1
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Bessis D, Bursztejn AC, Morice-Picard F, Capri Y, Barbarot S, Aubert H, Bodet D, Bourrat E, Chiaverini C, Poujade L, Willems M, Rouanet J, Dompmartin-Blanchère A, Geneviève D, Gerard M, Ginglinger E, Hadj-Rabia S, Martin L, Mazereeuw-Hautier J, Bibas N, Molinari N, Herman F, Phan A, Rod J, Roger H, Sigaudy S, Ziegler A, Vial Y, Verloes A, Cavé H, Lacombe D. Dermatological manifestations in Costello syndrome: A prospective multicentric study of 31 HRAS-positive variant patients. J Eur Acad Dermatol Venereol 2024. [PMID: 38595321 DOI: 10.1111/jdv.19996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 02/29/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Data on dermatological manifestations of Costello syndrome (CS) remain heterogeneous and lack in validated description. OBJECTIVES To describe the dermatological manifestations of CS; compare them with the literature findings; assess those discriminating CS from other RASopathies, including cardiofaciocutaneous syndrome (CFCS) and the main types of Noonan syndrome (NS); and test for dermatological phenotype-genotype correlations. METHODS We performed a 10-year, large, prospective, multicentric, collaborative dermatological and genetic study. RESULTS Thirty-one patients were enrolled. Hair abnormalities were ubiquitous, including wavy or curly hair and excessive eyebrows, respectively in 68% and 56%. Acral excessive skin (AES), papillomas and keratotic papules (PKP), acanthosis nigricans (AN), palmoplantar hyperkeratosis (PPHK) and 'cobblestone' papillomatous papules of the upper lip (CPPUL), were noted respectively in 84%, 61%, 65%, 55% and 32%. Excessive eyebrows, PKP, AN, CCPUL and AES best differentiated CS from CFCS and NS. Multiple melanocytic naevi (>50) may constitute a new marker of attenuated CS associated with intragenic duplication in HRAS. Oral acitretin may be highly beneficial for therapeutic management of PPHK. No significant dermatological phenotype-genotype correlation was determined between patients with and without HRAS c.34G>A (p.G12S). CONCLUSIONS AND RELEVANCE This validated phenotypic characterization of a large number of patients with CS will allow future researchers to make a positive diagnosis, and to differentiate CS from CFCS and NS.
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Affiliation(s)
- Didier Bessis
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- INSERM U1058, Montpellier, France
| | | | - Fanny Morice-Picard
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Paediatric Dermatology, Pellegrin University Hospital of Bordeaux, Bordeaux, France
| | - Yline Capri
- Department of Clinical Genetics, Robert-Debré Hospital, Paris, France
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
| | - Sébastien Barbarot
- Department of Dermatology, Hotel Dieu Hospital, University of Nantes, Nantes, France
| | - Hélène Aubert
- Department of Dermatology, Hotel Dieu Hospital, University of Nantes, Nantes, France
| | - Damien Bodet
- Department of Paediatric Haematology-Immunology-Oncology, Caen Normandie Hospital and University of Caen, Caen, France
| | - Emmanuelle Bourrat
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Paediatric Dermatology, Robert-Debré Hospital, AP-HP, Paris, France
| | - Christine Chiaverini
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Dermatology, l'Archet 2 Hospital, University of Nice, Nice, France
| | - Laura Poujade
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
| | - Marjolaine Willems
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
- French National Reference Centre for Developmental Anomalies - and Malformative Syndromes Sud Ouest Occitanie, University hospital of Montpellier, Montpellier, France
| | - Jacques Rouanet
- Department of Dermatology, d'Estaing Hospital and University Hospital of Clermont-Ferrand, Clermont-Ferrand, France
| | | | - David Geneviève
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
- French National Reference Centre for Developmental Anomalies - and Malformative Syndromes Sud Ouest Occitanie, University hospital of Montpellier, Montpellier, France
| | - Marion Gerard
- Department of Clinical Genetics, Caen Normandie Hospital and University of Caen, Caen, France
| | | | - Smaïl Hadj-Rabia
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Paediatric Dermatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - Ludovic Martin
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Dermatology, Angers Hospital University, Angers, France
| | - Juliette Mazereeuw-Hautier
- French National Reference Centre for Rare Diseases of the Skin and Mucous Membranes of Genetic Origin (MAGEC), University hospital of Montpellier, Montpellier, France
- Department of Dermatology, Larrey Hospital, University of Toulouse, Toulouse, France
| | - Nathalie Bibas
- Department of Dermatology, Larrey Hospital, University of Toulouse, Toulouse, France
| | - Nicolas Molinari
- Department of Statistics, La Colombière Hospital and University of Montpellier, Montpellier, France
| | - Fanchon Herman
- Department of Statistics, La Colombière Hospital and University of Montpellier, Montpellier, France
| | - Alice Phan
- Department of Paediatric Dermatology, Femme-Mère-Enfant Hospital-HCL, University of Lyon, Lyon, France
| | - Julien Rod
- Department of Paediatric Surgery, Caen Normandie Hospital and University of Caen, Caen, France
| | | | - Sabine Sigaudy
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
- Department of Clinical Genetics, La Timone Hospital, AP-HM and University of Marseille, Marseille, France
| | - Alban Ziegler
- Department of Clinical Genetics, Hospital and University of Angers, Angers, France
| | - Yoann Vial
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
- Department of Molecular Genetics, Robert-Debré Hospital, AP-HP, Paris, France
| | - Alain Verloes
- Department of Clinical Genetics, Robert-Debré Hospital, Paris, France
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
| | - Hélène Cavé
- French National Reference Centre for Developmental Anomalies and Malformative Syndromes - Ile de France, Robert-Debré Hospital, AP-HP, Paris, France
- Department of Molecular Genetics, Robert-Debré Hospital, AP-HP, Paris, France
| | - Didier Lacombe
- Department of Clinical Genetics, Pellegrin University Hospital of Bordeaux, Bordeaux, France
- French National Reference Centre for Developmental Anomalies - and Malformative Syndromes SOOR, University Hospital of Bordeaux, Bordeaux, France
- INSERM U1211, Bordeaux, France
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2
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Failoc-Rojas VE, Ugaz PAQ, León DAL, Zeña-Ñañez S. Fatal leukodystrophy in Costello syndrome: a case report. BMC Pediatr 2023; 23:374. [PMID: 37488489 PMCID: PMC10364348 DOI: 10.1186/s12887-023-04166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 06/28/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Costello syndrome (CS) is a rare genetic condition characterized by dysregulation of the signaling pathway, phenotypic alteration due to fetal macrosomia or growth retardation, facial abnormalities, loose skin, cardiovascular abnormalities, and a variable degree of intellectual disability. CASE PRESENTATION We describe the case of a 20-month-old male patient with fetal macrosomia and polyhydramnios, presenting psychomotor development delay and growth limitation during the first months of life. CS was diagnosed at four months of age after detecting a variant of the HRAS gene c.35G > C (p.G12A). A clinical description of his condition was recorded throughout his life, including cardiovascular diseases, endocrine disorders, and recurrent infections. At 20 months of age, after presenting events of marked hypotonia and generalized seizures, brain magnetic resonance revealed symmetrical lesions of the infra- and supratentorial white matter in both cerebral hemispheres, which resulted in the diagnosis of cerebral leukodystrophy. The patient had a rapid and progressive deterioration that eventually led to death. CONCLUSIONS This is the first report of a case of CS in Peru. In addition, this is a case that presented with multisystemic conditions culminating in leukodystrophy, which is a rare event according to the literature.
