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The Cardiovascular Phenotype in Fabry Disease: New Findings in the Research Field. Int J Mol Sci 2021; 22:ijms22031331. [PMID: 33572752 PMCID: PMC7865937 DOI: 10.3390/ijms22031331] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 01/25/2021] [Accepted: 01/26/2021] [Indexed: 02/06/2023] Open
Abstract
Fabry disease (FD) is a lysosomal storage disorder, depending on defects in alpha-galactosidase A (GAL) activity. At the clinical level, FD shows a high phenotype variability. Among them, cardiovascular dysfunction is often recurrent or, in some cases, is the sole symptom (cardiac variant) representing the leading cause of death in Fabry patients. The existing therapies, besides specific symptomatic treatments, are mainly based on the restoration of GAL activity. Indeed, mutations of the galactosidase alpha gene (GLA) cause a reduction or lack of GAL activity leading to globotriaosylceramide (Gb3) accumulation in several organs. However, several other mechanisms are involved in FD’s development and progression that could become useful targets for therapeutics. This review discusses FD’s cardiovascular phenotype and the last findings on molecular mechanisms that accelerate cardiac cell damage.
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Micheu MM, Popa-Fotea NM, Oprescu N, Bogdan S, Dan M, Deaconu A, Dorobantu L, Gheorghe-Fronea O, Greavu M, Iorgulescu C, Scafa-Udriste A, Ticulescu R, Vatasescu RG, Dorobanțu M. Yield of Rare Variants Detected by Targeted Next-Generation Sequencing in a Cohort of Romanian Index Patients with Hypertrophic Cardiomyopathy. Diagnostics (Basel) 2020; 10:diagnostics10121061. [PMID: 33297573 PMCID: PMC7762332 DOI: 10.3390/diagnostics10121061] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 12/04/2020] [Accepted: 12/06/2020] [Indexed: 12/13/2022] Open
Abstract
Background: The aim of this study was to explore the rare variants in a cohort of Romanian index cases with hypertrophic cardiomyopathy (HCM). Methods: Forty-five unrelated probands with HCM were screened by targeted next generation sequencing (NGS) of 47 core and emerging genes connected with HCM. Results: We identified 95 variants with allele frequency < 0.1% in population databases. MYBPC3 and TTN had the largest number of rare variants (17 variants each). A definite genetic etiology was found in 6 probands (13.3%), while inconclusive results due to either known or novel variants were established in 31 cases (68.9%). All disease-causing variants were detected in sarcomeric genes (MYBPC3 and MYH7 with two cases each, and one case in TNNI3 and TPM1 respectively). Multiple variants were detected in 27 subjects (60%), but no proband carried more than one causal variant. Of note, almost half of the rare variants were novel. Conclusions: Herein we reported for the first time the rare variants identified in core and putative genes associated with HCM in a cohort of Romanian unrelated adult patients. The clinical significance of most detected variants is yet to be established, additional studies based on segregation analysis being required for definite classification.
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Affiliation(s)
- Miruna Mihaela Micheu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Correspondence: (M.M.M.); (N.-M.P.-F.); Tel.: +4-072-245-1755 (M.M.M.); Tel: +4-072-438-1835 (N.-M.P.-F.)
| | - Nicoleta-Monica Popa-Fotea
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Department 4-Cardiothoracic Pathology, University of Medicine and Pharmacy Carol Davila, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
- Correspondence: (M.M.M.); (N.-M.P.-F.); Tel.: +4-072-245-1755 (M.M.M.); Tel: +4-072-438-1835 (N.-M.P.-F.)
| | - Nicoleta Oprescu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
| | - Stefan Bogdan
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Department 4-Cardiothoracic Pathology, University of Medicine and Pharmacy Carol Davila, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
| | - Monica Dan
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
| | - Alexandru Deaconu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Department 4-Cardiothoracic Pathology, University of Medicine and Pharmacy Carol Davila, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
| | - Lucian Dorobantu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Monza Hospital, Tony Bulandra Street, No. 27, 021967 Bucharest, Romania; (M.G.); (R.T.)
| | - Oana Gheorghe-Fronea
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Department 4-Cardiothoracic Pathology, University of Medicine and Pharmacy Carol Davila, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
| | - Maria Greavu
- Monza Hospital, Tony Bulandra Street, No. 27, 021967 Bucharest, Romania; (M.G.); (R.T.)
| | - Corneliu Iorgulescu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
| | - Alexandru Scafa-Udriste
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Department 4-Cardiothoracic Pathology, University of Medicine and Pharmacy Carol Davila, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
| | - Razvan Ticulescu
- Monza Hospital, Tony Bulandra Street, No. 27, 021967 Bucharest, Romania; (M.G.); (R.T.)
| | - Radu Gabriel Vatasescu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Department 4-Cardiothoracic Pathology, University of Medicine and Pharmacy Carol Davila, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
| | - Maria Dorobanțu
- Department of Cardiology, Clinical Emergency Hospital of Bucharest, Calea Floreasca 8, 014461 Bucharest, Romania; (N.O.); (S.B.); (M.D.); (A.D.); (L.D.); (O.G.-F.); (C.I.); (A.S.-U.); (R.G.V.); (M.D.)
- Department 4-Cardiothoracic Pathology, University of Medicine and Pharmacy Carol Davila, Eroii Sanitari Bvd. 8, 050474 Bucharest, Romania
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Demographic and Clinical Characteristics of the Full 2015-2018 Cohort of Romanian Fabry Disease Patients. CURRENT HEALTH SCIENCES JOURNAL 2020; 45:272-277. [PMID: 32042454 PMCID: PMC6993771 DOI: 10.12865/chsj.45.03.04] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 09/17/2019] [Indexed: 12/21/2022]
Abstract
Background. Fabry disease (FD) is a rare genetic lysosomal disease with an estimated prevalence of 1:100000. Mutations on the GLA gene lead to alpha-galactosidase deficiency and multiorgan involvement due to sphingolipid accumulation. Our aim was to present and analyze the demographic and clinical characteristics of the Fabry patients in Romania. Methods. All known Fabry patients in Romania between 2015-2018 were prospectively included in the study. Data on personal history, family history and clinical parameters were collected and statistically analyzed. Results. The study included 42 patients with a mean age of 47±15 years, of which 19 (45%) were men and 23 (55%) women. Women were significantly older (52±15 years vs. 40±13 years, p=0.006) and presented similar prevalence of cardiac, renal, neurologic, ophthalmologic and otologic burden. The majority of patients presented organ damage, most prevalent being cardiac (48%), cutaneous (45%) and neurologic (52%) involvements. There were 20 families in total, comprising on average of 2.1 members each. Of the 20 families, only two had the same pathogenic GLA mutation. Conclusion. FD patients in our country show a significant degree of multiorgan involvement with important psychological and social impact on the patients and their families. Women with Fabry disease show similar disease burden as men, but at a later age.
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