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Formicola D, Podda I, Pantaleo M, Andreucci E, Lopergolo D, Giglio S, Santorelli FM, Chilosi A. Evidence for a Pathogenic Role of CSMD1 in Childhood Apraxia of Speech. Neuropediatrics 2023; 54:407-411. [PMID: 37549685 DOI: 10.1055/s-0043-1771033] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/09/2023]
Abstract
Childhood apraxia of speech (CAS) is a pediatric motor speech disorder. The genetic etiology of this complex neurological condition is not yet well understood, although some genes have been linked to it. We describe the case of a boy with a severe and persistent motor speech disorder, consistent with CAS, and a coexisting language impairment.Whole exome sequencing in our case revealed a de novo and splicing mutation in the CSMD1 gene.
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Affiliation(s)
- Daniela Formicola
- Department of Neurobiology and Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Irina Podda
- Parole al Centro Studio di Logopedia, Genoa, Italy
| | - Marilena Pantaleo
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Elena Andreucci
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Diego Lopergolo
- Department of Neurobiology and Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Sabrina Giglio
- Department of Medical Sciences and Public Health, Medical Genetics Unit, University of Cagliari, Cagliari, Italy
| | - Filippo Maria Santorelli
- Department of Neurobiology and Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
- Department of Developmental Neuroscience, IRCCS "Stella Maris Foundation" Scientific Institute, Pisa, Italy
| | - Anna Chilosi
- Department of Developmental Neuroscience, IRCCS "Stella Maris Foundation" Scientific Institute, Pisa, Italy
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Saettini F, Guerra F, Fazio G, Bugarin C, McMillan HJ, Ohtake A, Ardissone A, Itoh M, Giglio S, Cappuccio G, Giardino G, Romano R, Quadri M, Gasperini S, Moratto D, Chiarini M, Akira I, Fukuhara Y, Hayakawa I, Okazaki Y, Mauri M, Piazza R, Cazzaniga G, Biondi A. Antibody Deficiency in Patients with Biallelic KARS1 Mutations. J Clin Immunol 2023; 43:2115-2125. [PMID: 37770806 DOI: 10.1007/s10875-023-01584-7] [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: 05/21/2023] [Accepted: 09/12/2023] [Indexed: 09/30/2023]
Abstract
Biallelic KARS1 mutations cause KARS-related diseases, a rare syndromic condition encompassing central and peripheral nervous system impairment, heart and liver disease, and deafness. KARS1 encodes the t-RNA synthase of lysine, an aminoacyl-tRNA synthetase, involved in different physiological mechanisms (such as angiogenesis, post-translational modifications, translation initiation, autophagy and mitochondrial function). Although patients with immune-hematological abnormalities have been individually described, results have not been collectively discussed and functional studies investigating how KARS1 mutations affect B cells have not been performed. Here, we describe one patient with severe developmental delay, sensoneurinal deafness, acute disseminated encephalomyelitis, hypogammaglobulinemia and recurrent infections. Pathogenic biallelic KARS1 variants (Phe291Val/ Pro499Leu) were associated with impaired B cell metabolism (decreased mitochondrial numbers and activity). All published cases of KARS-related diseases were identified. The corresponding authors and researchers involved in the diagnosis of inborn errors of immunity or genetic syndromes were contacted to obtain up-to-date clinical and immunological information. Seventeen patients with KARS-related diseases were identified. Recurrent/severe infections (9/17) and B cell abnormalities (either B cell lymphopenia [3/9], hypogammaglobulinemia [either IgG, IgA or IgM; 6/15] or impaired vaccine responses [4/7]) were frequently reported. Immunoglobulin replacement therapy was given in five patients. Full immunological assessment is warranted in these patients, who may require detailed investigation and specific supportive treatment.
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Affiliation(s)
- Francesco Saettini
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
| | - Fabiola Guerra
- Pediatria, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Dipartimento Di Medicina E Chirurgia, Università Degli Studi Milano-Bicocca, Milan, Italy
| | - Grazia Fazio
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Cristina Bugarin
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Hugh J McMillan
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Akira Ohtake
- Department of Clinical Genomics & Pediatrics, Saitama Medical University, Moroyama, Saitama, Japan
| | - Anna Ardissone
- Child Neurology, "Fondazione IRCCS IstitutoNeurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Masayuki Itoh
- Department of Mental Retardation and Birth Defect Research, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Sabrina Giglio
- Unit of Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Gerarda Cappuccio
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University of Naples, Naples, Italy
- Current address: Baylor College of Medicine, Houston, TX, USA
| | - Giuliana Giardino
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University of Naples, Naples, Italy
| | - Roberta Romano
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University of Naples, Naples, Italy
| | - Manuel Quadri
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Serena Gasperini
- Pediatria, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Daniele Moratto
- Flow Cytometry Unit, Clinical ChemistryLaboratory, ASST Spedali Civili, Brescia, Italy
| | - Marco Chiarini
- Flow Cytometry Unit, Clinical ChemistryLaboratory, ASST Spedali Civili, Brescia, Italy
| | - Ishiguro Akira
- Center for Postgraduate Education and Training, National Center for Child Health and Development (NCCHD), Tokyo, Japan
- Division of Hematology, National Center for Child Health and Development (NCCHD), Tokyo, Japan
| | - Yasuyuki Fukuhara
- Division of Medical Genetics, National Center for Child Health and Development, Tokyo, Japan
| | - Itaru Hayakawa
- Division of Neurology, National Center for Child Health and Development (NCCHD), Tokyo, Japan
| | - Yasushi Okazaki
- Division of Neurology, National Center for Child Health and Development (NCCHD), Tokyo, Japan
- Diagnostics and Therapeutic of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Mario Mauri
- Dipartimento Di Medicina E Chirurgia, Università Degli Studi Milano-Bicocca, Milan, Italy
| | - Rocco Piazza
- Ematologia, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Gianni Cazzaniga
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Dipartimento Di Medicina E Chirurgia, Università Degli Studi Milano-Bicocca, Milan, Italy
| | - Andrea Biondi
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Pediatria, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Dipartimento Di Medicina E Chirurgia, Università Degli Studi Milano-Bicocca, Milan, Italy
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Saettini F, Guerra F, Fazio G, Bugarin C, McMillan HJ, Ohtake A, Ardissone A, Itoh M, Giglio S, Cappuccio G, Giardino G, Romano R, Quadri M, Gasperini S, Moratto D, Chiarini M, Ishiguro A, Fukuhara Y, Hayakawa I, Okazaki Y, Mauri M, Piazza R, Cazzaniga G, Biondi A. Correction to: Antibody Deficiency in Patients with Biallelic KARS1 Mutations. J Clin Immunol 2023; 43:2126. [PMID: 37921915 DOI: 10.1007/s10875-023-01600-w] [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: 11/05/2023]
Affiliation(s)
- Francesco Saettini
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
| | - Fabiola Guerra
- Pediatria, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Dipartimento Di Medicina E Chirurgia, Università Degli Studi Milano-Bicocca, Milan, Italy
| | - Grazia Fazio
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Cristina Bugarin
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Hugh J McMillan
- Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Akira Ohtake
- Department of Clinical Genomics & Pediatrics, Saitama Medical University, Moroyama, Saitama, Japan
| | - Anna Ardissone
- Child Neurology, "Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133, Milan, Italy
| | - Masayuki Itoh
- Department of Mental Retardation and Birth Defect Research, National Center of Neurology and Psychiatry, Kodaira, Japan
| | - Sabrina Giglio
- Unit of Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Gerarda Cappuccio
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University of Naples, Naples, Italy
- Current address: Baylor College of Medicine, Houston, TX, USA
| | - Giuliana Giardino
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University of Naples, Naples, Italy
| | - Roberta Romano
- Department of Translational Medical Sciences, Section of Pediatrics, Federico II University of Naples, Naples, Italy
| | - Manuel Quadri
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Serena Gasperini
- Pediatria, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Daniele Moratto
- Flow Cytometry Unit, Clinical ChemistryLaboratory, ASST Spedali Civili, Brescia, Italy
| | - Marco Chiarini
- Flow Cytometry Unit, Clinical ChemistryLaboratory, ASST Spedali Civili, Brescia, Italy
| | - Akira Ishiguro
- Center for Postgraduate Education and Training, National Center for Child Health and Development (NCCHD), Tokyo, Japan
- Division of Hematology, National Center for Child Health and Development (NCCHD), Tokyo, Japan
| | - Yasuyuki Fukuhara
- Division of Medical Genetics, National Center for Child Health and Development, Tokyo, Japan
| | - Itaru Hayakawa
- Division of Neurology, National Center for Child Health and Development (NCCHD), Tokyo, Japan
| | - Yasushi Okazaki
- Division of Neurology, National Center for Child Health and Development (NCCHD), Tokyo, Japan
- Diagnostics and Therapeutic of Intractable Diseases, Intractable Disease Research Center, Graduate School of Medicine, Juntendo University, Tokyo, Japan
| | - Mario Mauri
- Dipartimento Di Medicina E Chirurgia, Università Degli Studi Milano-Bicocca, Milan, Italy
| | - Rocco Piazza
- Ematologia, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Gianni Cazzaniga
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Dipartimento Di Medicina E Chirurgia, Università Degli Studi Milano-Bicocca, Milan, Italy
| | - Andrea Biondi
- Centro Tettamanti, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Pediatria, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
- Dipartimento Di Medicina E Chirurgia, Università Degli Studi Milano-Bicocca, Milan, Italy
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Mocci S, Littera R, Chessa L, Campagna M, Melis M, Ottelio CM, Piras IS, Lai S, Firinu D, Tranquilli S, Mascia A, Vacca M, Schirru D, Lecca LI, Rassu S, Cannas F, Sanna C, Carta MG, Sedda F, Giuressi E, Cipri S, Miglianti M, Perra A, Giglio S. A review of the main genetic factors influencing the course of COVID-19 in Sardinia: the role of human leukocyte antigen-G. Front Immunol 2023; 14:1138559. [PMID: 37342325 PMCID: PMC10277491 DOI: 10.3389/fimmu.2023.1138559] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/23/2023] [Indexed: 06/22/2023] Open
Abstract
Introduction A large number of risk and protective factors have been identified during the SARS-CoV-2 pandemic which may influence the outcome of COVID-19. Among these, recent studies have explored the role of HLA-G molecules and their immunomodulatory effects in COVID-19, but there are very few reports exploring the genetic basis of these manifestations. The present study aims to investigate how host genetic factors, including HLA-G gene polymorphisms and sHLA-G, can affect SARS-CoV-2 infection. Materials and Methods We compared the immune-genetic and phenotypic characteristics between COVID-19 patients (n = 381) with varying degrees of severity of the disease and 420 healthy controls from Sardinia (Italy). Results HLA-G locus analysis showed that the extended haplotype HLA-G*01:01:01:01/UTR-1 was more prevalent in both COVID-19 patients and controls. In particular, this extended haplotype was more common among patients with mild symptoms than those with severe symptoms [22.7% vs 15.7%, OR = 0.634 (95% CI 0.440 - 0.913); P = 0.016]. Furthermore, the most significant HLA-G 3'UTR polymorphism (rs371194629) shows that the HLA-G 3'UTR Del/Del genotype frequency decreases gradually from 27.6% in paucisymptomatic patients to 15.9% in patients with severe symptoms (X2 = 7.095, P = 0.029), reaching the lowest frequency (7.0%) in ICU patients (X2 = 11.257, P = 0.004). However, no significant differences were observed for the soluble HLA-G levels in patients and controls. Finally, we showed that SARS-CoV-2 infection in the Sardinian population is also influenced by other genetic factors such as β-thalassemia trait (rs11549407C>T in the HBB gene), KIR2DS2/HLA-C C1+ group combination and the HLA-B*58:01, C*07:01, DRB1*03:01 haplotype which exert a protective effect [P = 0.005, P = 0.001 and P = 0.026 respectively]. Conversely, the Neanderthal LZTFL1 gene variant (rs35044562A>G) shows a detrimental consequence on the disease course [P = 0.001]. However, by using a logistic regression model, HLA-G 3'UTR Del/Del genotype was independent from the other significant variables [ORM = 0.4 (95% CI 0.2 - 0.7), PM = 6.5 x 10-4]. Conclusion Our results reveal novel genetic variants which could potentially serve as biomarkers for disease prognosis and treatment, highlighting the importance of considering genetic factors in the management of COVID-19 patients.
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Affiliation(s)
- Stefano Mocci
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Roberto Littera
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, University Hospital, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maurizio Melis
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Carla Maria Ottelio
- Anesthesia and Intensive Care Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Ignazio S. Piras
- Neurogenomics Division, Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Sara Lai
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefania Tranquilli
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Alessia Mascia
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniele Schirru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Luigi Isaia Lecca
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefania Rassu
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Celeste Sanna
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesca Sedda
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Erika Giuressi
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Selene Cipri
- GeneMos-APS (Association for Social Advancement), Reggio Calabria, Italy
| | - Michela Miglianti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Perra
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Sabrina Giglio
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
- Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Monserrato, Italy
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Fiorentini E, Giunti L, Di Rita A, Peraio S, Fonte C, Caporalini C, Buccoliero AM, Censullo ML, Gori G, Noris A, Pasquariello R, Battini R, Pavone R, Giordano F, Giglio S, Rinaldi B. SMARCE1-related meningiomas: A clear example of cancer predisposing syndrome. Eur J Med Genet 2023; 66:104784. [PMID: 37164167 DOI: 10.1016/j.ejmg.2023.104784] [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] [Received: 12/19/2022] [Revised: 04/23/2023] [Accepted: 05/06/2023] [Indexed: 05/12/2023]
Abstract
We report the case of a 16-year-old girl presenting with spinal clear-cell multiple meningiomas (CCMs). In view of this presentation, we sequenced a bioinformatic panel of genes associated with susceptibility to meningioma, identifying a germline heterozygous variant inSMARCE1. Somatic DNA investigations in the CCM demonstrated the deletion of the wild-type allele (loss of heterozygosity, LOH), supporting the causative role of this variant. Family segregation study detected the SMARCE1 variant in the asymptomatic father and in the asymptomatic sister who, nevertheless, presents 2 spinal lesions. Germline heterozygous loss-of-function (LoF) variants in SMARCE1, encoding a protein of the chromatin-remodeling complex SWI/SNF, have been described in few familial cases of susceptibility to meningioma, in particular the CCM subtype. Our case confirms the role of NGS in investigating predisposing genes for meningiomas (multiple or recurrent), with specific regard to SMARCE1 in case of pediatric CCM. In addition to the age of onset, the presence of familial clustering or the coexistence of multiple synchronous meningiomas also supports the role of a genetic predisposition that deserves a molecular assessment. Additionally, given the incomplete penetrance, it is of great importance to follow a specific screening or follow-up program for symptomatic and asymptomatic carriers of pathogenic variants in SMARCE1.
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Affiliation(s)
- Erika Fiorentini
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences 'Mario Serio', University of Florence, Firenze, Italy.
| | - Laura Giunti
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's Hospital, Firenze, Italy
| | - Andrea Di Rita
- Division of Neurosurgery - Meyer Children's Hospital - University of Florence, Firenze, Italy
| | - Simone Peraio
- Division of Neurosurgery - Meyer Children's Hospital - University of Florence, Firenze, Italy
| | - Carla Fonte
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's Hospital, Firenze, Italy
| | - Chiara Caporalini
- Pathology Unit, A. Meyer Children's University Hospital, Firenze, Italy
| | | | - Maria Luigia Censullo
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's Hospital, Firenze, Italy
| | - Giulia Gori
- Medical Genetics Unit, Meyer Children's University Hospital, Firenze, Italy
| | - Alice Noris
- Division of Neurosurgery - Meyer Children's Hospital - University of Florence, Firenze, Italy
| | - Rosa Pasquariello
- Dpt. of Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy
| | - Roberta Battini
- Dpt. of Neuroscience, IRCCS Fondazione Stella Maris, Calambrone, Pisa, Italy; Dpt. of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Rossana Pavone
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's Hospital, Firenze, Italy
| | - Flavio Giordano
- Division of Neurosurgery - Meyer Children's Hospital - University of Florence, Firenze, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Medical Sciences and Public Health and CeSAR, University Service for Research, University of Cagliari, 09124, Cagliari, Italy
| | - Berardo Rinaldi
- Medical Genetics Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Coci EG, Galesi O, Morgan T, Giglio S, Ostergaard E, Elia M. Heterozygous Deletion of Long Noncoding RNA AK127244 Is a Susceptibility Factor for Neurodevelopmental Delay. Cytogenet Genome Res 2023; 162:365-371. [PMID: 36758534 DOI: 10.1159/000528468] [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: 06/04/2022] [Accepted: 11/29/2022] [Indexed: 02/11/2023] Open
Abstract
Neurodevelopmental syndromes due to copy number variation are well-known clinical entities. While the numerical variation of gene-harboring regions has been widely investigated at both molecular and clinical levels, much less is understood about unbalanced expression of long noncoding RNAs. Few studies have been performed on the clinical consequences of such unbalanced expression. Heterozygous deletions of NRXN1 have been well described to cause neuropsychological features. Heterozygous deletion of adjacent long noncoding RNA AK127244, either isolated or combined with partial NRXN1 deletion, was recently reported in association with neurodevelopmental delay. In our retrospective study, we analyze a bicentric cohort of 4 individuals, comprising 2 siblings, which bear an isolated heterozygous deletion in long noncoding RNA AK127244 and present with nonsyndromic neurodevelopmental delay.
