile onset glycogen storage disease type II (Pompe disease). Neuromuscul Disord 2002; 12:159-66. [PMID: 11738358 DOI: 10.1016/s0960-8966(01)00247-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Glycogen storage disease type II is an autosomal recessive muscle disorder due to deficiency of lysosomal acid alpha-glucosidase and the resulting intralysosomal accumulation of glycogen. We found six novel mutations in three Spanish classic infantile onset glycogen storage disease type II patients with involvement of both cardiac and skeletal muscle; three missense mutations (G219R, E262K, M408V), a nonsense mutation (Y191X), a donor splice site mutation (IVS18 +2gt>ga) and an in frame deletion of an asparagine residue (nt1408-1410). The missense mutations were not found in 100 normal chromosomes and therefore are not normal polymorphic variants. The splice site mutation was subsequently detected in an additional 'Spanish' infantile onset glycogen storage disease type II patient from El Salvador. Further studies will be required to determine if the IVS18 +2gt>ga splice site mutation might in fact be a relatively common Spanish mutation. Mutations among Spanish glycogen storage disease type II patients appear to be genetically heterogeneous and differ from common mutations in neighboring countries.
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Affiliation(s)
- Roberto Fernandez-Hojas
- Division of Medical Genetics, Department of Medicine, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA
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24
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Stroppiano M, Bonuccelli G, Corsolini F, Filocamo M. Aberrant splicing at catalytic site as cause of infantile onset glycogen storage disease type II (GSDII): molecular identification of a novel IVS9 (+2GT-->GC) in combination with rare IVS10 (+1GT-->CT). AMERICAN JOURNAL OF MEDICAL GENETICS 2001; 101:55-8. [PMID: 11343339 DOI: 10.1002/ajmg.1310] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Glycogen storage disease type II (GSDII) results from deleterious mutations in acid alpha-glucosidase gene. To date several mutant alleles have been studied including missense and nonsense mutations, insertions, small and large deletions as well as splice site mutations. Apart from IVS1 (- 13-->G), 525delT, and Delta18, the other mutations are rare and often unique to single patients. Moreover, the molecular findings also observed in the different ethnic groups makes it difficult to attempt to correlate genotype and phenotype to explain the origin of clinical variability. Even though there are no conclusive genotype phenotype correlations, the in frame splice site mutations identified up until now have been found associated with the juvenile/adult onset of GSDII. In this study we describe a novel in frame splicing defect, IVS9 (+2GT-->GC), identified in combination with the rare IVS10 (+1GT-->CT) mutation in a patient with classic infantile GSDII disease. Because both mutations occur at the catalytic site region, it is likely that the alteration of both catalytic function and steric conformation of the enzyme may be responsible for the most severe form of the disease.
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Affiliation(s)
- M Stroppiano
- Laboratorio Diagnosi Pre-Postnatale Malattie Metaboliche, Istituto G. Gaslini, Largo G. Gaslini, 16147 Genoa, Italy
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25
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Tsujino S, Huie M, Kanazawa N, Sugie H, Goto Y, Kawai M, Nonaka I, Hirschhorn R, Sakuragawa N. Frequent mutations in Japanese patients with acid maltase deficiency. Neuromuscul Disord 2000; 10:599-603. [PMID: 11053688 DOI: 10.1016/s0960-8966(00)00142-5] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We screened 22 Japanese patients with acid maltase deficiency (seven with the infantile type, eight with the juvenile type and seven with the adult type) for three previously described mutations, D645E, S529V and R672Q, and a novel mutation, R600C. Although D645E has been reported to be common in Chinese patients with the infantile type, only three of 44 alleles (two of 14 infantile type alleles) from Japanese patients harbored the D645E mutation. The S529V mutation was identified in six of 14 alleles from adult-onset patients. None of the infantile or juvenile patients harbored the S529V mutation. Therefore, S529V apparently results in the adult type disease and is common in Japanese adult-onset patients. R672Q was identified in two pairs of siblings with the juvenile type. A novel mutation, R600C, was identified in eight of 22 patients (nine of 44 alleles). Therefore, R600C is another common Japanese mutation occurring at a CpG dinucleotide "hot spot". Homozygosity for this mutation apparently results in the infantile phenotype. Genetic diagnosis by detecting these four mutations might be feasible for most Japanese patients with acid maltase deficiency.
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Affiliation(s)
- S Tsujino
- Department of Inherited Metabolic Disease, National Institute of Neuroscience, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo 187-8502, Japan.
