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Hammoud M, Rodrigues AMS, Assiri I, Sabir E, Lafhal K, Najeh S, Jakani M, Imad N, Bourrahouat A, Ait Sab I, Elqadiry R, Nassih H, Outzourit A, Elamiri M, Maoulainine F, Slitine Elidrissi N, Bennaoui F, Bourous M, Mrhar S, Essaadouni L, Stien D, Rada N, Bouskraoui M, Houël E, Fdil N. Sphingolipidoses in Morocco: Chemical profiling for an affordable and rapid diagnosis strategy. Prostaglandins Other Lipid Mediat 2023; 168:106751. [PMID: 37295489 DOI: 10.1016/j.prostaglandins.2023.106751] [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: 02/27/2023] [Revised: 05/28/2023] [Accepted: 06/03/2023] [Indexed: 06/12/2023]
Abstract
Sphingolipidoses are a group of metabolic diseases in which lysosomal hydrolases dysfunction disrupt normal sphingolipids' metabolism, leading to excess accumulation in cellular compartments and excretion in urine. These pathologies represent a significant burden among Moroccan population, for which an easy access to enzymatic assays and genetic tests is not guaranteed. Parallel analytical methods thus have to be developed for preliminary screening. In this study, 107 patients were addressed to the metabolic platform of the Marrakesh Faculty of Medicine for diagnosis confirmation. Thin-Layer Chromatography was used as a first step to perform chemical profiling of the patients' urinary lipids, allowing 36% of the patients to be efficiently oriented towards the adequate enzymatic assay. UPLC-MS/MS analyses of urinary sulfatides excreted in urines patient had been used to control the reliability of TLC analysis and to obtain more accurate information related to the sulfatides isoforms. This analytical process combining TLC with UPLC-MS/MS has enabled rapid and appropriate patient management in a reduced time and with reduced resources.
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Affiliation(s)
- M Hammoud
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - A M S Rodrigues
- Sorbonne Université, CNRS, Laboratoire de Biodiversité et Biotechnologies Microbiennes, USR3579, LBBM, Observatoire Océanologique, Banyuls-sur-Mer 66650, France
| | - I Assiri
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - Es Sabir
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - K Lafhal
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - S Najeh
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - M Jakani
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco
| | - N Imad
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - A Bourrahouat
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - I Ait Sab
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - R Elqadiry
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - H Nassih
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - A Outzourit
- Internal Medicine Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - M Elamiri
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco
| | - F Maoulainine
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - N Slitine Elidrissi
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - F Bennaoui
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - M Bourous
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - S Mrhar
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - L Essaadouni
- Internal Medicine Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - D Stien
- Sorbonne Université, CNRS, Laboratoire de Biodiversité et Biotechnologies Microbiennes, USR3579, LBBM, Observatoire Océanologique, Banyuls-sur-Mer 66650, France
| | - N Rada
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - M Bouskraoui
- Paediatrics' Department, Mohammed VI Hospital University, Marrakesh, Morocco
| | - E Houël
- Sorbonne Université, CNRS, Laboratoire de Biodiversité et Biotechnologies Microbiennes, USR3579, LBBM, Observatoire Océanologique, Banyuls-sur-Mer 66650, France.
| | - N Fdil
- Metabolic platform, Biochemistry Laboratory, Team for Childhood, Health and Development, Faculty of Medicine, Cadi Ayyad University, B.P. 7010, Marrakesh, Morocco; Moroccan Association for Inherited Metabolic Diseases, Morocco.
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2
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Trinidad M, Hong X, Froelich S, Daiker J, Sacco J, Nguyen HP, Campagna M, Suhr D, Suhr T, LeBowitz JH, Gelb MH, Clark WT. Predicting disease severity in metachromatic leukodystrophy using protein activity and a patient phenotype matrix. Genome Biol 2023; 24:172. [PMID: 37480112 PMCID: PMC10360315 DOI: 10.1186/s13059-023-03001-z] [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: 07/26/2022] [Accepted: 06/29/2023] [Indexed: 07/23/2023] Open
Abstract
BACKGROUND Metachromatic leukodystrophy (MLD) is a lysosomal storage disorder caused by mutations in the arylsulfatase A gene (ARSA) and categorized into three subtypes according to age of onset. The functional effect of most ARSA mutants remains unknown; better understanding of the genotype-phenotype relationship is required to support newborn screening (NBS) and guide treatment. RESULTS We collected a patient data set from the literature that relates disease severity to ARSA genotype in 489 individuals with MLD. Patient-based data were used to develop a phenotype matrix that predicts MLD phenotype given ARSA alleles in a patient's genotype with 76% accuracy. We then employed a high-throughput enzyme activity assay using mass spectrometry to explore the function of ARSA variants from the curated patient data set and the Genome Aggregation Database (gnomAD). We observed evidence that 36% of variants of unknown significance (VUS) in ARSA may be pathogenic. By classifying functional effects for 251 VUS from gnomAD, we reduced the incidence of genotypes of unknown significance (GUS) by over 98.5% in the overall population. CONCLUSIONS These results provide an additional tool for clinicians to anticipate the disease course in MLD patients, identifying individuals at high risk of severe disease to support treatment access. Our results suggest that more than 1 in 3 VUS in ARSA may be pathogenic. We show that combining genetic and biochemical information increases diagnostic yield. Our strategy may apply to other recessive diseases, providing a tool to address the challenge of interpreting VUS within genotype-phenotype relationships and NBS.
