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Arai H, Matsui H, Chi S, Utsu Y, Masuda S, Aotsuka N, Minami Y. Germline Variants and Characteristic Features of Hereditary Hematological Malignancy Syndrome. Int J Mol Sci 2024; 25:652. [PMID: 38203823 PMCID: PMC10779750 DOI: 10.3390/ijms25010652] [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: 11/07/2023] [Revised: 12/25/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
Due to the proliferation of genetic testing, pathogenic germline variants predisposing to hereditary hematological malignancy syndrome (HHMS) have been identified in an increasing number of genes. Consequently, the field of HHMS is gaining recognition among clinicians and scientists worldwide. Patients with germline genetic abnormalities often have poor outcomes and are candidates for allogeneic hematopoietic stem cell transplantation (HSCT). However, HSCT using blood from a related donor should be carefully considered because of the risk that the patient may inherit a pathogenic variant. At present, we now face the challenge of incorporating these advances into clinical practice for patients with myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML) and optimizing the management and surveillance of patients and asymptomatic carriers, with the limitation that evidence-based guidelines are often inadequate. The 2016 revision of the WHO classification added a new section on myeloid malignant neoplasms, including MDS and AML with germline predisposition. The main syndromes can be classified into three groups. Those without pre-existing disease or organ dysfunction; DDX41, TP53, CEBPA, those with pre-existing platelet disorders; ANKRD26, ETV6, RUNX1, and those with other organ dysfunctions; SAMD9/SAMD9L, GATA2, and inherited bone marrow failure syndromes. In this review, we will outline the role of the genes involved in HHMS in order to clarify our understanding of HHMS.
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Affiliation(s)
- Hironori Arai
- Department of Hematology, National Cancer Center Hospital East, Kashiwa 277-8577, Japan; (H.A.); (S.C.)
- Department of Hematology and Oncology, Japanese Red Cross Narita Hospital, Iidacho, Narita 286-0041, Japan; (Y.U.); (S.M.); (N.A.)
| | - Hirotaka Matsui
- Department of Laboratory Medicine, National Cancer Center Hospital, Tsukiji, Chuoku 104-0045, Japan;
- Department of Medical Oncology and Translational Research, Graduate School of Medical Sciences, Kumamoto University, Kumamoto 860-8665, Japan
| | - SungGi Chi
- Department of Hematology, National Cancer Center Hospital East, Kashiwa 277-8577, Japan; (H.A.); (S.C.)
| | - Yoshikazu Utsu
- Department of Hematology and Oncology, Japanese Red Cross Narita Hospital, Iidacho, Narita 286-0041, Japan; (Y.U.); (S.M.); (N.A.)
| | - Shinichi Masuda
- Department of Hematology and Oncology, Japanese Red Cross Narita Hospital, Iidacho, Narita 286-0041, Japan; (Y.U.); (S.M.); (N.A.)
| | - Nobuyuki Aotsuka
- Department of Hematology and Oncology, Japanese Red Cross Narita Hospital, Iidacho, Narita 286-0041, Japan; (Y.U.); (S.M.); (N.A.)
| | - Yosuke Minami
- Department of Hematology, National Cancer Center Hospital East, Kashiwa 277-8577, Japan; (H.A.); (S.C.)
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Hirai M, Yagasaki H, Kanezawa K, Ueno M, Shimozawa K, Imai K, Morio T, Kato M, Gocho Y, Narumi S, Ebihara Y, Morioka I. Cord Blood Transplantation in 2 Infants Presenting Monosomy 7 Clonal Hematopoiesis: SAMD9 / SAMD9L Germline Mutation. J Pediatr Hematol Oncol 2023; 45:e290-e293. [PMID: 36730951 DOI: 10.1097/mph.0000000000002578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 09/17/2022] [Indexed: 02/04/2023]
Abstract
Recently, germline mutations in SAMD9 and SAMD9L were increasingly found in children with monosomy 7. We report the outcomes in 2 infants with the SAMD9/SAMD9L variant, who presented with anemia and thrombocytopenia (patient 1), and neutropenia and nonsymptomatic white-matter-encephalopathy (patient 2). Both patients received cord blood transplantation and experienced critical post-cord blood transplantation adverse events; patients 1 and 2 developed fulminant engraftment syndrome and life-threatening graft-versus-host disease, respectively. Of note, selective loss of chromosome 7 in bone marrow-derived CD34 + cells was inferred.
