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Li XX, Wang MT, Wu ZF, Sun Q, Ono N, Nagata M, Zang XL, Ono W. Etiological Mechanisms and Genetic/Biological Modulation Related to PTH1R in Primary Failure of Tooth Eruption. Calcif Tissue Int 2024:10.1007/s00223-024-01227-y. [PMID: 38833001 DOI: 10.1007/s00223-024-01227-y] [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: 01/27/2024] [Accepted: 05/07/2024] [Indexed: 06/06/2024]
Abstract
Primary failure of eruption (PFE) is a rare disorder that is characterized by the inability of a molar tooth/teeth to erupt to the occlusal plane or to normally react to orthodontic force. This condition is related to hereditary factors and has been extensively researched over many years. However, the etiological mechanisms of pathogenesis are still not fully understood. Evidence from studies on PFE cases has shown that PFE patients may carry parathyroid hormone 1 receptor (PTH1R) gene mutations, and genetic detection can be used to diagnose PFE at an early stage. PTH1R variants can lead to altered protein structure, impaired protein function, and abnormal biological activities of the cells, which may ultimately impact the behavior of teeth, as observed in PFE. Dental follicle cells play a critical role in tooth eruption and root development and are regulated by parathyroid hormone-related peptide (PTHrP)-PTH1R signaling in their differentiation and other activities. PTHrP-PTH1R signaling also regulates the activity of osteoblasts, osteoclasts and odontoclasts during tooth development and eruption. When interference occurs in the PTHrP-PTH1R signaling pathway, the normal function of dental follicles and bone remodeling are impaired. This review provides an overview of PTH1R variants and their correlation with PFE, and highlights that a disruption of PTHrP-PTH1R signaling impairs the normal process of tooth development and eruption, thus providing insight into the underlying mechanisms related to PTH1R and its role in driving PFE.
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Affiliation(s)
- Xiao-Xia Li
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China
| | - Man-Ting Wang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China
| | - Zhi-Fang Wu
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China
| | - Qiang Sun
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China
| | - Noriaki Ono
- University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, 77054, USA
| | - Mizuki Nagata
- University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, 77054, USA
| | - Xiao-Long Zang
- Stomatology Hospital, School of Stomatology, Zhejiang University School of Medicine, Zhejiang Provincial Clinical Research Center for Oral Diseases, Key Laboratory of Oral Biomedical Research of Zhejiang Province, Cancer Center of Zhejiang University, Engineering Research Center of Oral Biomaterials and Devices of Zhejiang Province, Hangzhou, 310000, China.
| | - Wanida Ono
- University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, 77054, USA.
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Xu M, Wang D, Li K, Ma T, Wang Y, Xia B. TMEM119 (c.G143A, p.S48L) Mutation Is Involved in Primary Failure of Eruption by Attenuating Glycolysis-Mediated Osteogenesis. Int J Mol Sci 2024; 25:2821. [PMID: 38474068 DOI: 10.3390/ijms25052821] [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: 01/25/2024] [Revised: 02/23/2024] [Accepted: 02/25/2024] [Indexed: 03/14/2024] Open
Abstract
Primary failure of eruption (PFE) is a rare oral disease with an incidence rate of 0.06%. It is characterized by abnormal eruption mechanisms that disrupt tooth eruption. The underlying pathogenic genetic variant and mechanism of PFE remain largely unknown. The purpose of this study was to explore the role of a novel transmembrane protein 119 (TMEM119) mutation in two PFE patients in a Chinese family. Information collection was performed on the family with a diagnosis of PFE, and blood samples from patients and healthy family members were extracted. Whole-exome sequencing was performed. Bioinformatics analysis revealed that a heterozygous variant in the TMEM119 gene (c.G143A, p.S48L) was a disease-associated mutation in this family. Recombinant pcDNA3.1 plasmid-containing wild-type and mutant TMEM119 expression cassettes were successfully constructed and transfected into MC3T3-E1 cells, respectively. The results of in vitro analysis suggested that the subcellular distribution of the TMEM119 protein was transferred from the cell cytoplasm to the nucleus, and the ability of cells to proliferate and migrate as well as glycolytic and mineralized capacities were reduced after mutation. Furthermore, rescue assays showed that activating transcription factor 4 (ATF4) overexpression rescued the attenuated glycolysis and mineralization ability of cells. Results of in vivo analysis demonstrated that TMEM119 was mainly expressed in the alveolar bone around the mouse molar germs, and the expression level increased with tooth eruption, demonstrated using immunohistochemistry and immunofluorescence. Collectively, the novel TMEM119 mutation is potentially pathogenic in the PFE family by affecting the glucose metabolism and mineralized function of osteoblasts, including interaction with ATF4. Our findings broaden the gene mutation spectrum of PFE and further elucidate the pathogenic mechanism of PFE.
