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Fioretti T, Martora F, De Maggio I, Ambrosio A, Piscopo C, Vallone S, Amato F, Passaro D, Acquaviva F, Gaudiello F, Di Girolamo D, Maiolo V, Zarrilli F, Esposito S, Vitiello G, Auricchio L, Sammarco E, Brasi DD, Petillo R, Gambale A, Cattaneo F, Ammendola R, Nappa P, Esposito G. Comprehensive Molecular Analysis of Disease-Related Genes as First-Tier Test for Early Diagnosis, Classification, and Management of Patients Affected by Nonsyndromic Ichthyosis. Biomedicines 2024; 12:1112. [PMID: 38791074 PMCID: PMC11117922 DOI: 10.3390/biomedicines12051112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Inherited ichthyoses are a group of clinically and genetically heterogeneous rare disorders of skin keratinization with overlapping phenotypes. The clinical picture and family history are crucial to formulating the diagnostic hypothesis, but only the identification of the genetic defect allows the correct classification. In the attempt to molecularly classify 17 unrelated Italian patients referred with congenital nonsyndromic ichthyosis, we performed massively parallel sequencing of over 50 ichthyosis-related genes. Genetic data of 300 Italian unaffected subjects were also analyzed to evaluate frequencies of putative disease-causing alleles in our population. For all patients, we identified the molecular cause of the disease. Eight patients were affected by autosomal recessive congenital ichthyosis associated with ALOX12B, NIPAL4, and TGM1 mutations. Three patients had biallelic loss-of-function variants in FLG, whereas 6/11 males were affected by X-linked ichthyosis. Among the 24 different disease-causing alleles we identified, 8 carried novel variants, including a synonymous TGM1 variant that resulted in a splicing defect. Moreover, we generated a priority list of the ichthyosis-related genes that showed a significant number of rare and novel variants in our population. In conclusion, our comprehensive molecular analysis resulted in an effective first-tier test for the early classification of ichthyosis patients. It also expands the genetic, mutational, and phenotypic spectra of inherited ichthyosis and provides new insight into the current understanding of etiologies and epidemiology of this group of rare disorders.
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Affiliation(s)
- Tiziana Fioretti
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (F.M.); (F.G.); (L.A.); (P.N.)
| | - Ilaria De Maggio
- Medical and Laboratory Genetics Unit, AORN A. Cardarelli, 80131 Naples, Italy; (I.D.M.); (C.P.); (R.P.)
| | - Adelaide Ambrosio
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
| | - Carmelo Piscopo
- Medical and Laboratory Genetics Unit, AORN A. Cardarelli, 80131 Naples, Italy; (I.D.M.); (C.P.); (R.P.)
| | - Sabrina Vallone
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Felice Amato
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Diego Passaro
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Fabio Acquaviva
- Medical Genetics Unit, Department of General and Emergency Paediatrics, AORN Santobono-Pausilipon, 80122 Naples, Italy; (F.A.); (D.D.B.)
| | - Francesca Gaudiello
- Section of Dermatology, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (F.M.); (F.G.); (L.A.); (P.N.)
| | - Daniela Di Girolamo
- Department of Biology, University of Naples “Federico II”, 80126 Naples, Italy;
| | - Valeria Maiolo
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Federica Zarrilli
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Speranza Esposito
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Giuseppina Vitiello
- Medical Genetics Unit, Integrated Care Department of Laboratory and Transfusion Medicine, Federico II Hospital, 80131 Naples, Italy; (G.V.); (A.G.)
| | - Luigi Auricchio
- Section of Dermatology, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (F.M.); (F.G.); (L.A.); (P.N.)
| | - Elena Sammarco
- Pediatric Dermatology Unit, Department of Dermo-Immuno-Rheumatology Paediatrics, AORN Santobono-Pausilipon, 80122 Naples, Italy;
| | - Daniele De Brasi
- Medical Genetics Unit, Department of General and Emergency Paediatrics, AORN Santobono-Pausilipon, 80122 Naples, Italy; (F.A.); (D.D.B.)
| | - Roberta Petillo
- Medical and Laboratory Genetics Unit, AORN A. Cardarelli, 80131 Naples, Italy; (I.D.M.); (C.P.); (R.P.)
| | - Antonella Gambale
- Medical Genetics Unit, Integrated Care Department of Laboratory and Transfusion Medicine, Federico II Hospital, 80131 Naples, Italy; (G.V.); (A.G.)
| | - Fabio Cattaneo
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Rosario Ammendola
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Paola Nappa
- Section of Dermatology, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (F.M.); (F.G.); (L.A.); (P.N.)
| | - Gabriella Esposito
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
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Esposito S, Zollo I, Villella VR, Scialò F, Giordano S, Esposito MV, Salemme N, Di Domenico C, Cernera G, Zarrilli F, Castaldo G, Amato F. Identification of an ultra-rare Alu insertion in the CFTR gene: Pitfalls and challenges in genetic test interpretation. Clin Chim Acta 2024; 558:118317. [PMID: 38580140 DOI: 10.1016/j.cca.2024.118317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 03/28/2024] [Accepted: 04/03/2024] [Indexed: 04/07/2024]
Abstract
Cystic fibrosis (CF) is a life-limiting genetic disorder characterized by defective chloride ion transport due to mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. Early detection through newborn screening programs significantly improves outcomes for individuals with CF by enabling timely intervention. Here, we report the identification of an Alu element insertion within the exon 15 of CFTR gene, initially overlooked in standard next-generation sequencing analyses. However, using traditional molecular techniques, based on polymerase chain reaction and Sanger sequencing, allowed the identification of the Alu element and the reporting of a correct diagnosis. Our analysis, based on bioinformatics tools and molecular techniques, revealed that the Alu element insertion severely affects the gene expression, splicing patterns, and structure of CFTR protein. In conclusion, this study emphasizes the importance of how the integration of human expertise and modern technologies represents a pivotal step forward in genomic medicine, ensuring the delivery of precision healthcare to individuals affected by genetic diseases.
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Affiliation(s)
- Speranza Esposito
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy; CEINGE- Advanced Biotechnologies Franco Salvatore, Naples, Italy
| | - Immacolata Zollo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy; CEINGE- Advanced Biotechnologies Franco Salvatore, Naples, Italy
| | - Valeria Rachela Villella
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy; CEINGE- Advanced Biotechnologies Franco Salvatore, Naples, Italy
| | - Filippo Scialò
- CEINGE- Advanced Biotechnologies Franco Salvatore, Naples, Italy; Department of Translational Medical Science, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Sonia Giordano
- AORN Ospedali dei Colli-Monaldi-Cotugno-CTO, Naples, Italy
| | | | - Nunzia Salemme
- San Giuseppe and Melorio Hospital, Santa Maria Capua Vetere, Caserta, Italy
| | | | - Gustavo Cernera
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy; CEINGE- Advanced Biotechnologies Franco Salvatore, Naples, Italy
| | - Federica Zarrilli
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy; CEINGE- Advanced Biotechnologies Franco Salvatore, Naples, Italy
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy; CEINGE- Advanced Biotechnologies Franco Salvatore, Naples, Italy
| | - Felice Amato
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy; CEINGE- Advanced Biotechnologies Franco Salvatore, Naples, Italy.
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Iacotucci P, Carnovale V, Ferrillo L, Somma J, Bocchino M, D’Ippolito M, Sanduzzi Zamparelli A, Rengo G, Ferrara N, Conti V, Corbi G. Cystic Fibrosis in Adults: A Paradigm of Frailty Syndrome? An Observational Study. J Clin Med 2024; 13:585. [PMID: 38276090 PMCID: PMC10816671 DOI: 10.3390/jcm13020585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/11/2024] [Accepted: 01/15/2024] [Indexed: 01/27/2024] Open
Abstract
This study aimed to assess the main clinical and anamnestic characteristics of adult Cystic Fibrosis (CF) patients and to evaluate the association of frailty with the CF genotyping classification. In an observational cross-sectional study, all ambulatory CF patients over 18 years old who received a diagnosis at the Regional Cystic Fibrosis Center for adults were enrolled and assessed by spirometry for respiratory function, by ADL and IADL for functional status, and by the Study of Osteoporotic Fractures (SOF) Index for frailty. The study population consisted of 139 CF patients (mean age 32.89 ± 10.94 years old, 46% women). Most of the subjects were robust (60.4%). The pre-frail/frail group was more frequently females (p = 0.020), had a lower BMI (p = 0.001), worse respiratory function, a higher number of pulmonary exacerbations/years, cycles of antibiotic therapy, and hospitalization (all p < 0.001) with respect to robust patients. The pre-frail/frail subjects used more drugs and were affected by more CF-related diseases (all p < 0.001). In relation to logistic regression, the best predictor of the pre-frail/frail status was a low FEV1 level. The CF patients show similarities to older pre-frail/frail subjects, suggesting that CF might be considered an early expression of this geriatric syndrome. This finding could help to better define the possible progression of CF, but overall, it could also suggest the usefulness employing of some tools used in the management and therapy of frailty subjects to identify the more severe CF subjects.
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Affiliation(s)
- Paola Iacotucci
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (P.I.); (M.B.); (A.S.Z.)
| | - Vincenzo Carnovale
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Lorenza Ferrillo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Jolanda Somma
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Marialuisa Bocchino
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (P.I.); (M.B.); (A.S.Z.)
| | - Marcella D’Ippolito
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Alessandro Sanduzzi Zamparelli
- Department of Clinical Medicine and Surgery, University of Naples “Federico II”, 80138 Naples, Italy; (P.I.); (M.B.); (A.S.Z.)
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Nicola Ferrara
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
| | - Valeria Conti
- Department of Medicine Surgery and Dentistry, Scuola Medica Salernitana, University of Salerno, Baronissi, 84084 Salerno, Italy;
| | - Graziamaria Corbi
- Department of Translational Medical Sciences, University of Naples “Federico II”, 80138 Naples, Italy; (L.F.); (J.S.); (M.D.); (G.R.); (N.F.); (G.C.)
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Caterino M, Fedele R, Carnovale V, Castaldo A, Gelzo M, Iacotucci P, Ruoppolo M, Castaldo G. Lipidomic alterations in human saliva from cystic fibrosis patients. Sci Rep 2023; 13:600. [PMID: 36635275 PMCID: PMC9837121 DOI: 10.1038/s41598-022-24429-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 11/15/2022] [Indexed: 01/14/2023] Open
Abstract
Cystic fibrosis is a hereditary metabolic disorder characterized by impaired traffic of chloride ions and water through membranes of the respiratory and gastrointestinal, that causes inadequate hydration of airway surfaces, dehydrated mucous secretions and a high-sodium chloride sweat. Although the classical presentation of the condition is well known, a better characterization of metabolic alterations related is need. In particular, the metabolic composition alterations of biological fluids may be influence by the disease state and could be captured as putative signature to set targeted therapeutic strategies. A targeted comprehensive mass spectrometry-based platform was employed to dissect the lipid content of saliva samples form CF patients, in order to investigate alterations in the lipid metabolic homeostasis related to the pathology, chronic obstructive pulmonary disease, Pseudomonas Aeruginosa infection, pancreatic insufficiency, liver disfunction and diabetes-related complications.
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Affiliation(s)
- Marianna Caterino
- grid.4691.a0000 0001 0790 385XDepartment of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, 80131 Naples, Italy ,grid.511947.f0000 0004 1758 0953CEINGE - Biotecnologie Avanzate F. Salvatore, s.c.ar.l, 80145 Napoli, Italy
| | - Roberta Fedele
- grid.511947.f0000 0004 1758 0953CEINGE - Biotecnologie Avanzate F. Salvatore, s.c.ar.l, 80145 Napoli, Italy
| | - Vincenzo Carnovale
- grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Alice Castaldo
- grid.4691.a0000 0001 0790 385XDepartment of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Monica Gelzo
- grid.4691.a0000 0001 0790 385XDepartment of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, 80131 Naples, Italy ,grid.511947.f0000 0004 1758 0953CEINGE - Biotecnologie Avanzate F. Salvatore, s.c.ar.l, 80145 Napoli, Italy
| | - Paola Iacotucci
- grid.4691.a0000 0001 0790 385XDepartment of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Margherita Ruoppolo
- Department of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, 80131, Naples, Italy. .,CEINGE - Biotecnologie Avanzate F. Salvatore, s.c.ar.l, 80145, Napoli, Italy.
| | - Giuseppe Castaldo
- grid.4691.a0000 0001 0790 385XDepartment of Molecular Medicine and Medical Biotechnology, School of Medicine, University of Naples Federico II, 80131 Naples, Italy ,grid.511947.f0000 0004 1758 0953CEINGE - Biotecnologie Avanzate F. Salvatore, s.c.ar.l, 80145 Napoli, Italy
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Cystic Fibrosis Patients with F508del/Minimal Function Genotype: Laboratory and Nutritional Evaluations after One Year of Elexacaftor/Tezacaftor/Ivacaftor Treatment. J Clin Med 2022; 11:jcm11236900. [PMID: 36498475 PMCID: PMC9735556 DOI: 10.3390/jcm11236900] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 11/03/2022] [Accepted: 11/21/2022] [Indexed: 11/24/2022] Open
Abstract
The last ten years have been characterized by an enormous step forward in the therapy and management of patients with Cystic Fibrosis (CF), thanks to the development and combination of Cystic Fibrosis Transmembrane Receptor (CFTR) correctors and potentiators. Specifically, the last approved triple combination elexacaftor/tezacaftor/ivacaftor has been demonstrated to improve lung function in CF patients with both homozygous Phe508del and Phe508del/minimal function genotypes. Here we have assessed the effect of elexacaftor/tezacaftor/ivacaftor in patients carrying the Phe508del/minimal function genotype (n = 20) after one year of treatments on liver function and nutrient absorption with a focus on lipid metabolism. We show that weight, BMI, and albumin significantly increase, suggesting a positive impact of the treatment on nutrient absorption. Furthermore, cholesterol levels as a biomarker of lipid metabolism increased significantly after one year of treatment. Most importantly, we suggest that these results were not dependent on the diet composition, possibly indicating that the drug improves the hepatic synthesis and secretion of proteins and cholesterol.