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Affiliation(s)
- Emanuele G Coci
- Department of Pediatrics, Prignitz Hospital, Brandenburg Medical School, Prignitz, Germany.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Thomas Morgan
- Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | | | - Elsebet Ostergaard
- Department of Clinical Genetics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Spinillo SL, Farina A, Sotiriadis A, Pozzoni M, Giglio S, Papale M, Candiani M, Cavoretto PI. Pregnancy outcome of confined placental mosaicism: meta-analysis of cohort studies. Am J Obstet Gynecol 2022; 227:714-727.e1. [PMID: 35934121 DOI: 10.1016/j.ajog.2022.07.034] [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: 05/04/2022] [Revised: 07/13/2022] [Accepted: 07/20/2022] [Indexed: 11/01/2022]
Abstract
OBJECTIVE This study aimed to assess the rate of adverse obstetrical and neonatal outcomes in pregnancies diagnosed with confined placental mosaicism relative to that of unaffected controls. DATA SOURCES Web-based databases were searched using relevant key words, and articles published from 1980 to February 2022 were retrieved. STUDY ELIGIBILITY CRITERIA Observational studies in English language including ≥10 cases of singleton pregnancies with diagnosis of confined placental mosaicism were included. The diagnosis was established after detection of any chromosomal abnormality at chorionic villus sampling for any indication, followed by normal karyotype from amniotic fluid or neonatal leukocyte culture. METHODS Two authors independently screened the references for eligibility, data extraction, and assessment of methodological quality using the Newcastle-Ottawa scale. All available obstetrical and neonatal outcomes were recorded. Random-effect meta-analysis was performed to estimate pooled odds ratios and 95% confidence intervals of available outcomes in pregnancies with and without confined placental mosaicism. Statistical heterogeneity was evaluated with I2 statistics (International Prospective Register of Systematic Reviews registration number: CRD42021260319). RESULTS Of the 80 articles reviewed, 8 retrospective matched-cohort studies (708 cases of confined placental mosaicism and 11,599 unaffected controls) compared cases with and without confined placental mosaicism and were included in the meta-analysis. The risk of delivering small-for-gestational-age neonates was significantly increased in confined placental mosaicism pregnancies according to crude analysis (odds ratio, 2.45; 95% confidence interval, 1.23-4.89; I2=72%) and to sensitivity analysis of high-quality studies (odds ratio, 3.65; 95% confidence interval, 2.43-5.57; I2=0%). Similarly, confined placental mosaicism resulted in an increased risk of birthweight below the third centile (odds ratio, 5.33; 95% confidence interval, 1.19-24.19; I2= 83%). Subgroup analysis revealed that the risk of delivering small-for-gestational-age neonates was 3-fold higher for confined placental mosaicism excluding trisomy 16, and 11-fold higher for cases including trisomy 16 only vs unaffected controls, respectively. No difference was found in the risk of low birthweight and preterm birth (at <37 weeks' gestation). Other outcomes were insufficiently reported, therefore they were not analyzed. CONCLUSION Pregnant women prenatally diagnosed with confined placental mosaicism have an increased risk of impaired fetal growth, suggesting the need for intensified antenatal surveillance.
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Affiliation(s)
- Silvia L Spinillo
- Department of Gynecology and Obstetrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Antonio Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery, (DIMEC) IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Alexandros Sotiriadis
- Faculty of Medicine, Second Department of Obstetrics and Gynecology, Aristotle University of Thessaloniki, Ippokrateio Hospital of Thessaloniki, Thessaloniki, Greece
| | - Mirko Pozzoni
- Department of Gynecology and Obstetrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Sabrina Giglio
- Departments of Medical Science and Public Health and Medical Genetics, Binaghi Hospital, Cagliari, Italy
| | - Margherita Papale
- Department of Gynecology and Obstetrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Massimo Candiani
- Department of Gynecology and Obstetrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy
| | - Paolo I Cavoretto
- Department of Gynecology and Obstetrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Raffaele Hospital, Vita-Salute San Raffaele University, Milan, Italy.
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Littera R, Perra A, Miglianti M, Piras IS, Mocci S, Lai S, Melis M, Zolfino T, Balestrieri C, Conti M, Serra G, Figorilli F, Firinu D, Onali S, Matta L, Porcu C, Pes F, Fanni D, Manieli C, Vacca M, Cusano R, Trucas M, Cipri S, Tranquilli S, Rassu S, Cannas F, Carta MG, Kowalik MA, Giuressi E, Faa G, Chessa L, Giglio S. The double-sided of human leukocyte antigen-G molecules in type 1 autoimmune hepatitis. Front Immunol 2022; 13:1007647. [PMID: 36311782 PMCID: PMC9597675 DOI: 10.3389/fimmu.2022.1007647] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 09/27/2022] [Indexed: 11/21/2022] Open
Abstract
The immunomodulatory effects of HLA-G expression and its role in cancers, human liver infections and liver transplantation are well documented, but so far, there are only a few reports addressing autoimmune liver diseases, particularly autoimmune hepatitis (AIH).
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Affiliation(s)
- Roberto Littera
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- *Correspondence: Roberto Littera, ; Andrea Perra, ; Stefano Mocci, ; Luchino Chessa,
| | - Andrea Perra
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- *Correspondence: Roberto Littera, ; Andrea Perra, ; Stefano Mocci, ; Luchino Chessa,
| | - Michela Miglianti
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Ignazio S. Piras
- Neurogenomics Division, Translational Genomics Research Institute (TGen), Phoenix, AZ, United States
| | - Stefano Mocci
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- *Correspondence: Roberto Littera, ; Andrea Perra, ; Stefano Mocci, ; Luchino Chessa,
| | - Sara Lai
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
| | - Maurizio Melis
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Teresa Zolfino
- Division of Gastroenterology, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | | | - Maria Conti
- Liver Unit, University Hospital, Cagliari, Italy
| | | | - Francesco Figorilli
- Division of Gastroenterology, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Simona Onali
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Laura Matta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Carmen Porcu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Pes
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniela Fanni
- Division of Pathology, Department of Medical Sciences and Public Health, University Hospital San Giovanni di Dio, Cagliari, Italy
| | - Cristina Manieli
- Department of Pathological Anatomy, Azienda di Rilievo Nazionale ed Alta Specializzazione (ARNAS), S. Michele Hospital, Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Cusano
- Biomedical Sector, Center for Advanced Studies, Research and Development (CRS4), Cagliari, Italy
| | - Marcello Trucas
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Selene Cipri
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
| | - Stefania Tranquilli
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Marta Anna Kowalik
- Section of Pathology, Oncology and Molecular Pathology Unit, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | | | - Gavino Faa
- Division of Pathology, Department of Medical Sciences and Public Health, University Hospital San Giovanni di Dio, Cagliari, Italy
| | - Luchino Chessa
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, University Hospital, Cagliari, Italy
- *Correspondence: Roberto Littera, ; Andrea Perra, ; Stefano Mocci, ; Luchino Chessa,
| | - Sabrina Giglio
- Medical Genetics, R. Binaghi Hospital, Sardegna, Italy
- AART-ODV (Association for the Advancement of Research on Transplantation), Cagliari, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Monserrato, Italy
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9
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DeYoung B, Morales M, Giglio S. Microbiology 2.0–A “behind the scenes” consideration for artificial intelligence applications for interpretive culture plate reading in routine diagnostic laboratories. Front Microbiol 2022; 13:976068. [PMID: 35992715 PMCID: PMC9386241 DOI: 10.3389/fmicb.2022.976068] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022] Open
Abstract
Laboratory automation with Artificial Intelligence (AI) features have now emerged into routine diagnostic clinical use to interpret growth on agar plates. Applications are currently limited to urine samples and infection control screens, yet some of the details around the development of algorithms remain entrenched with AI development specialists and are not well understood by laboratorians. The generation of algorithms is not a trivial task and is a highly structured process, with several considerations needed to develop the appropriate data for specific intended uses. Understanding these considerations highlights the limitations of any algorithm created and informs better design practices so that algorithm objectives can be thoroughly tested prior to routine use.
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10
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Palterer B, Salvati L, Capone M, Mecheri V, Maggi L, Mazzoni A, Cosmi L, Volpi N, Tiberi L, Provenzano A, Giglio S, Parronchi P, Maggiore G, Gallo O, Bartoloni A, Annunziato F, Zammarchi L, Liotta F. Variants Disrupting CD40L Transmembrane Domain and Atypical X-Linked Hyper-IgM Syndrome: A Case Report With Leishmaniasis and Review of the Literature. Front Immunol 2022; 13:840767. [PMID: 35572607 PMCID: PMC9096836 DOI: 10.3389/fimmu.2022.840767] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
X-linked hyper-IgM (XHIGM) syndrome is caused by mutations of the CD40LG gene, encoding the CD40L protein. The clinical presentation is characterized by early-onset infections, with profound hypogammaglobulinemia and often elevated IgM, susceptibility to opportunistic infections, such as Pneumocystis jirovecii pneumonia, biliary tract disease due to Cryptosporidium parvum, and malignancy. We report a 41-year-old male presenting with recurrent leishmaniasis, hypogammaglobulinemia, and myopathy. Whole-exome sequencing (WES) identified a missense variant in the CD40LG gene (c.107T>A, p.M36K), involving the transmembrane domain of the protein and a missense variant in the carnitine palmitoyl-transferase II (CPT2; c.593C>G; p.S198C) gene, leading to the diagnosis of hypomorphic XHIGM and CPT2 deficiency stress-induced myopathy. A review of all the previously reported cases of XHIGM with variants in the transmembrane domain showcased that these patients could present with atypical clinical features. Variants in the transmembrane domain of CD40LG act as hypomorphic generating a protein with a lower surface expression. Unlike large deletions or extracellular domain variants, they do not abolish the interaction with CD40, therefore preserving some biological activity.
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Affiliation(s)
- Boaz Palterer
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Flow Cytometric Diagnostic Centre and Immunotherapy, Careggi University Hospital, Florence, Italy
| | - Lorenzo Salvati
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Manuela Capone
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Valentina Mecheri
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Laura Maggi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Alessio Mazzoni
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
| | - Lorenzo Cosmi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Immunology and Cell Therapies Unit, Careggi University Hospital, Florence, Italy
| | - Nila Volpi
- Unit of Neurology and Neurophysiology, Department of Medical, Surgical and Neurological Sciences, University of Siena, Siena, Italy
| | - Lucia Tiberi
- Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy.,Medical Genetics Unit, Meyer University Hospital, Firenze, Italy
| | - Aldesia Provenzano
- Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Paola Parronchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Immunology and Cell Therapies Unit, Careggi University Hospital, Florence, Italy
| | | | - Oreste Gallo
- Department of Otorhinolaryngology, Careggi University Hospital, Florence, Italy
| | - Alessandro Bartoloni
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Flow Cytometric Diagnostic Centre and Immunotherapy, Careggi University Hospital, Florence, Italy
| | - Lorenzo Zammarchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Francesco Liotta
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Immunology and Cell Therapies Unit, Careggi University Hospital, Florence, Italy
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11
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Mocci S, Littera R, Tranquilli S, Provenzano A, Mascia A, Cannas F, Lai S, Giuressi E, Chessa L, Angioni G, Campagna M, Firinu D, Del Zompo M, La Nasa G, Perra A, Giglio S. A Protective HLA Extended Haplotype Outweighs the Major COVID-19 Risk Factor Inherited From Neanderthals in the Sardinian Population. Front Immunol 2022; 13:891147. [PMID: 35514995 PMCID: PMC9063452 DOI: 10.3389/fimmu.2022.891147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/07/2022] [Accepted: 03/24/2022] [Indexed: 11/13/2022] Open
Abstract
Sardinia has one of the lowest incidences of hospitalization and related mortality in Europe and yet a very high frequency of the Neanderthal risk locus variant on chromosome 3 (rs35044562), considered to be a major risk factor for a severe SARS-CoV-2 disease course. We evaluated 358 SARS-CoV-2 patients and 314 healthy Sardinian controls. One hundred and twenty patients were asymptomatic, 90 were pauci-symptomatic, 108 presented a moderate disease course and 40 were severely ill. All patients were analyzed for the Neanderthal-derived genetic variants reported as being protective (rs1156361) or causative (rs35044562) for severe illness. The β°39 C>T Thalassemia variant (rs11549407), HLA haplotypes, KIR genes, KIRs and their HLA class I ligand combinations were also investigated. Our findings revealed an increased risk for severe disease in Sardinian patients carrying the rs35044562 high risk variant [OR 5.32 (95% CI 2.53 - 12.01), p = 0.000]. Conversely, the protective effect of the HLA-A*02:01, B*18:01, DRB*03:01 three-loci extended haplotype in the Sardinian population was shown to efficiently contrast the high risk of a severe and devastating outcome of the infection predicted for carriers of the Neanderthal locus [OR 15.47 (95% CI 5.8 - 41.0), p < 0.0001]. This result suggests that the balance between risk and protective immunogenetic factors plays an important role in the evolution of COVID-19. A better understanding of these mechanisms may well turn out to be the biggest advantage in the race for the development of more efficient drugs and vaccines.
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Affiliation(s)
- Stefano Mocci
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Roberto Littera
- Medical Genetics Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy.,Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
| | - Stefania Tranquilli
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Aldesia Provenzano
- Medical Genetics Unit, Department of Experimental and Clinical Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Alessia Mascia
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Cannas
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara Lai
- Medical Genetics Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Erika Giuressi
- Medical Genetics Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy
| | - Luchino Chessa
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Goffredo Angioni
- Structure of Infectious Diseases Unit, SS Trinità Hospital, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Giorgio La Nasa
- Hematology Unit, Businco Hospital, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Andrea Perra
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy.,Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Monserrato, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Medical Genetics Unit, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Cagliari, Italy.,Centre for Research University Services (CeSAR, Centro Servizi di Ateneo per la Ricerca), University of Cagliari, Monserrato, Italy
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12
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Pisano S, Melis M, Figorilli M, Polizzi L, Rocchi L, Giglio S, Defazio G, Muroni A. Neurological Phenomenology of the IRF2BPL Mutation Syndrome: Analysis of a New Case and Systematic Review of the Literature. Seizure 2022; 99:12-15. [DOI: 10.1016/j.seizure.2022.04.010] [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: 11/30/2021] [Revised: 04/01/2022] [Accepted: 04/16/2022] [Indexed: 10/18/2022] Open
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13
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Bruni V, Spoleti CB, La Barbera A, Dattilo V, Colao E, Votino C, Bellacchio E, Perrotti N, Giglio S, Iuliano R. A Novel Splicing Variant of COL2A1 in a Fetus with Achondrogenesis Type II: Interpretation of Pathogenicity of In-Frame Deletions. Genes (Basel) 2021; 12:genes12091395. [PMID: 34573377 PMCID: PMC8467821 DOI: 10.3390/genes12091395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 09/07/2021] [Accepted: 09/08/2021] [Indexed: 01/08/2023] Open
Abstract
Achondrogenesis type II (ACG2) is a lethal skeletal dysplasia caused by dominant pathogenic variants in COL2A1. Most of the variants found in patients with ACG2 affect the glycine residue included in the Gly-X-Y tripeptide repeat that characterizes the type II collagen helix. In this study, we reported a case of a novel splicing variant of COL2A1 in a fetus with ACG2. An NGS analysis of fetal DNA revealed a heterozygous variant c.1267-2_1269del located in intron 20/exon 21. The variant occurred de novo since it was not detected in DNA from the blood samples of parents. We generated an appropriate minigene construct to study the effect of the variant detected. The minigene expression resulted in the synthesis of a COL2A1 messenger RNA lacking exon 21, which generated a predicted in-frame deleted protein. Usually, in-frame deletion variants of COL2A1 cause a phenotype such as Kniest dysplasia, which is milder than ACG2. Therefore, we propose that the size and position of an in-frame deletion in COL2A1 may be relevant in determining the phenotype of skeletal dysplasia.
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Affiliation(s)
- Valentina Bruni
- Medical Genetics Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.B.); (C.B.S.); (V.D.); (E.C.); (N.P.)
| | - Cristina Barbara Spoleti
- Medical Genetics Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.B.); (C.B.S.); (V.D.); (E.C.); (N.P.)
| | - Andrea La Barbera
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences “Mario Serio”, University of Florence, 50121 Florence, Italy;
| | - Vincenzo Dattilo
- Medical Genetics Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.B.); (C.B.S.); (V.D.); (E.C.); (N.P.)
| | - Emma Colao
- Medical Genetics Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.B.); (C.B.S.); (V.D.); (E.C.); (N.P.)
| | | | - Emanuele Bellacchio
- Genetics and Rare Diseases Research Division, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy;
| | - Nicola Perrotti
- Medical Genetics Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.B.); (C.B.S.); (V.D.); (E.C.); (N.P.)
| | - Sabrina Giglio
- Unit of Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, 09124 Cagliari, Italy;
| | - Rodolfo Iuliano
- Medical Genetics Unit, Department of Health Sciences, University “Magna Graecia” of Catanzaro, 88100 Catanzaro, Italy; (V.B.); (C.B.S.); (V.D.); (E.C.); (N.P.)