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Affiliation(s)
- Mindi Xu
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Haidian District, Beijing 100081, China
- National Clinical Research Center for Oral Diseases, Peking University School and Hospital of Stomatology, Haidian District, Beijing 100081, China
| | - Dandan Wang
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Haidian District, Beijing 100081, China
| | - Kefan Li
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Haidian District, Beijing 100081, China
| | - Tianyu Ma
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Haidian District, Beijing 100081, China
| | - Yixiang Wang
- Central Laboratory, Peking University School and Hospital of Stomatology, Haidian District, Beijing 100081, China
| | - Bin Xia
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology, Haidian District, Beijing 100081, China
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Thuaire A, Delebarre H, Marsili L, Colson C, Vanlerberghe C, Lauwers L, Raoul G, Touzet-Roumazeille S, Ferri J. Primary Failure of Dental Eruption Due to Variants Parathyroid Hormone Receptor 1: Retrospective Study and Proposal of Guidelines Treatment. J Craniofac Surg 2024:00001665-990000000-01318. [PMID: 38299863 DOI: 10.1097/scs.0000000000009963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 12/09/2023] [Indexed: 02/02/2024] Open
Abstract
OBJECTIVE Primary failure of eruption is characterized by a nonsyndromic defect in tooth eruption in the absence of mechanical obstruction. It is correlated to rare heterozygous variants in the parathyroid hormone receptor 1 gene. The management of primary failure of eruption is complex because many therapies are ineffective. The present study aimed to compare the clinical outcomes of our patients with the findings reported in the literature, and to propose a treatment guideline based on the literature and our experience. METHODS Retrospective study of patients affected by primary dental eruption failure in the department and analyse of the results and compare with those of the litterature. RESULTS Twelve patients belonging to 5 families (9 males, 3 females; 13-52 y old) diagnosed and treated in the maxillofacial surgery and stomatology department of the Lille University Hospital were included. All patients showed posterior tooth involvement, and most patients showed bilateral defects. None of the affected teeth had coronal alveolar bone, whereas 6 patients showed root resorption in the affected teeth. Genetic analyses, performed on 11 patients, identified a parathyroid hormone receptor 1 disease-causing variant in 7 of them (63%). Multidisciplinary treatment was required to rehabilitate these patients. Orthodontic interventions, even at an early age, are difficult in affected teeth, which are often blocked or have internal resorption. Moreover, retention of these affected teeth during growth leads to dentoskeletal malocclusions, requiring difficult surgical management in the long term. Therefore, early extraction of these teeth is frequently recommended once the diagnosis has been confirmed. An implant-borne prosthetic rehabilitation can then be achieved at the end of growth after correction of the jaw discrepancy. In case of a late diagnosis, other surgical or noninvasive techniques may be used depending on the clinical situation. Distraction osteogenesis or segmental osteotomy could be discussed for patients with mild phenotypes. CONCLUSIONS Early diagnosis of primary eruption defects is crucial to offer appropriate management as early as possible, and so to avoid late complicated treatments.
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Affiliation(s)
- Antoine Thuaire
- Department of Oral and Maxillo-Facial Surgery, Service de Stomatologie et de Chirurgie Maxillo-Faciale CHRU de Lille
| | - Hélène Delebarre
- Department of Oral and Maxillo-Facial Surgery, Service de Stomatologie et de Chirurgie Maxillo-Faciale CHRU de Lille
| | - Luisa Marsili
- Department of Clinical Genetics, Université de Lille, CHU Lille, Clinique de Génétique Guy Fontaine, Lille, France
- Department of Clinical Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Cindy Colson
- Department of Clinical Genetics, Service de Génétique Médicale CHRU de Lille
| | - Clemence Vanlerberghe
- Department of Oral and Maxillo-Facial Surgery, Service de Stomatologie et de Chirurgie Maxillo-Faciale CHRU de Lille
| | - Ludovic Lauwers
- Department of Oral and Maxillo-Facial Surgery, Service de Stomatologie et de Chirurgie Maxillo-Faciale CHRU de Lille
| | - Gwenael Raoul
- Department of Clinical Genetics, Service de Stomatologie et de Chirurgie Maxillo-Faciale CHRU de Lille, Lille, France
| | - Sandrine Touzet-Roumazeille
- Department of Oral and Maxillo-Facial Surgery, Service de Stomatologie et de Chirurgie Maxillo-Faciale CHRU de Lille
| | - Joël Ferri
- Department of Clinical Genetics, Service de Stomatologie et de Chirurgie Maxillo-Faciale CHRU de Lille, Lille, France
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Wang J, Zhao C, Zhang X, Yang L, Hu Y. Identification of a novel heterozygous PTH1R variant in a Chinese family with incomplete penetrance. Mol Genet Genomic Med 2024; 12:e2301. [PMID: 37840415 PMCID: PMC10767579 DOI: 10.1002/mgg3.2301] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/21/2023] [Accepted: 10/03/2023] [Indexed: 10/17/2023] Open
Abstract
BACKGROUND Mutations in PTH1R are associated with Jansen-type metaphyseal chondrodysplasia (JMC), Blomstrand osteochondrodysplasia (BOCD), Eiken syndrome, enchondroma, and primary failure of tooth eruption (PFE). Inheritance of the PTH1R gene can be either autosomal dominant or autosomal recessive, indicating the complexity of the gene. Our objective was to identify the phenotypic differences in members of a family with a novel PTH1R mutation. METHODS The proband was a 13-year, 6-month-old girl presenting with short stature, abnormal tooth eruption, skeletal dysplasia, and midface hypoplasia. The brother and father of the proband presented with short stature and abnormal tooth eruption. High-throughput sequencing was performed on the proband, and the variant was confirmed in the proband and other family members by Sanger sequencing. Amino acid sequence alignment was performed using ClustalX software. Three-dimensional structures were analyzed and displayed using the I-TASSER website and PyMOL software. RESULTS High-throughput genome sequencing and Sanger sequencing validation showed that the proband, her father, and her brother all carried the PTH1R (NM_000316) c.1393G>A (p.E465K) mutation. The c.1393G>A (p.E465K) mutation was novel, as it has not been reported in the literature database. According to the American College of Medical Genetics and Genomics (ACMG) guidelines, the p.E465K variant was considered to have uncertain significance. Biological information analysis demonstrated that this identified variant was highly conserved and highly likely pathogenic. CONCLUSIONS We identified a novel heterozygous mutation in the PTH1R gene leading to clinical manifestations with incomplete penetrance that expands the spectrum of known PTH1R mutations.