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Affiliation(s)
- Marena Trinidad
- Translational Genomics Group, BioMarin Pharmaceutical Inc., Novato, CA, USA
| | - Xinying Hong
- Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Steven Froelich
- Translational Genomics Group, BioMarin Pharmaceutical Inc., Novato, CA, USA
| | - Jessica Daiker
- Department of Chemistry, University of Washington, Seattle, WA, USA
| | - James Sacco
- Translational Genomics Group, BioMarin Pharmaceutical Inc., Novato, CA, USA
| | - Hong Phuc Nguyen
- Translational Genomics Group, BioMarin Pharmaceutical Inc., Novato, CA, USA
| | - Madelynn Campagna
- Department of Chemistry, University of Washington, Seattle, WA, USA
- Department of Biochemistry, University of Washington, Seattle, WA, USA
| | | | | | | | - Michael H Gelb
- Department of Chemistry, University of Washington, Seattle, WA, USA.
- Department of Biochemistry, University of Washington, Seattle, WA, USA.
| | - Wyatt T Clark
- Translational Genomics Group, BioMarin Pharmaceutical Inc., Novato, CA, USA.
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3
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Adang L. Leukodystrophies. Continuum (Minneap Minn) 2022; 28:1194-1216. [PMID: 35938662 DOI: 10.1212/con.0000000000001130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE OF REVIEW This article reviews the most common leukodystrophies and is focused on diagnosis, clinical features, and emerging therapeutic options. RECENT FINDINGS In the past decade, the recognition of leukodystrophies has exponentially increased, and now this class includes more than 30 distinct disorders. Classically recognized as progressive and fatal disorders affecting young children, it is now understood that leukodystrophies are associated with an increasing spectrum of neurologic trajectories and can affect all ages. Next-generation sequencing and newborn screening allow the opportunity for the recognition of presymptomatic and atypical cases. These new testing opportunities, in combination with growing numbers of natural history studies and clinical consensus guidelines, have helped improve diagnosis and clinical care. Additionally, a more granular understanding of disease outcomes informs clinical trial design and has led to several recent therapeutic advances. This review summarizes the current understanding of the clinical manifestations of disease and treatment options for the most common leukodystrophies. SUMMARY As early testing becomes more readily available through next-generation sequencing and newborn screening, neurologists will better understand the true incidence of the leukodystrophies and be able to diagnose children within the therapeutic window. As targeted therapies are developed, it becomes increasingly imperative that this broad spectrum of disorders is recognized and diagnosed. This work summarizes key advances in the leukodystrophy field.
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4
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Olea-Flores M, Kan J, Carlson A, Syed SA, McCann C, Mondal V, Szady C, Ricker HM, McQueen A, Navea JG, Caromile LA, Padilla-Benavides T. ZIP11 Regulates Nuclear Zinc Homeostasis in HeLa Cells and Is Required for Proliferation and Establishment of the Carcinogenic Phenotype. Front Cell Dev Biol 2022; 10:895433. [PMID: 35898402 PMCID: PMC9309433 DOI: 10.3389/fcell.2022.895433] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/13/2022] [Indexed: 12/12/2022] Open
Abstract
Zinc (Zn) is an essential trace element that plays a key role in several biological processes, including transcription, signaling, and catalysis. A subcellular network of transporters ensures adequate distribution of Zn to facilitate homeostasis. Among these are a family of importers, the Zrt/Irt-like proteins (ZIP), which consists of 14 members (ZIP1-ZIP14) that mobilize Zn from the extracellular domain and organelles into the cytosol. Expression of these transporters varies among tissues and during developmental stages, and their distribution at various cellular locations is essential for defining the net cellular Zn transport. Normally, the ion is bound to proteins or sequestered in organelles and vesicles. However, though research has focused on Zn internalization in mammalian cells, little is known about Zn mobilization within organelles, including within the nuclei under both normal and pathological conditions. Analyses from stomach and colon tissues isolated from mouse suggested that ZIP11 is the only ZIP transporter localized to the nucleus of mammalian cells, yet no clear cellular role has been attributed to this protein. We hypothesized that ZIP11 is essential to maintaining nuclear Zn homeostasis in mammalian cells. To test this, we utilized HeLa cells, as research in humans correlated elevated expression of ZIP11 with poor prognosis in cervical cancer patients. We stably knocked down ZIP11 in HeLa cancer cells and investigated the effect of Zn dysregulation in vitro. Our data show that ZIP11 knockdown (KD) reduced HeLa cells proliferation due to nuclear accumulation of Zn. RNA-seq analyses revealed that genes related to angiogenesis, apoptosis, mRNA metabolism, and signaling pathways are dysregulated. Although the KD cells undergoing nuclear Zn stress can activate the homeostasis response by MTF1 and MT1, the RNA-seq analyses showed that only ZIP14 (an importer expressed on the plasma membrane and endocytic vesicles) is mildly induced, which may explain the sensitivity to elevated levels of extracellular Zn. Consequently, ZIP11 KD HeLa cells have impaired migration, invasive properties and decreased mitochondrial potential. Furthermore, KD of ZIP11 delayed cell cycle progression and rendered an enhanced senescent state in HeLa cells, pointing to a novel mechanism whereby maintenance of nuclear Zn homeostasis is essential for cancer progression.