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Affiliation(s)
- Virgilio E Failoc-Rojas
- Facultad de Medicina, Universidad Cesar Vallejo, Raúl Mata La Cruz s/n, Piura, 20001, Perú, Peru.
| | - Piero A Quiroz Ugaz
- Universidad Nacional Pedro Ruiz Gallo, 391 Juan XXIII Avenue, Lambayeque, 14013, Perú, Peru
| | - Dante A Loconi León
- Universidad Nacional Pedro Ruiz Gallo, 391 Juan XXIII Avenue, Lambayeque, 14013, Perú, Peru
| | - Sandra Zeña-Ñañez
- Universidad Continental, 355 Junin Street, Miraflores, 15046, Lima, Perú
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3
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Kavamura MI, Leoni C, Neri G. Dermatological manifestations, management, and care in RASopathies. AMERICAN JOURNAL OF MEDICAL GENETICS. PART C, SEMINARS IN MEDICAL GENETICS 2022; 190:452-458. [PMID: 36541891 DOI: 10.1002/ajmg.c.32027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 11/20/2022] [Accepted: 12/10/2022] [Indexed: 12/24/2022]
Abstract
RASopathies are rare genetic disorders caused by germline pathogenic variants in genes belonging to the RAS/MAPK pathway, which signals cell proliferation, differentiation, survival and death. The dysfunction of such signaling pathway causes syndromes with overlapping clinical manifestations. Skin and adnexal lesions are the cardinal clinical signs of RASopathies, such as cardiofaciocutaneous syndrome, Noonan syndrome with multiple lentigines, formerly known as LEOPARD syndrome, Costello syndrome, neurofibromatosis (NF1), Legius syndrome, Noonan-like syndrome with loose anagen hair (NSLH) and Noonan syndrome. As NF1, one of the most common RASopathies, described in 1882, has its clinical features well delineated, we will focus on the dermatological diagnosis, management and care of non-NF1 RASopathies, which are less known and more recently described. Dermatological manifestations are important clinical diagnostic elements that can aid differential diagnosis among RASopathies. They can affect dermis and epidermis, causing pigmented lesions (melanocytic nevi, café-au-lait spots, and lentigines), hyperkeratosis (keratosis pilaris, ulerythema ophryogenes, and palmoplantar keratosis) or hyperplasia. To date there are rare known links to malignancy, but oftentimes skin lesions require close attention because they can highly affect quality of life.
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Affiliation(s)
| | - Chiara Leoni
- Center for Rare Diseases and Birth Defects, Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Giovanni Neri
- Institute of Genomic Medicine, Catholic University School of Medicine, Rome, Italy
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4
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Dard L, Hubert C, Esteves P, Blanchard W, Bou About G, Baldasseroni L, Dumon E, Angelini C, Delourme M, Guyonnet-Duperat V, Claverol S, Bonneu M, Fontenille L, Kissa K, Séguéla PE, Thambo JB, Levy N, Herault Y, Bellance N, Dias Amoedo N, Magdinier F, Sorg T, Lacombe D, Rossignol R. HRAS germline mutations impair LKB1/AMPK signaling and mitochondrial homeostasis in Costello syndrome models. J Clin Invest 2022; 132:131053. [PMID: 35230976 PMCID: PMC9012293 DOI: 10.1172/jci131053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 02/23/2022] [Indexed: 11/17/2022] Open
Abstract
Germline mutations that activate genes in the canonical RAS/MAPK signaling pathway are responsible for rare human developmental disorders known as RASopathies. Here, we analyzed the molecular determinants of Costello syndrome (CS) using a mouse model expressing HRAS p.G12S, patient skin fibroblasts, hiPSC-derived human cardiomyocytes, a HRAS p.G12V zebrafish model and human fibroblasts expressing lentiviral constructs carrying HRAS p.G12S or HRAS p.G12A mutations. The findings revealed alteration of mitochondrial proteostasis and defective oxidative phosphorylation in the heart and skeletal muscle of Costello mice that were also found in the cell models of the disease. The underpinning mechanisms involved the inhibition of the AMPK signaling pathway by mutant forms of HRAS, leading to alteration of mitochondrial proteostasis and bioenergetics. Pharmacological activation of mitochondrial bioenergetics and quality control restored organelle function in HRAS p.G12A and p.G12S cell models, reduced left ventricle hypertrophy in the CS mice and diminished the occurrence of developmental defects in the CS zebrafish model. Collectively, these findings highlight the importance of mitochondrial proteostasis in the pathophysiology of RASopathies and suggest that patients with Costello syndrome may benefit from treatment with mitochondrial modulators.