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ECFS standards of care on CFTR-related disorders: Updated diagnostic criteria. J Cyst Fibros 2022; 21:908-921. [DOI: 10.1016/j.jcf.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/07/2022]
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Tosco A, Castaldo A, Colombo C, Claut L, Carnovale V, Iacotucci P, Lucarelli M, Cimino G, Fabrizzi B, Caporelli N, Majo F, Ciciriello F, Padoan R, Poli P, Taccetti G, Centrone C, Casciaro R, Castellani C, Salvatore D, Colangelo C, Bonomi P, Castaldo G, Terlizzi V. Clinical outcomes of a large cohort of individuals with the F508del/5T;TG12 CFTR genotype. J Cyst Fibros 2022; 21:850-855. [PMID: 35523714 DOI: 10.1016/j.jcf.2022.04.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 03/16/2022] [Accepted: 04/26/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND In recent years, patients with cystic fibrosis (CF) conductance regulator (CFTR) variant poly(T) sequences have been increasingly reported with a wide spectrum of clinical severity. We describe the long-term clinical outcomes and progression to a CF diagnosis over time in a large Italian cohort of patients carrying the CFTR F508del/5T;TG12 genotype. METHODS A retrospective analysis of subjects from 10 CF centres in Italy with the F508del/5T;TG12 genotype was performed. Demographic, clinical, microbiological, and biochemical data, as well as information about the follow-ups and complications of the enroled patients, were collected. RESULTS A total of 129 subjects (54 females; median age: 15.0 years, range: 0-58 years; 59 older than 18 years) were included. In terms of initial diagnoses, 30 were CF (23.3%), 41 were CFTR-related disorder (CFTR-RD) (31.7%), and 58 were CF transmembrane conductance regulator-related metabolic syndrome/cystic fibrosis screen positive, inconclusive diagnosis (CRMS/CFSPID) (45.0%). After a median follow-up of 6.7 years (range 0.2-25 years), 15 patients progressed to CF, bringing the total number of CF diagnoses to 45/129 (34.9%). Most of these patients had mild lung diseases with pancreatic sufficiency and a low prevalence of CF-related complications. CONCLUSIONS At the end of the study, 34.9% of subjects with the CFTR F508del/5T;TG12 genotype were diagnosed with CF. We suggest including patients with the F508del/5T;TG12 genotype in long-term follow-ups.
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Affiliation(s)
- Antonella Tosco
- Paediatric Unit, Department of Translational Medical Sciences, Cystic Fibrosis Regional Reference Center, University of Naples Federico II, Naples, Italy
| | - Alice Castaldo
- Paediatric Unit, Department of Translational Medical Sciences, Cystic Fibrosis Regional Reference Center, University of Naples Federico II, Naples, Italy
| | - Carla Colombo
- Cystic Fibrosis Regional Reference Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Laura Claut
- Cystic Fibrosis Regional Reference Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy
| | - Vincenzo Carnovale
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Paola Iacotucci
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Marco Lucarelli
- Dept of Experimental Medicine, Sapienza University of Rome, Rome, Italy; Pasteur Institute, Cenci Bolognetti Foundation, Sapienza University of Rome, Rome, Italy
| | - Giuseppe Cimino
- Cystic Fibrosis Regional Reference Center, A.O.U. Policlinico Umberto I, Rome, Italy
| | - Benedetta Fabrizzi
- Cystic Fibrosis Regional Reference Center, Mother - Child Department, United Hospitals, Ancona, Italy
| | - Nicole Caporelli
- Cystic Fibrosis Regional Reference Center, Mother - Child Department, United Hospitals, Ancona, Italy
| | - Fabio Majo
- Cystic Fibrosis Centre, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Fabiana Ciciriello
- Cystic Fibrosis Centre, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Rita Padoan
- Cystic Fibrosis Regional Support Center, Department of Pediatrics, University of Brescia, ASST Spedali Civili Brescia, Brescia, Italy
| | - Piercarlo Poli
- Cystic Fibrosis Regional Support Center, Department of Pediatrics, University of Brescia, ASST Spedali Civili Brescia, Brescia, Italy
| | - Giovanni Taccetti
- Meyer Children's Hospital, Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Viale Gaetano Pieraccini 24, Florence, Italy
| | - Claudia Centrone
- Diagnostic Genetics Unit, Careggi University Hospital, Florence, Italy
| | | | | | | | | | | | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, Naples, Italy; CEINGE-Advanced Biotechnology, Naples, Italy
| | - Vito Terlizzi
- Meyer Children's Hospital, Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Viale Gaetano Pieraccini 24, Florence, Italy.
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Carnovale V, Castaldo A, Di Minno A, Gelzo M, Iacotucci P, Illiano A, Pinto G, Castaldo G, Amoresano A. Oxylipin profile in saliva from patients with cystic fibrosis reveals a balance between pro-resolving and pro-inflammatory molecules. Sci Rep 2022; 12:5838. [PMID: 35393448 PMCID: PMC8991203 DOI: 10.1038/s41598-022-09618-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 03/25/2022] [Indexed: 11/25/2022] Open
Abstract
Oxylipins are signaling molecules originated by fatty acids that modulate vascular and bronchial tone, bronchial secretion, cytokine production and immune cell activity. The unbalanced production of pro-inflammatory and pro-resolving (i.e., anti-inflammatory) oxylipins has a relevant role in the pathogenesis of pulmonary inflammation like in cystic fibrosis (CF). We analyzed by LC-MRM/MS 65 oxylipins and 4 fatty acids in resting saliva from 69 patients with CF and 50 healthy subjects (controls). The salivary levels of 48/65 oxylipins were significantly different between CF patients and controls. Among these, EpETE, DHET, 6ketoPGE1 and HDHA were significantly higher in saliva from CF patients than in controls. All these molecules display anti-inflammatory effects, i.e., releasing of bronchial and vascular tone, modulation of cytokine release. While 20-hydroxyPGF2A, PGB2, EpDPE, 9 K-12-ELA, bicyclo-PGE2, oleic acid, LTC4, linoleic acid, 15oxoEDE, 20 hydroxyPGE2 and DHK-PGD2/PGE2 (mostly associated to pro-inflammatory effects) resulted significantly lower in CF patients than in controls. Our data suggest that the salivary oxylipins profile in CF patients is addressed toward a global anti-inflammatory effect. Although these findings need be confirmed on larger populations in prospective studies, they will contribute to better understand the pathogenesis of CF chronic inflammation and to drive targeted therapies based on the modulation of oxylipins synthesis and degradation.
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Affiliation(s)
- Vincenzo Carnovale
- Centro Di Riferimento Regionale Fibrosi Cistica, Naples, Italy.,Dipartimento Di Scienze Mediche Traslazionali, Università Di Napoli Federico II, Naples, Italy
| | - Alice Castaldo
- Centro Di Riferimento Regionale Fibrosi Cistica, Naples, Italy.,Dipartimento Di Scienze Mediche Traslazionali, Università Di Napoli Federico II, Naples, Italy
| | - Alessandro Di Minno
- Dipartimento Di Farmacia, Università Di Napoli Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Scarl, Naples, Italy
| | - Monica Gelzo
- CEINGE-Biotecnologie Avanzate, Scarl, Naples, Italy.,Dipartimento Di Medicina Molecolare E Biotecnologie Mediche, Università Di Napoli Federico II, Naples, Italy
| | - Paola Iacotucci
- Centro Di Riferimento Regionale Fibrosi Cistica, Naples, Italy.,Dipartimento Di Scienze Mediche Traslazionali, Università Di Napoli Federico II, Naples, Italy
| | - Anna Illiano
- Dipartimento Di Scienze Chimiche, Università Di Napoli Federico II, Naples, Italy.,Consorzio Interuniversitario "Istituto Nazionale Nazionale Biostrutture E Biosistemi (INBB)", Rome, Italy
| | - Gabriella Pinto
- Dipartimento Di Scienze Chimiche, Università Di Napoli Federico II, Naples, Italy.,Consorzio Interuniversitario "Istituto Nazionale Nazionale Biostrutture E Biosistemi (INBB)", Rome, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie Avanzate, Scarl, Naples, Italy. .,Dipartimento Di Medicina Molecolare E Biotecnologie Mediche, Università Di Napoli Federico II, Naples, Italy.
| | - Angela Amoresano
- Dipartimento Di Scienze Chimiche, Università Di Napoli Federico II, Naples, Italy.,Consorzio Interuniversitario "Istituto Nazionale Nazionale Biostrutture E Biosistemi (INBB)", Rome, Italy
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9
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Carnovale V, Iacotucci P, Terlizzi V, Colangelo C, Medio P, Ferrillo L, De Gregorio F, Francalanci M, Taccetti G, Buonaurio S, d'Ippolito M, Marsicovetere G, D'Andria M, Ferrara N, Salvatore D. Effectiveness and safety of elexacaftor/tezacaftor/ivacaftor in patients with cystic fibrosis and advanced lung disease with the Phe508del/minimal function genotype. Respir Med 2021; 189:106646. [PMID: 34673344 DOI: 10.1016/j.rmed.2021.106646] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/31/2021] [Accepted: 10/06/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Elexacaftor/tezacaftor/ivacaftor (E/T/I) is a cystic fibrosis transmembrane conductance regulator (CFTR) triple combination therapy used for the treatment of cystic fibrosis (CF) in patients aged ≥12 years who have at least one copy of the Phe508del mutation (F) in the CFTR gene or another mutation that is responsive to treatment with E/T/I. This study determined the effectiveness and safety of E/T/I treatment in a cohort of CF patients. METHODS This retrospective cohort study collected data from the first 6 months of treatment of patients with CF, compound heterozygotes for the F and a minimal function (MF) mutations, enrolled in an E/T/I compassionate use program only available to patients having ppFEV1<40 or who are considered for lung transplantation. Forty-seven patients were included. Follow-up was performed after 1, 3, and 6 months from the beginning of therapy, assessing lung function, body mass index (BMI), sweat chloride concentration (SCC), quality of life (QoL), and safety. RESULTS After 6 months of treatment, the mean (standard deviation (SD)) SCC decreased from 91.1 (19.3) mmol/L to 46.2 (24.2) mmol/L. The decrease of SCC was accompanied by improvement of lung function (mean (95% Confidence Interval (CI) absolute increase in ppFEV1 was 10.69 (8.05,13.33) after 1 month and 14.16 (11.43, 16.89) after 6 months of treatment), nutrition (mean (SD) BMI increased from 20.7 (3.0) kg/m2 at baseline to 22.6 (3.1) after 6 months), and QoL. No safety concerns were observed. CONCLUSIONS E/T/I was clinically effective and safe in patients with advanced CF lung disease with an F/MF genotype.
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Affiliation(s)
- Vincenzo Carnovale
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy.
| | - Paola Iacotucci
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Vito Terlizzi
- Cystic Fibrosis Center, Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | | | - Pietro Medio
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Lorenza Ferrillo
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | | | - Michela Francalanci
- Cystic Fibrosis Center, Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - Giovanni Taccetti
- Cystic Fibrosis Center, Department of Paediatric Medicine, Anna Meyer Children's University Hospital, Florence, Italy
| | - Serena Buonaurio
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | - Marcella d'Ippolito
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
| | | | | | - Nicola Ferrara
- Department of Translational Medical Science, Cystic Fibrosis Center, Adult Unit, University of Naples "Federico II", Italy
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10
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Gelzo M, Iacotucci P, Sica C, Liguori R, Comegna M, Carnovale V, Dello Russo A, Corso G, Castaldo G. Influence of pancreatic status on circulating plasma sterols in patients with cystic fibrosis. Clin Chem Lab Med 2021; 58:1725-1730. [PMID: 32083440 DOI: 10.1515/cclm-2019-1112] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 12/26/2019] [Indexed: 12/12/2022]
Abstract
Background Patients with cystic fibrosis (CF) have a reduced intestinal absorption of cholesterol and in a preliminary study we observed differences in plasma sterol profile between patients with pancreatic sufficiency (PS) and those with pancreatic insufficiency (PI). Therefore, we hypothesized that the sterol analysis may contribute to study the digestion and absorption state of lipids in patients with CF. To this aim we evaluated plasma sterols in a significant number of adult patients with CF in relation to the pancreatic status. Methods Beside cholesterol, we measured phytosterols and lathosterol as markers of intestinal absorption and hepatic biosynthesis, respectively, by gas-chromatography in plasma of adult CF patients with pancreatic sufficiency (PS-CF, n = 57), insufficiency (PI-CF, n = 97) and healthy subjects (control group, CT, n = 71). Results PI-CF patients had cholesterol and phytosterols levels significantly lower than PS-CF and CT (p < 5 × 10-10) suggesting a reduced intestinal absorption of sterols related to PI. Instead, lathosterol was significantly higher in PI-CF patients than PS-CF and CT (p < 0.0003) indicating an enhanced cholesterol biosynthesis. In PI-CF patients, phytosterols positively correlate with vitamin E (p = 0.004). Both the classes of molecules need cholesterol esterase for the intestinal digestion, thus the reduced levels of such lipids in serum from PI-CF patients may depend on a reduced enzyme activity, despite the pancreatic enzyme supplementation in all PI-CF patients. Conclusions A plasma sterols profile may be useful to evaluate the metabolic status of lipids in adult patients with CF and could help to manage the pancreatic enzyme supplementation therapy.