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Affiliation(s)
- Monserrat Olea-Flores
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, United States
- Department of Biochemistry and Molecular Biotechnology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Julia Kan
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, United States
| | - Alyssa Carlson
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, United States
| | - Sabriya A. Syed
- Department of Biochemistry and Molecular Biotechnology, University of Massachusetts Chan Medical School, Worcester, MA, United States
| | - Cat McCann
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, United States
| | - Varsha Mondal
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, United States
| | - Cecily Szady
- Department of Chemistry, Skidmore College, Saratoga Springs, NY, United States
| | - Heather M. Ricker
- Department of Chemistry, Skidmore College, Saratoga Springs, NY, United States
| | - Amy McQueen
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, United States
| | - Juan G. Navea
- Department of Chemistry, Skidmore College, Saratoga Springs, NY, United States
| | - Leslie A. Caromile
- Department of Cell Biology, Center for Vascular Biology, UCONN Health-Center, Farmington, CT, United States
| | - Teresita Padilla-Benavides
- Department of Molecular Biology and Biochemistry, Wesleyan University, Middletown, CT, United States
- *Correspondence: Teresita Padilla-Benavides,
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5
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Pekgül F, Eroğlu-Ertuğrul NG, Bekircan-Kurt CE, Erdem-Ozdamar S, Çetinkaya A, Tan E, Konuşkan B, Karaağaoğlu E, Topçu M, Akarsu NA, Oguz KK, Anlar B, Özkara HA. Comprehensive clinical, biochemical, radiological and genetic analysis of 28 Turkish cases with suspected metachromatic leukodystrophy and their relatives. Mol Genet Metab Rep 2020; 25:100688. [PMID: 33335837 PMCID: PMC7734308 DOI: 10.1016/j.ymgmr.2020.100688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/13/2020] [Accepted: 11/23/2020] [Indexed: 01/01/2023] Open
Abstract
Metachromatic leukodystrophy (MLD) is a glycosphingolipid storage disease caused by deficiency of the lysosomal enzyme arylsulfatase A (ASA) or its activator protein saposin B. MLD can affect all age groups in severity varying from a severe fatal form to milder adult onset forms. Diagnosis is usually made by measuring leukocyte ASA activity. However, this test can give false negative or false positive laboratory results due to pseudodeficiency of ASA and saposin B deficiency, respectively. Therefore, we aimed to evaluate patients with suspected MLD in a Turkish population by comprehensive clinical, biochemical, radiological, and genetic analyses for molecular and phenotypic characterization. We analyzed 28 suspected MLD patients and 41 relatives from 24 families. ASA activity was found to be decreased in 21 of 28 patients. Sixteen patients were diagnosed as MLD (11 late infantile, 2 juvenile and 3 adult types), 2 MSD, 2 pseudodeficiency (PD) and the remaining 8 patients were diagnosed as having other leukodystrophies. Enzyme analysis showed that the age of onset of MLD did not correlate with residual ASA activity. Sequence analysis showed 11 mutations in ARSA, of which 4 were novel (p.Trp195GlyfsTer5, p.Gly298Asp, p.Arg301Leu, and p.Gly311Asp), and 2 mutations in SUMF1 causing multiple sulfatase deficiency, and confirmed the diagnosis of MLD in 2 presymptomatic relatives. All individuals with confirmed mutations had low ASA activity and urinary sulfatide excretion. Intra- and inter-familial variability was high for the same ARSA missense genotypes, indicating the contribution of other factors to disease expression. Imaging findings were evaluated through a modified brain MRI scoring system which indicated patients with protein-truncating mutations had more severe MRI findings and late-infantile disease onset. MRI findings were not specific for the diagnosis. Anti-sulfatide IgM was similar to control subjects, and IgG, elevated in multiple sulfatase deficiency. In conclusion, the knowledge on the biochemical, clinical and genetic basis of MLD was expanded, a modified diagnostic laboratory algorithm for MLD based on integrated evaluation of ASA activity, urinary sulfatide excretion and genetic tests was devised.
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Affiliation(s)
- Faruk Pekgül
- Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | | | - Can Ebru Bekircan-Kurt
- Department of Neurology, Neuromuscular Diseases Research Laboratory, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Sevim Erdem-Ozdamar
- Department of Neurology, Neuromuscular Diseases Research Laboratory, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Arda Çetinkaya
- Department of Medical Genetics, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Ersin Tan
- Department of Neurology, Neuromuscular Diseases Research Laboratory, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Bahadır Konuşkan
- Department of Pediatric Neurology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Ergun Karaağaoğlu
- Department of Biostatistics, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Meral Topçu
- Department of Pediatric Neurology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Nurten Ayşe Akarsu
- Department of Medical Genetics, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Kader K Oguz
- Department of Radiology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Banu Anlar
- Department of Pediatric Neurology, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
| | - Hatice Asuman Özkara
- Department of Medical Biochemistry, Faculty of Medicine, Hacettepe University, 06230 Ankara, Turkey
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6
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Beerepoot S, van Dooren SJM, Salomons GS, Boelens JJ, Jacobs EH, van der Knaap MS, van Kuilenburg ABP, Wolf NI. Metachromatic leukodystrophy genotypes in The Netherlands reveal novel pathogenic ARSA variants in non-Caucasian patients. Neurogenetics 2020; 21:289-299. [PMID: 32632536 PMCID: PMC7476914 DOI: 10.1007/s10048-020-00621-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 06/20/2020] [Indexed: 12/21/2022]
Abstract
Metachromatic leukodystrophy (MLD) is an autosomal recessively inherited sulfatide storage disease caused by deficient activity of the lysosomal enzyme arylsulfatase A (ASA). Genetic analysis of the ARSA gene is important in MLD diagnosis and screening of family members. In addition, more information on genotype prevalence will help interpreting MLD population differences between countries. In this study, we identified 31 different ARSA variants in the patient cohort (n = 67) of the Dutch expertise center for MLD. The most frequently found variant, c.1283C > T, p.(Pro428Leu), was present in 43 (64%) patients and resulted in a high prevalence of the juvenile MLD type (58%) in The Netherlands. Furthermore, we observed in five out of six patients with a non-Caucasian ethnic background previously unreported pathogenic ARSA variants. In total, we report ten novel variants including four missense, two nonsense, and two frameshift variants and one in-frame indel, which were all predicted to be disease causing in silico. In addition, one silent variant was found, c.1200C > T, that most likely resulted in erroneous exonic splicing, including partial skipping of exon 7. The c.1200C > T variant was inherited in cis with the pseudodeficiency allele c.1055A > G, p.(Asn352Ser) + ∗96A > G. With this study we provide a genetic base of the unique MLD phenotype distribution in The Netherlands. In addition, our study demonstrated the importance of genetic analysis in MLD diagnosis and the increased likelihood of unreported, pathogenic ARSA variants in patients with non-Caucasian ethnic backgrounds.
