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Ottaiano A, Ianniello M, Petrillo N, Santorsola M, De Falco L, Castaldi SG, Castaldi MA, Giudice V, Selleri C, Savarese G. Non-invasive prenatal testing can detect silent cancers in expecting mothers. Genes Dis 2024; 11:585-588. [PMID: 37692523 PMCID: PMC10491905 DOI: 10.1016/j.gendis.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 04/19/2023] [Indexed: 09/12/2023] Open
Affiliation(s)
- Alessandro Ottaiano
- Unit of Innovative Therapies for Abdominal Metastases, Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via Mariano Semmola, Napoli 80131, Italy
| | - Monica Ianniello
- AMES, Centro Polidiagnostico Strumentale SRL, Via Padre Carmine Fico 24, Casalnuovo Di Napoli 80013, Italy
| | - Nadia Petrillo
- AMES, Centro Polidiagnostico Strumentale SRL, Via Padre Carmine Fico 24, Casalnuovo Di Napoli 80013, Italy
| | - Mariachiara Santorsola
- Unit of Innovative Therapies for Abdominal Metastases, Istituto Nazionale Tumori di Napoli, IRCCS “G. Pascale”, Via Mariano Semmola, Napoli 80131, Italy
| | - Luigia De Falco
- AMES, Centro Polidiagnostico Strumentale SRL, Via Padre Carmine Fico 24, Casalnuovo Di Napoli 80013, Italy
| | - Salvatore Giovanni Castaldi
- Specialization School of Clinical Pathology, Università degli Studi di Salerno, Via Giovanni Paolo II 132, Fisciano 84084, Italy
| | - Maria Antonietta Castaldi
- Unit of High-Risk Pregnancy and Prenatal Diagnosis, University Hospital “San Giovanni di Dio e Ruggi d'Aragona”, Via San Leonardo, Salerno 84125, Italy
| | - Valentina Giudice
- Hematology and Transplant Center, University Hospital “San Giovanni di Dio e Ruggi d'Aragona”, Via San Leonardo, Salerno 84125, Italy
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Via Salvador Allende 43, Baronissi 84081, Italy
| | - Carmine Selleri
- Hematology and Transplant Center, University Hospital “San Giovanni di Dio e Ruggi d'Aragona”, Via San Leonardo, Salerno 84125, Italy
- Department of Medicine, Surgery and Dentistry, “Scuola Medica Salernitana”, Via Salvador Allende 43, Baronissi 84081, Italy
| | - Giovanni Savarese
- AMES, Centro Polidiagnostico Strumentale SRL, Via Padre Carmine Fico 24, Casalnuovo Di Napoli 80013, Italy
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De Falco L, Pelo E, Qi Z, Novelli A. Editorial: Unravelling the basis of non-invasive prenatal screening results. Front Genet 2023; 14:1247764. [PMID: 37529782 PMCID: PMC10390063 DOI: 10.3389/fgene.2023.1247764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 07/05/2023] [Indexed: 08/03/2023] Open
Affiliation(s)
- Luigia De Falco
- AMES, Centro Polidiagnostico Strumentale, srl, Naples, Italy
| | - Elisabetta Pelo
- SOD Diagnostica Genetica, Azienda Ospedaliero Universitaria Careggi, Florence, Italy
| | - Zhongxia Qi
- Medical Center, Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Antonio Novelli
- Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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De Falco L, Savarese G, Savarese P, Petrillo N, Ianniello M, Ruggiero R, Suero T, Barbato C, Mori A, Ramiro C, Della Corte L, Saccone G, Di Spiezio Sardo A, Fico A. Clinical Experience with Genome-Wide Noninvasive Prenatal Screening in a Large Cohort of Twin Pregnancies. Genes (Basel) 2023; 14:genes14050982. [PMID: 37239342 DOI: 10.3390/genes14050982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 04/19/2023] [Accepted: 04/24/2023] [Indexed: 05/28/2023] Open
Abstract
Non-invasive prenatal screening (NIPS) in twin gestations has been shown to have high detection rates and low false-positive rates for trisomy 21, as seen in singleton pregnancies, although there have been few large cohort twin studies, genome-wide studies in particular, to date. In this study, we looked at the performance of genome-wide NIPT in a large cohort consisting of 1244 twin pregnancy samples collected over a two-year period in a single laboratory in Italy. All samples underwent an NIPS for common trisomies, with 61.5% of study participants choosing to undergo genome-wide NIPS for additional fetal anomalies (namely, rare autosomal aneuploidies and CNVs). There were nine initial no-call results, all of which were resolved upon retest. Based on our NIPS results, 17 samples were at high risk for trisomy 21, one for trisomy 18, six for a rare autosomal aneuploidy, and four for a CNV. Clinical follow-up was available for 27 out of 29 high-risk cases; a sensitivity of 100%, a specificity of 99.9%, and a PPV of 94.4% were noted for trisomy 21. Clinical follow-up was also available for 1110 (96.6%) of the low-risk cases, all of which were true negatives. In conclusion, we found that NIPS was a reliable screening approach for trisomy 21 in twin pregnancies.
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Affiliation(s)
- Luigia De Falco
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Giovanni Savarese
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Pasquale Savarese
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Nadia Petrillo
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Monica Ianniello
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Raffaella Ruggiero
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Teresa Suero
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Cosimo Barbato
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
| | - Alessio Mori
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
| | - Cristina Ramiro
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Luigi Della Corte
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80013 Naples, Italy
| | - Gabriele Saccone
- Department of Neuroscience, Reproductive Sciences and Dentistry, School of Medicine, University of Naples Federico II, 80013 Naples, Italy
| | - Attilio Di Spiezio Sardo
- Department of Public Health, Gynecology Unit-Federico II University Hospital of Naples, 80138 Naples, Italy
| | - Antonio Fico
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
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De Falco L, Vitiello G, Savarese G, Suero T, Ruggiero R, Savarese P, Ianniello M, Petrillo N, Bruno M, Legnante A, Passaretti FF, Ardisia C, Di Spiezio Sardo A, Fico A. A Case Report of a Feto-Placental Mosaicism Involving a Segmental Aneuploidy: A Challenge for Genome Wide Screening by Non-Invasive Prenatal Testing of Cell-Free DNA in Maternal Plasma. Genes (Basel) 2023; 14:668. [PMID: 36980940 PMCID: PMC10048202 DOI: 10.3390/genes14030668] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Revised: 02/28/2023] [Accepted: 03/04/2023] [Indexed: 03/11/2023] Open
Abstract
Non-invasive prenatal testing (NIPT) using cell-free DNA can detect fetal chromosomal anomalies with high clinical sensitivity and specificity. In approximately 0.1% of clinical cases, the NIPT result and a subsequent diagnostic karyotype are discordant. Here we report a case of a 32-year-old pregnant patient with a 44.1 Mb duplication on the short arm of chromosome 4 detected by NIPT at 12 weeks' gestation. Amniocentesis was carried out at 18 weeks' gestation, followed by conventional and molecular cytogenetic analysis on cells from the amniotic fluid. SNP array analysis found a de novo deletion of 1.2 Mb at chromosome 4, and this deletion was found to be near the critical region of the Wolf-Hirschhorn syndrome. A normal 46,XY karyotype was identified by G-banding analysis. The patient underwent an elective termination and molecular investigations on tissues from the fetus, and the placenta confirmed the presence of type VI true fetal mosaicism. It is important that a patient receives counselling following a high-risk call on NIPT, with appropriate diagnostic analysis advised before any decisions regarding the pregnancy are taken. This case highlights the importance of genetic counselling following a high-risk call on NIPT, especially in light of the increasing capabilities of NIPT detection of sub-chromosomal deletions and duplications.
