1
|
Sarkozy A, Sa M, Ridout D, Fernandez-Garcia MA, Distefano MG, Main M, Sheehan J, Manzur AY, Munot P, Robb S, Wraige E, Quinlivan R, Scoto M, Baranello G, Gowda V, Mein R, Phadke R, Jungbluth H, Muntoni F. Long-term Natural History of Pediatric Dominant and Recessive RYR1-Related Myopathy. Neurology 2023; 101:e1495-e1508. [PMID: 37643885 PMCID: PMC10585689 DOI: 10.1212/wnl.0000000000207723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 06/14/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES RYR1-related myopathies are the most common congenital myopathies, but long-term natural history data are still scarce. We aim to describe the natural history of dominant and recessive RYR1-related myopathies. METHODS A cross-sectional and longitudinal retrospective data analysis of pediatric cases with RYR1-related myopathies seen between 1992-2019 in 2 large UK centers. Patients were identified, and data were collected from individual medical records. RESULTS Sixty-nine patients were included in the study, 63 in both cross-sectional and longitudinal studies and 6 in the cross-sectional analysis only. Onset ranged from birth to 7 years. Twenty-nine patients had an autosomal dominant RYR1-related myopathy, 31 recessive, 6 de novo dominant, and 3 uncertain inheritance. Median age at the first and last appointment was 4.0 and 10.8 years, respectively. Fifteen% of patients older than 2 years never walked (5 recessive, 4 de novo dominant, and 1 dominant patient) and 7% lost ambulation during follow-up. Scoliosis and spinal rigidity were present in 30% and 17% of patients, respectively. Respiratory involvement was observed in 22% of patients, and 12% needed ventilatory support from a median age of 7 years. Feeding difficulties were present in 30% of patients, and 57% of those needed gastrostomy or tube feeding. There were no anesthetic-induced malignant hyperthermia episodes reported in this cohort. We observed a higher prevalence of prenatal/neonatal features in recessive patients, in particular hypotonia and respiratory difficulties. Clinical presentation, respiratory outcomes, and feeding outcomes were consistently more severe at presentation and in the recessive group. Conversely, longitudinal analysis suggested a less progressive course for motor and respiratory function in recessive patients. Annual change in forced vital capacity was -0.2%/year in recessive vs -1.4%/year in dominant patients. DISCUSSION This clinical study provides long-term data on disease progression in RYR1-related myopathies that may inform management and provide essential milestones for future therapeutic interventions.
Collapse
Affiliation(s)
- Anna Sarkozy
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Mario Sa
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Deborah Ridout
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Miguel Angel Fernandez-Garcia
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Maria Grazia Distefano
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Marion Main
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Jennie Sheehan
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Adnan Y Manzur
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Pinki Munot
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Stephanie Robb
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Elizabeth Wraige
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Rosaline Quinlivan
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Mariacristina Scoto
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Giovanni Baranello
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Vasantha Gowda
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Rachael Mein
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Rahul Phadke
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Heinz Jungbluth
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom
| | - Francesco Muntoni
- From the Dubowitz Neuromuscular Centre (A.S., M.Sa, M.G.D., M.M., A.Y.M., P.M., S.R., R.Q., M. Scoto, G.B., R.P., F.M.), UCL Great Ormond Street Institute of Child Health & MRC Centre for Neuromuscular Diseases; Department of Paediatric Neurology (M. Sa, M.A.F.-G., E.W., V.G., H.J.), Neuromuscular Service, Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; Department of Population, Policy and Practice (D.R.), UCL Institute of Child Health; National Institute for Health Research Great Ormond Street Hospital Biomedical Research Centre (D.R., F.M.); Paediatric Physiotherapy (J.S.), Evelina Children's Hospital, Guy's and St Thomas' Hospital NHS Foundation Trust; DNA Laboratory (R.M.), Viapath, Guy's Hospital; and Randall Centre for Cell and Molecular Biophysics (H.J.), Muscle Signaling Section, Faculty of Life Sciences and Medicine, King's College London, United Kingdom.
