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del Real Á, Cruz R, Sañudo C, Pérez-Castrillón JL, Pérez-Núñez MI, Olmos JM, Hernández JL, García-Ibarbia C, Valero C, Riancho JA. High Frequencies of Genetic Variants in Patients with Atypical Femoral Fractures. Int J Mol Sci 2024; 25:2321. [PMID: 38396997 PMCID: PMC10889592 DOI: 10.3390/ijms25042321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Revised: 02/10/2024] [Accepted: 02/13/2024] [Indexed: 02/25/2024] Open
Abstract
This study explores the genetic factors associated with atypical femoral fractures (AFF), rare fractures associated with prolonged anti-resorptive therapy. AFF are fragility fractures that typically appear in the subtrochanteric or diaphyseal regions of the femur. While some cases resemble fractures in rare genetic bone disorders, the exact cause remains unclear. This study investigates 457 genes related to skeletal homeostasis in 13 AFF patients by exome sequencing, comparing the results with osteoporotic patients (n = 27) and Iberian samples from the 1000 Genomes Project (n = 107). Only one AFF case carried a pathogenic variant in the gene set, specifically in the ALPL gene. The study then examined variant accumulation in the gene set, revealing significantly more variants in AFF patients than in osteoporotic patients without AFF (p = 3.7 × 10-5), particularly in ACAN, AKAP13, ARHGEF3, P4HB, PITX2, and SUCO genes, all of them related to osteogenesis. This suggests that variant accumulation in bone-related genes may contribute to AFF risk. The polygenic nature of AFF implies that a complex interplay of genetic factors determines the susceptibility to AFF, with ACAN, SUCO, AKAP13, ARHGEF3, PITX2, and P4HB as potential genetic risk factors. Larger studies are needed to confirm the utility of gene set analysis in identifying patients at high risk of AFF during anti-resorptive therapy.
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Affiliation(s)
- Álvaro del Real
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
| | - Raquel Cruz
- Grupo de Medicina Xenómica, Centro de Investigación en Medicina Molecular y Enfermedades Crónicas, Universidade de Santiago de Compostela (USC), 15782 Santiago de Compostela, Spain;
| | - Carolina Sañudo
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
| | - José L. Pérez-Castrillón
- Internal Medicine Department, University Hospital Rio Hortega of Valladolid, 47012 Valladolid, Spain;
| | - María I. Pérez-Núñez
- Traumatology Department, University Hospital M. Valdecilla, 39008 Santander, Spain;
| | - Jose M. Olmos
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - José L. Hernández
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Carmen García-Ibarbia
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Carmen Valero
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
| | - Jose A. Riancho
- Departamento de Medicina y Psiquiatría, Instituto de Investigación Sanitaria Valdecilla (IDIVAL), Facultad de Medicina, Universidad de Cantabria, 39011 Santander, Spain; (Á.d.R.); (C.S.); (J.M.O.); (J.L.H.); (C.V.)
- Internal Medicine Department, Marqués de Valdecilla University Hospital, 39008 Santander, Spain;
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, 28029 Madrid, Spain
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Zhozhikov L, Sukhomyasova A, Gurinova E, Nogovicina A, Vasilev F, Maksimova N. Origins of SOPH syndrome: A study of 93 Yakut patients with review of C-terminal phenotype. Clin Genet 2023; 103:625-635. [PMID: 36843433 DOI: 10.1111/cge.14319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/21/2023] [Accepted: 02/22/2023] [Indexed: 02/28/2023]
Abstract
Since the first report of SOPH syndrome among the Yakut population in 2010, new clinical data of SOPH-like conditions continue to appear. We expand the phenotypic spectrum of SOPH syndrome and perform a comparative analysis of Yakut SOPH patients' clinical data with SOPH-like conditions reported in the world scientific literature to form a foundation for NBAS pathogenesis discussion. Clinical data from the genetic records of 93 patients with SOPH syndrome and global survey data on patients with pathogenic variants of the C-terminal in the NBAS gene were collected. A detailed phenotype description of patients is presented with a total number of 111 individuals. Underweight below the fifth centile and prone to delayed bone age in Yakut SOPH patients are retrospectively observed. We outline the short stature with optic atrophy as the leading phenotyping trait for C-terminal NBAS patients. The pathophysiology and patients management of SOPH-like conditions are discussed.
