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Zhong H, Sian V, Johari M, Katayama S, Oghabian A, Jonson PH, Hackman P, Savarese M, Udd B. Revealing myopathy spectrum: integrating transcriptional and clinical features of human skeletal muscles with varying health conditions. Commun Biol 2024; 7:438. [PMID: 38600180 PMCID: PMC11006663 DOI: 10.1038/s42003-024-06143-3] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 04/03/2024] [Indexed: 04/12/2024] Open
Abstract
Myopathy refers to a large group of heterogeneous, rare muscle diseases. Bulk RNA-sequencing has been utilized for the diagnosis and research of these diseases for many years. However, the existing valuable sequencing data often lack integration and clinical interpretation. In this study, we integrated bulk RNA-sequencing data from 1221 human skeletal muscles (292 with myopathies, 929 controls) from both databases and our local samples. By applying a method similar to single-cell analysis, we revealed a general spectrum of muscle diseases, ranging from healthy to mild disease, moderate muscle wasting, and severe muscle disease. This spectrum was further partly validated in three specific myopathies (97 muscles) through clinical features including trinucleotide repeat expansion, magnetic resonance imaging fat fraction, pathology, and clinical severity scores. This spectrum helped us identify 234 genuinely healthy muscles as unprecedented controls, providing a new perspective for deciphering the hallmark genes and pathways among different myopathies. The newly identified featured genes of general myopathy, inclusion body myositis, and titinopathy were highly expressed in our local muscles, as validated by quantitative polymerase chain reaction.
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Affiliation(s)
- Huahua Zhong
- Department of Neurology, Huashan Rare Disease Center, Huashan Hospital, Fudan University, Shanghai, China.
| | - Veronica Sian
- Department of Precision Medicine, "Luigi Vanvitelli" University of Campania, Via L. De Crecchio 7, Naples, Italy
| | - Mridul Johari
- Department of Medical and Clinical Genetics, Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
- Harry Perkins Institute of Medical Research, Centre for Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - Shintaro Katayama
- Department of Medical and Clinical Genetics, Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
- Department of Biosciences and Nutrition, Karolinska Institutet, Huddinge, Sweden
| | - Ali Oghabian
- Department of Medical and Clinical Genetics, Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
- Research Program for Clinical and Molecular Metabolism, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Per Harald Jonson
- Department of Medical and Clinical Genetics, Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Peter Hackman
- Department of Medical and Clinical Genetics, Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Marco Savarese
- Department of Medical and Clinical Genetics, Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Department of Medical and Clinical Genetics, Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
- Tampere Neuromuscular Center, University Hospital, Tampere, Finland
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Perrin A, Métay C, Savarese M, Ben Yaou R, Demidov G, Nelson I, Solé G, Péréon Y, Bertini ES, Fattori F, D'Amico A, Ricci F, Ginsberg M, Seferian A, Boespflug-Tanguy O, Servais L, Chapon F, Lagrange E, Gaudon K, Bloch A, Ghanem R, Guyant-Maréchal L, Johari M, Van Goethem C, Fardeau M, Morales RJ, Genetti CA, Marttila M, Koenig M, Beggs AH, Udd B, Bonne G, Cossée M. Titin copy number variations associated with dominant inherited phenotypes. J Med Genet 2024; 61:369-377. [PMID: 37935568 PMCID: PMC10957311 DOI: 10.1136/jmg-2023-109473] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 10/18/2023] [Indexed: 11/09/2023]
Abstract
BACKGROUND Titinopathies are caused by mutations in the titin gene (TTN). Titin is the largest known human protein; its gene has the longest coding phase with 364 exons. Titinopathies are very complex neuromuscular pathologies due to the variable age of onset of symptoms, the great diversity of pathological and muscular impairment patterns (cardiac, skeletal muscle or mixed) and both autosomal dominant and recessive modes of transmission. Until now, only few CNVs in TTN have been reported without clear genotype-phenotype associations. METHODS Our study includes eight families with dominant titinopathies. We performed next-generation sequencing or comparative genomic hybridisation array analyses and found CNVs in the TTN gene. We characterised these CNVs by RNA sequencing (RNAseq) analyses in six patients' muscles and performed genotype-phenotype inheritance association study by combining the clinical and biological data of these eight families. RESULTS Seven deletion-type CNVs in the TTN gene were identified among these families. Genotype and RNAseq results showed that five deletions do not alter the reading frame and one is out-of-reading frame. The main phenotype identified was distal myopathy associated with contractures. The analysis of morphological, clinical and genetic data and imaging let us draw new genotype-phenotype associations of titinopathies. CONCLUSION Identifying TTN CNVs will further increase diagnostic sensitivity in these complex neuromuscular pathologies. Our cohort of patients enabled us to identify new deletion-type CNVs in the TTN gene, with unexpected autosomal dominant transmission. This is valuable in establishing new genotype-phenotype associations of titinopathies, mainly distal myopathy in most of the patients.
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Affiliation(s)
- Aurélien Perrin
- Laboratoire de Génétique Moléculaire, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
| | - Corinne Métay
- Unité Fonctionnelle de Cardiogénétique et Myogénétique moléculaire et cellulaire, Centre de Génétique Moléculaire et Chromosomique, Groupe Hospitalier La Pitié-Salpêtrière-Charles Foix, Paris, France
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, Paris, France
| | - Marco Savarese
- Tampere Neuromuscular Center, Folkhälsan Research Center, Helsinki, Finland
| | - Rabah Ben Yaou
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, Paris, France
| | - German Demidov
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tubingen, Germany
| | - Isabelle Nelson
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, Paris, France
| | - Guilhem Solé
- CHU de Bordeaux, AOC National Reference Center for Neuromuscular Disorders, Bordeaux, France
| | - Yann Péréon
- Department of Clinical Neurophysiology, Reference Centre for Neuromuscular Diseases AOC, Filnemus, Euro-NMD, CHU Nantes, Nantes Université, Place Alexis-Ricordeau, Nantes, France
| | - Enrico Silvio Bertini
- Unit of Muscular and Neurodegenerative Disorders, Bambino Gesù Children Research Hospital, IRCCS, Rome, Italy
| | - Fabiana Fattori
- Unit of Muscular and Neurodegenerative Disorders, Bambino Gesù Children Research Hospital, IRCCS, Rome, Italy
| | - Adele D'Amico
- Unit of Muscular and Neurodegenerative Disorders, Bambino Gesù Children Research Hospital, IRCCS, Rome, Italy
| | - Federica Ricci
- Division of Child and Adolescent Neuropsychiatry, University of Turin, Turin, Italy
| | - Mira Ginsberg
- Department of Pediatric Neurology, Wolfson Medical Center, Holon, Israel
| | | | - Odile Boespflug-Tanguy
- Institut I-MOTION, Hôpital Armand Trousseau, Paris, France
- UMR 1141, INSERM, NeuroDiderot Université Paris Cité and APHP, Neuropédiatrie, French Reference Center for Leukodystrophies, LEUKOFRANCE, Hôpital Robert Debré, Paris, France
| | - Laurent Servais
- Institut I-MOTION, Hôpital Armand Trousseau, Paris, France
- MDUK Oxford Neuromuscular Centre & NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- Neuromuscular Reference Center, Division of Paediatrics, University and Hospital University of Liège, Liège, Belgium
| | - Françoise Chapon
- Département de pathologie, Centre de Compétence des Maladies Neuromusculaires, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Emmeline Lagrange
- Centre de Compétences des Maladies Neuro Musculaires, Centre Hospitalier Universitaire Grenoble Alpes, Grenoble, France
| | - Karen Gaudon
- Unité Fonctionnelle de Cardiogénétique et Myogénétique moléculaire et cellulaire, Centre de Génétique Moléculaire et Chromosomique, Groupe Hospitalier La Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Adrien Bloch
- Unité Fonctionnelle de Cardiogénétique et Myogénétique moléculaire et cellulaire, Centre de Génétique Moléculaire et Chromosomique, Groupe Hospitalier La Pitié-Salpêtrière-Charles Foix, Paris, France
| | - Robin Ghanem
- Unité Fonctionnelle de Cardiogénétique et Myogénétique moléculaire et cellulaire, Centre de Génétique Moléculaire et Chromosomique, Groupe Hospitalier La Pitié-Salpêtrière-Charles Foix, Paris, France
| | | | - Mridul Johari
- Tampere Neuromuscular Center, Folkhälsan Research Center, Helsinki, Finland
- Harry Perkins Institute of Medical Research, Centre for Medical Research, University of Western Australia, Nedlands, Western Australia, Australia
| | - Charles Van Goethem
- Laboratoire de Génétique Moléculaire, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
- Montpellier BioInformatique pour le Diagnostic Clinique (MOBIDIC), Plateau de Médecine Moléculaire et Génomique (PMMG), CHU Montpellier, Montpellier, France
| | - Michel Fardeau
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, Paris, France
| | - Raul Juntas Morales
- Department of Neurology, Hospital Universitario Vall d'Hebron, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Casie A Genetti
- Division of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Minttu Marttila
- Division of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
- HiLIFE Helsinki Institute of Life Science, Tukholmankatu 8, FI-00014, University of Helsinki, Helsinki, Finland
| | - Michel Koenig
- Laboratoire de Génétique Moléculaire, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
| | - Alan H Beggs
- Division of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Bjarne Udd
- Tampere Neuromuscular Center, Folkhälsan Research Center, Helsinki, Finland
| | - Gisèle Bonne
- Sorbonne Université, INSERM, Institut de Myologie, Centre de Recherche en Myologie, Paris, France
| | - Mireille Cossée
- Laboratoire de Génétique Moléculaire, Centre Hospitalier Universitaire de Montpellier, Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
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3
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Töpf A, Cox D, Zaharieva IT, Di Leo V, Sarparanta J, Jonson PH, Sealy IM, Smolnikov A, White RJ, Vihola A, Savarese M, Merteroglu M, Wali N, Laricchia KM, Venturini C, Vroling B, Stenton SL, Cummings BB, Harris E, Marini-Bettolo C, Diaz-Manera J, Henderson M, Barresi R, Duff J, England EM, Patrick J, Al-Husayni S, Biancalana V, Beggs AH, Bodi I, Bommireddipalli S, Bönnemann CG, Cairns A, Chiew MT, Claeys KG, Cooper ST, Davis MR, Donkervoort S, Erasmus CE, Fassad MR, Genetti CA, Grosmann C, Jungbluth H, Kamsteeg EJ, Lornage X, Löscher WN, Malfatti E, Manzur A, Martí P, Mongini TE, Muelas N, Nishikawa A, O'Donnell-Luria A, Ogonuki N, O'Grady GL, O'Heir E, Paquay S, Phadke R, Pletcher BA, Romero NB, Schouten M, Shah S, Smuts I, Sznajer Y, Tasca G, Taylor RW, Tuite A, Van den Bergh P, VanNoy G, Voermans NC, Wanschitz JV, Wraige E, Yoshimura K, Oates EC, Nakagawa O, Nishino I, Laporte J, Vilchez JJ, MacArthur DG, Sarkozy A, Cordell HJ, Udd B, Busch-Nentwich EM, Muntoni F, Straub V. Digenic inheritance involving a muscle-specific protein kinase and the giant titin protein causes a skeletal muscle myopathy. Nat Genet 2024; 56:395-407. [PMID: 38429495 PMCID: PMC10937387 DOI: 10.1038/s41588-023-01651-0] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 12/19/2023] [Indexed: 03/03/2024]
Abstract
In digenic inheritance, pathogenic variants in two genes must be inherited together to cause disease. Only very few examples of digenic inheritance have been described in the neuromuscular disease field. Here we show that predicted deleterious variants in SRPK3, encoding the X-linked serine/argenine protein kinase 3, lead to a progressive early onset skeletal muscle myopathy only when in combination with heterozygous variants in the TTN gene. The co-occurrence of predicted deleterious SRPK3/TTN variants was not seen among 76,702 healthy male individuals, and statistical modeling strongly supported digenic inheritance as the best-fitting model. Furthermore, double-mutant zebrafish (srpk3-/-; ttn.1+/-) replicated the myopathic phenotype and showed myofibrillar disorganization. Transcriptome data suggest that the interaction of srpk3 and ttn.1 in zebrafish occurs at a post-transcriptional level. We propose that digenic inheritance of deleterious changes impacting both the protein kinase SRPK3 and the giant muscle protein titin causes a skeletal myopathy and might serve as a model for other genetic diseases.
