1
|
Rice GI, Kitabayashi N, Barth M, Briggs TA, Burton AC, Carpanelli ML, Cerisola AM, Colson C, Dale RC, Danti FR, Darin N, De Azua B, De Giorgis V, De Goede CGL, Desguerre I, De Laet C, Eslahi A, Fahey MC, Fallon P, Fay A, Fazzi E, Gorman MP, Gowrinathan NR, Hully M, Kurian MA, Leboucq N, Lin JPSM, Lines MA, Mar SS, Maroofian R, Martí-Sanchez L, McCullagh G, Mojarrad M, Narayanan V, Orcesi S, Ortigoza-Escobar JD, Pérez-Dueñas B, Petit F, Ramsey KM, Rasmussen M, Rivier F, Rodríguez-Pombo P, Roubertie A, Stödberg TI, Toosi MB, Toutain A, Uettwiller F, Ulrick N, Vanderver A, Waldman A, Livingston JH, Crow YJ. Genetic, Phenotypic, and Interferon Biomarker Status in ADAR1-Related Neurological Disease. Neuropediatrics 2017; 48:166-184. [PMID: 28561207 PMCID: PMC5985975 DOI: 10.1055/s-0037-1601449] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
We investigated the genetic, phenotypic, and interferon status of 46 patients from 37 families with neurological disease due to mutations in ADAR1. The clinicoradiological phenotype encompassed a spectrum of Aicardi-Goutières syndrome, isolated bilateral striatal necrosis, spastic paraparesis with normal neuroimaging, a progressive spastic dystonic motor disorder, and adult-onset psychological difficulties with intracranial calcification. Homozygous missense mutations were recorded in five families. We observed a p.Pro193Ala variant in the heterozygous state in 22 of 23 families with compound heterozygous mutations. We also ascertained 11 cases from nine families with a p.Gly1007Arg dominant-negative mutation, which occurred de novo in four patients, and was inherited in three families in association with marked phenotypic variability. In 50 of 52 samples from 34 patients, we identified a marked upregulation of type I interferon-stimulated gene transcripts in peripheral blood, with a median interferon score of 16.99 (interquartile range [IQR]: 10.64-25.71) compared with controls (median: 0.93, IQR: 0.57-1.30). Thus, mutations in ADAR1 are associated with a variety of clinically distinct neurological phenotypes presenting from early infancy to adulthood, inherited either as an autosomal recessive or dominant trait. Testing for an interferon signature in blood represents a useful biomarker in this context.
Collapse
Affiliation(s)
- Gillian I. Rice
- Division of Evolution and Genomic Sciences, Manchester Academic
Health Science Centre, School of Biological Sciences, Faculty of Biology, Medicine
and Health, University of Manchester, Manchester, United Kingdom
| | - Naoki Kitabayashi
- Laboratory of Neurogenetics and Neuroinflammation, INSERM UMR 1163,
Paris, France,Sorbonne-Paris-Cité, Institut Imagine, Hôpital
Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris
Descartes University, Paris, France
| | | | - Tracy A. Briggs
- Division of Evolution and Genomic Sciences, Manchester Academic
Health Science Centre, School of Biological Sciences, Faculty of Biology, Medicine
and Health, University of Manchester, Manchester, United Kingdom,Manchester Centre for Genomic Medicine, Central Manchester
University Hospitals NHS Foundation Trust, Manchester Academic Health Science
Centre, St Mary’s Hospital, Manchester, United Kingdom
| | - Annabel C.E. Burton
- Department of Paediatrics and Child Health, St George’s
University Hospitals NHS Foundation Trust, London, United Kingdom
| | | | - Alfredo M. Cerisola
- Department of Pediatric Neurology, Facultad de Medicina, UDELAR,
Montevideo, Uruguay
| | - Cindy Colson
- Clinique de Génétique, Hôpital Jeanne de
Flandre, CHU Lille, Lille, France
| | - Russell C. Dale
- Institute for Neuroscience and Muscle Research, Children’s
Hospital at Westmead, University of Sydney, Sydney, Australia
| | - Federica Rachele Danti
