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Largeaud L, Collin M, Monselet N, Vergez F, Fregona V, Larcher L, Hirsch P, Duployez N, Bidet A, Luquet I, Bustamante J, Dufrechou S, Prade N, Nolla M, Hamelle C, Tavitian S, Habib C, Meynier M, Bellanne-Chantelot C, Donadieu J, De Fontbrune FS, Fieschi C, Ferster A, Delhommeau F, Delabesse E, Pasquet M. Somatic genetic alterations predict haematological progression in GATA2 deficiency. Haematologica 2023. [PMID: 36727400 DOI: 10.3324/haematol.2022.282250] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Indexed: 02/03/2023] Open
Abstract
Germline GATA2 mutations predispose to myeloid malignancies resulting from the progressive acquisition of additional somatic mutations. Here we describe clinical and biological features of 78 GATA2 deficient patients. Hematopoietic stem and progenitor cell phenotypic characterization revealed an exhaustion of myeloid progenitors. Somatic mutations in STAG2, ASXL1 and SETBP1 genes along with cytogenetic abnormalities (monosomy 7, trisomy 8, der(1;7)) occurred frequently in patients with GATA2 germline mutations. Patients were classified into three haematopoietic spectra based on bone marrow cytomorphology. No somatic additional mutations were detected in patients with normal bone marrow (spectrum 0), whereas clonal haematopoiesis mediated by STAG2 mutations was frequent in those with a hypocellular and/or myelodysplastic bone marrow without excess blasts (spectrum 1). Finally, SETBP1, RAS pathway and RUNX1 mutations were predominantly associated with leukemic transformation stage (spectrum 2), highlighting their implications in the transformation process. Specific somatic alterations, potentially providing distinct selective advantages to affected cells, are therefore associated with the clinical/haematological evolution of GATA2 syndrome. Our study not only suggests that somatic genetic profiling will help clinicians for their management of patients, but also clarify the mechanism of leukemogenesis in the context of germline GATA2 mutations.
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Affiliation(s)
- Laetitia Largeaud
- Laboratory of Hematology, Institut Universitaire du Cancer de Toulouse, France; Universite de Toulouse, Inserm, CNRS, Universite Toulouse III-Paul Sabatier, Centre de Recherches en Cancerologie de Toulouse, Toulouse
| | - Matthew Collin
- Human Dendritic Cell Laboratory, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne
| | - Nils Monselet
- Department of bioinformatic, Institut Claudius Rigaud, Toulouse
| | - Francois Vergez
- Laboratory of Hematology, Institut Universitaire du Cancer de Toulouse
| | - Vincent Fregona
- Universite de Toulouse, Inserm, CNRS, Universite Toulouse III-Paul Sabatier, Centre de Recherches en Cancerologie de Toulouse, Toulouse
| | - Lise Larcher
- Laboratory of Hematology, Hopital Saint-Louis, APHP
| | - Pierre Hirsch
- Sorbonne Universite, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, SIRIC CURAMUS, Hopital Saint-Antoine, Service d'Hematologie Biologique, 75012, Paris
| | | | | | - Isabelle Luquet
- Laboratory of Hematology, Institut Universitaire du Cancer de Toulouse
| | - Jacinta Bustamante
- Center for the Study of Primary Immunodeficiencies, Paris Cite University, Necker Hospital for Sick Children, APHP, France; Laboratory of Human Genetics of Infectious Diseases, Necker Branch, INSERM U1163, Imagine Institute, Paris, France; St Giles Laboratory of Human Genetics of Infectious Diseases, Rockefeller Branch, Rockefeller University, New York, NY
| | | | - Nais Prade
- Laboratory of Hematology, Institut Universitaire du Cancer de Toulouse
| | - Marie Nolla
- Department of Pediatric Hematology and Immunology, CHU Toulouse
| | - Camille Hamelle
- Department of Pediatric Hematology and Immunology, CHU Toulouse
| | | | | | | | | | - Jean Donadieu
- Pediatric Hematology Department, Hopital Trousseau, APHP
| | | | - Claire Fieschi
- Clinical immunology Department, Hopital Saint-Louis, APHP, Universite Paris Cite
| | - Alina Ferster
- Pediatric hematology, Hopital Reine Fabiola, Bruxelles, Belgium
| | - Francois Delhommeau
- Sorbonne Universite, INSERM, Centre de Recherche Saint-Antoine, CRSA, AP-HP, SIRIC CURAMUS, Hopital Saint-Antoine, Service d'Hematologie Biologique, 75012, Paris
| | - Eric Delabesse
- Laboratory of Hematology, Institut Universitaire du Cancer de Toulouse, France; Universite de Toulouse, Inserm, CNRS, Universite Toulouse III-Paul Sabatier, Centre de Recherches en Cancerologie de Toulouse, Toulouse
| | - Marlene Pasquet
- Universite de Toulouse, Inserm, CNRS, Universite Toulouse III-Paul Sabatier, Centre de Recherches en Cancerologie de Toulouse, Toulouse, France; Department of Pediatric Hematology and Immunology, CHU Toulouse.
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Donadieu J, Bou Mitri F, Beaupain B, Alajidi N, Viallard JF, Paih JPL, Yacoub M, Leblanc T, Quero L, Rouland A, Labbe L, Deback C, Bellanne-Chantelot C, Emile JF. ELANE neutropenia and solid tumors: Four cases from the French severe chronic neutropenia registry. Pediatr Blood Cancer 2022; 69:e29923. [PMID: 35969146 DOI: 10.1002/pbc.29923] [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: 05/31/2022] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 11/10/2022]
Abstract
Neutropenia related to ELANE gene mutations predisposes patients to infection and leukemia/myelodysplasia, but little is known about the predisposition to cancer. Among a cohort of 147 patients, we identified four with malignant solid tumors (papillary thyroid cancer, anal squamous cell cancer, papillary renal cell carcinoma, and adrenocortical carcinoma), all aged 25-50 years. Three occurred with cyclic neutropenia, and one occurred with severe chronic neutropenia. Previous radiotherapy was identified as a risk factor in one patient. No genetic predisposition was identified in the three other patients.