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Affiliation(s)
- Ana Töpf
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
| | - Dan Cox
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Irina T Zaharieva
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Valeria Di Leo
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Ian M Sealy
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Department of Medicine, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Andrei Smolnikov
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard J White
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Department of Medicine, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Neuromuscular Research Centre, Tampere University and University Hospital, Tampere, Finland
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Munise Merteroglu
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Laboratory of Angiogenesis and Cancer Metabolism, Department of Biology, University of Padua, Padua, Italy
| | - Neha Wali
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
| | - Kristen M Laricchia
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Cristina Venturini
- Division of Infection and Immunity, University College London, London, UK
| | | | - Sarah L Stenton
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Division of Genetics & Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Beryl B Cummings
- Laboratory of Angiogenesis and Cancer Metabolism, Department of Biology, University of Padua, Padua, Italy
| | - Elizabeth Harris
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
- Northern Genetics Service, Institute of Genetics Medicine, Newcastle upon Tyne, UK
| | - Chiara Marini-Bettolo
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Jordi Diaz-Manera
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Matt Henderson
- Muscle Immunoanalysis Unit, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | | | - Jennifer Duff
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Eleina M England
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jane Patrick
- Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, UK
| | - Sundos Al-Husayni
- The Manton Center for Orphan Disease Research, Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Valerie Biancalana
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U1258, Cnrs UMR7104, Université de Strasbourg, Illkirch, France
| | - Alan H Beggs
- The Manton Center for Orphan Disease Research, Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Istvan Bodi
- Department of Clinical Neuropathology, King's College Hospital NHS Foundation Trust, London, UK
| | - Shobhana Bommireddipalli
- Kids Neuroscience Centre, the Children's Hospital at Westmead, the University of Sydney and the Children's Medical Research Institute, Westmead, New South Wales, Australia
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Anita Cairns
- Neurosciences Department, Queensland Children's Hospital, Brisbane, Queensland, Australia
| | - Mei-Ting Chiew
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, Perth, Western Australia, Australia
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium
- Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Sandra T Cooper
- Kids Neuroscience Centre, the Children's Hospital at Westmead, the University of Sydney and the Children's Medical Research Institute, Westmead, New South Wales, Australia
| | - Mark R Davis
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, Perth, Western Australia, Australia
| | - Sandra Donkervoort
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Corrie E Erasmus
- Department of Paediatric Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Amalia Children's Hospital, Nijmegen, The Netherlands
| | - Mahmoud R Fassad
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Casie A Genetti
- The Manton Center for Orphan Disease Research, Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Carla Grosmann
- Department of Neurology, Rady Children's Hospital University of California San Diego, San Diego, CA, USA
| | - Heinz Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
- Randall Centre for Cell and Molecular Biophysics, Muscle Signalling Section, Faculty of Life Sciences and Medicine (FoLSM), King's College London, London, UK
| | - Erik-Jan Kamsteeg
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Xavière Lornage
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U1258, Cnrs UMR7104, Université de Strasbourg, Illkirch, France
| | - Wolfgang N Löscher
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Edoardo Malfatti
- APHP, Neuromuscular Reference Center Nord-Est-Ile-de-France, Henri Mondor Hospital, Université Paris Est, U955, INSERM, Creteil, France
| | - Adnan Manzur
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Pilar Martí
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Neuromuscular Research Group, IIS La Fe, Valencia, Spain
| | - Tiziana E Mongini
- Department of Neurosciences Rita Levi Montalcini, Università degli Studi di Torino, Torino, Italy
| | - Nuria Muelas
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Neuromuscular Research Group, IIS La Fe, Valencia, Spain
- Department of Medicine, Universitat de Valencia, Valencia, Spain
- Neuromuscular Diseases Unit, Neurology Department, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Atsuko Nishikawa
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Anne O'Donnell-Luria
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Division of Genetics & Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | | | - Gina L O'Grady
- Starship Children's Health, Auckland District Health Board, Auckland, New Zealand
| | - Emily O'Heir
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Stéphanie Paquay
- Cliniques Universitaires St-Luc, Centre de Référence Neuromusculaire, Université de Louvain, Brussels, Belgium
| | - Rahul Phadke
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Beth A Pletcher
- Division of Clinical Genetics, Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Norma B Romero
- Neuromuscular Morphology Unit, Myology Institute, Sorbonne Université, Centre de Référence de Pathologie Neuromusculaire Nord/Est/Ile-de-France (APHP), GH Pitié-Salpêtrière, Paris, France
| | - Meyke Schouten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Snehal Shah
- Department of Neurology, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Izelle Smuts
- Department of Paediatrics, Steve Biko Academic Hospital, University of Pretoria, Pretoria, South Africa
| | - Yves Sznajer
- Center for Human Genetic, Cliniques Universitaires Saint Luc, UCLouvain, Brussels, Belgium
| | - Giorgio Tasca
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Robert W Taylor
- Wellcome Centre for Mitochondrial Research, Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- NHS Highly Specialised Service for Rare Mitochondrial Disorders, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Allysa Tuite
- Division of Clinical Genetics, Department of Pediatrics, Rutgers New Jersey Medical School, Newark, NJ, USA
| | - Peter Van den Bergh
- Cliniques Universitaires St-Luc, Centre de Référence Neuromusculaire, Université de Louvain, Brussels, Belgium
| | - Grace VanNoy
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Julia V Wanschitz
- Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
| | - Elizabeth Wraige
- Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
| | | | - Emily C Oates
- School of Biotechnology and Biomolecular Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Osamu Nakagawa
- Department of Molecular Physiology, National Cerebral and Cardiovascular Center Research Institute, Osaka, Japan
| | - Ichizo Nishino
- Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Jocelyn Laporte
- Institut de Génétique et de Biologie Moléculaire et Cellulaire (IGBMC), Inserm U1258, Cnrs UMR7104, Université de Strasbourg, Illkirch, France
| | - Juan J Vilchez
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
- Neuromuscular Research Group, IIS La Fe, Valencia, Spain
| | - Daniel G MacArthur
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Centre for Population Genomics, Garvan Institute of Medical Research and UNSW, Sydney, New South Wales, Australia
- Centre for Population Genomics, Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| | - Anna Sarkozy
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Heather J Cordell
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Neuromuscular Research Centre, Tampere University and University Hospital, Tampere, Finland
| | - Elisabeth M Busch-Nentwich
- School of Biological and Behavioural Sciences, Queen Mary University of London, London, UK
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID), Department of Medicine, Jeffrey Cheah Biomedical Centre, University of Cambridge, Cambridge, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
- NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, UCL & Great Ormond Street Hospital Trust, London, UK
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Translational and Clinical Research Institute, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
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4
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Lehtonen J, Sulonen AM, Almusa H, Lehtokari VL, Johari M, Palva A, Hakonen AH, Wartiovaara K, Lehesjoki AE, Udd B, Wallgren-Pettersson C, Pelin K, Savarese M, Saarela J. Haplotype information of large neuromuscular disease genes provided by linked-read sequencing has a potential to increase diagnostic yield. Sci Rep 2024; 14:4306. [PMID: 38383731 PMCID: PMC10881483 DOI: 10.1038/s41598-024-54866-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 03/16/2023] [Accepted: 02/17/2024] [Indexed: 02/23/2024] Open
Abstract
Rare or novel missense variants in large genes such as TTN and NEB are frequent in the general population, which hampers the interpretation of putative disease-causing biallelic variants in patients with sporadic neuromuscular disorders. Often, when the first initial genetic analysis is performed, the reconstructed haplotype, i.e. phasing information of the variants is missing. Segregation analysis increases the diagnostic turnaround time and is not always possible if samples from family members are lacking. To overcome this difficulty, we investigated how well the linked-read technology succeeded to phase variants in these large genes, and whether it improved the identification of structural variants. Linked-read sequencing data of nemaline myopathy, distal myopathy, and proximal myopathy patients were analyzed for phasing, single nucleotide variants, and structural variants. Variant phasing was successful in the large muscle genes studied. The longest continuous phase blocks were gained using high-quality DNA samples with long DNA fragments. Homozygosity increased the number of phase blocks, especially in exome sequencing samples lacking intronic variation. In our cohort, linked-read sequencing added more information about the structural variation but did not lead to a molecular genetic diagnosis. The linked-read technology can support the clinical diagnosis of neuromuscular and other genetic disorders.
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Affiliation(s)
- Johanna Lehtonen
- Centre for Molecular Medicine Norway (NCMM), University of Oslo, Oslo, Norway
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
- Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Anna-Maija Sulonen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Henrikki Almusa
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Vilma-Lotta Lehtokari
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
- Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
- Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Harry Perkins Institute of Medical Research, Centre for Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - Aino Palva
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Anna H Hakonen
- Clinical Genetics, Helsinki University Hospital, Helsinki, Finland
| | | | - Anna-Elina Lehesjoki
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
- Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
- Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Carina Wallgren-Pettersson
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
- Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Katarina Pelin
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
- Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Marco Savarese
- Folkhälsan Research Center, Folkhälsan Institute of Genetics, Helsinki, Finland
- Medicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Janna Saarela
- Centre for Molecular Medicine Norway (NCMM), University of Oslo, Oslo, Norway.
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland.
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway.
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5
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Marcello M, Cetrangolo V, Morotti I, Squarci C, Caremani M, Reconditi M, Savarese M, Bianco P, Piazzesi G, Lombardi V, Udd B, Conte I, Nigro V, Linari M. Sarcomere level mechanics of the fast skeletal muscle of the medaka fish larva. Am J Physiol Cell Physiol 2024; 326:C632-C644. [PMID: 38145303 DOI: 10.1152/ajpcell.00530.2023] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 12/17/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
The medaka fish (Oryzias latipes) is a vertebrate model used in developmental biology and genetics. Here we explore its suitability as a model for investigating the molecular mechanisms of human myopathies caused by mutations in sarcomeric proteins. To this end, the relevant mechanical parameters of the intact skeletal muscle of wild-type medaka are determined using the transparent tail at larval stage 40. Tails were mounted at sarcomere length of 2.1 μm in a thermoregulated trough containing physiological solution. Tetanic contractions were elicited at physiological temperature (10°C-30°C) by electrical stimulation, and sarcomere length changes were recorded with nanometer-microsecond resolution during both isometric and isotonic contractions with a striation follower. The force output has been normalized for the actual fraction of the cross section of the tail occupied by the myofilament lattice, as established with transmission electron microscopy (TEM), and then for the actual density of myofilaments, as established with X-ray diffraction. Under these conditions, the mechanical performance of the contracting muscle of the wild-type larva can be defined at the level of the half-thick filament, where ∼300 myosin motors work in parallel as a collective motor, allowing a detailed comparison with the established performance of the skeletal muscle of different vertebrates. The results of this study point out that the medaka fish larva is a suitable model for the investigation of the genotype/phenotype correlations and therapeutic possibilities in skeletal muscle diseases caused by mutations in sarcomeric proteins.NEW & NOTEWORTHY The suitability of the medaka fish as a model for investigating the molecular mechanisms of human myopathies caused by mutations of sarcomeric proteins is tested by combining structural analysis and sarcomere-level mechanics of the skeletal muscle of the tail of medaka larva. The mechanical performance of the medaka muscle, scaled at the level of the myosin-containing thick filament, together with its reduced genome duplication makes this model unique for investigations of the genotype/phenotype correlations in human myopathies.
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Affiliation(s)
| | - Viviana Cetrangolo
- PhysioLab, University of Florence, Florence, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | | | | | | | | | - Marco Savarese
- Folkhälsan Research Center, Helsinki University, Helsinki, Finland
| | | | | | | | - Bjarne Udd
- Folkhälsan Research Center, Helsinki University, Helsinki, Finland
| | - Ivan Conte
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
- Department of Biology, University of Naples "Federico II", Naples, Italy
| | - Vincenzo Nigro
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
- Department of Precision Medicine, University of Campania, Naples, Italy
| | - Marco Linari
- PhysioLab, University of Florence, Florence, Italy
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6
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Ranta-Aho J, Felice KJ, Jonson PH, Sarparanta J, Palmio J, Tasca G, Sabatelli M, Yvorel C, Harzallah I, Touraine R, Pais L, Austin-Tse CA, Ganesh V, O'Leary MC, Rehm HL, Hehir MK, Subramony S, Wu Q, Udd B, Savarese M. Rare ACTN2 Frameshift Variants Resulting in Protein Extension Cause Distal Myopathy and Hypertrophic Cardiomyopathy through Protein Aggregation. medRxiv 2024:2024.01.17.23298671. [PMID: 38293186 PMCID: PMC10827258 DOI: 10.1101/2024.01.17.23298671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Distal myopathies are a group of rare, inherited muscular disorders characterized by progressive loss of muscle fibers that begins in the distal parts of arms and legs. Recently, variants in a new disease gene, ACTN2 , have been shown to cause distal myopathy. ACTN2 , a gene previously only associated with cardiomyopathies, encodes alpha-actinin-2, a protein expressed in both cardiac and skeletal sarcomeres. The primary function of alpha-actinin-2 is to link actin and titin to the sarcomere Z-disk. New ACTN2 variants are continuously discovered, however, the clinical significance of many variants remains unknown. Thus, lack of clear genotype-phenotype correlations in ACTN2 -related diseases, actininopathies, persists. Objective The objective of the study is to characterize the pathomechanisms underlying actininopathies. Methods Functional characterization in C2C12 cell models of several ACTN2 variants is conducted, including frameshift and missense variants associated with dominant actininopathies. We assess the genotype-phenotype correlations of actininopathies using clinical data from several patients carrying these variants. Results The results show that the missense variants associated with a recessive form of actininopathy do not cause detectable alpha-actinin-2 aggregates in the cell model. Conversely, dominant frameshift variants causing a protein extension do produce alpha-actinin-2 aggregates. Interpretation The results suggest that alpha-actinin-2 aggregation is the disease mechanism underlying some dominant actininopathies, and thus we recommend that protein-extending frameshift variants in ACTN2 should be classified as pathogenic. However, this mechanism is likely elicited by only a limited number of variants. Alternative functional characterization methods should be explored to further investigate other molecular mechanisms underlying actininopathies.
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7
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Owusu R, Savarese M. Long-read sequencing improves diagnostic rate in neuromuscular disorders. Acta Myol 2023; 42:123-128. [PMID: 38406378 PMCID: PMC10883326 DOI: 10.36185/2532-1900-394] [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] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 02/27/2024]
Abstract
Massive parallel sequencing methods, such as exome, genome, and targeted DNA sequencing, have aided molecular diagnosis of genetic diseases in the last 20 years. However, short-read sequencing methods still have several limitations, such inaccurate genome assembly, the inability to detect large structural variants, and variants located in hard-to-sequence regions like highly repetitive areas. The recently emerged PacBio single-molecule real-time (SMRT) and Oxford nanopore technology (ONT) long-read sequencing (LRS) methods have been shown to overcome most of these technical issues, leading to an increase in diagnostic rate. LRS methods are contributing to the detection of repeat expansions in novel disease-causing genes (e.g., ABCD3, NOTCH2NLC and RILPL1 causing an Oculopharyngodistal myopathy or PLIN4 causing a Myopathy with rimmed ubiquitin-positive autophagic vacuolation), of structural variants (e.g., in DMD), and of single nucleotide variants in repetitive regions (TTN and NEB). Moreover, these methods have simplified the characterization of the D4Z4 repeats in DUX4, facilitating the diagnosis of Facioscapulohumeral muscular dystrophy (FSHD). We review recent studies that have used either ONT or PacBio SMRT sequencing methods and discuss different types of variants that have been detected using these approaches in individuals with neuromuscular disorders.
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Affiliation(s)
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- University of Helsinki, Faculty of Medicine, Helsinki, Finland
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8
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Sarparanta J, Jonson PH, Reimann J, Vihola A, Luque H, Penttilä S, Johari M, Savarese M, Hackman P, Kornblum C, Udd B. Extension of the DNAJB2a isoform in a dominant neuromyopathy family. Hum Mol Genet 2023; 32:3029-3039. [PMID: 37070754 PMCID: PMC10586202 DOI: 10.1093/hmg/ddad058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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] [Received: 01/17/2023] [Revised: 03/29/2023] [Accepted: 03/31/2023] [Indexed: 04/19/2023] Open
Abstract
Recessive mutations in the DNAJB2 gene, encoding the J-domain co-chaperones DNAJB2a and DNAJB2b, have previously been reported as the genetic cause of progressive peripheral neuropathies, rarely involving pyramidal signs, parkinsonism and myopathy. We describe here a family with the first dominantly acting DNAJB2 mutation resulting in a late-onset neuromyopathy phenotype. The c.832 T > G p.(*278Glyext*83) mutation abolishes the stop codon of the DNAJB2a isoform resulting in a C-terminal extension of the protein, with no direct effect predicted on the DNAJB2b isoform of the protein. Analysis of the muscle biopsy showed reduction of both protein isoforms. In functional studies, the mutant protein mislocalized to the endoplasmic reticulum due to a transmembrane helix in the C-terminal extension. The mutant protein underwent rapid proteasomal degradation and also increased the turnover of co-expressed wild-type DNAJB2a, potentially explaining the reduced protein amount in the patient muscle tissue. In line with this dominant negative effect, both wild-type and mutant DNAJB2a were shown to form polydisperse oligomers.
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Affiliation(s)
- Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland and Medicum, University of Helsinki, FI-00290 Helsinki, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland and Medicum, University of Helsinki, FI-00290 Helsinki, Finland
| | - Jens Reimann
- Klinik und Poliklinik für Neurologie, Sektion Neuromuskuläre Erkrankungen, Universitätsklinikum Bonn, D-53127 Bonn, Germany
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland and Medicum, University of Helsinki, FI-00290 Helsinki, Finland
- Neuromuscular Research Center, Tampere University Hospital and Fimlab Laboratories, FI-33520 Tampere, Finland
| | - Helena Luque
- Folkhälsan Research Center, Helsinki, Finland and Medicum, University of Helsinki, FI-00290 Helsinki, Finland
| | - Sini Penttilä
- Neuromuscular Research Center, Tampere University Hospital and Fimlab Laboratories, FI-33520 Tampere, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland and Medicum, University of Helsinki, FI-00290 Helsinki, Finland
- Harry Perkins Institute of Medical Research, Centre for Medical Research, University of Western Australia, Nedlands WA, Australia
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland and Medicum, University of Helsinki, FI-00290 Helsinki, Finland
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland and Medicum, University of Helsinki, FI-00290 Helsinki, Finland
| | - Cornelia Kornblum
- Klinik und Poliklinik für Neurologie, Sektion Neuromuskuläre Erkrankungen, Universitätsklinikum Bonn, D-53127 Bonn, Germany
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland and Medicum, University of Helsinki, FI-00290 Helsinki, Finland
- Neuromuscular Research Center, Tampere University Hospital and Fimlab Laboratories, FI-33520 Tampere, Finland
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9
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Di Feo MF, Lillback V, Jokela M, McEntagart M, Homfray T, Giorgio E, Casalis Cavalchini GC, Brusco A, Iascone M, Spaccini L, D'Oria P, Savarese M, Udd B. The crucial role of titin in fetal development: recurrent miscarriages and bone, heart and muscle anomalies characterise the severe end of titinopathies spectrum. J Med Genet 2023; 60:866-873. [PMID: 36977548 DOI: 10.1136/jmg-2022-109018] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/18/2023] [Indexed: 03/30/2023]
Abstract
BACKGROUND Titin truncating variants (TTNtvs) have been associated with several forms of myopathies and/or cardiomyopathies. In homozygosity or in compound heterozygosity, they cause a wide spectrum of recessive phenotypes with a congenital or childhood onset. Most recessive phenotypes showing a congenital or childhood onset have been described in subjects carrying biallelic TTNtv in specific exons. Often karyotype or chromosomal microarray analyses are the only tests performed when prenatal anomalies are identified. Thereby, many cases caused by TTN defects might be missed in the diagnostic evaluations. In this study, we aimed to dissect the most severe end of the titinopathies spectrum. METHODS We performed a retrospective study analysing an international cohort of 93 published and 10 unpublished cases carrying biallelic TTNtv. RESULTS We identified recurrent clinical features showing a significant correlation with the genotype, including fetal akinesia (up to 62%), arthrogryposis (up to 85%), facial dysmorphisms (up to 73%), joint (up to 17%), bone (up to 22%) and heart anomalies (up to 27%) resembling complex, syndromic phenotypes. CONCLUSION We suggest TTN to be carefully evaluated in any diagnostic process involving patients with these prenatal signs. This step will be essential to improve diagnostic performance, expand our knowledge and optimise prenatal genetic counselling.