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Affiliation(s)
- Monica Gelzo
- CEINGE Advanced Biotechnologies s.c.a.r.l., Naples, Italy.,Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Paola Iacotucci
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Concetta Sica
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Renato Liguori
- Department of Science and Technology, University of Naples Parthenope, Naples, Italy
| | - Marika Comegna
- CEINGE Advanced Biotechnologies s.c.a.r.l., Naples, Italy.,Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Vincenzo Carnovale
- Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy
| | - Antonio Dello Russo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
| | - Gaetano Corso
- Department of Clinical and Experimental Medicine, University of Foggia, Viale L. Pinto 1, 71122 Foggia, Italy
| | - Giuseppe Castaldo
- CEINGE Advanced Biotechnologies s.c.a.r.l., Naples, Italy.,Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy
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11
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Terlizzi V, Colangelo C, Marsicovetere G, D’Andria M, Francalanci M, Innocenti D, Masi E, Avarello A, Taccetti G, Amato F, Comegna M, Castaldo G, Salvatore D. Effectiveness of Elexacaftor/Tezacaftor/Ivacaftor Therapy in Three Subjects with the Cystic Fibrosis Genotype Phe508del/Unknown and Advanced Lung Disease. Genes (Basel) 2021; 12:genes12081178. [PMID: 34440351 PMCID: PMC8391133 DOI: 10.3390/genes12081178] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 07/26/2021] [Accepted: 07/28/2021] [Indexed: 12/15/2022] Open
Abstract
We evaluated the effectiveness and safety of elexacaftor/tezacaftor/ivacaftor (ELX/TEZ/IVA) in three subjects carrying the Phe508del/unknown CFTR genotype. An ex vivo analysis on nasal epithelial cells (NEC) indicated a significant improvement of CFTR gating activity after the treatment. Three patients were enrolled in an ELX/TEZ/IVA managed-access program, including subjects with the highest percent predicted Forced Expiratory Volume in the 1st second (ppFEV1) < 40 in the preceding 3 months. Data were collected at baseline and after 8, 12 and 24 weeks of follow-up during treatment. All patients showed a considerable decrease of sweat chloride (i.e., meanly about 60 mmol/L as compared to baseline), relevant improvement of ppFEV1 (i.e., >8) and six-minute walk test, and an increase in body mass index after the first 8 weeks of treatment. No pulmonary exacerbations occurred during the 24 weeks of treatment and all domains of the CF Questionnaire-Revised improved. No safety concerns related to the treatment occurred. This study demonstrates the benefit from the ELX/TEZ/IVA treatment in patients with CF with the Phe508del and one unidentified CFTR variant. The preliminary ex vivo analysis of the drug response on NEC helps to predict the in vivo therapeutic endpoints.
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Affiliation(s)
- Vito Terlizzi
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
- Correspondence: ; Tel.: +39-0555-662474
| | - Carmela Colangelo
- Cystic Fibrosis Center, AOR Ospedale San Carlo, 19104 Potenza, Italy; (C.C.); (G.M.); (M.D.); (D.S.)
| | - Giovanni Marsicovetere
- Cystic Fibrosis Center, AOR Ospedale San Carlo, 19104 Potenza, Italy; (C.C.); (G.M.); (M.D.); (D.S.)
| | - Michele D’Andria
- Cystic Fibrosis Center, AOR Ospedale San Carlo, 19104 Potenza, Italy; (C.C.); (G.M.); (M.D.); (D.S.)
| | - Michela Francalanci
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
| | - Diletta Innocenti
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
| | - Eleonora Masi
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
| | - Angelo Avarello
- Infectious and Tropical Diseases Unit, Azienda Ospedaliero-Universitaria Careggi, 50134 Florence, Italy;
| | - Giovanni Taccetti
- Cystic Fibrosis Regional Reference Center, Department of Paediatric Medicine, Anna Meyer Children’s University, 50139 Florence, Italy; (M.F.); (D.I.); (E.M.); (G.T.)
| | - Felice Amato
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, 20122 Naples, Italy; (F.A.); (M.C.); (G.C.)
- CEINGE—Advanced Biotechnology, 20122 Naples, Italy
| | - Marika Comegna
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, 20122 Naples, Italy; (F.A.); (M.C.); (G.C.)
- CEINGE—Advanced Biotechnology, 20122 Naples, Italy
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples, 20122 Naples, Italy; (F.A.); (M.C.); (G.C.)
- CEINGE—Advanced Biotechnology, 20122 Naples, Italy
| | - Donatello Salvatore
- Cystic Fibrosis Center, AOR Ospedale San Carlo, 19104 Potenza, Italy; (C.C.); (G.M.); (M.D.); (D.S.)
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12
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Suay-Corredera C, Pricolo MR, Herrero-Galán E, Velázquez-Carreras D, Sánchez-Ortiz D, García-Giustiniani D, Delgado J, Galano-Frutos JJ, García-Cebollada H, Vilches S, Domínguez F, Molina MS, Barriales-Villa R, Frisso G, Sancho J, Serrano L, García-Pavía P, Monserrat L, Alegre-Cebollada J. Protein haploinsufficiency drivers identify MYBPC3 variants that cause hypertrophic cardiomyopathy. J Biol Chem 2021; 297:100854. [PMID: 34097875 PMCID: PMC8260873 DOI: 10.1016/j.jbc.2021.100854] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 05/21/2021] [Accepted: 06/03/2021] [Indexed: 02/06/2023] Open
Abstract
Hypertrophic cardiomyopathy (HCM) is the most common inherited cardiac disease. Variants in MYBPC3, the gene encoding cardiac myosin-binding protein C (cMyBP-C), are the leading cause of HCM. However, the pathogenicity status of hundreds of MYBPC3 variants found in patients remains unknown, as a consequence of our incomplete understanding of the pathomechanisms triggered by HCM-causing variants. Here, we examined 44 nontruncating MYBPC3 variants that we classified as HCM-linked or nonpathogenic according to cosegregation and population genetics criteria. We found that around half of the HCM-linked variants showed alterations in RNA splicing or protein stability, both of which can lead to cMyBP-C haploinsufficiency. These protein haploinsufficiency drivers associated with HCM pathogenicity with 100% and 94% specificity, respectively. Furthermore, we uncovered that 11% of nontruncating MYBPC3 variants currently classified as of uncertain significance in ClinVar induced one of these molecular phenotypes. Our strategy, which can be applied to other conditions induced by protein loss of function, supports the idea that cMyBP-C haploinsufficiency is a fundamental pathomechanism in HCM.
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Affiliation(s)
| | - Maria Rosaria Pricolo
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | | | | | | | | | - Javier Delgado
- EMBL/CRG Systems Biology Research Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain
| | - Juan José Galano-Frutos
- Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, Zaragoza, Spain; Biocomputation and Complex Systems Physics Institute (BIFI). Joint Units BIFI-IQFR (CSIC) and GBs-CSIC, Universidad de Zaragoza, Zaragoza, Spain
| | - Helena García-Cebollada
- Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, Zaragoza, Spain; Biocomputation and Complex Systems Physics Institute (BIFI). Joint Units BIFI-IQFR (CSIC) and GBs-CSIC, Universidad de Zaragoza, Zaragoza, Spain
| | - Silvia Vilches
- Heart Failure and Inherited Cardiac Diseases Unit. Department of Cardiology. Hospital Universitario Puerta de Hierro, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART), Madrid, Spain
| | - Fernando Domínguez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Heart Failure and Inherited Cardiac Diseases Unit. Department of Cardiology. Hospital Universitario Puerta de Hierro, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART), Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain
| | - María Sabater Molina
- European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART), Madrid, Spain; Hospital C. Universitario Virgen de la Arrixaca, El Palmar, Murcia, Spain
| | - Roberto Barriales-Villa
- Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Unidad de Cardiopatías Familiares, Instituto de Investigación Biomédica de A Coruña (INIBIC), Complexo Hospitalario Universitario de A Coruña, Servizo Galego de Saúde (SERGAS), Universidade da Coruña, A Coruña, Spain
| | - Giulia Frisso
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy; CEINGE Biotecnologie Avanzate, scarl, Naples, Italy
| | - Javier Sancho
- Departamento de Bioquímica y Biología Molecular y Celular, Facultad de Ciencias, Universidad de Zaragoza, Zaragoza, Spain; Biocomputation and Complex Systems Physics Institute (BIFI). Joint Units BIFI-IQFR (CSIC) and GBs-CSIC, Universidad de Zaragoza, Zaragoza, Spain; Aragon Health Research Institute (IIS Aragón), Zaragoza, Spain
| | - Luis Serrano
- EMBL/CRG Systems Biology Research Unit, Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain; Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain; Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Pablo García-Pavía
- Heart Failure and Inherited Cardiac Diseases Unit. Department of Cardiology. Hospital Universitario Puerta de Hierro, Madrid, Spain; European Reference Network for Rare and Low Prevalence Complex Diseases of the Heart (ERN GUARD-HEART), Madrid, Spain; Centro de Investigación Biomédica en Red en Enfermedades Cardiovasculares (CIBERCV), Madrid, Spain; Universidad Francisco de Vitoria (UFV), Pozuelo de Alarcón, Madrid, Spain
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13
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Cimbalo C, Tosco A, Terlizzi V, Sepe A, Castaldo A, Salvadori L, Raia V. Elevated sweat chloride test: is it always cystic fibrosis? Ital J Pediatr 2021; 47:112. [PMID: 33990208 PMCID: PMC8120719 DOI: 10.1186/s13052-021-01060-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 04/27/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The sweat chloride test (ST) is the gold standard for cystic fibrosis (CF) diagnosis in symptomatic patients, within the newborn screening and in the follow-up of CF patients during molecular therapies. However, false positives have been reported in patients with different diseases. We describe and discuss 4 cases due to different clinical conditions in which we recorded false positive ST, and the test remained altered for a period of varying length. CASES PRESENTATION Case 1: Eight months old female child suffering from constipation, recurrent vomiting and failure to thrive, family history of recurrent pancreatitis without mutations in the PRSS1 and SPINK1 genes. Both ST and fecal elastase were altered although no CFTR gene mutations were found. Due to rapid clinical deterioration, celiac disease was suspected and diagnosed by laboratory tests and intestinal biopsy. After 2 weeks of gluten-free diet ST and fecal elastase normalized. Case 2: 14 months old male suffering from bilateral renal dysplasia, episodes of metabolic alkalosis, recurrent respiratory infections and recurrent vomiting. The child had more ST positives, but no CFTR mutations were found. During follow-up, he developed sensorineural hearing loss and an atrial septic defect was found. Finally, a diagnosis of Klinefelter was made, but the ST normalized several years later. Case 3 and 4: Two boys with stubborn constipation and fecal occlusion treated with Poly Ethylene Glycol (PEG) with salts showed pathological ST. The test returned normal a few days after stopping treatment. CONCLUSIONS We hypotesized the possible causes of ST alteration in these conditions: in celiac disease it could be due to a transient dysregulation of the aquaporins, rapidly reversed by the diet; in Klinefelter, it may be due to stable pubertal hypoandrogenism; while, the PEG formulation itself contains salts that can temporarily alter ST.
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Affiliation(s)
- C Cimbalo
- Department of Translational Medical Sciences, Cystic Fibrosis Center, University Federico II, Naples, Italy.
| | - A Tosco
- Department of Translational Medical Sciences, Cystic Fibrosis Center, University Federico II, Naples, Italy
| | - V Terlizzi
- Department of Paediatric Medicine, Cystic Fibrosis Centre, Anna Meyer Children's University Hospital, Florence, Italy
| | - A Sepe
- Department of Translational Medical Sciences, Cystic Fibrosis Center, University Federico II, Naples, Italy
| | - A Castaldo
- Department of Translational Medical Sciences, Cystic Fibrosis Center, University Federico II, Naples, Italy
| | - L Salvadori
- Department of Translational Medical Sciences, Cystic Fibrosis Center, University Federico II, Naples, Italy
| | - V Raia
- Department of Translational Medical Sciences, Cystic Fibrosis Center, University Federico II, Naples, Italy
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14
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Extensive CFTR Gene Analysis Revealed a Higher Occurrence of Cystic Fibrosis Transmembrane Regulator-Related Disorders (CFTR-RD) among CF Carriers. J Clin Med 2020; 9:jcm9123853. [PMID: 33260873 PMCID: PMC7760778 DOI: 10.3390/jcm9123853] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/23/2020] [Accepted: 11/25/2020] [Indexed: 12/03/2022] Open
Abstract
Background: A wide range of cystic fibrosis (CF)-related conditions are reported in CF carriers, but no study has explored the possibility that such subjects may be affected by cystic fibrosis transmembrane regulator-related disorders (CFTR-RD). No data are available so far on the occurrence of CFTR-RD among CF carriers. Methods: We studied 706 CF carriers—first- and second-degree relatives of CF patients that carried the parental mutation; such subjects were divided in two groups: a first group (353 subjects, group A) performed at first only the analysis of the CFTR proband mutation; we retrospectively evaluated the number of cases that had been diagnosed as CFTR-RD based on subsequent symptoms; a second group (353 subjects, group B) performed extensive CFTR molecular analysis in absence of any reported symptoms, followed by a clinical evaluation in cases that carry a second CFTR mutation; we evaluated the number of cases that prospectively were diagnosed as CFTR-RD. Results: We found seven (2.0%) out of 353 subjects of group A and 24 (6.8%) out of 353 subjects of group B as affected by CFTR-RD (chi square, p = 0.002). Conclusions: A percentage of CF carriers are affected by undiagnosed CFTR-RD. Genetic tasting scanning analysis helps to identify CFTR-RD, some of which may benefit from follow-up and specific therapies improving their outcome.
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15
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Impaired Ratio of Unsaturated to Saturated Non-Esterified Fatty Acids in Saliva from Patients with Cystic Fibrosis. Diagnostics (Basel) 2020; 10:diagnostics10110915. [PMID: 33171650 PMCID: PMC7695280 DOI: 10.3390/diagnostics10110915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/02/2020] [Accepted: 11/06/2020] [Indexed: 12/17/2022] Open
Abstract
Impaired salivary non-esterified fatty acids (NEFA) levels have been previously observed in cystic fibrosis (CF). This study aimed to characterize the salivary NEFA profile in CF and to examine whether the alterations are related to the pancreatic status and/or lung disease severity. We analyzed salivary NEFA, cholesterol and interleukin-6 (IL-6) in CF patients (n = 66) and healthy subjects (n = 48). CF patients showed higher salivary levels of cholesterol, total NEFA (that was negatively correlated with serum triglycerides), unsaturated NEFA/saturated NEFA (U/S NEFA) ratio and IL-6 than controls. The U/S NEFA ratio was positively correlated with IL-6 in both patients and controls, suggesting an association between this parameter and local inflammation independently from the disease. No correlation between salivary lipids and pancreatic status was observed, while the U/S NEFA ratio was higher in patients with severe lung disease than mild/moderate severity and may represent a prognostic marker of lung disease in CF.