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Affiliation(s)
- Jie Wang
- Department of Pediatrics, Linyi People's HospitalPostgrad Training Base Jinzhou Med UniversityLinyiChina
- Department of PediatricsLinyi People's HospitalLinyiChina
| | - Chaoyue Zhao
- Department of Pediatrics, Linyi People's HospitalPostgrad Training Base Jinzhou Med UniversityLinyiChina
- Department of PediatricsLinyi People's HospitalLinyiChina
| | - Xin Zhang
- Department of Pediatrics, Linyi People's HospitalPostgrad Training Base Jinzhou Med UniversityLinyiChina
- Department of PediatricsLinyi People's HospitalLinyiChina
| | - Li Yang
- Department of PediatricsLinyi People's HospitalLinyiChina
| | - Yanyan Hu
- Department of PediatricsLinyi People's HospitalLinyiChina
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Inchingolo F, Ferrara I, Viapiano F, Ciocia AM, Palumbo I, Guglielmo M, Inchingolo AD, Palermo A, Bordea IR, Inchingolo AM, Di Venere D, Dipalma G. Primary Failure Eruption: Genetic Investigation, Diagnosis and Treatment: A Systematic Review. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1781. [PMID: 38002872 PMCID: PMC10670730 DOI: 10.3390/children10111781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/21/2023] [Accepted: 10/29/2023] [Indexed: 11/26/2023]
Abstract
AIM The aim of this systematic review is to explore the pathology, diagnosis, treatment, and genetic basis of Primary Failure of Eruption (PFE) in the field of pediatric dentistry and orthodontics. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed for this review. The databases PubMed, Science Direct, Scopus, and Web of Science were searched from 1 July 2013 to 1 July 2023, using keywords "primary failure of tooth eruption" OR "primary failure of eruption" OR "tooth eruption failure" OR "PFE" AND "orthodontics". The study selection process involved screening articles based on the inclusion and exclusion criteria. RESULTS A total of 1151 results were obtained from the database search, with 14 papers meeting the inclusion criteria. The review covers various aspects of PFE, including its clinical features, diagnosis, treatment options, and genetic associations with mutations in the PTH1R gene. Differentiation between PFE and Mechanical Failure of Eruption (MFE) is crucial for accurate treatment planning. Orthodontic and surgical interventions, along with multidisciplinary approaches, have been employed to manage PFE cases. Genetic testing for PTH1R mutations plays a significant role in confirming the diagnosis and guiding treatment decisions, although some cases may not be linked to this mutation. CONCLUSIONS This systematic review provides valuable insights into the diagnosis, treatment, and genetic basis of PFE. Early diagnosis and personalized treatment planning are crucial for successful management. Genetic testing for PTH1R mutations aids in accurate diagnosis and may influence treatment decisions. However, further research is needed to explore the complex genetic basis of PFE fully and improve treatment outcomes for affected individuals.
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Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Irene Ferrara
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Fabio Viapiano
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Anna Maria Ciocia
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Irene Palumbo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Mariafrancesca Guglielmo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK;
| | - Ioana Roxana Bordea
- Department of Oral Health, Iuliu Hatieganu University of Medicine and Pharmacy, 15 V. Babes Street, 400012 Cluj-Napoca, Romania;
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Daniela Di Venere
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, School of Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (I.F.); (F.V.); (A.M.C.); (I.P.); (M.G.); (A.D.I.); (A.M.I.); (D.D.V.); (G.D.)
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Complete Pseudo-Anodontia in an Adult Woman with Pseudo-Hypoparathyroidism Type 1a: A New Additional Nonclassical Feature? Diagnostics (Basel) 2022; 12:diagnostics12122997. [PMID: 36553004 PMCID: PMC9777483 DOI: 10.3390/diagnostics12122997] [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: 11/04/2022] [Revised: 11/28/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022] Open
Abstract
Pseudo-anodontia consists in the clinical, not radiographic, absence of teeth, due to failure in their eruption. It has been reported as part of an extremely rare syndrome, named GAPO syndrome. Pseudo-hypoparathyroidism type 1a (PHPT-1a) is a rare condition, characterized by resistance to the parathyroid hormone (PTH), as well as to many other hormones, and resulting in hypocalcemia, hyperphosphatemia, and elevated PTH. We report here the case of a 32-year-old woman with a long-standing history of non-treated hypocalcemia, in the context of an undiagnosed PHPT-1a. She had an intellectual disability, showed clinical features of the Albright hereditary osteodystrophy (AHO) and presented signs of multiple hormone resistances. She received treatment for seizures since the age of six. Examination of her mouth revealed a complete absence of teeth. Treatment of hypocalcemia and hormone deficiencies were started only at 29 years of age. Genetic testing demonstrated the presence of a frameshift variant in the GNAS gene in the proband as well as in her mother. A Single Nucleotide Polymorphism (SNP) array analysis failed to demonstrate pathogenic copy number variants (CNVs) but showed several regions with loss of heterozygosity (LOHs) for a final percentage of 1.75%, compatible with a fifth degree of relationship. Clinical exome sequencing (CES) ruled out any damaging variants in all the teeth agenesis-related genes. In conclusion, although we performed an extensive genetic analysis in search of possible additional gene alterations that could explain the presence of the peculiar phenotypic characteristics observed in our patient, we could not find any additional genetic defects. Our results suggest that the association of genetically confirmed PHPT-1a and complete pseudo-anodontia associated with persistent patchy alopecia areata is a new additional nonclassical feature related to the GNAS pathogenic variant.