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Affiliation(s)
- Luigia De Falco
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Giuseppina Vitiello
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University Hospital, Via Pansini 5, 80131 Naples, Italy
| | - Giovanni Savarese
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Teresa Suero
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Raffaella Ruggiero
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Pasquale Savarese
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Monica Ianniello
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Nadia Petrillo
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Mariasole Bruno
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Antonietta Legnante
- Department of Public Health, University of Naples “Federico II”, 80145 Naples, Italy
| | - Francesco Fioravanti Passaretti
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University Hospital, Via Pansini 5, 80131 Naples, Italy
| | - Carmela Ardisia
- CRR Genetica Medica, Azienda Ospedaliera s. Maria della Misericordia, 06156 Perugia, Italy
| | | | - Antonio Fico
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
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De Falco L, Suero T, Savarese G, Savarese P, Ruggiero R, Di Carlo A, Bruno M, Petrillo N, Ianniello M, Scarpato C, Sarli C, Fico A. Non-Invasive Prenatal Screening: The First Report of Pentasomy X Detected by Plasma Cell-Free DNA and Karyotype Analysis. Diagnostics (Basel) 2022; 12:diagnostics12071591. [PMID: 35885497 PMCID: PMC9321121 DOI: 10.3390/diagnostics12071591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/22/2022] [Accepted: 06/28/2022] [Indexed: 11/17/2022] Open
Abstract
Pentasomy X is a sex chromosome anomaly caused by the presence of three extra X chromosomes in females (49,XXXXX instead of 46,XX) and is probably due to a nondisjunction during the meiosis. So far, only five cases prenatally diagnosed were described. The main features in 49,XXXXX karyotype include severe intellectual disability with delayed speech development, short stature, facial dysmorphisms, osseous and articular abnormalities, congenital heart malformations, and skeletal and limb abnormalities. Prenatal diagnosis is often difficult due to the lack of a clear echographic sign like nuchal translucency (NT), and mostly cases were postnatally described. We report the first case of a 49,XXXXX female that was detected by non-invasive prenatal screening (NIPS), quantitative fluorescence polymerase chain reaction (QF-PCR) and a fetal karyotype.
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Affiliation(s)
- Luigia De Falco
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Correspondence:
| | - Teresa Suero
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Giovanni Savarese
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Pasquale Savarese
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Raffaella Ruggiero
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Antonella Di Carlo
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Mariasole Bruno
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Nadia Petrillo
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Monica Ianniello
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
| | - Ciro Scarpato
- Responsabile Ambulatorio Medicina Prenatale, P.O.S. Giuliano, 80014 Naples, Italy;
| | - Camilla Sarli
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80138 Naples, Italy;
- CEINGE Biotecnologie Avanzate, 80131 Naples, Italy
| | - Antonio Fico
- AMES-Centro Polidiagnostico Strumentale srl, 80013 Naples, Italy; (T.S.); (G.S.); (P.S.); (R.R.); (A.D.C.); (M.B.); (N.P.); (M.I.); (A.F.)
- Fondazione Genetica per la Vita Onlus, 80132 Naples, Italy
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De Falco L, Piscopo C, D’Angelo R, Evangelista E, Suero T, Sirica R, Ruggiero R, Savarese G, Di Carlo A, Furino G, Scarpato C, Fico A. Detection of 46, XY Disorder of Sex Development (DSD) Based on Plasma Cell-Free DNA and Targeted Next-Generation Sequencing. Genes (Basel) 2021; 12:genes12121890. [PMID: 34946839 PMCID: PMC8700836 DOI: 10.3390/genes12121890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 11/23/2021] [Accepted: 11/23/2021] [Indexed: 12/03/2022] Open
Abstract
Mutations in the HSD17B3 gene cause HSD17B3 deficiency and result in 46, XY Disorders of Sex Development (46, XY DSD). The diagnosis of 46, XY DSD is very challenging and not rarely is confirmed only at older ages, when an affected XY female presents with primary amenorrhea or develops progressive virilization. The patient described in this paper represents a case of discrepancies between non-invasive prenatal testing (NIPT) and ultrasound based fetal sex determination detected during prenatal screening. Exome sequencing was performed on the cell free fetal DNA (cffDNA), amniotic fluid, and the parents. Libraries were generated according to the manufacturer’s protocols using TruSight One Kits (Illumina Inc., San Diego, CA, USA). Sequencing was carried out on NEXT Seq 500 (Illumina) to mean sequencing depth of at least 100×. A panel of sexual disease genes was used in order to search for a causative variant. The finding of a mutation (c.645 A>T, p.Glu215Asp) in HSD17B3 gene in amniotic fluid as well as in cffDNA and both parents supported the hypothesis of the HSD17B3 deficiency. In conclusion, we used clinical exome sequencing and non-invasive prenatal detection, providing a solution for NIPT of a single-gene disorder. Early genetic diagnoses are useful for patients and clinicians, contribute to clinical knowledge of DSD, and are invaluable for genetic counseling of couples contemplating future pregnancies.
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Affiliation(s)
- Luigia De Falco
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
- Correspondence:
| | - Carmelo Piscopo
- Medical and Laboratory Genetic Unit, A. Cardarelli Hospital, 80131 Naples, Italy;
| | - Rossana D’Angelo
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Eloisa Evangelista
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Teresa Suero
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Roberto Sirica
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Raffaella Ruggiero
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Giovanni Savarese
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Antonella Di Carlo
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Giulia Furino
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
| | - Ciro Scarpato
- Ambulatorio Medicina Prenatale, PO S. Giuliano, 80014 Naples, Italy;
| | - Antonio Fico
- AMES, Centro Polidiagnostico Strumentale, 80013 Naples, Italy; (R.D.); (E.E.); (T.S.); (R.S.); (R.R.); (G.S.); (A.D.C.); (G.F.); (A.F.)
- Fondazione Genetica per la Vita Onlus, Via Cuma, 80132 Naples, Italy
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La Verde M, De Falco L, Torella A, Savarese G, Savarese P, Ruggiero R, Conte A, Fico V, Torella M, Fico A. Performance of cell-free DNA sequencing-based non-invasive prenatal testing: experience on 36,456 singleton and multiple pregnancies. BMC Med Genomics 2021; 14:93. [PMID: 33785045 PMCID: PMC8011149 DOI: 10.1186/s12920-021-00941-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/15/2021] [Indexed: 01/15/2023] Open
Abstract
Background This paper describes the clinical practice and performance of cell-free DNA sequencing-based non-invasive prenatal testing (NIPT) as a screening method for fetal trisomy 21, 18, and 13 (T21, T18, and T13) and sex chromosome aneuploidies (SCA) in a general Italian pregnancy population. Methods The AMES-accredited laboratory offers NIPT in maternal blood as a screening test for fetal T21, T18, T13 and SCA. Samples were sequenced on a NextSeq 550 (Illumina) using the VeriSeq NIPT Solution v1 assay. Results A retrospective analysis was performed on 36,456 consecutive maternal blood samples, including 35,650 singleton pregnancies, 800 twin pregnancies, and 6 triplet pregnancies. Samples were tested between April 2017 and September 2019. The cohort included 46% elevated-risk and 54% low-risk patients. A result indicative of a classic trisomy was found in 356 (1%) of singleton or twin samples: 254 T21, 69 T18, and 33 T13. In addition, 145 results (0.4%) were indicative of a SCA. Of the combined 501 screen-positive cases, 484 had confirmatory diagnostic testing. NIPT results were confirmed in 99.2% (247/249) of T21 cases, 91.2% (62/68) of T18 cases, 84.4% (27/32) of T13 cases, and 86.7% (117/135) of SCA cases. In the 35,955 cases reported as unaffected by a classic trisomy or SCA, no false negative cases were reported. Assuming that false negative results would be reported, the sensitivity of NIPT was 100.00% for T21 (95% Cl 98.47–100.0), T18 (95% Cl 94.17–100.0), and T13 (95% Cl 87.54–100.0). The specificities were 99.99% (95% Cl 99.98–100.0), 99.98% (95% Cl 99.96–100.0), 99.99% (95% Cl 99.97–100.0), and 99.95% (95% Cl 99.92–99.97) for T21, T18, T13, and SCA, respectively. Conclusion This retrospective analysis of a large cohort of consecutive patients who had whole-genome sequencing-based NIPT for classic trisomies and SCA shows excellent detection rates and low false positive rates. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-021-00941-y.