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Affiliation(s)
- Leonid Zhozhikov
- Research Laboratory of "Molecular Medicine and Human Genetics", Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia
| | - Aitalina Sukhomyasova
- Research Laboratory of "Molecular Medicine and Human Genetics", Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia
- Medical Genetic Center, Republic Hospital No1 - National Center of Medicine, Yakutsk, Russia
| | - Elizaveta Gurinova
- Medical Genetic Center, Republic Hospital No1 - National Center of Medicine, Yakutsk, Russia
| | - Anna Nogovicina
- Research Laboratory of "Molecular Medicine and Human Genetics", Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia
| | - Filipp Vasilev
- Research Laboratory of "Molecular Medicine and Human Genetics", Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia
| | - Nadezhda Maksimova
- Research Laboratory of "Molecular Medicine and Human Genetics", Institute of Medicine, North-Eastern Federal University, Yakutsk, Russia
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Palagano E, Gordon CT, Uva P, Strina D, Dimartino C, Villa A, Amiel J, Guion-Almeida ML, Vendramini-Pittoli S, Kokitsu-Nakata NM, Zechi-Ceide RM, Sobacchi C. A novel intronic variant in PIGB in Acrofrontofacionasal dysostosis type 1 patients expands the spectrum of phenotypes associated with GPI biosynthesis defects. Bone 2021; 153:116152. [PMID: 34400385 DOI: 10.1016/j.bone.2021.116152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 11/15/2022]
Abstract
Acrofrontofacionasal dysostosis type 1 (AFFND1) is an extremely rare disorder characterized by several dysmorphic features, skeletal abnormalities and intellectual disability, and described only in seven patients in the literature. A biallelic variant in the Neuroblastoma Amplified Sequence (NBAS) gene was recently identified in two Indian patients with AFFND1. Here we report genetic investigation of AFFND1 in the originally described Brazilian families and the identification of an extremely rare, recessively-inherited, intronic variant in the Phosphatidylinositol Glycan class B (PIGB) gene NC_000015.10 (NM_004855.4): c.795-19T > G) in the affected individuals. The PIGB gene encodes an enzyme involved in the biosynthesis of the glycosylphosphatidylinositol (GPI) anchor, which is required for the post-translational modification of a large variety of proteins, enabling their correct cellular localization and function. Recessive variants in PIGB have previously been reported in individuals with a neurodevelopmental syndrome having partial overlap with AFFND1. In vitro assays demonstrated that the intronic variant leads to exon skipping, suggesting the Brazilian AFFND1 patients may be null for PIGB, in agreement with their severe clinical phenotype. These data increase the number of pathogenic variants in the PIGB gene, place AFFND1 among GPI deficiencies and extend the spectrum of phenotypes associated with GPI biosynthesis defects.
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Affiliation(s)
- Eleonora Palagano
- CNR-IRGB, Milan Unit, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | | | - Paolo Uva
- IRCCS G. Gaslini, Genoa, Italy; Italian Institute of Technology, Genoa, Italy
| | - Dario Strina
- CNR-IRGB, Milan Unit, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano (MI), Italy
| | | | - Anna Villa
- CNR-IRGB, Milan Unit, Milan, Italy; San Raffaele Telethon Institute for Gene Therapy SR-Tiget, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Jeanne Amiel
- INSERM UMR1163, Institut Imagine, Université de Paris, Paris, France; Service de Génétique, Hôpital Necker-Enfants Malades, AP-HP, Paris, France
| | - Maria L Guion-Almeida
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
| | - Siulan Vendramini-Pittoli
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
| | - Nancy M Kokitsu-Nakata
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
| | - Roseli M Zechi-Ceide
- Department of Clinical Genetics, Hospital for Rehabilitation of Craniofacial Anomalies (HRCA), University of São Paulo, Bauru, Brazil
| | - Cristina Sobacchi
- CNR-IRGB, Milan Unit, Milan, Italy; IRCCS Humanitas Research Hospital, Rozzano (MI), Italy.
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