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Affiliation(s)
| | | | | | | | - Ghina Bou About
- Université de Strasbourg, CNRS, INSERM, CELPHEDIA, PHENOMIN, Institut Clinique de la Souris (ICS), Illkirch, France
| | | | - Elodie Dumon
- INSERM U688, University of Bordeaux, Bordeaux, France
| | | | | | | | | | - Marc Bonneu
- Plateforme Proteome, University of Bordeaux, Bordeaux, France
| | | | | | | | | | - Nicolas Levy
- Marseille Medical Genetics, INSERM, Marseille, France
| | - Yann Herault
- Université de Strasbourg, CNRS, INSERM, CELPHEDIA, PHENOMIN, Institut Clinique de la Souris (ICS), Illkirch, France
| | | | | | | | - Tania Sorg
- Université de Strasbourg, CNRS, INSERM, CELPHEDIA, PHENOMIN, Institut Clinique de la Souris (ICS), Illkirch, France
| | - Didier Lacombe
- Medical Genetics Department, Bordeaux University Hospital CHU Bordeaux, INSERM U121, Bordeaux, France
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5
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Jones VA, Patel PM, Valikodath T, Ashack KA. Dermatologic manifestations of pediatric cardiovascular diseases: Skin as a reflection of the heart. Pediatr Dermatol 2021; 38:1461-1474. [PMID: 34725847 DOI: 10.1111/pde.14841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Cutaneous disease can often be an initial clue of an underlying cardiovascular disease. Many congenital conditions (ie, Noonan syndrome with multiple lentigines, Carney complex, and Fabry disease) and acquired conditions may present initially with specific cutaneous features that should prompt clinicians to conduct a full cardiac workup. Given the extensive number of conditions with both cardiovascular and cutaneous findings, this review will focus on diseases with cardiocutaneous pathology with hopes of raising clinician awareness of these associations to decrease morbidity and mortality, as several of these diseases often result in fatal outcomes.
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Affiliation(s)
- Virginia A Jones
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Payal M Patel
- Department of Dermatology, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Tom Valikodath
- Cincinnati Children's Hospital Medical Center Heart Institute, Cincinnati, Ohio, USA
| | - Kurt A Ashack
- Dermatology Associates of West Michigan, Grand Rapids, Michigan, USA
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6
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Schremser V, Sinz C, Tanew A, Radakovic S. Myriad of pigmented lesions in a patient with Costello syndrome. J Eur Acad Dermatol Venereol 2021; 35:e514-e516. [PMID: 33783899 DOI: 10.1111/jdv.17254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- V Schremser
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Sinz
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - A Tanew
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - S Radakovic
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
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7
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Leoni C, Guerriero C, Onesimo R, Coco V, Di Ruscio C, Acampora A, Esposito I, Romano A, Tartaglia M, Genuardi M, Zampino G. Melanocytic nevi in RASopathies: insights on dermatological diagnostic handles. J Eur Acad Dermatol Venereol 2020; 35:e83-e85. [PMID: 32679607 DOI: 10.1111/jdv.16824] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Leoni
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - C Guerriero
- Dermatology Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - R Onesimo
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - V Coco
- Dermatology Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - C Di Ruscio
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - A Acampora
- Istituto di Sanità Pubblica, Sezione di Igiene, Università Cattolica del Sacro Cuore, Rome, Italy
| | - I Esposito
- Dermatology Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - A Romano
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - M Tartaglia
- Genetics and Rare Diseases Research Division, Ospedale Pediatrico Bambino Gesù, IRCCS, Rome, Italy
| | - M Genuardi
- Università Cattolica del Sacro Cuore, Rome, Italy.,Medical Genetics Unit, Department of Laboratory and Infectious Sciences, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy
| | - G Zampino
- Department of Woman and Child Health and Public Health, Center for Rare Diseases and Birth Defects, Fondazione Policlinico Universitario "A. Gemelli" IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
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8
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Dard L, Blanchard W, Hubert C, Lacombe D, Rossignol R. Mitochondrial functions and rare diseases. Mol Aspects Med 2020; 71:100842. [PMID: 32029308 DOI: 10.1016/j.mam.2019.100842] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/26/2019] [Accepted: 12/27/2019] [Indexed: 12/19/2022]
Abstract
Mitochondria are dynamic cellular organelles responsible for a large variety of biochemical processes as energy transduction, REDOX signaling, the biosynthesis of hormones and vitamins, inflammation or cell death execution. Cell biology studies established that 1158 human genes encode proteins localized to mitochondria, as registered in MITOCARTA. Clinical studies showed that a large number of these mitochondrial proteins can be altered in expression and function through genetic, epigenetic or biochemical mechanisms including the interaction with environmental toxics or iatrogenic medicine. As a result, pathogenic mitochondrial genetic and functional defects participate to the onset and the progression of a growing number of rare diseases. In this review we provide an exhaustive survey of the biochemical, genetic and clinical studies that demonstrated the implication of mitochondrial dysfunction in human rare diseases. We discuss the striking diversity of the symptoms caused by mitochondrial dysfunction and the strategies proposed for mitochondrial therapy, including a survey of ongoing clinical trials.
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Affiliation(s)
- L Dard
- Bordeaux University, 33000, Bordeaux, France; INSERM U1211, 33000, Bordeaux, France; CELLOMET, CGFB-146 Rue Léo Saignat, Bordeaux, France
| | - W Blanchard
- Bordeaux University, 33000, Bordeaux, France; INSERM U1211, 33000, Bordeaux, France; CELLOMET, CGFB-146 Rue Léo Saignat, Bordeaux, France
| | - C Hubert
- Bordeaux University, 33000, Bordeaux, France; INSERM U1211, 33000, Bordeaux, France
| | - D Lacombe
- Bordeaux University, 33000, Bordeaux, France; INSERM U1211, 33000, Bordeaux, France; CHU de Bordeaux, Service de Génétique Médicale, F-33076, Bordeaux, France
| | - R Rossignol
- Bordeaux University, 33000, Bordeaux, France; INSERM U1211, 33000, Bordeaux, France; CELLOMET, CGFB-146 Rue Léo Saignat, Bordeaux, France.
