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Cárdenas JM, Vergara D, Witting S, Balut F, Guerra P, Mesa JT, Silva S, Tello J, Retamales Á, Barrios A, Pinto F, Faundes V, Troncoso M. Genotype and Phenotype Characterization of Patients with Mucopolysaccharidosis IV-A in Chile. Mol Syndromol 2023; 14:416-427. [PMID: 37901859 PMCID: PMC10601820 DOI: 10.1159/000529807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/16/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Morquio syndrome or mucopolysaccharidosis type IV-A (MPS IV-A) is an autosomal recessive disease caused by biallelic variants in the GALNS gene, encoding the lysosomal enzyme GalN6S, responsible for glycosaminoglycan keratan sulfate and chondroitin-6-sulfate degradation. Studies have shown that the degree of evolutionary and chemical divergence of missense variants in GalN6S when compared to ancestral amino acids is associated with the severity of the syndrome, suggesting a genotype-phenotype correlation. There is little information on Latin American patients with MPS IV-A that replicate these findings. This study aimed to characterize the phenotype and genotype from patients with MPS IV-A, who are under Enzyme Replacement Therapy at the Children's Neuropsychiatry Service of the Hospital Clínico San Borja Arriarán, Santiago, Chile, and to determine if there is any association between genotype and phenotype with those findings. Methods Information was collected from medical charts, all patients went through a GalN6S enzymatic activity measurement in leukocytes from peripheral blood, and the GALNS gene was sequenced for all cases. Results 12 patients with MPS IV-A were recruited, all patients presented multisystem involvement, mostly skeletal, and 75% of cases underwent surgical interventions, and cervical arthrodesis was the most frequent procedure. In regards of the genotype, the two most frequent variants were c.319+2T>C (n = 10, 41.66%) and p.(Arg386Cys) (n = 8, 33.33%), the first one was previously described in 2018 in a patient from Chile [Bochernitsan et al., 2018]. Conclusion This is the first time that a genotype-phenotype correlation has been studied by analyzing the variants effect on the molecular structure of human GalN6S and the evolutionary conservation degree of affected residues in a cohort of patients in Chile. Albeit our work could not find statistically significant associations, we may infer that the evolutionary conservations of affected amino acids and the effect of variants on enzyme structure may play a main role. Further analyzes should consider a meta-analysis of published cases with genotype data and larger samples and include other variables that could provide more information. Finally, our data strongly suggest that variant c.319+2T>C could have a founder effect in Chilean patients with MPS IV-A.
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Affiliation(s)
- José Miguel Cárdenas
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Diane Vergara
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Scarlet Witting
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Fernanda Balut
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Patricio Guerra
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - José Tomás Mesa
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Sebastián Silva
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Javiera Tello
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Álvaro Retamales
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Andrés Barrios
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Fernando Pinto
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Víctor Faundes
- Laboratorio de Genética y Enfermedades Metabólicas, Instituto de Nutrición y Tecnología en Alimentos, Universidad de Chile, Santiago, Chile
| | - Mónica Troncoso
- Hospital Clínico San Borja Arriarán, Jefe de Unidad de Neurología Pediátrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
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Pachajoa H, Acosta MA, Alméciga-Díaz CJ, Ariza Y, Diaz-Ordoñez L, Caicedo-Herrera G, Cuartas D, Nastasi-Catanese JA, Ramírez-Montaño D, Silva YK, Moreno L, Satizabal J, Garcia N, Montoya J, Prada C, Porras G, Velasco H, Candelo E. Molecular characterization of mucopolysaccharidosis type IVA patients in the Andean region of Colombia. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2021; 187:388-395. [PMID: 34542925 DOI: 10.1002/ajmg.c.31936] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/27/2021] [Accepted: 09/01/2021] [Indexed: 01/30/2023]
Abstract
Colombia has a high prevalence of mucopolysaccharidosis (MPS) type IVA. Nevertheless, data regarding the mutation spectrum for MPS IVA in this population have not been completely characterized. Forty-seven families and 53 patients from seven different Colombian regions were tested for MPS IVA mutations. We compared the sequences with the N-acetylgalactosamine-6-sulfatase (GALNS) reference sequence NM_000512.4, and gene variants were reported. Bioinformatics analysis was performed using SWISS-MODEL. The mutant proteins were generated by homology from the wild-type GALNS 4FDJ template obtained from the PDB database, and visualization was performed using Swiss-PDBViewer and UCSF Chimera. The predictive analysis was run using different bioinformatic tools, and the deleterious annotation of genetic variants was performed using a neural network. We found that 79% and 21% of the cohort was homozygous and compound heterozygous, respectively. The most frequent mutation observed was p.Gly301Cys (78.3% of alleles), followed by p.Arg386Cys (10.4% of alleles). A novel mutation (p.Phe72Ile) was described and classified in silico as a pathogenic variant. This study reveals the mutation spectrum of MPS IVA in Colombia. The high prevalence of the p.Gly301Cys mutation suggests a founder effect of this variant in the Colombian population that causes diseases in the Andean region (via migration). These data can facilitate genetic counseling, prenatal diagnosis, and the design of therapeutic interventions.