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Yamaguchi T, Hosomichi K, Shirota T, Miyamoto Y, Ono W, Ono N. Primary failure of tooth eruption: Etiology and management. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:258-267. [PMID: 36159186 PMCID: PMC9489741 DOI: 10.1016/j.jdsr.2022.08.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/01/2022] [Accepted: 08/21/2022] [Indexed: 11/16/2022] Open
Abstract
Primary failure of eruption (PFE) is a rare disorder defined as incomplete tooth eruption despite the presence of a clear eruption pathway. PFE is known to be caused by rare variants in the parathyroid hormone 1 receptor gene (PTH1R). Although several PTH1R variants have been reported, the etiology of PFE remains unclear. However, important studies that help elucidate the pathology of PFE have recently been published. The purpose of this review is to summarize current treatment options, clinical symptoms or phenotypes for diagnosis, genetic information including solid evidence in mouse disease models and disease-specific induced pluripotent stem cells, thus approaching the etiology of PFE from the perspective of the latest research.
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Affiliation(s)
| | - Kazuyoshi Hosomichi
- Department of Bioinformatics and Genomics, Graduate School of Advanced Preventive Medical Sciences, Kanazawa University, Ishikawa, Japan
| | - Tatsuo Shirota
- Department of Oral and Maxillofacial Surgery, Showa University School of Dentistry, Tokyo, Japan
| | - Yoichi Miyamoto
- Department of Biochemistry, Showa University School of Dentistry, Tokyo, Japan
| | - Wanida Ono
- University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA
| | - Noriaki Ono
- University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, USA
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Portales‐Castillo I, Dean T, Khatri A, Jüppner H, Gardella TJ. Functional Properties of Two Distinct PTH1R Mutants Associated With Either Skeletal Defects or Pseudohypoparathyroidism. JBMR Plus 2022; 6:e10604. [PMID: 35720667 PMCID: PMC9189904 DOI: 10.1002/jbm4.10604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 01/11/2022] [Indexed: 12/03/2022] Open
Abstract
Consistent with a vital role of parathyroid hormone (PTH) receptor type 1 (PTH1R) in skeletal development, homozygous loss-of-function PTH1R mutations in humans results in neonatal lethality (Blomstrand chondrodysplasia), whereas such heterozygous mutations cause a primary failure of tooth eruption (PFE). Despite a key role of PTH1R in calcium and phosphate homeostasis, blood mineral ion levels are not altered in such cases of PFE. Recently, two nonlethal homozygous PTH1R mutations were identified in two unrelated families in which affected members exhibit either dental and skeletal abnormalities (PTH1R-V204E) or hypocalcemia and hyperphosphatemia (PTH1R-R186H). Arg186 and Val204 map to the first transmembrane helix of the PTH1R, and thus to a critical region of this class B G protein-coupled receptor. We used cell-based assays and PTH and PTH-related protein (PTHrP) ligand analogs to assess the impact of the R186H and V204E mutations on PTH1R function in vitro. In transiently transfected HEK293 cells, PTH1R-R186H mediated cyclic adenosine monophosphate (cAMP) responses to PTH(1-34) and PTHrP(1-36) that were of comparable potency to those observed on wild-type PTH1R (PTH1R-WT) (half maximal effective concentrations [EC50s] = 0.4nM to 1.2nM), whereas the response-maxima were significantly reduced for the PTH1R-V204E mutant (maximum effect [Emax] = 81%-77% of PTH1R-WT, p ≤ 0.004). Antibody binding to an extracellular hemagglutinin (HA) tag was comparable for PTH1R-R186H and PTH1R-WT, but was significantly reduced for PTH1R-V204E (maximum binding level [Bmax] = 44% ± 11% of PTH1R-WT, p = 0.002). The potency of cAMP signaling induced by a PTH(1-11) analog was reduced by ninefold and threefold, respectively, for PTH1R-R186H and PTH1R-V204E, relative to PTH1R-WT, and a PTH(1-15) radioligand analog that bound adequately to PTH1R-WT exhibited little or no specific binding to either mutant receptor. The data support a general decrease in PTH1R surface expression and/or function as a mechanism for PFE and a selective impairment in PTH ligand affinity as a potential PTH1R-mutation-based mechanism for pseudohypoparathyroidism. © 2022 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)
- Ignacio Portales‐Castillo
- Department of Medicine, Division of NephrologyMassachusetts General Hospital, and Harvard Medical SchoolBostonMAUSA
| | - Thomas Dean
- Endocrine UnitMassachusetts General Hospital, and Harvard Medical SchoolBostonMAUSA
| | - Ashok Khatri
- Endocrine UnitMassachusetts General Hospital, and Harvard Medical SchoolBostonMAUSA
| | - Harald Jüppner
- Endocrine UnitMassachusetts General Hospital, and Harvard Medical SchoolBostonMAUSA
- Pediatric Nephrology UnitMassachusetts General Hospital, and Harvard Medical SchoolBostonMAUSA
| | - Thomas J Gardella
- Endocrine UnitMassachusetts General Hospital, and Harvard Medical SchoolBostonMAUSA
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Demaret T, Wintjens R, Sana G, Docquir J, Bertin F, Ide C, Monestier O, Karadurmus D, Benoit V, Maystadt I. Case Report: Inactivating PTH/PTHrP Signaling Disorder Type 1 Presenting With PTH Resistance. Front Endocrinol (Lausanne) 2022; 13:928284. [PMID: 35846276 PMCID: PMC9280615 DOI: 10.3389/fendo.2022.928284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 05/31/2022] [Indexed: 11/21/2022] Open