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Affiliation(s)
- Shanice Beerepoot
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Center, VU University Amsterdam and Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, The Netherlands.,Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Silvy J M van Dooren
- Department of Clinical Chemistry, Metabolic Unit, Amsterdam University Medical Center, VU University Amsterdam, and Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Gajja S Salomons
- Department of Clinical Chemistry, Metabolic Unit, Amsterdam University Medical Center, VU University Amsterdam, and Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Clinical Chemistry, Laboratory of Genetic Metabolic Diseases, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Gastroenterology & Metabolism, Amsterdam, The Netherlands
| | - Jaap Jan Boelens
- Center for Translational Immunology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Pediatrics, Stem Cell Transplant and Cellular Therapies, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Edwin H Jacobs
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Marjo S van der Knaap
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Center, VU University Amsterdam and Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, The Netherlands.,Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, VU University, Amsterdam, The Netherlands
| | - André B P van Kuilenburg
- Department of Clinical Chemistry, Laboratory of Genetic Metabolic Diseases, Amsterdam University Medical Center, University of Amsterdam, Amsterdam Gastroenterology & Metabolism, Amsterdam, The Netherlands
| | - Nicole I Wolf
- Amsterdam Leukodystrophy Center, Department of Child Neurology, Emma Children's Hospital, Amsterdam University Medical Center, VU University Amsterdam and Amsterdam Neuroscience, De Boelelaan, 1117, Amsterdam, The Netherlands. .,Amsterdam UMC, location VUmc, De Boelelaan 1118, 1081 HV, Amsterdam, The Netherlands.
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7
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Doherty K, Frazier SB, Clark M, Childers A, Pruthi S, Wenger DA, Duis J. A closer look at ARSA activity in a patient with metachromatic leukodystrophy. Mol Genet Metab Rep 2019; 19:100460. [PMID: 30828547 PMCID: PMC6383325 DOI: 10.1016/j.ymgmr.2019.100460] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Revised: 02/05/2019] [Accepted: 02/05/2019] [Indexed: 11/19/2022] Open
Abstract
Metachromatic leukodystrophy (MLD) is an autosomal recessive lysosomal storage disease mainly caused by a deficiency of arylsulfatase A activity. The typical clinical course of patients with the late infantile form includes a regression in motor skills with progression to dysphagia, seizures, hypotonia and death. We present a case of a 4-year-old female with rapidly progressive developmental regression with loss of motor milestones, spasticity and dysphagia. MRI showed volume loss and markedly abnormal deep white matter. Enzymatic testing in one laboratory showed arylsulfatase A activity in their normal range. However, extraction of urine showed a large increase in sulfatide excretion in a second laboratory. Measurement of arylsulfatase A in that laboratory showed a partial decrease in arylsulfatase A activity measured under typical conditions (about 37% of the normal mean). When the concentration of substrate in the assay was lowered to one quarter of that normally used, this individual had activity <10% of controls. The patient was found to be homozygous for an unusual missense mutation in the arylsulfatase A gene confirming the diagnosis of MLD. This case illustrates the importance of careful biochemical and molecular testing for MLD if there is suspicion of this diagnosis.
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Affiliation(s)
- Kathleen Doherty
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - S. Barron Frazier
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew Clark
- Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Anna Childers
- Department of Pediatrics, Division of Medical Genetics & Genomic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sumit Pruthi
- Department of Pediatrics, Division of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, TN, USA
| | - David A. Wenger
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Jessica Duis
- Department of Pediatrics, Division of Medical Genetics & Genomic Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Corresponding author at: Vanderbilt University Medical Center, Division of Medical Genetics & Genomic Medicine, DD2205 Medical Center North, Nashville, TN 37232, USA.
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8
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Narayanan DL, Matta D, Gupta N, Kabra M, Ranganath P, Aggarwal S, Phadke SR, Datar C, Gowrishankar K, Kamate M, Jain JMN, Dalal A. Spectrum of ARSA variations in Asian Indian patients with Arylsulfatase A deficient metachromatic leukodystrophy. J Hum Genet 2019; 64:323-331. [PMID: 30674982 DOI: 10.1038/s10038-019-0560-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 12/26/2018] [Accepted: 12/28/2018] [Indexed: 01/08/2023]
Abstract
Metachromatic leukodystrophy due to Arylsulfatase A enzyme deficiency is an autosomal recessive disorder caused by biallelic variations in ARSA gene. Till date 186 variations have been reported in ARSA gene worldwide, but the variation spectrum in India is not known. The aim of this study was to identify the variation profile in Indian patients presenting with features of Arylsulfatase A deficient metachromatic leukodystrophy. We sequenced the ARSA gene in 51 unrelated families and identified 36 variants out of which 16 were novel. The variations included 23 missense, 3 nonsense, and 6 frameshift variants (3 single-base deletions and 3 single-base duplications), 1 indel, one 3 bp deletion, and 2 splice site variations. The pathogenicity of the novel variations was inferred with the help of mutation prediction softwares like MutationTaster, SIFT, Polyphen-2, PROVEAN, and HANSA. The effects of the identified sequence variants on the protein structure were studied using in silico methods. The most common variation was c.931 C > T(p.Arg311*), found in 11.4% (14 out of 122 alleles) of the tested individuals. To the best of our knowledge, this study is the first of its kind in India with respect to the size of the cohort and the molecular diagnostic method used and one of the largest cohorts of metachromatic leukodystrophy studied till date.