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Affiliation(s)
- Maria Francesca Di Feo
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, and Maternal and Child Health (DINOGMI), University of Genoa, Genova, Italy
| | - Victoria Lillback
- Folkhälsan Research Center, Helsinki, Uusimaa, Finland
- University of Helsinki Department of Medical and Clinical Genetics, Helsinki, Uusimaa, Finland
| | - Manu Jokela
- Tampere University Hospital, Tampere, Pirkanmaa, Finland
- TYKS Turku University Hospital, Turku, Varsinais-Suomi, Finland
| | - Meriel McEntagart
- Department of Medical Genetics, St George's University of London, London, London, UK
| | - Tessa Homfray
- St George's University of London, London, London, UK
| | - Elisa Giorgio
- Department of Molecular Medicine, University of Pavia, Pavia, Lombardia, Italy
- Fondazione Istituto Neurologico Nazionale C Mondino Istituto di Ricovero e Cura a Carattere Scientifico, Pavia, Lombardia, Italy
| | - Guido C Casalis Cavalchini
- Medical Genetics Unit, Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Torino, Piemonte, Italy
| | - Alfredo Brusco
- Department of Medical Sciences, University of Turin School of Medicine, Torino, Piemonte, Italy
| | - Maria Iascone
- Laboratorio di Genetica Medica, ASST Papa Giovanni XXIII, Bergamo, BG, Italy
| | - Luigina Spaccini
- Unità di Genetica Medica, UOC Ostetricia e Ginecologia, Ospedale dei Bambini Vittore Buzzi, Milano, Lombardia, Italy
| | - Patrizia D'Oria
- UOC Ostetrica e Ginecologia, Ospedale Bolognini di Seriate, Seriate, Lombardia, Italy
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Uusimaa, Finland
- Department of Medical Genetics, University of Helsinki, Helsinki, Uusimaa, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Uusimaa, Finland
- Tampere University Hospital Department of Musculoskeletal Diseases, Tampere, Pirkanmaa, Finland
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10
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Baban A, Cicenia M, Magliozzi M, Parlapiano G, Cirillo M, Pascolini G, Fattori F, Gnazzo M, Bruno P, De Luca L, Di Chiara L, Francalanci P, Udd B, Secinaro A, Amodeo A, Bertini ES, Savarese M, Drago F, Novelli A. Biallelic truncating variants in children with titinopathy represent a recognizable condition with distinctive muscular and cardiac characteristics: a report on five patients. Front Cardiovasc Med 2023; 10:1210378. [PMID: 37576110 PMCID: PMC10415037 DOI: 10.3389/fcvm.2023.1210378] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Background Monoallelic and biallelic TTN truncating variants (TTNtv) may be responsible for a wide spectrum of musculoskeletal and cardiac disorders with different age at onset. Although the prevalence of heterozygous TTNtv is relatively high in the general population, cardiac phenotyping (mainly cardiomyopathies, CMPs) in biallelic titinopathy has rarely been described in children. Methods We reviewed the medical records of pediatric patients with biallelic TTNtv and cardiac involvement. Clinical exome sequencing excluded pathogenic/likely pathogenic variants in major CMP genes. Results Five pediatric patients (four male) with biallelic TTNtv were included. Major arthrogryposis multiplex was observed in four patients; no patient showed intellectual disability. At a cardiac level, congenital heart defects (atrial and ventricular septal defects, n = 3) and left ventricular non-compaction (n = 1) were reported. All patients had dilated cardiomyopathy (DCM) diagnosed at birth in one patient and at the age of 10, 13, 14, and 17 years in the other four patients. Heart rhythm monitoring showed tachyarrhythmias (premature ventricular contractions, n = 2; non-sustained ventricular tachycardia, n = 2) and nocturnal first-degree atrio-ventricular block (n = 2). Cardiac magnetic resonance (CMR) imaging was performed in all patients and revealed a peculiar late gadolinium enhancement distribution in three patients. HyperCKemia was present in two patients and end-stage heart failure in four. End-organ damage requiring heart transplantation (HT) was indicated in two patients, who were operated on successfully. Conclusion Biallelic TTNtv should be considered when evaluating children with severe and early-onset DCM, particularly if skeletal and muscular abnormalities are present, e.g., arthrogryposis multiplex and congenital progressive myopathy. End-stage heart failure is common and may require HT.
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Affiliation(s)
- Anwar Baban
- Pediatric Cardiology and Arrhythmia/Syncope Complex Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Marianna Cicenia
- Pediatric Cardiology and Arrhythmia/Syncope Complex Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Monia Magliozzi
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giovanni Parlapiano
- Pediatric Cardiology and Arrhythmia/Syncope Complex Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Marco Cirillo
- Department of Imaging, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Giulia Pascolini
- Pediatric Cardiology and Arrhythmia/Syncope Complex Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Fabiana Fattori
- Unit of Muscular and Neurodegenerative Disorders, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Maria Gnazzo
- Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, Rome, Italy
| | - Pasqualina Bruno
- Department of Cardiac Surgery, Cardiology, Heart and Lung Transplantation, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Lorenzo De Luca
- Pediatric Cardiology and Arrhythmia/Syncope Complex Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Luca Di Chiara
- Pediatric Cardiac Intensive Care Unit, Department of Cardiology and Cardiac Surgery, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Paola Francalanci
- Department of Pathology, Bambino Gesù Children’s Hospital and Research Institute, IRCCS, Rome, Italy
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
| | - Aurelio Secinaro
- Advanced Cardiothoracic Imaging Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Antonio Amodeo
- Heart Failureand Transplant, Mechanical Circulatory Support Complex Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Enrico Silvio Bertini
- Unit of Muscular and Neurodegenerative Disorders, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Fabrizio Drago
- Pediatric Cardiology and Arrhythmia/Syncope Complex Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, Rome, Italy
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11
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Swan AH, Schindler RFR, Savarese M, Mayer I, Rinné S, Bleser F, Schänzer A, Hahn A, Sabatelli M, Perna F, Chapman K, Pfuhl M, Spivey AC, Decher N, Udd B, Tasca G, Brand T. Correction: Differential effects of mutations of POPDC proteins on heteromeric interaction and membrane trafficking. Acta Neuropathol Commun 2023; 11:114. [PMID: 37434226 DOI: 10.1186/s40478-023-01591-0] [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] [Indexed: 07/13/2023] Open
Affiliation(s)
- Alexander H Swan
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Department of Chemistry, Imperial College London, London, UK
| | - Roland F R Schindler
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
- Assay Biology, Domainex Ltd, Cambridge, CB10 1XL, UK
| | - Marco Savarese
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Isabelle Mayer
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Susanne Rinné
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, Marburg, Germany
| | - Felix Bleser
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, Marburg, Germany
| | - Anne Schänzer
- Institute of Neuropathology, Justus Liebig University Giessen, Giessen, Germany
| | - Andreas Hahn
- Department of Child Neurology, Justus Liebig University Giessen, Giessen, Germany
| | - Mario Sabatelli
- Department of Neurology, Universitá Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Perna
- Dipartimento Di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | | | - Mark Pfuhl
- School of Cardiovascular Medicine and Sciences and Randall Centre, King's College London, London, UK
| | - Alan C Spivey
- Department of Chemistry, Imperial College London, London, UK
| | - Niels Decher
- Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, Marburg, Germany
| | - Bjarne Udd
- Folkhälsan Research Center, University of Helsinki, Helsinki, Finland
| | - Giorgio Tasca
- Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
- John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trusts , Newcastle Upon Tyne, UK
| | - Thomas Brand
- National Heart and Lung Institute (NHLI), Imperial College London, London, UK.
- Imperial Centre of Translational and Experimental Medicine, Du Cane Road, London, W120NN, UK.
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12
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Lillback V, Savarese M, Sandholm N, Hackman P, Udd B. Long-term favorable prognosis in late onset dominant distal titinopathy: Tibial muscular dystrophy. Eur J Neurol 2023; 30:1080-1088. [PMID: 36692225 DOI: 10.1111/ene.15688] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/15/2022] [Accepted: 10/11/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE Tibial muscular dystrophy (TMD) is a dominant late onset distal titinopathy. It was first described in Finnish patients 3 decades ago. TMD patients with several other TTN mutations occur in many European populations. In this retrospective study, we were able to obtain longitudinal follow-up data of the disease progression over 15 years in 137 TMD patients. METHODS We retrieved clinical data retrospectively from three examinations spanning a period of 15 years. The data were analyzed in R. Frequencies, percentages, and median values were used to describe data. Probability values were determined with the chi-squared test. RESULTS In the cohort, the first symptoms were walking difficulties (97.8%) and weakness in distal lower limbs (98.5%). The progression of the weakness in distal lower limbs was moderate, and in the proximal lower limbs and proximal upper limbs it was mild. The distal upper limbs were not affected. Magnetic resonance imaging results indicated fatty degeneration preferentially in lower leg anterior muscles, gluteus minimus, and hamstring muscles. Serum creatine kinase values in the cohort were mostly normal (40.7%) or mildly elevated (53.7%). The data suggest that 50% of patients need walking aids by the age of 88 years. CONCLUSIONS Despite individual variability of severity, the overall disability due to walking difficulties and upper limb weakness remained moderate even at very advanced ages, and cardiomyopathy did not develop due to the titin defect alone. The acquired results promote the correct identification of TMD, and the obtained trajectories of disease evolution can be used as natural history data for any therapeutic intervention.
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Affiliation(s)
- Victoria Lillback
- Folkhälsan Research Center, Helsinki, Finland
- Medicum, University of Helsinki, Helsinki, Finland
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- Medicum, University of Helsinki, Helsinki, Finland
| | | | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland
- Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
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13
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Cardone N, Moula M, Baelde RJ, Biquand A, Villanova M, Metay C, Fiorillo C, Baratto S, Merlini L, Sabatelli P, Romero NB, Relaix F, Authier FJ, Taglietti V, Savarese M, de Winter J, Ottenheijm C, Richard I, Malfatti E. Clinical and functional characterization of a long survivor congenital titinopathy patient with a novel metatranscript-only titin variant. Acta Neuropathol Commun 2023; 11:48. [PMID: 36945066 PMCID: PMC10031982 DOI: 10.1186/s40478-023-01539-4] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 03/03/2023] [Indexed: 03/23/2023] Open
Abstract
Congenital titinopathies are an emerging group of a potentially severe form of congenital myopathies caused by biallelic mutations in titin, encoding the largest existing human protein involved in the formation and stability of sarcomeres. In this study we describe a patient with a congenital myopathy characterized by multiple contractures, a rigid spine, non progressive muscular weakness, and a novel homozygous TTN pathogenic variant in a metatranscript-only exon: the c.36400A > T, p.Lys12134*. Muscle biopsies showed increased internalized nuclei, variability in fiber size, mild fibrosis, type 1 fiber predominance, and a slight increase in the number of satellite cells. RNA studies revealed the retention of intron 170 and 171 in the open reading frame, and immunoflourescence and western blot studies, a normal titin content. Single fiber functional studies showed a slight decrease in absolute maximal force and a cross-sectional area with no decreases in tension, suggesting that weakness is not sarcomere-based but due to hypotrophy. Passive properties of single fibers were not affected, but the observed increased calcium sensitivity of force generation might contribute to the contractural phenotype and rigid spine of the patient. Our findings provide evidence for a pathogenic, causative role of a metatranscript-only titin variant in a long survivor congenital titinopathy patient with distal arthrogryposis and rigid spine.
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Affiliation(s)
- Nastasia Cardone
- Univ Paris-Est Créteil, INSERM, U955 IMRB, F-94010, Créteil, France
| | - Melissa Moula
- Univ Paris-Est Créteil, INSERM, U955 IMRB, F-94010, Créteil, France
| | - Rianne J Baelde
- Amsterdam UMC location Vrije Universiteit Amsterdam, Physiology, De Boelelaan 1117, Amsterdam, Netherlands
| | | | - Marcello Villanova
- Neuromuscular Unit, Presidio Ospedaliero Accreditato Villa Bellombra, Bologna, Italy
| | - Corinne Metay
- Unité Fonctionnelle de Cardiogénétique et Myogénétique moléculaire et cellulaire. Centre de Génétique Moléculaire et Chromosomique et INSERM UMRS 974, Institut de Myologie. Groupe Hospitalier La Pitié-Salpêtrière-Charles Foix, Paris, INSERM UMRS1166, Sorbonne Université, Paris, France
| | - Chiara Fiorillo
- Neurologia Pediatrica e Malattie Muscolari, Istituto G.Gaslini, Genoa, Italy
| | - Serena Baratto
- Neurologia Pediatrica e Malattie Muscolari, Istituto G.Gaslini, Genoa, Italy
| | - Luciano Merlini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126, Bologna, Italy
| | - Patrizia Sabatelli
- CNR, Institute of Molecular Genetics "Luigi Luca Cavalli Sforza" -Unit of Bologna, Bologna, Italy
- IRCCS-Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Norma B Romero
- Neuromuscular Morphology Unit, Myology Institute, GHU Pitié-Salpêtrière, Paris, France
| | - Frederic Relaix
- Univ Paris-Est Créteil, INSERM, U955 IMRB, F-94010, Créteil, France
| | - François Jérôme Authier
- Univ Paris-Est Créteil, INSERM, U955 IMRB, F-94010, Créteil, France
- APHP, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, Créteil, France
| | | | | | - Josine de Winter
- Amsterdam UMC location Vrije Universiteit Amsterdam, Physiology, De Boelelaan 1117, Amsterdam, Netherlands
| | - Coen Ottenheijm
- Amsterdam UMC location Vrije Universiteit Amsterdam, Physiology, De Boelelaan 1117, Amsterdam, Netherlands
| | | | - Edoardo Malfatti
- Univ Paris-Est Créteil, INSERM, U955 IMRB, F-94010, Créteil, France.
- APHP, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Henri Mondor Hospital, Créteil, France.
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14
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Swan AH, Schindler RFR, Savarese M, Mayer I, Rinné S, Bleser F, Schänzer A, Hahn A, Sabatelli M, Perna F, Chapman K, Pfuhl M, Spivey AC, Decher N, Udd B, Tasca G, Brand T. Differential effects of mutations of POPDC proteins on heteromeric interaction and membrane trafficking. Acta Neuropathol Commun 2023; 11:4. [PMID: 36624536 PMCID: PMC9830914 DOI: 10.1186/s40478-022-01501-w] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/22/2022] [Indexed: 01/11/2023] Open
Abstract
The Popeye domain containing (POPDC) genes encode sarcolemma-localized cAMP effector proteins. Mutations in blood vessel epicardial substance (BVES) also known as POPDC1 and POPDC2 have been associated with limb-girdle muscular dystrophy and cardiac arrhythmia. Muscle biopsies of affected patients display impaired membrane trafficking of both POPDC isoforms. Biopsy material of patients carrying mutations in BVES were immunostained with POPDC antibodies. The interaction of POPDC proteins was investigated by co-precipitation, proximity ligation, bioluminescence resonance energy transfer and bimolecular fluorescence complementation. Site-directed mutagenesis was utilised to map the domains involved in protein-protein interaction. Patients carrying a novel homozygous variant, BVES (c.547G > T, p.V183F) displayed only a skeletal muscle pathology and a mild impairment of membrane trafficking of both POPDC isoforms. In contrast, variants such as BVES p.Q153X or POPDC2 p.W188X were associated with a greater impairment of membrane trafficking. Co-transfection analysis in HEK293 cells revealed that POPDC proteins interact with each other through a helix-helix interface located at the C-terminus of the Popeye domain. Site-directed mutagenesis of an array of ultra-conserved hydrophobic residues demonstrated that some of them are required for membrane trafficking of the POPDC1-POPDC2 complex. Mutations in POPDC proteins that cause an impairment in membrane localization affect POPDC complex formation while mutations which leave protein-protein interaction intact likely affect some other essential function of POPDC proteins.
