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Islam S, Tekman M, Flanagan SE, Guay-Woodford L, Hussain K, Ellard S, Kleta R, Bockenhauer D, Stanescu H, Iancu D. Founder mutation in the PMM2 promotor causes hyperinsulinemic hypoglycaemia/polycystic kidney disease (HIPKD). Mol Genet Genomic Med 2021; 9:e1674. [PMID: 33811480 PMCID: PMC8683636 DOI: 10.1002/mgg3.1674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/17/2021] [Accepted: 03/22/2021] [Indexed: 01/03/2023] Open
Abstract
Background Polycystic kidney disease with hyperinsulinaemic hypoglycaemia (HIPKD) is a recently described disease caused by a single nucleotide variant, c.‐167G>T, in the promoter region of PMM2 (encoding phosphomannomutase 2), either in homozygosity or compound heterozygosity with a pathogenic coding variant in trans. All patients identified so far are of European descent, suggesting a possible founder effect. Methods We generated high density genotyping data from 11 patients from seven unrelated families, and used this information to identify a common haplotype that included the promoter variant. We estimated the age of the promoter mutation with DMLE+ software, using demographic parameters corresponding to the European population. Results All patients shared a 0.312 Mb haplotype which was absent in 503 European controls available in the 1000 Genomes Project. The age of this mutation was estimated as 105–110 generations, indicating its occurrence around 600 BC, a time of intense migration, which might explain the presence of the same mutations in Europeans around the globe. Conclusion The shared unique haplotype among seemingly unrelated patients is consistent with a founder effect in Europeans.
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Affiliation(s)
- Sumaya Islam
- Department Renal Medicine, University College London, London, UK
| | - Mehmet Tekman
- Department Renal Medicine, University College London, London, UK
| | - Sarah E Flanagan
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Lisa Guay-Woodford
- Center for Translational Research, Children's National Hospital Health System, Washington, DC, USA
| | - Khalid Hussain
- Department of Endocrinology, Sidra Medicine, Doha, Qatar
| | - Sian Ellard
- Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Robert Kleta
- Department Renal Medicine, University College London, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Detlef Bockenhauer
- Department Renal Medicine, University College London, London, UK.,Great Ormond Street Hospital for Children, NHS Foundation Trust, London, UK
| | - Horia Stanescu
- Department Renal Medicine, University College London, London, UK
| | - Daniela Iancu
- Department Renal Medicine, University College London, London, UK
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Pettinato F, Mostile G, Battini R, Martinelli D, Madeo A, Biamino E, Frattini D, Garozzo D, Gasperini S, Parini R, Sirchia F, Sortino G, Sturiale L, Matthijs G, Morrone A, Di Rocco M, Rizzo R, Jaeken J, Fiumara A, Barone R. Clinical and radiological correlates of activities of daily living in cerebellar atrophy caused by PMM2 mutations (PMM2-CDG). THE CEREBELLUM 2021; 20:596-605. [PMID: 33619652 PMCID: PMC8360885 DOI: 10.1007/s12311-021-01242-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 02/08/2021] [Indexed: 01/02/2023]
Abstract
We aimed to identify clinical, molecular and radiological correlates of activities of daily living (ADL) in patients with cerebellar atrophy caused by PMM2 mutations (PMM2-CDG), the most frequent congenital disorder of glycosylation. Twenty-six PMM2-CDG patients (12 males; mean age 13 ± 11.1 years) underwent a standardized assessment to measure ADL, ataxia (brief ataxia rating scale, BARS) and phenotype severity (Nijmegen CDG rating scale, NCRS). MRI biometry of the cerebellum and the brainstem were performed in 23 patients (11 males; aged 5 months-18 years) and 19 control subjects with equal gender and age distributions. The average total ADL score was 15.3 ± 8.5 (range 3-32 out of 36 indicating severe functional disability), representing variable functional outcome in PMM2-CDG patients. Total ADL scores were significantly correlated with NCRS (r2 = 0.55, p < 0.001) and BARS scores (r2 = 0.764; p < 0.001). Severe intellectual disability, peripheral neuropathy, and severe PMM2 variants were all significantly associated with worse functional outcome. Higher ADL scores were significantly associated with decreased diameters of cerebellar vermis (r2 = 0.347; p = 0.004), hemispheres (r2 = 0.436; p = 0.005), and brainstem, particularly the mid-pons (r2 = 0.64; p < 0.001) representing the major radiological predictor of functional disability score in multivariate regression analysis. We show that cerebellar syndrome severity, cognitive level, peripheral neuropathy, and genotype correlate with ADL used to quantify disease-related deficits in PMM2-CDG. Brainstem involvement should be regarded among functional outcome predictors in patients with cerebellar atrophy caused by PMM2-CDG.
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Affiliation(s)
- Fabio Pettinato
- Child Neurology and Psychiatry Section, Department of Clinical and Experimental Medicine, University of Catania, Policlinico, Via Santa Sofia 78, 95123 Catania, Italy
| | - Giovanni Mostile
- Department “GF Ingrassia”, Section of Neurosciences, University of Catania, Catania, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Diego Martinelli
- Division of Metabolism, Department of Pediatric Specialties, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Annalisa Madeo
- Unit of Rare Diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Elisa Biamino
- Department of Pediatrics, University of Turin, Turin, Italy
| | - Daniele Frattini
- Department of Pediatrics, Child Neurology Unit, Presidio Ospedaliero Provinciale Santa Maria Nuova Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Domenico Garozzo
- CNR, Institute for Polymers, Composites and Biomaterials, IPCB, Catania, Italy
| | - Serena Gasperini
- Pediatric Rare Diseases Unit, Department of Pediatrics, MBBM Foundation, ATS Monza e Brianza, Monza, Italy
| | - Rossella Parini
- Pediatric Rare Diseases Unit, Department of Pediatrics, MBBM Foundation, ATS Monza e Brianza, Monza, Italy
| | - Fabio Sirchia
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Giuseppe Sortino
- Department of Diagnostic Imaging, Radiology Unit, Policlinico University Hospital, Catania, Italy
| | - Luisa Sturiale
- CNR, Institute for Polymers, Composites and Biomaterials, IPCB, Catania, Italy
| | - Gert Matthijs
- Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Amelia Morrone
- Molecular and Cell Biology Laboratory of Neurometabolic Diseases, Neuroscience Department, Meyer Children’s Hospital, Florence, Italy
- Department of NEUROFARBA, University of Florence, Florence, Italy
| | - Maja Di Rocco
- Unit of Rare Diseases, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Renata Rizzo
- Child Neurology and Psychiatry Section, Department of Clinical and Experimental Medicine, University of Catania, Policlinico, Via Santa Sofia 78, 95123 Catania, Italy
| | - Jaak Jaeken
- Department of Development and Regeneration, Centre for Metabolic Diseases, University Hospital Gasthuisberg, KU Leuven, Leuven, Belgium
| | - Agata Fiumara
- Pediatric Unit, Regional Referral Center for Inherited Metabolic Disease, University of Catania, Catania, Italy
| | - Rita Barone
- Child Neurology and Psychiatry Section, Department of Clinical and Experimental Medicine, University of Catania, Policlinico, Via Santa Sofia 78, 95123 Catania, Italy
- CNR, Institute for Polymers, Composites and Biomaterials, IPCB, Catania, Italy
- Pediatric Unit, Regional Referral Center for Inherited Metabolic Disease, University of Catania, Catania, Italy
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