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Wen J, Ping H, Kong X, Chai W. Developmental dysplasia of the hip: A systematic review of susceptibility genes and epigenetics. Gene 2023; 853:147067. [PMID: 36435507 DOI: 10.1016/j.gene.2022.147067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/29/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Developmental dysplasia of the hip (DDH) is a complex developmental deformity whose pathogenesis and susceptibility-related genes have yet to be elucidated. This systematic review summarizes the current literature on DDH-related gene mutations, animal model experiments, and epigenetic changes in DDH. METHODS We performed a comprehensive search of relevant documents in the Medline, Scopus, Cochrane, and ScienceDirect databases covering the period from October 1991 to October 2021. We analyzed basic information on the included studies and summarized the DDH-related mutation sites, animal model experiments, and epigenetic changes associated with DDH. RESULTS A total of 63 studies were included in the analysis, of which 54 dealt with the detection of gene mutations, 7 presented details of animal experiments, and 6 were epigenetic studies. No genetic mutations were clearly related to the pathogenesis of DDH, including the most frequently studied genes on chromosomes 1, 17, and 20. Most gene-related studies were performed in Han Chinese or North American populations, and the quality of these studies was medium or low. GDF5 was examined in the greatest number of studies, and mutation sites with odds ratios > 10 were located on chromosomes 3, 9, and 13. Six mutations were found in animal experiments (i.e., CX3CR1, GDF5, PAPPA2, TENM3, UFSP2, and WISP3). Epigenetics research on DDH has focused on GDF5 promoter methylation, three microRNAs (miRNAs), and long noncoding RNAs. In addition, there was also a genetic test for miRNA and mRNA sequencing. CONCLUSIONS DDH is a complex joint deformity with a considerable genetic component whose early diagnosis is significant for preventing disease. At present, no genes clearly involved in the pathogenesis of DDH have been identified. Research on mutations associated with this condition is progressing in the direction of in vivo experiments in animal models to identify DDH susceptibility genes and epigenetics analyses to provide novel insights into its pathogenesis. In the future, genetic profiling may improve matters.
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Affiliation(s)
- Jiaxin Wen
- School of Medicine, Nankai University, Tianjin, China
| | - Hangyu Ping
- School of Medicine, Nankai University, Tianjin, China
| | | | - Wei Chai
- School of Medicine, Nankai University, Tianjin, China.
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Genetic Study of IL6, GDF5 and PAPPA2 in Association with Developmental Dysplasia of the Hip. Genes (Basel) 2021; 12:genes12070986. [PMID: 34203285 PMCID: PMC8303839 DOI: 10.3390/genes12070986] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 06/17/2021] [Accepted: 06/23/2021] [Indexed: 01/19/2023] Open
Abstract
Background: Developmental dysplasia of the hip (DDH) is one of the most prevalent skeletal disorders. DDH is considered a pathologic condition with polygenic background, but environmental and mechanic factors significantly contribute to its multifactorial etiology. Inheritance consistent with autosomal dominant type has also been observed. Single-nucleotide polymorphisms (SNPs) in various genes mostly related to formation of connective tissue are studied for a possible association with DDH. Methods: We genotyped three SNPs, rs1800796 located in the promoter region of the IL6 gene, rs143383 located in the 5′ untranslated region (UTR) of the GDF5 gene and rs726252 located in the fifth intron of the PAPPA2 gene. The study consisted of 45 subjects with DDH and 85 controls from all regions of Slovakia. Results: Association between DDH occurrence and studied genotypes affected by aforementioned polymorphisms was confirmed in the case of rs143383 in the GDF5 gene (p = 0.047), where the T allele was over-expressed in the study group. Meanwhile, in the matter of IL6 and PAPPA2, we found no association with DDH (p = 0.363 and p = 0.478, respectively). Conclusions: These results suggest that there is an association between DDH and GDF5 polymorphisms and that the T allele is more frequently presents in patients suffering from DDH.