- Correspondence: ; Tel.: +39-0961-3695182
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14
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Littera R, Chessa L, Deidda S, Angioni G, Campagna M, Lai S, Melis M, Cipri S, Firinu D, Santus S, Lai A, Porcella R, Rassu S, Meloni F, Schirru D, Cordeddu W, Kowalik MA, Ragatzu P, Vacca M, Cannas F, Alba F, Carta MG, Del Giacco S, Restivo A, Deidda S, Palimodde A, Congera P, Perra R, Orrù G, Pes F, Loi M, Murru C, Urru E, Onali S, Coghe F, Giglio S, Perra A. Natural killer-cell immunoglobulin-like receptors trigger differences in immune response to SARS-CoV-2 infection. PLoS One 2021; 16:e0255608. [PMID: 34352002 PMCID: PMC8341547 DOI: 10.1371/journal.pone.0255608] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 07/20/2021] [Indexed: 12/23/2022] Open
Abstract
Background The diversity in the clinical course of COVID-19 has been related to differences in innate and adaptative immune response mechanisms. Natural killer (NK) lymphocytes are critical protagonists of human host defense against viral infections. It would seem that reduced circulating levels of these cells have an impact on COVID-19 progression and severity. Their activity is strongly regulated by killer-cell immuno-globulin-like receptors (KIRs) expressed on the NK cell surface. The present study’s focus was to investigate the impact of KIRs and their HLA Class I ligands on SARS-CoV-2 infection. Methods KIR gene frequencies, KIR haplotypes, KIR ligands and combinations of KIRs and their HLA Class I ligands were investigated in 396 Sardinian patients with SARS-CoV-2 infection. Comparisons were made between 2 groups of patients divided according to disease severity: 240 patients were symptomatic or paucisymptomatic (Group A), 156 hospitalized patients had severe disease (Group S). The immunogenetic characteristics of patients were also compared to a population group of 400 individuals from the same geographical areas. Results Substantial differences were obtained for KIR genes, KIR haplotypes and KIR-HLA ligand combinations when comparing patients of Group S to those of Group A. Patients in Group S had a statistically significant higher frequency of the KIR A/A haplotype compared to patients in Group A [34.6% vs 23.8%, OR = 1.7 (95% CI 1.1–2.6); P = 0.02, Pc = 0.04]. Moreover, the KIR2DS2/HLA C1 combination was poorly represented in the group of patients with severe symptoms compared to those of the asymptomatic-paucisymptomatic group [33.3% vs 50.0%, OR = 0.5 (95% CI 0.3–0.8), P = 0.001, Pc = 0.002]. Multivariate analysis confirmed that, regardless of the sex and age of the patients, the latter genetic variable correlated with a less severe disease course [ORM = 0.4 (95% CI 0.3–0.7), PM = 0.0005, PMC = 0.005]. Conclusions The KIR2DS2/HLA C1 functional unit resulted to have a strong protective effect against the adverse outcomes of COVID-19. Combined to other well known factors such as advanced age, male sex and concomitant autoimmune diseases, this marker could prove to be highly informative of the disease course and thus enable the timely intervention needed to reduce the mortality associated with the severe forms of SARS-CoV-2 infection. However, larger studies in other populations as well as experimental functional studies will be needed to confirm our findings and further pursue the effect of KIR receptors on NK cell immune-mediated response to SARS-Cov-2 infection.
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Affiliation(s)
- Roberto Littera
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Luchino Chessa
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Silvia Deidda
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Goffredo Angioni
- Complex Structure of Infectious Diseases, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marcello Campagna
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Sara Lai
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Maurizio Melis
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
| | - Selene Cipri
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Davide Firinu
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | | | - Alberto Lai
- Local Crisis Unit (UCL), ATS Sardegna, Cagliari, Italy
| | - Rita Porcella
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Stefania Rassu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Federico Meloni
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Daniele Schirru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - William Cordeddu
- Complex Structure of Infectious Diseases, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Marta Anna Kowalik
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paola Ragatzu
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Monica Vacca
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Federica Cannas
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Francesco Alba
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
| | - Mauro Giovanni Carta
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Stefano Del Giacco
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Angelo Restivo
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Simona Deidda
- Colorectal Surgery Unit, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Antonella Palimodde
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Paola Congera
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Roberto Perra
- Complex Structure of Pneumology, SS Trinità Hospital, ASSL Cagliari, ATS Sardegna, Cagliari, Italy
| | - Germano Orrù
- Molecular Biology Service Laboratory, Department of Surgical Science, University of Cagliari, Cagliari, Italy
| | - Francesco Pes
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Martina Loi
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Claudia Murru
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Enrico Urru
- Liver Unit, Department of Internal Medicine, University Hospital of Cagliari, Cagliari, Italy
| | - Simona Onali
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Ferdinando Coghe
- Clinical Chemical and Microbiology Laboratory, University Hospital of Cagliari, Cagliari, Italy
| | - Sabrina Giglio
- Complex Structure of Medical Genetics, R. Binaghi Hospital, Local Public Health and Social Care Unit (ASSL) of Cagliari, Sardinian Regional Company for the Protection of Health (ATS Sardegna), Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
| | - Andrea Perra
- Association for the Advancement of Research on Transplantation O.d.V., Non Profit Organisation, Cagliari, Italy
- Unit of Oncology and Molecular Pathology, Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
- * E-mail: (RL); (LC); (SG); (AP)
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15
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Knoers N, Antignac C, Bergmann C, Dahan K, Giglio S, Heidet L, Lipska-Ziętkiewicz BS, Noris M, Remuzzi G, Vargas-Poussou R, Schaefer F. Genetic testing in the diagnosis of chronic kidney disease: recommendations for clinical practice. Nephrol Dial Transplant 2021; 37:239-254. [PMID: 34264297 PMCID: PMC8788237 DOI: 10.1093/ndt/gfab218] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Indexed: 11/20/2022] Open
Abstract
The overall diagnostic yield of massively parallel sequencing–based tests in patients with chronic kidney disease (CKD) is 30% for paediatric cases and 6–30% for adult cases. These figures should encourage nephrologists to frequently use genetic testing as a diagnostic means for their patients. However, in reality, several barriers appear to hinder the implementation of massively parallel sequencing–based diagnostics in routine clinical practice. In this article we aim to support the nephrologist to overcome these barriers. After a detailed discussion of the general items that are important to genetic testing in nephrology, namely genetic testing modalities and their indications, clinical information needed for high-quality interpretation of genetic tests, the clinical benefit of genetic testing and genetic counselling, we describe each of these items more specifically for the different groups of genetic kidney diseases and for CKD of unknown origin.
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Affiliation(s)
- Nine Knoers
- Department of Genetics, University Medical Centre Groningen, The Netherlands
| | - Corinne Antignac
- Institut Imagine (Inserm U1163) et Département de Génétique, 24 bd du Montparnasse, 75015, Paris, France
| | - Carsten Bergmann
- Medizinische Genetik Mainz, Limbach Genetics, Mainz, Germany.,Department of Medicine, Nephrology, University Hospital Freiburg, Germany
| | - Karin Dahan
- Division of Nephrology, Cliniques Universitaires Saint-Luc, Avenue Hippocrate, 10, B-1200, Brussels, Belgium.,Center of Human Genetics, Institut de Pathologie et de Génétique, Avenue Lemaître, 25, B-6041, Gosselies, Belgium
| | - Sabrina Giglio
- Unit of Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.,Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Laurence Heidet
- Service de Néphrologie Pédiatrique, Hôpital Universitaire Necker-Enfants Malades, 149 rue de Sèvres, 75743, Paris, Cedex 15, France
| | - Beata S Lipska-Ziętkiewicz
- BSL-Z - ORCID 0000-0002-4169-9685, Centre for Rare Diseases, Medical University of Gdansk, Gdansk, Poland.,Clinical Genetics Unit, Department of Biology and Medical Genetics, Medical University of Gdansk, Gdansk, Poland
| | - Marina Noris
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Aldo & Cele Daccò Clinical Research Center for Rare Diseases, Bergamo, Italy
| | - Giuseppe Remuzzi
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Aldo & Cele Daccò Clinical Research Center for Rare Diseases, Bergamo, Italy
| | - Rosa Vargas-Poussou
- Département de Génétique, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75908, Paris, Cedex 15, France
| | - Franz Schaefer
- Division of Pediatric Nephrology, Center for Pediatrics and Adolescent Medicine, University of Heidelberg, Germany
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16
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Peired AJ, Antonelli G, Angelotti ML, Allinovi M, Guzzi F, Sisti A, Semeraro R, Conte C, Mazzinghi B, Nardi S, Melica ME, De Chiara L, Lazzeri E, Lasagni L, Lottini T, Landini S, Giglio S, Mari A, Di Maida F, Antonelli A, Porpiglia F, Schiavina R, Ficarra V, Facchiano D, Gacci M, Serni S, Carini M, Netto GJ, Roperto RM, Magi A, Christiansen CF, Rotondi M, Liapis H, Anders HJ, Minervini A, Raspollini MR, Romagnani P. Acute kidney injury promotes development of papillary renal cell adenoma and carcinoma from renal progenitor cells. Sci Transl Med 2021; 12:12/536/eaaw6003. [PMID: 32213630 DOI: 10.1126/scitranslmed.aaw6003] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 10/15/2019] [Accepted: 02/11/2020] [Indexed: 12/11/2022]
Abstract
Acute tissue injury causes DNA damage and repair processes involving increased cell mitosis and polyploidization, leading to cell function alterations that may potentially drive cancer development. Here, we show that acute kidney injury (AKI) increased the risk for papillary renal cell carcinoma (pRCC) development and tumor relapse in humans as confirmed by data collected from several single-center and multicentric studies. Lineage tracing of tubular epithelial cells (TECs) after AKI induction and long-term follow-up in mice showed time-dependent onset of clonal papillary tumors in an adenoma-carcinoma sequence. Among AKI-related pathways, NOTCH1 overexpression in human pRCC associated with worse outcome and was specific for type 2 pRCC. Mice overexpressing NOTCH1 in TECs developed papillary adenomas and type 2 pRCCs, and AKI accelerated this process. Lineage tracing in mice identified single renal progenitors as the cell of origin of papillary tumors. Single-cell RNA sequencing showed that human renal progenitor transcriptome showed similarities to PT1, the putative cell of origin of human pRCC. Furthermore, NOTCH1 overexpression in cultured human renal progenitor cells induced tumor-like 3D growth. Thus, AKI can drive tumorigenesis from local tissue progenitor cells. In particular, we find that AKI promotes the development of pRCC from single progenitors through a classical adenoma-carcinoma sequence.
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Affiliation(s)
- Anna Julie Peired
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Giulia Antonelli
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Maria Lucia Angelotti
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Marco Allinovi
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy.,Nephrology, Dialysis and Transplantation Unit, Careggi University Hospital, Florence 50139, Italy
| | - Francesco Guzzi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Alessandro Sisti
- Nephrology and Dialysis Unit, Meyer Children's University Hospital, Florence 50139, Italy
| | - Roberto Semeraro
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Carolina Conte
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Benedetta Mazzinghi
- Nephrology and Dialysis Unit, Meyer Children's University Hospital, Florence 50139, Italy
| | - Sara Nardi
- Nephrology and Dialysis Unit, Meyer Children's University Hospital, Florence 50139, Italy
| | - Maria Elena Melica
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Letizia De Chiara
- Nephrology and Dialysis Unit, Meyer Children's University Hospital, Florence 50139, Italy
| | - Elena Lazzeri
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Laura Lasagni
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy.,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Tiziano Lottini
- Department of Experimental and Clinical Medicine, Section of Internal Medicine, University of Florence, Florence 50139, Italy
| | - Samuela Landini
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Sabrina Giglio
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | - Andrea Mari
- Department of Urology, Careggi Hospital, University of Florence, Florence 50139, Italy
| | - Fabrizio Di Maida
- Department of Urology, Careggi Hospital, University of Florence, Florence 50139, Italy
| | - Alessandro Antonelli
- Department of Urology, Spedali Civili Hospital, University of Brescia, Brescia 25123, Italy
| | - Francesco Porpiglia
- Department of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin 10043, Italy
| | - Riccardo Schiavina
- Department of Urology, S. Orsola-Malpighi Hospital, University of Bologna, Bologna 40138, Italy
| | | | - Davide Facchiano
- Department of Urology, Careggi Hospital, University of Florence, Florence 50139, Italy
| | - Mauro Gacci
- Department of Urology, Careggi Hospital, University of Florence, Florence 50139, Italy
| | - Sergio Serni
- Department of Urology, Careggi Hospital, University of Florence, Florence 50139, Italy
| | - Marco Carini
- Department of Urology, Careggi Hospital, University of Florence, Florence 50139, Italy
| | - George J Netto
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Rosa Maria Roperto
- Nephrology and Dialysis Unit, Meyer Children's University Hospital, Florence 50139, Italy
| | - Alberto Magi
- Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy
| | | | - Mario Rotondi
- Unit of Internal Medicine and Endocrinology, ICS Maugeri I.R.C.C.S., Scientific Institute of Pavia, Pavia 28100, Italy
| | | | - Hans-Joachim Anders
- Division of Nephrology, Medizinische Klinik and Poliklinik IV, Klinikum der LMU München, Munich 80336, Germany
| | - Andrea Minervini
- Department of Urology, Careggi Hospital, University of Florence, Florence 50139, Italy
| | | | - Paola Romagnani
- Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), University of Florence, Florence 50139, Italy. .,Department of Experimental and Clinical Biomedical Sciences "Mario Serio," University of Florence, Florence 50139, Italy.,Nephrology and Dialysis Unit, Meyer Children's University Hospital, Florence 50139, Italy
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17
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Tolomeo D, Rubegni A, Nesti C, Barghigiani M, Battini R, D'Amore F, Doccini S, Donati MA, Galatolo D, Giglio S, Guarducci S, Pantaleo M, Pasquariello R, Procopio E, Pochiero F, Tessa A, Santorelli FMM. Learning from massive testing of mitochondrial disorders: UPD explaining unorthodox transmission. J Med Genet 2021; 58:543-546. [PMID: 34135091 DOI: 10.1136/jmedgenet-2020-107644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 05/31/2021] [Indexed: 11/04/2022]
Affiliation(s)
- Deborah Tolomeo
- Neurology, IRCCS Fondazione Stella Maris, Pisa, Toscana, Italy
| | - Anna Rubegni
- Molecular Medicine, IRCCS Stella Maris, Pisa, Italy
| | | | | | - Roberta Battini
- Neurology, IRCCS Fondazione Stella Maris, Pisa, Toscana, Italy
| | | | | | | | | | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy, Florence, Italy.,Unit of Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Silvia Guarducci
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy, Florence, Italy
| | - Marilena Pantaleo
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy, Florence, Italy
| | | | - Elena Procopio
- Metabolic and Neuromuscular Unit, Meyer Hospital, Florence, Italy
| | | | | | - Filippo M M Santorelli
- Neurology, IRCCS Fondazione Stella Maris, Pisa, Toscana, Italy .,Molecular Medicine, IRCCS Stella Maris, Pisa, Italy
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18
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Raviglione F, Douzgou S, Scala M, Mingarelli A, D'Arrigo S, Freri E, Darra F, Giglio S, Bonaglia MC, Pantaleoni C, Mastrangelo M, Epifanio R, Elia M, Saletti V, Morlino S, Vari MS, De Liso P, Pavaine J, Spaccini L, Cattaneo E, Gardella E, Møller RS, Marchese F, Colonna C, Gandioli C, Gobbi G, Ram D, Palumbo O, Carella M, Germano M, Tonduti D, De Angelis D, Caputo D, Bergonzini P, Novara F, Zuffardi O, Verrotti A, Orsini A, Bonuccelli A, De Muto MC, Trivisano M, Vigevano F, Granata T, Bernardina BD, Tranchina A, Striano P. Electroclinical features of MEF2C haploinsufficiency-related epilepsy: A multicenter European study. Seizure 2021; 88:60-72. [PMID: 33831796 DOI: 10.1016/j.seizure.2021.03.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 07/14/2020] [Revised: 03/23/2021] [Accepted: 03/25/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Epilepsy is a main manifestation in the autosomal dominant mental retardation syndrome caused by heterozygous variants in MEF2C. We aimed to delineate the electro-clinical features and refine the genotype-phenotype correlations in patients with MEF2C haploinsufficiency. METHODS We thoroughly investigated 25 patients with genetically confirmed MEF2C-syndrome across 12 different European Genetics and Epilepsy Centers, focusing on the epileptic phenotype. Clinical features (seizure types, onset, evolution, and response to therapy), EEG recordings during waking/sleep, and neuroimaging findings were analyzed. We also performed a detailed literature review using the terms "MEF2C", "seizures", and "epilepsy". RESULTS Epilepsy was diagnosed in 19 out of 25 (~80%) subjects, with age at onset <30 months. Ten individuals (40%) presented with febrile seizures and myoclonic seizures occurred in ~50% of patients. Epileptiform abnormalities were observed in 20/25 patients (80%) and hypoplasia/partial agenesis of the corpus callosum was detected in 12/25 patients (~50%). Nine patients harbored a 5q14.3 deletion encompassing MEF2C and at least one other gene. In 7 out of 10 patients with myoclonic seizures, MIR9-2 and LINC00461 were also deleted, whereas ADGRV1 was involved in 3/4 patients with spasms. CONCLUSION The epileptic phenotype of MEF2C-syndrome is variable. Febrile and myoclonic seizures are the most frequent, usually associated with a slowing of the background activity and irregular diffuse discharges of frontally dominant, symmetric or asymmetric, slow theta waves with interposed spike-and-waves complexes. The haploinsufficiency of ADGRV1, MIR9-2, and LINC00461 likely contributes to myoclonic seizures and spasms in patients with MEF2C syndrome.