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Affiliation(s)
- Harry Pachajoa
- Health Science Faculty and Congenital Abnormalities and Rare Diseases Research Center (CIACER), Universidad Icesi, Colombia.,Fundación Valle del Lili, Cali, Colombia
| | | | - Carlos J Alméciga-Díaz
- Institute for the Study of Inborn Errors of Metabolism, Faculty of Science, Pontificia Universidad Javeriana, Bogotá, DC, Colombia
| | - Yoseth Ariza
- Health Science Faculty and Congenital Abnormalities and Rare Diseases Research Center (CIACER), Universidad Icesi, Colombia
| | - Lorena Diaz-Ordoñez
- Health Science Faculty and Congenital Abnormalities and Rare Diseases Research Center (CIACER), Universidad Icesi, Colombia
| | - Gabriela Caicedo-Herrera
- Health Science Faculty and Congenital Abnormalities and Rare Diseases Research Center (CIACER), Universidad Icesi, Colombia
| | - Daniel Cuartas
- Public Health Department, Universidad del Valle, Cali, Colombia
| | | | - Diana Ramírez-Montaño
- Health Science Faculty and Congenital Abnormalities and Rare Diseases Research Center (CIACER), Universidad Icesi, Colombia
| | - Yiseth Katherine Silva
- Health Science Faculty and Congenital Abnormalities and Rare Diseases Research Center (CIACER), Universidad Icesi, Colombia
| | - Lina Moreno
- Congenital and Metabolic Disorders Research Group, Health Science Department, Universidad del Valle, Cali, Colombia.,Biomedical Science Doctorate Program: Medical Genetics, Universidad del Valle, Cali, Colombia
| | - Jose Satizabal
- Congenital and Metabolic Disorders Research Group, Health Science Department, Universidad del Valle, Cali, Colombia.,Biomedical Science Doctorate Program: Medical Genetics, Universidad del Valle, Cali, Colombia
| | - Natalia Garcia
- Genetics Department, Universidad de Manizales, Cali, Colombia
| | - Jorge Montoya
- Genetic Department, Hospital Universitario San Vicente Fundación, Medellin, Colombia
| | - Carlos Prada
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA.,Centro de Medicina Genomica y Metabolismo, Fundacion Cardiovascular de Colombia, Floridablanca, Colombia
| | - Gloria Porras
- INCERHC Centro de investigación Salud Comfamiliar, Comfamiliar Risaralda, Pereira, Colombia
| | | | - Estephania Candelo
- Health Science Faculty and Congenital Abnormalities and Rare Diseases Research Center (CIACER), Universidad Icesi, Colombia.,Fundación Valle del Lili, Cali, Colombia
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Zanetti A, D'Avanzo F, AlSayed M, Brusius-Facchin AC, Chien YH, Giugliani R, Izzo E, Kasper DC, Lin HY, Lin SP, Pollard L, Singh A, Tonin R, Wood T, Morrone A, Tomanin R. Molecular basis of mucopolysaccharidosis IVA (Morquio A syndrome): A review and classification of GALNS gene variants and reporting of 68 novel variants. Hum Mutat 2021; 42:1384-1398. [PMID: 34387910 PMCID: PMC9291100 DOI: 10.1002/humu.24270] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 08/02/2021] [Accepted: 08/08/2021] [Indexed: 12/18/2022]
Abstract
Mucopolysaccharidosis IVA (MPS IVA, Morquio A syndrome) is a rare autosomal recessive lysosomal storage disorder caused by mutations in the N‐acetylgalactosamine‐6‐sulfatase (GALNS) gene. We collected, analyzed, and uniformly summarized all published GALNS gene variants, thus updating the previous mutation review (published in 2014). In addition, new variants were communicated by seven reference laboratories in Europe, the Middle East, Latin America, Asia, and the United States. All data were analyzed to determine common alleles, geographic distribution, level of homozygosity, and genotype‐phenotype correlation. Moreover, variants were classified according to their pathogenicity as suggested by ACMG. Including those previously published, we assembled 446 unique variants, among which 68 were novel, from 1190 subjects (including newborn screening positive subjects). Variants' distribution was missense (65.0%), followed by nonsense (8.1%), splicing (7.2%), small frameshift deletions(del)/insertions(ins) (7.0%), intronic (4.0%), and large del/ins and complex rearrangements (3.8%). Half (50.4%) of the subjects were homozygous, 37.1% were compound heterozygous, and 10.7% had only one variant detected. The novel variants underwent in silico analysis to evaluate their pathogenicity. All variants were submitted to ClinVar (https://www.ncbi.nlm.nih.gov/clinvar/) to make them publicly available. Mutation updates are essential for the correct molecular diagnoses, genetic counseling, prenatal and preimplantation diagnosis, and disease management.