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Affiliation(s)
- Marco La Verde
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Luigia De Falco
- AMES, Centro Polidiagnostico Strumentale, Srl, Naples, Italy.
| | - Annalaura Torella
- Department of Precision Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | | | | | - Anna Conte
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Vera Fico
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Marco Torella
- Department of Woman, Child and General and Specialized Surgery, Obstetrics and Gynecology Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Antonio Fico
- AMES, Centro Polidiagnostico Strumentale, Srl, Naples, Italy
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Matte A, Federti E, Winter M, Koerner A, Harmeier A, Mazer N, Tomka T, Di Paolo ML, De Falco L, Andolfo I, Beneduce E, Iolascon A, Macias-Garcia A, Chen JJ, Janin A, Lebouef C, Turrini F, Brugnara C, De Franceschi L. Bitopertin, a selective oral GLYT1 inhibitor, improves anemia in a mouse model of β-thalassemia. JCI Insight 2019; 4:130111. [PMID: 31593554 DOI: 10.1172/jci.insight.130111] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 10/02/2019] [Indexed: 01/09/2023] Open
Abstract
Anemia of β-thalassemia is caused by ineffective erythropoiesis and reduced red cell survival. Several lines of evidence indicate that iron/heme restriction is a potential therapeutic strategy for the disease. Glycine is a key initial substrate for heme and globin synthesis. We provide evidence that bitopertin, a glycine transport inhibitor administered orally, improves anemia, reduces hemolysis, diminishes ineffective erythropoiesis, and increases red cell survival in a mouse model of β-thalassemia (Hbbth3/+ mice). Bitopertin ameliorates erythroid oxidant damage, as indicated by a reduction in membrane-associated free α-globin chain aggregates, in reactive oxygen species cellular content, in membrane-bound hemichromes, and in heme-regulated inhibitor activation and eIF2α phosphorylation. The improvement of β-thalassemic ineffective erythropoiesis is associated with diminished mTOR activation and Rab5, Lamp1, and p62 accumulation, indicating an improved autophagy. Bitopertin also upregulates liver hepcidin and diminishes liver iron overload. The hematologic improvements achieved by bitopertin are blunted by the concomitant administration of the iron chelator deferiprone, suggesting that an excessive restriction of iron availability might negate the beneficial effects of bitopertin. These data provide important and clinically relevant insights into glycine restriction and reduced heme synthesis strategies for the treatment of β-thalassemia.
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Affiliation(s)
- Alessandro Matte
- Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Verona, Policlinico GB Rossi, Verona, Italy
| | - Enrica Federti
- Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Verona, Policlinico GB Rossi, Verona, Italy
| | - Michael Winter
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Annette Koerner
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Anja Harmeier
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Norman Mazer
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | - Tomas Tomka
- Pharmaceutical Research and Early Development, Roche Innovation Center Basel, F. Hoffmann-La Roche Ltd, Basel, Switzerland
| | | | - Luigia De Falco
- Department of Molecular Medicine and Medical Biotechnology, University Federico II and CEINGE, Naples, Italy
| | - Immacolata Andolfo
- Department of Molecular Medicine and Medical Biotechnology, University Federico II and CEINGE, Naples, Italy
| | - Elisabetta Beneduce
- Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Verona, Policlinico GB Rossi, Verona, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnology, University Federico II and CEINGE, Naples, Italy
| | - Alejandra Macias-Garcia
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Jane-Jane Chen
- Institute for Medical Engineering and Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Anne Janin
- INSERM, U1165, Paris, France.,Université Paris 7 - Denis Diderot, Paris, France.,AP-HP, Hôpital Saint-Louis, Paris, France
| | - Christhophe Lebouef
- INSERM, U1165, Paris, France.,Université Paris 7 - Denis Diderot, Paris, France.,AP-HP, Hôpital Saint-Louis, Paris, France
| | - Franco Turrini
- Department of Oncology, University of Torino, Torino, Italy
| | - Carlo Brugnara
- Department of Laboratory Medicine, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Lucia De Franceschi
- Department of Medicine, University of Verona and Azienda Ospedaliera Universitaria Verona, Policlinico GB Rossi, Verona, Italy
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9
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De Falco L, Savarese G, Suero T, Amabile S, Ruggiero R, Savarese P, Fico A. Detection of SRY-positive46,XX male syndrome by the analysis of cell-free fetal DNA via non-invasive prenatal testing. Clin Case Rep 2019; 7:1977-1981. [PMID: 31624621 PMCID: PMC6787777 DOI: 10.1002/ccr3.2389] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 07/22/2019] [Accepted: 07/29/2019] [Indexed: 11/12/2022] Open
Abstract
We report a new case of 46,XX male syndrome that was detected following an anomalous result by non-invasive prenatal testing (NIPT) and a discrepancy between the fetal karyotype and the ultrasonographic investigation. With the increasing use of NIPT, more gender discordances can be identified prenatally and be amenable to early therapy.
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Affiliation(s)
| | | | - Teresa Suero
- AMES, Centro Polidiagnostico Strumentale SrlNaplesItaly
| | - Sonia Amabile
- Department of Molecular Medicine and Medical BiotechnologyUniversity of Naples "Federico II"NaplesItaly
| | | | | | - Antonio Fico
- AMES, Centro Polidiagnostico Strumentale SrlNaplesItaly
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10
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Beneduce E, Matte A, De Falco L, Mbiandjeu S, Chiabrando D, Tolosano E, Federti E, Petrillo S, Mohandas N, Siciliano A, Babu W, Menon V, Ghaffari S, Iolascon A, De Franceschi L. Fyn kinase is a novel modulator of erythropoietin signaling and stress erythropoiesis. Am J Hematol 2019; 94:10-20. [PMID: 30252956 DOI: 10.1002/ajh.25295] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 09/17/2018] [Accepted: 09/19/2018] [Indexed: 01/12/2023]
Abstract
The signaling cascade induced by the interaction of erythropoietin (EPO) with its receptor (EPO-R) is a key event of erythropoiesis. We present here data indicating that Fyn, a Src-family-kinase, participates in the EPO signaling-pathway, since Fyn-/- mice exhibit reduced Tyr-phosphorylation of EPO-R and decreased STAT5-activity. The importance of Fyn in erythropoiesis is also supported by the blunted responsiveness of Fyn-/- mice to stress erythropoiesis. Fyn-/- mouse erythroblasts adapt to reactive oxygen species (ROS) by activating the redox-related-transcription-factor Nrf2. However, since Fyn is a physiologic repressor of Nrf2, absence of Fyn resulted in persistent-activation of Nrf2 and accumulation of nonfunctional proteins. ROS-induced over-activation of Jak2-Akt-mTOR-pathway and repression of autophagy with perturbation of lysosomal-clearance were also noted. Treatment with Rapamycin, a mTOR-inhibitor and autophagy activator, ameliorates Fyn-/- mouse baseline erythropoiesis and erythropoietic response to oxidative-stress. These findings identify a novel multimodal action of Fyn in the regulation of normal and stress erythropoiesis.
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Affiliation(s)
| | - Alessandro Matte
- Department of Medicine; University of Verona, AOUI Verona; Verona Italy
| | - Luigia De Falco
- Department of Biochemistry; Federico II University; Naples Italy
| | - Serge Mbiandjeu
- Department of Medicine; University of Verona, AOUI Verona; Verona Italy
| | - Deborah Chiabrando
- Department of Molecular Biotechnology and Health Sciences; University of Torino; Torino Italy
| | - Emanuela Tolosano
- Department of Molecular Biotechnology and Health Sciences; University of Torino; Torino Italy
| | - Enrica Federti
- Department of Medicine; University of Verona, AOUI Verona; Verona Italy
| | - Sara Petrillo
- Department of Molecular Biotechnology and Health Sciences; University of Torino; Torino Italy
| | | | - Angela Siciliano
- Department of Medicine; University of Verona, AOUI Verona; Verona Italy
| | - Wilson Babu
- Department of Medicine; University of Verona, AOUI Verona; Verona Italy
| | - Vijay Menon
- Department of Cell, Development and Regenerative Biology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Saghi Ghaffari
- Department of Cell, Development and Regenerative Biology; Icahn School of Medicine at Mount Sinai; New York New York
| | - Achille Iolascon
- Department of Biochemistry; Federico II University; Naples Italy
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11
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Heeney MM, Guo D, De Falco L, Campagna DR, Olbina G, Kao PPC, Schmitz-Abe K, Rahimov F, Gutschow P, Westerman K, Ostland V, Jackson T, Klaassen RJ, Markianos K, Finberg KE, Iolascon A, Westerman M, London WB, Fleming MD. Normalizing hepcidin predicts TMPRSS6 mutation status in patients with chronic iron deficiency. Blood 2018; 132:448-452. [PMID: 29895660 PMCID: PMC6071554 DOI: 10.1182/blood-2017-03-773028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Accepted: 06/06/2018] [Indexed: 12/30/2022] Open
Affiliation(s)
- Matthew M Heeney
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA
- Dana-Farber Cancer Institute, Boston, MA
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Dongjing Guo
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Luigia De Falco
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University Medical School, Naples, Italy
- CEINGE Biotecnologie Avanzate, Naples, Italy
| | - Dean R Campagna
- Department of Pathology, Boston Children's Hospital, Boston, MA
| | | | - Paige P-C Kao
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | | | - Fedik Rahimov
- Division of Genetics and Genomics, Department of Medicine, Boston Children's Hospital, Boston, MA
| | | | | | | | - Tracy Jackson
- Division of Pediatric Hematology-Oncology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada; and
| | - Robert J Klaassen
- Division of Pediatric Hematology-Oncology, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada; and
| | | | | | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies, Federico II University Medical School, Naples, Italy
- CEINGE Biotecnologie Avanzate, Naples, Italy
| | | | - Wendy B London
- Division of Hematology/Oncology, Boston Children's Hospital, Boston, MA
- Dana-Farber Cancer Institute, Boston, MA
- Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, MA
| | - Mark D Fleming
- Department of Pathology, Boston Children's Hospital, Boston, MA
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12
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De Falco L, Tortora R, Imperatore N, Bruno M, Capasso M, Girelli D, Castagna A, Caporaso N, Iolascon A, Rispo A. The role of TMPRSS6 and HFE variants in iron deficiency anemia in celiac disease. Am J Hematol 2018; 93:383-393. [PMID: 29194702 DOI: 10.1002/ajh.24991] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/23/2017] [Accepted: 11/27/2017] [Indexed: 12/14/2022]
Abstract
We investigated the role of HFE C282Y, H63D, and TMPRSS6 A736V variants in the pathogenesis of iron deficiency anemia (IDA) in celiac disease (CD) patients, at diagnosis and after 1 year of gluten-free diet (GFD). Demographic and clinical features were prospectively recorded for all CD patients between 2013 and 2017. C282Y, H63D, and A736V variants were evaluated for CD patients and controls. Finally, 505 consecutive CD patients and 539 age-matched control subjects were enrolled. At diagnosis, 229 CD subjects had IDA (45.3%), with a subgroup of anemic patients (45.4%) presented persistent IDA at follow-up. C282Y allele frequency was significantly increased in CD compared with controls (1.1% vs 0.2%, P = .001), whereas H63D and A736V allele frequencies were similar among patients and controls (P = .92 and .84, respectively). At diagnosis, C282Y variant in anemic CD patients was significantly increased compared to nonanemic group (2% and 0.5%, P = .04). At follow-up, A736V was significantly increased in IDA persistent than in IDA not persistent (57.7% vs 35.2%, P < .0001). CD patients with H63D mutation showed higher Hb, MCV, serum iron, and ferritin levels than subjects without HFE mutations. Decreased hepcidin values were observed in anemic compared to nonanemic subjects at follow-up (1.22 ± 1.14 vs 2.08 ± 2.15, P < .001). This study suggests a protective role of HFE in IDA CD patients and confirms the role of TMPRSS6 in predicting oral iron response modulating hepcidin action on iron absorption. Iron supplementation therapeutic management in CD could depend on TMPRSS6 genotype that could predict persistent IDA despite iron supplementation and GFD.