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Simionescu AA, Cirstoiu MM, Cirstoiu C, Stanescu AMA, Crețu B. Current Evidence about Developmental Dysplasia of the Hip in Pregnancy. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:655. [PMID: 34206824 PMCID: PMC8305660 DOI: 10.3390/medicina57070655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 11/16/2022]
Abstract
In adults, developmental dysplasia of the hip (DDH) represents a spectrum of disorders. It is commonly found in women in routine orthopedic practice. Hip dysplasia is a leading precursor of joint laxity; when untreated, it can contribute to chronic modifications, such as thickening of the pulvinar and ligamentum teres (which can also elongate), hypertrophy of the transverse acetabular ligament, and osteoarthritis. DDH is presumed to be associated with alterations in pelvic morphology that may affect vaginal birth by the reduction in the transverse diameter of the pelvic inlet or outlet. Here, we provide an overview of the current knowledge of pregnancy-associated DDH. We primarily focused on how a surgical DDH treatment might influence the pelvic shape and size and the effects on the mechanism of birth. We presented the female pelvis from the standpoint of bone and ligament morphology relative to a pelvic osteotomy. Then, we described whether the pregnancy was impacted by previous surgical DDH treatments, performed from infancy to adulthood. In conclusion, hip dysplasia is not associated with high-risk complications during pregnancy or with increased difficulty in vaginal delivery.
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Affiliation(s)
- Anca Angela Simionescu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, Filantropia Clinical Hospital, 011171 Bucharest, Romania;
| | - Monica Mihaela Cirstoiu
- Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania;
| | - Catalin Cirstoiu
- Department of Orthopedics and Traumatology, “Carol Davila” University of Medicine and Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania; (C.C.); (B.C.)
| | | | - Bogdan Crețu
- Department of Orthopedics and Traumatology, “Carol Davila” University of Medicine and Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania; (C.C.); (B.C.)
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Harsanyi S, Zamborsky R, Kokavec M, Danisovic L. Genetics of developmental dysplasia of the hip. Eur J Med Genet 2020; 63:103990. [PMID: 32540376 DOI: 10.1016/j.ejmg.2020.103990] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/09/2020] [Indexed: 12/12/2022]
Abstract
In the last decade, the advances in the molecular analyses and sequencing techniques allowed researchers to study developmental dysplasia of the hip (DDH) more thoroughly. Certain chromosomes, genes, loci and polymorphisms are being associated with variable severity of this disorder. The wide range of signs and symptoms is dependent either on isolated or systemic manifestation. Phenotypes of isolated cases range from only a mild ligamental laxity, through subluxation, to a complete dislocation of the femoral head. Systemic manifestation is connected to various forms of skeletal dysplasia and other malformations characterized by significant genetic aberrations. To reveal the background of DDH heredity, multiple studies focused on large sample sizes with an emphasis on the correlation between genotype, phenotype and continuous clinical examination. Etiological risk factors that have been observed and documented in patients include genetic, environmental, and mechanical factors, which significantly contribute to the familial or nonfamilial occurrence and phenotypic variability of this disorder. Still, the multifactorial etiology and pathogenesis of DDH are not yet sufficiently clarified, explained, or understood. Formation of connective tissue, osteogenesis, chondrogenesis, and all other affected pathways and variations in the function of their individual elements contribute to the creation of the pathology in a developing human body. This review article presents an up-to-date list of known DDH associated genes, their products, and functional characteristics.
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Affiliation(s)
- Stefan Harsanyi
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08, Bratislava, Slovakia.
| | - Radoslav Zamborsky
- Department of Orthopedics, Faculty of Medicine, Comenius University and National Institute of Children's Diseases, Limbova 1, 833 40, Bratislava, Slovakia.
| | - Milan Kokavec
- Department of Orthopedics, Faculty of Medicine, Comenius University and National Institute of Children's Diseases, Limbova 1, 833 40, Bratislava, Slovakia.
| | - Lubos Danisovic
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, 811 08, Bratislava, Slovakia.
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Harsanyi S, Zamborsky R, Krajciova L, Kokavec M, Danisovic L. Developmental Dysplasia of the Hip: A Review of Etiopathogenesis, Risk Factors, and Genetic Aspects. MEDICINA-LITHUANIA 2020; 56:medicina56040153. [PMID: 32244273 PMCID: PMC7230892 DOI: 10.3390/medicina56040153] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Revised: 03/25/2020] [Accepted: 03/28/2020] [Indexed: 12/11/2022]
Abstract
As one of the most frequent skeletal anomalies, developmental dysplasia of the hip (DDH) is characterized by a considerable range of pathology, from minor laxity of ligaments in the hip joint to complete luxation. Multifactorial etiology, of which the candidate genes have been studied the most, poses a challenge in understanding this disorder. Candidate gene association studies (CGASs) along with genome-wide association studies (GWASs) and genome-wide linkage analyses (GWLAs) have found numerous genes and loci with susceptible DDH association. Studies put major importance on candidate genes associated with the formation of connective tissue (COL1A1), osteogenesis (PAPPA2, GDF5), chondrogenesis (UQCC1, ASPN) and cell growth, proliferation and differentiation (TGFB1). Recent studies show that epigenetic factors, such as DNA methylation affect gene expression and therefore could play an important role in DDH pathogenesis. This paper reviews all existing risk factors affecting DDH incidence, along with candidate genes associated with genetic or epigenetic etiology of DDH in various studies.