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Affiliation(s)
- Alexander H. Swan
- grid.7445.20000 0001 2113 8111National Heart and Lung Institute (NHLI), Imperial College London, London, UK ,grid.7445.20000 0001 2113 8111Department of Chemistry, Imperial College London, London, UK
| | - Roland F. R. Schindler
- grid.7445.20000 0001 2113 8111National Heart and Lung Institute (NHLI), Imperial College London, London, UK ,grid.434240.5Present Address: Assay Biology, Domainex Ltd, Cambridge, CB10 1XL UK
| | - Marco Savarese
- grid.7737.40000 0004 0410 2071Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Isabelle Mayer
- grid.7445.20000 0001 2113 8111National Heart and Lung Institute (NHLI), Imperial College London, London, UK
| | - Susanne Rinné
- grid.10253.350000 0004 1936 9756Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, Marburg, Germany
| | - Felix Bleser
- grid.10253.350000 0004 1936 9756Institute for Physiology and Pathophysiology, Vegetative Physiology, Philipps-University of Marburg, Marburg, Germany
| | - Anne Schänzer
- grid.8664.c0000 0001 2165 8627Institute of Neuropathology, Justus Liebig University Giessen, Giessen, Germany
| | - Andreas Hahn
- grid.8664.c0000 0001 2165 8627Department of Child Neurology, Justus Liebig University Giessen, Giessen, Germany
| | - Mario Sabatelli
- grid.8142.f0000 0001 0941 3192Department of Neurology, Universitá Cattolica del Sacro Cuore, Rome, Italy
| | - Francesco Perna
- grid.414603.4Dipartimento Di Scienze Cardiovascolari, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Kathryn Chapman
- grid.434240.5Present Address: Assay Biology, Domainex Ltd, Cambridge, CB10 1XL UK
| | - Mark Pfuhl
- grid.13097.3c0000 0001 2322 6764School of Cardiovascular Medicine and Sciences and Randall Centre, King’s College London, London, UK
| | - Alan C. Spivey
- grid.7445.20000 0001 2113 8111Department of Chemistry, Imperial College London, London, UK
| | - Niels Decher
- grid.8664.c0000 0001 2165 8627Institute of Neuropathology, Justus Liebig University Giessen, Giessen, Germany
| | - Bjarne Udd
- grid.7737.40000 0004 0410 2071Folkhälsan Research Center, University of Helsinki, Helsinki, Finland
| | - Giorgio Tasca
- grid.414603.4Unità Operativa Complessa di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy ,grid.1006.70000 0001 0462 7212Present Address: John Walton Muscular Dystrophy Research Centre, Newcastle University and Newcastle Hospitals NHS Foundation Trusts, Newcastle Upon Tyne, UK
| | - Thomas Brand
- grid.7445.20000 0001 2113 8111National Heart and Lung Institute (NHLI), Imperial College London, London, UK ,Imperial Centre of Translational and Experimental Medicine, Du Cane Road, London, W120NN UK
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15
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Pelin K, Sagath L, Lehtonen J, Kiiski K, Tynninen O, Paetau A, Johari M, Savarese M, Wallgren-Pettersson C, Lehtokari VL. Novel Compound Heterozygous Splice-Site Variants in TPM3 Revealed by RNA Sequencing in a Patient with an Unusual Form of Nemaline Myopathy: A Case Report. J Neuromuscul Dis 2023; 10:977-984. [PMID: 37393515 PMCID: PMC10578209 DOI: 10.3233/jnd-230026] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 07/03/2023]
Abstract
BACKGROUND Pathogenic variants in the TPM3 gene, encoding slow skeletal muscle α-tropomyosin account for less than 5% of nemaline myopathy cases. Dominantly inherited or de novo missense variants in TPM3 are more common than recessive loss-of-function variants. The recessive variants reported to date seem to affect either the 5' or the 3' end of the skeletal muscle-specific TPM3 transcript. OBJECTIVES The aim of the study was to identify the disease-causing gene and variants in a Finnish patient with an unusual form of nemaline myopathy. METHODS The genetic analyses included Sanger sequencing, whole-exome sequencing, targeted array-CGH, and linked-read whole genome sequencing. RNA sequencing was done on total RNA extracted from cultured myoblasts and myotubes of the patient and controls. TPM3 protein expression was assessed by Western blot analysis. The diagnostic muscle biopsy was analyzed by routine histopathological methods. RESULTS The patient had poor head control and failure to thrive, but no hypomimia, and his upper limbs were clearly weaker than his lower limbs, features which in combination with the histopathology suggested TPM3-caused nemaline myopathy. Muscle histopathology showed increased fiber size variation and numerous nemaline bodies predominantly in small type 1 fibers. The patient was found to be compound heterozygous for two splice-site variants in intron 1a of TPM3: NM_152263.4:c.117+2_5delTAGG, deleting the donor splice site of intron 1a, and NM_152263.4:c.117 + 164 C>T, which activates an acceptor splice site preceding a non-coding exon in intron 1a. RNA sequencing revealed inclusion of intron 1a and the non-coding exon in the transcripts, resulting in early premature stop codons. Western blot using patient myoblasts revealed markedly reduced levels of the TPM3 protein. CONCLUSIONS Novel biallelic splice-site variants were shown to markedly reduce TPM3 protein expression. The effects of the variants on splicing were readily revealed by RNA sequencing, demonstrating the power of the method.
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Affiliation(s)
- Katarina Pelin
- Molecular and Integrative Biosciences Research Programme, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - Lydia Sagath
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Johanna Lehtonen
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Centre for Molecular Medicine Norway (NCMM), University of Oslo, Oslo, Norway
| | - Kirsi Kiiski
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Laboratory of Genetics, HUS Diagnostic Centre, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | - Olli Tynninen
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anders Paetau
- Department of Pathology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Harry Perkins Institute of Medical Research, Centre for Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Carina Wallgren-Pettersson
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Vilma-Lotta Lehtokari
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
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16
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Savarese M, Jokela M, Udd B. Distal myopathy. Handb Clin Neurol 2023; 195:497-519. [PMID: 37562883 DOI: 10.1016/b978-0-323-98818-6.00002-9] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
Distal myopathies are a group of genetic, primary muscle diseases. Patients develop progressive weakness and atrophy of the muscles of forearm, hands, lower leg, or feet. Currently, over 20 different forms, presenting a variable age of onset, clinical presentation, disease progression, muscle involvement, and histological findings, are known. Some of them are dominant and some recessive. Different variants in the same gene are often associated with either dominant or recessive forms, although there is a lack of a comprehensive understanding of the genotype-phenotype correlations. This chapter provides a description of the clinicopathologic and genetic aspects of distal myopathies emphasizing known etiologic and pathophysiologic mechanisms.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland; Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Manu Jokela
- Neuromuscular Research Center, Department of Neurology, Tampere University and University Hospital, Tampere, Finland; Division of Clinical Neurosciences, Department of Neurology, Turku University Hospital, Turku, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland; Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland; Neuromuscular Research Center, Department of Neurology, Tampere University and University Hospital, Tampere, Finland; Department of Neurology, Vaasa Central Hospital, Vaasa, Finland.
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17
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Onore ME, Savarese M, Picillo E, Passamano L, Nigro V, Politano L. Bi-Allelic DES Gene Variants Causing Autosomal Recessive Myofibrillar Myopathies Affecting Both Skeletal Muscles and Cardiac Function. Int J Mol Sci 2022; 23:ijms232415906. [PMID: 36555543 PMCID: PMC9785402 DOI: 10.3390/ijms232415906] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/09/2022] [Accepted: 12/11/2022] [Indexed: 12/15/2022] Open
Abstract
Mutations in the human desmin gene (DES) may cause both autosomal dominant and recessive cardiomyopathies leading to heart failure, arrhythmias and atrio-ventricular blocks, or progressive myopathies. Cardiac conduction disorders, arrhythmias and cardiomyopathies usually associated with progressive myopathy are the main manifestations of autosomal dominant desminopathies, due to mono-allelic pathogenic variants. The recessive forms, due to bi-allelic variants, are very rare and exhibit variable phenotypes in which premature sudden cardiac death could also occur in the first or second decade of life. We describe a further case of autosomal recessive desminopathy in an Italian boy born of consanguineous parents, who developed progressive myopathy at age 12, and dilated cardiomyopathy four years later and died of intractable heart failure at age 17. Next Generation Sequencing (NGS) analysis identified the homozygous loss-of-function variant c.634C>T; p.Arg212*, which was likely inherited from both parents. Furthermore, we performed a comparison of clinical and genetic results observed in our patient with those of cases so far reported in the literature.
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Affiliation(s)
- Maria Elena Onore
- Medical Genetics and Cardiomyology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Marco Savarese
- Folkhälsan Research Center, 00280 Helsinki, Finland
- Department of Medical and Clinical Genetics, Medicum, University of Helsinki, 00280 Helsinki, Finland
| | - Esther Picillo
- Medical Genetics and Cardiomyology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Luigia Passamano
- Medical Genetics and Cardiomyology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
| | - Vincenzo Nigro
- Medical Genetics and Cardiomyology, Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
- Telethon Institute of Genetics and Medicine, 80078 Pozzuoli, Italy
| | - Luisa Politano
- Cardiomyology and Medical Genetics, Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Napoli, Italy
- Correspondence:
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18
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Mogavero M, Mezzapesa D, Savarese M, DelRosso L, Lanza G, Ferri R. Structural Changes of the Subcortical Gray Structures in Restless Legs Syndrome. Sleep Med 2022. [DOI: 10.1016/j.sleep.2022.05.412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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19
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Ranta-Aho J, Olive M, Vandroux M, Roticiani G, Dominguez C, Johari M, Torella A, Böhm J, Turon J, Nigro V, Hackman P, Laporte J, Udd B, Savarese M. Mutation update for the ACTN2 gene. Hum Mutat 2022; 43:1745-1756. [PMID: 36116040 PMCID: PMC10087778 DOI: 10.1002/humu.24470] [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: 03/28/2022] [Revised: 07/29/2022] [Accepted: 09/12/2022] [Indexed: 01/24/2023]
Abstract
ACTN2 encodes alpha-actinin-2, a protein expressed in human cardiac and skeletal muscle. The protein, located in the sarcomere Z-disk, functions as a link between the anti-parallel actin filaments. This important structural protein also binds N-terminal titins, and thus contributes to sarcomere stability. Previously, ACTN2 mutations have been solely associated with cardiomyopathy, without skeletal muscle disease. Recently, however, ACTN2 mutations have been associated with novel congenital and distal myopathy. Previously reported variants are in varying locations across the gene, but the potential clustering effect of pathogenic locations is not clearly understood. Further, the genotype-phenotype correlations of these variants remain unclear. Here we review the previously reported ACTN2-related molecular and clinical findings and present an additional variant, c.1840-2A>T, that further expands the mutation and phenotypic spectrum. Our results show a growing body of clinical, genetic, and functional evidence, which underlines the central role of ACTN2 in the muscle tissue and myopathy. However, limited segregation and functional data are available to support the pathogenicity of most previously reported missense variants and clear-cut genotype-phenotype correlations are currently only demonstrated for some ACTN2-related myopathies.
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Affiliation(s)
- Johanna Ranta-Aho
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Montse Olive
- Department of Neurology, Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Marie Vandroux
- IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Université de Strasbourg, Illkirch, France
| | | | - Cristina Dominguez
- Department of Neurology, Neuromuscular Unit, Hospital Universitario 12 de Octubre, Research Institute imas12, Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Annalaura Torella
- Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Johann Böhm
- IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Université de Strasbourg, Illkirch, France
| | - Janina Turon
- Department of Neurology, Neuromuscular Diseases Unit, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,Biomedical Research Institute Sant Pau (IIB Sant Pau), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain
| | - Vincenzo Nigro
- Department of Precision Medicine, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Jocelyn Laporte
- IGBMC (Institut de Génétique et de Biologie Moléculaire et Cellulaire), Université de Strasbourg, Illkirch, France
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
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20
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Johari M, Papadimas G, Papadopoulos C, Xirou S, Kanavaki A, Chrysanthou-Piterou M, Rusanen S, Savarese M, Hackman P, Udd B. Adult-onset dominant muscular dystrophy in Greek families caused by Annexin A11. Ann Clin Transl Neurol 2022; 9:1660-1667. [PMID: 36134701 PMCID: PMC9539373 DOI: 10.1002/acn3.51665] [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: 08/03/2022] [Revised: 09/01/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022] Open
Abstract
Objective Mutations in the prion‐like domain of RNA binding proteins cause dysfunctional stress responses and associated aggregate pathology in patients with neurogenic and myopathic phenotypes. Recently, mutations in ANXA11 have been reported in patients with amyotrophic lateral sclerosis and multisystem proteinopathy. Here we studied families with an autosomal dominant muscle disease caused by ANXA11:c.118G > T;p.D40Y. Methods We performed deep phenotyping and exome sequencing of patients from four large Greek families, including seven affected individuals with progressive muscle disease but no family history of multi‐organ involvement or ALS. Results In our study, all patients presented with an autosomal dominant muscular dystrophy without any Paget disease of bone nor signs of frontotemporal dementia or Parkinson's disease. Histopathological analysis showed rimmed vacuoles with annexin A11 accumulations. Electron microscopy analysis showed myofibrillar abnormalities with disorganization of the sarcomeric structure and Z‐disc dissolution, and subsarcolemmal autophagic material with myeloid formations. Molecular genetic analysis revealed ANXA11:c.118G > T;p.D40Y segregating with the phenotype. Interpretation Although the pathogenic mechanisms associated with p.D40Y mutation in the prion‐like domain of Annexin A11 need to be further clarified, our study provides robust and clear genetic evidence to support the expansion of the phenotypic spectrum of ANXA11.
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Affiliation(s)
- Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - George Papadimas
- Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Constantinos Papadopoulos
- Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Sophia Xirou
- Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Margarita Chrysanthou-Piterou
- Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Salla Rusanen
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Neuromuscular Research Center, Department of Neurology, Tampere University and University Hospital, Tampere, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
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21
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Marcello M, Cetrangolo V, Savarese M, Udd B. Use of animal models to understand titin physiology and pathology. J Cell Mol Med 2022; 26:5103-5112. [PMID: 36065969 PMCID: PMC9575118 DOI: 10.1111/jcmm.17533] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [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: 06/30/2022] [Revised: 08/24/2022] [Accepted: 08/26/2022] [Indexed: 12/01/2022] Open
Abstract
In recent years, increasing attention has been paid to titin (TTN) and its mutations. Heterozygous TTN truncating variants (TTNtv) increase the risk of a cardiomyopathy. At the same time, TTNtv and few missense variants have been identified in patients with mainly recessive skeletal muscle diseases. The pathogenic mechanisms underlying titin‐related diseases are still partly unknown. Similarly, the titin mechanical and functional role in the muscle contraction are far from being exhaustively clarified. In the last few years, several animal models carrying variants in the titin gene have been developed and characterized to study the structural and mechanical properties of specific titin domains or to mimic patients' mutations. This review describes the main animal models so far characterized, including eight mice models and three fish models (Medaka and Zebrafish) and discusses the useful insights provided by a thorough characterization of the cell‐, tissue‐ and organism‐phenotypes in these models.
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Affiliation(s)
| | | | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
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22
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Johari M, Vihola A, Palmio J, Jokela M, Jonson PH, Sarparanta J, Huovinen S, Savarese M, Hackman P, Udd B. Comprehensive transcriptomic analysis shows disturbed calcium homeostasis and deregulation of T lymphocyte apoptosis in inclusion body myositis. J Neurol 2022; 269:4161-4173. [PMID: 35237874 PMCID: PMC9293871 DOI: 10.1007/s00415-022-11029-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [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: 10/15/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Inclusion body myositis (IBM) has an unclear molecular etiology exhibiting both characteristic inflammatory T-cell activity and rimmed-vacuolar degeneration of muscle fibers. Using in-depth gene expression and splicing studies, we aimed at understanding the different components of the molecular pathomechanisms in IBM. METHODS We performed RNA-seq on RNA extracted from skeletal muscle biopsies of clinically and histopathologically defined IBM (n = 24), tibial muscular dystrophy (n = 6), and histopathologically normal group (n = 9). In a comprehensive transcriptomics analysis, we analyzed the differential gene expression, differential splicing and exon usage, downstream pathway analysis, and the interplay between coding and non-coding RNAs (micro RNAs and long non-coding RNAs). RESULTS We observe dysregulation of genes involved in calcium homeostasis, particularly affecting the T-cell activity and regulation, causing disturbed Ca2+-induced apoptotic pathways of T cells in IBM muscles. Additionally, LCK/p56, which is an essential gene in regulating the fate of T-cell apoptosis, shows increased expression and altered splicing usage in IBM muscles. INTERPRETATION Our analysis provides a novel understanding of the molecular mechanisms in IBM by showing a detailed dysregulation of genes involved in calcium homeostasis and its effect on T-cell functioning in IBM muscles. Loss of T-cell regulation is hypothesized to be involved in the consistent observation of no response to immune therapies in IBM patients. Our results show that loss of apoptotic control of cytotoxic T cells could indeed be one component of their abnormal cytolytic activity in IBM muscles.