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Affiliation(s)
| | - Sofia Douzgou
- Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicines and Health, University of Manchester, Manchester, UK; Manchester Centre for Genomic Medicine, Saint Mary's Hospital, Manchester University NHS Foundation Trust, Manchester, UK; Member of ERN-ITHACA
| | - Marcello Scala
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy; Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Stefano D'Arrigo
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Elena Freri
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Member of ERN EpiCARE
| | - Francesca Darra
- Child Neuropsychiatry Unit, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy
| | - Sabrina Giglio
- Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Maria C Bonaglia
- Cytogenetics Laboratory, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Chiara Pantaleoni
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Massimo Mastrangelo
- Paediatric Neurology Unit, Department of Pediatrics, Children's Hospital Vittore Buzzi, Milan, Italy
| | - Roberta Epifanio
- Clinical Neurophysiology Unit, IRCCS, E Medea Scientific Institute, Bosisio Parini, Lecco, Italy
| | | | - Veronica Saletti
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Silvia Morlino
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, Poliambulatorio "Giovanni Paolo II", Viale Padre Pio, snc, San Giovanni Rotondo 71013, Italy
| | - Maria Stella Vari
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy; Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Paola De Liso
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Rome, Italy; Member of ERN EpiCARE
| | - Julija Pavaine
- Academic Unit of Paediatric Radiology, Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust, University of Manchester, Manchester, UK
| | - Luigina Spaccini
- Clinical Genetics Service, Department of Pediatrics, Vittore Buzzi Hospital, Milan, Italy
| | - Elisa Cattaneo
- Clinical Genetics Service, Department of Pediatrics, Vittore Buzzi Hospital, Milan, Italy
| | - Elena Gardella
- The Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Institute for Regional Health Services, University of Southern Denmark, Odense, Denmark; Member of ERN EpiCARE
| | - Rikke S Møller
- The Danish Epilepsy Centre Filadelfia, Dianalund, Denmark; Institute for Regional Health Services, University of Southern Denmark, Odense, Denmark; Member of ERN EpiCARE
| | - Francesca Marchese
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy; Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Clara Colonna
- Hospital Neuropsychiatry Service, ASST Rhodense, Rho, Milan, Italy
| | - Claudia Gandioli
- Hospital Neuropsychiatry Service, ASST Rhodense, Rho, Milan, Italy
| | - Giuseppe Gobbi
- Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, Bologna, Italy
| | - Dipak Ram
- Department of Paediatric Neurology, Royal Manchester Children's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester, UK
| | - Orazio Palumbo
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, Poliambulatorio "Giovanni Paolo II", Viale Padre Pio, snc, San Giovanni Rotondo 71013, Italy
| | - Massimo Carella
- Division of Medical Genetics, Fondazione IRCCS Casa Sollievo della Sofferenza, Poliambulatorio "Giovanni Paolo II", Viale Padre Pio, snc, San Giovanni Rotondo 71013, Italy
| | - Michele Germano
- Maternal and Pediatric Department, Fondazione IRCCS Casa Sollievo della Sofferenza, Poliambulatorio "Giovanni Paolo II", Viale Padre Pio, snc, San Giovanni Rotondo (FG) 71013, Italy
| | - Davide Tonduti
- Paediatric Neurology Unit, Department of Pediatrics, Children's Hospital Vittore Buzzi, Milan, Italy
| | - Diego De Angelis
- Pediatric Department, "Sapienza" University of Rome, Rome 00185, Italy
| | - Davide Caputo
- Department of Health Sciences, Child Neuropsychiatry Unit - Epilepsy Center, San Paolo Hospital, University of Medicine, Milan, Italy; Member of ERN EpiCARE
| | | | - Francesca Novara
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Orsetta Zuffardi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Alberto Verrotti
- Department of Pediatrics, San Salvatore Hospital, University of L'Aquila, L'Aquila, Italy
| | - Alessandro Orsini
- Pediatric Neurology Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | - Alice Bonuccelli
- Pediatric Neurology Santa Chiara Hospital, University of Pisa, Pisa, Italy
| | | | - Marina Trivisano
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Rome, Italy; Member of ERN EpiCARE
| | - Federico Vigevano
- Department of Neuroscience, Bambino Gesù Children's Hospital, IRRCS, Rome, Italy; Member of ERN EpiCARE
| | - Tiziana Granata
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy; Member of ERN EpiCARE
| | - Bernardo Dalla Bernardina
- Child Neuropsychiatry Unit, Department of Life and Reproduction Sciences, University of Verona, Verona, Italy
| | - Antonia Tranchina
- Department of Pediatric Neuroscience, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Pasquale Striano
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy; Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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19
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Guarino FM, Di Nocera F, Galiero G, Iaccarino D, Giglio S, Madeo E, Pollaro F, Mezzasalma M, Iavarone I, Odierna G, Petraccioli A, Maio N, Lockyer CH. Age estimation and growth of striped dolphins Stenella coeruleoalba stranded along the coasts of south-western Italy. The European Zoological Journal 2021. [DOI: 10.1080/24750263.2021.1892218] [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: 10/21/2022] Open
Affiliation(s)
- F. M. Guarino
- Dipartimento di Biologia, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - F. Di Nocera
- Dipartimento di Sanità Animale, Istituto Zooprofilattico del Mezzogiorno, Portici (Naples), Italy
| | - G. Galiero
- Dipartimento di Sanità Animale, Istituto Zooprofilattico del Mezzogiorno, Portici (Naples), Italy
| | - D. Iaccarino
- Dipartimento di Sanità Animale, Istituto Zooprofilattico del Mezzogiorno, Portici (Naples), Italy
| | - S. Giglio
- Marine Animal Rescue Effort (MARE) Association, Montepaone (Cosenza), Italy
| | - E. Madeo
- Marine Animal Rescue Effort (MARE) Association, Montepaone (Cosenza), Italy
| | - F. Pollaro
- Centro Studi Ecosistemi Marini Mediterranei, Pioppi (Pollica, Salerno), Italy
| | - M. Mezzasalma
- Dipartimento di Biologia, Università Degli Studi di Napoli Federico II, Naples, Italy
- CIBIO, Centro de Investigação em Biodiversidade e Recursos Genéticos, InBIO, Universidade do Porto, Vairaõ, Portugal
| | - I. Iavarone
- Dipartimento di Biologia, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - G. Odierna
- Dipartimento di Biologia, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - A. Petraccioli
- Dipartimento di Biologia, Università Degli Studi di Napoli Federico II, Naples, Italy
| | - N. Maio
- Dipartimento di Biologia, Università Degli Studi di Napoli Federico II, Naples, Italy
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20
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Giglio S, Montini G, Trepiccione F, Gambaro G, Emma F. Distal renal tubular acidosis: a systematic approach from diagnosis to treatment. J Nephrol 2021; 34:2073-2083. [PMID: 33770395 PMCID: PMC8610947 DOI: 10.1007/s40620-021-01032-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 11/24/2020] [Accepted: 03/16/2021] [Indexed: 12/03/2022]
Abstract
Renal tubular acidosis (RTA) comprises a group of disorders in which excretion of hydrogen ions or reabsorption of filtered HCO3 is impaired, leading to chronic metabolic acidosis with normal anion gap. In the current review, the focus is placed on the most common type of RTA, Type 1 RTA or Distal RTA (dRTA), which is a rare chronic genetic disorder characterized by an inability of the distal nephron to secrete hydrogen ions in the presence of metabolic acidosis. Over the years, knowledge of the molecular mechanisms behind acid secretion has improved, thereby greatly helping the diagnosis of dRTA. The primary or inherited form of dRTA is mostly diagnosed in infancy, childhood, or young adulthood, while the acquired secondary form, as a consequence of other disorders or medications, can happen at any age, although it is more commonly seen in adults. dRTA is not as “benign” as previously assumed, and can have several, highly variable long-term consequences. The present review indeed reports and summarizes both clinical symptoms and diagnosis, long-term outcomes, genetic inheritance, epidemiology and current treatment options, with the aim of shedding more light onto this rare disorder. Being a chronic condition, dRTA also deserves attention in the transition between pediatric and adult nephrology care, and as a rare disease it has a place in the European and Italian rare nephrological diseases network.
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Affiliation(s)
- Sabrina Giglio
- Medical Genetics Unit, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
| | - Giovanni Montini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Nephrology, Dialysis and PediatricTransplant Unit, Milan, Italy.,Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Francesco Trepiccione
- Department of Translational Medical Sciences, University of Campania "L. Vanvitelli", Naples, Italy.,Biogem Research Institute Ariano Irpino, Ariano Irpino, Italy
| | - Giovanni Gambaro
- Nephrology Department of Medicine, University of Verona, Verona, Italy
| | - Francesco Emma
- Division of Nephrology, Department of Pediatric Subspecialties, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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21
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Peluso F, Palazzo V, Indolfi G, Mari F, Pasqualetti R, Procopio E, Nesti C, Guerrini R, Santorelli F, Giglio S. Leopard-like retinopathy and severe early-onset portal hypertension expand the phenotype of KARS1-related syndrome: a case report. BMC Med Genomics 2021; 14:25. [PMID: 33478492 PMCID: PMC7818779 DOI: 10.1186/s12920-020-00863-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 12/25/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Mutations in lysyl-tRNA synthetase (KARS1), an enzyme that charges tRNA with the amino acid lysine in both the cytoplasm and mitochondria, have been associated thus far with autosomal recessive Charcot-Marie-Tooth type CMTRIB, hearing loss type DFNB89, and mitochondrial encephalohepatopathy (MEH) featuring neurodevelopmental disorders with microcephaly, white matter changes, and cardiac and hepatic failure in less than 30 patients. CASE PRESENTATION We report the clinical, biochemical and molecular findings of a 14-month-old girl with severe MEH compatible clinical features, profound sensorineural hearing loss, leopard spot retinopathy, pancytopenia, and advanced liver disease with portal hypertension leading to death at the age of 30 months. CONCLUSIONS Whole exome sequencing identified two rare variants in KARS1 gene. Our report expands the allelic and clinical features of tRNA synthase disorders. Moreover, with our report we confirm the usefulness of WES as first tier diagnostic method in infants with complex multisystem phenotypes.
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Affiliation(s)
| | - Viviana Palazzo
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Giuseppe Indolfi
- Paediatric and Liver Unit, Meyer Children's University Hospital, Florence, Italy
| | - Francesco Mari
- Paediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Meyer Children's University Hospital, Florence, Italy
| | - Roberta Pasqualetti
- Paediatric Ophthalmology Unit, Meyer Children's University Hospital, Florence, Italy
| | - Elena Procopio
- Metabolic and Muscular Unit, Meyer Children's University Hospital of Florence, Florence, Italy
| | - Claudia Nesti
- Molecular Medicine, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Renzo Guerrini
- Paediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Meyer Children's University Hospital, Florence, Italy
| | | | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy. .,Sabrina Giglio MD, PhD Unit of Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
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22
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Pagliazzi A, Oranges T, Traficante G, Trapani C, Facchini F, Martin A, Semeraro A, Perrone A, Filippeschi C, Giglio S. PIK3CA-Related Overgrowth Spectrum From Diagnosis to Targeted Therapy: A Case of CLOVES Syndrome Treated With Alpelisib. Front Pediatr 2021; 9:732836. [PMID: 34568242 PMCID: PMC8459713 DOI: 10.3389/fped.2021.732836] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 08/10/2021] [Indexed: 11/26/2022] Open
Abstract
PIK3CA-related overgrowth spectrum (PROS) is an umbrella term referring to various clinical entities, which share the same pathogenetic mechanism. These conditions are caused by somatic gain-of-function mutations in PIK3CA, which encodes the 110-kD catalytic α subunit of PI3K (p110α). These PIK3CA mutations occur as post-zygotic events and lead to a gain of function of PI3K, with consequent constitutional activation of the downstream cascades (e.g., AKT/mTOR pathway), involved in cellular proliferation, survival and growth, as well as in vascular development in the embryonic stage. PIK3CA-related cancers and PROS share almost the same PIK3CA mutational profile, with about 80% of mutations occurring at three hotspots, E542, E545, and H1047. These hotspot mutations show the most potent effect on enzymatic activation of PI3K and consequent downstream biological responses. If present at the germinal level, these gain-of-function mutations would be lethal to the embryo, therefore we only see them in the mosaic state. The common clinical denominator of PROS disorders is that they are sporadic conditions, presenting with congenital or early childhood onset overgrowth with a typical mosaic distribution. However, the severity of PROS is highly variable, ranging from localized and apparently isolate overgrowth to progressive and extensive lipomatous overgrowth associated with life-threatening vascular malformations, as seen in CLOVES syndrome. Traditional therapeutic approaches, such as sclerotherapy and surgical debulking, are often not curative in PROS patients, leading to a recrudescence of the overgrowth in the treated area. Specific attention has been recently paid to molecules that are used and studied in the oncogenic setting and that are targeted on specific alterations of the pathway PI3K/AKT/mTOR. In June 2018, Venot et al. showed the effect of Alpelisib (BYL719), a specific inhibitor for the p110α subunit of PI3K, in patients with PROS disorders who had severe or life-threatening complications and were not sensitive to any other treatment. In these cases, dramatic anatomical and functional improvements occurred in all patients across many types of affected organ. Molecular testing in PROS patients is a crucial step in providing the conclusive diagnosis and then the opportunity for tailored therapy. The somatic nature of this group of diseases makes challenging to reach a molecular diagnosis, requiring deep sequencing methods that have to be performed on DNA extracted from affected tissue. Moreover, even analyzing the DNA extracted from affected tissue there is no guarantee to succeed in detection of the casual somatic mutation, since the affected tissue itself is highly heterogeneous and biopsy approaches can be burdened by incorrect sampling or inadequate tissue sample. We present an 8-year-old girl with CLOVES syndrome, born with a large cystic lymphangioma involving the left hemithorax and flank, multiple lipomas, and hypertrophy of the left foot and leg. She developed severe scoliosis. Many therapeutic approaches have been attempted, including Sildenafil treatment, scleroembolization, laser therapy, and multiple debulking surgeries, but none of these were of benefit to our patient's clinical status. She then started treatment with Rapamycin from May 2019, without significant improvement in both vascular malformation and leg hypertrophy. A high-coverage Whole Exome Sequencing analysis performed on DNA extracted from a skin sample showed a mosaic gain-of-function variant in the PIK3CA gene (p.H1047R, 11% of variant allele frequency). Once molecular confirmation of our clinical suspicion was obtained, after a multidisciplinary evaluation, we decided to discontinue Sirolimus and start targeted therapy with Alpelisib (50 mg/day). We noticed a decrease in fibroadipose overgrowth at the dorsal level, an improvement in in posture and excellent tolerability. The treatment is still ongoing.
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Affiliation(s)
- Angelica Pagliazzi
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Teresa Oranges
- Dermatology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Giovanna Traficante
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Chiara Trapani
- Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Flavio Facchini
- Department of Plastic Surgery, Meyer Children's University Hospital, Florence, Italy
| | - Alessandra Martin
- Department of Plastic Surgery, Meyer Children's University Hospital, Florence, Italy
| | - Alessandro Semeraro
- Department of Radiology, Meyer Children's University Hospital, Florence, Italy
| | - Anna Perrone
- Department of Radiology, Meyer Children's University Hospital, Florence, Italy
| | - Cesare Filippeschi
- Dermatology Unit, Department of Pediatrics, Meyer Children's University Hospital, Florence, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy.,Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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23
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Giordano F, Lenge M, Donati P, Mongardi L, Di Giacomo G, Mura R, Taverna M, Cini C, Peraio S, Poggi G, Tuccinardi G, Giglio S, Genitori L. Exclusive Neurogenic Bladder and Fecal Incontinency in an Achondroplasic Child Successfully Treated with Lumbar Foraminal Decompression. Pediatr Neurosurg 2021; 56:471-476. [PMID: 34320505 DOI: 10.1159/000517652] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 06/06/2021] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Achondroplasia is a genetic disorder characterized by defects in the development of endochondral bone resulting in skeletal abnormalities like stenosis of the foramen magnum and of the spine, shortened limb bones, and macrocephaly. Congenital spinal stenosis is frequent and due to premature fusion of the pedicles to the laminae. CASE PRESENTATION We report a case of neurogenic bladder and fecal incontinence due to lumbar stenosis successfully treated with L1-L5 partial laminectomy and foraminotomy in a 7-year-old achondroplasic child. DISCUSSION/CONCLUSION To our knowledge, this is the first case report of exclusive neurogenic bladder and fecal incontinence in an achondroplasic child. Neurogenic bladder and fecal incontinence without motor impairment may be early and exclusive clinical findings of lumbar stenosis in children with achondroplasia.