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Affiliation(s)
- Stefan Harsanyi
- Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, 811-08 Bratislava, Slovakia; (L.K.); (L.D.)
- Correspondence: ; Tel.: +421-2-59357-299
| | - Radoslav Zamborsky
- Department of Orthopedics, Faculty of Medicine, Comenius University and National Institute of Children’s Diseases, 833-40 Bratislava, Slovakia; (R.Z.); (M.K.)
| | - Lubica Krajciova
- Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, 811-08 Bratislava, Slovakia; (L.K.); (L.D.)
| | - Milan Kokavec
- Department of Orthopedics, Faculty of Medicine, Comenius University and National Institute of Children’s Diseases, 833-40 Bratislava, Slovakia; (R.Z.); (M.K.)
| | - Lubos Danisovic
- Faculty of Medicine, Institute of Medical Biology, Genetics and Clinical Genetics, Comenius University in Bratislava, 811-08 Bratislava, Slovakia; (L.K.); (L.D.)
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Meeson RL, Todhunter RJ, Blunn G, Nuki G, Pitsillides AA. Spontaneous dog osteoarthritis - a One Medicine vision. Nat Rev Rheumatol 2020; 15:273-287. [PMID: 30953036 PMCID: PMC7097182 DOI: 10.1038/s41584-019-0202-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Osteoarthritis (OA) is a global disease that, despite extensive research, has limited treatment options. Pet dogs share both an environment and lifestyle attributes with their owners, and a growing awareness is developing in the public and among researchers that One Medicine, the mutual co-study of animals and humans, could be beneficial for both humans and dogs. To that end, this Review highlights research opportunities afforded by studying dogs with spontaneous OA, with a view to sharing this active area of veterinary research with new audiences. Similarities and differences between dog and human OA are examined, and the proposition is made that suitably aligned studies of spontaneous OA in dogs and humans, in particular hip and knee OA, could highlight new avenues of discovery. Developing cross-species collaborations will provide a wealth of research material and knowledge that is relevant to human OA and that cannot currently be obtained from rodent models or experimentally induced dog models of OA. Ultimately, this Review aims to raise awareness of spontaneous dog OA and to stimulate discussion regarding its exploration under the One Medicine initiative to improve the health and well-being of both species. Osteoarthritis occurs spontaneously in pet dogs, which often share environmental and lifestyle risk-factors with their owners. This Review aims to stimulate cooperation between medical and veterinary research under the One Medicine initiative to improve the welfare of dogs and humans. Dogs have many analogous spontaneous diseases that result in end-stage osteoarthritis (OA). Inbreeding and the predisposition of certain dog breeds for OA enable easier identification of candidate genetic associations than in outbred humans. Dog OA subtypes offer a potential stratification rationale for aetiological differences and alignment to analogous human OA phenotypes. The relatively compressed time course of spontaneous dog OA offers longitudinal research opportunities. Collaboration with veterinary researchers can provide tissue samples from early-stage OA and opportunities to evaluate new therapeutics in a spontaneous disease model. Awareness of the limitations and benefits of using clinical veterinary patients in research is important.
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Affiliation(s)
- Richard L Meeson
- Skeletal Biology Group, Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK.,Department of Clinical Services and Sciences, Royal Veterinary College, University of London, London, UK.,Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK
| | - Rory J Todhunter
- Department of Clinical Sciences, Cornell University, Ithaca, NY, USA.,Cornell Veterinary Biobank, Cornell University, Ithaca, NY, USA
| | - Gordon Blunn
- Institute of Orthopaedics and Musculoskeletal Science, University College London, London, UK.,School of Pharmacy and Biomedical Sciences, University of Portsmouth, Portsmouth, UK
| | - George Nuki
- Institute for Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, UK
| | - Andrew A Pitsillides
- Skeletal Biology Group, Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, UK.