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16
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Castaldo A, Cimbalo C, Castaldo RJ, D’Antonio M, Scorza M, Salvadori L, Sepe A, Raia V, Tosco A. Cystic Fibrosis-Screening Positive Inconclusive Diagnosis: Newborn Screening and Long-Term Follow-Up Permits to Early Identify Patients with CFTR-Related Disorders. Diagnostics (Basel) 2020; 10:diagnostics10080570. [PMID: 32784480 PMCID: PMC7460402 DOI: 10.3390/diagnostics10080570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/22/2022] Open
Abstract
Background: Newborn screening (NBS) early-identifies cystic fibrosis (CF), but in CF-screening positive inconclusive diagnosis (CF-SPID) the results of immunoreactive trypsinogen (IRT), molecular analysis and sweat test (ST) are discordant. A percentage of CF-SPID evolves to CF, but data on long-term monitoring are lacking. We describe the follow-up of all CF and CF-SPID identified between 2008 and 2019. Methods: NBS was performed by IRT followed by molecular analysis and ST between 2008 and 2014; double IRT followed by molecular analysis and ST after 2014. Results: NBS revealed 47 CF and 99 CF-SPID newborn, a ratio 1:2.1—the highest reported so far. This depends on the identification by gene sequencing of the second variant with undefined effect in 40 CF-SPID that otherwise would have been defined as carriers. Clinical complications and pulmonary infections occurred more frequently among CF patients than among CF-SPID. Two CF-SPID cases evolved to CF (at two years), while eight evolved to CFTR-related disorders (CFTR-RD), between one and eight years, with bronchiectasis (two), recurrent pneumonia (four, two with sinonasal complications), recurrent pancreatitis (two). No clinical, biochemical or imaging data predicted the evolution. Conclusion: Gene sequencing within the NBS reveals a higher number of CF-SPID and we first describe an approach to early identify CFTR-RD, with relevant impact on their outcome.
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Affiliation(s)
- Alice Castaldo
- Department of Translational Medical Sciences, Cystic Fibrosis Centre, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (R.J.C.); (L.S.); (A.S.); (V.R.); (A.T.)
- Correspondence: ; Tel.: +39-3480360653
| | - Chiara Cimbalo
- Department of Translational Medical Sciences, Cystic Fibrosis Centre, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (R.J.C.); (L.S.); (A.S.); (V.R.); (A.T.)
| | - Raimondo J. Castaldo
- Department of Translational Medical Sciences, Cystic Fibrosis Centre, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (R.J.C.); (L.S.); (A.S.); (V.R.); (A.T.)
| | - Marcella D’Antonio
- CEINGE-Advanced Biotechnology, Via Gaetano Salvatore 486, 80145 Naples, Italy; (M.D.); (M.S.)
| | - Manuela Scorza
- CEINGE-Advanced Biotechnology, Via Gaetano Salvatore 486, 80145 Naples, Italy; (M.D.); (M.S.)
| | - Laura Salvadori
- Department of Translational Medical Sciences, Cystic Fibrosis Centre, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (R.J.C.); (L.S.); (A.S.); (V.R.); (A.T.)
| | - Angela Sepe
- Department of Translational Medical Sciences, Cystic Fibrosis Centre, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (R.J.C.); (L.S.); (A.S.); (V.R.); (A.T.)
| | - Valeria Raia
- Department of Translational Medical Sciences, Cystic Fibrosis Centre, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (R.J.C.); (L.S.); (A.S.); (V.R.); (A.T.)
| | - Antonella Tosco
- Department of Translational Medical Sciences, Cystic Fibrosis Centre, University Federico II, Via Sergio Pansini 5, 80131 Naples, Italy; (C.C.); (R.J.C.); (L.S.); (A.S.); (V.R.); (A.T.)
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17
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Lumacaftor/ivacaftor improves liver cholesterol metabolism but does not influence hypocholesterolemia in patients with cystic fibrosis. J Cyst Fibros 2020; 20:e1-e6. [PMID: 32586737 DOI: 10.1016/j.jcf.2020.06.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Cystic fibrosis (CF) patients have reduced intestinal absorption of sterols and, despite enhanced endogenous synthesis, low plasma cholesterol. Lumacaftor/ivacaftor CFTR protein modulator therapy is used to improve the clinical outcome of CF patients homozygous for F508del mutation (homo-deltaF508). Aim of the study is to evaluate the cholesterol metabolism and hepatobiliary injury/function in adult homo-deltaF508 patients, before and after lumacaftor/ivacaftor treatment. Baseline parameters in homo-deltaF508 patients were compared to those in CF patients compound heterozygous for F508del mutation and another severe mutation (hetero-deltaF508). METHODS Cholesterol metabolism was evaluated measuring plasma phytosterols and cholestanol, as intestinal absorption markers, and lathosterol, as liver biosynthesis marker. We quantified serum vitamin E, as nutritional marker. We evaluated liver injury by aspartate aminotransferase (AST) and alanine transaminase (ALT), biliary injury by γ-glutamyltransferase (γGT) and AP, and the liver function by bilirubin and albumin. RESULTS Before the treatment, homo-deltaF508 patients (n = 20) had significantly lower cholesterol and vitamin E compared to hetero-deltaF508 (n = 20). Lumacaftor/ivacaftor treatment caused: 1) further reduction of cholesterol; 2) lathosterol reduction, suggesting a normalization of endogenous synthesis; 3) cholestanol and vitamin E increment, indicating an improvement of lipid digestion/absorption. Vitamin E difference (after-before treatment) was positively associated to treatment months. Alkaline phosphatase was also reduced. CONCLUSIONS These data suggest an effect of lumacaftor/ivacaftor on cholesterol metabolism and enterohepatic flux in CF patients. However, lumacaftor/ivacaftor does not promote the increase of cholesterol serum concentration that on the contrary declines. Further studies are needed to research the real mechanism causing this reduction.
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18
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Castaldo A, Iacotucci P, Carnovale V, Cimino R, Liguori R, Comegna M, Raia V, Corso G, Castaldo G, Gelzo M. Salivary Cytokines and Airways Disease Severity in Patients with Cystic Fibrosis. Diagnostics (Basel) 2020; 10:diagnostics10040222. [PMID: 32326546 PMCID: PMC7235910 DOI: 10.3390/diagnostics10040222] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 03/31/2020] [Accepted: 04/13/2020] [Indexed: 02/06/2023] Open
Abstract
About 50% of patients with cystic fibrosis (CF) have sinonasal complications, which include inferior turbinate hypertrophy (NTH) and/or nasal polyposis (NP), and different degrees of lung disease, which represents the main cause of mortality. Monitoring of sinonasal disease requires complex instrumental procedures, while monitoring of lung inflammation requires invasive collection of bronchoalveolar lavage fluid. The aim of this study was to investigate the associations between salivary cytokines levels and CF-related airway diseases. Salivary biochemical parameters and cytokines, i.e., interleukin-6 (IL-6), IL-8, and tumor necrosis factor alpha (TNF-α), were analyzed in resting saliva from healthy subjects and patients with CF. Patients with CF showed significantly higher levels of salivary chloride, IL-6, IL-8, and TNF-α and lower calcium levels than healthy subjects. Among patients with CF, IL-6 and IL-8 were significantly higher in patients with NTH, while TNF-α was significantly lower in patients with NP. A decreasing trend of TNF-α in patients with severe lung disease was also observed. On the other hand, we did not find significant correlation between cytokine levels and Pseudomonas aeruginosa or Stenotrophomonas maltophilia colonization. These preliminary results suggest that salivary IL-6 and IL-8 levels increase during the acute phase of sinonasal disease (i.e., NTH), while the end stages of pulmonary disease and sinonasal disease (i.e., NP) show decreased TNF-α levels.
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Affiliation(s)
- Alice Castaldo
- Dipartimento di Scienze Mediche Traslazionali, University of Naples Federico II, 80131 Naples, Italy; (A.C.); (P.I.); (V.C.); (V.R.)
| | - Paola Iacotucci
- Dipartimento di Scienze Mediche Traslazionali, University of Naples Federico II, 80131 Naples, Italy; (A.C.); (P.I.); (V.C.); (V.R.)
| | - Vincenzo Carnovale
- Dipartimento di Scienze Mediche Traslazionali, University of Naples Federico II, 80131 Naples, Italy; (A.C.); (P.I.); (V.C.); (V.R.)
| | - Roberta Cimino
- Dipartimento di Neuroscienze, Scienze Riproduttive ed Odontostomatologiche, University of Naples Federico II, 80131 Naples, Italy;
| | - Renato Liguori
- Dipartimento di Scienze e Tecnologie, University of Naples Parthenope, 80133 Naples, Italy;
| | - Marika Comegna
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, University of Naples Federico II, 80138 Naples, Italy; (M.C.); (M.G.)
- CEINGE-Biotecnologie Avanzate, 80145 Naples, Italy
| | - Valeria Raia
- Dipartimento di Scienze Mediche Traslazionali, University of Naples Federico II, 80131 Naples, Italy; (A.C.); (P.I.); (V.C.); (V.R.)
| | - Gaetano Corso
- Dipartimento di Medicina Clinica e Sperimentale, University of Foggia, 71122 Foggia, Italy;
| | - Giuseppe Castaldo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, University of Naples Federico II, 80138 Naples, Italy; (M.C.); (M.G.)
- CEINGE-Biotecnologie Avanzate, 80145 Naples, Italy
- Correspondence:
| | - Monica Gelzo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, University of Naples Federico II, 80138 Naples, Italy; (M.C.); (M.G.)
- CEINGE-Biotecnologie Avanzate, 80145 Naples, Italy
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19
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TAS2R38 is a novel modifier gene in patients with cystic fibrosis. Sci Rep 2020; 10:5806. [PMID: 32242045 PMCID: PMC7118092 DOI: 10.1038/s41598-020-62747-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/16/2020] [Indexed: 12/17/2022] Open
Abstract
The clinical manifestation of cystic fibrosis (CF) is heterogeneous also in patients with the same cystic fibrosis transmembrane regulator (CFTR) genotype and in affected sibling pairs. Other genes, inherited independently of CFTR, may modulate the clinical manifestation and complications of patients with CF, including the severity of chronic sinonasal disease and the occurrence of chronic Pseudomonas aeruginosa colonization. The T2R38 gene encodes a taste receptor and recently its functionality was related to the occurrence of sinonasal diseases and upper respiratory infections. We assessed the T2R38 genotype in 210 patients with CF and in 95 controls, relating the genotype to the severity of sinonasal disease and to the occurrence of P. aeruginosa pulmonary colonization. The frequency of the PAV allele i.e., the allele associated with the high functionality of the T2R38 protein, was significantly lower in i) CF patients with nasal polyposis requiring surgery, especially in patients who developed the complication before 14 years of age; and ii) in CF patients with chronic pulmonary colonization by P. aeruginosa, especially in patients who were colonized before 14 years of age, than in control subjects. These data suggest a role for T2R38 as a novel modifier gene of sinonasal disease severity and of pulmonary P. aeruginosa colonization in patients with CF.
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20
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Comegna M, Maruotti GM, Sarno L, Cernera G, Gelzo M, Guida M, Zullo F, Zarrilli F, Castaldo G. Prenatal Diagnosis of Cystic Fibrosis and Hemophilia: Incidental Findings and Weak Points. Diagnostics (Basel) 2019; 10:diagnostics10010007. [PMID: 31877800 PMCID: PMC7168058 DOI: 10.3390/diagnostics10010007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/16/2019] [Accepted: 12/19/2019] [Indexed: 12/15/2022] Open
Abstract
Because of the progression of genetics and genomics, the demand for prenatal diagnosis (PD) for inherited genetic diseases has increased. However, several incidental findings may emerge during PD, like misattributed paternity, the evidence of disease in a parent, and the possible misinterpretation of the results because of complex alleles or de novo mutations that have several implications. In a retrospective observational study on all the couples referred to our Medical School (1993–2018) for PD of genetic inherited diseases (n = 1502), we selected the cases of PD for cystic fibrosis (CF, n = 239) and hemophilia A and B (HA, HB, n = 47), revising all incidental findings previously mentioned. We found one case in which a technical error led to PD of carrier in two siblings that were born affected by CF, four cases of misattributed paternity, eight cases of asymptomatic parents revealed as affected by CF transmembrane regulator (CFTR)-related disorders, a case of a novel complex allele that could have caused the diagnosis of CF in a carrier fetus, and a case of a de novo mutation in a mother (already a carrier) that caused hemophilia in a child that PD had revealed as healthy. We present these conditions as clinical cases and discuss the technical, clinical, ethical, and legal aspects to be considered.
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Affiliation(s)
- Marika Comegna
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.C.); (G.C.); (M.G.); (G.C.)
- CEINGE-Advanced Biotechnology, Via G. Salvatore 486, 80145 Naples, Italy
| | - Giuseppe Maria Maruotti
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy (L.S.); (M.G.)
| | - Laura Sarno
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy (L.S.); (M.G.)
| | - Gustavo Cernera
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.C.); (G.C.); (M.G.); (G.C.)
- CEINGE-Advanced Biotechnology, Via G. Salvatore 486, 80145 Naples, Italy
| | - Monica Gelzo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.C.); (G.C.); (M.G.); (G.C.)
- CEINGE-Advanced Biotechnology, Via G. Salvatore 486, 80145 Naples, Italy
| | - Maurizio Guida
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy (L.S.); (M.G.)
| | - Fulvio Zullo
- Department of Neuroscience, Reproductive and Odontostomatological Sciences, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy (L.S.); (M.G.)
| | - Federica Zarrilli
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.C.); (G.C.); (M.G.); (G.C.)
- CEINGE-Advanced Biotechnology, Via G. Salvatore 486, 80145 Naples, Italy
- Correspondence:
| | - Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (M.C.); (G.C.); (M.G.); (G.C.)