Abstract
PTH resistance is characterized by elevated parathyroid hormone (PTH) levels, hypocalcemia, hyperphosphatemia and it is classically associated with GNAS locus genetic or epigenetic defects. Inactivating PTH/PTHrP signaling disorders (iPPSD) define overlapping phenotypes based on their molecular etiology. iPPSD1 is associated with PTH1R variants and variable phenotypes including ossification anomalies and primary failure of tooth eruption but no endocrine disorder. Here we report on a 10-month-old child born from consanguineous parents, who presented with mild neurodevelopmental delay, seizures, enlarged fontanelles, round face, and bilateral clinodactyly. Hand x-rays showed diffuse delayed bone age, osteopenia, short metacarpal bones and cone-shaped distal phalanges. A diagnosis of PTH resistance was made on the basis of severe hypocalcemia, hyperphosphatemia, elevated PTH and normal vitamin D levels on blood sample. The patient was treated with calcium carbonate and alfacalcidol leading to rapid bio-clinical improvement. Follow-up revealed multiple agenesis of primary teeth and delayed teeth eruption, as well as Arnold-Chiari type 1 malformation requiring a ventriculoperitoneal shunt placement. GNAS gene analysis showed no pathogenic variation, but a likely pathogenic homozygous substitution c.723C>G p.(Asp241Glu) in PTH1R gene was found by trio-based whole exome sequencing. We studied the deleterious impact of the variant on the protein conformation with bioinformatics tools. In conclusion, our study reports for the first time PTH resistance in a child with a biallelic PTH1R mutation, extending thereby the clinical spectrum of iPPSD1 phenotypes.
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Affiliation(s)
- Tanguy Demaret
- Centre de Génétique Humaine, Institut de Pathologie et Génétique (IPG), Gosselies, Belgium
- *Correspondence: Tanguy Demaret,
| | - René Wintjens
- Unité Microbiologie, Chimie Bioorganique et Macromoléculaire (CP206/04), Institut de Pharmacie, Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - Gwenaelle Sana
- Service de Pédiatrie, Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium
| | - Joachim Docquir
- Service de Pédiatrie, Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium
| | - Frederic Bertin
- Service de Radiologie, Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium
| | - Christophe Ide
- Service de Radiologie, Grand Hôpital de Charleroi (GHdC), Charleroi, Belgium
| | - Olivier Monestier
- Centre de Génétique Humaine, Institut de Pathologie et Génétique (IPG), Gosselies, Belgium
| | - Deniz Karadurmus
- Centre de Génétique Humaine, Institut de Pathologie et Génétique (IPG), Gosselies, Belgium
| | - Valerie Benoit
- Centre de Génétique Humaine, Institut de Pathologie et Génétique (IPG), Gosselies, Belgium
| | - Isabelle Maystadt
- Centre de Génétique Humaine, Institut de Pathologie et Génétique (IPG), Gosselies, Belgium
- Département de Médecine, Unité de Recherche en Physiologie Moléculaire (URPhyM), Université de Namur (UNamur), Namur, Belgium
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10
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Tokavanich N, Gupta A, Nagata M, Takahashi A, Matsushita Y, Yatabe M, Ruellas A, Cevidanes L, Maki K, Yamaguchi T, Ono N, Ono W. A three-dimensional analysis of primary failure of eruption in humans and mice. Oral Dis 2019; 26:391-400. [PMID: 31802584 DOI: 10.1111/odi.13249] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 11/02/2019] [Accepted: 11/24/2019] [Indexed: 12/29/2022]
Abstract
OBJECTIVES Primary failure of eruption (PFE) is a genetic disorder exhibiting the cessation of tooth eruption. Loss-of-function mutations in parathyroid hormone (PTH)/parathyroid hormone-related peptide (PTHrP) receptor (PTH/PTHrP receptor, PPR) were reported as the underlying cause of this disorder in humans. We showed in a PFE mouse model that PTHrP-PPR signaling is responsible for normal dental follicle cell differentiation and tooth eruption. However, the mechanism underlying the eruption defect in PFE remains undefined. In this descriptive study, we aim to chronologically observe tooth eruption and root formation of mouse PFE molars through 3D microCT analyses. SETTING AND SAMPLE POPULATION Two individuals with PFE were recruited at Showa University. A mouse PFE model was generated by deleting PPR specifically in PTHrP-expressing dental follicle and divided into three groups, PPRfl/fl ;R26RtdTomato/+ (Control), PTHrP-creER;PPRfl/+ ;R26RtdTomato/+ (cHet), and PTHrP-creER;PRRfl/fl ;R26RtdTomato/+ (cKO). MATERIALS AND METHODS Images from human PFE subjects were acquired by CBCT. All groups of mouse samples were studied at postnatal days 14, 25, 91, and 182 after a tamoxifen pulse at P3, and superimposition of 3D microCT images among three groups was rendered. RESULTS Mouse and human PFE molars exhibited a similar presentation in the 3D CT analyses. The quantitative analysis in mice demonstrated a statistically significant decrease in the eruption height of cKO first and second molars compared to other groups after postnatal day 25. Additionally, cKO molars demonstrated significantly shortened roots with dilacerations associated with the reduced interradicular bone height. CONCLUSIONS Mouse PFE molars erupt at a much slower rate compared to normal molars, associated with shortened and dilacerated roots and defective interradicular bones.