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Affiliation(s)
- Luigia De Falco
- Department of Molecular Medicine and Medical Biotechnologies; University “Federico II” of Naples; Naples Italy
- CEINGE, Advanced Biotechnologies; Naples Italy
| | - Raffaella Tortora
- Gastroenterology, Department of Clinical Medicine and Surgery; School of Medicine “Federico II” of Naples; Naples Italy
| | - Nicola Imperatore
- Gastroenterology, Department of Clinical Medicine and Surgery; School of Medicine “Federico II” of Naples; Naples Italy
| | - Mariasole Bruno
- CEINGE, Advanced Biotechnologies; Naples Italy
- Department of Medicine, Section of Internal Medicine; University of Verona; Verona Italy
| | - Mario Capasso
- Department of Molecular Medicine and Medical Biotechnologies; University “Federico II” of Naples; Naples Italy
- CEINGE, Advanced Biotechnologies; Naples Italy
- SDN Diagnostic and Nuclear Research Institute; Naples Italy
| | - Domenico Girelli
- Department of Medicine, Section of Internal Medicine; University of Verona; Verona Italy
| | - Annalisa Castagna
- Department of Medicine, Section of Internal Medicine; University of Verona; Verona Italy
| | - Nicola Caporaso
- Gastroenterology, Department of Clinical Medicine and Surgery; School of Medicine “Federico II” of Naples; Naples Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies; University “Federico II” of Naples; Naples Italy
- CEINGE, Advanced Biotechnologies; Naples Italy
| | - Antonio Rispo
- Gastroenterology, Department of Clinical Medicine and Surgery; School of Medicine “Federico II” of Naples; Naples Italy
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13
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Matte A, De Falco L, Federti E, Cozzi A, Iolascon A, Levi S, Mohandas N, Zamo A, Bruno M, Lebouef C, Janin A, Siciliano A, Ganz T, Federico G, Carlomagno F, Mueller S, Silva I, Carbone C, Melisi D, Kim DW, Choi SY, De Franceschi L. Peroxiredoxin-2: A Novel Regulator of Iron Homeostasis in Ineffective Erythropoiesis. Antioxid Redox Signal 2018; 28:1-14. [PMID: 28793778 DOI: 10.1089/ars.2017.7051] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [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: 01/05/2023]
Abstract
AIMS Iron overload (IO) is a life-threatening complication of chronic hemolytic disorders such as β-thalassemia. IO results in severe cellular oxidative damage, leading to organ failure. Peroxiredoxin-2 (Prx2), a typical 2-cysteine-(Cys)-peroxiredoxin, is an important component of the cytoprotective system, but its response to IO is still to be fully defined. RESULTS We studied the effects of IO on Prx2-knockout mice (Prx2-/-). The absence of Prx2 enhanced toxicity due to IO on erythropoiesis. We found that IO failed to induce the typical hepcidin (Hamp) upregulation in Prx2-/- mice due to its failure to activate the signal transducer and activator of transcription-3 (STAT3) with intact Jak2 signaling. In Prx2-/- mice, the loss of Hamp response was also observed after administration of a single dose of oral iron. When lipopolysaccharide (LPS) was used to explore IL6-STAT3 activation in Prx2-/- mice, STAT3 activation and Hamp upregulation were once again defective. Treatment with PEP-fusion-recombinant-Prx2 (PEP Prx2) significantly increased STAT3 activation with upregulation of Hamp expression in both IO- and LPS-exposed Prx2-/- mice. We also confirmed the beneficial effects of PEP Prx2 on Hamp expression through STAT3 activation in β-thalassemic mice. INNOVATION We propose that Prx2 plays a key role in responding to cytotoxicity of IO, directly targeting STAT3-transcriptional factor in a Jak2-independent fashion and regulating Hamp in response to canonical stimuli. CONCLUSION Collectively, our data highlight a novel role of Prx2 in iron homeostasis. Prx2 is a key cytoprotector against IO that is induced either by iron supplementation or due to chronic hemolysis as in β-thalassemia. Prx2 is required to support STAT3 transcriptional activity and regulation of Hamp expression. Antioxid. Redox Signal. 28, 1-14.