- Department of Developmental Neurosciences, Institute of Child
Health, UCL, London, United Kingdom,Department of Neurology, Great Ormond Street Hospital, London,
United Kingdom,Department of Paediatrics, Child Neurology and Psychiatry, Sapienza
University, Rome, Italy
| | - Niklas Darin
- Department of Pediatrics, Institute of Clinical Sciences,
Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Begoña De Azua
- Department of Pediatrics, Hospital Son Llátzer, Palma de
Mallorca, Spain
| | - Valentina De Giorgis
- Child Neurology and Psychiatry Unit, C. Mondino National
Neurological Institute, Pavia, Italy
| | | | - Isabelle Desguerre
- Department of Paediatric Neurology, Hôpital Necker-Enfants
Malades, AP-HP, Paris, France
| | - Corinne De Laet
- Nutrition and metabolic Unit, Hôpital Universitaire des
Enfants Reine Fabiola, Brussels, Belgium
| | - Atieh Eslahi
- Department of Medical Genetics, School of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran
| | - Michael C. Fahey
- Department of Paediatrics, Monash University, Melbourne,
Australia
| | - Penny Fallon
- Department of Paediatric Neurology, St George’s University
Hospitals NHS Foundation Trust, London, United Kingdom
| | - Alex Fay
- Department of Neurology, University of California, California, San
Francisco, United States
| | - Elisa Fazzi
- Unit of Child Neurology and Psychiatry, Department of Clinical and
Experimental Sciences, Civil Hospital, University of Brescia, Brescia, Italy
| | - Mark P. Gorman
- Department of Neurology, Boston Children’s Hospital,
Boston, United States
| | | | - Marie Hully
- Department of Paediatric Neurology, Hôpital Necker-Enfants
Malades, AP-HP, Paris, France
| | - Manju A. Kurian
- Department of Developmental Neurosciences, Institute of Child
Health, UCL, London, United Kingdom,Department of Neurology, Great Ormond Street Hospital, London,
United Kingdom
| | | | - Jean-Pierre S-M Lin
- General Neurology and Complex Motor Disorders Service, Evelina
Children’s Hospital, Guy’s & St Thomas’ NHS Foundation
Trust, London, United Kingdom
| | | | - Soe S. Mar
- Department of Pediatric Neurology, St. Louis Children’s
Hospital, Washington University School of Medicine, St. Louis, United States
| | - Reza Maroofian
- Medical Research, RILD Wellcome Wolfson Centre, Exeter Medical
School, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom
| | - Laura Martí-Sanchez
- Department of Child Neurology, Hospital Sant Joan de Déu,
Esplugues de Llobregat, Catalonia, Spain
| | - Gary McCullagh
- Department of Paediatric Neurology, Royal Manchester
Children’s Hospital, Manchester, United Kingdom
| | - Majid Mojarrad
- Department of Medical Genetics, School of Medicine, Mashhad
University of Medical Sciences, Mashhad, Iran
| | - Vinodh Narayanan
- Neurogenomics Division, Center for Rare Childhood Disorders, TGen
–The Translational Genomics Research Institute, Phoenix, United States
| | - Simona Orcesi
- Child Neurology and Psychiatry Unit, C. Mondino National
Neurological Institute, Pavia, Italy
| | | | - Belén Pérez-Dueñas
- Department of Child Neurology, Hospital Sant Joan de Déu,
Esplugues de Llobregat, Catalonia, Spain
| | - Florence Petit
- Clinique de Génétique, Hôpital Jeanne de
Flandre, CHU Lille, Lille, France
| | - Keri M. Ramsey
- Neurogenomics Division, Center for Rare Childhood Disorders, TGen
–The Translational Genomics Research Institute, Phoenix, United States
| | - Magnhild Rasmussen
- Department of Clinical Neurosciences for Children, and Unit for
Congenital and Hereditary Neuromuscular Disorders, Oslo University Hospital, Oslo,
Norway
| | - François Rivier
- Department of Neuropédiatrie and CR Maladies
Neuromusculaires, CHU de Montpellier, France,PhyMedExp, University of Montpellier, INSERM U1046, CNRS UMR 9214,
Montpellier, France