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9
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Gripp KW, Morse LA, Axelrad M, Chatfield KC, Chidekel A, Dobyns W, Doyle D, Kerr B, Lin AE, Schwartz DD, Sibbles BJ, Siegel D, Shankar SP, Stevenson DA, Thacker MM, Weaver KN, White SM, Rauen KA. Costello syndrome: Clinical phenotype, genotype, and management guidelines. Am J Med Genet A 2019; 179:1725-1744. [PMID: 31222966 DOI: 10.1002/ajmg.a.61270] [Citation(s) in RCA: 65] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Revised: 05/22/2019] [Accepted: 06/01/2019] [Indexed: 12/16/2022]
Abstract
Costello syndrome (CS) is a RASopathy caused by activating germline mutations in HRAS. Due to ubiquitous HRAS gene expression, CS affects multiple organ systems and individuals are predisposed to cancer. Individuals with CS may have distinctive craniofacial features, cardiac anomalies, growth and developmental delays, as well as dermatological, orthopedic, ocular, and neurological issues; however, considerable overlap with other RASopathies exists. Medical evaluation requires an understanding of the multifaceted phenotype. Subspecialists may have limited experience in caring for these individuals because of the rarity of CS. Furthermore, the phenotypic presentation may vary with the underlying genotype. These guidelines were developed by an interdisciplinary team of experts in order to encourage timely health care practices and provide medical management guidelines for the primary and specialty care provider, as well as for the families and affected individuals across their lifespan. These guidelines are based on expert opinion and do not represent evidence-based guidelines due to the lack of data for this rare condition.
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Affiliation(s)
- Karen W Gripp
- Division of Medical Genetics, Department of Pediatrics, A.I. duPont Hospital for Children, Wilmington, Delaware
| | | | - Marni Axelrad
- Psychology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Kathryn C Chatfield
- Section of Cardiology, Department of Pediatrics, University of Colorado School of Medicine, Aurora, Colorado
| | - Aaron Chidekel
- Division of Pulmonology, Department of Pediatrics, A.I. duPont Hospital for Children, Wilmington, Delaware
| | - William Dobyns
- Division of Medical Genetics, Seattle Children's Hospital, Seattle, Washington
| | - Daniel Doyle
- Division of Endocrinology, A.I. duPont Hospital for Children, Wilmington, Delaware
| | - Bronwyn Kerr
- Manchester Center for Genomic Medicine, University of Manchester, Manchester, UK
| | - Angela E Lin
- Medical Genetics Unit, Department of Pediatrics, MassGeneral Hospital for Children, Boston, Massachusetts
| | - David D Schwartz
- Psychology Section, Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Barbara J Sibbles
- Division of Pediatrics, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Dawn Siegel
- Department of Dermatology, Medical College of Wisconsin, Milwaukee, Wisconsin
| | - Suma P Shankar
- Division of Genomic Medicine, Department of Pediatrics, University of California Davis, Sacramento, California
| | - David A Stevenson
- Division of Medical Genetic, Department of Pediatrics, Stanford University, Palo Alto, California
| | - Mihir M Thacker
- Department of Orthopedic Surgery, Nemoirs-Alfred I. duPont Hospital for Children, Wilmington, Delaware
| | - K Nicole Weaver
- Division of Human Genetics, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Sue M White
- Victorian Clinical Genetics Services, Royal Children's Hospital, Victoria, Australia
| | - Katherine A Rauen
- Division of Genomic Medicine, Department of Pediatrics, University of California Davis, Sacramento, California
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10
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Nishihara K, Tohyama M, Kubo A. A case of woolly hair nevus, multiple linear pigmentation, and epidermal nevi with somatic HRAS p.G12S mutation. Pediatr Dermatol 2019; 36:368-371. [PMID: 30864170 PMCID: PMC6593414 DOI: 10.1111/pde.13783] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Woolly hair nevus is a rare syndrome that presents as woolly hair in restricted areas of the scalp and may be associated with pigmented macules or epidermal nevus on the body. Here, we report a case of woolly hair nevus, linear pigmentation, and multiple epidermal nevi with a somatic HRAS c.34G>A(p.G12S) mutation.
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Affiliation(s)
- Katsuhiko Nishihara
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Mikiko Tohyama
- Department of Dermatology, Ehime University Graduate School of Medicine, Toon, Ehime, Japan
| | - Akiharu Kubo
- Department of Biochemistry, Keio University School of Medicine, Tokyo, Japan
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11
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Smid CJ, Modaff P, Alade A, Legare JM, Pauli RM. Acanthosis nigricans in achondroplasia. Am J Med Genet A 2018; 176:2630-2636. [PMID: 30380187 DOI: 10.1002/ajmg.a.40506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2018] [Revised: 06/19/2018] [Accepted: 07/23/2018] [Indexed: 12/24/2022]
Abstract
Acanthosis nigricans (AN) in those with achondroplasia has been reported occasionally in the literature previously. Other disorders arising from constitutive activation of FGFR3 also manifest AN at various frequencies. We assessed the prevalence of AN in a sequential series of 477 individuals with achondroplasia. Using a REDCap database, we collected and analyzed what other features or medical issues may co-occur with AN in those with achondroplasia. AN arises in approximately 10% of individuals with achondroplasia. It usually first appears in preadolescence or adolescence, is more likely in the non-White population and in those who are obese. It is not severe and generally will need no treatment. It is not associated with any evident risk for neither hyperinsulinemic states nor malignancy, and therefore, no special investigations are warranted when it is recognized. Thus, clinicians should not be surprised or concerned upon discovering this finding in those with achondroplasia. In addition, the mechanisms and genetic causes of AN are detailed.