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Affiliation(s)
- Flavio Giordano
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Matteo Lenge
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy, .,Department of Neuroscience, Child Neurology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy,
| | - Pierarturo Donati
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Lorenzo Mongardi
- Department of Neurosurgery, Nuovo Ospedale Cona, University of Ferrara, Ferrara, Italy
| | - Gianpiero Di Giacomo
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy.,Department of Neuroscience, Child Neurology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Regina Mura
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Maria Taverna
- Department of Surgery, Pediatric Urology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Chiara Cini
- Department of Surgery, Pediatric Urology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Simone Peraio
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Giovanni Poggi
- Department of Pediatrics, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Germana Tuccinardi
- Neuroanesthesiology Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Sabrina Giglio
- Clinical Genetics Unit, Children's Hospital A. Meyer-University of Florence, Florence, Italy
| | - Lorenzo Genitori
- Department of Neurosurgery, Children's Hospital A. Meyer-University of Florence, Florence, Italy
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24
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Errichiello E, Giorda R, Gambale A, Iolascon A, Zuffardi O, Giglio S. RB1CC1 duplication and aberrant overexpression in a patient with schizophrenia: further phenotype delineation and proposal of a pathogenetic mechanism. Mol Genet Genomic Med 2020; 9:e1561. [PMID: 33340270 PMCID: PMC7963413 DOI: 10.1002/mgg3.1561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 11/20/2020] [Accepted: 11/05/2020] [Indexed: 12/26/2022] Open
Abstract
Background Copy number variants in coding and noncoding genomic regions have been implicated as risk factor for schizophrenia (SCZ). Rare duplications of the RB1CC1 gene were found enriched in SCZ patients. Considering that the effect of such duplications on RB1CC1 expression has never been evaluated and partial gene duplications of RB1CC1 have also been reported in SCZ patients, it is unclear whether the pathogenesis is mediated by haploinsufficiency rather than genuine overexpression of the gene. Methods and Results We studied a patient with schizophrenia, suicidality, and obesity, who carried a de novo RB1CC1 complete duplication, as assessed by high‐resolution array‐CGH. Molecular breakpoint cloning allowed to identify nonhomologous end joining (NHEJ) as driving mechanism in this rearrangement. On the contrary, trio‐based whole‐exome sequencing excluded other potential causative variants related to the phenotype. Functional assays showed significant overexpression of RB1CC1 in the peripheral blood lymphocytes of the proband compared to control subjects, suggesting overdosage as leading mechanism in SCZ pathophysiology. Conclusion We hypothesized a pathogenetic model that might explain the correlation between RB1CC1 overexpression and schizophrenia by altering different cell signaling pathways, including autophagy, a promising therapeutic target for schizophrenic patients.
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Affiliation(s)
- Edoardo Errichiello
- Unit of Medical Genetics, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Roberto Giorda
- Laboratory of Molecular Biology, Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Antonella Gambale
- Department of Molecular Medicine and Medical Biotechnologies, University "Federico II" of Naples, Naples, Italy.,CEINGE, Advanced Biotechnologies, Naples, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies, University "Federico II" of Naples, Naples, Italy.,CEINGE, Advanced Biotechnologies, Naples, Italy
| | - Orsetta Zuffardi
- Unit of Medical Genetics, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Sabrina Giglio
- Unit of Medical Genetics, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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25
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Provenzano A, La Barbera A, Scagnet M, Pagliazzi A, Traficante G, Pantaleo M, Tiberi L, Vergani D, Kurtas NE, Guarducci S, Bargiacchi S, Forzano G, Artuso R, Palazzo V, Kura A, Giordano F, di Feo D, Mortilla M, De Filippi C, Mattei G, Garavelli L, Giusti B, Genitori L, Zuffardi O, Giglio S. Chiari 1 malformation and exome sequencing in 51 trios: the emerging role of rare missense variants in chromatin-remodeling genes. Hum Genet 2020; 140:625-647. [PMID: 33337535 PMCID: PMC7981314 DOI: 10.1007/s00439-020-02231-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 08/04/2020] [Accepted: 10/20/2020] [Indexed: 02/07/2023]
Abstract
Type 1 Chiari malformation (C1M) is characterized by cerebellar tonsillar herniation of 3–5 mm or more, the frequency of which is presumably much higher than one in 1000 births, as previously believed. Its etiology remains undefined, although a genetic basis is strongly supported by C1M presence in numerous genetic syndromes associated with different genes. Whole-exome sequencing (WES) in 51 between isolated and syndromic pediatric cases and their relatives was performed after confirmation of the defect by brain magnetic resonance image (MRI). Moreover, in all the cases showing an inherited candidate variant, brain MRI was performed in both parents and not only in the carrier one to investigate whether the defect segregated with the variant. More than half of the variants were Missense and belonged to the same chromatin-remodeling genes whose protein truncation variants are associated with severe neurodevelopmental syndromes. In the remaining cases, variants have been detected in genes with a role in cranial bone sutures, microcephaly, neural tube defects, and RASopathy. This study shows that the frequency of C1M is widely underestimated, in fact many of the variants, in particular those in the chromatin-remodeling genes, were inherited from a parent with C1M, either asymptomatic or with mild symptoms. In addition, C1M is a Mendelian trait, in most cases inherited as dominant. Finally, we demonstrate that modifications of the genes that regulate chromatin architecture can cause localized anatomical alterations, with symptoms of varying degrees.
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Affiliation(s)
- Aldesia Provenzano
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.
| | - Andrea La Barbera
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Mirko Scagnet
- Department of Neurosurgery, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Angelica Pagliazzi
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Giovanna Traficante
- Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Marilena Pantaleo
- Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Lucia Tiberi
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Debora Vergani
- Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Nehir Edibe Kurtas
- Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Silvia Guarducci
- Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Sara Bargiacchi
- Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Giulia Forzano
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Rosangela Artuso
- Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Viviana Palazzo
- Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Ada Kura
- Department of Experimental and Clinical Medicine, Atherothrombotic Diseases Center, University of Florence, Careggi Hospital, Florence, Italy
| | - Flavio Giordano
- Department of Neurosurgery, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Daniele di Feo
- Department of Radiology, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Marzia Mortilla
- Department of Radiology, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Claudio De Filippi
- Department of Radiology, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Gianluca Mattei
- Department of Information Engineering, University of Florence, Florence, Italy
| | - Livia Garavelli
- Medical Genetics Unit, Department of Mother and Child, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Betti Giusti
- Department of Experimental and Clinical Medicine, Atherothrombotic Diseases Center, University of Florence, Careggi Hospital, Florence, Italy
| | - Lorenzo Genitori
- Department of Neurosurgery, "A. Meyer" Children Hospital of Florence, Florence, Italy
| | - Orsetta Zuffardi
- Unit of Medical Genetics, Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.,Medical Genetics Unit, "A. Meyer" Children Hospital of Florence, Florence, Italy
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26
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Guazzarotti L, Sani I, Giglio S, Brunello F, Perilongo G, Bocciardi R. A novel stop codon variant affecting ΔNp63 isoforms associated with non-syndromic limb-mammary phenotype and uterine cervix dysplasia. Clin Genet 2020; 99:486-487. [PMID: 33258108 DOI: 10.1111/cge.13889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/18/2020] [Accepted: 11/20/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Guazzarotti
- Department of Woman's and Child 's Health - Pediatric Endocrinology and Adolescence Unit, University Hospital of Padova, Padova, Italy
| | - Ilaria Sani
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Sabrina Giglio
- Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Francesco Brunello
- Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy
| | - Giorgio Perilongo
- Department of Woman's and Child's Health, University Hospital of Padova, Padova, Italy
| | - Renata Bocciardi
- DINOGMI, University of Genova - UOC Genetica Medica IRCCS Giannina Gaslini, Genoa, Italy
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27
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Gandini O, Criniti A, Gagliardi MC, Ballesio L, Giglio S, Balena A, Caputi A, Angeloni A, Lubrano C. Sex-disaggregated data confirm serum ferritin as an independent predictor of disease severity both in male and female COVID-19 patients. J Infect 2020; 82:414-451. [PMID: 33131700 PMCID: PMC7578700 DOI: 10.1016/j.jinf.2020.10.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 10/19/2020] [Indexed: 12/24/2022]
Affiliation(s)
- O Gandini
- Department of Molecular Medicine, Sapienza University of Rome, Italy.
| | - A Criniti
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - M C Gagliardi
- Center for Gender Specific Medicine, Istituto Superiore di Sanità, Rome, Italy
| | - L Ballesio
- Department of Radiology, Anatomo- Pathology and Oncology, Sapienza University of Rome, Italy
| | - S Giglio
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - A Balena
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - A Caputi
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - A Angeloni
- Department of Experimental Medicine, Sapienza University of Rome, Italy
| | - C Lubrano
- Department of Experimental Medicine, Sapienza University of Rome, Italy
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28
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Giangiobbe S, Caraffi SG, Ivanovski I, Maini I, Pollazzon M, Rosato S, Trimarchi G, Lauriello A, Marinelli M, Nicoli D, Baldo C, Laurie S, Flores-Daboub J, Provenzano A, Andreucci E, Peluso F, Rizzo R, Stewart H, Lachlan K, Bayat A, Napoli M, Carboni G, Baker J, Mendel A, Piatelli G, Pantaleoni C, Mattina T, Prontera P, Mendelsohn NJ, Giglio S, Zuffardi O, Garavelli L. Expanding the phenotype of Wiedemann-Steiner syndrome: Craniovertebral junction anomalies. Am J Med Genet A 2020; 182:2877-2886. [PMID: 33043602 DOI: 10.1002/ajmg.a.61859] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 01/29/2020] [Revised: 07/23/2020] [Accepted: 08/22/2020] [Indexed: 12/16/2022]
Abstract
Wiedemann-Steiner syndrome (WDSTS) is a rare autosomal dominant condition caused by heterozygous loss of function variants in the KMT2A (MLL) gene, encoding a lysine N-methyltransferase that mediates a histone methylation pattern specific for epigenetic transcriptional activation. WDSTS is characterized by a distinctive facial phenotype, hypertrichosis, short stature, developmental delay, intellectual disability, congenital malformations, and skeletal anomalies. Recently, a few patients have been reported having abnormal skeletal development of the cervical spine. Here we describe 11 such individuals, all with KMT2A de novo loss-of-function variants: 10 showed craniovertebral junction anomalies, while an 11th patient had a cervical abnormality in C7. By evaluating clinical and diagnostic imaging data we characterized these anomalies, which consist primarily of fused cervical vertebrae, C1 and C2 abnormalities, small foramen magnum and Chiari malformation type I. Craniovertebral anomalies in WDSTS patients have been largely disregarded so far, but the increasing number of reports suggests that they may be an intrinsic feature of this syndrome. Specific investigation strategies should be considered for early identification and prevention of craniovertebral junction complications in WDSTS patients.
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Affiliation(s)
- Sara Giangiobbe
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy.,Medical Genetics Unit, San Raffaele Hospital, Milan, Italy
| | - Stefano Giuseppe Caraffi
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ivan Ivanovski
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Ilenia Maini
- Unità Operativa di Psichiatria e Psicologia dell'Infanzia e dell'Adolescenza, DAI-SMDP, AUSL Parma, Parma, Italy
| | - Marzia Pollazzon
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Simonetta Rosato
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Gabriele Trimarchi
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Anna Lauriello
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Maria Marinelli
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Davide Nicoli
- Molecular Biology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Chiara Baldo
- UOC Laboratorio di Genetica Umana, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Steven Laurie
- Clinical Genomics, Centre Nacional d'Anàlisi Genòmica, Centre de Regulació Genòmica, Barcelona, Spain
| | - Josue Flores-Daboub
- Division of Pediatric Clinical Genetics, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Aldesia Provenzano
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Elena Andreucci
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Francesca Peluso
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy.,Neurobiology and Molecular Medicine, IRCCS Stella Maris, Pisa, Italy
| | - Renata Rizzo
- Child Neuropsychiatry, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Helen Stewart
- Oxford Centre for Genomic Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Katherine Lachlan
- Wessex Clinical Genetics Service, Southampton University Hospitals NHS Foundation Trust, Princess Anne Hospital, Southampton, UK.,Human Genetics and Genomic Medicine, University of Southampton, Southampton, UK
| | - Allan Bayat
- Department of Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark
| | - Manuela Napoli
- Neuroradiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Giorgia Carboni
- Radiology Unit, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
| | - Janice Baker
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Alyssa Mendel
- Coordination of Rare Diseases at Sanford (CoRDS), Sanford Research, Sioux Falls, SD, USA
| | | | - Chiara Pantaleoni
- Developmental Neurology Department, Fondazione IRCCS Istituto Neurologico "C. Besta", Milan, Italy
| | - Teresa Mattina
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Paolo Prontera
- Medical Genetics Unit, "Santa Maria della Misericordia" Hospital, Perugia, Italy
| | | | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Orsetta Zuffardi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Livia Garavelli
- Medical Genetics Unit, Mother and Child Health Department, Azienda USL-IRCCS di Reggio Emilia, Reggio Emilia, Italy
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Giglio S, De Nunzio C, Cirombella R, Stoppacciaro A, Pesce M, Omar F, Volinia S, Baldassarre G, Tubaro A, Croce C, Vecchione A. Micro-RNAs as minimally invasive biomarkers for diagnosis, staging and outcome prediction in prostate cancer patients. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)35402-1] [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: 10/23/2022] Open
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Milone R, Cesario C, Goldoni M, Pasquariello R, Fusilli C, Giovannetti A, Giglio S, Novelli A, Caputo V, Cioni G, Mazza T, Battaglia A, Bernardini L, Battini R. Correlating Neuroimaging and CNVs Data: 7 Years of Cytogenomic Microarray Analysis on Patients Affected by Neurodevelopmental Disorders. J Pediatr Genet 2020; 10:292-299. [PMID: 34849274 DOI: 10.1055/s-0040-1716398] [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: 05/27/2020] [Accepted: 07/27/2020] [Indexed: 11/08/2022]
Abstract
The aim of this study was to evaluate the relationship between neurodevelopmental disorders, brain anomalies, and copy number variations (CNVs) and to estimate the diagnostic potential of cytogenomical microarray analysis (CMA) in individuals neuroradiologically characterized with intellectual developmental disorders (IDDs) isolated or associated with autism spectrum disorders (ASDs) and epilepsy (EPI), all of which were identified as a "synaptopathies." We selected patients who received CMA and brain magnetic resonance imaging (MRI) over a 7-year period. We divided them into four subgroups: IDD, IDD + ASD, IDD + EPI, and IDD + ASD + EPI. The diagnostic threshold of CMA was 16%. The lowest detection rate for both CMA and brain anomalies was found in IDD + ASD, while MRI was significantly higher in IDD and IDD + EPI subgroups. CMA detection rate was significantly higher in patients with brain anomalies, so CMA may be even more appropriate in patients with pathological MRI, increasing the diagnostic value of the test. Conversely, positive CMA in IDD patients should require an MRI assessment, which is more often associated with brain anomalies. Posterior fossa anomalies, both isolated and associated with other brain anomalies, showed a significantly higher rate of CMA positive results and of pathogenic CNVs. In the next-generation sequencing era, our study confirms once again the relevant diagnostic output of CMA in patients with IDD, either isolated or associated with other comorbidities. Since more than half of the patients presented brain anomalies in this study, we propose that neuroimaging should be performed in such cases, particularly in the presence of genomic imbalances.