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Affiliation(s)
- Jean Donadieu
- French Registry for Severe Chronic Neutropenia, Armand-Trousseau Hospital, APHP, Paris, France
| | - Fares Bou Mitri
- French Registry for Severe Chronic Neutropenia, Armand-Trousseau Hospital, APHP, Paris, France
| | - Blandine Beaupain
- French Registry for Severe Chronic Neutropenia, Armand-Trousseau Hospital, APHP, Paris, France
| | - Nathalie Alajidi
- Onco-hematology Unit, Pediatic Department, Children Hospital, Groupe Hospitalier Pellegrin, Bordeaux, France
| | - Jean Francois Viallard
- Internal Medicine and Infectious Disease Department, Haut-Lévêque Hospital, University of Bordeaux, Bordeaux, France
| | | | - Mokrane Yacoub
- Pathology Department, Bordeaux University Hospital, Bordeaux, France
| | | | - Laurent Quero
- Oncology and Radiotherapy Department, Hopital Saint Louis, APHP, Paris, France
| | - Alexia Rouland
- Endocrinology Department, Dijon University Hospital, Dijon, France
| | - Louis Labbe
- Endocrinology Department, Hotel Dieu, Le Creusot, France
| | - Claire Deback
- Virology Department, Paul Brousse Hospital, Villejuif, France
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Ludwig-Słomczyńska AH, Seweryn MT, Radkowski P, Kapusta P, Machlowska J, Pruhova S, Gasperikova D, Bellanne-Chantelot C, Hattersley A, Kandasamy B, Letourneau-Freiberg L, Philipson L, Doria A, Wołkow PP, Małecki MT, Klupa T. Variants influencing age at diagnosis of HNF1A-MODY. Mol Med 2022; 28:113. [PMID: 36104811 PMCID: PMC9476297 DOI: 10.1186/s10020-022-00542-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/06/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND HNF1A-MODY is a monogenic form of diabetes caused by variants in the HNF1A gene. Different HNF1A variants are associated with differences in age of disease onset, but other factors are postulated to influence this trait. Here, we searched for genetic variants influencing age of HNF1A-MODY onset. METHODS Blood samples from 843 HNF1A-MODY patients from Czech Republic, France, Poland, Slovakia, the UK and the US were collected. A validation set consisted of 121 patients from the US. We conducted a genome-wide association study in 843 HNF1A-MODY patients. Samples were genotyped using Illumina Human Core arrays. The core analysis was performed using the GENESIS package in R statistical software. Kinship coefficients were estimated with the KING and PC-Relate algorithms. In the linear mixed model, we accounted for year of birth, sex, and location of the HNF1A causative variant. RESULTS A suggestive association with age of disease onset was observed for rs2305198 (p = 2.09E-07) and rs7079157 (p = 3.96E-06) in the HK1 gene, rs2637248 in the LRMDA gene (p = 2.44E-05), and intergenic variant rs2825115 (p = 2.04E-05). Variant rs2637248 reached nominal significance (p = 0.019), while rs7079157 (p = 0.058) and rs2825115 (p = 0.068) showed suggestive association with age at diabetes onset in the validation set. CONCLUSIONS rs2637248 in the LRMDA gene is associated with age at diabetes onset in HNF1A-MODY patients.
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Affiliation(s)
| | - Michał T. Seweryn
- grid.5522.00000 0001 2162 9631Center For Medical Genomics OMICRON, Jagiellonian University Medical College, Kraków, Poland ,grid.261331.40000 0001 2285 7943Department of Pharmacogenomics, The Ohio State University, Columbus, OH USA
| | - Piotr Radkowski
- grid.5522.00000 0001 2162 9631Center For Medical Genomics OMICRON, Jagiellonian University Medical College, Kraków, Poland
| | - Przemysław Kapusta
- grid.5522.00000 0001 2162 9631Center For Medical Genomics OMICRON, Jagiellonian University Medical College, Kraków, Poland
| | - Julita Machlowska
- grid.5522.00000 0001 2162 9631Center For Medical Genomics OMICRON, Jagiellonian University Medical College, Kraków, Poland
| | - Stepanka Pruhova
- grid.4491.80000 0004 1937 116XDepartment of Pediatrics, Charles University in Prague, Second Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Daniela Gasperikova
- grid.419303.c0000 0001 2180 9405Institute of Experimental Endocrinology, Biomedical Research Center, Slovak Academy of Sciences, Bratislava, Slovakia
| | | | | | - Balamurugan Kandasamy
- grid.170205.10000 0004 1936 7822Kovler Diabetes Center, University of Chicago, Chicago, IL USA
| | | | - Louis Philipson
- grid.170205.10000 0004 1936 7822Kovler Diabetes Center, University of Chicago, Chicago, IL USA
| | - Alessandro Doria
- grid.38142.3c000000041936754XJoslin Diabetes Center, Harvard Medical School, Boston, MA USA
| | - Paweł P. Wołkow
- grid.5522.00000 0001 2162 9631Center For Medical Genomics OMICRON, Jagiellonian University Medical College, Kraków, Poland
| | - Maciej T. Małecki
- grid.5522.00000 0001 2162 9631Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland
| | - Tomasz Klupa
- grid.5522.00000 0001 2162 9631Department of Metabolic Diseases, Jagiellonian University Medical College, Kraków, Poland
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Timsit J, Ciangura C, Dubois-Laforgue D, Saint-Martin C, Bellanne-Chantelot C. Pregnancy in Women With Monogenic Diabetes due to Pathogenic Variants of the Glucokinase Gene: Lessons and Challenges. Front Endocrinol (Lausanne) 2022; 12:802423. [PMID: 35069449 PMCID: PMC8766338 DOI: 10.3389/fendo.2021.802423] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/13/2021] [Indexed: 12/12/2022] Open
Abstract
Heterozygous loss-of-function variants of the glucokinase (GCK) gene are responsible for a subtype of maturity-onset diabetes of the young (MODY). GCK-MODY is characterized by a mild hyperglycemia, mainly due to a higher blood glucose threshold for insulin secretion, and an up-regulated glucose counterregulation. GCK-MODY patients are asymptomatic, are not exposed to diabetes long-term complications, and do not require treatment. The diagnosis of GCK-MODY is made on the discovery of hyperglycemia by systematic screening, or by family screening. The situation is peculiar in GCK-MODY women during pregnancy for three reasons: 1. the degree of maternal hyperglycemia is sufficient to induce pregnancy adverse outcomes, as in pregestational or gestational diabetes; 2. the probability that a fetus inherits the maternal mutation is 50% and; 3. fetal insulin secretion is a major stimulus of fetal growth. Consequently, when the fetus has not inherited the maternal mutation, maternal hyperglycemia will trigger increased fetal insulin secretion and growth, with a high risk of macrosomia. By contrast, when the fetus has inherited the maternal mutation, its insulin secretion is set at the same threshold as the mother's, and no fetal growth excess will occur. Thus, treatment of maternal hyperglycemia is necessary only in the former situation, and will lead to a risk of fetal growth restriction in the latter. It has been recommended that the management of diabetes in GCK-MODY pregnant women should be guided by assessment of fetal growth by serial ultrasounds, and institution of insulin therapy when the abdominal circumference is ≥ 75th percentile, considered as a surrogate for the fetal genotype. This strategy has not been validated in women with in GCK-MODY. Recently, the feasibility of non-invasive fetal genotyping has been demonstrated, that will improve the care of these women. Several challenges persist, including the identification of women with GCK-MODY before or early in pregnancy, and the modalities of insulin therapy. Yet, retrospective observational studies have shown that fetal genotype, not maternal treatment with insulin, is the main determinant of fetal growth and of the risk of macrosomia. Thus, further studies are needed to specify the management of GCK-MODY pregnant women during pregnancy.