- CEINGE-Advanced Biotechnology, Via G. Salvatore 486, 80145 Naples, Italy
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21
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Cariati F, D'Argenio V, Tomaiuolo R. The evolving role of genetic tests in reproductive medicine. J Transl Med 2019; 17:267. [PMID: 31412890 PMCID: PMC6694655 DOI: 10.1186/s12967-019-2019-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 08/06/2019] [Indexed: 02/08/2023] Open
Abstract
Infertility is considered a major public health issue, and approximately 1 out of 6 people worldwide suffer from infertility during their reproductive lifespans. Thanks to technological advances, genetic tests are becoming increasingly relevant in reproductive medicine. More genetic tests are required to identify the cause of male and/or female infertility, identify carriers of inherited diseases and plan antenatal testing. Furthermore, genetic tests provide direction toward the most appropriate assisted reproductive techniques. Nevertheless, the use of molecular analysis in this field is still fragmented and cumbersome. The aim of this review is to highlight the conditions in which a genetic evaluation (counselling and testing) plays a role in improving the reproductive outcomes of infertile couples. We conducted a review of the literature, and starting from the observation of specific signs and symptoms, we describe the available molecular tests. To conceive a child, both partners' reproductive systems need to function in a precisely choreographed manner. Hence to treat infertility, it is key to assess both partners. Our results highlight the increasing importance of molecular testing in reproductive medicine.
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Affiliation(s)
| | - Valeria D'Argenio
- KronosDNA srl, Spinoff of Università Federico II, Naples, Italy.
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
- CEINGE-Biotecnologie Avanzate scarl, Via Gaetano Salvatore 486, 80145, Naples, Italy.
| | - Rossella Tomaiuolo
- KronosDNA srl, Spinoff of Università Federico II, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy
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22
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Feng J, Wu X, Zhang Y, Yang X, Ma G, Chen S, Luo S, Zhang Y. A novel mutation (-195C>A) in the promoter region of CFTR gene is associated with Chinese Congenital Bilateral Absence of Vas Deferens (CBAVD). Gene 2019; 719:144007. [PMID: 31357024 DOI: 10.1016/j.gene.2019.144007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 07/23/2019] [Accepted: 07/24/2019] [Indexed: 10/26/2022]
Abstract
Congenital bilateral absence of vas deferens (CBAVD), a frequent cause of obstructive azoospermia and male infertility in Chinese, is mainly due to mutations in the cystic fibrosis transmembrane conductance regulator (CFTR) gene. This study aim to explore the promoter region of CFTR gene in CBAVD patients and study the mutations by functional analysis, and to discuss the significance of mutation testing in this area. We performed screening analysis on 65 CBAVD patients and 50 controls to detect mutations in the CFTR gene, and studied the functions of promoter mutations using reporter gene constructs, transient transfection techniques and subsequent assessment of transcriptional activity and expression levels. Mutations c.-195C>A and c.-34C>T in the promoter region of the CFTR gene were detected in 4 of our Chinese CBAVD patients, one of which was novel (c.-195C>A) and located in the conservative area, as well as the binding site of SP1 transcription factor through the prediction of bioinformatics analysis. By reverse transcription qPCR assay and luciferase assay, we validated it as a functional disease-causing variant that down-regulates the CFTR gene expression, and this effect was related to the amount of transcription factors. This study was the first to explore the promoter region of the CFTR gene in Chinese, and we believe that mutations in this region are associated with Chinese CBAVD patients. We also suggest a systematic strategy for genotyping Chinese CBAVD couples, which should help in developing reproductive counseling.
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Affiliation(s)
- Jiarong Feng
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiao Wu
- Department of Urology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yanan Zhang
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Xiaojian Yang
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Gongchao Ma
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Shitao Chen
- International Peace Maternity & Child Health Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Shaoge Luo
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China
| | - Yan Zhang
- Department of Infertility and Sexual Medicine, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
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23
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Di Lullo AM, Scorza M, Amato F, Comegna M, Raia V, Maiuri L, Ilardi G, Cantone E, Castaldo G, Iengo M. An "ex vivo model" contributing to the diagnosis and evaluation of new drugs in cystic fibrosis. ACTA OTORHINOLARYNGOLOGICA ITALICA 2018; 37:207-213. [PMID: 27897275 PMCID: PMC5463510 DOI: 10.14639/0392-100x-1328] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 07/25/2016] [Indexed: 01/09/2023]
Abstract
Cystic fibrosis (CF) is an autosomal recessive disease caused by mutations in the cystic fibrosis transmembrane regulator (CFTR) gene. About 2000 mutations have been described so far. We setup an ex vivo model of human nasal epithelial cells (HNECs) to study CF patients testing the effect of novel mutations and molecular therapies. We performed sampling (by brushing), followed by culture and analysis of HNECs using a series of molecular techniques. We performed 50 brushings from CF patients and controls. Using cultured cells, we: i) demonstrated the widely heterogeneous CFTR expression in patients and in controls; ii) defined the splicing effect of a CFTR mutation; iii) assessed the CFTR gating activity in patients bearing different mutations; iv) demonstrated that butyrate significantly enhances CFTR expression. Based on our data, we can conclude: 1) HNEC brushing is performed without anaesthesia and is well tolerated in all CF patients (children and adults); 2) HNECs can be preserved for up to 48 hours before culture allowings multicentre studies; 3) HNECs culture can be considered a suitable model to study the molecular effects of new CFTR gene mutations and/or uncertain meaning specific mutations of carriers; 4) an ex vivo model of HNECs may be used to evaluate, before human use, the effect of new drugs on patients’ cells bearing specific CFTR mutations; 5) the methodology is adequate for a quantitative measurement, by fluorescence, of the CFTR gating activity of the HNECs from patients with different genotypes identifying: a) CF patients bearing two severe mutations with an activity < 10% (compared to controls – 100%); b) CF patients bearing at least a mild mutation with an activity of 10-20%; c) CF carriers (heterozygous subjects) with an activity between 40-70%.
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Affiliation(s)
- A M Di Lullo
- Department of Neuroscience, Section of Otorhinolaryngology, University of Naples "Federico II", Italy.,CEINGE-Advanced Biotechnologies scarl, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Italy
| | - M Scorza
- CEINGE-Advanced Biotechnologies scarl, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Italy
| | - F Amato
- CEINGE-Advanced Biotechnologies scarl, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Italy
| | - M Comegna
- CEINGE-Advanced Biotechnologies scarl, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Italy
| | - V Raia
- Department of Translational Medical Sciences, University of Naples "Federico II", Italy
| | - L Maiuri
- Department of Science and Technology Innovation, University of Piemonte Orientale, Novara, Italy
| | - G Ilardi
- European Institute for Research in Cystic Fibrosis, San Raffaele Hospital, Milan, Italy
| | - E Cantone
- Department of Neuroscience, Section of Otorhinolaryngology, University of Naples "Federico II", Italy
| | - G Castaldo
- CEINGE-Advanced Biotechnologies scarl, Naples, Italy.,Department of Molecular Medicine and Medical Biotechnologies, University of Naples "Federico II", Italy
| | - M Iengo
- Department of Neuroscience, Section of Otorhinolaryngology, University of Naples "Federico II", Italy
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24
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Cozzolino C, Villani GR, Frisso G, Scolamiero E, Albano L, Gallo G, Romanelli R, Ruoppolo M. Biochemical and molecular characterization of 3-Methylcrotonylglycinuria in an Italian asymptomatic girl. Genet Mol Biol 2018; 41:379-385. [PMID: 29767664 PMCID: PMC6082241 DOI: 10.1590/1678-4685-gmb-2017-0093] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 10/22/2017] [Indexed: 12/16/2022] Open
Abstract
3-Methylcrotonylglycinuria is an organic aciduria resulting from deficiency of
3-methylcrotonyl-CoA carboxylase (3-MCC), a biotin-dependent mitochondrial enzym
carboxylating 3-methylcrotonyl-CoA to 3-methylglutaconyl-CoA during leucine
catabolism. Its deficiency, due to mutations on MCCC1 and
MCCC2 genes, leads to accumulation of 3-methylcrotonyl-CoA
metabolites in blood and/or urine, primarily 3-hydroxyisovaleryl-carnitine
(C5-OH) in plasma and 3-methylcrotonyl-glycine (3-MCG) and 3-hydroxyisovaleric
acid (3-HIVA) in the urine. The phenotype of 3-MCC deficiency is highly
variable, ranging from severe neurological abnormalities and death in infancy to
asymptomatic adults. Here we report the biochemical and molecular
characterization of an Italian asymptomatic girl, positive for the newborn
screening test. Molecular analysis showed two mutations in the
MCCC2 gene, an already described missense mutation, c.691A
> T (p.I231F), and a novel splicing mutation, c.1150-1G > A. We
characterized the expression profile of the splice mutation by functional
studies.
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Affiliation(s)
| | - Guglielmo Rd Villani
- CEINGE Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli, "Federico II", Naples, Italy
| | - Giulia Frisso
- CEINGE Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli, "Federico II", Naples, Italy
| | | | | | | | | | - Margherita Ruoppolo
- CEINGE Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli, "Federico II", Naples, Italy
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25
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Terlizzi V, Di Lullo AM, Comegna M, Centrone C, Pelo E, Castaldo G, Raia V, Braggion C. S737F is a new CFTR mutation typical of patients originally from the Tuscany region in Italy. Ital J Pediatr 2018; 44:2. [PMID: 29298718 PMCID: PMC5753463 DOI: 10.1186/s13052-017-0443-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 12/26/2017] [Indexed: 01/29/2023] Open
Abstract
Background An increasing number of patients have been described as having a number of Cystic Fibrosis Transmembrane conductance Regulator (CFTR) variants for which it lacks a clear genotype–phenotype correlation. We assesses the clinical features of patients bearing the S737F (p.Ser737Phe) CFTR missense variant and evaluated the residual function of CFTR protein on nasal epithelial cells (NEC). Methods A retrospective database was performed from individuals homozygous or compound heterozygous for the S737F variant followed in the Cystic Fibrosis (CF) Centre of Florence. We performed a nasal brushing in cooperating patients and compared the results with those of patients followed in the pediatric CF Centre of Naples. Results 9/295 (3%) subjects carrying at least S737F CFTR variant on one allele were identified. Patients were diagnosed in 7/9 cases by newborn screening and in two cases for dehydration with hypochloremic metabolic alkalosis; at diagnosis sweat chloride levels (SCL) were in the pathological range in only one case. After a mean follow up of 8,6 years (range 0,5–15,8), SCL were in the pathological range in 8/9 cases (mean age at CF diagnosis: 1,5 years), all patients were pancreatic sufficiency and respiratory function was normal. The gating activity on NEC was 15.6% and 12.7% in two patients compound heterozygous for W1282X and DelE22_24, while it was ranged between 6,2% and 9,8% in CF patients. Conclusions S737F is a CFTR mutation associated to hypochloremic alkalosis in childhood, mild CF phenotype in teenage years and a residual function of CFTR protein.
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Affiliation(s)
- Vito Terlizzi
- Centro Regionale Toscano per la Fibrosi Cistica, Azienda Ospedaliero-Universitaria Meyer, Via Gaetano Pieraccini 24, 50141, Florence, Italy.
| | - Antonella Miriam Di Lullo
- CEINGE-Biotecnologie Avanzate scarl, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy.,Dipartimento di Neuroscienze, Sezione di ORL, Università di Napoli Federico II, Naples, Italy
| | - Marika Comegna
- CEINGE-Biotecnologie Avanzate scarl, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Claudia Centrone
- SOD Diagnostica Genetica, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Elisabetta Pelo
- SOD Diagnostica Genetica, Azienda Ospedaliera Universitaria Careggi, Florence, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie Avanzate scarl, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Valeria Raia
- Centro Regionale Fibrosi Cistica Unità Pediatrica, Dipartimento di Scienze Mediche Traslazionali, Università di Napoli Federico II, Naples, Italy
| | - Cesare Braggion
- Centro Regionale Toscano per la Fibrosi Cistica, Azienda Ospedaliero-Universitaria Meyer, Via Gaetano Pieraccini 24, 50141, Florence, Italy
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26
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Abstract
OBJECTIVES We aimed to improve the knowledge of pathogenic mutations in sporadic cases of congenital chloride diarrhea (CCD) and emphasize the importance of functional studies to define the effect of novel mutations. METHODS All member 3 of solute carrier family 26 (SLC26A3) coding regions were sequenced in 17 sporadic patients with CCD. Moreover, the minigene system was used to analyze the effect of 2 novel splicing mutations. RESULTS We defined the SLC26A3 genotype of all 17 patients with CCD and identified 12 novel mutations. Using the minigene system, we confirmed the in silico prediction of a complete disruption of splicing pattern caused by 2 of these novel mutations: the c.971+3_971+4delAA and c.735+4_c.735+7delAGTA. Moreover, several prediction tools and a structure-function prediction defined the pathogenic role of 6 novel missense mutations. CONCLUSIONS We confirm the molecular heterogeneity of sporadic CCD adding 12 novel mutations to the list of known pathogenic mutations. Moreover, we underline the importance, for laboratories that offer molecular diagnosis and genetic counseling, to perform fast functional analysis of novel mutations.
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Gelzo M, Sica C, Elce A, Dello Russo A, Iacotucci P, Carnovale V, Raia V, Salvatore D, Corso G, Castaldo G. Reduced absorption and enhanced synthesis of cholesterol in patients with cystic fibrosis: a preliminary study of plasma sterols. Clin Chem Lab Med 2017; 54:1461-6. [PMID: 26913457 DOI: 10.1515/cclm-2015-1151] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 01/12/2016] [Indexed: 11/15/2022]
Abstract
BACKGROUND Low cholesterol is typically observed in the plasma of patients with cystic fibrosis (CF) contrasting with the subcellular accumulation of cholesterol demonstrated in CF cells and in mice models. However, the homeostasis of cholesterol has not been well investigated in patients with CF. METHODS We studied the plasma of 26 patients with CF and 33 unaffected controls campesterol and β-sitosterol as markers of intestinal absorption and lathosterol as a marker of de novo cholesterol biosynthesis by gas chromatography (GC-FID and GC-MS). RESULTS Plasma campesterol and β-sitosterol results were significantly (p=0.01) lower while plasma lathosterol was significantly higher (p=0.001) in patients with CF as compared to control subjects. Plasma cholesterol results were significantly lower (p=0.01) in CF patients. CONCLUSIONS Our data suggest that the impaired intestinal absorption of exogenous sterols in patients with CF stimulates the endogenous synthesis of cholesterol, but the levels of total cholesterol in plasma remain lower. This may be due to the CFTR dysfunction that reduces cholesterol blood excretion causing the accumulation of cholesterol in liver cells and in other tissues contributing to trigger CF chronic inflammation.