| |
Collapse
|
2
|
Silwal A, Sarkozy A, Scoto M, Ridout D, Schmidt A, Laverty A, Henriques M, D'Argenzio L, Main M, Mein R, Manzur AY, Abel F, Al-Ghamdi F, Genetti CA, Ardicli D, Haliloglu G, Topaloglu H, Beggs AH, Muntoni F. Selenoprotein N-related myopathy: a retrospective natural history study to guide clinical trials. Ann Clin Transl Neurol 2020; 7:2288-2296. [PMID: 33037864 PMCID: PMC7664282 DOI: 10.1002/acn3.51218] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 09/15/2020] [Accepted: 09/20/2020] [Indexed: 12/28/2022] Open
Abstract
Objective To describe clinical features and disease progression of Selenoprotein N‐related myopathy in a large multicenter cohort of patients. Methods Cross‐sectional multicenter data analysis of 60 patients (53 families) with Selenoprotein N‐related myopathy and single‐center retrospective longitudinal analysis of 25 patients (21 families) over a median period of 5.3 years. Results The majority of patients (46/60, 77%) presented before age 2 years with hypotonia, poor head/neck control, and developmental delay. At last assessment (median age 14 years; range 2.5 to 36 years), 10/60 patients had minimal or no ambulation. Ventilatory support was initiated in 50/60 patients at a mean Forced Vital Capacity (FVC) of 38% and at a median age of 13 years. Forty‐five/60 patients developed scoliosis (at median age 12.1 years) and 18 had scoliosis surgery at a median age of 13.6 years. Five children needed nasogastric feeds and/or gastrostomy. Longitudinal data analysis on 25 patients showed progressive decline of Hammersmith functional motor scores (estimated annual change −0.55 point), time to walk 10 meter, time standing from sitting, and from lying. Sixteen patients had weights < 2nd centile. The estimated change in FVC % per year was −2.04, with a 95% CI (−2.94, −1.14). Conclusions This comprehensive analysis of patients with Selenoprotein N‐related myopathy further describes the clinical course of this rare condition. The observed functional motor and respiratory data provide evidence of the slow decline patients experience over time which is useful when considering therapeutic intervention.
Collapse
Affiliation(s)
- Arpana Silwal
- The Dubowitz Neuromuscular Centre, Developmental Neuroscience Program, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, London, UK
| | - Anna Sarkozy
- The Dubowitz Neuromuscular Centre, Developmental Neuroscience Program, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, London, UK
| | - Mariacristina Scoto
- The Dubowitz Neuromuscular Centre, Developmental Neuroscience Program, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, London, UK
| | - Deborah Ridout
- Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, Great Ormond Street Hospital Trust, London, UK
| | - Anne Schmidt
- Respiratory Department, Sleep and Non-Invasive Ventilation, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Aidan Laverty
- Respiratory Department, Sleep and Non-Invasive Ventilation, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Matilde Henriques
- Respiratory Department, Sleep and Non-Invasive Ventilation, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Luigi D'Argenzio
- The Dubowitz Neuromuscular Centre, Developmental Neuroscience Program, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, London, UK
| | - Marion Main
- The Dubowitz Neuromuscular Centre, Developmental Neuroscience Program, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, London, UK
| | - Rachael Mein
- Genetic Department, Molecular Genetics Laboratory Viapath, Guy's Hospital, London, UK
| | - Adnan Y Manzur
- The Dubowitz Neuromuscular Centre, Developmental Neuroscience Program, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, London, UK
| | - Francois Abel
- Respiratory Department, Sleep and Non-Invasive Ventilation, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
| | - Fouad Al-Ghamdi
- Division of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Casie A Genetti
- Division of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Didem Ardicli
- Hacettepe University Children's Hospital, Department of Paediatric Neurology, Ankara, Turkey
| | - Goknur Haliloglu
- Hacettepe University Children's Hospital, Department of Paediatric Neurology, Ankara, Turkey
| | - Haluk Topaloglu
- Hacettepe University Children's Hospital, Department of Paediatric Neurology, Ankara, Turkey
| | - Alan H Beggs
- Division of Genetics and Genomics, The Manton Center for Orphan Disease Research, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Francesco Muntoni