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Affiliation(s)
- Alessandro Matte
- 1 Department of Medicine, University of Verona-AOUI Verona , Verona, Italy
| | - Luigia De Falco
- 2 CEINGE and Department of Biochemistry, Federico II University , Naples, Italy
| | - Enrica Federti
- 1 Department of Medicine, University of Verona-AOUI Verona , Verona, Italy
| | - Anna Cozzi
- 3 Division of Neuroscience, San Raffaele Scientific Institute , Milano, Italy
| | - Achille Iolascon
- 2 CEINGE and Department of Biochemistry, Federico II University , Naples, Italy
| | - Sonia Levi
- 3 Division of Neuroscience, San Raffaele Scientific Institute , Milano, Italy .,4 Vita-Salute San Raffaele University , Milano, Italy
| | | | - Alberto Zamo
- 6 Department of Pathology and Diagnostic University of Verona-AOUI Verona , Verona, Italy
| | - Mariasole Bruno
- 2 CEINGE and Department of Biochemistry, Federico II University , Naples, Italy
| | | | - Anne Janin
- 7 Inserm, U1165, Paris, France .,8 Université Paris 7-Denis Diderot , Paris, France .,9 AP-HP , Hôpital Saint-Louis, Paris, France
| | - Angela Siciliano
- 1 Department of Medicine, University of Verona-AOUI Verona , Verona, Italy
| | - Tom Ganz
- 10 Department of Pathology and Laboratory of Medicine, UCLA School of Medicine , Los Angeles, California
| | - Giorgia Federico
- 11 Department of Molecular Medicine and Medical Biotechnologies Federico II University , Naples, Italy
| | - Francesca Carlomagno
- 11 Department of Molecular Medicine and Medical Biotechnologies Federico II University , Naples, Italy
| | - Sebastian Mueller
- 12 Medical Department, Salem Medical Center, University of Heidelberg , Heidelberg, Germany
| | - Ines Silva
- 12 Medical Department, Salem Medical Center, University of Heidelberg , Heidelberg, Germany
| | - Carmine Carbone
- 1 Department of Medicine, University of Verona-AOUI Verona , Verona, Italy
| | - Davide Melisi
- 1 Department of Medicine, University of Verona-AOUI Verona , Verona, Italy
| | - Dae Won Kim
- 13 Department of Biomedical Sciences, Institute of Bioscience and Biotechnology, Hallym University , Chunchon, Korea
| | - Soo Young Choi
- 13 Department of Biomedical Sciences, Institute of Bioscience and Biotechnology, Hallym University , Chunchon, Korea
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14
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Falco M, Franzè A, Iossa S, De Falco L, Gambale A, Marciano E, Iolascon A. Novel compound heterozygous mutations in BCS1L
gene causing Bjornstad syndrome in two siblings. Am J Med Genet A 2017; 173:1348-1352. [DOI: 10.1002/ajmg.a.38146] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Revised: 12/27/2016] [Accepted: 01/02/2017] [Indexed: 11/08/2022]
Affiliation(s)
- Mariateresa Falco
- Department of Molecular Medicine and Medical Biotechnologies; “Federico II” University of Naples; Naples Italy
- CEINGE; Biotecnologie Avanzate; Naples Italy
| | - Annamaria Franzè
- CEINGE; Biotecnologie Avanzate; Naples Italy
- Unit of Audiology, Department of Neurosciences, Reproductive and Odontostomatologic Sciences; University of Naples “Federico II”; Naples Italy
| | | | | | - Antonella Gambale
- Department of Molecular Medicine and Medical Biotechnologies; “Federico II” University of Naples; Naples Italy
- CEINGE; Biotecnologie Avanzate; Naples Italy
| | - Elio Marciano
- Unit of Audiology, Department of Neurosciences, Reproductive and Odontostomatologic Sciences; University of Naples “Federico II”; Naples Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies; “Federico II” University of Naples; Naples Italy
- CEINGE; Biotecnologie Avanzate; Naples Italy
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15
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Abstract
Iron-refractory iron deficiency anemia (IRIDA) is a rarely diagnosed autosomal recessive disorder that presents with hypochromic, microcytic anemia due to mutations in TMPRSS6, which encodes matriptase-2. Contrary to classical iron deficiency anemia, serum hepcidin levels are found to be elevated in this disorder. Here, we report 5 cases from 4 unrelated families with inadequate response to iron therapy, who were consequently diagnosed as IRIDA. The mean age of the cases at diagnosis was 5.0 years (range: 0.7-11.3 years). All cases were either homozygous or compound heterozygous for missense or frameshift mutations in the TMPRSS6 gene, 2 of the mutations being novel (Cys410Ser and Leu689Pro). IRIDA should be considered in patients with findings of iron deficiency anemia unresponsive to oral iron therapy, whose serum ferritin levels are found normal or elevated.
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Affiliation(s)
- Ertan Sal
- a Clinic of Pediatric Hematology-Oncology, Batman State Hospital , Batman , Turkey
| | - Ebru Yılmaz Keskin
- b Clinic of Pediatric Hematology-Oncology, Samsun Education and Research Hospital , Samsun , Turkey
| | - Idil Yenicesu
- c Department of Pediatric Hematology , Gazi University Faculty of Medicine , Ankara , Turkey
| | - Mariasole Bruno
- d Department of Molecular Medicine and Medical Biotechnology , University Federico II , Naples , Italy.,e CEINGE, Advanced Biotechnologies , Naples , Italy
| | - Luigia De Falco
- d Department of Molecular Medicine and Medical Biotechnology , University Federico II , Naples , Italy.,e CEINGE, Advanced Biotechnologies , Naples , Italy
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16
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De Falco L, Bruno M, Yilmaz-Keskin E, Sal E, Büyükavci M, Kaya Z, Girelli D, Iolascon A. The role of Matriptase-2 during the early postnatal development in humans. Haematologica 2016; 101:e126-8. [PMID: 26802052 DOI: 10.3324/haematol.2015.139808] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Affiliation(s)
- Luigia De Falco
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy CEINGE, Advanced Biotechnologies, Naples, Italy
| | - Mariasole Bruno
- CEINGE, Advanced Biotechnologies, Naples, Italy Department of Medicine, Section of Internal Medicine, University of Verona, AOUI-Policlinico GB Rossi, 37134 Verona, Italy
| | - Ebru Yilmaz-Keskin
- Pediatric Hematology and Oncology, Samsun Education and Research Hospital, Samsun, Turkey
| | - Ertan Sal
- Batman Regional Hospital, Department of Pediatric Hematology and Oncology, Batman, Turkey
| | - Mustafa Büyükavci
- Sakarya University, Faculty of Medicine Division of Pediatric Hematology-Oncology Sakarya, Turkey
| | - Zühre Kaya
- The Pediatric Hematology Unit of the Department of Pediatrics, Medical School of Gazi University, Ankara, Turkey
| | - Domenico Girelli
- Department of Medicine, Section of Internal Medicine, University of Verona, AOUI-Policlinico GB Rossi, 37134 Verona, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy CEINGE, Advanced Biotechnologies, Naples, Italy
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17
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Matte A, De Falco L, Iolascon A, Mohandas N, An X, Siciliano A, Leboeuf C, Janin A, Bruno M, Choi SY, Kim DW, De Franceschi L. The Interplay Between Peroxiredoxin-2 and Nuclear Factor-Erythroid 2 Is Important in Limiting Oxidative Mediated Dysfunction in β-Thalassemic Erythropoiesis. Antioxid Redox Signal 2015; 23:1284-97. [PMID: 26058667 PMCID: PMC4677567 DOI: 10.1089/ars.2014.6237] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [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] [Indexed: 02/06/2023]
Abstract
AIMS β-Thalassemia is a common inherited red cell disorder characterized by ineffective erythropoiesis and severe oxidative stress. Peroxiredoxin-2 (Prx2), a typical 2-cysteine peroxiredoxin, is upregulated during β-thalassemic erythropoiesis, but its contribution to stress erythropoiesis, a common feature of thalassemia, is yet to be fully defined. RESULTS Here, we showed that Prx2(-/-) mice displayed reactive oxygen species related abnormalities in erythropoiesis similar to that of Hbb(th3/+) mice associated with activation of redox response transcriptional factor nuclear factor-erythroid 2 (Nrf2). We generated β-thalassemic mice genetically lacking Prx2 (Prx2(-/-)Hbb(th3/+)) and documented a worsened β-thalassemic hematological phenotype with severe ineffective erythropoiesis. To further validate a key role of Prx2 in stress erythropoiesis, we administrated fused recombinant PEP1Prx2 to Hbb(th3/+) mice and documented a decrease in ineffective erythropoiesis. We further show that Prx2 effects are mediated by activation of Nrf2 and upregulation of genes that protect against oxidative damage such as gluthatione S-transferase, heme-oxygenase-1, and NADPH dehydrogenase quinone-1. INNOVATION We propose Prx2 as a key antioxidant system and Nrf2 activation is a cellular adaptive process in response to oxidative stress, resulting in upregulation of antioxidant (antioxidant responsive element) genes required to ensure cell survival. CONCLUSION Our data shed new light on adaptive mechanisms against oxidative damage through the interplay of Prx2 and Nrf2 during stress erythropoiesis and suggest new therapeutic options to decrease ineffective erythropoiesis by modulation of endogenous antioxidant systems.
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Affiliation(s)
- Alessandro Matte
- 1 Department of Medicine, University of Verona-AOUI Verona , Verona, Italy
| | - Luigia De Falco
- 2 CEINGE and Department of Biochemistry, University of Naples , Naples, Italy
| | - Achille Iolascon
- 2 CEINGE and Department of Biochemistry, University of Naples , Naples, Italy
| | | | - Xiuli An
- 3 New York Blood Center , New York, New York
| | - Angela Siciliano
- 1 Department of Medicine, University of Verona-AOUI Verona , Verona, Italy
| | | | - Anne Janin
- 4 Inserm , U1165, Paris, France .,5 Université Paris 7 , Denis Diderot, Paris, France .,6 AP-HP, Hôpital Saint-Louis , Paris, France
| | - Mariasole Bruno
- 1 Department of Medicine, University of Verona-AOUI Verona , Verona, Italy .,2 CEINGE and Department of Biochemistry, University of Naples , Naples, Italy
| | - Soo Young Choi
- 7 Institute of Bioscience and Biotechnology, Hallym University , Chuncheon, Korea
| | - Dae Won Kim
- 7 Institute of Bioscience and Biotechnology, Hallym University , Chuncheon, Korea
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Abstract
Microcytic anemia is the most common form of anemia, characterized by reduced hemoglobin (Hb) synthesis associated with decreased red blood cell volume (MCV). It is a very heterogeneous group of diseases that may be either acquired or inherited. Microcytic hypochromic anemia can result from defects in globin (hemoglobinopathies or thalassemias) or heme synthesis or in iron availability, or acquisition by the erythroid precursors. Diagnosis of microcytic anaemia appears to be important in children/adolescents, especially to set, where possible, a treatment plan on the basis of the etiology and pathogenesis. After excluding the acquired causes of microcytic anemia that represent the most frequent etiology, according to the differential diagnosis, the analysis of genetic causes, mostly hereditary, must be considered. This review will consider acquired and hereditary microcytic anemias due to heme synthesis or to iron metabolism defects and their diagnosis.