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Affiliation(s)
- Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland. .,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland.
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Neuromuscular Research Center, Department of Genetics, Fimlab Laboratories, Tampere, Finland
| | - Johanna Palmio
- Neuromuscular Research Center, Department of Neurology, Tampere University and University Hospital, Tampere, Finland
| | - Manu Jokela
- Neuromuscular Research Center, Department of Genetics, Fimlab Laboratories, Tampere, Finland.,Division of Clinical Neurosciences, Department of Neurology, Turku University Hospital, Turku, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Sanna Huovinen
- Department of Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical and Clinical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Neuromuscular Research Center, Department of Neurology, Tampere University and University Hospital, Tampere, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
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23
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Pichette É, O'Ferrall E, Karamchandani J, Savarese M, Udd B, Massie R. Scapuloperoneal syndrome with mitochondrial DNA deletion. J Neurol Sci 2022; 434:120164. [DOI: 10.1016/j.jns.2022.120164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 12/26/2021] [Accepted: 01/18/2022] [Indexed: 11/30/2022]
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24
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Cabrera-Serrano M, Caccavelli L, Savarese M, Vihola A, Jokela M, Johari M, Capiod T, Madrange M, Bugiardini E, Brady S, Quinlivan R, Merve A, Scalco R, Hilton-Jones D, Houlden H, Ibrahim Aydin H, Ceylaner S, Vockley J, Taylor RL, Folland C, Kelly A, Goullee H, Ylikallio E, Auranen M, Tyynismaa H, Udd B, Forrest ARR, Davis MR, Bratkovic D, Manton N, Robertson T, McCombe P, Laing NG, Phillips L, de Lonlay P, Ravenscroft G. Bi-allelic loss-of-function OBSCN variants predispose individuals to severe recurrent rhabdomyolysis. Brain 2021; 145:3985-3998. [DOI: 10.1093/brain/awab484] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/04/2021] [Accepted: 12/10/2021] [Indexed: 11/14/2022] Open
Abstract
Abstract
Rhabdomyolysis is the acute breakdown of skeletal myofibres in response to an initiating factor, most commonly toxins and over exertion. A variety of genetic disorders predispose to rhabdomyolysis through different pathogenic mechanisms, particularly in patients with recurrent episodes. However, most cases remain without a genetic diagnosis. Here we present six patients who presented with severe and recurrent rhabdomyolysis, usually with onset in the teenage years; other features included a history of myalgia and muscle cramps. We identified ten bi-allelic loss-of-function variants in the gene encoding obscurin (OBSCN) predisposing individuals to recurrent rhabdomyolysis. We show reduced expression of OBSCN and loss of obscurin protein in patient muscle. Obscurin is proposed to be involved in SR function and Ca2+ handling. Patient cultured myoblasts appear more susceptible to starvation as evidenced by a greater decreased in SR Ca2+ content compared to control myoblasts. This likely reflects a lower efficiency when pumping Ca2+ back into the SR and/or a decrease in Ca2+ SR storage ability when metabolism is diminished. OSBCN variants have previously been associated with cardiomyopathies. None of the patients presented with a cardiomyopathy and cardiac examinations were normal in all cases in which cardiac function was assessed. There was also no history of cardiomyopathy in first degree relatives, in particular in any of the carrier parents. This cohort is relatively young, thus follow-up studies and the identification of additional cases with bi-allelic null OBSCN variants will further delineate OBSCN-related disease and the clinical course of disease.
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Affiliation(s)
- Macarena Cabrera-Serrano
- Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
- Centre of Medical Research, University of Western Australia, Nedlands, WA, Australia
- Unidad de Enfermedades Neuromusculares. Servicio de Neurologia y Neurofisiologia. Hospital Virgen del Rocio, Sevilla, Spain
| | - Laure Caccavelli
- Inserm U1151, Institut Necker Enfants-Malades, Reference Center of Inherited Metabolic Diseases and MetabERN, Necker-Enfants-Malades Hospital, Paris University, Paris, France
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland and Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland and Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
| | - Manu Jokela
- Neuromuscular Research Center, Department of Neurology, Tampere University and University Hospital, Tampere, Finland
- Neurocenter, Department of Neurology, Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland and Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Thierry Capiod
- Inserm U1151, Institut Necker Enfants-Malades, Reference Center of Inherited Metabolic Diseases and MetabERN, Necker-Enfants-Malades Hospital, Paris University, Paris, France
| | - Marine Madrange
- Inserm U1151, Institut Necker Enfants-Malades, Reference Center of Inherited Metabolic Diseases and MetabERN, Necker-Enfants-Malades Hospital, Paris University, Paris, France
| | - Enrico Bugiardini
- Department of Neuromuscular Disorders, UCL Queen Square Institute of Neurology, London, UK
| | - Stefen Brady
- Department of Neurology, Southmead Hospital, Bristol, UK
| | - Rosaline Quinlivan
- MRC Centre for Neuromuscular Diseases, University College Hospitals, London, UK
| | - Ashirwad Merve
- MRC Centre for Neuromuscular Diseases, University College Hospitals, London, UK
| | - Renata Scalco
- MRC Centre for Neuromuscular Diseases, University College Hospitals, London, UK
| | - David Hilton-Jones
- Neurosciences Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Henry Houlden
- Department of Neuromuscular Disorders, UCL Queen Square Institute of Neurology, London, UK
| | | | - Serdar Ceylaner
- Intergen Genetic Diagnosis and Research Center, Ankara, Turkey
| | - Jerry Vockley
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Rhonda L. Taylor
- Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
- Centre of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - Chiara Folland
- Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
- Centre of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - Aasta Kelly
- Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
| | - Hayley Goullee
- Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
- Centre of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - Emil Ylikallio
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
| | - Mari Auranen
- Clinical Neurosciences, Neurology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Henna Tyynismaa
- Stem Cells and Metabolism Research Program, Faculty of Medicine, University of Helsinki, 00290 Helsinki, Finland
- Neuroscience Center, Helsinki Institute of Life Science, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland and Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Tampere Neuromuscular Center, Tampere University Hospital, Tampere, Finland
| | - Alistair R. R. Forrest
- Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
- Centre of Medical Research, University of Western Australia, Nedlands, WA, Australia
| | - Mark R. Davis
- Department of Diagnostic Genomics, PathWest Laboratory Medicine WA, Nedlands, WA, Australia
| | - Drago Bratkovic
- Metabolic Clinic, Women and Children’s Hospital, North Adelaide, SA, Australia
| | - Nicholas Manton
- SA Pathology, Women and Children’s Hospital, North Adelaide, SA, Australia
| | - Thomas Robertson
- Anatomical Pathology, Queensland Pathology, Brisbane, Queensland, Australia
| | - Pamela McCombe
- Department of Neurology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia
- Centre for Clinical Research, The University of Queensland Centre for Clinical Research, Brisbane, Queensland, Australia
| | - Nigel G. Laing
- Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
- Centre of Medical Research, University of Western Australia, Nedlands, WA, Australia
- Department of Diagnostic Genomics, PathWest Laboratory Medicine WA, Nedlands, WA, Australia
| | - Liza Phillips
- SA Pathology, Women and Children’s Hospital, North Adelaide, SA, Australia
- The University of Adelaide, Adelaide, SA, Australia
| | - Pascale de Lonlay
- Inserm U1151, Institut Necker Enfants-Malades, Reference Center of Inherited Metabolic Diseases and MetabERN, Necker-Enfants-Malades Hospital, Paris University, Paris, France
| | - Gianina Ravenscroft
- Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
- Centre of Medical Research, University of Western Australia, Nedlands, WA, Australia
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25
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Salih MA, Hamad MH, Savarese M, Alorainy IA, Al-Jarallah AS, Alkhalidi H, AlQudairy H, Albader A, Alotaibi AJ, Alsagob M, Al-Bakheet A, Colak D, Udd B, Kaya N. Exome Sequencing Reveals Novel TTN Variants in Saudi Patients with Congenital Titinopathies. Genet Test Mol Biomarkers 2021; 25:757-764. [DOI: 10.1089/gtmb.2021.0085] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Affiliation(s)
- Mustafa A. Salih
- Division of Pediatric Neurology, Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
| | - Muddathir H. Hamad
- Division of Pediatric Neurology, Department of Pediatrics, King Saud University, Riyadh, Saudi Arabia
| | - Marco Savarese
- The Folkhälsan Institute of Genetics and the Department of Medical Genetics, Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Ibrahim A. Alorainy
- Department of Radiology and Diagnostic Imaging, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Abdullah S. Al-Jarallah
- Pediatric Cardiology Division, Cardiac Science Department, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hisham Alkhalidi
- Department of Pathology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Hanan AlQudairy
- Translational Genomics Department, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, MBC: 03, Riyadh, Saudi Arabia
| | - Anoud Albader
- Translational Genomics Department, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, MBC: 03, Riyadh, Saudi Arabia
| | - Amal Jahz Alotaibi
- Translational Genomics Department, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, MBC: 03, Riyadh, Saudi Arabia
| | - Maysoon Alsagob
- Translational Genomics Department, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, MBC: 03, Riyadh, Saudi Arabia
| | - Albandary Al-Bakheet
- Translational Genomics Department, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, MBC: 03, Riyadh, Saudi Arabia
| | - Dilek Colak
- Biostatistics, Epidemiology, and Scientific Computing Department, MBC: 03, Riyadh, Saudi Arabia
| | - Bjarne Udd
- Tampere Neuromuscular Research Unit, The Folkhälsan Institute of Genetics and the Department of Medical Genetics, Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Namik Kaya
- Translational Genomics Department, Center for Genomic Medicine, King Faisal Specialist Hospital and Research Centre, MBC: 03, Riyadh, Saudi Arabia
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26
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Hackman P, Rusanen SM, Johari M, Vihola A, Jonson PH, Sarparanta J, Donner K, Lahermo P, Koivunen S, Luque H, Soininen M, Mahjneh I, Auranen M, Arumilli M, Savarese M, Udd B. Dominant Distal Myopathy 3 (MPD3) Caused by a Deletion in the HNRNPA1 Gene. Neurol Genet 2021; 7:e632. [PMID: 34722876 PMCID: PMC8552285 DOI: 10.1212/nxg.0000000000000632] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 12/15/2022]
Abstract
Background and Objectives To determine the genetic cause of the disease in the previously reported family with adult-onset autosomal dominant distal myopathy (myopathy, distal, 3; MPD3). Methods Continued clinical evaluation including muscle MRI and muscle pathology. A linkage analysis with single nucleotide polymorphism arrays and genome sequencing were used to identify the genetic defect, which was verified by Sanger sequencing. RNA sequencing was used to investigate the transcriptional effects of the identified genetic defect. Results Small hand muscles (intrinsic, thenar, and hypothenar) were first involved with spread to the lower legs and later proximal muscles. Dystrophic changes with rimmed vacuoles and cytoplasmic inclusions were observed in muscle biopsies at advanced stage. A single nucleotide polymorphism array confirmed the previous microsatellite-based linkage to 8p22-q11 and 12q13-q22. Genome sequencing of three affected family members combined with structural variant calling revealed a small heterozygous deletion of 160 base pairs spanning the second last exon 10 of the heterogeneous nuclear ribonucleoprotein A1 (HNRNPA1) gene, which is in the linked region on chromosome 12. Segregation of the mutation with the disease was confirmed by Sanger sequencing. RNA sequencing showed that the mutant allele produces a shorter mutant mRNA transcript compared with the wild-type allele. Immunofluorescence studies on muscle biopsies revealed small p62 and larger TDP-43 inclusions. Discussion A small exon 10 deletion in the gene HNRNPA1 was identified as the cause of MPD3 in this family. The new HNRNPA1-related phenotype, upper limb presenting distal myopathy, was thus confirmed, and the family displays the complexities of gene identification.
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Affiliation(s)
- Peter Hackman
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Salla M Rusanen
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Mridul Johari
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Anna Vihola
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Jaakko Sarparanta
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Kati Donner
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Päivi Lahermo
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Sampo Koivunen
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Helena Luque
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Merja Soininen
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Ibrahim Mahjneh
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Mari Auranen
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Meharji Arumilli
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Marco Savarese
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
| | - Bjarne Udd
- Folkhälsan Research Center (P.H., S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S., B.U.); University of Helsinki (S.M.R., M.J., A.V., P.H.J., J.S., S.K., H.L., M.S., M.A., M.S.), Helsinki; Finnish Neuromuscular Center, Fimlab Laboratories and Tampere University (A.V.); Institute for Molecular Medicine Finland (FIMM), University of Helsinki (K.D., P.L.); MRC, University of Oulu, Oulu (I.M.); Pietarsaari Hospital, Pietarsaari, Finland (I.M.); Clinical Neurosciences, Neurology, Helsinki University Hospital (M.A.); Vaasa Central Hospital (B.U.), Vaasa, Finland
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Riccardi MT, Savarese M, Acquati G, Nurchis MC, Sapienza M, Mastrilli V, Graps EA, Guendalina G, Damiani G. Promoting food literacy in type 2 diabetes: a systematic review. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.190] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Diabetes is one of the major global health threats whose burden is sharply increasing. Food literacy is proved to be relevant to optimize self-management in diabetic patients. The present review aims to map the current literature on educational interventions to promote food literacy in type 2 diabetes, with a particular focus on the concept of patient engagement.
Methods
Five databases were queried using the Population-Intervention-Context-Outcome (PICO) model. Individual study quality was assessed using the Quality Criteria Checklist for primary research provided by the American Diabetes Association. Data were summarized using descriptive statistic and a comparison between intervention carried out by a multidisciplinary team versus a single professionist was performed adopting a Chi-square test (p < 0.05 was deemed as statistically significant).
Results
Of 1580 articles, 28 were finally included. Outcome categories were narratively labelled as “clinical”, “psychological”, “behavioural” and “literacy”. When the provider was a multidisciplinary team (25% of studies) improvement in self-management occurred in 86% of cases while in single-provider intervention the percentage was 71%, but the difference was not significant (p = 0.45). In the 10.7% of articles the use of technologies was reported, but generically descripted as the use of webpages, email or social media. Globally, an improvement in food literacy was reported in 75% of the interventions.
Conclusions
Nowadays, the use of a technology proxy is recognized as an efficient support in boosting patients' education, but the evidence in improving food literacy is scarce and difficult to compare. Public health programs improving food literacy are effective at different levels. These findings should encourage decision makers to allocate resources in this kind of programs.
Key messages
Engaging people in the management of their disease by increasing food literacy level may represent a first step to reach the “health in all policies” approach. When planning a public health intervention, allocating resources for improving individual’s education is essential to achieve better health outcomes.