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Affiliation(s)
- Roberta Milone
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Claudia Cesario
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marina Goldoni
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - Rosa Pasquariello
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Caterina Fusilli
- Bioinformatics Unit, IRCCS Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - Agnese Giovannetti
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Viviana Caputo
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - Giovanni Cioni
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Tommaso Mazza
- Bioinformatics Unit, IRCCS Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - Agatino Battaglia
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy
| | - Laura Bernardini
- Medical Genetics Unit, IRCCS Casa Sollievo della Sofferenza Foundation, San Giovanni Rotondo, Italy
| | - Roberta Battini
- Department of Developmental Neuroscience, IRCCS Stella Maris Foundation, Pisa, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
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Gandini O, Criniti A, Ballesio L, Giglio S, Galardo G, Gianni W, Santoro L, Angeloni A, Lubrano C. Serum Ferritin is an independent risk factor for Acute Respiratory Distress Syndrome in COVID-19. J Infect 2020; 81:979-997. [PMID: 32946917 PMCID: PMC7490639 DOI: 10.1016/j.jinf.2020.09.006] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 09/13/2020] [Indexed: 01/04/2023]
Affiliation(s)
- O Gandini
- Department of Molecular Medicine, Sapienza University of Rome, Rome, Italy.
| | - A Criniti
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - L Ballesio
- Department of Radiology, Anatomo- Pathology and Oncology, Sapienza University of Rome, Rome, Italy
| | - S Giglio
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - G Galardo
- Medical Emergency Unit, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - W Gianni
- II Division of Internal Medicine and Geriatrics, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy
| | - L Santoro
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - A Angeloni
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
| | - C Lubrano
- Department of Experimental Medicine, Sapienza University of Rome, Rome, Italy
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32
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Palterer B, Bartalesi F, Mazzoni A, Maggi L, Provenzano A, Vergoni F, Giglio S, Annunziato F, Parronchi P. Disseminated Mycobacterium xenopi in an Adult with IL-12Rβ1 Deficiency. J Clin Immunol 2020; 40:1166-1170. [PMID: 32856198 DOI: 10.1007/s10875-020-00848-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 08/18/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Boaz Palterer
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, FI, Italy. .,Flow Cytometric Diagnostic Centre and Immunotherapy, Careggi University Hospital, Florence, Italy.
| | - Filippo Bartalesi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - Alessio Mazzoni
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, FI, Italy
| | - Laura Maggi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, FI, Italy
| | - Aldesia Provenzano
- Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy.,Medical Genetics Unit, Meyer University Hospital, Florence, Italy
| | - Federica Vergoni
- Pathological Anatomy Unit, Careggi University Hospital, Florence, Italy
| | - Sabrina Giglio
- Department of Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy.,Medical Genetics Unit, Meyer University Hospital, Florence, Italy
| | - Francesco Annunziato
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, FI, Italy.,Flow Cytometric Diagnostic Centre and Immunotherapy, Careggi University Hospital, Florence, Italy
| | - Paola Parronchi
- Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla 3, 50134, Florence, FI, Italy.,Immunology and Cell Therapies Unit, Careggi University Hospital, Florence, Italy
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Pagliazzi A, Mancano G, Forzano G, di Giovanni F, Gori G, Traficante G, Iolascon A, Giglio S. Genetic counseling during COVID-19 pandemic: Tuscany experience. Mol Genet Genomic Med 2020; 8:e1433. [PMID: 32743952 PMCID: PMC7435534 DOI: 10.1002/mgg3.1433] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [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: 05/29/2020] [Revised: 06/30/2020] [Accepted: 07/02/2020] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND COVID-19 outbreak prompted health centres to reorganize their clinical and surgical activity. In this paper, we show how medical genetics department's activity, in our tertiary pediatric hospital, has changed due to pandemic. METHODS We stratified all our scheduled visits, from March 9th through April 30th, and assessed case-by-case which genetic consultations should be maintained as face-to-face visit, or postponed/switched to telemedicine. RESULTS Out of 288 scheduled appointments, 60 were prenatal consultations and 228 were postnatal visits. We performed most of prenatal consultations as face-to-face visits, as women would have been present in the hospital to perform other procedures in addition to our consult. As for postnatal care, we suspended all outpatient first visits and opted for telemedicine for selected follow-up consultations: interestingly, 75% of our patients' parents revealed that they would have cancelled the appointment themselves for the fear to contract an infection. CONCLUSIONS Spread of COVID-19 in Italy forced us to change our working habits. Given the necessity to optimize healthcare resources and minimize the risk of in-hospital infections, we experienced the benefits of telegenetics. Current pandemic made us familiar with telemedicine, laying the foundations for its application to deal with the increasing number of requests in clinical genetics.
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Affiliation(s)
- Angelica Pagliazzi
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Giorgia Mancano
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Giulia Forzano
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Fabiana di Giovanni
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Giulia Gori
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Giovanna Traficante
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnology, University Federico II of Naples, Naples, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy.,Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
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Brizola E, Gnoli M, Tremosini M, Nucci P, Bargiacchi S, La Barbera A, Giglio S, Sangiorgi L. Variable clinical expression of Stickler Syndrome: A case report of a novel COL11A1 mutation. Mol Genet Genomic Med 2020; 8:e1353. [PMID: 32558342 PMCID: PMC7507508 DOI: 10.1002/mgg3.1353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [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: 04/10/2020] [Revised: 05/12/2020] [Accepted: 05/19/2020] [Indexed: 01/13/2023] Open
Abstract
Background Stickler Syndrome is a rare connective tissue disorder, characterized by clinical, and genetic heterogeneity. The clinical expression is highly variable, including moderate to severe myopia in childhood, hearing loss, facial dysmorphic features, cleft palate, and early osteoarthritis. COL2A1, COL11A1, and COL11A2 mutations account of the majority of autosomal dominant Stickler Syndrome and, in particular, a heterozygous mutation in COL11A1 gene is identified in about 10 to 20% of Stickler Syndrome patients. Methods Herein, we report a case of an 8‐year‐ old child with Stickler Syndrome, presenting with early‐onset of myopia with vitreal abnormalities, facial dysmorphic characteristics, and mild hearing loss later in childhood. To identify the underlying genetic cause, Whole Exome Sequencing was carried out for COL11A1 gene. Results A novel de novo heterozygous splice site variant (NM_001854: c.1845 + 5G> C) of the COL11A1 gene, which had not been previously reported, was identified by Whole Exome Sequencing. Conclusion We reported a novel COL11A1 mutation in a child with Stickler Syndrome presenting a phenotype of early‐onset of ocular anomalies and mild hearing loss later in childhood. Our findings confirm the variability of the expression of the disease, even in the contest of the same gene‐related disorder, thus, contributing to improve the knowledge on clinical and molecular basis of this rare disease.
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Affiliation(s)
- Evelise Brizola
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Maria Gnoli
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Morena Tremosini
- Department of Rare Skeletal Disorders, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Paolo Nucci
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Sara Bargiacchi
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Andrea La Barbera
- Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Firenze, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy.,Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Firenze, Italy.,Excellence Centre for Research, Transfer and High Education for the development of DE NOVO Therapies (DENOTHE), Florence, Italy
| | - Luca Sangiorgi
- Department of Rare Skeletal Disorders & CLIBI Laboratory, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy
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Manenti L, Pisani I, Allinovi M, Gentile M, Farina MT, Peyronel F, Zanelli P, Sebastio P, Palazzo V, Giglio S, Giuliotti S, Fiaccadori E. P0059CLINICAL AND IMAGING FEATURES OF A NOVEL DNAJB11 MUTATION COMPARED TO PKD1-PKD2 ADULT POLYCYSTIC KIDNEY DISEASE (ADPKD). TWO DIFFERENT DISEASES? Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0059] [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 and Aims
ADPKD is characterized by the progressive development of bulky renal cysts, often resulting in end-stage renal disease (ESRD). Among this group 85% of cases recognize a genetic mutation concerning PKD1/PKD2 genes (ADPKD). Among the remaining 15% of ADPKD patients, DNAJB11 mutations (DNAJB11-PKD) has been recently recognized. [Cornec-Le Gall E, Olson RJ, Beesse W t al. Monoallelic Mutations to DNAJB11 Cause Atypical Autosomal-Dominant Polycystic Kidney Disease. Am Journ Hum Gen 2018, 102:832-844.]
DNAJB11 encodes a co-chaperone of the endoplasmic reticulum (ER) also called ERdj3. It is part of the HSP40 protein family and plays a central role in both intracellular and extracellular proteomic homeostasis (proteostasis). In the intracellular compartment it acts as a co-chaperone in the pathway of the unfolded protein response (UPR) in which it binds misfolded proteins which have to be secreted and activates BiP an HSP70 of ER whose function is to correct the misfolding. In our Nephrology Unit we collected the largest cohort of patients with a new stop codon mutation (p.Arg34*) of DNAJB11. All patients are relatives of different ranks and were born in a small village in the mountains of the Parma province.In this study we compare clinical features of DNAJB11-PKD with ADPKD to define differences between the two groups.
Method
We identified retrospectively from outpatient and dialysis databases of the Nephrology Unit of Parma patients carrying pArg34* DNAJB11 or PKD1-PKD2 mutations. We collected the clinical features and the available diagnostic imaging of all identified patients.
Results
We collected 19 patients with DNAJB11-PKD and 37 with ADPKD. The clinical characteristics are reported in Figure 1 . Our DNAJB11-PKD cohort vs ADPKD presented significantly a normal renal size (median value 10.5cm vs 16cm respectively) and smaller cysts size (median value 2cm vs 5cm respectively). Interestingly 5/19 DNAJB11 patients had type 2 diabetes vs no cases in the ADPKD group (p<0.05). ADPKD patients presented ESRD about 10 years before DNAJB11-PKD and renal survival resulted significantly worse (Figure 2).We revised also the previous diagnosis of our DNAJB11-PKD patients; 3/19 DNAJB11-PKD cases were diagnosed as having ADPKD. The remaining were classified as medullary sponge kidney disease (7/19), diabetic nephropathy (3/19) or nephroangiosclerosis (6/19).
Conclusion
DNAJB11 mutations were reported as a cause of ADPKD for the first time in May 2018 by Cornec-Le-Gall and colleagues. In their study were reported 7 different mutations in 23 patients and they identified 2/23 patients with type II diabetes. We here report the larger single DNAJB11 mutation cohort in the literature and compared it with genetic proven ADPKD. We documented differences in pathognomonic clinical features of ADPKD like renal survival, enlarged kidneys and bulky cysts. Moreover about 30% of DNAJB11-PKD patients present Type II diabetes that would be related to altered proteostasis in the ER. Since DNAJB11-PKD appears to differ in relevant aspects from well known ADPKD, it would be less confusing to classify DNAJB11-PKD indipendently from ADPKD.
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Affiliation(s)
- Lucio Manenti
- Azienda Ospedaliero-Universitaria di Parma, UOC Nefrologia,, Parma, Italy
| | - Isabella Pisani
- Azienda Ospedaliero-Universitaria di Parma, UOC Nefrologia,, Parma, Italy
| | - Marco Allinovi
- Careggi University Hospital, SOD Nefrologia, Dialisi e Trapianto, Firenze, Italy
| | - Micaela Gentile
- Azienda Ospedaliero-Universitaria di Parma, UOC Nefrologia,, Parma, Italy
| | | | - Francesco Peyronel
- Azienda Ospedaliero-Universitaria di Parma, UOC Nefrologia,, Parma, Italy
| | - Paola Zanelli
- Azienda Ospedaliero-Universitaria di Parma, SSD Immunogenetica dei trapianti, Parma, Italy
| | - Paola Sebastio
- Azienda Ospedaliero-Universitaria di Parma, SSD Immunogenetica dei trapianti, Parma, Italy
| | - Viviana Palazzo
- Azienda Ospedaliero-Universitaria Meyer, SOD Complessa di Genetica Medica, Firenze, Italy
| | - Sabrina Giglio
- Azienda Ospedaliero-Universitaria Meyer, SOD Complessa di Genetica Medica, Firenze, Italy
| | - Sara Giuliotti
- Azienda Ospedaliera Universitaria di Parma, UOC Radiologia, Parma, Italy
| | - Enrico Fiaccadori
- Azienda Ospedaliero-Universitaria di Parma, UOC Nefrologia,, Parma, Italy
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Provenzano A, Palazzo V, Reho P, Pagliazzi A, Marozza A, Farina A, Zuffardi O, Giglio S. Cover Image. Prenat Diagn 2020. [DOI: 10.1002/pd.5776] [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: 11/10/2022]
Affiliation(s)
- Aldesia Provenzano
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio"University of Florence Florence Italy
| | - Viviana Palazzo
- Medical Genetics UnitMeyer Children's University Hospital Florence Italy
| | - Paolo Reho
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio"University of Florence Florence Italy
| | - Angelica Pagliazzi
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio"University of Florence Florence Italy
| | | | - Antonio Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC), Sant'Orsola‐Malpighi HospitalUniversity of Bologna Bologna Italy
| | - Orsetta Zuffardi
- Unit of Medical Genetics, Department of Molecular MedicineUniversity of Pavia Pavia Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio"University of Florence Florence Italy
- Medical Genetics UnitMeyer Children's University Hospital Florence Italy
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Pisani I, Allinovi M, Palazzo V, Gentile M, Giglio S, Fiaccadori E, Manenti L. P0077A NEW MUTATION OF DNAJB11 AS A CAUSE OF CYSTIC KYDNEY DISEASE: THE FOURTH GENE OF ADPKD. Nephrol Dial Transplant 2020. [DOI: 10.1093/ndt/gfaa142.p0077] [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: 11/12/2022] Open
Abstract
Abstract
Background and Aims
Monogenic inherited diseases are an underestimated but important cause of chronic kidney disease (CKD). Despite the increasing knowledge about their inheritance, they are identified in fewer than 10% of CKD patients. Among monogenic causes of CKD, polycystic kidney diseases (PKD) represent a group of disorders with a clinical and genetic heterogeneity and a variable phenotype (from early manifestations during pregnancy or childhood to the absence of clinical manifestations until adulthood). We here present a PKD family with 5 members displaying the disease (Figure 1).
Method
We revised patients clinical history, laboratory data and imaging exams. An accurate family history was recovered. Blood samples were collected from living patients to perform an exome analysis using next generation sequencing to analyze all possible genes involved in PKD.
Results
Each patient presented a clinical history of nephrolithiasis, a variable degree of CKD (from normal kidney function to renal transplant), urinary and blood parameters compatible with distal renal tubular acidosis (hypercalciuria, low urinary citrate excretion and hypokalemia). Imaging exams showed several renal cysts in the medulla or at the cortico-medullary junction with intracystic calcifications (Figure 2). Some patients displayed also large cortical renal cysts and also hepatic and pancreatic cysts. The genetic analysis performed using next generation sequencing in four patients showed a new mutation on the gene DNAJB11; the mutation introduced a stop codon and was identified as pathogenic by prediction programs. It was present in heterozygosity in all subjects and had an autosomal dominant pattern of inheritance.
Conclusion
DNAJB11 mutations were reported as a cause of PKD for the first time in 2018 by Cornec-Le-Gall and colleagues. The nephropathy derived from these mutations need to be differentiated from ADPKD (autosomal dominant polycystic kidney disease), from ADTKD (autosomal dominant tubulointerstitial kidney disease) and from medullary sponge kidney. DNAJB11 encodes a co-chaperone of the endoplasmic reticulum (ER) also called ERdj3. It is part of the HSP40 protein family and plays a central role in both intracellular and extracellular proteomic homeostasis (proteostasis). In the intracellular compartment it acts as a co-chaperone in the pathway of the unfolded protein response (UPR) in which it binds misfolded proteins which have to be secreted and activates BiP an HSP70 of ER whose function is to correct the misfolding. In the kidney it is mainly expressed in the thick ascending limb of Henle’s loop, in the distal tubule and in the collecting duct justifying the clinical presentation of nephropathy and differentiating the disease from ADPKD (Figure 3).
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Affiliation(s)
- Isabella Pisani
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma, Dipartimento di Medicina e Chirurgia, Parma, Italy
| | - Marco Allinovi
- SOD Nefrologia Dialisi e Trapianto, Azienda Ospedaliero-Universitaria Careggi, Firenze, Italy
| | - Viviana Palazzo
- SOD complessa di Genetica Medica, Azienda Ospedaliero-Universitaria Meyer, Firenze, Italy
| | - Micaela Gentile
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma, Scuola di Specializzazione in Nefrologia, Università di Parma, Dipartimento di Medicina e Chirurgia, Parma, Italy
| | - Sabrina Giglio
- SOD complessa di Genetica Medica, Azienda Ospedaliero-Universitaria Meyer, Firenze, Italy
| | - Enrico Fiaccadori
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma, Dipartimento di Medicina e Chirurgia, Parma, Italy
| | - Lucio Manenti
- UO Nefrologia, Azienda Ospedaliero-Universitaria di Parma, Dipartimento di Medicina e Chirurgia, Parma, Italy
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Provenzano A, Palazzo V, Reho P, Pagliazzi A, Marozza A, Farina A, Zuffardi O, Giglio S. Noninvasive prenatal diagnosis in a family at risk for Fraser syndrome. Prenat Diagn 2020; 40:905-908. [DOI: 10.1002/pd.5700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/06/2020] [Accepted: 04/04/2020] [Indexed: 01/21/2023]
Affiliation(s)
- Aldesia Provenzano
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio"University of Florence Florence Italy
| | - Viviana Palazzo
- Medical Genetics UnitMeyer Children's University Hospital Florence Italy
| | - Paolo Reho
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio"University of Florence Florence Italy
| | - Angelica Pagliazzi
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio"University of Florence Florence Italy
| | | | - Antonio Farina
- Division of Obstetrics and Prenatal Medicine, Department of Medicine and Surgery (DIMEC), Sant'Orsola‐Malpighi HospitalUniversity of Bologna Bologna Italy
| | - Orsetta Zuffardi
- Unit of Medical Genetics, Department of Molecular MedicineUniversity of Pavia Pavia Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio"University of Florence Florence Italy
- Medical Genetics UnitMeyer Children's University Hospital Florence Italy
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Barone R, Gulisano M, Amore R, Domini C, Milana MC, Giglio S, Madia F, Mattina T, Casabona A, Fichera M, Rizzo R. Clinical correlates in children with autism spectrum disorder and CNVs: Systematic investigation in a clinical setting. Int J Dev Neurosci 2020; 80:276-286. [PMID: 32159884 DOI: 10.1002/jdn.10024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/06/2020] [Accepted: 03/06/2020] [Indexed: 01/09/2023] Open
Abstract
Autism spectrum disorder (ASD) is associated with various molecular mechanisms including copy number variants (CNVs). We investigated possible associations between CNVs and ASD clinical correlates. We evaluated pertinent physical characteristics and phenotypic measures such as cognitive level, severity of ASD symptoms and comorbid conditions in ASD patients consecutively recruited over the study period. Children with causative (C-CNVs), non-causative (NC-CNVs) and without CNVs (W-CNVs) were compared. Out of 109 patients, 31 imbalances (16 duplications and 15 deletions) were detected in 25 subjects. Seven (6.4%) had C-CNVs and 18 (16.5%) had NC-CNVs. Paired post hoc comparisons with Bonferroni adjustment showed that dysmorphisms and microcephaly were significantly more frequent in the C-CNVs group. Patients with C-CNVs had more severe autistic core symptoms, while comorbid internalizing behavioral symptoms were more represented among participants with NC-CNVs. No significant differences were observed for distribution of macrocephaly, intellectual disability, epilepsy, isolated electroencephalogram abnormalities and studied neuroimaging characteristics among groups. Recurrent and rare C-CNVs highlighting genes relevant to neurodevelopment had a statistically higher occurrence in children with more severe ASD symptoms and further developmental abnormalities. This study documents the importance of measuring the physical and neurobehavioural correlates of ASD phenotypes to unravel the underlying molecular mechanisms in patient subgroups.