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Kenanidis E, Gkekas NK, Karasmani A, Anagnostis P, Christofilopoulos P, Tsiridis E. Genetic Predisposition to Developmental Dysplasia of the Hip. J Arthroplasty 2020; 35:291-300.e1. [PMID: 31522852 DOI: 10.1016/j.arth.2019.08.031] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/14/2019] [Accepted: 08/12/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The etiopathogenesis of developmental dysplasia of the hip (DDH) has not been clarified. This systematic review evaluated current literature concerning all known chromosomes, loci, genes, and their polymorphisms that have been associated or not with the prevalence and severity of DDH. METHODS Following the established methodology of Meta-analysis of Observational Studies in Epidemiology guidelines, MEDLINE, EMBASE, and Cochrane Register of Controlled Trials were systematically searched from inception to January 2019. RESULTS Forty-five studies were finally included. The majority of genetic studies were candidate gene association studies assessing Chinese populations with moderate methodological quality. Among the most frequently studied are the first, third, 12th,17th, and 20th chromosomes. No gene was firmly associated with DDH phenotype. Studies from different populations often report conflicting results on the same single-nucleotide polymorphism (SNP). The SNP rs143384 of GDF5 gene on chromosome 20 demonstrated the most robust relationship with DDH phenotype in association studies. The highest odds of coinheritance in linkage studies have been reported for regions of chromosome 3 and 13. Five SNPs have been associated with the severity of DDH. Animal model studies validating previous human findings provided suggestive evidence of an inducing role of mutations of the GDF5, CX3CR1, and TENM3 genes in DDH etiopathogenesis. CONCLUSION DDH is a complex disorder with environmental and genetic causes. However, no firm correlation between genotype and DDH phenotype currently exists. Systematic genome evaluation in studies with larger sample size, better methodological quality, and assessment of DDH patients is necessary to clarify the DDH heredity. The role of next-generation sequencing techniques is promising.
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Affiliation(s)
- Eustathios Kenanidis
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece; Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Nifon K Gkekas
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece; Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Areti Karasmani
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece
| | - Panagiotis Anagnostis
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece
| | | | - Eleftherios Tsiridis
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece; Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
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Simonsen PO, Hertz JM, Søballe K, Mechlenburg I. Association between periacetabular osteotomy and hip dysplasia among relatives: a cross-sectional study. Hip Int 2019; 29:424-429. [PMID: 30062924 DOI: 10.1177/1120700018785293] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Previous studies indicate a familial predisposition for developmental dysplasia of the hip (DDH), especially among first-degree relatives. This study investigated the association between unilateral or bilateral periacetabular osteotomy (PAO), family history of DDH and the degree of relationship with relatives with DDH. MATERIAL AND METHODS This cross-sectional study consisted of 815 consecutive patients undergoing PAO from 1998 to 2016. Information regarding unilateral or bilateral PAO, gender and age at the time of surgery was obtained from the clinical PAO database at Aarhus University Hospital, Denmark. A questionnaire was used to collect information about the family history of DDH. The association was assessed by logistic regression analysis, and divided into 615 unilateral and 200 bilateral PAO patients. RESULTS PAO patients with a first-degree relative with DDH had a 72% (odds ratio [OR] = 1.72, 95% confidence interval [CI] 1.17; 2.50) higher occurrence of bilateral PAO than patients without family relatives with DDH. This association was statistically significant (p = 0.005), even when adjusting for gender and age at the time of surgery. A similar association was not demonstrated among any other degrees of relationship. CONCLUSION Danish patients with DDH and a first-degree relative with DDH have an increased risk of being surgically treated with bilateral PAO compared to patients without a family history of DDH. Patients undergoing bilateral PAO may therefore have a strong genetic predisposition for DDH. This study reveals a potential group of patients with DDH where genetic analysis may identify relatives with a higher risk of the disease.
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Affiliation(s)
- Pernille O Simonsen
- 1 Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Jens M Hertz
- 2 Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - Kjeld Søballe
- 1 Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark
| | - Inger Mechlenburg
- 1 Department of Orthopaedic Surgery, Aarhus University Hospital, Aarhus, Denmark.,3 Centre of Research in Rehabilitation (CORIR), Department of Clinical Medicine, Aarhus University Hospital and Aarhus University, Aarhus, Denmark
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9
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Zamborsky R, Kokavec M, Harsanyi S, Attia D, Danisovic L. Developmental Dysplasia of Hip: Perspectives in Genetic Screening. Med Sci (Basel) 2019; 7:medsci7040059. [PMID: 30979092 PMCID: PMC6524033 DOI: 10.3390/medsci7040059] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/16/2019] [Accepted: 04/10/2019] [Indexed: 12/18/2022] Open
Abstract
Development dysplasia of the hip (DDH) is a complex developmental disorder despite being a relatively common condition mainly caused by incompatibility of the femoral head and the abnormal joint socket. Development dysplasia of the hip describes a wide spectrum of disorders ranging from minor acetabular dysplasia to irreducible dislocation of the hip. Modern medicine still suffers from lack of information about screening and precise genetic examination. Genome wide linkage and association studies have brought significant progress to DDH diagnosis. Association studies managed to identify many candidate (susceptible) genes, such as PAPPA2, COL2A1, HOXD9, GDF-5, and TGFB1, which play a considerable role in the pathogenesis of DDH. Early detection of DDH has a big chance to help in preventing further disability and improve the psychological health and quality of life in those children. This emphasizes the importance to establish a universal screening program along with the genetic counseling.