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Affiliation(s)
- MT Riccardi
- Department of Life science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - M Savarese
- EngageMinds HUB-Consumer, Food & Health Engagement Research, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
| | - G Acquati
- Faculty of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - MC Nurchis
- Department of Woman and child health and Public Health, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
| | - M Sapienza
- Department of Life science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - V Mastrilli
- DGPrev. Ufficio 8, Ministero della Salute, Rome, Italy
| | - EA Graps
- Area Valutazione e Ricerca, A.Re.S.S. Puglia, Bari, Italy
| | - G Guendalina
- EngageMinds HUB-Consumer, Food & Health Engagement Research, Università Cattolica del Sacro Cuore, Milan, Italy
- Faculty of Agriculture, Food and Environmental Sciences, Università Cattolica del Sacro Cuore, Milan, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Milan, Italy
| | - G Damiani
- Department of Life science and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
- Department of Woman and child health and Public Health, Fondazione Policlinico Universitario A.Gemelli IRCCS, Rome, Italy
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28
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Savarese M, Sapienza M, Acquati GM, Nurchis MC, Riccardi MT, Mastrilli V, D’Elia R, Graps EA, Graffigna G, Damiani G. Educational Interventions for Promoting Food Literacy and Patient Engagement in Preventing Complications of Type 2 Diabetes: A Systematic Review. J Pers Med 2021; 11:jpm11080795. [PMID: 34442439 PMCID: PMC8399193 DOI: 10.3390/jpm11080795] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 06/25/2021] [Revised: 08/09/2021] [Accepted: 08/12/2021] [Indexed: 01/02/2023] Open
Abstract
The present review aims to map the current literature on educational interventions to promote food literacy in type 2 diabetes, with a particular focus on the concept of patient engagement. The systematic review was implemented on five databases with no restrictions on the publication year. The studies selected for the review were focused on patients with type 2 diabetes, ranging from 2003 to 2021 and published in 13 countries (44% USA). Thirty-three articles were analyzed. Twenty-seven articles targeted singular patients; fifteen articles conceptualized patient engagement as self-management. In seven articles, the provider is a multidisciplinary team. Twenty articles did not report a theoretical framework in the intervention development, and eleven did not use an intervention material. Twenty-six articles did not use a technology proxy. Outcome categories were narratively mapped into four areas: clinical, psychological, behavioral, and literacy. To date, most of the interventions are heterogeneous in the adopted methodology, measures, and outcomes considered. More attention should be given to the psychosocial characterization of patient engagement as well as the technological support. High-quality, randomized controlled trials and longitudinal studies are lacking and need to be conducted to verify the efficacy of these insights.
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Affiliation(s)
- M. Savarese
- EngageMinds HUB–Consumer Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Largo A.Gemelli 1, 20123 Milano, Italy; (M.S.); (G.G.)
- Faculty of Agriculture Food and Environmental Sciences, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
| | - M. Sapienza
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.S.); (G.D.)
| | - G. M. Acquati
- Faculty of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy;
| | - M. C. Nurchis
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A.Gemelli IRCCS, Largo A.Gemelli 8, 00168 Rome, Italy;
| | - M. T. Riccardi
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.S.); (G.D.)
- Correspondence: ; Tel.: +39-06-3015-4396
| | - V. Mastrilli
- Ministero Della Salute, Direzione Generale della Prevenzione, Ufficio 8-Promozione Salute e Prevenzione Controllo Malattie Cronico-Degenerative, 20123 Milano, Italy; (V.M.); (R.D.)
| | - R. D’Elia
- Ministero Della Salute, Direzione Generale della Prevenzione, Ufficio 8-Promozione Salute e Prevenzione Controllo Malattie Cronico-Degenerative, 20123 Milano, Italy; (V.M.); (R.D.)
| | - E. A. Graps
- A.Re.S.S. Puglia-Agenzia Regionale Strategica per la Salute ed il Sociale Area Valutazione e Ricerca, 20123 Milano, Italy;
| | - G. Graffigna
- EngageMinds HUB–Consumer Food & Health Engagement Research Center, Università Cattolica del Sacro Cuore, Largo A.Gemelli 1, 20123 Milano, Italy; (M.S.); (G.G.)
- Faculty of Agriculture Food and Environmental Sciences, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A.Gemelli 1, 20123 Milano, Italy
| | - G. Damiani
- Department of Health Sciences and Public Health, Section of Hygiene, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (M.S.); (G.D.)
- Department of Woman and Child Health and Public Health, Fondazione Policlinico Universitario A.Gemelli IRCCS, Largo A.Gemelli 8, 00168 Rome, Italy;
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29
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Savarese M, Vihola A, Jokela ME, Huovinen SP, Gerevini S, Torella A, Johari M, Scarlato M, Jonson PH, Onore ME, Hackman P, Gautel M, Nigro V, Previtali SC, Udd B. Out-of-Frame Mutations in ACTN2 Last Exon Cause a Dominant Distal Myopathy With Facial Weakness. Neurol Genet 2021; 7:e619. [PMID: 34386585 PMCID: PMC8356702 DOI: 10.1212/nxg.0000000000000619] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 07/01/2021] [Indexed: 11/18/2022]
Abstract
Background and Objectives To clinically, genetically, and histopathologically characterize patients presenting with an unusual combination of distal myopathy and facial weakness, without involvement of upper limb or shoulder girdle muscles. Methods Two families with a novel form of actininopathy were identified. Patients had been followed up over 10 years. Their molecular genetic diagnosis was not clear after extensive investigations, including analysis of candidate genes and FSHD1-related D4Z4 repeats. Results Patients shared a similar clinical phenotype and a common pattern of muscle involvement. They presented with a very slowly progressive myopathy involving anterior lower leg and facial muscles. Muscle MRI finding showed complete fat replacement of anterolateral compartment muscles of the lower legs with variable involvement of soleus and gastrocnemius but sparing thigh muscles. Muscle biopsy showed internalized nuclei, myofibrillar disorganization, and rimmed vacuoles. High-throughput sequencing identified in each proband a heterozygous single nucleotide deletion (c.2558del and c.2567del) in the last exon of the ACTN2 gene. The deletions are predicted to lead to a novel but unstructured slightly extended C-terminal amino acid sequence. Discussion Our findings indicate an unusual form of actininopathy with specific molecular and clinical features. Actininopathy should be considered in the differential diagnosis of distal myopathy combined with facial weakness.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Anna Vihola
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Manu E Jokela
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Sanna Pauliina Huovinen
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Simonetta Gerevini
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Annalaura Torella
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Mridul Johari
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Marina Scarlato
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Maria Elena Onore
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Peter Hackman
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Mathias Gautel
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Vincenzo Nigro
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Stefano Carlo Previtali
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
| | - Bjarne Udd
- Folkhälsan Research Center (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Helsinki; Department of Medical Genetics (M. Savarese, A.V., M.J., P.H.J., P.H., B.U.), Medicum, University of Helsinki; Neuromuscular Research Center (A.V.), Department of Genetics, Fimlab Laboratories, Tampere; Division of Clinical Neurosciences (M.E.J.), Department of Neurology, Turku University and University Hospital; Neuromuscular Research Center (S.P.H.), Department of Pathology, Fimlab Laboratories, Tampere, Finland; Neuroradiology Unit (S.G.), ASST Papa Giovanni XXIII, Bergamo; Dipartimento di Medicina di Precisione (A.T., M.E.O., V.N.), Università degli Studi della Campania "Luigi Vanvitelli," Napoli; Telethon Institute of Genetics and Medicine (A.T., V.N.), Pozzuoli; Division of Neuroscience and U.O. Neurologia (M. Scarlato, S.C.P.), IRCCS Ospedale San Raffaele, Milano, Italy; Randall Centre for Cell and Molecular Biophysics (M.G.), King's College London BHF Centre of Research Excellence, United Kingdom; Department of Neurology (B.U.), Vaasa Central Hospital; and Neuromuscular Research Center (M.E.J., B.U.), Department of Neurology, Tampere University and University Hospital, Finland
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30
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Johari M, Sarparanta J, Vihola A, Jonson PH, Savarese M, Jokela M, Torella A, Piluso G, Said E, Vella N, Cauchi M, Magot A, Magri F, Mauri E, Kornblum C, Reimann J, Stojkovic T, Romero NB, Luque H, Huovinen S, Lahermo P, Donner K, Comi GP, Nigro V, Hackman P, Udd B. Missense mutations in small muscle protein X-linked (SMPX) cause distal myopathy with protein inclusions. Acta Neuropathol 2021; 142:375-393. [PMID: 33974137 PMCID: PMC8270885 DOI: 10.1007/s00401-021-02319-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 01/05/2023]
Abstract
Using
deep phenotyping and high-throughput sequencing, we have identified a novel type of distal myopathy caused by mutations in the Small muscle protein X-linked (SMPX) gene. Four different missense mutations were identified in ten patients from nine families in five different countries, suggesting that this disease could be prevalent in other populations as well. Haplotype analysis of patients with similar ancestry revealed two different founder mutations in Southern Europe and France, indicating that the prevalence in these populations may be higher. In our study all patients presented with highly similar clinical features: adult-onset, usually distal more than proximal limb muscle weakness, slowly progressing over decades with preserved walking. Lower limb muscle imaging showed a characteristic pattern of muscle involvement and fatty degeneration. Histopathological and electron microscopic analysis of patient muscle biopsies revealed myopathic findings with rimmed vacuoles and the presence of sarcoplasmic inclusions, some with amyloid-like characteristics. In silico predictions and subsequent cell culture studies showed that the missense mutations increase aggregation propensity of the SMPX protein. In cell culture studies, overexpressed SMPX localized to stress granules and slowed down their clearance.
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Affiliation(s)
- Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland.
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland.
| | - Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Neuromuscular Research Center, Fimlab Laboratories, Tampere University and University Hospital, Tampere, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Manu Jokela
- Neuromuscular Research Center, Department of Neurology, Tampere University and University Hospital, Tampere, Finland
- Division of Clinical Neurosciences, Department of Neurology, Turku University Hospital, Turku, Finland
| | - Annalaura Torella
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Giulio Piluso
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Edith Said
- Section of Medical Genetics, Mater Dei Hospital, Msida, Malta
- Department of Anatomy and Cell Biology, Faculty of Medicine and Surgery, University of Malta, Msida, Malta
| | - Norbert Vella
- Neuroscience Department, Mater Dei Hospital, Msida, Malta
| | - Marija Cauchi
- Neuroscience Department, Mater Dei Hospital, Msida, Malta
| | - Armelle Magot
- Neuromuscular Disease Center AOC, University Hospital Nantes, Nantes, France
| | - Francesca Magri
- IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | - Eleonora Mauri
- IRCCS Foundation Ca' Granda Ospedale Maggiore Policlinico, Neurology Unit, Milan, Italy
| | | | - Jens Reimann
- Department of Neurology, University Hospital Bonn, Bonn, Germany
| | - Tanya Stojkovic
- AP-HP, Institute of Myology, Centre de Référence des Maladies Neuromusculaires, Hôpital Pitié-Salpêtrière, Paris, France
| | - Norma B Romero
- Neuromuscular Morphology Unit, Institute of Myology, Myology Research Centre INSERM, Sorbonne Université, Hôpital Pitié-Salpêtrière, Paris, France
| | - Helena Luque
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Sanna Huovinen
- Department of Pathology, Fimlab Laboratories, Tampere University Hospital, Tampere, Finland
| | - Päivi Lahermo
- Institute for Molecular Medicine Finland FIMM, Technology Centre, University of Helsinki, Helsinki, Finland
| | - Kati Donner
- Institute for Molecular Medicine Finland FIMM, Technology Centre, University of Helsinki, Helsinki, Finland
| | - Giacomo Pietro Comi
- IRCCS Fondazione Ca' Granda Ospedale Maggiore Policlinico, Neuromuscular and Rare Disease Unit, Milan, Italy
- Dino Ferrari Center, Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Vincenzo Nigro
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Neuromuscular Research Center, Department of Neurology, Tampere University and University Hospital, Tampere, Finland
- Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
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31
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Savarese M, Qureshi T, Torella A, Laine P, Giugliano T, Jonson PH, Johari M, Paulin L, Piluso G, Auvinen P, Nigro V, Udd B, Hackman P. Identification and Characterization of Splicing Defects by Single-Molecule Real-Time Sequencing Technology (PacBio). J Neuromuscul Dis 2021; 7:477-481. [PMID: 32597815 DOI: 10.3233/jnd-200523] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although DNA-sequencing is the most effective procedure to achieve a molecular diagnosis in genetic diseases, complementary RNA analyses are often required.Reverse-Transcription polymerase chain reaction (RT-PCR) is still a valuable option when the clinical phenotype and/or available DNA-test results address the diagnosis toward a gene of interest or when the splicing effect of a single variant needs to be assessed.We use Single-Molecule Real-Time sequencing to detect and characterize splicing defects and single nucleotide variants in well-known disease genes (DMD, NF1, TTN). After proper optimization, the procedure could be used in the diagnostic setting, simplifying the workflow of cDNA analysis.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Talha Qureshi
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Annalaura Torella
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Pia Laine
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Teresa Giugliano
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Lars Paulin
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Giulio Piluso
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy
| | - Petri Auvinen
- Institute of Biotechnology, University of Helsinki, Helsinki, Finland
| | - Vincenzo Nigro
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Vaasa Central Hospital, Vaasa, Finland
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
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Petrucci A, Primiano G, Savarese M, Sancricca C, Udd B, Servidei S. Novel TNNT1 mutation and mild nemaline myopathy phenotype in an Italian patient. Neuromuscul Disord 2021; 31:532-538. [PMID: 33832840 DOI: 10.1016/j.nmd.2021.03.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 02/15/2021] [Accepted: 03/01/2021] [Indexed: 12/19/2022]
Abstract
Mutations in the TNNT1 gene cause an infantile, lethal form of myopathy named "Amish" Nemaline Myopathy. Adult patients are very rarely described. We report a 49-year-old patient who presented a slowly progressive phenotype characterized by myalgia, exercise intolerance and dyspnea since infancy. In adult life she lapsed into a coma as a result of acute respiratory failure, with the need of tracheostomy, subsequently removed once her respiratory condition improved. Afterwards, non-invasive ventilation was started. Short stature, contractures, a small size posterior cranial fossa and osteonecrosis were additional clinical findings. Muscle MRI showed minor hypotrophy and degenerative changes of the muscles of the posterior thigh compartment and involvement of the paraspinal, medial gastrocnemius and soleus muscles with sparing of the gracilis muscle. Muscle biopsy revealed multiminicores and nemaline rods. Genetic analysis identified a new pathogenetic biallelic deletion c.786delG p.(Lys263Serfs*36) in exon 13 of TNNT1 gene. This case confirms that recessive mutations in TNNT1 gene can manifest mainly with respiratory failure in adult life.
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Affiliation(s)
- Antonio Petrucci
- Center for Neuromuscular and Neurological Rare Diseases, Neuroscience Department, San Camillo-Forlanini Hospital, Rome, Italy
| | - Guido Primiano
- UOC Neurofisiopatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, Rome 00168, Italy; Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, Roma, Italy.