- The Dubowitz Neuromuscular Centre, Developmental Neuroscience Program, UCL Great Ormond Street Institute of Child Health, Great Ormond Street Hospital, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, Great Ormond Street Institute of Child Health, University College London, Great Ormond Street Hospital Trust, London, UK
| |
Collapse
|
3
|
Sa M, Ridout D, Distefano M, Fernandez-Garcia M, Main M, Mein R, Phadke R, Jungbluth H, Muntoni F, Sarkozy A. CONGENITAL MYOPATHIES 2. Neuromuscul Disord 2020. [DOI: 10.1016/j.nmd.2020.08.100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
4
|
Zambon AA, Ridout D, Main M, Mein R, Phadke R, Muntoni F, Sarkozy A. LAMA2-related muscular dystrophy: Natural history of a large pediatric cohort. Ann Clin Transl Neurol 2020; 7:1870-1882. [PMID: 32910545 PMCID: PMC7545609 DOI: 10.1002/acn3.51172] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 08/09/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022] Open
Abstract
Objective To characterize natural history of Laminin‐α2 related muscular dystrophies (LAMA2‐RD) to help anticipating complications and identifying reliable outcome measures for clinical trial design and powering. Methods We conducted a retrospective, single‐center, cross‐sectional and longitudinal study on 46 LAMA2‐RD pediatric patients (37 families). Patients were seen at the Dubowitz Neuromuscular Centre, London between 1985 and 2019. Data were collected by case note reviews. Time‐to‐event analysis was performed to estimate median age at complications occurrence. Results Forty two patients had complete deficiency of Laminin‐α2 (CD) and four had partial deficiency (PD). Median age at first and last assessment was 2 years and 12.1 years, respectively. Median follow‐up length was 7.8 years (range 0‐18 years). Seven CD patients died at median age 12 years. One CD and two PD subjects achieved independent ambulation. We observed a linear increase in elbow flexor contractures in CD subjects. Thirty‐two CD and one PD patient developed scoliosis, nine underwent spinal surgery. Twenty‐two CD required nocturnal noninvasive ventilation (median age 11.7 years). CD subjects showed a 2.9% linear annual decline in forced vital capacity % predicted. Nineteen CD and one PD patient required gastrostomy insertion for failure to thrive and/or unsafe swallow (median age 10.9 years). Four CD patients had partial seizures. Mild left cardiac ventricular dysfunction and rhythm disturbances were identified in seven CD patients. Interpretation This retrospective longitudinal study provides long‐term natural history of LAMA2‐RD. This will help management and identification of key milestones of disease progression that could be considered for future therapeutic intervention.
Collapse
Affiliation(s)
- Alberto A Zambon
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK.,Neurology Department, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Deborah Ridout
- Department of Population, Policy and Practice, UCL Institute of Child Health, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Marion Main
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | | | - Rahul Phadke
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK.,NIHR Great Ormond Street Hospital Biomedical Research Centre, London, UK
| | - Anna Sarkozy
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| |
Collapse
|
5
|
Zhou G, Mein R, Game D, Rottenberg G, Bultitude M, Thomas K. Defining the inheritance of cystinuria: Is it always autosomal recessive? EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33297-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
|
6
|
Sarkozy A, Fernandez-Garcia M, Manzur A, Mein R, Bodi I, Phadke R, Wraige E, Deshpande C, Holder S, Hurst J, Gautel M, Jungbluth H, Muntoni F. P.109Congenital myopathy in patients with Kabuki and Au-Kline syndromes - Double trouble or expansion of the phenotypes? Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
7
|
Sarkozy A, Mein R, Oates E, Zaharieva I, Jungbluth H, Manzur A, Robb S, Munot P, Feng L, Sewry C, Phadke R, Muntoni F. P.238The Dubowitz neuromuscular centre experience in TTN gene analysis in UK patients with congenital myopathies. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
8
|
Silwal A, Muntoni F, Mein R, Manzur A. E-POSTERS – INFLAMMATORY MYOPATHIES AND MUSCULAR DYSTROPHIES – CASE REPORTS. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
9
|
Phadke R, Sarkozy A, Oates E, Mein R, Bodi I, Feng L, Manzur A, Thomas N, Illingworth M, Mazanti I, Ellard S, Sewry C, Gautel M, Jungbluth H, Muntoni F. P.236Myofibres with subsarcolemmal rims and/or central aggregates of mitochondria (SRCAM) are prevalent in congenital titinopathies. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
10
|