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Affiliation(s)
- Maiko Hirai
- Department of Pediatrics and Child Health, Nihon University Itabashi Hospital
| | - Hiroshi Yagasaki
- Department of Pediatrics and Child Health, Nihon University Itabashi Hospital
| | - Koji Kanezawa
- Department of Pediatrics and Child Health, Nihon University Itabashi Hospital
| | - Masaru Ueno
- Department of Pediatrics and Child Health, Nihon University Itabashi Hospital
| | | | - Kohsuke Imai
- Department of Pediatrics, Tokyo Medical and Dental University
| | - Tomohiro Morio
- Department of Pediatrics, Tokyo Medical and Dental University
| | - Motohiro Kato
- Children's Cancer Center, National Center for Child Health and Development
| | - Yoshihiro Gocho
- Children's Cancer Center, National Center for Child Health and Development
| | - Satoshi Narumi
- Department of Molecular Endocrinology, National Research Institute for Child Health and Development, Tokyo
| | - Yasuhiro Ebihara
- Department of Laboratory Medicine, Saitama Medical University International Medical Center, Saitama, Japan
| | - Ichiro Morioka
- Department of Pediatrics and Child Health, Nihon University Itabashi Hospital
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Clonal Elimination of the Pathogenic Allele as Diagnostic Pitfall in SAMD9L-Associated Neuropathy. Genes (Basel) 2022; 13:genes13122356. [PMID: 36553623 PMCID: PMC9778166 DOI: 10.3390/genes13122356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/06/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Heterozygous gain-of-function variants in SAMD9L are associated with ataxia-pancytopenia syndrome (ATXPC) and monosomy 7 myelodysplasia and leukemia syndrome-1 (M7MLS1). Association with peripheral neuropathy has rarely been described. METHODS Whole-exome sequencing (WES) from DNA extracted from peripheral blood was performed in a 10-year-old female presenting with demyelinating neuropathy, her similarly affected mother and the unaffected maternal grandparents. In addition to evaluation of single nucleotide variants, thorough work-up of copy number and exome-wide variant allele frequency data was performed. RESULTS Combined analysis of the mother's and daughter's duo-exome data and analysis of the mother's and her parents' trio-exome data initially failed to detect a disease-associated variant. More detailed analysis revealed a copy number neutral loss of heterozygosity of 7q in the mother and led to reanalysis of the exome data for respective sequence variants. Here, a previously reported likely pathogenic variant in the SAMD9L gene on chromosome 7q (NM_152703.5:c.2956C>T; p.(Arg986Cys)) was identified that was not detected with standard filter settings because of a low percentage in blood cells (13%). The variant also showed up in the daughter at 32%, a proportion well below the expected 50%, which in each case can be explained by clonal selection processes in the blood due to this SAMD9L variant. CONCLUSION The report highlights the specific pitfalls of molecular genetic analysis of SAMD9L and, furthermore, shows that gain-of-function variants in this gene can lead to a clinical picture associated with the leading symptom of peripheral neuropathy. Due to clonal hematopoietic selection, displacement of the mutant allele occurred, making diagnosis difficult.