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland; Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Cristina Sancricca
- UOC Neurofisiopatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, Rome 00168, Italy; Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, Roma, Italy
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland; Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland; Neuromuscular Research Center, Tampere University and University Hospital, Tampere, Finland; Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
| | - Serenella Servidei
- UOC Neurofisiopatologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, Rome 00168, Italy; Dipartimento Universitario di Neuroscienze, Università Cattolica del Sacro Cuore, Roma, Italy
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Abstract
Human genes have a variable length. Those having a coding sequence of extraordinary length and a high number of exons were almost impossible to sequence using the traditional Sanger-based gene-by-gene approach. High-throughput sequencing has partly overcome the size-related technical issues, enabling a straightforward, rapid and relatively inexpensive analysis of large genes. Several large genes (e.g. TTN, NEB, RYR1, DMD) are recognized as disease-causing in patients with skeletal muscle diseases. However, because of their sheer size, the clinical interpretation of variants in these genes is probably the most challenging aspect of the high-throughput genetic investigation in the field of skeletal muscle diseases. The main aim of this review is to discuss the technical and interpretative issues related to the diagnostic investigation of large genes and to reflect upon the current state of the art and the future advancements in the field.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Salla Välipakka
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Neuromuscular Research Center, Tampere University and University Hospital, Tampere, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
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Savarese M, Sarparanta J, Vihola A, Jonson PH, Johari M, Rusanen S, Hackman P, Udd B. Panorama of the distal myopathies. Acta Myol 2020; 39:245-265. [PMID: 33458580 PMCID: PMC7783427 DOI: 10.36185/2532-1900-028] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022]
Abstract
Distal myopathies are genetic primary muscle disorders with a prominent weakness at onset in hands and/or feet. The age of onset (from early childhood to adulthood), the distribution of muscle weakness (upper versus lower limbs) and the histological findings (ranging from nonspecific myopathic changes to myofibrillar disarrays and rimmed vacuoles) are extremely variable. However, despite being characterized by a wide clinical and genetic heterogeneity, the distal myopathies are a category of muscular dystrophies: genetic diseases with progressive loss of muscle fibers. Myopathic congenital arthrogryposis is also a form of distal myopathy usually caused by focal amyoplasia. Massive parallel sequencing has further expanded the long list of genes associated with a distal myopathy, and contributed identifying as distal myopathy-causative rare variants in genes more often related with other skeletal or cardiac muscle diseases. Currently, almost 20 genes (ACTN2, CAV3, CRYAB, DNAJB6, DNM2, FLNC, HNRNPA1, HSPB8, KHLH9, LDB3, MATR3, MB, MYOT, PLIN4, TIA1, VCP, NOTCH2NLC, LRP12, GIPS1) have been associated with an autosomal dominant form of distal myopathy. Pathogenic changes in four genes (ADSSL, ANO5, DYSF, GNE) cause an autosomal recessive form; and disease-causing variants in five genes (DES, MYH7, NEB, RYR1 and TTN) result either in a dominant or in a recessive distal myopathy. Finally, a digenic mechanism, underlying a Welander-like form of distal myopathy, has been recently elucidated. Rare pathogenic mutations in SQSTM1, previously identified with a bone disease (Paget disease), unexpectedly cause a distal myopathy when combined with a common polymorphism in TIA1. The present review aims at describing the genetic basis of distal myopathy and at summarizing the clinical features of the different forms described so far.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Neuromuscular Research Center, Department of Genetics, Fimlab Laboratories, Tampere, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Salla Rusanen
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland
- Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
- Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
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35
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Savarese M, Johari M, Johnson K, Arumilli M, Torella A, Töpf A, Rubegni A, Kuhn M, Giugliano T, Gläser D, Fattori F, Thompson R, Penttilä S, Lehtinen S, Gibertini S, Ruggieri A, Mora M, Maver A, Peterlin B, Mankodi A, Lochmüller H, Santorelli FM, Schoser B, Fajkusová L, Straub V, Nigro V, Hackman P, Udd B. Improved Criteria for the Classification of Titin Variants in Inherited Skeletal Myopathies. J Neuromuscul Dis 2020; 7:153-166. [PMID: 32039858 DOI: 10.3233/jnd-190423] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Extensive genetic screening results in the identification of thousands of rare variants that are difficult to interpret. Because of its sheer size, rare variants in the titin gene (TTN) are detected frequently in any individual. Unambiguous interpretation of molecular findings is almost impossible in many patients with myopathies or cardiomyopathies. OBJECTIVE To refine the current classification framework for TTN-associated skeletal muscle disorders and standardize the interpretation of TTN variants. METHODS We used the guidelines issued by the American College of Medical Genetics and Genomics (ACMG) and the Association for Molecular Pathology (AMP) to re-analyze TTN genetic findings from our patient cohort. RESULTS We identified in the classification guidelines three rules that are not applicable to titin-related skeletal muscle disorders; six rules that require disease-/gene-specific adjustments and four rules requiring quantitative thresholds for a proper use. In three cases, the rule strength need to be modified. CONCLUSIONS We suggest adjustments are made to the guidelines. We provide frequency thresholds to facilitate filtering of candidate causative variants and guidance for the use and interpretation of functional data and co-segregation evidence. We expect that the variant classification framework for TTN-related skeletal muscle disorders will be further improved along with a better understanding of these diseases.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Katherine Johnson
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Meharji Arumilli
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Annalaura Torella
- Dipartimento di Medicina di Precisione, Universitá degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Ana Töpf
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Teresa Giugliano
- Dipartimento di Medicina di Precisione, Universitá degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | | | - Fabiana Fattori
- Unit for Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, Rome, Italy
| | - Rachel Thompson
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Sini Penttilä
- Neuromuscular Research Center, Department of Genetics, Fimlab Laboratories, Tampere, Finland
| | - Sara Lehtinen
- Neuromuscular Research Center, Department of Genetics, Fimlab Laboratories, Tampere, Finland
| | - Sara Gibertini
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Alessandra Ruggieri
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.,Department of Molecular and Translation Medicine, Unit of Biology and Genetics, University of Brescia, Brescia, Italy
| | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Ales Maver
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ami Mankodi
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, Unites States
| | - Hanns Lochmüller
- Department of Neuropediatrics and Muscle Disorders, Medical Center - University of Freiburg, Faculty of Medicine, Freiburg, Germany.,Centro Nacional de Análisis Genómico (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Spain.,Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada.,Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Canada
| | | | - Benedikt Schoser
- Friedrich-Baur-Institut, Neurologische Klinik Ludwig-Maximilians-Universität München, Munich, Germany
| | - Lenka Fajkusová
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic
| | - Volker Straub
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Vincenzo Nigro
- Dipartimento di Medicina di Precisione, Universitá degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland.,Neuromuscular Research Center, Tampere University and University Hospital, Tampere, Finland
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36
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Johari M, Savarese M, Vihola A, Jokela M, Torella A, Piluso G, Jonson P, Luque H, Magot A, Magri F, Kornblum C, Stojkovic T, Romero N, Lahermo P, Donner K, Nigro V, Hackman P, Udd B. NEW GENES IN NEUROMUSCULAR DISEASES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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37
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Johari M, Savarese M, Jonson P, Koivunen S, Udd B, Hackman P. NEW GENES AND DISEASES / NGS & RELATED TECHNIQUES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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38
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Lehtonen J, Johari M, Almusa H, Lehesjoki A, Wartiovaara K, Saarela J, Hackman P, Wallgren-Pettersson C, Udd B, Lehtokari V, Pelin K, Savarese M. OMICs AND AI APPROACHES FOR MUSCLE DISEASES. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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39
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Graffigna G, Barello S, Palamenghi L, Savarese M, Castellini G. Patient health engagement model: explaining citizens noncompliance and maladaptive behaviors. Eur J Public Health 2020. [PMCID: PMC7543550 DOI: 10.1093/eurpub/ckaa166.620] [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] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background At the end of February 2020 a new case was diagnosed with COVID-19 in north Italy, suddenly followed by new cases. Italian health authorities decided to enforce restrictive measures. Northern areas of Italy were identified as “red areas” to slow down the epidemic and its impact on the healthcare system. From this perspective, the COVID-19 epidemic in Italy constitutes a testing ground for the assessment of the ability of consumers to cope with this health risk. Methods A cross-sectional study on a representative sample of 1000 Italian citizens was conducted over the period 27 February- 5 March exploring the following hypotheses: 1) less engaged individuals are more concerned for the health emergency and feel more vulnerable; 2) less engaged have higher probability to develop negative attitudes and dysfunctional behaviors. Results only the 16% the interviewees presented a high level of engagement. Lower levels of engagement were measured in the southern parts of Italy (not yet touched by the epidemics at the time of data collection). People with lowers levels of engagement reported higher fears for the contagion and sense of vulnerability. Furthermore, they showed the lower levels of trust in the Public Health Authorities, in medical research and in vaccines. Finally, they appeared more dismissive in their preventive behaviors and more disorganized in the fruition of the healthcare services. Conclusions A psychological analysis of processes of attitudinal and role change in the direction of becoming more engaged in health prevention is worthy in order to forecast potential dysfunctional reactions to restrictive health prevention measures and to orient personalized education initiatives to consumers with different level of engagement. Key messages Profiling based on the levels of health engagement is important in order to plan more effective healthcare measures during epidemics. Targeted educational initiatives should take into account citizens' engagement profiles.
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Affiliation(s)
- G Graffigna
- EngageMinds HUB Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - S Barello
- EngageMinds HUB Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - L Palamenghi
- EngageMinds HUB Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - M Savarese
- EngageMinds HUB Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
| | - G Castellini
- EngageMinds HUB Research Center, Università Cattolica del Sacro Cuore, Milan, Italy
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40
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Torella A, Zanobio M, Zeuli R, del Vecchio Blanco F, Savarese M, Giugliano T, Garofalo A, Piluso G, Politano L, Nigro V. The position of nonsense mutations can predict the phenotype severity: A survey on the DMD gene. PLoS One 2020; 15:e0237803. [PMID: 32813700 PMCID: PMC7437896 DOI: 10.1371/journal.pone.0237803] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 08/03/2020] [Indexed: 12/23/2022] Open
Abstract
A nonsense mutation adds a premature stop signal that hinders any further translation of a protein-coding gene, usually resulting in a null allele. To investigate the possible exceptions, we used the DMD gene as an ideal model. First, because dystrophin absence causes Duchenne muscular dystrophy (DMD), while its reduction causes Becker muscular dystrophy (BMD). Second, the DMD gene is X-linked and there is no second allele that can interfere in males. Third, databases are accumulating reports on many mutations and phenotypic data. Finally, because DMD mutations may have important therapeutic implications. For our study, we analyzed large databases (LOVD, HGMD and ClinVar) and literature and revised critically all data, together with data from our internal patients. We totally collected 2593 patients. Positioning these mutations along the dystrophin transcript, we observed a nonrandom distribution of BMD-associated mutations within selected exons and concluded that the position can be predictive of the phenotype. Nonsense mutations always cause DMD when occurring at any point in fifty-one exons. In the remaining exons, we found milder BMD cases due to early 5’ nonsense mutations, if reinitiation can occur, or due to late 3’ nonsense when the shortened product retains functionality. In the central part of the gene, all mutations in some in-frame exons, such as in exons 25, 31, 37 and 38 cause BMD, while mutations in exons 30, 32, 34 and 36 cause DMD. This may have important implication in predicting the natural history and the efficacy of therapeutic use of drug-stimulated translational readthrough of premature termination codons, also considering the action of internal natural rescuers. More in general, our survey confirm that a nonsense mutation should be not necessarily classified as a null allele and this should be considered in genetic counselling.
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Affiliation(s)
- Annalaura Torella
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
| | - Mariateresa Zanobio
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Roberta Zeuli
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | | | - Marco Savarese
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
- Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Teresa Giugliano
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Arcomaria Garofalo
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Giulio Piluso
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Luisa Politano
- Dipartimento di Medicina Sperimentale, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
| | - Vincenzo Nigro
- Dipartimento di Medicina di Precisione, Università degli Studi della Campania “Luigi Vanvitelli”, Napoli, Italy
- Telethon Institute of Genetics and Medicine (TIGEM), Pozzuoli, Italy
- * E-mail:
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41
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Välipakka S, Savarese M, Sagath L, Arumilli M, Giugliano T, Udd B, Hackman P. Improving Copy Number Variant Detection from Sequencing Data with a Combination of Programs and a Predictive Model. J Mol Diagn 2020; 22:40-49. [DOI: 10.1016/j.jmoldx.2019.08.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 06/25/2019] [Accepted: 08/08/2019] [Indexed: 12/18/2022] Open
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42
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Bryen SJ, Ewans LJ, Pinner J, MacLennan SC, Donkervoort S, Castro D, Töpf A, O'Grady G, Cummings B, Chao KR, Weisburd B, Francioli L, Faiz F, Bournazos AM, Hu Y, Grosmann C, Malicki DM, Doyle H, Witting N, Vissing J, Claeys KG, Urankar K, Beleza-Meireles A, Baptista J, Ellard S, Savarese M, Johari M, Vihola A, Udd B, Majumdar A, Straub V, Bönnemann CG, MacArthur DG, Davis MR, Cooper ST. Recurrent TTN metatranscript-only c.39974-11T>G splice variant associated with autosomal recessive arthrogryposis multiplex congenita and myopathy. Hum Mutat 2019; 41:403-411. [PMID: 31660661 DOI: 10.1002/humu.23938] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 10/01/2019] [Accepted: 10/24/2019] [Indexed: 12/12/2022]
Abstract
We present eight families with arthrogryposis multiplex congenita and myopathy bearing a TTN intron 213 extended splice-site variant (NM_001267550.1:c.39974-11T>G), inherited in trans with a second pathogenic TTN variant. Muscle-derived RNA studies of three individuals confirmed mis-splicing induced by the c.39974-11T>G variant; in-frame exon 214 skipping or use of a cryptic 3' splice-site effecting a frameshift. Confounding interpretation of pathogenicity is the absence of exons 213-217 within the described skeletal muscle TTN N2A isoform. However, RNA-sequencing from 365 adult human gastrocnemius samples revealed that 56% specimens predominantly include exons 213-217 in TTN transcripts (inclusion rate ≥66%). Further, RNA-sequencing of five fetal muscle samples confirmed that 4/5 specimens predominantly include exons 213-217 (fifth sample inclusion rate 57%). Contractures improved significantly with age for four individuals, which may be linked to decreased expression of pathogenic fetal transcripts. Our study extends emerging evidence supporting a vital developmental role for TTN isoforms containing metatranscript-only exons.
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Affiliation(s)
- Samantha J Bryen
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Lisa J Ewans
- Department of Medical Genomics, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.,Central Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Jason Pinner
- Department of Medical Genomics, Royal Prince Alfred Hospital, Camperdown, New South Wales, Australia.,Centre for Clinical Genetics, Sydney Children's Hospital, Randwick, NSW, 2031, Australia
| | - Suzanna C MacLennan
- Neurology Department, Women's and Children's Hospital, North Adelaide, South Australia, Australia.,School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia
| | - Sandra Donkervoort
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Diana Castro
- Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ana Töpf
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Gina O'Grady
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Beryl Cummings
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts.,Center for Mendelian Genomics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts.,Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Katherine R Chao
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts.,Center for Mendelian Genomics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts.,Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Ben Weisburd
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts.,Center for Mendelian Genomics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts.,Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Laurent Francioli
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts.,Center for Mendelian Genomics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts.,Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Fathimath Faiz
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, Nedlands, WA, Australia
| | - Adam M Bournazos
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia
| | - Ying Hu
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Carla Grosmann
- Department of Neurology, Rady Children's Hospital University of California San Diego, San Diego, California
| | - Denise M Malicki
- Department of Pathology, Rady Children's Hospital University of California San Diego, San Diego, California
| | - Helen Doyle
- Department of Histopathology, The Children's Hospital at Westmead, Sydney Children's Hospital Network, Westmead, NSW, Australia
| | - Nanna Witting
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - John Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, Experimental Neurology, KU Leuven-University of Leuven, Leuven, Belgium
| | - Kathryn Urankar
- Department of Neuropathology, Southmead Hospital, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Ana Beleza-Meireles
- Clinical Genetics, Bristol Royal Hospital For Children, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Julia Baptista
- Molecular Genetics Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom.,Institute of Biomedical and Clinical Science, University of Exeter Medical School University of Exeter, Exeter, United Kingdom
| | - Sian Ellard
- Molecular Genetics Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, United Kingdom.,Institute of Biomedical and Clinical Science, University of Exeter Medical School University of Exeter, Exeter, United Kingdom
| | - Marco Savarese
- Folkhälsan Research Center, Medicum, University of Helsinki, Haartmaninkatu 8, Helsinki, 00290, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Medicum, University of Helsinki, Haartmaninkatu 8, Helsinki, 00290, Finland
| | - Anna Vihola
- Folkhälsan Research Center, Medicum, University of Helsinki, Haartmaninkatu 8, Helsinki, 00290, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Medicum, University of Helsinki, Haartmaninkatu 8, Helsinki, 00290, Finland.,Tampere Neuromuscular Center, Tampere University Hospital, Teiskontie 35, Tampere, 33520, Finland
| | - Anirban Majumdar
- Paediatric Neurology, Bristol Royal Hospital For Children, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Carsten G Bönnemann
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
| | - Daniel G MacArthur
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, Massachusetts.,Center for Mendelian Genomics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts.,Program in Medical and Population Genetics, Broad Institute of Massachusetts Institute of Technology and Harvard, Cambridge, Massachusetts
| | - Mark R Davis
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, Nedlands, WA, Australia
| | - Sandra T Cooper
- Kids Neuroscience Centre, Kids Research, Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Discipline of Child and Adolescent Health, The University of Sydney Children's Hospital Westmead Clinical School, Westmead, New South Wales, Australia.,Functional Neuromics, The Children's Medical Research Institute, Westmead, New South Wales, Australia
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Palmio J, Jonson PH, Inoue M, Sarparanta J, Bengoechea R, Savarese M, Vihola A, Jokela M, Nakagawa M, Noguchi S, Olivé M, Masingue M, Kerty E, Hackman P, Weihl CC, Nishino I, Udd B. Mutations in the J domain of DNAJB6 cause dominant distal myopathy. Neuromuscul Disord 2019; 30:38-46. [PMID: 31955980 DOI: 10.1016/j.nmd.2019.11.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 08/26/2019] [Revised: 11/13/2019] [Accepted: 11/15/2019] [Indexed: 01/28/2023]
Abstract
Eight patients from five families with undiagnosed dominant distal myopathy underwent clinical, neurophysiological and muscle biopsy examinations. Molecular genetic studies were performed using targeted sequencing of all known myopathy genes followed by segregation of the identified mutations in the affected families using Sanger sequencing. Two novel mutations in DNAJB6 J domain, c.149C>T (p.A50V) and c.161A>C (p.E54A), were identified as the cause of disease. The muscle involvement with p.A50V was distal calf-predominant, and the p.E54A was more proximo-distal. Histological findings were similar to those previously reported in DNAJB6 myopathy. In line with reported pathogenic mutations in the glycine/phenylalanine (G/F) domain of DNAJB6, both the novel mutations showed reduced anti-aggregation capacity by filter trap assay and TDP-43 disaggregation assays. Modeling of the protein showed close proximity of the mutated residues with the G/F domain. Myopathy-causing mutations in DNAJB6 are not only located in the G/F domain, but also in the J domain. The identified mutations in the J domain cause dominant distal and proximo-distal myopathy, confirming that mutations in DNAJB6 should be considered in distal myopathy cases.