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Affiliation(s)
- Radoslav Zamborsky
- Department of Orthopaedics, Faculty of Medicine, Comenius University and National Institute of Children's Diseases, Limbova 1, 833 40 Bratislava, Slovakia.
| | - Milan Kokavec
- Department of Orthopaedics, Faculty of Medicine, Comenius University and National Institute of Children's Diseases, Limbova 1, 833 40 Bratislava, Slovakia.
| | - Stefan Harsanyi
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia.
| | - Doaa Attia
- Department of Internal Medicine, Faculty of Medicine, Alexandria University, Chamblion St., Azarita, 21131 Alexandria, Egypt.
| | - Lubos Danisovic
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia.
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Feldman G, Kappes D, Mookerjee-Basu J, Freeman T, Fertala A, Parvizi J. Novel mutation in Teneurin 3 found to co-segregate in all affecteds in a multi-generation family with developmental dysplasia of the hip. J Orthop Res 2019; 37:171-180. [PMID: 30273960 DOI: 10.1002/jor.24148] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/04/2018] [Indexed: 02/04/2023]
Abstract
DDH is a debilitating condition characterized by incomplete formation of the acetabulum leading to dislocation of the hip, suboptimal joint function and accelerated wear of the articular cartilage resulting in early onset crippling arthritis of the hip in 20-40 year olds. Current diagnostic tests in newborns using physical manipulation of the femur or ultrasound either under or over-diagnose this condition. Developing an accurate, cost effective diagnostic test is a goal of this study. To better understand the biologic pathways involved in acetabular development, DNA from severely affected individuals in a four generation family that showed inter-generational transmission of the disorder was isolated and whole exome sequenced. A novel A to C transversion at position 183721398 on human chromosome four was found to co-segregate with the affected phenotype in this family. This mutation encodes a glutamine to proline change at position 2665 in the Teneurin 3 (TENM3) gene and was judged damaging by four prediction programs. Eight week old knock-in mutant mice show delayed development of the left acetabulum and the left glenoid fossa as shown by the presence of more Alcian blue staining on the socket rims of both the hip and the shoulder. We hypothesize that mutated TENM3 will slow chondrogenesis. MMP13 has been shown to impair extracellular matrix remodeling and suppress differentiation. Bone marrow cells from the knock-in mouse were found to overexpress MMP13 with or without BMP2 stimulation. This variant may elucidate pathways responsible for normal hip development and become part of an accurate test for DDH. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
- George Feldman
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, Pennsylvania
| | | | | | - Theresa Freeman
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, Pennsylvania
| | - Andrzej Fertala
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, Pennsylvania
| | - Javad Parvizi
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, Pennsylvania.,Rothman Institute of Orthopaedics, Philadelphia, Pennsylvania
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CORR Insights®: The 2018 Nicholas Andry Award: The Evidence Base for the Treatment of Developmental Dysplasia of the Hip: The Iowa Contribution. Clin Orthop Relat Res 2018; 476:1052-1054. [PMID: 29481365 PMCID: PMC5916612 DOI: 10.1007/s11999.0000000000000236] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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12
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Zhu LQ, Su GH, Dai J, Zhang WY, Yin CH, Zhang FY, Zhu ZH, Guo ZX, Fang JF, Zou CD, Chen XG, Zhang Y, Xu CY, Zhen YF, Wang XD. Whole genome sequencing of pairwise human subjects reveals DNA mutations specific to developmental dysplasia of the hip. Genomics 2018; 111:320-326. [PMID: 29486210 DOI: 10.1016/j.ygeno.2018.02.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 02/05/2018] [Accepted: 02/12/2018] [Indexed: 01/26/2023]
Abstract
Developmental dysplasia of the hip (DDH) is a common congenital malformation characterized by mismatch in shape between the femoral head and acetabulum, and leads to hip dysplasia. To date, the pathogenesis of DDH is poorly understood and may involve multiple factors, including genetic predisposition. However, comprehensive genetic analysis has not been applied to investigate a genetic component of DDH. In the present study, 10 pairs of healthy fathers and DDH daughters were enrolled to identify genetic hallmarks of DDH using high throughput whole genome sequencing. The DDH-specific DNA mutations were found in each patient. Overall 1344 genes contained DDH-specific mutations. Functional enrichment analysis showed that these genes played important roles in the cytoskeleton, microtubule cytoskeleton, sarcoplasm and microtubule associated complex. These functions affected osteoblast and osteoclast development. Therefore, we proposed that the DDH-specific mutations might affect bone development, and caused DDH. Our pairwise high throughput sequencing results comprehensively delineated genetic hallmarks of DDH. Further research into the biological impact of these mutations may inform the development of DDH diagnostic tools and allow neonatal gene screening.