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Affiliation(s)
| | - Divya Matta
- Diagnostics Division, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
| | - Neerja Gupta
- Department of Pediatrics, Division of Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Madhulika Kabra
- Department of Pediatrics, Division of Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Prajnya Ranganath
- Department of Medical Genetics, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Shagun Aggarwal
- Department of Medical Genetics, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Shubha R Phadke
- Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India
| | - Chaitanya Datar
- Sahyadri Medical Genetics and Tissue Engineering Facility (SMGTEF), Pune, India
| | | | - Mahesh Kamate
- Division of Pediatric Neurology, Department of Pediatrics, KAHER's J N Medical College, Belagavi, India
| | | | - Ashwin Dalal
- Diagnostics Division, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India.
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9
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Tang D, Fakiola M, Syn G, Anderson D, Cordell HJ, Scaman ESH, Davis E, Miles SJ, McLeay T, Jamieson SE, Lassmann T, Blackwell JM. Arylsulphatase A Pseudodeficiency (ARSA-PD), hypertension and chronic renal disease in Aboriginal Australians. Sci Rep 2018; 8:10912. [PMID: 30026549 PMCID: PMC6053446 DOI: 10.1038/s41598-018-29279-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Accepted: 06/25/2018] [Indexed: 12/22/2022] Open
Abstract
Chronic renal disease (CRD) associated with cardiovascular disease (CVD) and/or type 2 diabetes (T2D) is a significant problem in Aboriginal Australians. Whole exome sequencing data (N = 72) showed enrichment for ClinVar pathogenic variants in gene sets/pathways linking lipoprotein, lipid and glucose metabolism. The top Ingenuity Pathway Analysis canonical pathways were Farsenoid X Receptor and Retinoid Receptor (FXR/RXR; (P = 1.86 × 10−7), Liver X Receptor and Retinoid Receptor (LXR/RXR; P = 2.88 × 10−6), and atherosclerosis signalling (P = 3.80 × 10−6). Top pathways/processes identified using Enrichr included: Reactome 2016 chylomicron-mediated lipid transport (P = 3.55 × 10−7); Wiki 2016 statin (P = 8.29 × 10−8); GO Biological Processes 2017 chylomicron remodelling (P = 1.92 × 10−8). ClinVar arylsulfatase A pseudodeficiency (ARSA-PD) pathogenic variants were common, including the missense variant c.511 G > A (p.Asp171Asn; rs74315466; frequency 0.44) only reported in Polynesians. This variant is in cis with known ARSA-PD 3′ regulatory c.*96 A > G (rs6151429; frequency 0.47) and missense c.1055 A > G (p.Asn352Ser; rs2071421; frequency 0.47) variants. These latter two variants are associated with T2D (risk haplotype GG; odds ratio 2.67; 95% CI 2.32–3.08; P = 2.43 × 10−4) in genome-wide association data (N = 402), but are more strongly associated with quantitative traits (DBP, SBP, ACR, eGFR) for hypertension and renal function in non-diabetic than diabetic subgroups. Traits associated with CVD, CRD and T2D in Aboriginal Australians provide novel insight into function of ARSA-PD variants.
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Affiliation(s)
- Dave Tang
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, 6008, Australia
| | | | - Genevieve Syn
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, 6008, Australia
| | - Denise Anderson
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, 6008, Australia
| | - Heather J Cordell
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, NE1 3BZ, United Kingdom
| | - Elizabeth S H Scaman
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, 6008, Australia
| | - Elizabeth Davis
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, 6008, Australia.,Department of Endocrinology and Diabetes, Princess Margaret Hospital for Children, Subiaco, Western Australia, 6008, Australia
| | - Simon J Miles
- Ngangganawili Aboriginal Health Service, Wiluna, Western Australia, 6646, Australia
| | - Toby McLeay
- Ngangganawili Aboriginal Health Service, Wiluna, Western Australia, 6646, Australia
| | - Sarra E Jamieson
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, 6008, Australia
| | - Timo Lassmann
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, 6008, Australia
| | - Jenefer M Blackwell
- Telethon Kids Institute, The University of Western Australia, Subiaco, Western Australia, 6008, Australia.
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10
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Liaw HR, Lee HF, Chi CS, Tsai CR. Late infantile metachromatic leukodystrophy: Clinical manifestations of five Taiwanese patients and Genetic features in Asia. Orphanet J Rare Dis 2015; 10:144. [PMID: 26553228 PMCID: PMC4638099 DOI: 10.1186/s13023-015-0363-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/30/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study was conducted to describe the clinical and genetic features of patients with late infantile metachromatic leukodystrophy. METHODS Clinical and genetic manifestations of five Taiwanese patients with late infantile metachromatic leukodystrophy from January 2003 to April 2014 were reviewed. The genetic features of such patients reported in Asian countries during a period of 20 years were also analyzed. RESULTS The median age at disease onset was 1 year and 3 months with the first clinical symptom being gait disturbance. All five patients became bed-ridden at a median age of 2 years and 5 months. Nerve conduction velocity revealed demyelinating polyneuropathy and brain MRI disclosed tigroid and leopard skin pattern of dysmyelination in all 5 patients. All patients had decreased ARSA activities in leukocytes accounting for 15.88% to 30.75% of controls. Five novel mutations, p.A316D, p.G303R, p.Q176X, p.R293X, and c.749 insGCGGGCCA, were identified in our case series. Eighteen patients, including our 5 patients, were reported in Asian countries. A total of 22 different disease-causing alleles were found, in which p.W320X was identified in Taiwan and China, and p.G101V was found in Taiwan and Korea. CONCLUSIONS Patients with late infantile metachromatic leukodystrophy exhibited a rapid and devastating clinical course. The pattern of dysmyelination on brain MRI together with peripheral demyelination polyneuropathy indicates that evaluation of ARSA activity in leukocytes is warranted. A wide diversity of ARSA gene mutations was noted in Asia.