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Affiliation(s)
- Mariasole Bruno
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy; CEINGE, Advanced Biotechnologies, Naples, Italy; Department of Medicine, Section of Internal Medicine, University of Verona, AOUI-Policlinico GB Rossi, 37134 Verona, Italy
| | - Luigia De Falco
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy; CEINGE, Advanced Biotechnologies, Naples, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnology, University Federico II, Naples, Italy; CEINGE, Advanced Biotechnologies, Naples, Italy.
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De Falco L, Silvestri L, Kannengiesser C, Morán E, Oudin C, Rausa M, Bruno M, Aranda J, Argiles B, Yenicesu I, Falcon-Rodriguez M, Yilmaz-Keskin E, Kocak U, Beaumont C, Camaschella C, Iolascon A, Grandchamp B, Sanchez M. Functional and clinical impact of novel TMPRSS6 variants in iron-refractory iron-deficiency anemia patients and genotype-phenotype studies. Hum Mutat 2014; 35:1321-9. [PMID: 25156943 DOI: 10.1002/humu.22632] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 07/29/2014] [Indexed: 12/11/2022]
Abstract
Iron-refractory iron-deficiency anemia (IRIDA) is a rare autosomal-recessive disorder characterized by hypochromic microcytic anemia, low transferrin saturation, and inappropriate high levels of the iron hormone hepcidin. The disease is caused by variants in the transmembrane protease serine 6 (TMPRSS6) gene that encodes the type II serine protease matriptase-2, a negative regulator of hepcidin transcription. Sequencing analysis of the TMPRSS6 gene in 21 new IRIDA patients from 16 families with different ethnic origin reveal 17 novel mutations, including the most frequent mutation in Southern Italy (p.W590R). Eight missense mutations were analyzed in vitro. All but the p.T287N variant impair matriptase-2 autoproteotylic activation, decrease the ability to cleave membrane HJV and inhibit the HJV-dependent hepcidin activation. Genotype-phenotype studies in IRIDA patients have been so far limited due to the relatively low number of described patients. Our genotype-phenotype correlation analysis demonstrates that patients carrying two nonsense mutations present a more severe anemia and microcytosis and higher hepcidin levels than the other patients. We confirm that TMPRSS6 mutations are spread along the gene and that mechanistically they fully or partially abrogate hepcidin inhibition. Genotyping IRIDA patients help in predicting IRIDA severity and may be useful for predicting response to iron treatment.
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De Falco L, Sanchez M, Silvestri L, Kannengiesser C, Muckenthaler MU, Iolascon A, Gouya L, Camaschella C, Beaumont C. Iron refractory iron deficiency anemia. Haematologica 2013; 98:845-53. [PMID: 23729726 DOI: 10.3324/haematol.2012.075515] [Citation(s) in RCA: 111] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Iron refractory iron deficiency anemia is a hereditary recessive anemia due to a defect in the TMPRSS6 gene encoding Matriptase-2. This protein is a transmembrane serine protease that plays an essential role in down-regulating hepcidin, the key regulator of iron homeostasis. Hallmarks of this disease are microcytic hypochromic anemia, low transferrin saturation and normal/high serum hepcidin values. The anemia appears in the post-natal period, although in some cases it is only diagnosed in adulthood. The disease is refractory to oral iron treatment but shows a slow response to intravenous iron injections and partial correction of the anemia. To date, 40 different Matriptase-2 mutations have been reported, affecting all the functional domains of the large ectodomain of the protein. In vitro experiments on transfected cells suggest that Matriptase-2 cleaves Hemojuvelin, a major regulator of hepcidin expression and that this function is altered in this genetic form of anemia. In contrast to the low/undetectable hepcidin levels observed in acquired iron deficiency, in patients with Matriptase-2 deficiency, serum hepcidin is inappropriately high for the low iron status and accounts for the absent/delayed response to oral iron treatment. A challenge for the clinicians and pediatricians is the recognition of the disorder among iron deficiency and other microcytic anemias commonly found in pediatric patients. The current treatment of iron refractory iron deficiency anemia is based on parenteral iron administration; in the future, manipulation of the hepcidin pathway with the aim of suppressing it might become an alternative therapeutic approach.
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Asci R, Vallefuoco F, Andolfo I, Bruno M, De Falco L, Iolascon A. Trasferrin receptor 2 gene regulation by microRNA 221 in SH-SY5Y cells treated with MPP⁺ as Parkinson's disease cellular model. Neurosci Res 2013; 77:121-7. [PMID: 24055409 DOI: 10.1016/j.neures.2013.09.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Revised: 09/03/2013] [Accepted: 09/08/2013] [Indexed: 01/08/2023]
Abstract
Parkinson's disease (PD) is one of the most frequent human neurodegenerations. The neurodegeneration in PD is related to cellular iron increase but the mechanisms involved in iron accumulation remain unclear. Transferrin receptor type 2 (TFR2) is a protein expressed on cell membrane and involved in the cellular iron uptake. We hypothesized that microRNA 221 could regulate the expression of TfR2 in an in vitro model of Parkinson's disease, SH-SY5Y cells treated with MPP⁺. The miRNA 221 was selected by in silico analysis of several miRNAs predicted to target the TFR2 gene in SHSY5Y cells treated with MPP⁺. Taqman miRNA assay was used to evaluate the expression of the selected miRNAs. Using a luciferase assay we demonstrated the inhibition of TFR2 by miRNA 221. We show that in PD cellular model, TFR2 expression is regulated by miRNA 221. TFR2 and miR 221 are inversely correlated in SHSY5Y cells during the treatment with MPP⁺. Moreover, overexpression of miRNA 221 decreases the expression of TFR2, respectively, at the mRNA and protein levels. The inhibition of endogenous miRNA 221 also is able to regulate TFR2. These data suggest that miRNA 221 regulate TFR2 in PD model.
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Affiliation(s)
- Roberta Asci
- CEINGE, Biotecnologie Avanzate, Naples, Italy; Department of Biochemistry and Medical Biotechnologies, "Federico II" University of Naples, Naples, Italy
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Palamaro L, Guarino V, Scalia G, Antonini D, De Falco L, Bianchino G, Fusco A, Romano R, Grieco V, Missero C, Del Vecchio L, Ambrosio L, Pignata C. Human skin-derived keratinocytes and fibroblasts co-cultured on 3D poly ε-caprolactone scaffold support in vitro HSC differentiation into T-lineage committed cells. Int Immunol 2013; 25:703-14. [DOI: 10.1093/intimm/dxt035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
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Franco SS, De Falco L, Ghaffari S, Brugnara C, Sinclair DA, Matte' A, Iolascon A, Mohandas N, Bertoldi M, An X, Siciliano A, Rimmelé P, Cappellini MD, Michan S, Zoratti E, Anne J, De Franceschi L. Resveratrol accelerates erythroid maturation by activation of FoxO3 and ameliorates anemia in beta-thalassemic mice. Haematologica 2013; 99:267-75. [PMID: 23975182 DOI: 10.3324/haematol.2013.090076] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Resveratrol, a polyphenolic-stilbene, has received increased attention in the last decade due to its wide range of biological activities. Beta(β)-thalassemias are inherited red cell disorders, found worldwide, characterized by ineffective erythropoiesis and red cell oxidative damage with reduced survival. We evaluated the effects of low-dose-resveratrol (5 μM) on in vitro human erythroid differentiation of CD34(+) from normal and β-thalassemic subjects. We found that resveratrol induces accelerated erythroid-maturation, resulting in the reduction of colony-forming units of erythroid cells and increased intermediate and late erythroblasts. In sorted colony-forming units of erythroid cells resveratrol activates Forkhead-box-class-O3, decreases Akt activity and up-regulates anti-oxidant enzymes as catalase. In an in vivo murine model for β-thalassemia, resveratrol (2.4 mg/kg) reduces ineffective erythropoiesis, increases hemoglobin levels, reduces reticulocyte count and ameliorates red cell survival. In both wild-type and β-thalassemic mice, resveratrol up-regulates scavenging enzymes such as catalase and peroxiredoxin-2 through Forkhead-box-class-O3 activation. These data indicate that resveratrol inhibits Akt resulting in FoxO3 activation with upregulation of cytoprotective systems enabling the pathological erythroid precursors to resist the oxidative damage and continue to differentiate. Our data suggest that the dual effect of resveratrol on erythropoiesis through activation of FoxO3 transcriptional factor combined with the amelioration of oxidative stress in circulating red cells may be considered as a potential novel therapeutic strategy in treating β-thalassemia.