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Affiliation(s)
- Cory J Smid
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Peggy Modaff
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.,Midwest Regional Bone Dysplasia Clinic, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Adekemi Alade
- Greenberg Center for Skeletal Dysplasias, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Janet M Legare
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.,Midwest Regional Bone Dysplasia Clinic, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Richard M Pauli
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.,Midwest Regional Bone Dysplasia Clinic, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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12
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Bessis D, Morice-Picard F, Bourrat E, Abadie C, Aouinti S, Baumann C, Best M, Bursztejn AC, Capri Y, Chiaverini C, Coubes C, Giuliano F, Hadj-Rabia S, Jacquemont ML, Lacombe D, Lyonnet S, Mallet S, Mazereeuw-Hautier J, Miquel J, Molinari N, Parfait B, Pernet C, Philip N, Pinson L, Pouvreau N, Vial Y, Sarda P, Sigaudy S, Verloes A, Cavé H, Geneviève D. Dermatological manifestations in cardiofaciocutaneous syndrome: a prospective multicentric study of 45 mutation-positive patients. Br J Dermatol 2018; 180:172-180. [PMID: 30141192 DOI: 10.1111/bjd.17077] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Data on dermatological manifestations of cardiofaciocutaneous syndrome (CFCS) remain heterogeneous and almost without expert dermatological classification. OBJECTIVES To describe the dermatological manifestations of CFCS; to compare them with the literature findings; to assess those discriminating CFCS from other RASopathies, including Noonan syndrome (NS) and Costello syndrome (CS); and to test for dermatological phenotype-genotype correlations. METHODS We performed a 4-year, large, prospective, multicentric, collaborative dermatological and genetic study. RESULTS Forty-five patients were enrolled. Hair abnormalities were ubiquitous, including scarcity or absence of eyebrows and wavy or curly hair in 73% and 69% of patients, respectively. Keratosis pilaris (KP), ulerythema ophryogenes (UO), palmoplantar hyperkeratosis (PPHK) and multiple melanocytic naevi (MMN; over 50 naevi) were noted in 82%, 44%, 27% and 29% of patients, respectively. Scarcity or absence of eyebrows, association of UO and PPHK, diffuse KP and MMN best differentiated CFCS from NS and CS. Oral acitretin may be highly beneficial for therapeutic management of PPHK, whereas treatment of UO by topical sirolimus 1% failed. No significant dermatological phenotype-genotype correlation was determined. CONCLUSIONS A thorough knowledge of CFCS skin manifestations would help in making a positive diagnosis and differentiating CFCS from CS and NS.
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Affiliation(s)
- D Bessis
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France.,INSERM U1058, Montpellier, France
| | - F Morice-Picard
- Department of Pediatric Dermatology, Pellegrin University Hospital of Bordeaux, Bordeaux, AP-HP, France
| | - E Bourrat
- Department of Pediatric Dermatology, Robert-Debré Hospital, AP-HP, Paris, France
| | - C Abadie
- Department of Clinical Genetics, Sud Hospital and University Hospital of Rennes, Rennes, France
| | - S Aouinti
- Department of Statistics, La Colombière Hospital and University of Montpellier, Montpellier, France
| | - C Baumann
- Department of Clinical Genetics, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - M Best
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France
| | - A-C Bursztejn
- Department of Dermatology, Brabois Hospital, University of Nancy, Nancy, France
| | - Y Capri
- Department of Clinical Genetics, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - C Chiaverini
- Department of Dermatology, L'Archet 2 Hospital and University of Nice, Nice, France
| | - C Coubes
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
| | - F Giuliano
- Department of Clinical Genetics, L'Archet 2 Hospital and University of Nice, Nice, France
| | - S Hadj-Rabia
- Department of Pediatric Dermatology, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - M-L Jacquemont
- Department of Clinical Genetics, Femme-Mère-Enfant Hospital, University of South Reunion, Saint-Pierre, Réunion, France
| | - D Lacombe
- Department of Clinical Genetics, Pellegrin University Hospital of Bordeaux, Bordeaux, AP-HP, France
| | - S Lyonnet
- Department of Clinical Genetics, Necker-Enfants Malades Hospital, AP-HP, Paris, France
| | - S Mallet
- Department of Dermatology, La Timone Hospital, AP-HM and University of Marseille, Marseille, France
| | - J Mazereeuw-Hautier
- Department of Dermatology, Larrey Hospital, Reference Center for Rare Skin Diseases, University of Toulouse, Toulouse, France
| | - J Miquel
- Department of Pediatric Dermatology, Femme-Mère-Enfant Hospital, University of South Reunion, Saint-Pierre, Réunion, France.,Department of Dermatology, University of Rennes, Rennes, France
| | - N Molinari
- Department of Statistics, La Colombière Hospital and University of Montpellier, Montpellier, France
| | - B Parfait
- Department of Molecular Genetics and Biology, Cochin Hospital, AP-HP, University Paris V, Paris, France
| | - C Pernet
- Department of Dermatology, Saint-Eloi Hospital, University of Montpellier, Montpellier, France
| | - N Philip
- Department of Clinical Genetics, La Timone Hospital, AP-HM and University of Marseille, Marseille, France
| | - L Pinson
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
| | - N Pouvreau
- Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - Y Vial
- Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - P Sarda
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France
| | - S Sigaudy
- Department of Clinical Genetics, La Timone Hospital, AP-HM and University of Marseille, Marseille, France
| | - A Verloes
- Department of Clinical Genetics, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - H Cavé
- Department of Genetic Biochemistry, Robert-Debré Hospital, AP-HP and University of Paris-Diderot, Paris, France
| | - D Geneviève
- Department of Clinical Genetics, Arnaud de Villeneuve Hospital, University of Montpellier, Montpellier, France.,INSERM U1183, Montpellier, France
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13
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Genomic Analysis of Pigmented Epithelioid Melanocytomas Reveals Recurrent Alterations in PRKAR1A, and PRKCA Genes. Am J Surg Pathol 2017; 41:1333-1346. [DOI: 10.1097/pas.0000000000000902] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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14
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Bertola D, Buscarilli M, Stabley DL, Baker L, Doyle D, Bartholomew DW, Sol-Church K, Gripp KW. Phenotypic spectrum of Costello syndrome individuals harboring the rare HRAS mutation p.Gly13Asp. Am J Med Genet A 2017; 173:1309-1318. [PMID: 28371260 DOI: 10.1002/ajmg.a.38178] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Revised: 12/12/2016] [Accepted: 01/18/2017] [Indexed: 12/19/2022]
Abstract
Costello syndrome is part of the RASopathies, a group of neurocardiofaciocutaneous syndromes caused by deregulation of the RAS mitogen-activated protein kinase pathway. Heterozygous mutations in HRAS are responsible for Costello syndrome, with more than 80% of the patients harboring the specific p.Gly12Ser variant. These individuals show a homogeneous phenotype. The clinical characteristics of the Costello syndrome individuals harboring rarer HRAS mutations are less understood, due to the small number of reported cases. Here, we describe the phenotypic spectrum of five additional individuals with HRAS c.38G>A; p.Gly13Asp, including one with somatic mosaicism, and review five previously described cases. The facial and hair abnormalities of the HRAS p.Gly13Asp individuals differ from the typical pattern observed in those showing the common HRAS (p.Gly12Ser) mutation, with less coarse facial features and slow growing, sparse hair with abnormal texture, the latter resembling the pattern observed in Noonan syndrome-like disorder with loose anagen hair and individuals harboring another amino acid substitution in HRAS (p.Gly13Cys). Although some individuals with HRAS p.Gly13Asp developed papillomata and vascular proliferation lesions, no malignant tumors occurred, similar to what was reported for individuals harboring the HRAS p.Gly13Cys. The fact that no malignant tumors were described in these individuals does not allow definitive conclusions about the risk for cancer development. It remains to be determined if substitutions of amino acid 13 in HRAS (p.Gly13Asp and p.Gly13Cys) increase the risk of tumor development.