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Affiliation(s)
- Hsiang-Ru Liaw
- Department of Pediatrics, Taichung Veterans General Hospital, 1650, Taiwan Boulevard Sec. 4, Taichung, 40705, Taiwan
| | - Hsiu-Fen Lee
- Department of Pediatrics, Taichung Veterans General Hospital, 1650, Taiwan Boulevard Sec. 4, Taichung, 40705, Taiwan.,School of Medicine, Chung Shan Medical University, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan
| | - Ching-Shiang Chi
- Department of Pediatrics, Tungs' Taichung Metroharbor Hospital, 699, Taiwan Boulevard Sec. 8, Wuchi, Taichung, 435, Taiwan. .,School of Medicine, Chung Shan Medical University, 110, Sec. 1, Jianguo N. Rd, Taichung, 40201, Taiwan.
| | - Chi-Ren Tsai
- Department of Pediatrics, Taichung Veterans General Hospital, 1650, Taiwan Boulevard Sec. 4, Taichung, 40705, Taiwan.,Institute of Molecular Biology, National Chung Hsing University, 250, Kuo Kuang Rd, Taichung, 402, Taiwan
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11
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Cesani M, Lorioli L, Grossi S, Amico G, Fumagalli F, Spiga I, Filocamo M, Biffi A. Mutation Update ofARSAandPSAPGenes Causing Metachromatic Leukodystrophy. Hum Mutat 2015; 37:16-27. [DOI: 10.1002/humu.22919] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 10/08/2015] [Indexed: 12/31/2022]
Affiliation(s)
- Martina Cesani
- San Raffaele Telethon Institute for Gene Therapy; Division of Regenerative Medicine; Stem Cells and Gene Therapy; San Raffaele Scientific Institute; Milan Italy
| | - Laura Lorioli
- San Raffaele Telethon Institute for Gene Therapy; Division of Regenerative Medicine; Stem Cells and Gene Therapy; San Raffaele Scientific Institute; Milan Italy
- Vita-Salute San Raffaele University; Milan Italy
| | - Serena Grossi
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche; Istituto G. Gaslini; Genova Italy
| | - Giulia Amico
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche; Istituto G. Gaslini; Genova Italy
| | - Francesca Fumagalli
- San Raffaele Telethon Institute for Gene Therapy; Division of Regenerative Medicine; Stem Cells and Gene Therapy; San Raffaele Scientific Institute; Milan Italy
- Neurology Department; Division of Neuroscience; San Raffaele Scientific Institute; Milan Italy
| | - Ivana Spiga
- Clinical Molecular Biology Laboratory; San Raffaele Hospital; Milan Italy
| | - Mirella Filocamo
- Centro di Diagnostica Genetica e Biochimica delle Malattie Metaboliche; Istituto G. Gaslini; Genova Italy
| | - Alessandra Biffi
- San Raffaele Telethon Institute for Gene Therapy; Division of Regenerative Medicine; Stem Cells and Gene Therapy; San Raffaele Scientific Institute; Milan Italy
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12
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Boucher AA, Miller W, Shanley R, Ziegler R, Lund T, Raymond G, Orchard PJ. Long-term outcomes after allogeneic hematopoietic stem cell transplantation for metachromatic leukodystrophy: the largest single-institution cohort report. Orphanet J Rare Dis 2015; 10:94. [PMID: 26245762 PMCID: PMC4545855 DOI: 10.1186/s13023-015-0313-y] [Citation(s) in RCA: 98] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 07/29/2015] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Metachromatic Leukodystrophy (MLD) is a rare, fatal demyelinating disorder with limited treatment options. Published outcomes after hematopoietic stem cell transplantation (HSCT) are scant and mixed. We report survival and function following HSCT for a large, single-center MLD cohort. METHODS Transplant-related data, survival and serial measures (brain MRI, nerve conduction velocity (NCV), neurologic and neuropsychology evaluations) were reviewed. When possible, parental interviews informed current neurologic status, quality-of-life, and adaptive functioning. Gross motor and expressive functions for late-infantile (LI-MLD) and juvenile (J-MLD) patients were described using previously reported, MLD-specific scales. RESULTS Forty patients with confirmed MLD have undergone HSCT at our center. Twenty-one (53 %) survive at a median 12 years post-HSCT. Most deaths (n = 17) were treatment-related; two died from disease progression. Survival did not depend upon MLD subtype or symptom status at transplant. LI-MLD patients survive beyond reported life expectancy in untreated disease. Abnormal brain MRI and peripheral nerve conduction velocities (NCV) were common before HSCT. Following transplant, fewer patients experienced MRI progression compared to NCV deterioration. Sixteen LI-MLD and J-MLD survivors were evaluable for long-term gross motor and/or expressive language functioning using existing MLD clinical scoring systems. While most J-MLD patients regressed, the aggregate cohort demonstrated superior retention of function compared to published natural history. Seventeen LI-MLD, J-MLD and adult subtype (A-MLD) survivors were evaluable for long-term adaptive functioning, activities of daily living, and/or cognition. Relative cognitive sparing was observed despite overall global decline. Five sibling pairs (one LI-MLD and four J-MLD), in which at least one underwent transplant in our cohort, were evaluable. Within each familial dyad, survival or function was superior for the treated sibling, or if both siblings were transplanted, for the pre-symptomatic sibling. CONCLUSIONS HSCT is a viable treatment option for MLD, but has significant limitations. Later-onset phenotypes may benefit most from early, pre-symptomatic transplant. Until superior, novel treatment strategies are demonstrated, MLD patients should be carefully considered for HSCT.