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Affiliation(s)
- Lun-Qing Zhu
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Guang-Hao Su
- Pediatric Institute of Soochow University, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Jin Dai
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Wen-Yan Zhang
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Chun-Hua Yin
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Fu-Yong Zhang
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Zhen-Hua Zhu
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Zhi-Xiong Guo
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Jian-Feng Fang
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Cheng-da Zou
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Xing-Guang Chen
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Ya Zhang
- Pediatric Institute of Soochow University, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Cai-Ying Xu
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China
| | - Yun-Fang Zhen
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China.
| | - Xiao-Dong Wang
- Department of Orthopaedics, Children's Hospital of Soochow University, Suzhou 215000, China.
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13
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Huang M, Hayward JJ, Corey E, Garrison SJ, Wagner GR, Krotscheck U, Hayashi K, Schweitzer PA, Lust G, Boyko AR, Todhunter RJ. A novel iterative mixed model to remap three complex orthopedic traits in dogs. PLoS One 2017; 12:e0176932. [PMID: 28614352 PMCID: PMC5470659 DOI: 10.1371/journal.pone.0176932] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 04/19/2017] [Indexed: 12/31/2022] Open
Abstract
Hip dysplasia (HD), elbow dysplasia (ED), and rupture of the cranial (anterior) cruciate ligament (RCCL) are the most common complex orthopedic traits of dogs and all result in debilitating osteoarthritis. We reanalyzed previously reported data: the Norberg angle (a quantitative measure of HD) in 921 dogs, ED in 113 cases and 633 controls, and RCCL in 271 cases and 399 controls and their genotypes at ~185,000 single nucleotide polymorphisms. A novel fixed and random model with a circulating probability unification (FarmCPU) function, with marker-based principal components and a kinship matrix to correct for population stratification, was used. A Bonferroni correction at p<0.01 resulted in a P< 6.96 ×10-8. Six loci were identified; three for HD and three for RCCL. An associated locus at CFA28:34,369,342 for HD was described previously in the same dogs using a conventional mixed model. No loci were identified for RCCL in the previous report but the two loci for ED in the previous report did not reach genome-wide significance using the FarmCPU model. These results were supported by simulation which demonstrated that the FarmCPU held no power advantage over the linear mixed model for the ED sample but provided additional power for the HD and RCCL samples. Candidate genes for HD and RCCL are discussed. When using FarmCPU software, we recommend a resampling test, that a positive control be used to determine the optimum pseudo quantitative trait nucleotide-based covariate structure of the model, and a negative control be used consisting of permutation testing and the identical resampling test as for the non-permuted phenotypes.