Beck M, Aguti S, Ala P, Richard-Loendt A, Chambers D, Scaglioni D, Ardicli D, Feng L, Mein R, Zhou H, Sewry C, Sarkozy A, Torelli S, Muntoni F, Phadke R. P.387A novel in situ hybridisation (ISH) assay mapping the in-frame pseudoexon 11 (pE11) expression in cultured dermal fibroblasts (CDF) and skeletal muscle in patients with severe collagen VI disease due to a deep intronic mutation in COL6A1. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
11
|
Zambon A, Main M, Mein R, Phadke R, Sewry C, Feng L, Munot P, Manzur A, Quinlivan R, Robb S, Sarkozy A, Muntoni F. P.333LAMA2-related congenital muscular dystrophy: clinical course in a large paediatric cohort. Neuromuscul Disord 2019. [DOI: 10.1016/j.nmd.2019.06.447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
12
|
Sa M, DiStefano M, Mein R, Phadke R, Feng L, Munot P, Quinlivan R, Manzur A, Robb S, Main M, Sewry C, Sarkozy A, Muntoni F. CONGENITAL MYOPATHIES: GENERAL AND RYR1. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
13
|
Sarkozy A, Torelli S, Mein R, Henderson M, Phadke R, Feng L, Sewry C, Ala P, Yau M, Bertoli M, Willis T, Hammans S, Manzur A, Sframeli M, Norwood F, Rakowicz W, Radunovic A, Vaidya SS, Parton M, Walker M, Marino S, Offiah C, Farrugia ME, Mamutse G, Marini-Bettolo C, Wraige E, Beeson D, Lochmüller H, Straub V, Bushby K, Barresi R, Muntoni F. Mobility shift of beta-dystroglycan as a marker of GMPPB gene-related muscular dystrophy. J Neurol Neurosurg Psychiatry 2018; 89:762-768. [PMID: 29437916 DOI: 10.1136/jnnp-2017-316956] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [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: 07/26/2017] [Revised: 12/20/2017] [Accepted: 01/03/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Defects in glycosylation of alpha-dystroglycan (α-DG) cause autosomal-recessive disorders with wide clinical and genetic heterogeneity, with phenotypes ranging from congenital muscular dystrophies to milder limb girdle muscular dystrophies. Patients show variable reduction of immunoreactivity to antibodies specific for glycoepitopes of α-DG on a muscle biopsy. Recessive mutations in 18 genes, including guanosine diphosphate mannose pyrophosphorylase B (GMPPB), have been reported to date. With no specific clinical and pathological handles, diagnosis requires parallel or sequential analysis of all known genes. METHODS We describe clinical, genetic and biochemical findings of 21 patients with GMPPB-associated dystroglycanopathy. RESULTS We report eight novel mutations and further expand current knowledge on clinical and muscle MRI features of this condition. In addition, we report a consistent shift in the mobility of beta-dystroglycan (β-DG) on Western blot analysis of all patients analysed by this mean. This was only observed in patients with GMPPB in our large dystroglycanopathy cohort. We further demonstrate that this mobility shift in patients with GMPPB was due to abnormal N-linked glycosylation of β-DG. CONCLUSIONS Our data demonstrate that a change in β-DG electrophoretic mobility in patients with dystroglycanopathy is a distinctive marker of the molecular defect in GMPPB.
Collapse
Affiliation(s)
- Anna Sarkozy
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Silvia Torelli
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Rachael Mein
- DNA Laboratory, Viapath, Guy's Hospital, London, UK
| | - Matt Henderson
- Rare Diseases Advisory Group Service for Neuromuscular Diseases, Muscle Immunoanalysis Unit, Dental Hospital, Newcastle upon Tyne, UK
| | - Rahul Phadke
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Lucy Feng
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Caroline Sewry
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK.,The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Pierpaolo Ala
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Michael Yau
- DNA Laboratory, Viapath, Guy's Hospital, London, UK
| | - Marta Bertoli
- The John Walton Muscular Dystrophy Research Centre, MRC Centre for Neuromuscular Diseases Institute of Genetic Medicine, University of Newcastle, Newcastle upon Tyne, UK.,Northern Genetics Service, Newcastle upon Tyne NHS Trust, Newcastle upon Tyne, UK
| | - Tracey Willis
- The Robert Jones and Agnes Hunt Orthopaedic Hospital, Oswestry, UK
| | - Simon Hammans
- Wessex Neurological Centre, University Hospital of Southampton, Southampton, UK
| | - Adnan Manzur
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Maria Sframeli
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Fiona Norwood
- Department of Neurology, King's College Hospital, London, UK
| | - Wojtek Rakowicz
- Department of Neurology, Hampshire Hospitals NHS Foundation Trust, Royal Hampshire County Hospital, Winchester, UK
| | | | | | - Matt Parton
- MRC Centre for Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Mark Walker