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28
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Vecchio-Pagán B, Blackman SM, Lee M, Atalar M, Pellicore MJ, Pace RG, Franca AL, Raraigh KS, Sharma N, Knowles MR, Cutting GR. Deep resequencing of CFTR in 762 F508del homozygotes reveals clusters of non-coding variants associated with cystic fibrosis disease traits. Hum Genome Var 2016; 3:16038. [PMID: 27917292 PMCID: PMC5121184 DOI: 10.1038/hgv.2016.38] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 01/09/2023] Open
Abstract
Extensive phenotypic variability is commonly observed in individuals with Mendelian disorders, even among those with identical genotypes in the disease-causing gene. To determine whether variants within and surrounding CFTR contribute to phenotypic variability in cystic fibrosis (CF), we performed deep sequencing of CFTR in 762 patients homozygous for the common CF-causing variant, F508del. In phase 1, ~200 kb encompassing CFTR and extending 10 kb 5' and 5 kb 3' of the gene was sequenced in 486 F508del homozygotes selected from the extremes of sweat chloride concentration. In phase 2, a 510 kb region, which included the entire topologically associated domain of CFTR, was sequenced in 276 F508del homozygotes drawn from extremes of lung function. An additional 163 individuals who carried F508del and a different CF-causing variant were sequenced to inform haplotype construction. Region-based burden testing of both common and rare variants revealed seven regions of significance (α=0.01), five of which overlapped known regulatory elements or chromatin interactions. Notably, the -80 kb locus known to interact with the CFTR promoter was associated with variation in both CF traits. Haplotype analysis revealed a single rare recombination event (1.9% frequency) in intron 15 of CFTR bearing the F508del variant. Otherwise, the majority of F508del chromosomes were markedly similar, consistent with a single origin of the F508del allele. Together, these high-resolution variant analyses of the CFTR locus suggest a role for non-coding regulatory motifs in trait variation among individuals carrying the common CF allele.
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Affiliation(s)
- Briana Vecchio-Pagán
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Scott M Blackman
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Division of Pediatric Endocrinology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Melissa Lee
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Melis Atalar
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew J Pellicore
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rhonda G Pace
- Cystic Fibrosis-Pulmonary Research and Treatment Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Arianna L Franca
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Karen S Raraigh
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Neeraj Sharma
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael R Knowles
- Cystic Fibrosis-Pulmonary Research and Treatment Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Garry R Cutting
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Functional Studies and In Silico Analyses to Evaluate Non-Coding Variants in Inherited Cardiomyopathies. Int J Mol Sci 2016; 17:ijms17111883. [PMID: 27834932 PMCID: PMC5133883 DOI: 10.3390/ijms17111883] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2016] [Revised: 10/19/2016] [Accepted: 10/27/2016] [Indexed: 12/18/2022] Open
Abstract
Point mutations are the most common cause of inherited diseases. Bioinformatics tools can help to predict the pathogenicity of mutations found during genetic screening, but they may work less well in determining the effect of point mutations in non-coding regions. In silico analysis of intronic variants can reveal their impact on the splicing process, but the consequence of a given substitution is generally not predictable. The aim of this study was to functionally test five intronic variants (MYBPC3-c.506-2A>C, MYBPC3-c.906-7G>T, MYBPC3-c.2308+3G>C, SCN5A-c.393-5C>A, and ACTC1-c.617-7T>C) found in five patients affected by inherited cardiomyopathies in the attempt to verify their pathogenic role. Analysis of the MYBPC3-c.506-2A>C mutation in mRNA from the peripheral blood of one of the patients affected by hypertrophic cardiac myopathy revealed the loss of the canonical splice site and the use of an alternative splicing site, which caused the loss of the first seven nucleotides of exon 5 (MYBPC3-G169AfsX14). In the other four patients, we generated minigene constructs and transfected them in HEK-293 cells. This minigene approach showed that MYBPC3-c.2308+3G>C and SCN5A-c.393-5C>A altered pre-mRNA processing, thus resulting in the skipping of one exon. No alterations were found in either MYBPC3-c.906-7G>T or ACTC1-c.617-7T>C. In conclusion, functional in vitro analysis of the effects of potential splicing mutations can confirm or otherwise the putative pathogenicity of non-coding mutations, and thus help to guide the patient's clinical management and improve genetic counseling in affected families.
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30
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Terlizzi V, Castaldo G, Salvatore D, Lucarelli M, Raia V, Angioni A, Carnovale V, Cirilli N, Casciaro R, Colombo C, Di Lullo AM, Elce A, Iacotucci P, Comegna M, Scorza M, Lucidi V, Perfetti A, Cimino R, Quattrucci S, Seia M, Sofia VM, Zarrilli F, Amato F. Genotype-phenotype correlation and functional studies in patients with cystic fibrosis bearing CFTR complex alleles. J Med Genet 2016; 54:224-235. [PMID: 27738188 DOI: 10.1136/jmedgenet-2016-103985] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 09/12/2016] [Accepted: 09/22/2016] [Indexed: 01/08/2023]
Abstract
BACKGROUND The effect of complex alleles in cystic fibrosis (CF) is poorly defined for the lack of functional studies. OBJECTIVES To describe the genotype-phenotype correlation and the results of either in vitro and ex vivo studies performed on nasal epithelial cells (NEC) in a cohort of patients with CF carrying cystic fibrosis transmembrane conductance regulator (CFTR) complex alleles. METHODS We studied 70 homozygous, compound heterozygous or heterozygous for CFTR mutations: p.[Arg74Trp;Val201Met;Asp1270Asn], n=8; p.[Ile148Thr;Ile1023_Val1024del], n=5; p.[Arg117Leu;Leu997Phe], n=6; c.[1210-34TG[12];1210-12T[5];2930C>T], n=3; p.[Arg74Trp;Asp1270Asn], n=4; p.Asp1270Asn, n=2; p.Ile148Thr, n=6; p.Leu997Phe, n=36. In 39 patients, we analysed the CFTR gating activity on NEC in comparison with patients with CF (n=8) and carriers (n=4). Finally, we analysed in vitro the p.[Arg74Trp;Val201Met;Asp1270Asn] complex allele. RESULTS The p.[Ile148Thr;Ile1023_Val1024del] caused severe CF in five compound heterozygous with a class I-II mutation. Their CFTR activity on NEC was comparable with patients with two class I-II mutations (mean 7.3% vs 6.9%). The p.[Arg74Trp;Asp1270Asn] and the p.Asp1270Asn have scarce functional effects, while p.[Arg74Trp;Val201Met;Asp1270Asn] caused mild CF in four of five subjects carrying a class I-II mutation in trans, or CFTR-related disorders (CFTR-RD) in three having in trans a class IV-V mutation. The p.[Arg74Trp;Val201Met;Asp1270Asn] causes significantly (p<0.001) higher CFTR activity compared with compound heterozygous for class I-II mutations. Furthermore, five of six compounds heterozygous with the p.[Arg117Leu;Leu997Phe] had mild CF, whereas the p.Leu997Phe, in trans with a class I-II CFTR mutation, caused CFTR-RD or a healthy status (CFTR activity: 21.3-36.9%). Finally, compounds heterozygous for the c.[1210-34TG[12];1210-12T[5];2930C>T] and a class I-II mutation had mild CF or CFTR-RD (gating activity: 18.5-19.0%). CONCLUSIONS The effect of complex alleles partially depends on the mutation in trans. Although larger studies are necessary, the CFTR activity on NEC is a rapid contributory tool to classify patients with CFTR dysfunction.
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Affiliation(s)
- Vito Terlizzi
- Dipartimento di Pediatria, Centro Regionale Toscano per la Fibrosi Cistica, Azienda Ospedaliero-Universitaria Meyer, Florence, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | | | - Marco Lucarelli
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Istituto Pasteur Fondazione Cenci Bolognetti, Sapienza Università e Policlinico Umberto I, Rome, Italy
| | - Valeria Raia
- Centro Regionale Fibrosi Cistica, Sezione Pediatrica, Dipartimento di Scienze Mediche Traslazionali, Università di Napoli Federico II, Naples, Italy
| | - Adriano Angioni
- Laboratorio di Genetica Medica, Ospedale Pediatrico Bambino Gesù, Rome, Italy
| | - Vincenzo Carnovale
- Dipartimento di Scienze Mediche Traslazionali, Centro Regionale Fibrosi Cistica, Sezione Adulti, Università di Napoli Federico II, Naples, Italy
| | - Natalia Cirilli
- Dipartimento Materno-Infantile, Ospedali Riuniti Ancona, Centro Regionale Fibrosi Cistica, Ancona, Italy
| | - Rosaria Casciaro
- Dipartimento di Pediatria, Centro Regionale Fibrosi Cistica, IRCCS G. Gaslini, Genova, Italy
| | - Carla Colombo
- Centro Regionale Fibrosi Cistica, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy
| | - Antonella Miriam Di Lullo
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy.,Dipartimento di Neuroscienze, Sezione di ORL, Università di Napoli Federico II, Naples, Italy
| | | | - Paola Iacotucci
- Dipartimento di Scienze Mediche Traslazionali, Centro Regionale Fibrosi Cistica, Sezione Adulti, Università di Napoli Federico II, Naples, Italy
| | - Marika Comegna
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Manuela Scorza
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Biotecnologie e Bioscienze, Università di Milano Bicocca, Milan, Italy
| | - Vincenzina Lucidi
- Unità di Fibrosi Cistica, IRCCS Ospedale Pediatrico Bambin Gesù, Rome, Italy
| | | | - Roberta Cimino
- Dipartimento di Scienze Neurologiche, Riproduttive ed Odontostomatologiche, Università di Napoli Federico II, Naples, Italy
| | - Serena Quattrucci
- Centro Fibrosi Cistica, Sapienza Università e Policlinico Umberto I, Rome, Italy
| | - Manuela Seia
- Laboratorio Genetica Medica, Ospedale Maggiore Policlinico, Milano, Italy
| | | | - Federica Zarrilli
- Dipartimento di Bioscienze e Territorio, Università del Molise, Isernia, Italy
| | - Felice Amato
- CEINGE-Biotecnologie Avanzate, Naples, Italy.,Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
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Hanukoglu I, Hanukoglu A. Epithelial sodium channel (ENaC) family: Phylogeny, structure-function, tissue distribution, and associated inherited diseases. Gene 2016; 579:95-132. [PMID: 26772908 PMCID: PMC4756657 DOI: 10.1016/j.gene.2015.12.061] [Citation(s) in RCA: 238] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2015] [Revised: 12/20/2015] [Accepted: 12/22/2015] [Indexed: 01/24/2023]
Abstract
The epithelial sodium channel (ENaC) is composed of three homologous subunits and allows the flow of Na(+) ions across high resistance epithelia, maintaining body salt and water homeostasis. ENaC dependent reabsorption of Na(+) in the kidney tubules regulates extracellular fluid (ECF) volume and blood pressure by modulating osmolarity. In multi-ciliated cells, ENaC is located in cilia and plays an essential role in the regulation of epithelial surface liquid volume necessary for cilial transport of mucus and gametes in the respiratory and reproductive tracts respectively. The subunits that form ENaC (named as alpha, beta, gamma and delta, encoded by genes SCNN1A, SCNN1B, SCNN1G, and SCNN1D) are members of the ENaC/Degenerin superfamily. The earliest appearance of ENaC orthologs is in the genomes of the most ancient vertebrate taxon, Cyclostomata (jawless vertebrates) including lampreys, followed by earliest representatives of Gnathostomata (jawed vertebrates) including cartilaginous sharks. Among Euteleostomi (bony vertebrates), Actinopterygii (ray finned-fishes) branch has lost ENaC genes. Yet, most animals in the Sarcopterygii (lobe-finned fish) branch including Tetrapoda, amphibians and amniotes (lizards, crocodiles, birds, and mammals), have four ENaC paralogs. We compared the sequences of ENaC orthologs from 20 species and established criteria for the identification of ENaC orthologs and paralogs, and their distinction from other members of the ENaC/Degenerin superfamily, especially ASIC family. Differences between ENaCs and ASICs are summarized in view of their physiological functions and tissue distributions. Structural motifs that are conserved throughout vertebrate ENaCs are highlighted. We also present a comparative overview of the genotype-phenotype relationships in inherited diseases associated with ENaC mutations, including multisystem pseudohypoaldosteronism (PHA1B), Liddle syndrome, cystic fibrosis-like disease and essential hypertension.