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Affiliation(s)
- José Timsit
- Department of Diabetology, Université de Paris, AP-HP, Cochin-Port-Royal Hospital, DMU ENDROMED, Paris, France
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Monogenic Diabetes Study Group of the Société Francophone du Diabète, Paris, France
| | - Cécile Ciangura
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Monogenic Diabetes Study Group of the Société Francophone du Diabète, Paris, France
- Department of Diabetology, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Danièle Dubois-Laforgue
- Department of Diabetology, Université de Paris, AP-HP, Cochin-Port-Royal Hospital, DMU ENDROMED, Paris, France
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Monogenic Diabetes Study Group of the Société Francophone du Diabète, Paris, France
- INSERM U1016, Cochin Hospital, Paris, France
| | - Cécile Saint-Martin
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Department of Medical Genetics, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, DMU BioGeM, Paris, France
| | - Christine Bellanne-Chantelot
- PRISIS National Reference Center for Rare Diseases of Insulin Secretion and Insulin Sensitivity, Department of Endocrinology, Diabetology and Reproductive Endocrinology, Assistance Publique-Hôpitaux de Paris, Saint-Antoine University Hospital, Paris, France
- Monogenic Diabetes Study Group of the Société Francophone du Diabète, Paris, France
- Department of Medical Genetics, Sorbonne Université, AP-HP, Pitié-Salpêtrière Hospital, DMU BioGeM, Paris, France
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5
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Bou Mitri F, Beaupain B, Flejou JF, Patient M, Okhremchuck I, Blaise D, Izadifar-Legrand F, Martignoles JA, Delhommeau F, Bellanne-Chantelot C, Emile JF, Donadieu J. Shwachman-Diamond syndrome and solid tumors: Three new patients from the French Registry for Severe Chronic Neutropenia and literature review. Pediatr Blood Cancer 2021; 68:e29071. [PMID: 33871916 DOI: 10.1002/pbc.29071] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 03/17/2021] [Accepted: 04/05/2021] [Indexed: 12/23/2022]
Abstract
Shwachman-Diamond syndrome with Shwachman-Bodian-Diamond syndrome (SBDS) biallelic variants is a rare disorder that predisposes the carrier to malignant hemopathies but solid-cancer predisposition is poorly known. Among 155 cases entered in the French Registry for Severe Chronic Neutropenia, three were identified with malignant solid tumors (ovary, breast, and esophagus). All cancers occurred during the fifth decade and, despite being localized at diagnosis, were rapidly fatal thereafter. No cancer was observed post transplantation in the 14 HSCT survivors. Based on the literature and our patient data, we can merely advance that this complication is predominantly diagnosed in adults.
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Affiliation(s)
- Fares Bou Mitri
- Centre de Recherche Saint-Antoine, APHP, Armand-Trousseau Hospital, French Registry for Severe Chronic Neutropenia, CRMR of Chronic Neutropenia, Department of Pediatrics Hematology and Oncology, Sorbonne Université, Inserm, Paris, France
| | - Blandine Beaupain
- Centre de Recherche Saint-Antoine, APHP, Armand-Trousseau Hospital, French Registry for Severe Chronic Neutropenia, CRMR of Chronic Neutropenia, Department of Pediatrics Hematology and Oncology, Sorbonne Université, Inserm, Paris, France
| | | | - Matthieu Patient
- Department of Hematology and Oncology, Hôpital d'Instruction des Armées (HIA) Sainte-Anne, Toulon, France
| | | | - Didier Blaise
- Department of Hematology, Paoli-Calmettes Institut, Marseille, France
| | | | - Jean Alain Martignoles
- Inserm, Centre de Recherche Saint-Antoine, Hématologie Biologique, Hôpital Saint-Antoine, APHP, Sorbonne Université, Paris, France
| | - François Delhommeau
- Inserm, Centre de Recherche Saint-Antoine, Hématologie Biologique, Hôpital Saint-Antoine, APHP, Sorbonne Université, Paris, France
| | | | | | - Jean Donadieu
- Centre de Recherche Saint-Antoine, APHP, Armand-Trousseau Hospital, French Registry for Severe Chronic Neutropenia, CRMR of Chronic Neutropenia, Department of Pediatrics Hematology and Oncology, Sorbonne Université, Inserm, Paris, France
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Rotulo GA, Beaupain B, Rialland F, Paillard C, Nachit O, Galambrun C, Gandemer V, Bertrand Y, Neven B, Dore E, Moshous D, Filhon B, Aladjdi N, Sicre de Fontbrune F, de la Tour RP, Ouachee M, Bellanne-Chantelot C, Dalle JH, Donadieu J. HSCT may lower leukemia risk in ELANE neutropenia: a before-after study from the French Severe Congenital Neutropenia Registry. Bone Marrow Transplant 2020; 55:1614-1622. [PMID: 31992846 PMCID: PMC7091645 DOI: 10.1038/s41409-020-0800-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 11/28/2019] [Accepted: 01/16/2020] [Indexed: 11/26/2022]
Abstract
ELANE neutropenia is associated with myelodysplasia and acute leukemia (MDS–AL), and severe infections. Because the MDS–AL risk has also been shown to be associated with exposure to GCSF, since 2005, in France, patients receiving high daily GCSF doses (>15 μg/kg/day) are eligible for HSCT, in addition to classic indications (MDS–AL or GCSF refractoriness). We analyzed the effect of this policy. Among 144 prospectively followed ELANE-neutropenia patients enrolled in the French Severe Congenital Neutropenia Registry, we defined two groups according to period: “before 2005” for those born before 2005 and followed until 31/12/2004 (1588 person-years); and “after 2005” comprised of those born after 2005 or born before 2005 but followed after 2005 until 31/03/2019 (1327 person-years). Sixteen of our cohort patients underwent HSCT (14 long-term survivors) and six developed MDS–ALs. Six leukemic transformations occurred in the before-2005 group and none after 2005 (respective frequencies 3.8 × 10–3 vs. 0; P < 0.01), while four HSCTs were done before 2005 and 12 since 2005 (respective HSCT rates increased 2.5 × 10–3 vs. 9 × 10–3; P < 0.01). Our results support early HSCT for patients with ELANE mutations who received high GCSF doses, as it might lower the risk of leukemic transformation.
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Affiliation(s)
- Gioacchino Andrea Rotulo
- Registre des Neutropénies Chroniques, Centre de Référence des Neutropénies Chroniques, Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Hôpital Trousseau, APHP, Paris, F-75012, France.,IRCCS Giannina Gaslini and Università degli Studi di Genova, Genoa, Italy
| | - Blandine Beaupain
- Registre des Neutropénies Chroniques, Centre de Référence des Neutropénies Chroniques, Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Hôpital Trousseau, APHP, Paris, F-75012, France
| | | | | | - Ouahiba Nachit
- Registre des Neutropénies Chroniques, Centre de Référence des Neutropénies Chroniques, Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Hôpital Trousseau, APHP, Paris, F-75012, France
| | | | - Virginie Gandemer
- Department of Pediatric Hematology/Oncology, University Hospital of Rennes, Rennes, France
| | - Yves Bertrand
- Institut d'Hémato-Oncologie Pédiatrie IHOPE, Lyon, France
| | - Benedicte Neven
- Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eric Dore
- CHU Clermont-Ferrand, Centre Régional de Cancérologie et Thérapie Cellulaire Pédiatrique, Clermont-Ferrand, France
| | - Despina Moshous
- Unité d'Immunologie Hématologie Pédiatrique, Necker Children's Hospital, Paris, France
| | - Bruno Filhon
- Départment de Pédiatrie, Hémato-Oncologie, CHU de Bordeaux, Bordeaux, France
| | - Nathalie Aladjdi
- Départment de Pédiatrie, Hémato-Oncologie, CHU de Rouen, Rouen, France
| | - Flore Sicre de Fontbrune
- Department d'Hématologie, Service de Transplantation Médullaire, Hôpital Saint-Louis, Paris, France
| | | | - Marie Ouachee
- Institut d'Hémato-Oncologie Pédiatrie IHOPE, Lyon, France
| | | | - Jean-Hugues Dalle
- Pediatric Hematology Department, Robert-Debré Hospital, Paris, France
| | - Jean Donadieu
- Registre des Neutropénies Chroniques, Centre de Référence des Neutropénies Chroniques, Sorbonne Université, Inserm, Centre de Recherche Saint-Antoine, Hôpital Trousseau, APHP, Paris, F-75012, France.