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Affiliation(s)
- Débora Bertola
- Unidade de Genética Clínica, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Instituto de Biociências da Universidade de São Paulo, São Paulo, Brazil
| | - Michelle Buscarilli
- Unidade de Genética Clínica, Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - Deborah L Stabley
- Center for Applied Clinical Genomics, A. I. duPont Hospital for Children/Nemours, Wilmington, Delaware
| | - Laura Baker
- Division of Medical Genetics, A. I. duPont Hospital for Children/Nemours, Wilmington, Delaware
| | - Daniel Doyle
- Division of Endocrinology, A. I. duPont Hospital for Children/Nemours, Wilmington, Delaware
| | - Dennis W Bartholomew
- Division of Molecular and Human Genetics, Nationwide Children's Hospital, Columbus, Ohio
| | - Katia Sol-Church
- Center for Applied Clinical Genomics, A. I. duPont Hospital for Children/Nemours, Wilmington, Delaware
| | - Karen W Gripp
- Center for Applied Clinical Genomics, A. I. duPont Hospital for Children/Nemours, Wilmington, Delaware.,Division of Medical Genetics, A. I. duPont Hospital for Children/Nemours, Wilmington, Delaware
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15
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Bardawil T, Khalil S, Bergqvist C, Abbas O, Kibbi AG, Bitar F, Nemer G, Kurban M. Genetics of inherited cardiocutaneous syndromes: a review. Open Heart 2016; 3:e000442. [PMID: 27933191 PMCID: PMC5133403 DOI: 10.1136/openhrt-2016-000442] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 07/13/2016] [Accepted: 07/19/2016] [Indexed: 12/17/2022] Open
Abstract
The life of a human being originates as a single cell which, under the influence of certain factors, divides sequentially into multiple cells that subsequently become committed to develop and differentiate into the different structures and organs. Alterations occurring early on in the development process may lead to fetal demise in utero. Conversely, abnormalities at later stages may result in structural and/or functional abnormalities of varying severities. The cardiovascular system and skin share certain developmental and structural factors; therefore, it is not surprising to find several inherited syndromes with both cardiac and skin manifestations. Here, we will review the overlapping pathways in the development of the skin and heart, as well as the resulting syndromes. We will also highlight several cutaneous clues that may help physicians screen and uncover cardiac anomalies that may be otherwise hidden and result in sudden cardiac death.
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Affiliation(s)
| | | | | | - Ossama Abbas
- Department of Dermatology , American University of Beirut , Beirut Lebanon
| | - Abdul Ghani Kibbi
- Department of Dermatology , American University of Beirut , Beirut Lebanon
| | - Fadi Bitar
- Department of Biochemistry and Molecular Genetics, American University of Beirut, BeirutLebanon; Department of Pediatrics, American University of Beirut, BeirutLebanon
| | - Georges Nemer
- Department of Biochemistry and Molecular Genetics , American University of Beirut , Beirut Lebanon
| | - Mazen Kurban
- Department of Dermatology, American University of Beirut, BeirutLebanon; Department of Biochemistry and Molecular Genetics, American University of Beirut, BeirutLebanon; Department of Dermatology, Columbia University Medical Center, New York, New York, USA
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16
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Hernández-Martín A, Duat-Rodríguez A. An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots, Freckling, and Neurofibromas. An Update. Part I. Dermatological Clinical Criteria Diagnostic of the Disease. ACTAS DERMO-SIFILIOGRAFICAS 2016. [DOI: 10.1016/j.adengl.2016.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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17
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Hernández-Martín A, Duat-Rodríguez A. An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots, Freckling, and Neurofibromas. An Update. Part I. Dermatological Clinical Criteria Diagnostic of the Disease. ACTAS DERMO-SIFILIOGRAFICAS 2016; 107:454-64. [PMID: 26979265 DOI: 10.1016/j.ad.2016.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 01/07/2016] [Accepted: 01/17/2016] [Indexed: 01/10/2023] Open
Abstract
Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome and probably the one best known to dermatologists, who are generally the first physicians to suspect its diagnosis. Although the genetic locus of NF1 was identified on chromosome 17 in 1987, diagnosis of the disease is still mainly based on clinical observations and the diagnostic criteria of the National Institute of Health, dating from 1988. Cutaneous manifestations are particularly important because café-au-lait spots, freckling on flexural areas, and cutaneous neurofibromas comprise 3 of the 7 clinical diagnostic criteria. However, café-au-lait spots and freckling can also be present in other diseases. These manifestations are therefore not pathognomonic and are insufficient for definitive diagnosis in the early years of life. NF1 is a multisystemic disease associated with a predisposition to cancer. A multidisciplinary follow-up is necessary and dermatologists play an important role.
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Affiliation(s)
- A Hernández-Martín
- Servicio de Dermatología, Hospital Infantil del Niño Jesús, Madrid, España.