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Affiliation(s)
- Alessandra Zanetti
- Laboratory of Diagnosis and Therapy of Lysosomal Disorders, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Francesca D'Avanzo
- Laboratory of Diagnosis and Therapy of Lysosomal Disorders, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
| | - Moeenaldeen AlSayed
- King Faisal Specialist Hospital and Research Centre, Faculty of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | | | - Yin-Hsiu Chien
- Department of Medical Genetics and Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - Roberto Giugliani
- Department of Genetics/UFRGS, Medical Genetics Service/HCPA, DR BRASIL Research Group/HCPA, and INAGEMP, Porto Alegre, Brazil
| | - Emanuela Izzo
- BioMarin Pharmaceutical Inc., Novato, California, USA
| | | | - Hsiang-Yu Lin
- Division of Genetics and Metabolism, Departments of Pediatrics and Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Shuan-Pei Lin
- Division of Genetics and Metabolism, Departments of Pediatrics and Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Laura Pollard
- Biochemical Diagnostic Laboratory, Greenwood Genetic Center, Greenwood, South Carolina, USA
| | | | - Rodolfo Tonin
- Molecular and Cell Biology Laboratory, Pediatric Neurology Unit and Laboratories, Meyer Children's Hospital, Florence, Italy.,Department of Neurosciences, Psychology, Pharmacology and Child Health, University of Florence, Florence, Italy
| | - Tim Wood
- Biochemical Diagnostic Laboratory, Greenwood Genetic Center, Greenwood, South Carolina, USA
| | - Amelia Morrone
- Molecular and Cell Biology Laboratory, Pediatric Neurology Unit and Laboratories, Meyer Children's Hospital, Florence, Italy.,Department of Neurosciences, Psychology, Pharmacology and Child Health, University of Florence, Florence, Italy
| | - Rosella Tomanin
- Laboratory of Diagnosis and Therapy of Lysosomal Disorders, Department of Women's and Children's Health, University of Padova, Padova, Italy.,Fondazione Istituto di Ricerca Pediatrica Città della Speranza, Padova, Italy
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Dos Santos-Lopes SS, de Oliveira JMF, de Queiroga Nascimento D, Montenegro YHA, Leistner-Segal S, Brusius-Facchin AC, Eufrazino Gondim C, Giugliani R, de Medeiros PFV. Demographic, clinical, and ancestry characterization of a large cluster of mucopolysaccharidosis IV A in the Brazilian Northeast region. Am J Med Genet A 2021; 185:2929-2940. [PMID: 34076347 DOI: 10.1002/ajmg.a.62375] [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: 12/09/2020] [Revised: 05/04/2021] [Accepted: 05/13/2021] [Indexed: 11/08/2022]
Abstract
Mucopolysaccharidosis (MPS) IVA is a rare autosomal recessive disease with a highly variable distribution worldwide. Discrepancies in the incidence of MPS IVA among populations of different ethnicities are mostly attributed to founder effects. Demographic and clinical data from 28 MPS IVA patients, followed at a single center, and ancestry (Y chromosome and mitochondrial markers) of a subsample of 17 patients, most with the p.Ser341Arg (c.1023C>G) mutation were analyzed. Parental consanguinity was observed in 15/20 couples; a rare homozygous N-acetylgalactosamine-6-sulfatase (GALNS) mutation was found in 7/16 families with intra-familial phenotypic heterogeneity. Paternal ancestry was 94.2% (16/17) European, 5.8% (1/17) African, and 0% Amerindian. The European paternal haplogroups R1a, R1b, and R* accounted for 94.2% (16/17) of the patients. The R1b haplogroup, identified in 59% (10/17) of the patients, is frequently found in populations from the Iberian Peninsula. European, Amerindian, and African maternal ancestry was observed in 46.9% (8/17), 35.4% (6/17), and 17.7% (3/17) of the patients, respectively. Study of a cluster of MPS IVA patients from Northeastern Brazil, with high parental consanguinity and phenotypic heterogeneity showed predominantly European parental ancestry. This ancestry finding corroborates historical data on the local settlement, formed predominantly by European men.