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7
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Haddouche A, Bellanne-Chantelot C, Rod A, Fournier L, Chiche L, Gautier JF, Timsit J, Laboureau S, Chaillous L, Valero R, Larger E, Jeandidier N, Wilhelm JM, Popelier M, Guillausseau PJ, Thivolet C, Lecomte P, Benhamou PY, Reznik Y. Liver adenomatosis in patients with hepatocyte nuclear factor-1 alpha maturity onset diabetes of the young (HNF1A-MODY): Clinical, radiological and pathological characteristics in a French series. J Diabetes 2020; 12:48-57. [PMID: 31166087 DOI: 10.1111/1753-0407.12959] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 05/13/2019] [Accepted: 05/30/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Liver adenomatosis (LA) is a rare disease resulting from biallelic inactivation of the hepatocyte nuclear factor-1 alpha (HNF1A) gene, which induces the proliferation of adenoma cells in liver parenchyma. Liver adenomatosis has only been documented in case reports from patients carrying a HNF1A germline mutation. We have evaluated the frequency of LA among a large cohort of patients with HNF1A-maturity onset diabetes of the young (MODY), previously termed "MODY3," and herein describe its clinical, radiological, and pathological characteristics. METHODS In all, 137 HNF1A-MODY subjects from 74 families were screened by liver ultrasonography in 13 centers, and 15 additional cases of LA were later included in the series. Liver adenomatosis was confirmed by liver computed tomography, magnetic resonance imaging (MRI), and/or histopathology. RESULTS Among 137 carriers of an HNF1A mutation, 9 patients (6.5%) from seven families were diagnosed with LA. Diabetes mellitus was present in 87.5% of patients with LA. In 25% of patients, LA was diagnosed due to intra-abdominal or intratumoral bleeding. Liver biochemistry was near normal in all patients. Liver imaging showed adenomas of various sizes and numbers. On MRI, most nodules had the radiological characteristics of steatotic adenomas. Histopathological confirmation of LA was available in 13 cases, and these adenomas were mostly steatotic. Surgery was initially performed in 37.5% of patients, and liver disease progression was observed in 30%. No disease progression was observed in 14 pregnancies. CONCLUSIONS The frequency of LA in a cohort of screened HNF1A-MODY patients and the high incidence of LA progression and/or hemorrhage warrants systematic screening for liver adenomatosis in HNF1A-MODY families.
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Affiliation(s)
- Aini Haddouche
- Department of Endocrinology and Diabetology, Caen University Hospital, Caen, France
| | - Christine Bellanne-Chantelot
- Department of Genetics, Pitié-Salpetrière Hospital, Assistance Publique-Hôpitaux de Paris, Sorbonne University, Paris, France
| | - Anne Rod
- Department of Endocrinology and Diabetology, Caen University Hospital, Caen, France
| | - Luc Fournier
- Department of Radiology, Caen University Hospital, Caen, France
| | - Laurence Chiche
- Department of Hepatobiliary and Pancreatic Surgery, Bordeaux University Hospital, Maison du Haut Lévèque, Bordeaux, France
| | - Jean-Francois Gautier
- Department of Endocrinology and Diabetology, Saint Louis University Hospital, Paris, France
| | - Jose Timsit
- Department of Immunology and Diabetology, Cochin University Hospital, Paris, France
| | - Sandrine Laboureau
- Department of Endocrinology and Diabetology, Angers University Hospital, Angers, France
| | - Lucy Chaillous
- Department of Endocrinology, Hôtel Dieu University Hospital, Nantes, France
| | - Rene Valero
- Department of Nutrition and Metabolic Diseases, La Conception Hospital, Marseille, France
| | - Etienne Larger
- Department of Immunology and Diabetology, Cochin University Hospital, Paris, France
| | - Nathalie Jeandidier
- Department of Endocrinology, Diabetology and Metabolic Diseases, Leriche Pavillon, Civil Hospital, Strasbourg, France
| | | | - Marc Popelier
- Department of Medicine, Pitié-Salpetrière Hospital, Paris, France
| | | | - Charles Thivolet
- Department of Endocrinology and Metabolic Diseases, Debrousse University Hospital, Lyon, France
| | - Pierre Lecomte
- Department of Endocrinology and Diabetology, Bretonneau University Hospital, Tours, France
| | - Pierre-Yves Benhamou
- Department of Diabetology, Endocrinology and Nutrition, Grenoble University Hospital, Grenoble, France
| | - Yves Reznik
- Department of Endocrinology and Diabetology, Caen University Hospital, Caen, France
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8
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Bejjani N, Beaupain B, Bertrand Y, Bellanne-Chantelot C, Donadieu J. How to differentiate congenital from noncongenital chronic neutropenia at the first medical examination? Proposal of score: A pilot study from the French Severe Chronic Neutropenia registry. Pediatr Blood Cancer 2017; 64. [PMID: 28727239 DOI: 10.1002/pbc.26722] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 05/30/2017] [Accepted: 06/13/2017] [Indexed: 11/07/2022]
Abstract
OBJECTIVES We developed a diagnostic score to differentiate congenital from noncongenital neutropenia at the time of diagnosis using reliable data collected at the first visit of a patients with neutropenia. STUDY DESIGN In a pilot retrospective study, we included 120 patients diagnosed with chronic neutropenia; 61 had congenital and 59 had noncongenital neutropenia. We reviewed patient medical charts and collected the initial complete blood count (CBC) and other reliable data. We used logistic regression to determine the probability that the neutropenia was congenital. RESULTS On the initial CBC, the degree of neutropenia had no predictive value; only monocytosis >1.5 × 109 /l, hemoglobin <90 g/l, or mild thrombocytopenia <150 × 109 /l suggested congenital neutropenia. The most predictive factors for congenital neutropenia were a medical history (consanguinity and patient history of neutropenia), severe infections, and oral stomatitis or gingivitis at the time of diagnosis. The age at diagnosis had limited predictive value. CONCLUSION A diagnosis of congenital neutropenia may be reliably suspected based only on information from the CBC, some basic information from patient and parent interviews, and a clinical examination. A pilot score with six factors that could be readily, reliably collected, should facilitate the diagnosis of congenital neutropenia.