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Affiliation(s)
- Nicha Tokavanich
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Aditi Gupta
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Mizuki Nagata
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Akira Takahashi
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Yuki Matsushita
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Marilia Yatabe
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Antonio Ruellas
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Lucia Cevidanes
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Koutaro Maki
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan
| | - Tetsutaro Yamaguchi
- Department of Orthodontics, School of Dentistry, Showa University, Tokyo, Japan.,Department of Oral Interdisciplinary, Division of Orthodontics, Kanagawa Dental University Graduate School of Dentistry, Kanagawa, Japan
| | - Noriaki Ono
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
| | - Wanida Ono
- Department of Orthodontics and Pediatric Dentistry, University of Michigan School of Dentistry, Ann Arbor, MI, USA
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11
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Assiry AA, Albalawi AM, Zafar MS, Khan SD, Ullah A, Almatrafi A, Ramzan K, Basit S. KMT2C, a histone methyltransferase, is mutated in a family segregating non-syndromic primary failure of tooth eruption. Sci Rep 2019; 9:16469. [PMID: 31712638 PMCID: PMC6848163 DOI: 10.1038/s41598-019-52935-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 10/24/2019] [Indexed: 12/22/2022] Open
Abstract
Primary failure of tooth eruption (PFE) is a rare odontogenic defect and is characterized by failure of eruption of one or more permanent teeth. The aim of the study is to identify the genetic defect in a family with seven affected individuals segregating autosomal dominant non-syndromic PFE. Whole genome single-nucleotide polymorphism (SNP) genotyping was performed. SNP genotypes were analysed by DominantMapper and multiple shared haplotypes were detected on different chromosomes. Four individuals, including three affected, were exome sequenced. Variants were annotated and data were analysed while considering candidate chromosomal regions. Initial analysis of variants obtained by whole exome sequencing identified damaging variants in C15orf40, EPB41L4A, TMEM232, KMT2C, and FBXW10 genes. Sanger sequencing of all family members confirmed segregation of splice acceptor site variant (c.1013-2 A > G) in the KMT2C gene with the phenotype. KMT2C is considered as a potential candidate gene based on segregation analysis, the absence of variant in the variation databases, the presence of variant in the shared identical by descent (IBD) region and in silico pathogenicity prediction. KMT2C is a histone methyltransferase and recently the role of another member of this family (KMT2D) has been implicated in tooth development. Moreover, protein structures of KMT2C and KMT2D are highly similar. In conclusion, we have identified that the KMT2C gene mutation causes familial non-syndromic PFE. These findings suggest the involvement of KMT2C in the physiological eruption of permanent teeth.
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Affiliation(s)
- Ali A Assiry
- Department of Pediatric Dentistry, College of Dentistry, Najran University, Najran, Saudi Arabia
| | - Alia M Albalawi
- Center for Genetics and Inherited Diseases, Taibah University, Almadinah Almunawwarah, Saudi Arabia
| | - Muhammad S Zafar
- College of Dentistry, Taibah University, Almadinah Almunawwarah, Saudi Arabia.,Department of Dental Materials, Islamic International Dental College, Riphah International University, Islamabad, 44000, Pakistan
| | - Siraj D Khan
- Department of Pediatric Dentistry, College of Dentistry, Najran University, Najran, Saudi Arabia
| | - Anhar Ullah
- Cardiac Sciences department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Almatrafi
- College of Science, Taibah University, Almadinah Almunawwarah, Saudi Arabia
| | - Khushnooda Ramzan
- Department of Genetics, Research Centre, King Faisal Specialist Hospital and Research Centre Riyadh, Riyadh, Saudi Arabia
| | - Sulman Basit
- Center for Genetics and Inherited Diseases, Taibah University, Almadinah Almunawwarah, Saudi Arabia.