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Affiliation(s)
| | | | | | | | - Sandra Leistner-Segal
- National Institute of Populational Medical Genetics-INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ana Carolina Brusius-Facchin
- National Institute of Populational Medical Genetics-INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cátia Eufrazino Gondim
- Alcides Carneiro University Hospital - HUAC, Federal University of Campina Grande, Campina Grande, Paraiba, Brazil
| | - Roberto Giugliani
- National Institute of Populational Medical Genetics-INAGEMP, Porto Alegre, Rio Grande do Sul, Brazil.,Medical Genetics Service, Hospital de Clinicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil.,Department of Genetics, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
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Epidemiology of Mucopolysaccharidoses Update. Diagnostics (Basel) 2021; 11:diagnostics11020273. [PMID: 33578874 PMCID: PMC7916572 DOI: 10.3390/diagnostics11020273] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/03/2021] [Accepted: 02/05/2021] [Indexed: 12/26/2022] Open
Abstract
Mucopolysaccharidoses (MPS) are a group of lysosomal storage disorders caused by a lysosomal enzyme deficiency or malfunction, which leads to the accumulation of glycosaminoglycans in tissues and organs. If not treated at an early stage, patients have various health problems, affecting their quality of life and life-span. Two therapeutic options for MPS are widely used in practice: enzyme replacement therapy and hematopoietic stem cell transplantation. However, early diagnosis of MPS is crucial, as treatment may be too late to reverse or ameliorate the disease progress. It has been noted that the prevalence of MPS and each subtype varies based on geographic regions and/or ethnic background. Each type of MPS is caused by a wide range of the mutational spectrum, mainly missense mutations. Some mutations were derived from the common founder effect. In the previous study, Khan et al. 2018 have reported the epidemiology of MPS from 22 countries and 16 regions. In this study, we aimed to update the prevalence of MPS across the world. We have collected and investigated 189 publications related to the prevalence of MPS via PubMed as of December 2020. In total, data from 33 countries and 23 regions were compiled and analyzed. Saudi Arabia provided the highest frequency of overall MPS because of regional or consanguineous marriages (or founder effect), followed by Portugal, Brazil, the Netherlands, and Australia. The newborn screening is an efficient and early diagnosis for MPS. MPS I has been approved for newborn screening in the United States. After the newborn screening of MPS I, the frequency of MPS I increased, compared with the past incidence rates. Overall, we conclude that the current identification methods are not enough to recognize all MPS patients, leading to an inaccurate incidence and status. Differences in ethnic background and/or founder effects impact on the frequency of MPS, which affects the prevalence of MPS. Two-tier newborn screening has accelerated early recognition of MPS I, providing an accurate incidence of patients.
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Brusius-Facchin AC, Rojas Malaga D, Leistner-Segal S, Giugliani R. Recent advances in molecular testing to improve early diagnosis in children with mucopolysaccharidoses. Expert Rev Mol Diagn 2018; 18:855-866. [DOI: 10.1080/14737159.2018.1523722] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
| | - Diana Rojas Malaga
- Medical Genetics Service, HCPA, Porto Alegre, RS, Brazil
- Postgraduate Program of Genetics and Molecular Biology, UFRGS, Porto Alegre, RS, Brazil
| | - Sandra Leistner-Segal
- Medical Genetics Service, HCPA, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Science, UFRGS, Porto Alegre, RS, Brazil
| | - Roberto Giugliani
- Medical Genetics Service, HCPA, Porto Alegre, RS, Brazil
- Postgraduate Program of Genetics and Molecular Biology, UFRGS, Porto Alegre, RS, Brazil
- Postgraduate Program in Medical Science, UFRGS, Porto Alegre, RS, Brazil
- Department of Genetics, UFRGS, Porto Alegre, RS, Brazil
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