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De Falco L, Bruno M, Andolfo I, David BP, Girelli D, Noce FD, Camaschella C, Iolascon A. Identification and characterization of the first SLC11A2 isoform 1a mutation causing a defect in splicing process and an hypomorphic allele expression of theSLC11A2gene. Br J Haematol 2012; 159:492-5. [DOI: 10.1111/bjh.12062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Luigia De Falco
- CEINGE; Centro di Ingegneria Genetica e Biotecnologie Avanzate; Naples; Italy
| | - Mariasole Bruno
- CEINGE; Centro di Ingegneria Genetica e Biotecnologie Avanzate; Naples; Italy
| | - Immacolata Andolfo
- CEINGE; Centro di Ingegneria Genetica e Biotecnologie Avanzate; Naples; Italy
| | - Beneitez Pastor David
- Red Cell Pathology Unit; Department of Haematology; Clinical Laboratories Hospital Universitari Vall d'Hebron (HUVH); Universitat Autònoma Barcelona (UAB); Verona; Italy
| | - Domenico Girelli
- Department of Medicine; University of Verona; Policlinico G.B. Rossi; Verona; Italy
| | - Francesca Di Noce
- CEINGE; Centro di Ingegneria Genetica e Biotecnologie Avanzate; Naples; Italy
| | - Clara Camaschella
- Vita-Salute University and San Raffaele Scientific Institute; Milan; Italy
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De Franceschi L, Bertoldi M, De Falco L, Santos Franco S, Ronzoni L, Turrini F, Colancecco A, Camaschella C, Cappellini MD, Iolascon A. Oxidative stress modulates heme synthesis and induces peroxiredoxin-2 as a novel cytoprotective response in β-thalassemic erythropoiesis. Haematologica 2011; 96:1595-604. [PMID: 21750082 DOI: 10.3324/haematol.2011.043612] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND β-thalassemic syndromes are inherited red cell disorders characterized by severe ineffective erythropoiesis and increased levels of reactive oxygen species whose contribution to β-thalassemic anemia is only partially understood. DESIGN AND METHODS We studied erythroid precursors from normal and β-thalassemic peripheral CD34(+) cells in two-phase liquid culture by proteomic, reverse transcriptase polymerase chain reaction and immunoblot analyses. We measured intracellular reactive oxygen species, heme levels and the activity of δ-aminolevulinate-synthase-2. We exposed normal cells and K562 cells with silenced peroxiredoxin-2 to H(2)O(2) and generated a recombinant peroxiredoxin-2 for kinetic measurements in the presence of H(2)O(2) or hemin. RESULTS In β-thalassemia the increased production of reactive oxygen species was associated with down-regulation of heme oxygenase-1 and biliverdin reductase and up-regulation of peroxiredoxin-2. In agreement with these observations in β-thalassemic cells we found decreased heme levels related to significantly reduced activity of the first enzyme of the heme pathway, δ-aminolevulinate synthase-2 without differences in its expression. We demonstrated that the activity of recombinant δ-aminolevulinate synthase-2 is inhibited by both reactive oxygen species and hemin as a protective mechanism in β-thalassemic cells. We then addressed the question of the protective role of peroxiredoxin-2 in erythropoiesis by exposing normal cells to oxidative stress and silencing peroxiredoxin-2 in human erythroleukemia K562 cells. We found that peroxiredoxin-2 expression is up-regulated in response to oxidative stress and required for K562 cells to survive oxidative stress. We then showed that peroxiredoxin-2 binds heme in erythroid precursors with high affinity, suggesting a possible multifunctional cytoprotective role of peroxiredoxin-2 in β-thalassemia. CONCLUSIONS In β-thalassemic erythroid cells the reduction of δ-aminolevulinate synthase-2 activity and the increased expression of peroxiredoxin-2 might represent two novel stress-response protective systems.
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Affiliation(s)
- Lucia De Franceschi
- Department of Medicine, University of Verona, Policlinico GB Rossi, Verona, Italy.
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Andolfo I, De Falco L, Asci R, Russo R, Colucci S, Gorrese M, Zollo M, Iolascon A. Regulation of divalent metal transporter 1 (DMT1) non-IRE isoform by the microRNA Let-7d in erythroid cells. Haematologica 2010; 95:1244-52. [PMID: 20410187 DOI: 10.3324/haematol.2009.020685] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Divalent metal transporter 1 (DMT1) is a widely expressed metal-iron transporter gene encoding four variant mRNA transcripts, differing for alternative promoter at 5' (DMT1 1A and 1B) and alternative splicing at 3' UTR, differing by a specific sequence either containing or lacking an iron regulatory element (+IRE and -IRE, respectively). DMT1-IRE might be the major DMT1 isoform expressed in erythroid cells, although its regulation pathways are still unknown. DESIGN AND METHODS The microRNA (miRNA) Let-7d (miR-Let-7d) was selected by the analysis of four miRNAs, predicted to target the DMT1-IRE gene in CD34(+) hematopoietic progenitor cells, in K562 and in HEL cells induced to erythroid differentiation. Using a luciferase reporter assay we demonstrated the inhibition of DMT1-IRE by miR-Let-7d in K562 and HEL cells. The function of miR-Let-7d in erythroid cells was evaluated by the flow cytometry analysis of erythroid differentiation markers, by benzidine staining and by iron flame atomic absorption for the evaluation of iron concentration in the endosomes from K562 cells over-expressing miR-Let-7d. RESULTS We show that in erythroid cells, DMT1-IRE expression is under the regulation of miR-Let-7d. DMT1-IRE and miR-Let-7d are inversely correlated with CD34(+) cells, K562 and HEL cells during erythroid differentiation. Moreover, overexpression of miR-Let-7d decreases the expression of DMT1-IRE at the mRNA and protein levels in K562 and HEL cells. MiR-Let-7d impairs erythroid differentiation of K562 cells by accumulation of iron in the endosomes. CONCLUSIONS Overall, these data suggest that miR-Let-7d participates in the finely tuned regulation of iron metabolism by targeting DMT1-IRE isoform in erythroid cells.
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Affiliation(s)
- Immacolata Andolfo
- CEINGE, Biotecnologie Avanzate, Via, Comunale Margherita 482, 80145 Naples, Italy
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De Falco L, Totaro F, Nai A, Pagani A, Girelli D, Silvestri L, Piscopo C, Campostrini N, Dufour C, Manjomi FAL, Minkov M, Van Vuurden DG, Feliu A, Kattamis A, Camaschella C, Iolascon A. Novel TMPRSS6 mutations associated with iron-refractory iron deficiency anemia (IRIDA). Hum Mutat 2010; 31:E1390-405. [DOI: 10.1002/humu.21243] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Iolascon A, De Falco L, Borgese F, Esposito MR, Avvisati RA, Izzo P, Piscopo C, Guizouarn H, Biondani A, Pantaleo A, De Franceschi L. A novel erythroid anion exchange variant (Gly796Arg) of hereditary stomatocytosis associated with dyserythropoiesis. Haematologica 2009; 94:1049-59. [PMID: 19644137 DOI: 10.3324/haematol.2008.002873] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Stomatocytoses are a group of inherited autosomal dominant hemolytic anemias and include overhydrated hereditary stomatocytosis, dehydrated hereditary stomatocytosis, hereditary cryohydrocytosis and familial pseudohyperkalemia. DESIGN AND METHODS We report a novel variant of hereditary stomatocytosis due to a de novo band 3 mutation (p. G796R-band3 CEINGE) associated with a dyserythropoietic phenotype. Band 3 genomic analysis, measurement at of hematologic parameters and red cell indices and morphological analysis of bone marrow were carried out. We then evaluated the red cell membrane permeability and ion transport systems by functional studies of the patient's erythrocytes and Xenopus oocytes transfected with mutated band 3. We analyzed the red cell membrane tyrosine phosphorylation profile and the membrane association of the tyrosine kinases Syk and Lyn from the Src-family-kinase group, since the activity of the membrane cation transport pathways is related to cyclic phosphorylation-dephosphorylation events. RESULTS The patient showed mild hemolytic anemia with circulating stomatocytes together with signs of dyserythropoiesis. Her red cells displayed increased Na(+) content with decreased K(+)content and abnormal membrane cation transport activities. Functional characterization of band 3 CEINGE in Xenopus oocytes showed that the mutated band 3 is converted from being an anion exchanger (Cl(-), HCO(3)(-)) to being a cation pathway for Na(+) and K(+). Increased tyrosine phosphorylation of some red cell membrane proteins was observed in diseased erythrocytes. Syk and Lyn membrane association was increased in the patient's red cells compared to in normal controls, indicating perturbation of phospho-signaling pathways involved in cell volume regulation events. CONCLUSIONS Band 3 CEINGE alters function from that of anion exchange to cation transport, affects the membrane tyrosine phosphorylation profile, in particular of band 3 and stomatin, and its presence during red cell development likely contributes to dyserythropiesis.