| | - Pilar Rodríguez-Pombo
- Centro de Diagnóstico de Enfermedades Moleculares, Centro
de Biología Molecular Severo Ochoa, Universidad Autónoma Madrid,
CIBERER, IDIPAZ, Madrid, Spain
| | - Agathe Roubertie
- Department of Neuropédiatrie and CR Maladies
Neuromusculaires, CHU de Montpellier, France,INSERM U1051, Institut des Neurosciences de Montpellier,
Montpellier, France
| | - Tommy I. Stödberg
- Neuropediatric Unit, Karolinska University Hospital, Stockholm,
Sweden
| | - Mehran Beiraghi Toosi
- Department of Pediatric Neurology, Ghaem Medical Center, School of
Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Florence Uettwiller
- Pediatric Immunology-Hematology and Rheumatology Unit, Institut
Imagine, Hôpital Necker Enfants Malades, Assistance
Publique-Hôpitaux de Paris, Paris, France,Department of Allergology and Clinical Immunology, CHRU Tours,
Tours, France
| | - Nicole Ulrick
- Department of Pediatrics, Children’s Hospital of
Philadelphia, Philadelphia, United States
| | - Adeline Vanderver
- Department of Pediatrics, Children’s Hospital of
Philadelphia, Philadelphia, United States
| | - Amy Waldman
- Department of Pediatrics, Children’s Hospital of
Philadelphia, Philadelphia, United States
| | - John H. Livingston
- Department of Paediatric Neurology, Leeds General Infirmary, Leeds,
United Kingdom
| | - Yanick J. Crow
- Division of Evolution and Genomic Sciences, Manchester Academic
Health Science Centre, School of Biological Sciences, Faculty of Biology, Medicine
and Health, University of Manchester, Manchester, United Kingdom,Laboratory of Neurogenetics and Neuroinflammation, INSERM UMR 1163,
Paris, France,Sorbonne-Paris-Cité, Institut Imagine, Hôpital
Necker Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris
Descartes University, Paris, France
| |
Collapse
|
2
|
Elze MC, Gimeno H, Tustin K, Baker L, Lumsden DE, Hutton JL, Lin JPSM. Burke-Fahn-Marsden dystonia severity, Gross Motor, Manual Ability, and Communication Function Classification scales in childhood hyperkinetic movement disorders including cerebral palsy: a 'Rosetta Stone' study. Dev Med Child Neurol 2016; 58:145-53. [PMID: 26616635 DOI: 10.1111/dmcn.12965] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/24/2015] [Indexed: 11/29/2022]
Abstract
AIM Hyperkinetic movement disorders (HMDs) can be assessed using impairment-based scales or functional classifications. The Burke-Fahn-Marsden Dystonia Rating Scale-movement (BFM-M) evaluates dystonia impairment, but may not reflect functional ability. The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and Communication Function Classification System (CFCS) are widely used in the literature on cerebral palsy to classify functional ability, but not in childhood movement disorders. We explore the concordance of these three functional scales in a large sample of paediatric HMDs and the impact of dystonia severity on these scales. METHOD Children with HMDs (n=161; median age 10y 3mo, range 2y 6mo-21y) were assessed using the BFM-M, GMFCS, MACS, and CFCS from 2007 to 2013. This cross-sectional study contrasts the information provided by these scales. RESULTS All four scales were strongly associated (all Spearman's rank correlation coefficient rs >0.72, p<0.001), with worse dystonia severity implying worse function. Secondary dystonias had worse dystonia and less function than primary dystonias (p<0.001). A longer proportion of life lived with dystonia is associated with more severe dystonia (rs =0.42, p<0.001). INTERPRETATION The BFM-M is strongly linked with the GMFCS, MACS, and CFCS, irrespective of aetiology. Each scale offers interrelated but complementary information and is applicable to all aetiologies. Movement disorders including cerebral palsy can be effectively evaluated using these scales.