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Affiliation(s)
- Alexander A Boucher
- Department of Internal Medicine and Pediatrics, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Weston Miller
- Division of Pediatric Blood and Marrow Transplantation, 420 Delaware Street SE, MMC 484, Minneapolis, MN, 55455, USA.
| | - Ryan Shanley
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Richard Ziegler
- Division of Pediatric Clinical Neurosciences, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Troy Lund
- Division of Pediatric Blood and Marrow Transplantation, 420 Delaware Street SE, MMC 484, Minneapolis, MN, 55455, USA.
| | - Gerald Raymond
- Division of Pediatric Clinical Neurosciences, University of Minnesota, Minneapolis, MN, 55455, USA.
| | - Paul J Orchard
- Division of Pediatric Blood and Marrow Transplantation, 420 Delaware Street SE, MMC 484, Minneapolis, MN, 55455, USA.
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13
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Abstract
Background Many genetic variants have been identified in the human genome. The functional effects of a single variant have been intensively studied. However, the joint effects of multiple variants in the same genes have been largely ignored due to their complexity or lack of data. This paper uses HMMvar, a hidden Markov model based approach, to investigate the combined effect of multiple variants from the 1000 Genomes Project. Two tumor suppressor genes, TP53 and phosphatase and tensin homolog (PTEN), are also studied for the joint effect of compensatory indel variants. Results Results show that there are cases where the joint effect of having multiple variants in the same genes is significantly different from that of a single variant. The deleterious effect of a single indel variant can be alleviated by their compensatory indels in TP53 and PTEN. Compound mutations in two genes, β-MHC and MyBP-C, leading to severer cardiovascular disease compared to single mutations, are also validated. Conclusions This paper extends the functionality of HMMvar, a tool for assigning a quantitative score to a variant, to measure not only the deleterious effect of a single variant but also the joint effect of multiple variants. HMMvar is the first tool that can predict the functional effects of both single and general multiple variations on proteins. The precomputed scores for multiple variants from the 1000 Genomes Project and the HMMvar package are available at https://bioinformatics.cs.vt.edu/zhanglab/HMMvar/
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Affiliation(s)
- Mingming Liu
- Department of Computer Science, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
| | - Layne T Watson
- Department of Computer Science, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA. .,Department of Mathematics, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA. .,Department of Aerospace and Ocean Engineering, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
| | - Liqing Zhang
- Department of Computer Science, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
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14
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Luzi P, Rafi MA, Rao HZ, Wenger DA. Sixteen novel mutations in the arylsulfatase A gene causing metachromatic leukodystrophy. Gene 2013; 530:323-8. [PMID: 24001781 DOI: 10.1016/j.gene.2013.08.065] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Revised: 08/16/2013] [Accepted: 08/17/2013] [Indexed: 10/26/2022]
Abstract
Metachromatic leukodystrophy (MLD) is a lysosomal storage disorder caused mainly by mutations in the arylsulfatase A (ARSA) gene. In this manuscript we report sixteen novel mutations identified in the ARSA gene of fifteen unrelated patients affected with MLD. Of these 16 mutations nine were missense mutations (p.L11Q, p.S44P, p.L81P, p.R84L, p.V177D, p.P284S, p.R288S, p.G301R, p.P425S), three were nonsense mutations (p.Q51X, p.Y149X, p.C156X), three were frame shift mutations (c.28delG, c.105C>A+106_124dup, c.189delC) and one was a splice-site mutation (c.1102-2A>G). In addition, three previously reported mutations were identified on an allelic background different from the one in the original reports. Two mutations, p.G309S and p.E312D, were identified on the background of the so-called pseudodeficiency (Pd) allele while previously they were reported alone. On the other hand, mutation p.R311X was identified in two unrelated patients not in cis with the Pd mutations, as previously reported.
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Affiliation(s)
- Paola Luzi
- Lysosomal Diseases Testing Laboratory, Department of Neurology, Thomas Jefferson University, 1020 Locust Street, Room 346, Philadelphia, PA 19107, USA.
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15
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Naidu S, Lin DDM. Advances in the diagnosis of leukoencephalopathies. ACTA ACUST UNITED AC 2013; 6:259-73. [PMID: 23480738 DOI: 10.1517/17530059.2012.665869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Introduction : Leukoencephalopathies (LEs) are a diverse group of diseases involving cerebral white matter. Some of the disorders may be infectious or immunologically mediated and, therefore, tend to be more amenable to treatment. Most of these disorders have a genetic basis, for which genetic counseling becomes important as currently very few of them have effective therapies. Areas covered : This review calls attention to the diagnostic dilemmas, highlights the diagnostic tests of choice for separating conditions with similar clinical, laboratory or neuroimaging findings, and describes several LEs that have been newly discovered within the last 20 years. Imaging of LEs has progressed rapidly since the introduction of magnetic resonance imaging (MRI) and spectroscopy (MRS), allowing recognition of new diseases, with and without identifiable corresponding biochemical or genetic defects. The distinguishing MRI and MRS features of LEs are described, as well as the resources available for biochemical, CSF and blood sample testing for diagnosis and differentiation from previously known LEs. Expert opinion : Although there is no treatment at present for many of the LEs, their detection as a cause of intellectual and motor disabilities, and as inherited disorders, makes it necessary to accurately categorize them. This knowledge will then allow further elucidation of the etiology, understanding the biological underpinnings, and eventually progress toward rational therapies.