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26
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Vidal V, Bay JO, Champomier F, Grancho M, Beauville L, Glowaczower C, Lemery D, Ferrara M, Bignon YJ. The 1396del A mutation and a missense mutation or a rare polymorphism of the WRN gene detected in a French Werner family with a severe phenotype and a case of an unusual vulvar cancer. Mutations in brief no. 136. Online. Hum Mutat 2000; 11:413-4. [PMID: 10206685 DOI: 10.1002/(sici)1098-1004(1998)11:5<413::aid-humu16>3.0.co;2-i] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The Werner's syndrome (WS) is a rare recessive disease characterized by an early onset of geriatric disorders. The Werner's syndrome gene (WRN) recently cloned, encodes for an helicase and therefore plays a role in DNA metabolism and DNA repair. Here, we report the study of a French family with two affected members and numerous cancers. Using the protein truncation test and sequencing, we identified a homozygous mutation in the WRN gene. This mutation generates a frame shift leading to a very short 391 amino acids truncated protein without the helicase motif. A particularly severe phenotype of the affected patient was associated with an unusual vulvar cancer traditionaly observed in elderly patients and therefore likely to be related to the Werner's syndrome. An additional substitution of G for A at nucleotidic position 1392 was also described. We suggest that a relation between genotype and phenotype could exist in the studied family.
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Affiliation(s)
- V Vidal
- Laboratoire d'Oncologie moléculaire (INSERM CRI9402), Centre Jean Perrin, BP 392,63011 Clemont-Ferrand, France
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27
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Abstract
Glycogen storage disease type II (GSD II, Pompe's disease), an autosomal recessive inherited disease, is caused by the deficiency of acid alpha-D-glucosidase, which results in the impaired glycogen degradation in lysosome and causes excess glycogen accumulation in lysosome. In Taiwan, the infantile form of GSD II is the most common type of glycogen storage diseases. The frequency of C1935A mutant allele is 0.8 in these Chinese patients. In this study, we analyzed four single point polymorphic markers (324, 1203, 2065, 2338) by ACRS-based RFLP We observed that the alleles possessing the C1935A mutation in 19 of 25 Chinese patients who were heterozygous or homozygous have conserved polymorphic markers, and all of C1935A mutant alleles in these patients are linked to a specific haplotype. The allele frequency of this specific haplotype in 19 Chinese patients and in 42 normal individuals is 0.95 and 0.17, respectively (P<0.005, chi2 = 66.018). This result suggests that the C1935A mutation in Chinese patients with infantile form of GSD II is due to the founder effect.
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Affiliation(s)
- J J Shieh
- Graduate Institute of Microbiology & Immunology, National Yang-Ming University, Taipei, Taiwan
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28
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Abstract
The molecular pathology of classical glycogen storage disorders, glycogen synthase deficiency and Fanconi-Bickel syndrome is reviewed. The isolation of the respective cDNAs, the chromosomal localization of the genes and the elucidation of the genomic organization enabled mutation analysis in most disorders. The findings have shed light on the multi-protein structure of the glucose-6-phosphatase system, the phosphorylase kinase enzymatic complex and the molecular background of the differential tissue expression in debranching enzyme deficiency. The immediate practical benefit of these studies is our extending ability to predict the outcome of clinical variants and to offer genetic counseling to most families. The elucidation of the tertiary structure of these proteins and their structure-function relationship poses major challenges for the future.
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Affiliation(s)
- O N Elpeleg
- Metabolic Disease Unit, Shaare Zedek Medical Center, Jerusalem, Israel
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29
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Ponce E, Witte DP, Hirschhorn R, Huie ML, Grabowski GA. Murine acid alpha-glucosidase: cell-specific mRNA differential expression during development and maturation. THE AMERICAN JOURNAL OF PATHOLOGY 1999; 154:1089-96. [PMID: 10233847 PMCID: PMC1866561 DOI: 10.1016/s0002-9440(10)65361-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/22/1998] [Indexed: 11/22/2022]
Abstract
Acid alpha-glucosidase (GAA) cleaves the alpha1-4 and alpha1-6 glycosidic linkages of glycogen and related alpha-glucosyl substrates within lysosomes. Its deficiency results in glycogen storage disease type II (GSDII) variants including Pompe disease. To gain insight into the tissue patterns of involvement by glycogen storage in GSDII, GAA mRNA expression in mouse tissues was evaluated by Northern blot and in situ hybridization analyses. Extensive temporal and spatial variation of GAA mRNA was observed. During preterm maturation, GAA mRNA levels of whole mice progressively increased as assessed by Northern analysis. By in situ hybridization with GAA antisense mRNA, low signals were detected in most tissues throughout gestation. However, increased expression in specific cell types of different tissues was observed beginning at 16 days post coitum in developing brain neurons, primitive inner ear cells, and seminiferous tubular epithelium. In adult mice, whole-organ GAA mRNA levels were highest in brain, moderate in heart, liver, and skeletal muscle, and lowest in the series kidney > lung > testis > spleen. By in situ hybridization, the highest-intensity signals were in neurons of the central and peripheral nervous systems whereas neuroglial cells had only low-level signal. Signals of moderate intensity were in cardiomyocytes whereas low signals were in hepatocytes and skeletal muscle myocytes and very low in cells of the lungs, thymus, pancreas, spleen, and adrenal glands. However, testicular Sertoli cells and kidney tubular epithelial cells had significant signals even though surrounding cells had very low signals. The discrete temporal and spatial variations of GAA mRNA during development indicate different physiological roles for this enzyme in various cell types and developmental stages.