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Affiliation(s)
- Naim Bejjani
- AP-HP, Registre français des Neutropénies, Centre de référence des neutropénies chroniques, Service d'Hémato-Oncologie Pédiatrique, Hôpital Trousseau, Paris, France.,Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | - Blandine Beaupain
- AP-HP, Registre français des Neutropénies, Centre de référence des neutropénies chroniques, Service d'Hémato-Oncologie Pédiatrique, Hôpital Trousseau, Paris, France
| | - Yves Bertrand
- Institut d'Hématologie et d'Oncologie Pédiatrique, Lyon, France
| | | | - Jean Donadieu
- AP-HP, Registre français des Neutropénies, Centre de référence des neutropénies chroniques, Service d'Hémato-Oncologie Pédiatrique, Hôpital Trousseau, Paris, France
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9
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Moreira MC, Piazzon FB, Carvalho MDF, Quaio CRDC, Dutra AB, Ceccon ME, Della-Manna T, Tannuri U, Lee JH, Zerbini MCN, Bellanne-Chantelot C, Lonlay P, Bertola DR, Kim CA. A dominant ABCC8-related hyperinsulinism: familial case report. Moreira et al. ABCC8-related hyperinsulinism. Fetal Pediatr Pathol 2013; 32:384-6. [PMID: 23301914 DOI: 10.3109/15513815.2012.754531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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10
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Colclough K, Bellanne-Chantelot C, Saint-Martin C, Flanagan SE, Ellard S. Mutations in the genes encoding the transcription factors hepatocyte nuclear factor 1 alpha and 4 alpha in maturity-onset diabetes of the young and hyperinsulinemic hypoglycemia. Hum Mutat 2013; 34:669-85. [PMID: 23348805 DOI: 10.1002/humu.22279] [Citation(s) in RCA: 141] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2012] [Accepted: 01/08/2013] [Indexed: 12/16/2022]
Abstract
Maturity-onset diabetes of the young (MODY) is a monogenic disorder characterized by autosomal dominant inheritance of young-onset (typically <25 years), noninsulin-dependent diabetes due to defective insulin secretion. MODY is both clinically and genetically heterogeneous with mutations in at least 10 genes. Mutations in the HNF1A gene encoding hepatocyte nuclear factor-1 alpha are the most common cause of MODY in most adult populations studied. The number of different pathogenic HNF1A mutations totals 414 in 1,247 families. Mutations in the HNF4A gene encoding hepatocyte nuclear factor-4 alpha are a rarer cause of MODY with 103 different mutations reported in 173 families to date. Sensitivity to treatment with sulfonylurea tablets is a feature of both HNF1A and HNF4A mutations. The HNF4A MODY phenotype has been expanded by the reports of macrosomia in ∼50% of babies, and more rarely, neonatal hyperinsulinemic hypoglycemia. The identification of an HNF1A or HNF4A gene mutation has important implications for clinical management in diabetes and pregnancy, but MODY is significantly underdiagnosed. Current research is focused on identifying biomarkers and developing probability models to identify those patients most likely to have MODY, until next generation sequencing technology enables cost-effective gene analysis for all patients with young onset diabetes.
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Affiliation(s)
- Kevin Colclough
- Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, UK
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11
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Tudorache E, Sellier-Leclerc AL, Lenoir M, Tubiana-Rufi N, Bensman A, Bellanne-Chantelot C, Ulinski T, Ulinski T. Childhood onset diabetes posttransplant in a girl with TCF2 mutation. Pediatr Diabetes 2012; 13:e35-9. [PMID: 22260488 DOI: 10.1111/j.1399-5448.2011.00842.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2011] [Accepted: 11/17/2011] [Indexed: 12/01/2022] Open
Abstract
Heterozygous mutations of TCF2 (transcription factor 2) have been associated with maturity onset diabetes of the young, renal malformations, hyperuricemia, and occasionally internal genital malformations in female. We report a female patient with bilateral renal hypodysplasia and de novo heterozygous TCF2 gene mutation. At the age of 9 yr, she developed transient ketoacidosis immediately posttransplant, temporarily requiring insulin. During glucocorticoid tapering, impaired glucose tolerance persisted and overt insulin-dependent diabetes mellitus developed 1 yr later. Pathogenic factors which might have played a role in the acceleration of diabetes were (i) switch from cyclosporine to tacrolimus, (ii) weight excess, and (iii) cytomegalovirus infection. TCF2 analysis might, therefore, be of interest in patients with congenital abnormalities of the kidney and the urinary tract in order to improve posttransplant management in terms of steroid and tacrolimus exposure.
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Affiliation(s)
- Elena Tudorache
- Department of Pediatric Nephrology, Armand-Trousseau Hospital, AP-HP, Paris, France; University Pierre et Marie Curie (UPMC), Paris, 6, France
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12
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Malak S, Labopin M, Saint-Martin C, Bellanne-Chantelot C, Najman A. Long term follow up of 93 families with myeloproliferative neoplasms: life expectancy and implications of JAK2V617F in the occurrence of complications. Blood Cells Mol Dis 2012; 49:170-6. [PMID: 22818858 DOI: 10.1016/j.bcmd.2012.06.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Accepted: 06/06/2012] [Indexed: 02/02/2023]
Abstract
The long-term evolution of familial myeloproliferative neoplasms was studied in 93 families with 227 subjects including 97 with polycythemia vera (PV), 105 essential thrombocythemia (ET), 14 primary myelofibrosis (PMF) and 11 chronic myeloid leukemia (CML). In PV patients, with 12years of median follow-up, overall survival was 83% at 10years and 37% at 20years. A high JAK2(V617F) allele burden was correlated with the transformation to myelofibrosis (p<0.0001), but not with the transformation to acute leukemia. Among the 105 ET, with 8years of median follow-up, overall survival was 83% at 10years and 57% at 20years. Progression to acute leukemia and progression to myelofibrosis were 10% and 13%. There was a trend toward a more frequent evolution to myelofibrosis when the JAK2(V617F) mutated allele burden was >50% (p=0.09), but not to AML. Hematologic transformation of the MPN was responsible for 69% of the deaths, cerebral stroke for 7% and 4% died of myocardial infarction. Eleven JAK2(V617F) mutated patients developed 13 deep splanchnic thromboses in PV and ET. Finally whereas patients with familial PV and ET have a comparable prognosis to non-familial MPN, the JAK2(V617F) mutation was associated with a more frequent occurrence of thrombosis in the entire population.
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Affiliation(s)
- Sandra Malak
- Department of Hematology, Assistance Publique-Hopitaux de Paris (AP-HP) Saint-Antoine, Universite Pierre et Marie Curie, Paris, France
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13
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Poitou C, Francois H, Bellanne-Chantelot C, Noel C, Jacquet A, Clauin S, Beaudreuil S, Damieri H, Hebibi H, Hammoudi Y, Benoit G, Charpentier B, Durrbach A. Maturity onset diabetes of the young: clinical characteristics and outcome after kidney and pancreas transplantation in MODY3 and RCAD patients: a single center experience. Transpl Int 2012; 25:564-72. [DOI: 10.1111/j.1432-2277.2012.01458.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Damaj L, le Lorch M, Verkarre V, Werl C, Hubert L, Nihoul-Fékété C, Aigrain Y, de Keyzer Y, Romana SP, Bellanne-Chantelot C, de Lonlay P, Jaubert F. Chromosome 11p15 paternal isodisomy in focal forms of neonatal hyperinsulinism. J Clin Endocrinol Metab 2008; 93:4941-7. [PMID: 18796520 DOI: 10.1210/jc.2008-0673] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT Focal forms of congenital hyperinsulinism are due to a constitutional heterozygous mutation of paternal origin in the ABCC8 gene, more often than the KCNJ11 gene, located in the 11p15.1 region. This mutation is associated with the loss of the maternally inherited 11p15.1 to 11p15.5 region in the lesion. We investigated the possible occurrence of a compensatory duplication of the paternal 11p15.1-11p15.5 region. MATERIALS AND METHODS A combined immunohistochemistry and fluorescent in situ hybridization study on beta-cell interphase nuclei with probes covering two genes located in this region (ABCC8 and CDKN1C genes) was performed in four cases of focal forms of hyperinsulinism. RESULTS beta-Cells in the lesions of four cases of focal congenital hyperinsulinism were diploid for chromosomes 11 and 13. The 11p15.1 to 11p15.2 and 11p15.4 to 11p15.5 regions containing ABCC8 and CDKN1C genes, respectively, were present with two copies. Loss of the maternal allele was confirmed in these focal lesions with microsatellite markers flanking the ABCC8 and CDKN1C genes, whereas a heterozygous mutation in the ABCC8 gene was inherited from the father. CONCLUSIONS There is a duplication of the paternal allele on chromosome 11 in the focal forms of hyperinsulinism lesion. The paternal isodisomy observed rendered the beta-cells homozygous for ABCC8 mutation and harbored a K-channel defect in the lesion similar to that observed in diffuse forms of congenital hyperinsulinism.