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Affiliation(s)
- Rita Barone
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- CNR-Institute for Polymers, Composites and Biomaterials IPCB, Catania, Italy
| | - Mariangela Gulisano
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Renata Amore
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Carla Domini
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Maria Chiara Milana
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's Hospital, University of Florence, Firenze, Italy
| | - Francesca Madia
- Laboratory of Neurogenetics and Neuroscience, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Teresa Mattina
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, Catania, Italy
| | - Antonino Casabona
- Department of Biomedical and Biotechnological Sciences, Section of Physiology, University of Catania, Catania, Italy
| | - Marco Fichera
- Department of Biomedical and Biotechnological Sciences, Medical Genetics, University of Catania, Catania, Italy
- Oasi Research Institute-IRCCS, Troina, Italy
| | - Renata Rizzo
- Child Neuropsychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
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40
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Squeo GM, Augello B, Massa V, Milani D, Colombo EA, Mazza T, Castellana S, Piccione M, Maitz S, Petracca A, Prontera P, Accadia M, Della Monica M, Di Giacomo MC, Melis D, Selicorni A, Giglio S, Fischetto R, Di Fede E, Malerba N, Russo M, Castori M, Gervasini C, Merla G. Customised next-generation sequencing multigene panel to screen a large cohort of individuals with chromatin-related disorder. J Med Genet 2020; 57:760-768. [PMID: 32170002 DOI: 10.1136/jmedgenet-2019-106724] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 02/11/2020] [Accepted: 02/19/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND The regulation of the chromatin state by epigenetic mechanisms plays a central role in gene expression, cell function, and maintenance of cell identity. Hereditary disorders of chromatin regulation are a group of conditions caused by abnormalities of the various components of the epigenetic machinery, namely writers, erasers, readers, and chromatin remodelers. Although neurological dysfunction is almost ubiquitous in these disorders, the constellation of additional features characterizing many of these genes and the emerging clinical overlap among them indicate the existence of a community of syndromes. The introduction of high-throughput next generation sequencing (NGS) methods for testing multiple genes simultaneously is a logical step for the implementation of diagnostics of these disorders. METHODS We screened a heterogeneous cohort of 263 index patients by an NGS-targeted panel, containing 68 genes associated with more than 40 OMIM entries affecting chromatin function. RESULTS This strategy allowed us to identify clinically relevant variants in 87 patients (32%), including 30 for which an alternative clinical diagnosis was proposed after sequencing analysis and clinical re-evaluation. CONCLUSION Our findings indicate that this approach is effective not only in disorders with locus heterogeneity, but also in order to anticipate unexpected misdiagnoses due to clinical overlap among cognate disorders. Finally, this work highlights the utility of a prompt diagnosis in such a clinically and genetically heterogeneous group of disorders that we propose to group under the umbrella term of chromatinopathies.
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Affiliation(s)
- Gabriella Maria Squeo
- Division of Medical Genetics, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Bartolomeo Augello
- Division of Medical Genetics, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Valentina Massa
- Dipartimento di Scienze della Salute, Universita degli Studi di Milano Dipartimento di Scienze della Salute, Milano, Italy
| | - Donatella Milani
- UOSD Pediatria ad alta intensità di cura, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Elisa Adele Colombo
- Dipartimento di Scienze della Salute, Universita degli Studi di Milano Dipartimento di Scienze della Salute, Milano, Italy
| | - Tommaso Mazza
- Bioinformatics Unit, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Stefano Castellana
- Bioinformatics Unit, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Maria Piccione
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Silvia Maitz
- Clinical Pediatric Genetics Unit, Pediatrics Clinics, MBBM Foundation, Hospital San Gerardo, Monza, Italy
| | - Antonio Petracca
- Division of Medical Genetics, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Paolo Prontera
- Medical Genetics Unit, University of Perugia Hospital SM della Misericordia, Perugia, Italy
| | - Maria Accadia
- Medical Genetics Service, Hospital "Cardinale G. Panico", Tricase, Italy
| | - Matteo Della Monica
- Medical Genetics Unit, Cardarelli Hospital, Largo A Cardarelli, Napoli, Italy
| | | | - Daniela Melis
- Department of Translational Medical Science, Section of Pediatrics, University of Naples Federico II, Napoli, Italy
| | - Angelo Selicorni
- Pediatric Department, ASST Lariana, Sant'Anna General Hospital, Como, Italy
| | - Sabrina Giglio
- Department of Biomedical, Experimental and Clinical Sciences 'Mario Serio', Medical Genetics Unit, University Hospital Meyer, Firenze, Italy
| | - Rita Fischetto
- Metabolic Diseases, Clinical Genetics and Diabetology Unit, Paediatric Hospital Giovanni XXIII, Bari, Italy
| | - Elisabetta Di Fede
- Dipartimento di Scienze della Salute, Universita degli Studi di Milano Dipartimento di Scienze della Salute, Milano, Italy
| | - Natascia Malerba
- Division of Medical Genetics, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Matteo Russo
- Division of Medical Genetics, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Marco Castori
- Division of Medical Genetics, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Cristina Gervasini
- Dipartimento di Scienze della Salute, Universita degli Studi di Milano Dipartimento di Scienze della Salute, Milano, Italy
| | - Giuseppe Merla
- Division of Medical Genetics, IRCCS Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
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41
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Giunti L, Cetica V, De Gregorio V, Mei D, Barba C, Buccoliero A, Genitori L, Guerrini R, Giglio S, Sardi I, Guidi M, Censullo M. P04.08 The role of SCN1A in glioblastomas and mixed neuronal glial tumors of pediatric age. Neuro Oncol 2019. [DOI: 10.1093/neuonc/noz126.103] [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: 11/15/2022] Open
Abstract
Abstract
BACKGROUND
Low and high grade gliomas, are the most common pediatric central nervous system (CNS) tumors and they show an extremely broad range of clinical behavior. Pediatric glioma is distinct from its adult counterpart with different genetic/epigenetic profile and biological features. Recently, several studies have shown the involvement of voltage-gated Na+ channels (VGSC) in different types of cancer, including gliomas. VGSC are multimeric transmembrane complexes, responsible for membrane depolarization in excitable cells playing an important role also in cell proliferation, migration, apoptosis and differentiation. VGSC are therapeutic targets in cardiovascular and neurological disorders and, in cancers, they could be a novel target for the development of promising anticancer therapy
MATERIAL AND METHODS
Firstly, we explored the genetic background of 9 pediatric glioblastomas (1–9 pGBMs), through whole-exome sequencing (WES) using HiSeq1000 platform (Illumina) with paired-end approach. On the basis of our results, we extended our study in another group of 16 epileptogenic mixed neuronal-glial tumors of pediatric age, (WHO grade I and II), through an amplicon approach (TSCA) using MiniSeq System platform (Illumina)
RESULTS
We identified variants in SCN1A gene in 3/9 pGBMs: case 3 had c.5782C>G in tumor and blood; case 5 showed c.2278G>T and two mosaic variants (c.5933C>T, 22% and c.4942C>T, 14%); case 6 showed c.667G>T variant only in tumor, and not in other non tumoral tissues (blood, urine and buccal swab). No variants in SCN1A were identified in a group of 16 pediatric mixed gliomas
CONCLUSION
In this study, we explore the genetic background of two groups of pediatric neuroepithelial brain tumors, through Next generation sequencing approach. We identified only in pGBMs variants in SCN1A gene that encoded for VGSCs and is involved in a spectrum of early-onset epileptic encephalopathies. None of our mutated patients showed history of epilepsy. Now, it is not clear the significance of these variants in pGBMs but interestingly, these variants are present in pGBM and not in mixed gliomas. Further studies on a big cohort of patients are needed to establish if they could play a role in pGBMs aggressiveness, migration and progression. Moreover, VGSCs could be a pharmacological target in pGBMs treatment
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Affiliation(s)
- L Giunti
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - V Cetica
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - V De Gregorio
- Neuro-Oncology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - D Mei
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - C Barba
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - A Buccoliero
- Pathology Unit Meyer Children’s University Hospital, Firenze, Italy
| | - L Genitori
- Neurosurgery Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - R Guerrini
- Child Neurology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - S Giglio
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - I Sardi
- Neuro-Oncology Unit, Meyer Children’s University Hospital, Firenze, Italy
| | - M Guidi
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
| | - M Censullo
- Medical Genetics Unit, Meyer Children Hospital, Firenze, Italy
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42
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Gambale A, Russo R, Andolfo I, Quaglietta L, De Rosa G, Contestabile V, De Martino L, Genesio R, Pignataro P, Giglio S, Capasso M, Parasole R, Pasini B, Iolascon A. Germline mutations and new copy number variants among 40 pediatric cancer patients suspected for genetic predisposition. Clin Genet 2019; 96:359-365. [DOI: 10.1111/cge.13600] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 07/03/2019] [Accepted: 07/03/2019] [Indexed: 12/12/2022]
Affiliation(s)
- Antonella Gambale
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Roberta Russo
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Immacolata Andolfo
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Lucia Quaglietta
- Azienda Ospedaliera di Rilievo Nazionale Santobono PausiliponS.C. Pediatria Oncologia, Dip. di Oncoematologia Pediatrica Napoli Italy
| | - Gianluca De Rosa
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Valentina Contestabile
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
| | - Lucia De Martino
- Azienda Ospedaliera di Rilievo Nazionale Santobono PausiliponS.C. Pediatria Oncologia, Dip. di Oncoematologia Pediatrica Napoli Italy
| | - Rita Genesio
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
| | - Piero Pignataro
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
| | - Sabrina Giglio
- Biomedical Experimental and Clinical Sciences "Mario Serio"University of Florence Florence Italy
- SOD Genetica MedicaAzienda Ospedaliero‐Universitaria Meyer Florence Italy
| | - Mario Capasso
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
- IRCCS SDN Naples Italy
| | - Rosanna Parasole
- Azienda Ospedaliera di Rilievo Nazionale Santobono PausiliponS.C. Pediatria Oncologia, Dip. di Oncoematologia Pediatrica Napoli Italy
| | - Barbara Pasini
- Dipartimento di Scienze MedicheUniversità degli Studi di Torino Torino Italy
| | - Achille Iolascon
- Dipartimento di Medicina Molecolare e Biotecnologie MedicheUniversità degli Studi di Napoli Federico II Naples Italy
- CEINGE Biotecnologie Avanzate Naples Italy
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43
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Vergine G, Ravaioli E, Palazzo V, Gambaro G, Giglio S. [A child with severe growth delay and renal cysts]. G Ital Nefrol 2019; 36:36-1-2019-5. [PMID: 30758150] [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] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
We describe the case of a 5-year-old who came to our attention for a growth delay. Among the investigations planned because of the child's short stature, we performed an abdominal ultrasound showing normal-sized kidneys with signs of cortico-medullar de-differentiation, diffuse medullary hyperechogenicity with reduction of cortical thickness and cortical-medullary cysts. The ultrasound findings, also confirmed in MRI, led us to suspect a genetically determined cystic nephropathy of the nephronophthisis or medullary cystic disease type. No mutation was identified in NPHP1, HNFb1 and UMOD genes. Interestingly, laboratory investigations revealed a severe metabolic acidosis with normal renal function and hypokalemia. These findings are not characteristics of a nephronophthisis. We therefore also performed molecular analysis for distal tubular acidosis (dRTA) that showed the association of two genetic variants of ATP6V1B1 and SLC4A genes. These "double mutations" have been inherited from the mother, which however does not have the classic dRTA phenotype. These variants do not currently meet the criteria for a conclusive molecular diagnosis of dRTA but represent variants of uncertain clinical significance. However, considering the clinical and laboratory data one can reasonably conclude that the child has a "probable" diagnosis of distal tubular acidosis. The rapid recovery of staturo-ponderal growth after the start of alkalizing treatment supports our diagnostic hypothesis. The association between distal tubular acidosis and renal cysts is well described in the literature. The hypothesis is that chronic hypokalemia may play a possible role in the formation of renal cysts.
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Affiliation(s)
| | | | | | - Giovanni Gambaro
- UO Nefrologia, Policlinico Universitario A. Gemelli-Università Cattolica del Sacro Cuore, Roma
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44
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Lucenteforte E, Vannacci A, Crescioli G, Lombardi N, Vagnoli L, Giunti L, Cetica V, Coniglio ML, Pugi A, Bonaiuti R, Aricò M, Giglio S, Messeri A, Barale R, Giovannelli L, Mugelli A, Maggini V. Opioid response in paediatric cancer patients and the Val158Met polymorphism of the human catechol-O-methyltransferase (COMT) gene: an Italian study on 87 cancer children and a systematic review. BMC Cancer 2019; 19:113. [PMID: 30704436 PMCID: PMC6357360 DOI: 10.1186/s12885-019-5310-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Accepted: 01/21/2019] [Indexed: 01/08/2023] Open
Abstract
Background Genetic polymorphisms in genes involved in pain modulation have been reported to be associated to opioid efficacy and safety in different clinical settings. Methods The association between COMT Val158Met polymorphism (rs4680) and the inter-individual differences in the response to opioid analgesic therapy was investigated in a cohort of 87 Italian paediatric patients receiving opioids for cancer pain (STOP Pain study). Furthermore, a systematic review of the association between opioid response in cancer patients and the COMT polymorphism was performed in accordance with the Cochrane Handbook and the Prisma Statement. Results In the 87 paediatric patients, pain intensity (total time needed to reach the lowest possible level) was significantly higher for G/G than A/G and A/A carriers (p-value = 0.042). In the 60 patients treated only with morphine, the mean of total dose to reach the same pain intensity was significantly higher for G/G than A/G and A/A carriers (p-value = 0.010). Systematic review identified five studies on adults, reporting that opioid dose (mg after 24 h of treatment from the first pain measurement) was higher for G/G compared to A/G and A/A carriers. Conclusions Present research suggests that the A allele in COMT polymorphism could be a marker of opioid sensitivity in paediatric cancer patients (STOP Pain), as well as in adults (Systematic Review), indicating that the polymorphism impact could be not age-dependent in the cancer pain context. Trial registration Registration number: CRD42017057831. Electronic supplementary material The online version of this article (10.1186/s12885-019-5310-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine University of Pisa, Pisa, Italy
| | - Alfredo Vannacci
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Giada Crescioli
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Niccolò Lombardi
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Laura Vagnoli
- Pain and Palliative Care Unit, Meyer Children's University Hospital, Florence, Italy
| | - Laura Giunti
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy
| | - Valentina Cetica
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Neuroscience Department, Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Maria Luisa Coniglio
- Department of Paediatric Oncohematology, Meyer Children's University Hospital, Florence, Italy
| | - Alessandra Pugi
- Clinical Trial Office, Meyer Children's University Hospital, Florence, Italy
| | - Roberto Bonaiuti
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Maurizio Aricò
- Direzione Generale, Azienda Sanitaria Provinciale, Ragusa, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy.,Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Andrea Messeri
- Pain and Palliative Care Unit, Meyer Children's University Hospital, Florence, Italy
| | | | - Lisa Giovannelli
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Alessandro Mugelli
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Valentina Maggini
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy. .,Center for Integrative Medicine, Department of Experimental and Clinical Medicine, Careggi University Hospital, University of Florence, Largo Brambilla, 3 -, 50134, Florence, Italy.
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45
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Giunti L, Da Ros M, De Gregorio V, Magi A, Landini S, Mazzinghi B, Buccoliero AM, Genitori L, Giglio S, Sardi I. A microRNA profile of pediatric glioblastoma: The role of NUCKS1 upregulation. Mol Clin Oncol 2019; 10:331-338. [PMID: 30847170 PMCID: PMC6388501 DOI: 10.3892/mco.2019.1795] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [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: 06/29/2018] [Accepted: 12/10/2018] [Indexed: 12/16/2022] Open
Abstract
MicroRNAs (miRNAs/miRs) are a novel class of gene regulators that may be involved in tumor chemoresistance. Recently, specific miRNA expression profiles have been identified in adult glioblastoma (aGBM), but there are only limited data available on the role of miRNAs in pediatric GBM (pGBM). In the present study, the expression profile of miRNAs was examined in seven pGBMs and three human GBM cell lines (U87MG, A172 and T98G), compared with a non-tumoral pool of pediatric cerebral cortex samples by microarray analysis. A set of differentially expressed miRNAs was identified, including miR-490, miR-876-3p, miR-876-5p, miR-448 and miR-137 (downregulated), as well as miR-501-3p (upregulated). Through bioinformatics analysis, a series of target genes was predicted. In addition, similar gene expression patterns in pGBMs and cell lines was confirmed. Of note, drug resistant T98G cells had upregulated nuclear casein kinase and cyclin-dependent kinase substrate 1 (NUCKS1) expression, a protein overexpressed in many tumors that serves an important role in cell proliferation and progression. On the basis of the present preliminary report, it could be intriguing to further investigate the relationship between each of the identified differentially expressed miRNAs and NUCKS1, in order to clarify their involvement in the multi-drug resistance mechanism of pGBMs.
