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Chagay NB, Khayt GY, Vdovina TM, Shaforost AA. [Cystic fibrosis being a polyendocrine disease (Review)]. ACTA ACUST UNITED AC 2021; 67:28-39. [PMID: 34004101 PMCID: PMC8926149 DOI: 10.14341/probl12694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2020] [Revised: 02/22/2021] [Accepted: 03/30/2021] [Indexed: 11/06/2022]
Abstract
The cystic fibrosis transmembrane regulator (CFTR) gene encodes the synthesis of a protein of the same name, which functions as a direct activator of anionic transport. Chloride is the most abundant anion; as an antagonist of Na+ and K+, it provides electroneutrality of cell membranes at rest; together with cations, it serves as an important osmolyte and forms water flow across cell membranes for transepithelial secretion.Glandular cells in CF trap Cl- and Na+, and the prodused secretion is excessively viscous. Subnormal CFTR activity leads to stagnation of mucociliary clearance, inhibition of intestinal transport.In addition to exocrine disorders, CFTR mutations are associated with a decrease in volume, mass, increased apoptosis of β-cells of the pancreas, a significant suppression of insulin exocytosis in response to stimulation with glucose and glucagon-like peptide-1, hyperglucagonemia against the background of a defect in the suppression of α-cell function by insulin, but a decrease in maximum capacity α-cells.Deficiency and progressive decline in bone mineral density is an expected secondary manifestation of CF due to pancreatic exocrine insufficiency with malabsorption of nutrients and fat-soluble vitamins. However, in patients with the F508del mutation, a significant decrease in the synthesis of OPG, COX-2, PGE2 in the osteoblastic formation, and an increase in the activity of the antianabolic NF-kB were found. We are talking about a defect in the canonical signaling pathway (Wnt/β-catenin), which regulates the expression of genes-activators of osteoblastogenesis, dissociation of the stages of physiological bone remodeling.In addition to congenital bilateral or unilateral aplasia of the vas deferens, an increase in the frequency of CFTR mutations is also found in non-obstructive azoospermia, oligo-, astheno- and teratospermia. CFTR is involved in the entry of HCO3- into Sertoli cells to trigger cAMP-dependent transcription and its defects lead to suppression of FSH-dependent gene expression of spermatogenesis, loss of sequence in the Wnt cascade, destruction of the PGE2-dependent transepithelial interaction and, as a consequence, the blood-testicular barrier.CF is characterized, along with classical signs, by endocrine dysfunction of the pancreas, osteoporosis with suppression of osteoblastogenesis, and a defect in spermatogenesis.
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Affiliation(s)
- N B Chagay
- Stavropol Regional Clinical Consultative and Diagnostic Center; Stavropol State Medical University
| | - G Ya Khayt
- Stavropol Regional Clinical Consultative and Diagnostic Center; Stavropol State Medical University
| | - T M Vdovina
- Stavropol Regional Clinical Consultative and Diagnostic Center
| | - A A Shaforost
- Stavropol Regional Clinical Consultative and Diagnostic Center
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Petrova NV, Kashirskaya NY, Krasovskiy SA, Amelina EL, Kondratyeva EI, Marakhonov AV, Vasilyeva TA, Voronkova AY, Sherman VD, Ginter EK, Kutsev SI, Zinchenko RA. Clinical Presentation of the c.3844T>C (p.Trp1282Arg, W1282R) Variant in Russian Cystic Fibrosis Patients. Genes (Basel) 2020; 11:E1137. [PMID: 32992607 PMCID: PMC7600230 DOI: 10.3390/genes11101137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 09/12/2020] [Accepted: 09/23/2020] [Indexed: 11/25/2022] Open
Abstract
The goal was to study the phenotypic manifestations of c.3844T>C (p.Trp1282Arg, W1282R) variant, a CF-causing mutation, in patients from the Russian Federation. Clinical manifestations and complications (the age at CF diagnosis, sweat test, pancreatic status, lung function, microbial infection, body mass index (BMI), the presence of meconium ileus (MI), diabetes, and severe liver disease) were compared in four groups: group 1-patients carrying c.3844T>C and severe class I or II variant in trans; group 2-3849+10kbC>T/F508del patients; group 3-F508del/F508del patients; and group 4-patients with W1282R and "mild" variant in trans. Based on the analyses, W1282R with class I or II variant in trans appears to cause at least as severe CF symptoms as F508del homozygotes as reflected in the early age of diagnosis, high sweat chloride concentration, insufficient pancreatic function, and low lung function, in contrast to 3849+10kbC-T/F508del compound heterozygotes having milder clinical phenotypes. The W1282R pathogenic variant is seemed to lead to severe disease phenotype with pancreatic insufficiency similarly to the F508del homozygous genotype.
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Affiliation(s)
- Nika V. Petrova
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Nataliya Y. Kashirskaya
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Stanislav A. Krasovskiy
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
- Pulmonology Research Institute under FMBA of Russia, Orekhoviy boulevard, 28, 115682 Moscow, Russia;
| | - Elena L. Amelina
- Pulmonology Research Institute under FMBA of Russia, Orekhoviy boulevard, 28, 115682 Moscow, Russia;
| | - Elena I. Kondratyeva
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Andrey V. Marakhonov
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Tatyana A. Vasilyeva
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Anna Y. Voronkova
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Victoria D. Sherman
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Evgeny K. Ginter
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Sergey I. Kutsev
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
| | - Rena A. Zinchenko
- Research Centre for Medical Genetics, Russian Federation, Moskvorechie St., 1, 115522 Moscow, Russia; (N.V.P.); (S.A.K.); (E.I.K.); (A.V.M.); (T.A.V.); (A.Y.V.); (V.D.S.); (E.K.G.); (S.I.K.); (R.A.Z.)
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Adyan TA, Stepanova AA, Krasovskiy SA, Polyakov AV. Updating Diagnostic Spectrum of Recurring CFTR Mutations. RUSS J GENET+ 2018. [DOI: 10.1134/s1022795418100022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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