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Affiliation(s)
- L Damaj
- Department of Pathology, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Service d'Anatomie Pathologique and Tumorotheque, 149 rue de Sèvres, 75015 Paris, France.
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15
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Pierron D, Rocher C, Amati-Bonneau P, Reynier P, Martin-Négrier ML, Allouche S, Batandier C, Mousson de Camaret B, Godinot C, Rotig A, Feldmann D, Bellanne-Chantelot C, Arveiler B, Pennarun E, Rossignol R, Crouzet M, Murail P, Thoraval D, Letellier T. New evidence of a mitochondrial genetic background paradox: impact of the J haplogroup on the A3243G mutation. BMC Med Genet 2008; 9:41. [PMID: 18462486 PMCID: PMC2409300 DOI: 10.1186/1471-2350-9-41] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/19/2007] [Accepted: 05/07/2008] [Indexed: 11/10/2022]
Abstract
BACKGROUND The A3243G mutation in the tRNALeu gene (UUR), is one of the most common pathogenic mitochondrial DNA (mtDNA) mutations in France, and is associated with highly variable and heterogeneous disease phenotypes. To define the relationships between the A3243G mutation and mtDNA backgrounds, we determined the haplogroup affiliation of 142 unrelated French patients - diagnosed as carriers of the A3243G mutation - by control-region sequencing and RFLP survey of their mtDNAs. RESULTS The analysis revealed 111 different haplotypes encompassing all European haplogroups, indicating that the 3243 site might be a mutational hot spot. However, contrary to previous findings, we observed a statistically significant underepresentation of the A3243G mutation on haplogroup J in patients (p = 0.01, OR = 0.26, C.I. 95%: 0.08-0.83), suggesting that might be due to a strong negative selection at the embryo or germ line stages. CONCLUSION Thus, our study supports the existence of mutational hotspot on mtDNA and a "haplogroup J paradox," a haplogroup that may increase the expression of mtDNA pathogenic mutations, but also be beneficial in certain environmental contexts.
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Affiliation(s)
- Denis Pierron
- 1Université Bordeaux 1, Laboratoire d'Anthropologie des Populations du Passé, UMR 5199 PACEA, 33400 Talence, France.
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16
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Mefford HC, Clauin S, Sharp AJ, Moller RS, Ullmann R, Kapur R, Pinkel D, Cooper GM, Ventura M, Ropers HH, Tommerup N, Eichler EE, Bellanne-Chantelot C. Recurrent reciprocal genomic rearrangements of 17q12 are associated with renal disease, diabetes, and epilepsy. Am J Hum Genet 2007; 81:1057-69. [PMID: 17924346 DOI: 10.1086/522591] [Citation(s) in RCA: 190] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2007] [Accepted: 07/27/2007] [Indexed: 01/20/2023] Open
Abstract
Most studies of genomic disorders have focused on patients with cognitive disability and/or peripheral nervous system defects. In an effort to broaden the phenotypic spectrum of this disease model, we assessed 155 autopsy samples from fetuses with well-defined developmental pathologies in regions predisposed to recurrent rearrangement, by array-based comparative genomic hybridization. We found that 6% of fetal material showed evidence of microdeletion or microduplication, including three independent events that likely resulted from unequal crossing-over between segmental duplications. One of the microdeletions, identified in a fetus with multicystic dysplastic kidneys, encompasses the TCF2 gene on 17q12, previously shown to be mutated in maturity-onset diabetes, as well as in a subset of pediatric renal abnormalities. Fine-scale mapping of the breakpoints in different patient cohorts revealed a recurrent 1.5-Mb de novo deletion in individuals with phenotypes that ranged from congenital renal abnormalities to maturity-onset diabetes of the young type 5. We also identified the reciprocal duplication, which appears to be enriched in samples from patients with epilepsy. We describe the first example of a recurrent genomic disorder associated with diabetes.
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Affiliation(s)
- Heather C Mefford
- Department of Genome Sciences, University of Washington, Seattle, WA 98195, USA
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17
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Delonlay P, Simon A, Galmiche-Rolland L, Giurgea I, Verkarre V, Aigrain Y, Santiago-Ribeiro MJ, Polak M, Robert JJ, Bellanne-Chantelot C, Brunelle F, Nihoul-Fekete C, Jaubert F. Neonatal hyperinsulinism: clinicopathologic correlation. Hum Pathol 2007; 38:387-99. [PMID: 17303499 DOI: 10.1016/j.humpath.2006.12.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2006] [Revised: 12/19/2006] [Accepted: 12/20/2006] [Indexed: 11/26/2022]
Abstract
Neonatal hyperinsulinism is a life-threatening disease that, when treated by total pancreatectomy, leads to diabetes and pancreatic insufficiency. A more conservative approach is now possible since the separation of the disease into a nonrecurring focal form, which is cured by partial surgery, and a diffuse form, which necessitates total pancreas removal only in cases of medical treatment failure. The pathogenesis of the disease is now divided into K-channel disease (hyperinsulinemic hypoglycemia, familial [HHF] 1 and 2), which can mandate surgery, and other metabolic causes, HHF 3 to 6, which are treated medically in most patients. The diffuse form is inherited as a recessive gene on chromosome 11, whereas most cases of the focal form are caused by a sulfonylurea receptor 1 defect inherited from the father, which is associated with a loss of heterozygosity on the corresponding part of the mother's chromosome 11. The rare bifocal forms result from a maternal loss of heterozygosity specific to each focus. Paternal disomy of chromosome 11 is a rare cause of a condition similar to Beckwith-Wiedemann syndrome. A preoperative PET scan with fluorodihydroxyphenylalanine and perioperative frozen-section confirmation are the types of studies done before surgery when needed. Adult variants of the disease are less well defined at the present time.
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Affiliation(s)
- P Delonlay
- Department of Pediatrics, Hospital Necker-Enfants Malades, Paris 75743, France
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18
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Hummel M, Vasseur F, Mathieu C, Bellanne-Chantelot C, Froguel P, Standl E, Füchtenbusch M. Two Caucasian Families with the Hepatocyte Nuclear Factor-1Alpha Mutation Tyr218Cys. Exp Clin Endocrinol Diabetes 2007; 115:62-4. [PMID: 17286239 DOI: 10.1055/s-2007-955099] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
We report on the first two Caucasian families with the MODY3 HNF-1alpha mutation Tyr218Cys. Clinical and laboratory examinations are shown in detail. Patients with HNF-1alpha related MODY may develop the full spectrum of diabetic complications. Therefore, early detection of family members with MODY3 is warranted.