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12
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Nagata M, Ono N, Ono W. Mesenchymal Progenitor Regulation of Tooth Eruption: A View from PTHrP. J Dent Res 2019; 99:133-142. [PMID: 31623502 DOI: 10.1177/0022034519882692] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Tooth eruption is a unique biological process by which highly mineralized tissues emerge into the outer world, and it occurs concomitantly with tooth root formation. These 2 processes have been considered independent phenomena; however, recent studies support the theory that they are indeed intertwined. Dental mesenchymal progenitor cells in the dental follicle lie at the heart of the coupling of these 2 processes, providing a source for diverse mesenchymal cells that support formation of the highly functional tooth root and the periodontal attachment apparatus, while facilitating formation of osteoclasts. These cells are regulated by autocrine signaling by parathyroid hormone-related protein (PTHrP) and its parathyroid hormone/PTHrP receptor PPR. This PTHrP-PPR signaling appears to crosstalk with other signaling pathways and regulates proper cell fates of mesenchymal progenitor cell populations. Disruption of this autocrine PTHrP-PPR signaling in these cells leads to defective formation of the periodontal attachment apparatus, tooth root malformation, and failure of tooth eruption in molars, which essentially recapitulate primary failure of eruption in humans, a rare genetic disorder exclusively affecting tooth eruption. Diversity and distinct functionality of these mesenchymal progenitor cell populations that regulate tooth eruption and tooth root formation are beginning to be unraveled.
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Affiliation(s)
- M Nagata
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - N Ono
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
| | - W Ono
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
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13
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Strub M, Kramer E, Manière MC, Wagner D. [Primary failure of eruption: a French prospective survey among the orthodontists from the Grand Est and Bourgogne-Franche-Comté regions]. Orthod Fr 2019; 90:149-159. [PMID: 31241457 DOI: 10.1051/orthodfr/2019013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 05/10/2019] [Indexed: 06/09/2023]
Abstract
INTRODUCTION Primary failure of eruption (PFE) can be defined as the partial or complete failure of eruption of at least one posterior tooth, without any mechanical obstacle; isolated and syndromic forms exist. PFE results from an abnormal dental eruption process that can affect temporary teeth and / or permanent teeth. Molars are the main affected teeth, inducing posterior infraclusions. Orthodontists are the specialists most often concerned by this rare pathology. Unsuccessful orthodontic-surgical traction therapies are commonly reported. MATERIALS AND METHODS The aim of our study using a prospective survey was to evaluate the level of knowledge reported by the orthodontists and the therapeutic difficulties they reported. An anonymous questionnaire was submitted to practitioners practicing in north-eastern France (Grand Est and Bourgogne-Franche-Comté regions). RESULTS The participation rate was 33.5%. In France, until 2015, specialization in orthodontics was obtained thanks to a local qualification, the Certificat d'Etudes Cliniques Spéciales - Mention Orthodontie (CECSMO), which has now been replaced by specialization following a national ranking competition. Most respondents obtained their qualification between 1980 and 2009 (80%), via the CECSMO (87%). Eighty-six per cent were aware of PFE but only 20% of them knew that PTHR1 (Parathyroid Hormone Receptor 1) gene could be involved in this pathology. The wide range of proposed therapies and the variable satisfaction rates highlight the difficulties encountered by practitioners. DISCUSSION Phenotypic variability complicates the diagnosis and makes any therapeutic systematization uncertain. CONCLUSION New clinical research projects, particularly in the field of molecular diagnosis, may improve understanding of genotype-phenotype correlations, and may potentially pilot therapeutic management.
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Affiliation(s)
- Marion Strub
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France - Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Centre de Référence des maladies rares orales et dentaires O-Rares, 1 place de l'Hôpital, 67000 Strasbourg, France - INSERM, UMR 1260 Nanomédecine régénérative, 11 rue Humann, 67000 Strasbourg, France
| | - Elie Kramer
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France
| | - Marie-Cécile Manière
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France - Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Centre de Référence des maladies rares orales et dentaires O-Rares, 1 place de l'Hôpital, 67000 Strasbourg, France - INSERM, UMR 1260 Nanomédecine régénérative, 11 rue Humann, 67000 Strasbourg, France
| | - Delphine Wagner
- Université de Strasbourg, Faculté de Chirurgie Dentaire, 8 rue Sainte Elisabeth, 67000 Strasbourg, France - Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Centre de Référence des maladies rares orales et dentaires O-Rares, 1 place de l'Hôpital, 67000 Strasbourg, France - Hôpitaux Universitaires de Strasbourg, Pôle de Médecine et Chirurgie Bucco-dentaires, Unité Fonctionnelle d'Orthopédie Dento-Faciale, 1 place de l'Hôpital, 67000 Strasbourg, France
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14
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Abstract
Mesenchymal progenitor cells play important roles in the formation of skeletal tissues; however, how cell fates of mesenchymal progenitor cells are regulated remains largely unclear. We made use of the dental follicle surrounding the developing tooth bud, which critically regulates tooth eruption and tooth root formation. Dental follicle mesenchymal progenitor cells express parathyroid hormone-related peptide (PTHrP), a locally acting autocrine/paracrine ligand, and become essential skeletal cell types establishing the root–bone interface. These PTHrP+ mesenchymal progenitors maintained their physiological cell fates through the PTH/PTHrP receptor, a deficiency of which resulted in failure of tooth eruption phenotypes closely resembling human genetic conditions. We conclude that proper cell fates of mesenchymal progenitor cells are maintained by autocrine signaling to achieve functional formation of skeletal tissues. Formation of functional skeletal tissues requires highly organized steps of mesenchymal progenitor cell differentiation. The dental follicle (DF) surrounding the developing tooth harbors mesenchymal progenitor cells for various differentiated cells constituting the tooth root–bone interface and coordinates tooth eruption in a manner dependent on signaling by parathyroid hormone-related peptide (PTHrP) and the PTH/PTHrP receptor (PPR). However, the identity of mesenchymal progenitor cells in the DF and how they are regulated by PTHrP-PPR signaling remain unknown. Here, we show that the PTHrP-PPR autocrine signal maintains physiological cell fates of DF mesenchymal progenitor cells to establish the functional periodontal attachment apparatus and orchestrates tooth eruption. A single-cell RNA-seq analysis revealed cellular heterogeneity of PTHrP+ cells, wherein PTHrP+ DF subpopulations abundantly express PPR. Cell lineage analysis using tamoxifen-inducible PTHrP-creER mice revealed that PTHrP+ DF cells differentiate into cementoblasts on the acellular cementum, periodontal ligament cells, and alveolar cryptal bone osteoblasts during tooth root formation. PPR deficiency induced a cell fate shift of PTHrP+ DF mesenchymal progenitor cells to nonphysiological cementoblast-like cells precociously forming the cellular cementum on the root surface associated with up-regulation of Mef2c and matrix proteins, resulting in loss of the proper periodontal attachment apparatus and primary failure of tooth eruption, closely resembling human genetic conditions caused by PPR mutations. These findings reveal a unique mechanism whereby proper cell fates of mesenchymal progenitor cells are tightly maintained by an autocrine system mediated by PTHrP-PPR signaling to achieve functional formation of skeletal tissues.