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Affiliation(s)
- Meng Huang
- Department of Crop and Soil Science, Washington State University, Pullman, Washington, United States of America
| | - Jessica J. Hayward
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Elizabeth Corey
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Susan J. Garrison
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Gabriela R. Wagner
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Ursula Krotscheck
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Kei Hayashi
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Peter A. Schweitzer
- Sequencing Core, Biotechnology Resource Center, Cornell University, Ithaca, New York, United States of America
| | - George Lust
- Baker Institute for Animal Health, Cornell University, Ithaca, New York, United States of America
| | - Adam R. Boyko
- Department of Biomedical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
- Chief Scientific Officer of Embark Veterinary Inc., Austin, Texas, United States of America
| | - Rory J. Todhunter
- Cornell Veterinary Biobank, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
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14
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Basit S, Hannan MA, Khoshhal KI. Developmental dysplasia of the hip: usefulness of next generation genomic tools for characterizing the underlying genes - a mini review. Clin Genet 2016; 90:16-20. [DOI: 10.1111/cge.12755] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 01/13/2023]
Affiliation(s)
- S. Basit
- Centre for Genetics and Inherited Diseases; Almadinah Almunawwarah Kingdom of Saudi Arabia
| | - M. A. Hannan
- Centre for Genetics and Inherited Diseases; Almadinah Almunawwarah Kingdom of Saudi Arabia
| | - K. I. Khoshhal
- College of Medicine; Taibah University; Almadinah Almunawwarah Kingdom of Saudi Arabia
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15
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Back-carrying infants to prevent developmental hip dysplasia and its sequelae: is a new public health initiative needed? J Pediatr Orthop 2015; 35:57-61. [PMID: 24942071 DOI: 10.1097/bpo.0000000000000234] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Developmental dysplasia of the hip (DDH) is rarely encountered in the native sub-Saharan African population. We present a retrospective review of the incidence of symptomatic DDH in Malawi and a systematic review of the role of back-carrying as a potential influence of prevalence in this population group. METHODS We retrospectively reviewed the diagnosis and management of all infants seen at the Beit CURE International Hospital, Malawi and its mobile clinics, from November 2002 to September 2012. In addition, methodical review of the literature using the Preferred Reporting Items for Systematic Reviews and Meta-analyses checklist and algorithm was performed. RESULTS A total of 40,683 children aged less than 16 years were managed at our institute over a 10-year period, of which 9842 children underwent surgery. No infant presented with, or underwent surgical intervention, for symptomatic DDH. CONCLUSIONS The majority of mothers in Malawi back-carry their infants during the first 2 to 24 months of life, in a position that is similar to that of the Pavlik harness. We believe this to be the prime reason for the low incidence of DDH in the country. In addition, there is established evidence indicating that swaddling, the opposite position to back-carrying, causes an increase in the incidence of DDH. There is a need for the establishment of a large clinical trial into back-carrying and prevention of DDH in non-African population groups. LEVEL OF EVIDENCE Level II.
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16
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Feldman GJ, Parvizi J, Sawan H, Erickson JA, Peters CL. Linkage mapping and whole exome sequencing identify a shared variant in CX3CR1 in a large multi-generation family. J Arthroplasty 2014; 29:238-41. [PMID: 24998320 DOI: 10.1016/j.arth.2014.05.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 04/02/2014] [Accepted: 05/10/2014] [Indexed: 02/01/2023] Open
Abstract
Developmental dysplasia of the hip (DDH) is a crippling condition that affects children and adults, with an average incidence of 1-1.5 cases per 1000 live births. It results in disabling arthritis of the hip in up to 60% patients in the 20-40 year age group. There is no accurate diagnostic test available for newborns. The purpose of our study is to develop a sensitive and specific genetic test for DDH by identifying causative mutations. Linkage analysis and whole exome sequencing of 4 severely affected individuals of a 4 generation 71 member family was performed. The damaging rs3732378 variant in the CX3CR1 chemokine receptor was shared by all affected family members and by 15% of 28 sporadic dysplastics.