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Affiliation(s)
- M Hummel
- Diabetes Research Institute and Academical Hospital Munich-Schwabing, Munich, Germany.
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19
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Robins T, Bellanne-Chantelot C, Barbaro M, Cabrol S, Wedell A, Lajic S. Characterization of novel missense mutations in CYP21 causing congenital adrenal hyperplasia. J Mol Med (Berl) 2006; 85:247-55. [PMID: 17119906 DOI: 10.1007/s00109-006-0121-x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2006] [Revised: 07/30/2006] [Accepted: 08/31/2006] [Indexed: 11/27/2022]
Abstract
Congenital adrenal hyperplasia due to 21-hydroxylase deficiency is the most common inherited disorder of steroid metabolism, with an incidence of 1/10,000 in the general Caucasian population. Although most patients carry a deletion of the CYP21 gene or any of nine pseudogene-derived point mutations, the number of reported rare mutations continues to increase, and consist today of more than 80 different point mutations. In this study, we report the characterization of four additional missense mutations in CYP21. Two of these, L166P and A391T, are novel missense mutations, whereas the R479L and R483Q mutations have been detected previously. Functional assays of mutagenized CYP21 were performed in transiently transfected mammalian cells in vitro, and enzymatic ability of substrate conversion of the two natural substrates of CYP21-17-hydroxyprogesterone and progesterone-was determined. All mutants displayed reduced in vitro enzyme activities compared with wild type, but to different extents, corresponding to clinical phenotypes that span the whole spectrum of disease severity. Functional studies are important to further establish the relationships between genotype and clinical phenotype as well as in vitro CYP21 activity in congenital adrenal hyperplasia due to 21-hydroxylase deficiency. This has relevance for diagnosis, prognosis, and genetic counseling for affected families.
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Affiliation(s)
- Tiina Robins
- Department of Molecular Medicine and Surgery, Center for Molecular Medicine (CMM) L8:02, Karolinska Institutet/Karolinska University Hospital, 17176, Stockholm, Sweden.
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20
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Harries LW, Bingham C, Bellanne-Chantelot C, Hattersley AT, Ellard S. The position of premature termination codons in the hepatocyte nuclear factor -1 beta gene determines susceptibility to nonsense-mediated decay. Hum Genet 2005; 118:214-24. [PMID: 16133182 DOI: 10.1007/s00439-005-0023-y] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2005] [Accepted: 06/15/2005] [Indexed: 11/24/2022]
Abstract
The nonsense-mediated decay (NMD) pathway is an mRNA surveillance mechanism that detects and degrades transcripts containing premature termination codons. The position of a truncating mutation can govern the resulting phenotype as mutations in the last exon evade NMD. In this study we investigated the susceptibility to NMD of six truncating HNF-1beta mutations by allele-specific quantitative real-time PCR using transformed lymphoblastoid cell lines. Four of six mutations (R181X, Q243fsdelC, P328L329fsdelCCTCT and A373fsdel29) showed evidence of NMD with levels of mutant transcript at 71% (p=0.009), 24% (p=0.008), 22% (p=0.008) and 3% (p=0.016) of the wild-type allele respectively. Comparable results were derived from lymphoblastoid cells and renal tubule cells isolated from a patient's overnight urine confirming that cell lines provide a good model for mRNA analysis. Two mutations (H69fsdelAC and P159fsdelT) produced transcripts unexpectedly immune to NMD. We conclude that truncating mutant transcripts of the HNF-1beta gene do not conform to the known rules governing NMD susceptibility, but instead demonstrate a previously unreported 5' to 3' polarity. We hypothesise that this may be due to reinitiation of translation downstream of the premature termination codon. Our study suggests that reinitiation of translation may be an important mechanism in the evasion of NMD, but that other factors such as the distance from the native initiation codon may also play a part.
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Affiliation(s)
- L W Harries
- Institute of Biomedical and Clinical Sciences, Peninsula Medical School, Barrack Road, Exeter, UK
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21
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Barbacci E, Chalkiadaki A, Masdeu C, Haumaitre C, Lokmane L, Loirat C, Cloarec S, Talianidis I, Bellanne-Chantelot C, Cereghini S. HNF1beta/TCF2 mutations impair transactivation potential through altered co-regulator recruitment. Hum Mol Genet 2004; 13:3139-49. [PMID: 15509593 DOI: 10.1093/hmg/ddh338] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Mutations in the HNF1beta gene, encoding the dimeric POU-homeodomain transcription factor HNF1beta (TCF2 or vHNF1), cause various phenotypes including maturity onset diabetes of the young 5 (MODY5), and abnormalities in kidney, pancreas and genital tract development. To gain insight into the molecular mechanisms underlying these phenotypes and into the structure of HNF1beta, we functionally characterized eight disease-causing mutations predicted to produce protein truncations, amino acids substitutions or frameshift deletions in different domains of the protein. Truncated mutations, retaining the dimerization domain, displayed defective nuclear localization and weak dominant-negative activity when co-expressed with the wild-type protein. A frameshift mutation located within the C-terminal QSP-rich domain partially reduced transcriptional activity, whereas selective deletion of this domain abolished transactivation. All five missense mutations, which concern POU-specific and homeodomain residues, were correctly expressed and localized to the nucleus. Although having different effects on DNA-binding capacity, which ranged from complete loss to a mild reduction, these mutations exhibited a severe reduction in their transactivation capacity. The transcriptional impairment of those mutants, whose DNA-binding activity was weakly or not affected, correlated with the loss of association with one of the histone-acetyltransferases CBP or PCAF. In contrast to wild-type HNF1beta, whose transactivation potential depends on the synergistic action of CBP and PCAF, the activity of these mutants was not increased by the synergistic action of these two coactivators or by treatment with the specific histone-deacetylase inhibitor TSA. Our findings suggest that the complex syndrome associated with HNF1beta-MODY5 mutations arise from either defective DNA-binding or transactivation function through impaired coactivator recruitment.
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Affiliation(s)
- Elena Barbacci
- Biologie du Développement, UMR 7622, CNRS, Université Pierre et Marie Curie, 9 quai St Bernard, 75005 Paris, France
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22
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Reznik Y, Dao T, Coutant R, Chiche L, Jeannot E, Clauin S, Rousselot P, Fabre M, Oberti F, Fatome A, Zucman-Rossi J, Bellanne-Chantelot C. Hepatocyte nuclear factor-1 alpha gene inactivation: cosegregation between liver adenomatosis and diabetes phenotypes in two maturity-onset diabetes of the young (MODY)3 families. J Clin Endocrinol Metab 2004; 89:1476-80. [PMID: 15001650 DOI: 10.1210/jc.2003-031552] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Heterozygous germline mutations of the hepatocyte nuclear factor (HNF)-1 alpha are associated with maturity-onset diabetes of the young (MODY)3. Recently, the biallelic inactivation of the HNF-1 alpha gene was reported in liver adenomas. We show the occurrence of liver adenomatosis in six MODY3-affected patients from two unrelated and large families. Liver adenomatosis was characterized by the presence of numerous adenomas within a normal hepatic parenchyma. The HNF-1 alpha hot-spot germline mutation P291fs was identified in the two probands and in 16 relatives from the two families. The six patients affected by liver adenomatosis and diabetes exhibited the mutation. The analysis of liver-cell tumors from two affected patients evidenced the biallelic inactivation of HNF-1 alpha. The familial screening confirmed the clinical heterogeneity of the liver phenotype, from silent liver adenomatosis to fatal hemorrhage. These observations warrant the systematic screening for liver adenomatosis in MODY3 families to prevent its potentially deadly complications. Moreover, such screening may help to determine if a particular mutational spectrum of HNF-1 alpha is associated with liver adenomatosis and to establish its prevalence in this frequent form of diabetes in the young adult.