Collapse
Affiliation(s)
- Markus C Elze
- Department of Statistics, University of Warwick, Coventry, UK.,Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK
| | - Hortensia Gimeno
- Complex Motor Disorders Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.,Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, King's College London, London, UK
| | - Kylee Tustin
- Complex Motor Disorders Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Lesley Baker
- Complex Motor Disorders Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Daniel E Lumsden
- Complex Motor Disorders Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Jane L Hutton
- Department of Statistics, University of Warwick, Coventry, UK
| | - Jean-Pierre S-M Lin
- Complex Motor Disorders Service, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
3
|
Crow YJ, Chase DS, Lowenstein Schmidt J, Szynkiewicz M, Forte GMA, Gornall HL, Oojageer A, Anderson B, Pizzino A, Helman G, Abdel-Hamid MS, Abdel-Salam GM, Ackroyd S, Aeby A, Agosta G, Albin C, Allon-Shalev S, Arellano M, Ariaudo G, Aswani V, Babul-Hirji R, Baildam EM, Bahi-Buisson N, Bailey KM, Barnerias C, Barth M, Battini R, Beresford MW, Bernard G, Bianchi M, Billette de Villemeur T, Blair EM, Bloom M, Burlina AB, Carpanelli ML, Carvalho DR, Castro-Gago M, Cavallini A, Cereda C, Chandler KE, Chitayat DA, Collins AE, Sierra Corcoles C, Cordeiro NJV, Crichiutti G, Dabydeen L, Dale RC, D'Arrigo S, De Goede CGEL, De Laet C, De Waele LMH, Denzler I, Desguerre I, Devriendt K, Di Rocco M, Fahey MC, Fazzi E, Ferrie CD, Figueiredo A, Gener B, Goizet C, Gowrinathan NR, Gowrishankar K, Hanrahan D, Isidor B, Kara B, Khan N, King MD, Kirk EP, Kumar R, Lagae L, Landrieu P, Lauffer H, Laugel V, La Piana R, Lim MJ, Lin JPSM, Linnankivi T, Mackay MT, Marom DR, Marques Lourenço C, McKee SA, Moroni I, Morton JEV, Moutard ML, Murray K, Nabbout R, Nampoothiri S, Nunez-Enamorado N, Oades PJ, Olivieri I, Ostergaard JR, Pérez-Dueñas B, Prendiville JS, Ramesh V, Rasmussen M, Régal L, Ricci F, Rio M, Rodriguez D, Roubertie A, Salvatici E, Segers KA, Sinha GP, Soler D, Spiegel R, Stödberg TI, Straussberg R, Swoboda KJ, Suri M, Tacke U, Tan TY, te Water Naude J, Wee Teik K, Thomas MM, Till M, Tonduti D, Valente EM, Van Coster RN, van der Knaap MS, Vassallo G, Vijzelaar R, Vogt J, Wallace GB, Wassmer E, Webb HJ, Whitehouse WP, Whitney RN, Zaki MS, Zuberi SM, Livingston JH, Rozenberg F, Lebon P, Vanderver A, Orcesi S, Rice GI. Characterization of human disease phenotypes associated with mutations in TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR, and IFIH1. Am J Med Genet A 2015; 167A:296-312. [PMID: 25604658 DOI: 10.1002/ajmg.a.36887] [Citation(s) in RCA: 393] [Impact Index Per Article: 43.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Accepted: 10/31/2014] [Indexed: 01/14/2023]
Abstract
Aicardi-Goutières syndrome is an inflammatory disease occurring due to mutations in any of TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, ADAR or IFIH1. We report on 374 patients from 299 families with mutations in these seven genes. Most patients conformed to one of two fairly stereotyped clinical profiles; either exhibiting an in utero disease-onset (74 patients; 22.8% of all patients where data were available), or a post-natal presentation, usually within the first year of life (223 patients; 68.6%), characterized by a sub-acute encephalopathy and a loss of previously acquired skills. Other clinically distinct phenotypes were also observed; particularly, bilateral striatal necrosis (13 patients; 3.6%) and non-syndromic spastic paraparesis (12 patients; 3.4%). We recorded 69 deaths (19.3% of patients with follow-up data). Of 285 patients for whom data were available, 210 (73.7%) were profoundly disabled, with no useful motor, speech and intellectual function. Chilblains, glaucoma, hypothyroidism, cardiomyopathy, intracerebral vasculitis, peripheral neuropathy, bowel inflammation and systemic lupus erythematosus were seen frequently enough to be confirmed as real associations with the Aicardi-Goutieres syndrome phenotype. We observed a robust relationship between mutations in all seven genes with increased type I interferon activity in cerebrospinal fluid and serum, and the increased expression of interferon-stimulated gene transcripts in peripheral blood. We recorded a positive correlation between the level of cerebrospinal fluid interferon activity assayed within one year of disease presentation and the degree of subsequent disability. Interferon-stimulated gene transcripts remained high in most patients, indicating an ongoing disease process. On the basis of substantial morbidity and mortality, our data highlight the urgent need to define coherent treatment strategies for the phenotypes associated with mutations in the Aicardi-Goutières syndrome-related genes. Our findings also make it clear that a window of therapeutic opportunity exists relevant to the majority of affected patients and indicate that the assessment of type I interferon activity might serve as a useful biomarker in future clinical trials.