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Affiliation(s)
- Laura Giunti
- Medical Genetics Unit, Meyer Children's University Hospital, I-50139 Florence, Italy
| | - Martina Da Ros
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's University Hospital, I-50139 Florence, Italy
| | - Veronica De Gregorio
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's University Hospital, I-50139 Florence, Italy
| | - Alberto Magi
- Department of Experimental and Clinical Medicine, University of Florence, I-50139 Florence, Italy
| | - Samuela Landini
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences 'Mario Serio', University of Florence, I-50139 Florence, Italy
| | - Benedetta Mazzinghi
- Nephrology and Dialysis Unit, Meyer Children's University Hospital, I-50139 Florence, Italy
| | | | - Lorenzo Genitori
- Neurosurgery Unit, Meyer Children's University Hospital, I-50139 Florence, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, I-50139 Florence, Italy.,Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences 'Mario Serio', University of Florence, I-50139 Florence, Italy
| | - Iacopo Sardi
- Neuro-Oncology Unit, Department of Pediatric Oncology, Meyer Children's University Hospital, I-50139 Florence, Italy
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46
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Kurtas NE, Xumerle L, Leonardelli L, Delledonne M, Brusco A, Chrzanowska K, Schinzel A, Larizza D, Guerneri S, Natacci F, Bonaglia MC, Reho P, Manolakos E, Mattina T, Soli F, Provenzano A, Al-Rikabi AH, Errichiello E, Nazaryan-Petersen L, Giglio S, Tommerup N, Liehr T, Zuffardi O. Small supernumerary marker chromosomes: A legacy of trisomy rescue? Hum Mutat 2018; 40:193-200. [PMID: 30412329 DOI: 10.1002/humu.23683] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 08/21/2018] [Revised: 11/07/2018] [Accepted: 11/07/2018] [Indexed: 11/11/2022]
Abstract
We studied by a whole genomic approach and trios genotyping, 12 de novo, nonrecurrent small supernumerary marker chromosomes (sSMC), detected as mosaics during pre- or postnatal diagnosis and associated with increased maternal age. Four sSMCs contained pericentromeric portions only, whereas eight had additional non-contiguous portions of the same chromosome, assembled together in a disordered fashion by repair-based mechanisms in a chromothriptic event. Maternal hetero/isodisomy was detected with a paternal origin of the sSMC in some cases, whereas in others two maternal alleles in the sSMC region and biparental haplotypes of the homologs were detected. In other cases, the homologs were biparental while the sSMC had the same haplotype of the maternally inherited chromosome. These findings strongly suggest that most sSMCs are the result of a multiple-step mechanism, initiated by maternal meiotic nondisjunction followed by postzygotic anaphase lagging of the supernumerary chromosome and its subsequent chromothripsis.
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Affiliation(s)
| | - Luciano Xumerle
- Department of Biotechnology, University of Verona, Verona, Italy
| | | | | | - Alfredo Brusco
- Department of Medical Sciences, University of Turin, Torino, Italy
| | - Krystyna Chrzanowska
- Department of Medical Genetics, The Children's Memorial Health Institute, Warsaw, Poland
| | - Albert Schinzel
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Daniela Larizza
- Pediatrics and Adolescentology Unit, University of Pavia, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Silvana Guerneri
- Laboratory of Medical Genetics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Federica Natacci
- Laboratory of Medical Genetics, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Clara Bonaglia
- Cytogenetics Laboratory, Scientific Institute, IRCCS Eugenio Medea, Bosisio Parini, Lecco, Italy
| | - Paolo Reho
- Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Firenze, Italy
| | | | - Teresa Mattina
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Fiorenza Soli
- Department of Genetics, Santa Chiara Hospital, Trento, Italy
| | - Aldesia Provenzano
- Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Firenze, Italy.,Azienda Ospedaliero-Universitaria Meyer, Firenze, Italy
| | - Ahmed H Al-Rikabi
- Institute of Human Genetics, Jena University Hospital, Jena, Germany
| | | | | | - Sabrina Giglio
- Biomedical Experimental and Clinical Sciences "Mario Serio", University of Florence, Firenze, Italy.,Azienda Ospedaliero-Universitaria Meyer, Firenze, Italy
| | - Niels Tommerup
- Department of Cellular and Molecular Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Liehr
- Institute of Human Genetics, Jena University Hospital, Jena, Germany
| | - Orsetta Zuffardi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
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47
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Sticchi E, De Cario R, Magi A, Giglio S, Provenzano A, Nistri S, Pepe G, Giusti B. Bicuspid Aortic Valve: Role of Multiple Gene Variants in Influencing the Clinical Phenotype. Biomed Res Int 2018; 2018:8386123. [PMID: 30255099 PMCID: PMC6145047 DOI: 10.1155/2018/8386123] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/20/2018] [Accepted: 07/31/2018] [Indexed: 02/06/2023]
Abstract
Background. Bicuspid aortic valve (BAV) is a common congenital heart defect with increased prevalence of aortic dilatation and dissection. BAV has an autosomal dominant pattern of inheritance with reduced penetrance and variable expressivity. BAV has been described as an isolated trait or associated with other clinical manifestations in syndromic conditions. Identification of a syndromic condition in a BAV patient is clinically relevant in order to personalize indication to aortic surgery. We aimed to point out how genetic diagnosis by next-generation sequencing (NGS) can improve management of a patient with complex BAV clinical picture. Methods and Results. We describe a 45-year-old Caucasian male with BAV, thoracic aortic root and ascending aorta dilatation, and connective features evocative but inconclusive for clinical diagnosis of Marfan syndrome (MFS). Targeted (91 genes) NGS was used. Proband genetic variants were investigated in first-degree relatives. Proband carried 5 rare variants in 4 genes: FBN1(p.Asn542Ser and p.Lys2460Arg), NOTCH1(p.Val1739Met), LTBP1(p.Arg1330Gln), and TGFBR3(p.Arg423Trp). The two FBN1 variants were inherited in cis by the mother, showing systemic features evocative of MFS, but with a milder phenotype than that observed in the proband. Careful clinical observation along with the presence of the FBN1 variants allowed diagnosis of MFS in the proband and in his mother. NOTCH1 variant was found in mother and brother, not exhibiting BAV, thus not definitely supporting/excluding association with BAV. Interestingly, the proband, his brother and father, all showing root dilatation, and his sister, with upper range aortic root dimension, were carriers of a TGFBR3 variant. LTBP1 might also modulate the vascular phenotype. Conclusions. Our results underline the usefulness of NGS together with family evaluation in diagnosis of patients with monogenic traits and overlapping clinical manifestations due to contribution of the same genes and/or presence of comorbidities determined by different genes.
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Affiliation(s)
- Elena Sticchi
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of Florence, Italy
- Marfan Syndrome and Related Disorders Regional Referral Center, Careggi Hospital, Florence, Italy
- Excellence Centre for Research, Transfer and High Education for the Development of De Novo Therapies (DENOTHE), University of Florence, Florence, Italy
| | - Rosina De Cario
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of Florence, Italy
| | - Alberto Magi
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of Florence, Italy
| | - Sabrina Giglio
- Department of Biomedical Experimental and Clinical Sciences 'Mario Serio', University of Florence, Italy
- Medical Genetic Unit, Meyer Children's University Hospital, Florence, Italy
| | - Aldesia Provenzano
- Department of Biomedical Experimental and Clinical Sciences 'Mario Serio', University of Florence, Italy
| | - Stefano Nistri
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of Florence, Italy
- Cardiology Service, CMSR Veneto Medica, Altavilla Vicentina, Italy
| | - Guglielmina Pepe
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of Florence, Italy
- Marfan Syndrome and Related Disorders Regional Referral Center, Careggi Hospital, Florence, Italy
- Excellence Centre for Research, Transfer and High Education for the Development of De Novo Therapies (DENOTHE), University of Florence, Florence, Italy
| | - Betti Giusti
- Department of Experimental and Clinical Medicine, Section of Critical Medical Care and Medical Specialities, University of Florence, Italy
- Marfan Syndrome and Related Disorders Regional Referral Center, Careggi Hospital, Florence, Italy
- Excellence Centre for Research, Transfer and High Education for the Development of De Novo Therapies (DENOTHE), University of Florence, Florence, Italy
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48
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Delvecchio M, Salzano G, Bonura C, Cauvin V, Cherubini V, d'Annunzio G, Franzese A, Giglio S, Grasso V, Graziani V, Iafusco D, Iughetti L, Lera R, Maffeis C, Maltoni G, Mantovani V, Menzaghi C, Patera PI, Rabbone I, Reindstadler P, Scelfo S, Tinto N, Toni S, Tumini S, Lombardo F, Nicolucci A, Barbetti F. Can HbA1c combined with fasting plasma glucose help to assess priority for GCK-MODY vs HNF1A-MODY genetic testing? Acta Diabetol 2018; 55:981-983. [PMID: 29948406 DOI: 10.1007/s00592-018-1179-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 06/07/2018] [Indexed: 10/14/2022]
Affiliation(s)
- Maurizio Delvecchio
- Pediatric and Neonatology Unit, Mother and Children Health Care Department, "Madonna delle Grazie" Hospital, ASL Matera, Contrada Cattedra Ambulante, 85100, Matera, Italy.
| | | | - Clara Bonura
- Endocrine Unit, Department of Pediatrics, Diabetes Research Institute (OSR-DRI), Scientific Institute Hospital San Raffaele, Milan, Italy
| | - Vittoria Cauvin
- Pediatric Diabetology Unit, S. Chiara Hospital, Trento, Italy
| | - Valentino Cherubini
- S.O.D. Pediatric Diabetology, Department of Women's and Children Health, Salesi Hospital, Ancona, Italy
| | - Giuseppe d'Annunzio
- Istituto Giannina Gaslini, Regional Center for Pediatric Diabetes, Genoa, Italy
| | - Adriana Franzese
- Regional Center of Pediatric Diabetology, University of Naples Federico II, Naples, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", and Meyer Children's University Hospital, University of Florence, Florence, Italy
| | - Valeria Grasso
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy
| | - Vanna Graziani
- Pediatric Unit, S. Maria delle Croci Hospital, AUSL della Romagna, Ravenna, Italy
| | - Dario Iafusco
- Department of Pediatrics, Regional Center for Pediatric Diabetology "G.Stoppoloni", University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Lorenzo Iughetti
- Pediatric Unit, Department of Medical and Surgical Sciences for Mothers, Children and Adults, University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Lera
- Department of Pediatrics, Alessandria Hospital, Alessandria, Italy
| | - Claudio Maffeis
- Pediatric Diabetes and Metabolic Disorders Unit, Department of Surgical Science, Dentistry, Ginecology and Pediatrics, University of Verona, Verona, Italy
| | - Giulio Maltoni
- Department of Pediatrics, S. Orsola-Malpighi University Hospital, Bologna, Italy
| | - Vilma Mantovani
- Center for Applied Biomedical Research (CRBA) and Medical Genetics Unit, St. Orsola University Hospital, Bologna, Italy
| | - Claudia Menzaghi
- Research Unit of Diabetes and Endocrine Disease, IRCCS Casa del Sollievo della Sofferenza, San Giovanni Rotondo (FG), Italy
| | - Patrizia I Patera
- Pediatric Diabetology Unit, University Department of Pediatric Medicine, Bambino Gesù Children Hospital, Rome, Italy
| | - Ivana Rabbone
- Department of Pediatrics, Regina Margherita Children Hospital, Turin, Italy
| | | | - Sabrina Scelfo
- Pediatric Diabetes Unit, Health Service of Caltanissetta, Caltanissetta, Italy
| | - Nadia Tinto
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, and CEINGE, Advanced Biotechnology, Naples, Italy
| | - Sonia Toni
- Juvenile Diabetes Center, Meyer Children's Hospital, Florence, Italy
| | - Stefano Tumini
- Center of Pediatric Diabetology, University of Chieti, Chieti, Italy
| | | | - Antonio Nicolucci
- CORESEARCH-Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - Fabrizio Barbetti
- Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, Via Montpellier 1, 00133, Rome, Italy.
- Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
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49
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Lukic A, Di Properzio M, Carico E, De Vitis C, Giglio S, Bordi G, Caserta D, Mancini R. MicroRNA-551b expression profile in low and high-grade cervical intraepithelial neoplasia. Eur Rev Med Pharmacol Sci 2018; 22:4448-4457. [PMID: 30058680 DOI: 10.26355/eurrev_201807_15496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To evaluate the expression of microRNA (miR)-551b in patients with low and high grade cervical intraepithelial neoplasia (CIN) and to find an association with high-risk Human Papillomavirus (HR-HPV) infection-related prognostic biomarkers. PATIENTS AND METHODS The expression level of miR-551b was determined in 50 paraffin-embedded cervical specimens (10 normal squamous epithelium, 18 condylomas, 8 CIN1, and 14 CIN2-3) using quantitative Real-time polymerase chain reaction (qRT-PCR). χ2-test compared miR-551b expression in different diagnosis groups. An Ordered Logistic Regression and a Probit correlation were made to correlate miR-551b expression levels with the cervical tissue histological findings. The immunohistochemical distribution of p16 and Ki-67 according to histopathological findings was also assessed. RESULTS The distribution of the miR-551b expression profile was significantly lower in CIN1-3 samples compared to other histological diagnosis groups (condyloma and negative). The expression levels were inversely correlated to the cervical pathological grade, from negative to CIN2-3. A 1% increase in miR-551b expression level produced an increase of 19% to the probability of a minor histological grade diagnosis in a range from negative to CIN2-3 and an increase of 13% to the probability of a negative histological grade diagnosis. Among the cases with miR-551b expression < 0.02 (considered as cut-off value) a significant statistical correlation was found between p16 and Ki-67 expression and the diagnosis of CIN2-3. CONCLUSIONS Our data showed a significant inverse correlation between miR-551b expression and the histological grading of the lesions, suggesting a tumor suppressive function in the different stages of cervical dysplasia.
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Affiliation(s)
- A Lukic
- Department of Surgical and Medical Sciences and Translational Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.
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50
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Lucenteforte E, Vagnoli L, Pugi A, Crescioli G, Lombardi N, Bonaiuti R, Aricò M, Giglio S, Messeri A, Mugelli A, Vannacci A, Maggini V. A systematic review of the risk factors for clinical response to opioids for all-age patients with cancer-related pain and presentation of the paediatric STOP pain study. BMC Cancer 2018; 18:568. [PMID: 29776346 PMCID: PMC5960169 DOI: 10.1186/s12885-018-4478-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 03/01/2018] [Accepted: 05/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inter-patient variability in response to opioids is well known but a comprehensive definition of its pathophysiological mechanism is still lacking and, more importantly, no studies have focused on children. The STOP Pain project aimed to evaluate the risk factors that contribute to clinical response and adverse drug reactions to opioids by means of a systematic review and a clinical investigation on paediatric oncological patients. METHODS We conducted a systematic literature search in EMBASE and PubMed up to the 24th of November 2016 following Cochrane Handbook and PRISMA guidelines. Two independent reviewers screened titles and abstracts along with full-text papers; disagreements were resolved by discussion with two other independent reviewers. We used a data extraction form to provide details of the included studies, and conducted quality assessment using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. RESULTS Young age, lung or gastrointestinal cancer, neuropathic or breakthrough pain and anxiety or sleep disturbance were associated to a worse response to opioid analgesia. No clear association was identified in literature regarding gender, ethnicity, weight, presence of metastases, biochemical or hematological factors. Studies in children were lacking. Between June 2011 and April 2014, the Italian STOP Pain project enrolled 87 paediatric cancer patients under treatment with opioids (morphine, codeine, oxycodone, fentanyl and tramadol). CONCLUSIONS Future studies on cancer pain should be designed with consideration for the highlighted factors to enhance our understanding of opioid non-response and safety. Studies in children are mandatory. TRIAL REGISTRATION CRD42017057740 .
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Affiliation(s)
- Ersilia Lucenteforte
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy.,Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Laura Vagnoli
- Pain and Palliative Care Unit, Meyer children's hospital, Florence, Italy
| | - Alessandra Pugi
- Clinical Trial Office, Meyer Children's Hospital, Florence, Italy
| | - Giada Crescioli
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Niccolò Lombardi
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Roberto Bonaiuti
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Maurizio Aricò
- Direzione Generale, Azienda Sanitaria Provinciale, Ragusa, Italy
| | - Sabrina Giglio
- Medical Genetics Unit, Meyer Children's University Hospital, Florence, Italy.,Medical Genetics Unit, Department of Clinical and Experimental Biomedical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Andrea Messeri
- Pain and Palliative Care Unit, Meyer children's hospital, Florence, Italy
| | - Alessandro Mugelli
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Alfredo Vannacci
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy
| | - Valentina Maggini
- Department of Neuroscience, Psychology, Drug Research and Children's Health, University of Florence, Florence, Italy. .,Center for Integrative Medicine, Careggi University Hospital, Department of Experimental and Clinical Medicine, University of Florence, Largo Brambilla, 3 - 50134, Florence, Italy.
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