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Affiliation(s)
- Yves Reznik
- Department of Endocrinology, Centre Hospitalier Universitaire of Caen, 14033 Cannes, France.
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23
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Lajić S, Clauin S, Robins T, Vexiau P, Blanché H, Bellanne-Chantelot C, Wedell A. Novel mutations in CYP21 detected in individuals with hyperandrogenism. J Clin Endocrinol Metab 2002; 87:2824-9. [PMID: 12050257 DOI: 10.1210/jcem.87.6.8525] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
We studied the functional and structural consequences of two novel missense mutations in CYP21 found in women with hyperandrogenism. The women were predicted to carry mutations by hormonal evaluation, but did not display any of the genotypes commonly associated with congenital adrenal hyperplasia. In one woman the novel mutation V304M was found in homozygous form. After expression in COS-1 cells the mutated enzyme was found to have a residual activity of 46% for conversion of 17-hydroxyprogesterone and 26% for conversion of progesterone compared with the normal enzyme. The V304M variant thus represents the sixth known missense mutation associated with nonclassical disease. A normal degradation pattern for this mutant enzyme indicates that the missense mutation is of functional, rather than structural, importance. The other mutation, G375S, was detected in a young woman with signs of hyperandrogenism, in heterozygous form together with P453S, a mutation known to cause nonclassical congenital adrenal hyperplasia (her genotype was G375S+P453S/wild type). This novel variant almost completely abolished enzyme activity; conversion was 1.6% and 0.7% of normal for 17-hydroxyprogesterone and progesterone, respectively. These results underline the importance of genetic evaluation and counseling in hyperandrogenic women who are predicted to carry congenital adrenal hyperplasia-causing mutations by biochemical tests. It also supports the idea that the heterozygous carrier state for CYP21 mutations can be associated with symptoms of androgen excess in certain susceptible individuals.
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Affiliation(s)
- Svetlana Lajić
- Department of Molecular Medicine, CMM (L8:02), Karolinska Hospital, 171 76 Stockholm, Sweden.
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24
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Moises RS, Reis AF, Morel V, Chacra AR, Dib SA, Bellanne-Chantelot C, Velho G. Prevalence of maturity-onset diabetes of the young mutations in Brazilian families with autosomal-dominant early-onset type 2 diabetes. Diabetes Care 2001; 24:786-8. [PMID: 11315851 DOI: 10.2337/diacare.24.4.786] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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25
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Doleris LM, Hill GS, Chedin P, Nochy D, Bellanne-Chantelot C, Hanslik T, Bedrossian J, Caillat-Zucman S, Cahen-Varsaux J, Bariety J. Focal segmental glomerulosclerosis associated with mitochondrial cytopathy. Kidney Int 2000; 58:1851-8. [PMID: 11044204 DOI: 10.1111/j.1523-1755.2000.00356.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The nonspecific lesion of focal segmental glomerulosclerosis (FSGS) can occur as a primary disease or in a variety of secondary settings. In mitochondrial cytopathies (MCs), the phenotypic expression of the disease depends on the degree of cellular dysfunction, and this correlates with the proportion of abnormal mitochondrial DNA in the cells and the dependence of tissues on oxidative metabolism. The most common renal manifestation in MCs is tubular dysfunction; little has been reported about glomerular diseases. METHODS Cases of four adult patients with FSGS and MC are reported. Routine histology and mitochondrial DNA analysis were carried out on renal biopsies. RESULTS Family history and clinical manifestations in the four patients with FSGS suggested a diagnosis of MC. An A3243G transition in the mitochondrial DNA tRNA(leu(UUR)) was found in lymphocytes and kidney. Glomerular lesions of FSGS were associated with unusual hyaline lesions, which appeared to represent individual myocyte necrosis in afferent arterioles and small arteries. CONCLUSION FSGS is a renal manifestation of MCs. The renal lesion can precede other manifestations of the genetic disease by many years. The striking arteriolar lesions in these cases may have resulted in glomerular hypertension and hyperperfusion, leading to secondary epithelial cell abnormalities and, ultimately, FSGS. However, primary epithelial cell dysfunction caused by mitochondrial defects could not be ruled out on morphological grounds. MCs should be considered in cases of so-called primary FSGS, particularly if there is a familial history of diabetes, neuromuscular disorders, or deafness.
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Affiliation(s)
- L M Doleris
- Department of Internal Medicine and Nephrology, Hôpital A. Paré, Boulogne Billancourt, France.
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26
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Valeri A, Berthon P, Fournier G, Buzzi JC, Briollais L, Meria P, Blanche H, Bellanne-Chantelot C, Teillac P, Demenais F, Mangin P, Cohen N, Le Duc A, Cussenot O. [The PROGENE study, the French project of genetic analysis of familial prostatic cancer: recruitment and analysis]. Prog Urol 1996; 6:226-35. [PMID: 8777415] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVES To initiate a genetic linkage study in order to localize one or several predisposition gene(s) for hereditary prostatic cancer (PC), as various epidemiological studies have demonstrated a possible family aggregation in about 25% of cases. A family segregation study [14] has also shown that a genetic predisposition, with autosomal dominant transmission and high penetrance (88% at 85 years) could be responsible for 9% of all PC. METHODS A national collection of families with at least 2 cases of PC allowed: 1) identification of families with hereditary forms of PC, 2) creation of a constitutional DNA bank after collecting blood samples from subjects belonging to these families, and 3) a simulation study of genetic linkage analysis prior to microsatellite genotyping. RESULTS From July 1994 to September 1995, we included 67 families (180 cases of PC). Another 45 families are currently being included. 24 of these 67 families (89 PC, 54 survivors) satisfied at least one of the criteria defined in the study by CARTER et al. for hereditary forms of familial PC. Two families were also included as the 3 patients with PC were second degree relatives. A total of 26 families therefore presented a hereditary form, 18 of which (73 PC, 46 survivors) were considered to be informative for a genetic linkage study (lod score = 4 for theta = 0.001 with an 8 allele marker). The constitutional DNA of 271 individuals of these informative families was extracted from circulating cells obtained from blood samples, immortalized lymphocytes, and the genotyping was initiated for 216 microsatellite markers distributed throughout the genome, an average of every 20 cM. CONCLUSION Although the recruitment allowed us to identify many informative families for an inherited risk of PC, the predictive study suggested a high probability for localization of a predisposition gene by genetic linkage analysis. It would therefore be possible to identify, within the families concerned, the subjects carrying the genetic anomaly and consequently at high-risk of PC. Finally, the demonstration of the locus would allow cloning and identification of the gene (s) involved.
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Affiliation(s)
- A Valeri
- Département d'Urologie, Hôpital Saint-Louis, Paris
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