| | - A Duat-Rodríguez
- Servicio de Neurología, Hospital Infantil del Niño Jesús, Madrid, España
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18
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García-Cruz R, Camats M, Calin GA, Liu CG, Volinia S, Taccioli C, Croce CM, Bach-Elias M. The role of p19 and p21 H-Ras proteins and mutants in miRNA expression in cancer and a Costello syndrome cell model. BMC MEDICAL GENETICS 2015; 16:46. [PMID: 26138095 PMCID: PMC4631104 DOI: 10.1186/s12881-015-0184-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 06/01/2015] [Indexed: 02/03/2023]
Abstract
Background P19 H-Ras, a second product derived from the H-Ras gene by alternative splicing, induces a G1/S phase delay, thereby maintaining cells in a reversible quiescence state. When P21 H-Ras is mutated in tumour cells, the alternative protein P19 H-Ras is also mutated. The H-Ras mutation Q61L is frequently detected in different tumours, which acts as constitutive activator of Ras functions and is considered to be a strong activating mutant. Additionally, a rare congenital disorder named Costello Syndrome, is described as a H-Ras disorder in children, mainly due to mutation G12S in p19 and p21 H-Ras proteins, which is present in 90 % of the Costello Syndrome patients. Our aim is to better understand the role of p19 and p21 H-Ras proteins in the cancer and Costello Syndrome development, concerning the miRNAs expression. Methods Total miRNAs expression regulated by H-Ras proteins were first analyzed in human miRNA microarrays assays. Previously selected miRNAs, were further analyzed in developed cell lines containing H-Ras protein mutants, that included the G12S Costello Syndrome mutant, with PCR Real-Time Taq Man miRNA Assays primers. Results This study describes how p19 affects the RNA world and shows that: i) miR-342, miR-206, miR-330, miR-138 and miR-99b are upregulated by p19 but not by p19W164A mutant; ii) anti-miR-206 can restore the G2 phase in the presence of p19; iii) p19 and p21Q61L regulate their own alternative splicing; iv) miR-206 and miR-138 are differentially regulated by p19 and p21 H-Ras and v) P19G12S Costello mutants show a clear upregulation of miR-374, miR-126, miR-342, miR-330, miR-335 and let-7. Conclusions These results allow us to conclude that the H-Ras G12S mutation plays an important role in miRNA expression and open up a new line of study to understand the consequences of this mutation on Costello syndrome. Furthermore, they suggest that oncogenes may have a sufficiently important impact on miRNA expression to promote the development of numerous cancers. Electronic supplementary material The online version of this article (doi:10.1186/s12881-015-0184-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roseli García-Cruz
- Instituto de Investigaciones Biomédicas de Barcelona- CSIC, C/ Egipcíacas15, 08001, Barcelona, Spain.
| | - Maria Camats
- Instituto de Investigaciones Biomédicas de Barcelona- CSIC, C/ Egipcíacas15, 08001, Barcelona, Spain.
| | - George A Calin
- Ohio State University, Department of Molecular Immunology, Virology and Molecular Genetics, Columbus, Ohio, 43210, USA. .,Present address: Departments of Experimental Therapeutics & Cancer Genetics, University of Texas, MD Anderson Cancer Center, Houston, TX, 77030, USA.
| | - Chang-Gong Liu
- Ohio State University, Department of Molecular Immunology, Virology and Molecular Genetics, Columbus, Ohio, 43210, USA.
| | - Stefano Volinia
- Ohio State University, Department of Molecular Immunology, Virology and Molecular Genetics, Columbus, Ohio, 43210, USA.
| | - Cristian Taccioli
- Ohio State University, Department of Molecular Immunology, Virology and Molecular Genetics, Columbus, Ohio, 43210, USA.
| | - Carlo M Croce
- Ohio State University, Department of Molecular Immunology, Virology and Molecular Genetics, Columbus, Ohio, 43210, USA.
| | - Montse Bach-Elias
- Instituto de Investigaciones Biomédicas de Barcelona- CSIC, C/ Egipcíacas15, 08001, Barcelona, Spain.
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19
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Costello syndrome with severe nodulocystic acne: unexpected significant improvement of acanthosis nigricans after oral isotretinoin treatment. Case Rep Pediatr 2015; 2015:934865. [PMID: 25815234 PMCID: PMC4359863 DOI: 10.1155/2015/934865] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Accepted: 02/23/2015] [Indexed: 01/17/2023] Open
Abstract
We report the case of 17-year-old female diagnosed with Costello syndrome. Genetic testing provided a proof with G12S mutation in the HRAS gene since 3 years of age with a presentation of severe nodulocystic acne on her face. After 2 months of oral isotretinoin treatment, improvement in her acne was observed. Interestingly, an unexpected significant improvement of acanthosis nigricans on her neck and dorsum of her hands was found as well. We present this case as a successful treatment option by using oral isotretinoin for the treatment of acanthosis nigricans in Costello syndrome patients.
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20
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21
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Lim YH, Douglas SR, Ko CJ, Antaya RJ, McNiff JM, Zhou J, Choate KA, Narayan D. Somatic Activating RAS Mutations Cause Vascular Tumors Including Pyogenic Granuloma. J Invest Dermatol 2015; 135:1698-1700. [PMID: 25695684 PMCID: PMC4430357 DOI: 10.1038/jid.2015.55] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- Young H Lim
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Stephanie R Douglas
- Section of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Christine J Ko
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Richard J Antaya
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jennifer M McNiff
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Jing Zhou
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Keith A Choate
- Department of Dermatology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Pathology, Yale University School of Medicine, New Haven, Connecticut, USA; Department of Genetics, Yale University School of Medicine, New Haven, Connecticut, USA.
| | - Deepak Narayan
- Section of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut, USA
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22
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Xu F, Wang HJ, Lin ZM, Yu B. Recurrent duplication mutation in HRAS causing mild Costello syndrome in a Chinese patient. Clin Exp Dermatol 2015; 40:404-7. [PMID: 25677562 DOI: 10.1111/ced.12571] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2014] [Indexed: 11/29/2022]
Abstract
Costello syndrome (CS; OMIM 218040) is caused by heterozygous germline mutations of HRAS (OMIM 190020).We report on a patient with sporadic CS presenting with characteristic craniofacial dysmorphism, congenital cardiopulmonary disorders, intellectual impairment, and skin abnormalities manifesting as loose redundant skin of the hands and feet, acanthosis nigricans, multiple naevi and hypotrichosis. Using Sanger sequencing for the case-parents trio, we detected a de novo insertion mutation (c.187_207dup) in HRAS, which was predicted to result in duplication of amino acids 63-69 (p.E63_D69dup). This mutation was recently described in a mild case of CS, with hyperactivation of HRAS and disrupted capacity to respond to incoming signals. Our study delineates the detailed clinical features associated with this noncanonical HRAS mutation and further expands the phenotypic spectrum of CS.