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Affiliation(s)
- George J Feldman
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, PA
| | - Javad Parvizi
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, PA; Rothman Institute of Orthopaedics, Philadelphia, PA
| | - Hind Sawan
- Rothman Institute of Orthopaedics, Philadelphia, PA
| | - Jill A Erickson
- University Orthopaedic Center, University of Utah, Salt Lake City, UT
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17
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Eytan O, Sarig O, Israeli S, Mevorah B, Basel-Vanagaite L, Sprecher E. A novel splice-site mutation in theAAGABgene segregates with hereditary punctate palmoplantar keratoderma and congenital dysplasia of the hip in a large family. Clin Exp Dermatol 2013; 39:182-6. [DOI: 10.1111/ced.12213] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2013] [Indexed: 02/07/2023]
Affiliation(s)
- O. Eytan
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
- Department of Human Molecular Genetics and Biochemistry; Sackler Faculty of Medicine; Tel Aviv University; Ramat Aviv Israel
| | - O. Sarig
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - S. Israeli
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - B. Mevorah
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - L. Basel-Vanagaite
- Department of Human Molecular Genetics and Biochemistry; Sackler Faculty of Medicine; Tel Aviv University; Ramat Aviv Israel
- Schneider Children's Medical Center of Israel and Raphael Recanati Genetics Institute; Petah Tikva Israel
- Felsenstein Medical Research Center; Rabin Medical Center; Petah Tikva Israel
| | - E. Sprecher
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
- Department of Human Molecular Genetics and Biochemistry; Sackler Faculty of Medicine; Tel Aviv University; Ramat Aviv Israel
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18
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Feldman GJ, Parvizi J, Levenstien M, Scott K, Erickson JA, Fortina P, Devoto M, Peters CL. Developmental dysplasia of the hip: linkage mapping and whole exome sequencing identify a shared variant in CX3CR1 in all affected members of a large multigeneration family. J Bone Miner Res 2013; 28:2540-9. [PMID: 23716478 DOI: 10.1002/jbmr.1999] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 04/24/2013] [Accepted: 05/09/2013] [Indexed: 11/09/2022]
Abstract
Developmental dysplasia of the hip (DDH) is a debilitating condition characterized by incomplete formation of the acetabulum leading to dislocation of the femur, suboptimal joint function, and accelerated wear of the articular cartilage resulting in arthritis. DDH affects 1 in 1000 newborns in the United States; there are well-defined "pockets" of high prevalence in Japan, and in Italy and other Mediterranean countries. Although reasonably accurate for detecting gross forms of hip dysplasia, existing techniques fail to find milder forms of dysplasia. Undetected hip dysplasia is the leading cause of osteoarthritis of the hip in young individuals, causing over 40% of cases in this age group. A sensitive and specific test for DDH has remained a desirable yet elusive goal in orthopedics for a long time. A 72-member, four-generation affected family has been recruited, and DNA from its members retrieved. Genomewide linkage analysis revealed a 2.61-Mb candidate region (38.7-41.31 Mb from the p term of chromosome 3) co-inherited by all affected members with a maximum logarithm (base 10) of odds (LOD) score of 3.31. Whole exome sequencing and analysis of this candidate region in four severely affected family members revealed one shared variant, rs3732378, that causes a threonine (polar) to methionine (non-polar) alteration at position 280 in the transmembrane domain of CX3CR1. This mutation is predicted to have a deleterious effect on its encoded protein, which functions as a receptor for the ligand fractalkine. By Sanger sequencing this variant was found to be present in the DNA of all affected individuals and obligate heterozygotes. CX3CR1 mediates cellular adhesive and migratory functions and is known to be expressed in mesenchymal stem cells destined to become chondrocytes. A genetic risk factor that might be among the etiologic factors for the family in this study has been identified, along with other possible aggravating mutations shared by four severely affected family members. These findings might illuminate the molecular pathways affecting chondrocyte maturation and bone formation.
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Affiliation(s)
- George J Feldman
- Division of Orthopaedic Research, Thomas Jefferson University, Philadelphia, PA, USA
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19
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Li L, Sun K, Zhang L, Zhao Q, Cheng X, Dang Y. Heritability and sibling recurrent risk of developmental dysplasia of the hip in Chinese population. Eur J Clin Invest 2013; 43:589-94. [PMID: 23550629 DOI: 10.1111/eci.12084] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Accepted: 03/10/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Previous familial segregation studies supported that developmental dysplasia of the hip (DDH) is a multifactorial genetic disease. However, the exact extent of genetic effects has not been fully evaluated, especially in Asian population. The aim of this study is to estimate the sibling recurrent risk and heritability of DDH in a large Chinese cohort. MATERIALS AND METHODS Four hundred and twenty-nine DDH probands and 534 matched normal controls were recruited from a screening programme for DDH, including 628 siblings in families of probands and 889 siblings in those of controls, respectively. The detailed information of family history was obtained, and the prevalence of DDH among siblings of probands, as well as controls, was determined. The sibling recurrent risk and heritability was estimated using classical liability threshold model. RESULTS Eighty-seven siblings (13.85%) in families of proband and 14 siblings (1.57%) in normal control families were diagnosed as DDH. The recurrent risk in siblings of probands was at least tenfolds that in siblings of controls. Compared with the normal controls, the sibling recurrent risk was about 12-fold increase in male sib, and 9-fold increase in female sib. Overall, a high heritability of 83.59 ± 4.90% (h(2) ± SE) was observed. When stratified by genders, it was even higher for female siblings (91.02 ± 7.25%). CONCLUSION This study for the first time exhibits a high sibling recurrent risk and heritability for DDH in Asian population. It also shows there is a high probability to identify the underlying predisposition genes in future genetic study.
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Affiliation(s)
- Lianyong Li
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, China
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