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Affiliation(s)
- Achille Iolascon
- Department of Biochemistry and Medical Biotechnologies, University Federico II, Naples, Italy.
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Abstract
Divalent metal transporter 1 (DMT1) is the protein that allows elemental iron entry into the duodenal cell. It is expressed ubiquitously and it also allows the iron exit from the endosomes. This protein plays a central role in iron metabolism and it is strictly regulated. Several animal models elucidate its role in physiology. Recently three patients affected with DMT1 deficiency have been described. This recessively inherited condition appears at birth with severe microcytic anemia. Serum markers could be particularly useful to establish a correct diagnosis: high serum iron, normal total iron-binding capacity (TIBC), increased saturation of transferrin (Tf), slightly elevated ferritin, and increased soluble transferrin receptor (sTfR). Increased free erythrocyte protoporphyrins (FEPs) could address the diagnosis to iron-deficient anemia. All patients appeared to respond to erythropoietin (Epo) administration. Because mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) did not change during Epo treatment, it was concluded that Epo did not improve iron utilization of the erythroblasts but likely reduced the degree or intensity of apoptosis, affecting erythropoiesis. Moreover liver iron overload was present and documented in all of the affected patients. In this review we analyze the role of DMT1 in iron metabolism and the major causes of reduction and their consequences in animal models as well in humans, and we attempt to define the correct treatment for human mutants.
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Affiliation(s)
- Achille Iolascon
- CEINGE, Advanced Biotechnologies, Naples; and Department of Biochemistry and Medical Biotechnologies, University Federico II, Naples, Italy.
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Perrotta S, Della Ragione F, Rossi F, Avvisati RA, Di Pinto D, De Mieri G, Scianguetta S, Mancusi S, De Falco L, Marano V, Iolascon A. Beta-spectrinBari: a truncated beta-chain responsible for dominant hereditary spherocytosis. Haematologica 2009; 94:1753-7. [PMID: 19608679 DOI: 10.3324/haematol.2009.010124] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
We describe a beta-spectrin variant, named beta-spectrin Bari, characterized by a truncated chain and associated with hereditary spherocytosis. The clinical phenotype consists of a moderately severe hemolytic anemia, splenomegaly, and spherocytes and acanthocytes in the blood smear. The occurrence of the truncated protein, that represents about 8% of the total beta-spectrin occurring on the membrane, results in a marked spectrin deficiency. The altered protein is due to a single point mutation at position -2 (A->G) of the acceptor splice site of intron 16 leading to an aberrant beta-spectrin message skipping exons 16 and 17 indistinguishable from that reported for beta-spectrin Winston-Salem. We provide evidence that the mutated gene is transcribed but its mRNA is less abundant than either its normal counterpart or beta-spectrin Winston-Salem mRNA. Our findings are an example of how mutations in different splice sites, although causing the same truncating effect, result in clearly different clinical pictures.
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Affiliation(s)
- Silverio Perrotta
- Department of Pediatrics, Second University of Naples, Naples, Italy.
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31
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Schwarz K, Iolascon A, Verissimo F, Trede NS, Horsley W, Chen W, Paw BH, Hopfner KP, Holzmann K, Russo R, Esposito MR, Spano D, De Falco L, Heinrich K, Joggerst B, Rojewski MT, Perrotta S, Denecke J, Pannicke U, Delaunay J, Pepperkok R, Heimpel H. Mutations affecting the secretory COPII coat component SEC23B cause congenital dyserythropoietic anemia type II. Nat Genet 2009; 41:936-40. [DOI: 10.1038/ng.405] [Citation(s) in RCA: 220] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2009] [Accepted: 06/01/2009] [Indexed: 11/09/2022]
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Iolascon A, De Falco L, Beaumont C. Molecular basis of inherited microcytic anemia due to defects in iron acquisition or heme synthesis. Haematologica 2009; 94:395-408. [PMID: 19181781 DOI: 10.3324/haematol.13619] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Microcytic anemia is the most commonly encountered anemia in general medical practice. Nutritional iron deficiency and beta thalassemia trait are the primary causes in pediatrics, whereas bleeding disorders and anemia of chronic disease are common in adulthood. Microcytic hypochromic anemia can result from a defect in globin genes, in heme synthesis, in iron availability or in iron acquisition by the erythroid precursors. These microcytic anemia can be sideroblastic or not, a trait which reflects the implications of different gene abnormalities. Iron is a trace element that may act as a redox component and therefore is integral to vital biological processes that require the transfer of electrons as in oxygen transport, oxidative phosphorylation, DNA biosynthesis and xenobiotic metabolism. However, it can also be pro-oxidant and to avoid its toxicity, iron metabolism is strictly controlled and failure of these control systems could induce iron overload or iron deficient anemia. During the past few years, several new discoveries mostly arising from human patients or mouse models have highlighted the implication of iron metabolism components in hereditary microcytic anemia, from intestinal absorption to its final inclusion into heme. In this paper we will review the new information available on the iron acquisition pathway by developing erythrocytes and its regulation, and we will consider only inherited microcytosis due to heme synthesis or to iron metabolism defects. This information could be useful in the diagnosis and classification of these microcytic anemias.
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Affiliation(s)
- Achille Iolascon
- Department of Biochemistry and Medical Biotechnologies, University Federico II, Naples, Italy.
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Camaschella C, Campanella A, De Falco L, Boschetto L, Merlini R, Silvestri L, Levi S, Iolascon A. The human counterpart of zebrafish shiraz shows sideroblastic-like microcytic anemia and iron overload. Blood 2007; 110:1353-8. [PMID: 17485548 DOI: 10.1182/blood-2007-02-072520] [Citation(s) in RCA: 229] [Impact Index Per Article: 13.5] [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: 11/20/2022] Open
Abstract
Abstract
Inherited microcytic-hypochromic anemias in rodents and zebrafish suggest the existence of corresponding human disorders. The zebrafish mutant shiraz has severe anemia and is embryonically lethal because of glutaredoxin 5 (GRLX5) deletion, insufficient biogenesis of mitochondrial iron-sulfur (Fe/S) clusters, and deregulated iron-regulatory protein 1 (IRP1) activity. This leads to stabilization of transferrin receptor 1 (TfR) RNA, repression of ferritin, and ALA-synthase 2 (ALAS2) translation with impaired heme synthesis. We report the first case of GLRX5 deficiency in a middle-aged anemic male with iron overload and a low number of ringed sideroblasts. Anemia was worsened by blood transfusions but partially reversed by iron chelation. The patient had a homozygous (c.294A>G) mutation that interferes with intron 1 splicing and drastically reduces GLRX5 RNA. As in shiraz, aconitase and H-ferritin levels were low and TfR level was high in the patient's cells, compatible with increased IRP1 binding. Based on the biochemical and clinical phenotype, we hypothesize that IRP2, less degraded by low heme, contributes to the repression of the erythroblasts ferritin and ALAS2, increasing mitochondrial iron. Iron chelation, redistributing iron to the cytosol, might relieve IRP2 excess, improving heme synthesis and anemia. GLRX5 function is highly conserved, but at variance with zebrafish, its defect in humans leads to anemia and iron overload.
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D'Apolito M, Marrone A, Servedio V, Vajro P, De Falco L, Iolascon A. Seven novel mutations of the UGT1A1 gene in patients with unconjugated hyperbilirubinemia. Haematologica 2007; 92:133-4. [PMID: 17229650 DOI: 10.3324/haematol.10585] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
The aim of this study was to identify new pathogenic variations of the UGT1A1 gene in 11 patients diagnosed with neonatal unconjugated hyperbilirubinemia. We describe two cases in which clinically unapparent heterozygotic mutations in the UGT1A1 gene may become evident in combination with certain environmental conditions or additional genetic defects.
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