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Affiliation(s)
- Sakkubai Naidu
- Johns Hopkins University School of Medicine, Hugo Moser Research Institute, Kennedy Krieger Institute , 707, N. Broadway, Baltimore, MD 21205 , USA +1 443 923 2778 ; +1 443 923 2779 ;
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17
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Colsch B, Afonso C, Turpin JC, Portoukalian J, Tabet JC, Baumann N. Sulfogalactosylceramides in motor and psycho-cognitive adult metachromatic leukodystrophy: relations between clinical, biochemical analysis and molecular aspects. Biochim Biophys Acta Gen Subj 2008; 1780:434-40. [DOI: 10.1016/j.bbagen.2007.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Revised: 10/04/2007] [Accepted: 10/06/2007] [Indexed: 12/20/2022]
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18
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Generation and characterization of the binding epitope of a novel monoclonal antibody to sulfatide (sulfogalactosylceramide) OL-2: Applications of antigen immunodetections in brain tissues and urinary samples. J Neuroimmunol 2008; 193:52-8. [DOI: 10.1016/j.jneuroim.2007.10.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Revised: 10/08/2007] [Accepted: 10/08/2007] [Indexed: 12/21/2022]
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Gärtner J, Kohlschütter A, Gieselmann V. Netzwerkprojekte für die Erforschung von Leukodystrophien, einer Gruppe seltener Erkrankungen der weißen Substanz des Nervensystems. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007; 50:1531-40. [DOI: 10.1007/s00103-007-0388-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Cui Y, Colsch B, Afonso C, Alonso C, Baumann N, Tabet JC, Mallet JM, Zhang Y. Synthetic sulfogalactosylceramide (sulfatide) and its use for the mass spectrometric quantitative urinary determination in metachromatic leukodystrophies. Glycoconj J 2007; 25:147-55. [PMID: 17701343 DOI: 10.1007/s10719-007-9067-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2007] [Accepted: 07/17/2007] [Indexed: 11/30/2022]
Abstract
3-O-Sulfogalactosylceramides (sulfatides) accumulate in the genetic disease metachromatic leukodystrophy which is due to a defect in the catabolic enzyme, arylsulfatase A. Clinical diagnosis is usually confirmed by in vitro enzymatic deficiency of arylsulfatase A activity. The diagnosis may be complicated because of arylsulfatase A pseudo-deficiencies and another cause of MLD, sphingolipid activator B deficiency. As large quantities of sulfatides can be found in the urine in this disease, sulfatiduria appears as an extremely useful test. As recently enzyme replacement is underway, the quantitative determination, using an internal standard, appears particularly useful as a follow-up. Thus a non-physiological sulfatide was synthesized for this purpose, i.e. 3-O-sulfo-beta-D-C17 galactosylceramide (3-O-Sulfo-D: -Galactosyl-beta1'-->1-N-Heptadecanoyl-D-erythro-Sphingosine). It has been prepared through condensation of an azidosphingosine derivative with a protected D-galactopyranosyltrichloroacetimidate. Reduction of the azide was followed by acylation of a C-17 fatty acid. The key step was achieved by selective sulfation of the desired hydroxyl group on the sugar residue of the galactosylceramide using the stannylene methodology to give a 3'-sulfated beta-galactosyl C-17 ceramide.
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Affiliation(s)
- Yanli Cui
- Département de Chimie, Ecole Normale Supérieure, UMR 8642, CNRS-ENS-UPMC, 24 rue Lhomond, 75231 Paris cedex 05, France
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Greenberg SA, Walsh RJ. Molecular diagnosis of inheritable neuromuscular disorders. Part II: Application of genetic testing in neuromuscular disease. Muscle Nerve 2005; 31:431-51. [PMID: 15704143 DOI: 10.1002/mus.20279] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Molecular genetic advances have led to refinements in the classification of inherited neuromuscular disease, and to methods of molecular testing useful for diagnosis and management of selected patients. Testing should be performed as targeted studies, sometimes sequentially, but not as wasteful panels of multiple genetic tests performed simultaneously. Accurate diagnosis through molecular testing is available for the vast majority of patients with inherited neuropathies, resulting from mutations in three genes (PMP22, MPZ, and GJB1); the most common types of muscular dystrophies (Duchenne and Becker, facioscapulohumeral, and myotonic dystrophies); the inherited motor neuron disorders (spinal muscular atrophy, Kennedy's disease, and SOD1 related amyotrophic lateral sclerosis); and many other neuromuscular disorders. The role of potential multiple genetic influences on the development of acquired neuromuscular diseases is an increasingly active area of research.
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Affiliation(s)
- Steven A Greenberg
- Department of Neurology, Division of Neuromuscular Disease, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, Massachusetts 02115, USA.
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Rocha CT, Escolar DM. Update on diagnosis and treatment of hereditary and acquired polyneuropathies in childhood. SUPPLEMENTS TO CLINICAL NEUROPHYSIOLOGY 2004; 57:255-71. [PMID: 16106624 DOI: 10.1016/s1567-424x(09)70362-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Carolina Tesi Rocha
- Department of Neurology, Research Center for Genetic Medicine, MDA Clinic, Children's National Medical Center, George Washington University, Washington, DC 20010, USA
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