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Affiliation(s)
- F Xu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - H J Wang
- Department of Dermatology, Peking University First Hospital, Beijing, China.,Peking-Tsinghua Center for Life Sciences, Beijing, China
| | - Z M Lin
- Department of Dermatology, Peking University First Hospital, Beijing, China
| | - B Yu
- State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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23
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Pierpont MEM, Magoulas PL, Adi S, Kavamura MI, Neri G, Noonan J, Pierpont EI, Reinker K, Roberts AE, Shankar S, Sullivan J, Wolford M, Conger B, Santa Cruz M, Rauen KA. Cardio-facio-cutaneous syndrome: clinical features, diagnosis, and management guidelines. Pediatrics 2014; 134:e1149-62. [PMID: 25180280 PMCID: PMC4179092 DOI: 10.1542/peds.2013-3189] [Citation(s) in RCA: 122] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2014] [Indexed: 12/22/2022] Open
Abstract
Cardio-facio-cutaneous syndrome (CFC) is one of the RASopathies that bears many clinical features in common with the other syndromes in this group, most notably Noonan syndrome and Costello syndrome. CFC is genetically heterogeneous and caused by gene mutations in the Ras/mitogen-activated protein kinase pathway. The major features of CFC include characteristic craniofacial dysmorphology, congenital heart disease, dermatologic abnormalities, growth retardation, and intellectual disability. It is essential that this condition be differentiated from other RASopathies, as a correct diagnosis is important for appropriate medical management and determining recurrence risk. Children and adults with CFC require multidisciplinary care from specialists, and the need for comprehensive management has been apparent to families and health care professionals caring for affected individuals. To address this need, CFC International, a nonprofit family support organization that provides a forum for information, support, and facilitation of research in basic medical and social issues affecting individuals with CFC, organized a consensus conference. Experts in multiple medical specialties provided clinical management guidelines for pediatricians and other care providers. These guidelines will assist in an accurate diagnosis of individuals with CFC, provide best practice recommendations, and facilitate long-term medical care.
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Affiliation(s)
- Mary Ella M Pierpont
- Division of Genetics and Metabolism, Department of Pediatrics and Ophthalmology, and Children's Hospitals and Clinics of Minnesota, Saint Paul, Minnesota;
| | - Pilar L Magoulas
- Department of Molecular and Human Genetics, Texas Children's Hospital and Baylor College of Medicine, Houston, Texas
| | - Saleh Adi
- Madison Clinic for Pediatric Diabetes, Benioff Children's Hospital and University of California at San Francisco, San Francisco, California
| | | | - Giovanni Neri
- Institute of Medical Genetics, A Gemelli School of Medicine, Catholic University, Rome, Italy
| | - Jacqueline Noonan
- Department of Pediatrics, University of Kentucky, Lexington, Kentucky
| | - Elizabeth I Pierpont
- Division of Clinical Behavioral Neuroscience, Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
| | - Kent Reinker
- Department of Orthopedics, University of Texas Health Sciences Center, San Antonio, Texas
| | - Amy E Roberts
- Department of Cardiology and Division of Genetics, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts
| | - Suma Shankar
- Departments of Human Genetics and Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Joseph Sullivan
- Departments of Neurology and Pediatrics, University of California at San Francisco, San Francisco, California
| | - Melinda Wolford
- Department of Counseling, Special Education and School Psychology, Youngstown State University, Youngstown, Ohio
| | | | | | - Katherine A Rauen
- Division of Genomic Medicine, Department of Pediatrics, UC Davis MIND Institute, University of California at Davis, Sacramento, California
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24
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Carcavilla A, García-Miñaúr S, Pérez-Aytés A, Vendrell T, Pinto I, Guillén-Navarro E, González-Meneses A, Aoki Y, Grinberg D, Ezquieta B. [Cardiofaciocutaneous syndrome, a Noonan syndrome related disorder: clinical and molecular findings in 11 patients]. Med Clin (Barc) 2014; 144:67-72. [PMID: 25194980 DOI: 10.1016/j.medcli.2014.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2014] [Revised: 06/14/2014] [Accepted: 06/19/2014] [Indexed: 12/21/2022]
Abstract
OBJECTIVES To describe 11 patients with cardiofaciocutaneous syndrome (CFC) and compare them with 130 patients with other RAS-MAPK syndromes (111 Noonan syndrome patients [NS] and 19 patients with LEOPARD syndrome). PATIENTS AND METHODS Clinical data from patients submitted for genetic analysis were collected. Bidirectional sequencing analysis of PTPN11, SOS1, RAF1, BRAF, and MAP2K1 focused on exons carrying recurrent mutations, and of all KRAS exons were performed. RESULTS Six different mutations in BRAF were identified in 9 patients, as well as 2 MAP2K1 mutations. Short stature, developmental delay, language difficulties and ectodermal anomalies were more frequent in CFC patients when compared with other neuro-cardio-faciocutaneous syndromes (P<.05). In at least 2 cases molecular testing helped reconsider the diagnosis. DISCUSSION CFC patients showed a rather severe phenotype but at least one patient with BRAF mutation showed no developmental delay, which illustrates the variability of the phenotypic spectrum caused by BRAF mutations. Molecular genetic testing is a valuable tool for differential diagnosis of CFC and NS related disorders.
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Affiliation(s)
| | - Sixto García-Miñaúr
- Instituto de Genética Médica y Molecular, Hospital La Paz, Madrid, España; Centro de Investigación Biomédica en Red en enfermedades raras (CIBERER)
| | | | - Teresa Vendrell
- Unidad de Genética Clínica, Hospital Vall d'Hebron, Barcelona, España
| | - Isabel Pinto
- Servicio de Pediatría, Hospital Severo Ochoa, Leganés, Madrid, España
| | - Encarna Guillén-Navarro
- Centro de Investigación Biomédica en Red en enfermedades raras (CIBERER); Unidad de Genética Médica, Servicio de Pediatría, Hospital Virgen de la Arrixaca, Cátedra de Genética Médica, Universidad Católica San Antonio de Murcia, Murcia, España
| | | | - Yoko Aoki
- Departamento de Genética Médica, Facultad de Medicina, Universidad de Tohoku, Sendai, Japón
| | - Daniel Grinberg
- Centro de Investigación Biomédica en Red en enfermedades raras (CIBERER); Departamento de Genética, Facultad de Biología, Universidad de Barcelona, Instituto de Biomedicina de la Universitad de Barcelona (IBUB), Barcelona, España
| | - Begoña Ezquieta
- Centro de Investigación Biomédica en Red en enfermedades raras (CIBERER); Laboratorio Diagnóstico Molecular, Servicio de Bioquímica, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, España
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