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Papa R, Rusmini M, Volpi S, Dell'Orso G, Giarratana MC, Caorsi R, Giardino S, Bocca P, Barone P, Severino M, Ceccherini I, Gattorno M, Faraci M. Progression of non-hematologic manifestations in SAMD9L-associated autoinflammatory disease (SAAD) after hematopoietic stem cell transplantation. Pediatr Allergy Immunol 2022; 33:e13711. [PMID: 34894360 DOI: 10.1111/pai.13711] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 11/25/2021] [Accepted: 11/30/2021] [Indexed: 12/17/2022]
Affiliation(s)
- Riccardo Papa
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marta Rusmini
- Laboratory of Genetics and Genomics of Rare Diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Stefano Volpi
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Gianluca Dell'Orso
- Hematopoietic Stem Cell Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Roberta Caorsi
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Stefano Giardino
- Hematopoietic Stem Cell Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Paola Bocca
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Patrizia Barone
- Department of Pediatrics, University of Catania, Catania, Italy
| | | | - Isabella Ceccherini
- Laboratory of Genetics and Genomics of Rare Diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marco Gattorno
- Center for Autoinflammatory Diseases and Immunodeficiencies, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Maura Faraci
- Hematopoietic Stem Cell Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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Corral-Juan M, Casquero P, Giraldo-Restrepo N, Laurie S, Martinez-Piñeiro A, Mateo-Montero RC, Ispierto L, Vilas D, Tolosa E, Volpini V, Alvarez-Ramo R, Sánchez I, Matilla-Dueñas A. OUP accepted manuscript. Brain Commun 2022; 4:fcac030. [PMID: 35310830 PMCID: PMC8928420 DOI: 10.1093/braincomms/fcac030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/20/2021] [Accepted: 02/08/2022] [Indexed: 11/18/2022] Open
Abstract
Spinocerebellar ataxias consist of a highly heterogeneous group of inherited movement disorders clinically characterized by progressive cerebellar ataxia variably associated with additional distinctive clinical signs. The genetic heterogeneity is evidenced by the myriad of associated genes and underlying genetic defects identified. In this study, we describe a new spinocerebellar ataxia subtype in nine members of a Spanish five-generation family from Menorca with affected individuals variably presenting with ataxia, nystagmus, dysarthria, polyneuropathy, pyramidal signs, cerebellar atrophy and distinctive cerebral demyelination. Affected individuals presented with horizontal and vertical gaze-evoked nystagmus and hyperreflexia as initial clinical signs, and a variable age of onset ranging from 12 to 60 years. Neurophysiological studies showed moderate axonal sensory polyneuropathy with altered sympathetic skin response predominantly in the lower limbs. We identified the c.1877C > T (p.Ser626Leu) pathogenic variant within the SAMD9L gene as the disease causative genetic defect with a significant log-odds score (Zmax = 3.43; θ = 0.00; P < 3.53 × 10−5). We demonstrate the mitochondrial location of human SAMD9L protein, and its decreased levels in patients’ fibroblasts in addition to mitochondrial perturbations. Furthermore, mutant SAMD9L in zebrafish impaired mobility and vestibular/sensory functions. This study describes a novel spinocerebellar ataxia subtype caused by SAMD9L mutation, SCA49, which triggers mitochondrial alterations pointing to a role of SAMD9L in neurological motor and sensory functions.
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Affiliation(s)
- Marc Corral-Juan
- Functional and Translational Neurogenetics Unit, Department of Neuroscience, Research Institute Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona-Can Ruti Campus, Badalona, Barcelona, Spain
| | - Pilar Casquero
- Neurology and Neurophysiology Section, Hospital Mateu Orfila, Mahón, Menorca, Spain
| | | | - Steve Laurie
- Centro Nacional de Análisis Genómico (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain
| | - Alicia Martinez-Piñeiro
- Neuromuscular and Functional Studies Unit, Neurology Service, University Hospital Germans Trias i Pujol (HUGTiP), Universitat Autònoma de Barcelona-Can Ruti Campus, Badalona, Barcelona, Spain
| | | | - Lourdes Ispierto