Collapse
Affiliation(s)
- Yanick J Crow
- INSERM UMR 1163, Laboratory of Neurogenetics and Neuroinflammation, Paris Descartes - Sorbonne Paris Cité University, Institut Imagine, Hôpital Necker, Paris, France; Manchester Centre for Genomic Medicine, Institute of Human Development, Faculty of Medical and Human Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Rice GI, Forte GMA, Szynkiewicz M, Chase DS, Aeby A, Abdel-Hamid MS, Ackroyd S, Allcock R, Bailey KM, Balottin U, Barnerias C, Bernard G, Bodemer C, Botella MP, Cereda C, Chandler KE, Dabydeen L, Dale RC, De Laet C, De Goede CGEL, Del Toro M, Effat L, Enamorado NN, Fazzi E, Gener B, Haldre M, Lin JPSM, Livingston JH, Lourenco CM, Marques W, Oades P, Peterson P, Rasmussen M, Roubertie A, Schmidt JL, Shalev SA, Simon R, Spiegel R, Swoboda KJ, Temtamy SA, Vassallo G, Vilain CN, Vogt J, Wermenbol V, Whitehouse WP, Soler D, Olivieri I, Orcesi S, Aglan MS, Zaki MS, Abdel-Salam GMH, Vanderver A, Kisand K, Rozenberg F, Lebon P, Crow YJ. Assessment of interferon-related biomarkers in Aicardi-Goutières syndrome associated with mutations in TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, and ADAR: a case-control study. Lancet Neurol 2013; 12:1159-69. [PMID: 24183309 PMCID: PMC4349523 DOI: 10.1016/s1474-4422(13)70258-8] [Citation(s) in RCA: 301] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Aicardi-Goutières syndrome (AGS) is an inflammatory disorder caused by mutations in any of six genes (TREX1, RNASEH2A, RNASEH2B, RNASEH2C, SAMHD1, and ADAR). The disease is severe and effective treatments are urgently needed. We investigated the status of interferon-related biomarkers in patients with AGS with a view to future use in diagnosis and clinical trials. METHODS In this case-control study, samples were collected prospectively from patients with mutation-proven AGS. The expression of six interferon-stimulated genes (ISGs) was measured by quantitative PCR, and the median fold change, when compared with the median of healthy controls, was used to create an interferon score for each patient. Scores higher than the mean of controls plus two SD (>2·466) were designated as positive. Additionally, we collated historical data for interferon activity, measured with a viral cytopathic assay, in CSF and serum from mutation-positive patients with AGS. We also undertook neutralisation assays of interferon activity in serum, and looked for the presence of autoantibodies against a panel of interferon proteins. FINDINGS 74 (90%) of 82 patients had a positive interferon score (median 12·90, IQR 6·14-20·41) compared with two (7%) of 29 controls (median 0·93, IQR 0·57-1·30). Of the eight patients with a negative interferon score, seven had mutations in RNASEH2B (seven [27%] of all 26 patients with mutations in this gene). Repeat sampling in 16 patients was consistent for the presence or absence of an interferon signature on 39 of 41 occasions. Interferon activity (tested in 147 patients) was negatively correlated with age (CSF, r=-0·604; serum, r=-0·289), and was higher in CSF than in serum in 104 of 136 paired samples. Neutralisation assays suggested that measurable antiviral activity was related to interferon α production. We did not record significantly increased concentrations of autoantibodies to interferon subtypes in patients with AGS, or an association between the presence of autoantibodies and interferon score or serum interferon activity. INTERPRETATION AGS is consistently associated with an interferon signature, which is apparently sustained over time and can thus be used to differentiate patients with AGS from controls. If future studies show that interferon status is a reactive biomarker, the measurement of an interferon score might prove useful in the assessment of treatment efficacy in clinical trials. FUNDING European Union's Seventh Framework Programme; European Research Council.
Collapse
Affiliation(s)
- Gillian I Rice
- Manchester Centre for Genomic Medicine, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester Academic Health Sciences Centre (MAHSC), Manchester, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|