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Affiliation(s)
- Johanna Palmio
- Neuromuscular Research Center, Tampere University Hospital and Tampere University, P.O. box 100, FIN-33014 Tampere, Finland.
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland and University of Helsinki, Medicum, Helsinki, Finland
| | - Michio Inoue
- National Center of Neurology and Psychiatry (NCNP), Department of Neuromuscular Research, National Institute of Neuroscience, Tokyo, Japan
| | - Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland and University of Helsinki, Medicum, Helsinki, Finland
| | - Rocio Bengoechea
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland and University of Helsinki, Medicum, Helsinki, Finland
| | - Anna Vihola
- Neuromuscular Research Center, Tampere University Hospital and Tampere University, P.O. box 100, FIN-33014 Tampere, Finland; Folkhälsan Research Center, Helsinki, Finland and University of Helsinki, Medicum, Helsinki, Finland
| | - Manu Jokela
- Neuromuscular Research Center, Tampere University Hospital and Tampere University, P.O. box 100, FIN-33014 Tampere, Finland; Division of Clinical Neurosciences, Turku University Hospital and University of Turku, Turku, Finland
| | - Masanori Nakagawa
- North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Satoru Noguchi
- National Center of Neurology and Psychiatry (NCNP), Department of Neuromuscular Research, National Institute of Neuroscience, Tokyo, Japan
| | - Montse Olivé
- Department of Pathology and Neuromuscular Unit, IDIBELL-Hospital de Bellvitge, Barcelona, Spain
| | - Marion Masingue
- University Hospital of Salpêtrière, UPMC, Institute of Myology, National Reference Center for Neuromuscular Disorders, Paris, France
| | - Emilia Kerty
- Department of Neurology, Oslo University Hospital, Rikshospitalet, University of Oslo, Oslo, Norway
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland and University of Helsinki, Medicum, Helsinki, Finland
| | - Conrad C Weihl
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, USA
| | - Ichizo Nishino
- National Center of Neurology and Psychiatry (NCNP), Department of Neuromuscular Research, National Institute of Neuroscience, Tokyo, Japan
| | - Bjarne Udd
- Neuromuscular Research Center, Tampere University Hospital and Tampere University, P.O. box 100, FIN-33014 Tampere, Finland; Folkhälsan Research Center, Helsinki, Finland and University of Helsinki, Medicum, Helsinki, Finland
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Silvestri R, Aricò I, Bonanni E, Bonsignore M, Caretto M, Caruso D, Di Perri M, Galletta S, Lecca R, Lombardi C, Maestri M, Miccoli M, Palagini L, Provini F, Puligheddu M, Savarese M, Spaggiari M, Simoncini T. Italian Association of Sleep Medicine (AIMS) position statement and guideline on the treatment of menopausal sleep disorders. Maturitas 2019; 129:30-39. [DOI: 10.1016/j.maturitas.2019.08.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/14/2019] [Indexed: 12/29/2022]
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Papadopoulos C, Malfatti E, Anagnostou E, Savarese M, Udd B, Papadimas GK. Valosin-containing protein-related myopathy and Meige syndrome: Just a coincidence or not? Muscle Nerve 2019; 60:E43-E45. [PMID: 31509253 DOI: 10.1002/mus.26704] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Revised: 09/04/2019] [Accepted: 09/07/2019] [Indexed: 11/08/2022]
Affiliation(s)
- Constantinos Papadopoulos
- First Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Edoardo Malfatti
- Neurology Department, Raymond-Poincaré teaching hospital, centre de référence des maladies neuromusculaires Nord/Est/Ile-de-France, AP-HP, Garches, France
| | - Evangelos Anagnostou
- First Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
| | - Marco Savarese
- The Folkhälsan Institute of Genetics, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Finland
| | - Bjarne Udd
- The Folkhälsan Institute of Genetics, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Finland.,Tampere Neuromuscular Center, University and University Hospital of Tampere, Finland
| | - George Konstantinos Papadimas
- First Department of Neurology, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Greece
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46
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Johari M, Savarese M, Vihola A, Palmio J, Jokela M, Buzkova J, Pihlajamaki L, Wartiovaara A, Hackman P, Udd B. DIAGNOSTIC AND EXPERIMENTAL TREATMENT APPROACHES. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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47
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Jonson P, Savarese M, Johari M, Paulin L, Auvinen P, Udd B, Hackman P. P.293Novel splicing events in skeletal muscle revealed by RNA sequencing. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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48
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Papadopoulos C, Malfatti E, Anagnostou E, Savarese M, Udd B, Papadimas G. EP.15Valosin-containing protein-related myopathy and Meige's syndrome: just a coincidence or not? Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Savarese M, Maggi L, Vihola A, Jonson PH, Tasca G, Ruggiero L, Bello L, Magri F, Giugliano T, Torella A, Evilä A, Di Fruscio G, Vanakker O, Gibertini S, Vercelli L, Ruggieri A, Antozzi C, Luque H, Janssens S, Pasanisi MB, Fiorillo C, Raimondi M, Ergoli M, Politano L, Bruno C, Rubegni A, Pane M, Santorelli FM, Minetti C, Angelini C, De Bleecker J, Moggio M, Mongini T, Comi GP, Santoro L, Mercuri E, Pegoraro E, Mora M, Hackman P, Udd B, Nigro V. Interpreting Genetic Variants in Titin in Patients With Muscle Disorders. JAMA Neurol 2019; 75:557-565. [PMID: 29435569 DOI: 10.1001/jamaneurol.2017.4899] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance Mutations in the titin gene (TTN) cause a wide spectrum of genetic diseases. The interpretation of the numerous rare variants identified in TTN is a difficult challenge given its large size. Objective To identify genetic variants in titin in a cohort of patients with muscle disorders. Design, Setting, and Participants In this case series, 9 patients with titinopathy and 4 other patients with possibly disease-causing variants in TTN were identified. Titin mutations were detected through targeted resequencing performed on DNA from 504 patients with muscular dystrophy, congenital myopathy, or other skeletal muscle disorders. Patients were enrolled from 10 clinical centers in April 2012 to December 2013. All of them had not received a diagnosis after undergoing an extensive investigation, including Sanger sequencing of candidate genes. The data analysis was performed between September 2013 and January 2017. Sequencing data were analyzed using an internal custom bioinformatics pipeline. Main Outcomes and Measures The identification of novel mutations in the TTN gene and novel patients with titinopathy. We performed an evaluation of putative causative variants in the TTN gene, combining genetic, clinical, and imaging data with messenger RNA and/or protein studies. Results Of the 9 novel patients with titinopathy, 5 (55.5%) were men and the mean (SD) age at onset was 25 (15.8) years (range, 0-46 years). Of the 4 other patients (3 men and 1 woman) with possibly disease-causing TTN variants, 2 (50%) had a congenital myopathy and 2 (50%) had a slowly progressive distal myopathy with onset in the second decade. Most of the identified mutations were previously unreported. However, all the variants, even the already described mutations, require careful clinical and molecular evaluation of probands and relatives. Heterozygous truncating variants or unique missense changes are not sufficient to make a diagnosis of titinopathy. Conclusions and Relevance The interpretation of TTN variants often requires further analyses, including a comprehensive evaluation of the clinical phenotype (deep phenotyping) as well as messenger RNA and protein studies. We propose a specific workflow for the clinical interpretation of genetic findings in titin.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland.,Dipartimento di Biochimica, Biofisica e Patologia Generale, Università degli Studi della Campania "Luigi Vanvitelli," Napoli, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Lorenzo Maggi
- Neuromuscular Diseases and Neuroimmunology Unit, Institute for Research and Health Care Foundation Neurological Institute C. Besta, Milan, Italy
| | - Anna Vihola
- Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Giorgio Tasca
- Istituto di Neurologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario "A. Gemelli," Rome, Italy
| | - Lucia Ruggiero
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli "Federico II," Napoli, Italy
| | - Luca Bello
- Neuromuscular Center, Dipartimento di Neuroscienze, Università di Padova, Padova, Italy
| | - Francesca Magri
- Centro Dino Ferrari, Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Fondazione Institute for Research and Health Care Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Teresa Giugliano
- Dipartimento di Biochimica, Biofisica e Patologia Generale, Università degli Studi della Campania "Luigi Vanvitelli," Napoli, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Annalaura Torella
- Dipartimento di Biochimica, Biofisica e Patologia Generale, Università degli Studi della Campania "Luigi Vanvitelli," Napoli, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Anni Evilä
- Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Giuseppina Di Fruscio
- Dipartimento di Biochimica, Biofisica e Patologia Generale, Università degli Studi della Campania "Luigi Vanvitelli," Napoli, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Olivier Vanakker
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Sara Gibertini
- Neuromuscular Diseases and Neuroimmunology Unit, Institute for Research and Health Care Foundation Neurological Institute C. Besta, Milan, Italy
| | - Liliana Vercelli
- Neuromuscular Unit, Department of Neurosciences, Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Alessandra Ruggieri
- Neuromuscular Diseases and Neuroimmunology Unit, Institute for Research and Health Care Foundation Neurological Institute C. Besta, Milan, Italy
| | - Carlo Antozzi
- Neuromuscular Diseases and Neuroimmunology Unit, Institute for Research and Health Care Foundation Neurological Institute C. Besta, Milan, Italy
| | - Helena Luque
- Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Sandra Janssens
- Center for Medical Genetics, Ghent University Hospital, Ghent, Belgium
| | - Maria Barbara Pasanisi
- Neuromuscular Diseases and Neuroimmunology Unit, Institute for Research and Health Care Foundation Neurological Institute C. Besta, Milan, Italy
| | - Chiara Fiorillo
- Pediatric Neurology and Neuromuscular Disorders Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal, and Child Health; University of Genoa, Istituto G. Gaslini, Genova, Italy
| | | | - Manuela Ergoli
- Dipartimento di Medicina Sperimentale, Cardiomiologia e Genetica Medica, Università degli Studi della Campania "Luigi Vanvitelli," Napoli, Italy
| | - Luisa Politano
- Dipartimento di Medicina Sperimentale, Cardiomiologia e Genetica Medica, Università degli Studi della Campania "Luigi Vanvitelli," Napoli, Italy
| | - Claudio Bruno
- Center of Myology and Neurodegenerative Disease, Istituto Giannina Gaslini, Genova, Italy
| | - Anna Rubegni
- Medicina Molecolare, Institute for Research and Health Care Fondazione Stella Maris, Pisa, Italy
| | - Marika Pane
- Department of Pediatric Neurology, Catholic University and Nemo Roma Center for Neuromuscular Disorders, Rome, Italy
| | - Filippo M Santorelli
- Medicina Molecolare, Institute for Research and Health Care Fondazione Stella Maris, Pisa, Italy
| | - Carlo Minetti
- Pediatric Neurology and Neuromuscular Disorders Unit, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal, and Child Health; University of Genoa, Istituto G. Gaslini, Genova, Italy
| | - Corrado Angelini
- Fondazione Hospital S.Camillo Institute for Research and Health Care, Venezia, Italy
| | - Jan De Bleecker
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Maurizio Moggio
- Neuromuscular and Rare Disease Unit, Dipartimento di Neuroscienze, Università degli Studi di Milano, Fondazione Institute for Research and Health Care Ca' Granda, Ospedale Maggiore Policlinico, Milano, Italy
| | - Tiziana Mongini
- Neuromuscular Unit, Department of Neurosciences, Rita Levi Montalcini, University of Torino, Torino, Italy
| | - Giacomo Pietro Comi
- Centro Dino Ferrari, Dipartimento di Fisiopatologia Medico-Chirurgica e dei Trapianti, Università degli Studi di Milano, Fondazione Institute for Research and Health Care Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Lucio Santoro
- Dipartimento di Neuroscienze e Scienze Riproduttive ed Odontostomatologiche, Università degli Studi di Napoli "Federico II," Napoli, Italy
| | - Eugenio Mercuri
- Department of Pediatric Neurology, Catholic University and Nemo Roma Center for Neuromuscular Disorders, Rome, Italy
| | - Elena Pegoraro
- Neuromuscular Center, Dipartimento di Neuroscienze, Università di Padova, Padova, Italy
| | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology Unit, Institute for Research and Health Care Foundation Neurological Institute C. Besta, Milan, Italy
| | - Peter Hackman
- Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Medicum, University of Helsinki, Helsinki, Finland.,Neuromuscular Research Center, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Vincenzo Nigro
- Dipartimento di Biochimica, Biofisica e Patologia Generale, Università degli Studi della Campania "Luigi Vanvitelli," Napoli, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
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Savarese M, Palmio J, Poza JJ, Weinberg J, Olive M, Cobo AM, Vihola A, Jonson PH, Sarparanta J, García-Bragado F, Urtizberea JA, Hackman P, Udd B. Actininopathy: A new muscular dystrophy caused by ACTN2 dominant mutations. Ann Neurol 2019; 85:899-906. [PMID: 30900782 DOI: 10.1002/ana.25470] [Citation(s) in RCA: 15] [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: 11/04/2018] [Revised: 02/07/2019] [Accepted: 03/17/2019] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To clinically and pathologically characterize a cohort of patients presenting with a novel form of distal myopathy and to identify the genetic cause of this new muscular dystrophy. METHODS We studied 4 families (3 from Spain and 1 from Sweden) suffering from an autosomal dominant distal myopathy. Affected members showed adult onset asymmetric distal muscle weakness with initial involvement of ankle dorsiflexion later progressing also to proximal limb muscles. RESULTS In all 3 Spanish families, we identified a unique missense variant in the ACTN2 gene cosegregating with the disease. The affected members of the Swedish family carry a different ACTN2 missense variant. INTERPRETATION ACTN2 encodes for alpha actinin2, which is highly expressed in the sarcomeric Z-disk with a major structural and functional role. Actininopathy is thus a new genetically determined distal myopathy. ANN NEUROL 2019;85:899-906.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Medicum, University of Helsinki, Helsinki, Finland
| | - Johanna Palmio
- Neuromuscular Research Center, Tampere University Hospital and Tampere University, Tampere, Finland
| | - Juan José Poza
- Department of Neurology, Donostia University Hospital, San Sebastián, Spain
| | - Jan Weinberg
- Department of Neurology, Karolinska University Hospital, Stockholm, Sweden
| | - Montse Olive
- Department of Pathology, Neuropathology and Neuromuscular Unit, Biomedical Research Institute of Bellvitge, Bellvitge University Hospital, Hospitalet de Llobregat, Spain
| | - Ana Maria Cobo
- Neuromuscular Diseases Center of Competence, Marin Hospital, Public Hospital Network of Paris, Hendaye, France
| | - Anna Vihola
- Folkhälsan Research Center, Helsinki, Finland.,Medicum, University of Helsinki, Helsinki, Finland
| | - Per Harald Jonson
- Folkhälsan Research Center, Helsinki, Finland.,Medicum, University of Helsinki, Helsinki, Finland
| | - Jaakko Sarparanta
- Folkhälsan Research Center, Helsinki, Finland.,Medicum, University of Helsinki, Helsinki, Finland
| | | | - Jon Andoni Urtizberea
- Neuromuscular Diseases Center of Competence, Marin Hospital, Public Hospital Network of Paris, Hendaye, France
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland.,Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Medicum, University of Helsinki, Helsinki, Finland.,Neuromuscular Research Center, Tampere University Hospital and Tampere University, Tampere, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland
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