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Affiliation(s)
- E Ponce
- Division of Human Genetics, Children's Hospital Medical Center, Cincinnati, Ohio, USA.
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30
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Huie ML, Tsujino S, Sklower Brooks S, Engel A, Elias E, Bonthron DT, Bessley C, Shanske S, DiMauro S, Goto YI, Hirschhorn R. Glycogen storage disease type II: identification of four novel missense mutations (D645N, G648S, R672W, R672Q) and two insertions/deletions in the acid alpha-glucosidase locus of patients of differing phenotype. Biochem Biophys Res Commun 1998; 244:921-7. [PMID: 9535769 DOI: 10.1006/bbrc.1998.8255] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Glycogen storage disease type II (GSDII), an autosomal recessive myopathic disorder, results from deficiency of lysosomal acid alpha-glucosidase. We searched for mutations in an evolutionarily conserved region in 54 patients of differing phenotype. Four novel mutations (D645N, G448S, R672W, and R672Q) and a previously described mutation (C647W) were identified in five patients and their deleterious effect on enzyme expression demonstrated in vitro. Two novel frame-shifting insertions/deletions (delta nt766-785/insC and +insG@nt2243) were identified in two patients with exon 14 mutations. The remaining three patients were either homozygous for their mutations (D645N/D645 and C647W/C647W) or carried a previously described leaky splice site mutation (IVS1-13T-->G). For all patients "in vivo" enzyme activity was consistent with clinical phenotype. Agreement of genotype with phenotype and in vitro versus in vivo enzyme was seen in three patients (two infantile patients carrying C647W/C647W and D645N/+insG@nt2243 and an adult patient heteroallelic for G648S/IVS1-13T-->G). Relative discordance was found in a juvenile patient homozygous for the non-expressing R672Q and an adult patient heterozygous for the minimally expressing R672W and delta nt766-785/+insC. Possible explanations include differences in in vitro assays vs in vivo enzyme activity, tissue specific expression with diminished enzyme expression/stability in fibroblasts vs muscle, somatic mosaicism, and modifying genes.
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Affiliation(s)
- M L Huie
- Department of Medicine, NYU Med Center, New York 10016, USA
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31
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Acland GM, Ray K, Mellersh CS, Gu W, Langston AA, Rine J, Ostrander EA, Aguirre GD. Linkage analysis and comparative mapping of canine progressive rod-cone degeneration (prcd) establishes potential locus homology with retinitis pigmentosa (RP17) in humans. Proc Natl Acad Sci U S A 1998; 95:3048-53. [PMID: 9501213 PMCID: PMC19692 DOI: 10.1073/pnas.95.6.3048] [Citation(s) in RCA: 77] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/1997] [Accepted: 01/02/1998] [Indexed: 02/06/2023] Open
Abstract
Progressive rod-cone degeneration (prcd) is the most widespread hereditary retinal disease leading to blindness in dogs and phenotypically is the canine counterpart of retinitis pigmentosa (RP) in humans. In previous efforts to identify the genetic locus for prcd, the canine homologs for many of the genes causally associated with RP in humans, such as RHO, PDE6B, and RDS/peripherin, have been excluded. In parallel with a recent undertaking to establish a framework map of the canine genome, multiple prcd-informative pedigrees have been typed with a panel of more than 100 anchor loci and microsatellite-based markers. Identification of a linkage group flanking prcd ([TK1, GALK1, prcd]-[MYL4, C09.173, C09.2263]-RARA-C09.250-C09.474-NF1) localizes prcd close to the centromeric end of canine chromosome 9 (CFA9), and excludes RARA as a candidate gene. The conserved synteny of this region of CFA9 and distal human chromosome 17q establishes the potential locus homology of prcd in the dog with RP17, a human retinitis pigmentosa locus for which no gene has yet been identified. Assignment of the prcd disease locus to an identified canine autosome represents a powerful application of the developing canine linkage map in medical genetics. The usefulness of this approach is further demonstrated by identification of the correspondence of the prcd interval to homologous human and mouse chromosomal regions. The rapid progress that is now occurring in the field of canine genetics will expedite the identification of the genes underlying many of the inherited traits and diseases that make the dog a unique asset for the study of mammalian traits.
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Affiliation(s)
- G M Acland
- James A. Baker Institute for Animal Health, College of Veterinary Medicine, Cornell University, Ithaca NY 14853, USA.
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