- Neurodegenerative Diseases Unit, Neurology Service, Department of Neuroscience, University Hospital Germans Trias i Pujol (HUGTiP), Universitat Autònoma de Barcelona-Can Ruti Campus, Badalona, Barcelona, Spain
| | - Dolores Vilas
- Neurodegenerative Diseases Unit, Neurology Service, Department of Neuroscience, University Hospital Germans Trias i Pujol (HUGTiP), Universitat Autònoma de Barcelona-Can Ruti Campus, Badalona, Barcelona, Spain
- Parkinson Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Spain
| | - Eduardo Tolosa
- Parkinson Disease and Movement Disorders Unit, Neurology Service, Hospital Clínic de Barcelona, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona (UB), Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED: CB06/05/0018-ISCIII), Barcelona, Spain
| | | | - Ramiro Alvarez-Ramo
- Neurodegenerative Diseases Unit, Neurology Service, Department of Neuroscience, University Hospital Germans Trias i Pujol (HUGTiP), Universitat Autònoma de Barcelona-Can Ruti Campus, Badalona, Barcelona, Spain
| | - Ivelisse Sánchez
- Functional and Translational Neurogenetics Unit, Department of Neuroscience, Research Institute Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona-Can Ruti Campus, Badalona, Barcelona, Spain
| | - Antoni Matilla-Dueñas
- Functional and Translational Neurogenetics Unit, Department of Neuroscience, Research Institute Germans Trias i Pujol (IGTP), Universitat Autònoma de Barcelona-Can Ruti Campus, Badalona, Barcelona, Spain
- Correspondence to: Dr Antoni Matilla-Dueñas Head of the Neurogenetics Unit Health Sciences Research Institute Germans Trias i Pujol (IGTP) Ctra. de Can Ruti, Camí de les Escoles s/n 08916 Badalona, Barcelona, Spain E-mail:
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Bogdanova-Mihaylova P, Plapp HM, Chen H, Early A, Cassidy L, Walsh RA, Murphy SM. Longitudinal Assessment Using Optical Coherence Tomography in Patients with Friedreich's Ataxia. Tomography 2021; 7:915-931. [PMID: 34941648 PMCID: PMC8706975 DOI: 10.3390/tomography7040076] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/16/2022] Open
Abstract
Ocular abnormalities occur frequently in Friedreich's ataxia (FRDA), although visual symptoms are not always reported. We evaluated a cohort of patients with FRDA to characterise the clinical phenotype and optic nerve findings as detected with optical coherence tomography (OCT). A total of 48 patients from 42 unrelated families were recruited. Mean age at onset was 13.8 years (range 4-40), mean disease duration 19.5 years (range 5-43), mean disease severity as quantified with the Scale for the Assessment and Rating of Ataxia 22/40 (range 4.5-38). All patients displayed variable ataxia and two-thirds had ocular abnormalities. Statistically significant thinning of average retinal nerve fibre layer (RNFL) and thinning in all but the temporal quadrant compared to controls was demonstrated on OCT. Significant RNFL and macular thinning was documented over time in 20 individuals. Disease severity and visual acuity were correlated with RNFL and macular thickness, but no association was found with disease duration. Our results highlight that FDRA is associated with subclinical optic neuropathy. This is the largest longitudinal study of OCT findings in FRDA to date, demonstrating progressive RNFL thickness decline, suggesting that RNFL thickness as measured by OCT has the potential to become a quantifiable biomarker for the evaluation of disease progression in FRDA.
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Affiliation(s)
- Petya Bogdanova-Mihaylova
- National Ataxia Clinic, Department of Neurology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland; (R.A.W.); (S.M.M.)
| | - Helena Maria Plapp
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland; (H.M.P.); (H.C.)
| | - Hongying Chen
- School of Medicine, Trinity College Dublin, Dublin 2, Ireland; (H.M.P.); (H.C.)
| | - Anne Early
- Department of Ophthalmology, Tallaght University Hospital, Dublin 24, Ireland; (A.E.); (L.C.)
| | - Lorraine Cassidy
- Department of Ophthalmology, Tallaght University Hospital, Dublin 24, Ireland; (A.E.); (L.C.)
| | - Richard A. Walsh
- National Ataxia Clinic, Department of Neurology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland; (R.A.W.); (S.M.M.)
- Dublin Neurological Institute at the Mater Hospital and University College Dublin, Dublin 7, Ireland
- Academic Unit of Neurology, Trinity College Dublin, Dublin 2, Ireland
| | - Sinéad M. Murphy
- National Ataxia Clinic, Department of Neurology, Tallaght University Hospital, Tallaght, Dublin 24, Ireland; (R.A.W.); (S.M.M.)