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Affiliation(s)
- Israel Hanukoglu
- Laboratory of Cell Biology, Faculty of Natural Sciences, Ariel University, Ariel, Israel.
| | - Aaron Hanukoglu
- Division of Pediatric Endocrinology, E. Wolfson Medical Center, Holon, Israel; Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
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32
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Assessment of epithelial sodium channel variants in nonwhite cystic fibrosis patients with non-diagnostic CFTR genotypes. J Cyst Fibros 2016; 15:52-9. [DOI: 10.1016/j.jcf.2015.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Revised: 03/31/2015] [Accepted: 04/01/2015] [Indexed: 11/23/2022]
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Balázs A, Ruffert C, Hegyi E, Hritz I, Czakó L, Takács T, Szepes Z, Németh BC, Gervain J, Izbéki F, Halász A, Kelemen D, Szmola R, Novák J, Crai S, Illés A, Vincze Á, Molnár Z, Varga M, Bod B, Farkas G, Sümegi J, Szepes A, Dubravcsik Z, Lásztity N, Párniczky A, Hamvas J, Andorka C, Veres G, Szentkereszty Z, Rakonczay Z, Maléth J, Sahin-Tóth M, Rosendahl J, Hegyi P. Genetic analysis of the bicarbonate secreting anion exchanger SLC26A6 in chronic pancreatitis. Pancreatology 2015; 15:508-513. [PMID: 26372434 DOI: 10.1016/j.pan.2015.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 08/19/2015] [Accepted: 08/21/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pancreatic ductal HCO3(-) secretion is critically dependent on the cystic fibrosis transmembrane conductance regulator chloride channel (CFTR) and the solute-linked carrier 26 member 6 anion transporter (SLC26A6). Deterioration of HCO3(-) secretion is observed in chronic pancreatitis (CP), and CFTR mutations increase CP risk. Therefore, SLC26A6 is a reasonable candidate for a CP susceptibility gene, which has not been investigated in CP patients so far. METHODS As a first screening cohort, 106 subjects with CP and 99 control subjects with no pancreatic disease were recruited from the Hungarian National Pancreas Registry. In 60 non-alcoholic CP cases the entire SLC26A6 coding region was sequenced. In the Hungarian cohort variants c.616G > A (p.V206M) and c.1191C > A (p.P397=) were further genotyped by restriction fragment length polymorphism analysis. In a German replication cohort all exons were sequenced in 40 non-alcoholic CP cases and variant c.616G > A (p.V206M) was further analyzed by sequencing in 321 CP cases and 171 controls. RESULTS Sequencing of the entire coding region revealed four common variants: intronic variants c.23 + 78_110del, c.183-4C > A, c.1134 + 32C > A, and missense variant c.616G > A (p.V206M) which were found in linkage disequilibrium indicating a conserved haplotype. The distribution of the haplotype did not show a significant difference between patients and controls in the two cohorts. A synonymous variant c.1191C > A (p.P397=) and two intronic variants c.1248 + 9_20del and c.-10C > T were detected in single cases. CONCLUSION Our data show that SLC26A6 variants do not alter the risk for the development of CP.
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Affiliation(s)
- Anita Balázs
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Claudia Ruffert
- Department of Internal Medicine, Neurology and Dermatology, Division of Gastroenterology and Rheumatology, University of Leipzig, Leipzig, Germany
| | - Eszter Hegyi
- First Department of Medicine, University of Szeged, Szeged, Hungary; 2nd Department of Pediatrics, Comenius University Medical School, University Children's Hospital, Bratislava, Slovakia
| | - István Hritz
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - László Czakó
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Tamás Takács
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Zoltán Szepes
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Balázs Csaba Németh
- Department of Molecular and Cell Biology, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA 02118, USA
| | - Judit Gervain
- Szent György University Teaching Hospital of County Fejér, Székesfehérvár, Hungary
| | - Ferenc Izbéki
- Szent György University Teaching Hospital of County Fejér, Székesfehérvár, Hungary
| | - Adrienn Halász
- Szent György University Teaching Hospital of County Fejér, Székesfehérvár, Hungary
| | | | - Richárd Szmola
- Department of Interventional Gastroenterology, National Institute of Oncology, Budapest, Hungary
| | - János Novák
- Pándy Kálmán County Hopsital, Gyula, Hungary
| | - Stefan Crai
- Pándy Kálmán County Hopsital, Gyula, Hungary
| | - Anita Illés
- First Department of Medicine, University of Pécs, Hungary
| | - Áron Vincze
- First Department of Medicine, University of Pécs, Hungary
| | - Zsolt Molnár
- Department of Anestesiology and Intensive Care, University of Szeged, Szeged, Hungary
| | | | | | - Gyula Farkas
- Department of Surgery, University of Szeged, Hungary
| | - János Sümegi
- B-A-Z County Hopspital and University Teaching Hospital, Miskolc, Hungary
| | - Attila Szepes
- Department of Gastroenterology, Bács-Kiskun County Hospital, Kecskemét, Hungary
| | - Zsolt Dubravcsik
- Department of Gastroenterology, Bács-Kiskun County Hospital, Kecskemét, Hungary
| | | | | | | | - Csilla Andorka
- 1st Department of Pediatrics, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Gábor Veres
- 1st Department of Pediatrics, Semmelweis University, Faculty of Medicine, Budapest, Hungary
| | - Zsolt Szentkereszty
- Institute of Surgery, University of Debrecen, Clinical Center, Debrecen Hungary
| | - Zoltán Rakonczay
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - József Maléth
- First Department of Medicine, University of Szeged, Szeged, Hungary
| | - Miklós Sahin-Tóth
- Department of Molecular and Cell Biology, Boston University Henry M. Goldman School of Dental Medicine, Boston, MA 02118, USA
| | - Jonas Rosendahl
- Department of Internal Medicine, Neurology and Dermatology, Division of Gastroenterology and Rheumatology, University of Leipzig, Leipzig, Germany
| | - Péter Hegyi
- First Department of Medicine, University of Szeged, Szeged, Hungary; MTA-SZTE Translational Gastroenterology Research Group, Szeged, Hungary.
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Castaldo G, Amato F. Editorial Comment to p.Leu636Pro mutation is associated with cystic fibrosis transmembrane conductance regulator-related disorders (congenital bilateral absence of vas deferens). Int J Urol 2015; 22:804. [DOI: 10.1111/iju.12823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Giuseppe Castaldo
- Department of Molecular Medicine and Medical Biotechnology; University of Naples Federico II; Naples Italy
- CEINGE-Advanced Biotechnology Scarl; Naples Italy
| | - Felice Amato
- Department of Molecular Medicine and Medical Biotechnology; University of Naples Federico II; Naples Italy
- CEINGE-Advanced Biotechnology Scarl; Naples Italy
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35
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Terlizzi V, Carnovale V, Castaldo G, Castellani C, Cirilli N, Colombo C, Corti F, Cresta F, D'Adda A, Lucarelli M, Lucidi V, Macchiaroli A, Madarena E, Padoan R, Quattrucci S, Salvatore D, Zarrilli F, Raia V. Clinical expression of patients with the D1152H CFTR mutation. J Cyst Fibros 2015; 14:447-52. [PMID: 25583415 DOI: 10.1016/j.jcf.2014.12.012] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 12/17/2014] [Accepted: 12/18/2014] [Indexed: 01/30/2023]
Abstract
BACKGROUND Discordant results were reported on the clinical expression of subjects bearing the D1152H CFTR mutation, and also for the small number of cases reported so far. METHODS A retrospective review of clinical, genetic and biochemical data was performed from individuals homozygous or compound heterozygous for the D1152H mutation followed in 12 Italian cystic fibrosis (CF) centers. RESULTS 89 subjects carrying at least D1152H on one allele were identified. 7 homozygous patients had very mild clinical expression. Over half of the 74 subjects compound heterozygous for D1152H and a I-II-III class mutation had borderline or pathological sweat test and respiratory or gastrointestinal symptoms; one third had pulmonary bacteria colonization and 10/74 cases had complications (i.e. diabetes, allergic bronchopulmonary aspergillosis, and hemoptysis). However, their clinical expression was less severe as compared to a group of CF patients homozygous for the F508del mutation. Finally, 8 subjects compound heterozygous for D1152H and a IV-V class mutation showed very mild disease. CONCLUSIONS The natural history of subjects bearing the D1152H mutation is widely heterogeneous and is influenced by the mutation in trans.
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Affiliation(s)
- Vito Terlizzi
- Dipartimento di Scienze Mediche Traslazionali, Sezione di Pediatria, Università di Napoli Federico II, Naples, Italy
| | - Vincenzo Carnovale
- Centro Fibrosi Cistica Adulti, Dipartimento di Scienze Traslazionali, Università di Napoli Federico II, Naples, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie avanzate, Naples, Italy; Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Carlo Castellani
- Centro Fibrosi Cistica, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Natalia Cirilli
- Centro Regionale Fibrosi Cistica, Dipartimento Materno-Infantile, Ospedali Riuniti Ancona, Ancona, Italy
| | - Carla Colombo
- Centro Fibrosi Cistica, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Fabiola Corti
- Centro Fibrosi Cistica, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Federico Cresta
- Centro Fibrosi Cistica, Dipartimento di Pediatria, IRCCS G. Gaslini, Genova, Italy
| | - Alice D'Adda
- Centro Fibrosi Cistica, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Marco Lucarelli
- Dipartimento di Biotecnologie Cellulari ed Ematologia, Istituto Pasteur Fondazione Cenci Bolognetti, Sapienza Università e Policlinico Umberto I, Rome, Italy
| | - Vincenzina Lucidi
- Unità di Fibrosi Cistica, IRCCS Ospedale Pediatrico Bambin Gesù, Rome, Italy
| | | | - Elisa Madarena
- Centro Fibrosi Cistica, Ospedale Giovanni Paolo II, Lamezia, Italy
| | - Rita Padoan
- Centro di supporto Fibrosi Cistica, Dipartimento di Pediatria, Università di Brescia, Brescia, Italy
| | - Serena Quattrucci
- Dipartimento di Pediatria, Centro Fibrosi Cistica, Sapienza Università e Policlinico Umberto I, Rome, Italy
| | - Donatello Salvatore
- Centro Fibrosi Cistica, Centro Pediatrico Bambino Gesù Basilicata, AOR San Carlo, Potenza, Italy
| | - Federica Zarrilli
- Dipartimento di Bioscienze e Territorio, Università del Molise, Isernia, Italy
| | - Valeria Raia
- Dipartimento di Scienze Mediche Traslazionali, Sezione di Pediatria, Università di Napoli Federico II, Naples, Italy.
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Tomaiuolo R, Nardiello P, Martinelli P, Sacchetti L, Salvatore F, Castaldo G. Prenatal diagnosis of cystic fibrosis: an experience of 181 cases. Clin Chem Lab Med 2014; 51:2227-32. [PMID: 23612672 DOI: 10.1515/cclm-2013-0200] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/08/2013] [Indexed: 11/15/2022]
Abstract
BACKGROUND The demand for prenatal diagnosis (PD) of cystic fibrosis (CF) is increasing. METHODS We performed pre-test multidisciplinary counselling for 192 couples at CF reproductive risk. In 11/192 (5.7%) cases PD was not performed mainly because counselling revealed a reproductive risk for atypical (mild) CF, while 181 PDs were performed in couples revealed at high risk for CF mainly because they already had a CF child (148/181, 81.8%) or had been identified through cascade screening (28/181, 15.5%). RESULTS In 167/181 (92.3%) cases (including two dichorionic twin pregnancies), PD was performed on chorionic villi, and in 14 on amniocyte DNA. Only 1/181 PD was unsuccessful. In all other cases, single tandem repeat analysis excluded maternal contamination, and PD was made within 7 days of sampling. In total 116/180 (64.4%) PDs were made with dot-blot analysis; 40 (22.2%) required gene sequencing; in 4/180 cases we tested the gene for large rearrangements; in 23/180 (12.8%) cases linkage analysis was necessary because parental mutation(s) were unknown. Forty-two out of 180 (23.3%) PDs revealed an affected foetus. All couples but one interrupted pregnancy. The first twin PD revealed the absence (1 foetus) and the presence of one mutation (the other foetus); the second twin PD revealed one parental mutation (1 foetus) and both parental mutations (the other foetus); the couple planned selective interruption. CONCLUSIONS PD for CF should be performed in reference laboratories equipped for gene scanning and linkage analysis, with a multidisciplinary staff able to offer counselling to couples during all phases of PD.
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Scorza M, Elce A, Zarrilli F, Liguori R, Amato F, Castaldo G. Genetic diseases that predispose to early liver cirrhosis. Int J Hepatol 2014; 2014:713754. [PMID: 25132997 PMCID: PMC4123515 DOI: 10.1155/2014/713754] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Accepted: 06/30/2014] [Indexed: 12/11/2022] Open
Abstract
Inherited liver diseases are a group of metabolic and genetic defects that typically cause early chronic liver involvement. Most are due to a defect of an enzyme/transport protein that alters a metabolic pathway and exerts a pathogenic role mainly in the liver. The prevalence is variable, but most are rare pathologies. We review the pathophysiology of such diseases and the diagnostic contribution of laboratory tests, focusing on the role of molecular genetics. In fact, thanks to recent advances in genetics, molecular analysis permits early and specific diagnosis for most disorders and helps to reduce the invasive approach of liver biopsy.
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Affiliation(s)
- Manuela Scorza
- CEINGE—Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Napoli, Italy
| | - Ausilia Elce
- CEINGE—Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Napoli, Italy
- Università Telematica Pegaso, Piazza Trieste e Trento 48, 80132 Napoli, Italy
| | - Federica Zarrilli
- CEINGE—Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
- Dipartimento di Bioscienze e Territorio, Università del Molise, Contrada Fonte Lappone, Pesche, 86090 Isernia, Italy
| | - Renato Liguori
- CEINGE—Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Napoli, Italy
| | - Felice Amato
- CEINGE—Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Napoli, Italy
| | - Giuseppe Castaldo
- CEINGE—Biotecnologie Avanzate Scarl, Via Gaetano Salvatore 486, 80145 Napoli, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Via Sergio Pansini 5, 80131 Napoli, Italy
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Terlizzi V, Tosco A, Tomaiuolo R, Sepe A, Amato N, Casale A, Mercogliano C, De Gregorio F, Improta F, Elce A, Castaldo G, Raia V. Prediction of acute pancreatitis risk based on PIP score in children with cystic fibrosis. J Cyst Fibros 2014; 13:579-84. [PMID: 24525081 DOI: 10.1016/j.jcf.2014.01.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Revised: 01/14/2014] [Accepted: 01/15/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Currently no tools to predict risk of acute (AP) and recurrent pancreatitis (ARP) in children with cystic fibrosis (CF) are available. We assessed the prevalence of AP/ARP and tested the potential role of Pancreatic Insufficiency Prevalence (PIP) score in a cohort of children with CF. METHODS We identified two groups of children, on the basis of presence/absence of AP/ARP, who were compared for age at diagnosis, clinical features, genotypes and sweat chloride level. PIP score was calculated for each patient. RESULTS 10/167 (5.9%) experienced at least one episode of AP during follow up; 10/10 were pancreatic sufficient (PS). Patients with AP/ARP showed a PIP score ≤0.25 more frequently (6/10) than patients without AP/ARP. The odds ratio (95% CI) of developing pancreatitis was 4.54 (1.22-16.92) for patients with PIP <0.25 when compared with those who have a PIP score >0.25 (p 0.0151). PIP score was correlated with sweat chloride test (p < 0.01). CONCLUSION PIP score, PS status and normal/borderline sweat chloride levels could be applied to predict pancreatitis development in children with CF. ARP could lead to pancreatic insufficiency.