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15
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Moirangthem A, Narayanan DL, Jacob P, Nishimura G, Mortier G, Girisha KM. Report of second case and clinical and molecular characterization of Eiken syndrome. Clin Genet 2018; 94:457-460. [PMID: 29987841 DOI: 10.1111/cge.13413] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 07/04/2018] [Accepted: 07/06/2018] [Indexed: 11/29/2022]
Abstract
We report a boy with Eiken syndrome caused by a homozygous missense variant in Parathyroid hormone 1 receptor (PTH1R) c.103G > A [p.(Glu35Lys)]. Eiken syndrome is a very rare skeletal dysplasia due to bi-allelic variants in PTH1R. Only one affected family has been known to-date. The hallmarks include delayed ossification of bone including the epiphyses, pubic symphysis, and primary ossification centers of the short tubular bones, coarse bone trabeculae, and modeling abnormalities. The phenotype being described here recapitulates the delayed ossification and modeling abnormalities of Eiken syndrome. In addition, supernumerary epiphyses of the tubular bones of the hands and primary failure of eruption of teeth were observed in our proband. This report characterizes Eiken syndrome and confirms that bi-allelic hypomorphic variants in PTH1R are probably to cause this condition.
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Affiliation(s)
- A Moirangthem
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - D L Narayanan
- Department of Medical Genetics, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - P Jacob
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
| | - G Nishimura
- Center for Intractable Diseases, Saitama Medical University Hospital, Saitama, Japan
| | - G Mortier
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - K M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, India
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Hanisch M, Hanisch L, Kleinheinz J, Jung S. Primary failure of eruption (PFE): a systematic review. Head Face Med 2018; 14:5. [PMID: 29544499 PMCID: PMC5856369 DOI: 10.1186/s13005-018-0163-7] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/09/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Primary failure of eruption (PFE) is a rare disease defined as incomplete tooth eruption despite the presence of a clear eruption pathway. Orthodontic extrusion is not feasible in this case because it results in ankylosis of teeth. To the best of our knowledge, besides the study of Ahmad et al. (Eur J Orthod 28:535-540, 2006), no study has systematically analysed the clinical features of and factors associated with PFE. Therefore, the aim of this study was to systematically evaluate the current literature (from 2006 to 2017) for new insights and developments on the aetiology, diagnosis, genetics, and treatment options of PFE. METHODS Following the PRISMA guidelines, a systematic search was performed using the PubMed/Medline database for studies reporting on PFE. The following terms were used: "primary failure of tooth eruption", "primary failure of eruption", "tooth eruption failure", and "PFE". RESULTS Overall, 17 articles reporting clinical data of 314 patients were identified. In all patients, the molars were affected. In 81 reported cases, both the molars and the premolars were affected by PFE. Further, 38 patients' primary teeth were also affected. In 27 patients, no family members were affected. Additional dental anomalies were observed in 39 patients. A total of 51 different variants of the PTH1R gene associated with PFE were recorded. CONCLUSIONS Infraocclusion of the posterior teeth, especially if both sides are affected, is the hallmark of PFE. If a patient is affected by PFE, all teeth distal to the most mesial tooth are also affected by PFE. Primary teeth can also be impacted; however, this may not necessarily occur. If a patient is suspected of having PFE, a genetic test for mutation in the PTH1R gene should be recommended prior to any orthodontic treatment to avoid ankylosis. Treatment options depend on the patient's age and the clinical situation, and they must be evaluated individually.
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Affiliation(s)
- Marcel Hanisch
- Department of Cranio-Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations (RDOM), University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude W 30, D-48149 Münster, Germany
| | - Lale Hanisch
- Department of Orthodontics, Faculty of Health, School of Dentistry, Witten/Herdecke University, Alfred-Herrhausen-Strasse 44, 58455 Witten, Germany
| | - Johannes Kleinheinz
- Department of Cranio-Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations (RDOM), University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude W 30, D-48149 Münster, Germany
| | - Susanne Jung
- Department of Cranio-Maxillofacial Surgery, Research Unit Rare Diseases with Orofacial Manifestations (RDOM), University Hospital Münster, Albert-Schweitzer-Campus 1, Gebäude W 30, D-48149 Münster, Germany
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