- Academic Unit of Neurology, Trinity College Dublin, Dublin 2, Ireland
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Paucar M, Tesi B, Eshtad S, Eriksson C, Hashim F, Nilsson D, Pourhamidi K, Hellström-Lindberg E, Bryceson YT, Svenningsson P. Adult-Onset Ataxia With Neuropathy and White Matter Abnormalities Due to a Novel SAMD9L Variant. NEUROLOGY-GENETICS 2021; 7:e628. [PMID: 34722875 PMCID: PMC8554712 DOI: 10.1212/nxg.0000000000000628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 08/24/2021] [Indexed: 11/15/2022]
Affiliation(s)
- Martin Paucar
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Bianca Tesi
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Saeed Eshtad
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Caroline Eriksson
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Farouk Hashim
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Daniel Nilsson
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Kaveh Pourhamidi
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Eva Hellström-Lindberg
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Yenan T Bryceson
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
| | - Per Svenningsson
- Department of Clinical Neuroscience (M.P., F.H., K.P., P.S.), Karolinska Institutet; Department of Neurology (M.P., P.S.); Department of Clinical Genetics (B.T., D.N.), Karolinska University Hospital; Department of Molecular Medicine and Surgery (B.T., D.N.); Center for Hematology and Regenerative Medicine (S.E., C.E., E.H.-L.), Department of Medicine, Karolinska Institutet; Department of Pediatric Radiology (F.H.); Department of Neurophysiology (K.P.); Department of Hematology (E.H.-L., Y.T.B.); Department of Immunology and Transfusion Medicine (Y.T.B.), Karolinska University Hospital, Stockholm, Sweden; and Broegelmann Laboratory (Y.T.B.), Department of Clinical Sciences, University of Bergen, Norway
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8
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SAMD9L autoinflammatory or ataxia pancytopenia disease mutations activate cell-autonomous translational repression. Proc Natl Acad Sci U S A 2021; 118:2110190118. [PMID: 34417303 PMCID: PMC8403910 DOI: 10.1073/pnas.2110190118] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The experiments here advance understanding of the function of the SAMD9L gene and protein in innate immune mechanisms in resisting virus infection and in the pathogenesis of inflammatory, hematological, and neurological disorders. The clinical syndrome defined in two children with de novo truncating SAMD9L mutations expands the phenotypes in this newly recognized autoinflammatory disorder. Analysis of cells expressing normal or mutant SAMD9L reveals the protein represses protein translation, with the truncating mutations greatly exaggerating this activity. The experiments find equally potent gain of function caused by the truncating mutations or a recurrent missense mutation associated with clinically milder ataxia and pancytopenia syndromes, demonstrating that diverse clinical manifestations can arise from mutations that appear cell-biologically equivalent. Sterile α motif domain-containing protein 9-like (SAMD9L) is encoded by a hallmark interferon-induced gene with a role in controlling virus replication that is not well understood. Here, we analyze SAMD9L function from the perspective of human mutations causing neonatal-onset severe autoinflammatory disease. Whole-genome sequencing of two children with leukocytoclastic panniculitis, basal ganglia calcifications, raised blood inflammatory markers, neutrophilia, anemia, thrombocytopaenia, and almost no B cells revealed heterozygous de novo SAMD9L mutations, p.Asn885Thrfs*6 and p.Lys878Serfs*13. These frameshift mutations truncate the SAMD9L protein within a domain a region of homology to the nucleotide-binding and oligomerization domain (NOD) of APAF1, ∼80 amino acids C-terminal to the Walker B motif. Single-cell analysis of human cells expressing green fluorescent protein (GFP)-SAMD9L fusion proteins revealed that enforced expression of wild-type SAMD9L repressed translation of red fluorescent protein messenger RNA and globally repressed endogenous protein translation, cell autonomously and in proportion to the level of GFP-SAMD9L in each cell. The children’s truncating mutations dramatically exaggerated translational repression even at low levels of GFP-SAMD9L per cell, as did a missense Arg986Cys mutation reported recurrently as causing ataxia pancytopenia syndrome. Autoinflammatory disease associated with SAMD9L truncating mutations appears to result from an interferon-induced translational repressor whose activity goes unchecked by the loss of C-terminal domains that may normally sense virus infection.
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