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Affiliation(s)
- V Terlizzi
- Department of Translational Medical Sciences, University of Naples Federico II, Italy
| | - A Tosco
- Department of Translational Medical Sciences, University of Naples Federico II, Italy
| | - R Tomaiuolo
- CEINGE-Advanced Biotechnology, Naples, Italy; Department of Biochemistry and Biotechnology, University of Naples Federico II, Italy
| | - A Sepe
- Department of Translational Medical Sciences, University of Naples Federico II, Italy
| | - N Amato
- Department of Translational Medical Sciences, University of Naples Federico II, Italy
| | - A Casale
- Department of Translational Medical Sciences, University of Naples Federico II, Italy
| | - C Mercogliano
- Department of Translational Medical Sciences, University of Naples Federico II, Italy
| | - F De Gregorio
- Department of Translational Medical Sciences, University of Naples Federico II, Italy
| | - F Improta
- Department of Translational Medical Sciences, University of Naples Federico II, Italy
| | - A Elce
- CEINGE-Advanced Biotechnology, Naples, Italy; Department of Biochemistry and Biotechnology, University of Naples Federico II, Italy
| | - G Castaldo
- CEINGE-Advanced Biotechnology, Naples, Italy; Department of Biochemistry and Biotechnology, University of Naples Federico II, Italy
| | - V Raia
- Department of Translational Medical Sciences, University of Naples Federico II, Italy.
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Castaldo G, Tomaiuolo R. What is the role of the non-coding regions of theCFTRgene in cystic fibrosis? Expert Rev Respir Med 2014; 7:327-9. [DOI: 10.1586/17476348.2013.814404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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40
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Tomaiuolo G, Rusciano G, Caserta S, Carciati A, Carnovale V, Abete P, Sasso A, Guido S. A new method to improve the clinical evaluation of cystic fibrosis patients by mucus viscoelastic properties. PLoS One 2014; 9:e82297. [PMID: 24404129 PMCID: PMC3880261 DOI: 10.1371/journal.pone.0082297] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 10/22/2013] [Indexed: 11/18/2022] Open
Abstract
In cystic fibrosis (CF) patients airways mucus shows an increased viscoelasticity due to the concentration of high molecular weight components. Such mucus thickening eventually leads to bacterial overgrowth and prevents mucus clearance. The altered rheological behavior of mucus results in chronic lung infection and inflammation, which causes most of the cases of morbidity and mortality, although the cystic fibrosis complications affect other organs as well. Here, we present a quantitative study on the correlation between cystic fibrosis mucus viscoelasticity and patients clinical status. In particular, a new diagnostic parameter based on the correlation between CF sputum viscoelastic properties and the severity of the disease, expressed in terms of FEV1 and bacterial colonization, was developed. By using principal component analysis, we show that the types of colonization and FEV1 classes are significantly correlated to the elastic modulus, and that the latter can be used for CF severity classification with a high predictive efficiency (88%). The data presented here show that the elastic modulus of airways mucus, given the high predictive efficiency, could be used as a new clinical parameter in the prognostic evaluation of cystic fibrosis.
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Affiliation(s)
- Giovanna Tomaiuolo
- Dipartimento di Ingegneria Chimica, dei Materiali e della Produzione Industriale, Università di Napoli Federico II, Napoli, Italy
- CEINGE-Advanced Biotechnologies, Napoli, Italy
- * E-mail:
| | - Giulia Rusciano
- Dipartimento di Fisica, Università di Napoli Federico II, Complesso Universitario M.S. Angelo, Napoli, Italy
| | - Sergio Caserta
- Dipartimento di Ingegneria Chimica, dei Materiali e della Produzione Industriale, Università di Napoli Federico II, Napoli, Italy
- CEINGE-Advanced Biotechnologies, Napoli, Italy
| | - Antonio Carciati
- Dipartimento di Ingegneria Chimica, dei Materiali e della Produzione Industriale, Università di Napoli Federico II, Napoli, Italy
| | - Vincenzo Carnovale
- Dipartimento di Scienze mediche Traslazionali - Unità di Fibrosi Cistica dell’adulto, Università di Napoli Federico II, Napoli, Italy
| | - Pasquale Abete
- Dipartimento di Scienze mediche Traslazionali - Unità di Fibrosi Cistica dell’adulto, Università di Napoli Federico II, Napoli, Italy
| | - Antonio Sasso
- Dipartimento di Fisica, Università di Napoli Federico II, Complesso Universitario M.S. Angelo, Napoli, Italy
| | - Stefano Guido
- Dipartimento di Ingegneria Chimica, dei Materiali e della Produzione Industriale, Università di Napoli Federico II, Napoli, Italy
- CEINGE-Advanced Biotechnologies, Napoli, Italy
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Amato F, Tomaiuolo R, Borbone N, Elce A, Amato J, D'Errico S, De Rosa G, Mayol L, Piccialli G, Oliviero G, Castaldo G. Design, synthesis and biochemical investigation, by in vitro luciferase reporter system, of peptide nucleic acids as new inhibitors of miR-509-3p involved in the regulation of cystic fibrosis disease-gene expression. MEDCHEMCOMM 2014. [DOI: 10.1039/c3md00257h] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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An update on laboratory diagnosis of liver inherited diseases. BIOMED RESEARCH INTERNATIONAL 2013; 2013:697940. [PMID: 24222913 PMCID: PMC3816025 DOI: 10.1155/2013/697940] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 08/26/2013] [Indexed: 12/14/2022]
Abstract
Liver inherited diseases are a group of genetically determined clinical entities that appear with an early chronic liver involvement. They include Wilson's disease (hepatolenticular degeneration), hereditary hemochromatosis, and alpha-1-antitrypsin deficiency. In addition, cystic fibrosis, although it is not specifically a liver disease, may cause a severe liver involvement in a significant percentage of cases. For all these pathologies, the disease gene is known, and molecular analysis may contribute to the unequivocal diagnosis. This approach could avoid the patient invasive procedures and limit complications associated with a delay in diagnosis. We review liver inherited diseases on the basis of the genetic defect, focusing on the contribution of molecular analysis in the multistep diagnostic workup.
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Castaldo G, Scorza M, Elce A, Giordano S, Liguori R, Guerra G. Omics in laboratory medicine. J Matern Fetal Neonatal Med 2013; 26 Suppl 2:13-6. [DOI: 10.3109/14767058.2013.829694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Montagnani M, Cazzato S, Mutignani M, Cevenini M, Guidetti E, Zvi IB, Aldini R, Saraceni G, Cavoli C, Garagnani P, Ferrari S, Mantovani V. A patient with pancreas divisum, recurrent acute pancreatitis, and homozygosity for the cystic fibrosis transmembrane regulator-associated protein 5T allele. Clin Gastroenterol Hepatol 2013; 11:579-81. [PMID: 23416327 DOI: 10.1016/j.cgh.2013.02.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Revised: 01/06/2013] [Accepted: 02/01/2013] [Indexed: 02/07/2023]
Abstract
Mutations in the gene encoding the cystic fibrosis transmembrane regulator (CFTR) have been reported to increase the risk of recurrent acute pancreatitis in patients with pancreas divisum. We assessed the CFTR gene in a young male patient with pancreas divisum and recurrent acute pancreatitis. Magnetic resonance cholangiopancreatography and computed tomography revealed that the patient had pancreas divisum, with an enlarged and tortuous pancreatic duct; he also had positive results from the cystic fibrosis sweat test. Genetic analysis did not identify any common CFTR mutations, but did show that he was homozygous for the 5T allele in intron 8 IVS8 5T-12TG (which affects splicing at intron 8). Endoscopic sphincterotomy and stenting of papilla minor was performed. The IVS8 5T-12TG variant has been associated with abnormal organ development, therefore it is possible that CFTR has an important role in the development of the pancreatic duct. We propose this patient has recurrent acute pancreatitis resulting from a developmental defect associated with a suboptimal CFTR function.
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Affiliation(s)
- Marco Montagnani
- Dipartimento di Scienze Mediche e Chirurgiche, Policlinico S Orsola-Malpighi-Università di Bologna, Bologna, Italy.
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Amato F, Seia M, Giordano S, Elce A, Zarrilli F, Castaldo G, Tomaiuolo R. Gene mutation in microRNA target sites of CFTR gene: a novel pathogenetic mechanism in cystic fibrosis? PLoS One 2013; 8:e60448. [PMID: 23555973 PMCID: PMC3608608 DOI: 10.1371/journal.pone.0060448] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2012] [Accepted: 02/26/2013] [Indexed: 01/01/2023] Open
Abstract
Cystic fibrosis (CF) is the most frequent lethal genetic disorder among Caucasians. It depends on alterations of a chloride channel expressed by most epithelial cells and encoded by CFTR gene. Also using scanning techniques to analyze the whole coding regions of CFTR gene, mutations are not identified in up to 10% of CF alleles, and such figure increases in CFTR-related disorders (CFTR-RD). Other gene regions may be the site of causing-disease mutations. We searched for genetic variants in the 1500 bp of CFTR 3′ untranslated region, typical target of microRNA (miRNA) posttranscriptional gene regulation, in either CF patients with the F508del homozygous genotype and different clinical expression (n = 20), CF (n = 32) and CFTR-RD (n = 43) patients with one or none mutation after CFTR scanning and in controls (n = 50). We identified three SNPs, one of which, the c.*1043A>C, was located in a region predicted to bind miR-433 and miR-509-3p. Such mutation was peculiar of a CFTR-RD patient that had Congenital Bilateral Absence of Vas Deferens (CBAVD), diffuse bronchiectasis, a borderline sweat chloride test and the heterozygous severe F508del mutation on the other allele. The expression analysis demonstrated that the c.*1043A>C increases the affinity for miR-509-3p and slightly decreases that for the miR-433. Both miRNAs cause in vitro a reduced expression of CFTR protein. Thus, the c.*1043A>C may act as a mild CFTR mutation enhancing the affinity for inhibitory miRNAs as a novel pathogenetic mechanism in CF.
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Affiliation(s)
- Felice Amato
- CEINGE-Biotecnologie avanzate, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Manuela Seia
- Laboratorio di Genetica Medica, Fondazione IRCCS Cà Granda - Ospedale Maggiore Policlnico, Mangiagalli e Regina Elena, Milan, Italy
| | - Sonia Giordano
- CEINGE-Biotecnologie avanzate, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Ausilia Elce
- CEINGE-Biotecnologie avanzate, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
| | - Federica Zarrilli
- CEINGE-Biotecnologie avanzate, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
- Dipartimento di Bioscienze e Territorio, Università del Molise, Isernia, Italy
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie avanzate, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
- * E-mail:
| | - Rossella Tomaiuolo
- CEINGE-Biotecnologie avanzate, Naples, Italy
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, Naples, Italy
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Giordano S, Amato F, Elce A, Monti M, Iannone C, Pucci P, Seia M, Angioni A, Zarrilli F, Castaldo G, Tomaiuolo R. Molecular and functional analysis of the large 5' promoter region of CFTR gene revealed pathogenic mutations in CF and CFTR-related disorders. J Mol Diagn 2013; 15:331-40. [PMID: 23470247 DOI: 10.1016/j.jmoldx.2013.01.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2012] [Revised: 01/07/2013] [Accepted: 01/10/2013] [Indexed: 11/17/2022] Open
Abstract
Patients with cystic fibrosis (CF) manifest a multisystemic disease due to mutations in the gene encoding the cystic fibrosis transmembrane conductance regulator (CFTR); despite extensive testing of coding regions, a proportion of CF alleles remains unidentified. We studied 118 patients with CF and CFTR-related disorders, most with one or both unknown mutations after the scanning of CFTR coding regions, and a non-CF control group (n = 75) by sequencing the 6000-bp region at the 5' of the CFTR gene. We identified 23 mutations, of which 9 were novel. We expressed such mutations in vitro using four cell systems to explore their functional effect, relating the data to the clinical expression of each patient. Some mutations reduced expression of the gene reporter firefly luciferase in various cell lines and may act as disease-causing mutations. Other mutations caused an increase in luciferase expression in some cell lines. One mutation had a different effect in different cells. For other mutations, the expression assay excluded a functional role. Gene variants in the large 5' region may cause altered regulation of CFTR gene expression, acting as disease-causing mutations or modifiers of its clinical phenotype. Studies of in vitro expression in different cell systems may help reveal the effect of such mutations.
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47
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Maruotti GM, Frisso G, Calcagno G, Fortunato G, Castaldo G, Martinelli P, Sacchetti L, Salvatore F. Prenatal diagnosis of inherited diseases: 20 years’ experience of an Italian Regional Reference Centre. Clin Chem Lab Med 2013; 51:2211-7. [DOI: 10.1515/cclm-2013-0194] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Accepted: 03/08/2013] [Indexed: 11/15/2022]
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Congenital diarrheal disorders: an updated diagnostic approach. Int J Mol Sci 2012; 13:4168-4185. [PMID: 22605972 PMCID: PMC3344208 DOI: 10.3390/ijms13044168] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 03/02/2012] [Accepted: 03/19/2012] [Indexed: 01/07/2023] Open
Abstract
Congenital diarrheal disorders (CDDs) are a group of inherited enteropathies with a typical onset early in the life. Infants with these disorders have frequently chronic diarrhea of sufficient severity to require parenteral nutrition. For most CDDs the disease-gene is known and molecular analysis may contribute to an unequivocal diagnosis. We review CDDs on the basis of the genetic defect, focusing on the significant contribution of molecular analysis in the complex, multistep diagnostic work-up.
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