- Department of Cellular Pathology, Southampton University Hospitals, Southampton, UK
| | - Silvia Marino
- Queen Mary University of London, Barts and the London School of Medicine and Dentistry, London, UK
| | - Curtis Offiah
- Department of Radiology, Royal London Hospital, London, UK
| | - Maria Elena Farrugia
- Department of Neurology, Institute of Neurological Sciences, Southern General Hospital, Glasgow, UK
| | - Godwin Mamutse
- Department of Neurology, Norfolk and Norwich University Hospital, Norwich, UK
| | - Chiara Marini-Bettolo
- The John Walton Muscular Dystrophy Research Centre, MRC Centre for Neuromuscular Diseases Institute of Genetic Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Elizabeth Wraige
- Department of Paediatric Neurology, Neuromuscular Service, Evelina Children's Hospital, St Thomas' Hospital, London, UK
| | - David Beeson
- Neuromuscular Disorders Group, Nuffield Department of Clinical Neurosciences, Weatherall Institute of Molecular Medicine, Oxford, UK
| | - Hanns Lochmüller
- The John Walton Muscular Dystrophy Research Centre, MRC Centre for Neuromuscular Diseases Institute of Genetic Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Volker Straub
- The John Walton Muscular Dystrophy Research Centre, MRC Centre for Neuromuscular Diseases Institute of Genetic Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Kate Bushby
- The John Walton Muscular Dystrophy Research Centre, MRC Centre for Neuromuscular Diseases Institute of Genetic Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Rita Barresi
- Rare Diseases Advisory Group Service for Neuromuscular Diseases, Muscle Immunoanalysis Unit, Dental Hospital, Newcastle upon Tyne, UK.,The John Walton Muscular Dystrophy Research Centre, MRC Centre for Neuromuscular Diseases Institute of Genetic Medicine, University of Newcastle, Newcastle upon Tyne, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, MRC Centre for Neuromuscular Diseases, UCL Great Ormond Street Institute of Child Health, London, UK
| |
Collapse
|
14
|
Marks S, van Ruitenbeek E, Fallon P, Johns P, Phadke R, Mein R, Mohammed S, Jungbluth H. Parental mosaicism in RYR1-related Central Core Disease. Neuromuscul Disord 2018; 28:422-426. [PMID: 29576327 DOI: 10.1016/j.nmd.2018.02.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 07/29/2017] [Revised: 01/20/2018] [Accepted: 02/20/2018] [Indexed: 11/15/2022]
Abstract
Myopathies due to mutations in the skeletal muscle ryanodine receptor (RYR1) gene are amongst the most common non-dystrophic neuromuscular disorders and have been associated with both dominant and recessive inheritance. Several cases with apparently de novo dominant inheritance have been reported. Here we report two siblings with features of Central Core Disease (CCD) born to unaffected parents. Genetic testing revealed a heterozygous dominant RYR1 c.14582G>A (p. Arg4861His) mutation previously identified in other CCD pedigrees. The variant was absent in blood from the asymptomatic mother but detected at low but variable levels in blood- and saliva-derived DNA from the unaffected father, suggesting that this mutation has arisen as a paternal post-zygotic de novo event. These findings suggest that parental mosaicism should be considered in RYR1-related myopathies, and may provide one possible explanation for the marked intergenerational variability seen in some RYR1 pedigrees.
Collapse
Affiliation(s)
- S Marks
- Viapath, Guy's Hospital, London, UK
| | - E van Ruitenbeek
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK; Radboud University Medical School, Nijmegen, The Netherlands
| | - P Fallon
- Department of Paediatric Neurology, St. George's Hospital, London, UK
| | - P Johns
- Department of Cellular Pathology, St. George's Hospital, London, UK
| | - R Phadke
- Dubowitz Neuromuscular Centre, Great Ormond Street Hospital for Children, London, UK
| | - R Mein
- Viapath, Guy's Hospital, London, UK
| | - S Mohammed
- Department of Clinical Genetics, Guy's Hospital, London, UK
| | - H Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK; Randall Division for Cell and Molecular Biophysics, Muscle Signaling Section, King's College, London, UK; Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK.
| |
Collapse
|
15
|
Touraine R, Laquerrière A, Petcu CA, Marguet F, Byrne S, Mein R, Yau S, Mohammed S, Guibaud L, Gautel M, Jungbluth H. Autopsy findings in EPG5-related Vici syndrome with antenatal onset. Am J Med Genet A 2017; 173:2522-2527. [PMID: 28748650 DOI: 10.1002/ajmg.a.38342] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [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: 12/16/2016] [Revised: 05/18/2017] [Accepted: 06/06/2017] [Indexed: 11/11/2022]
Abstract
Vici syndrome is one of the most extensive inherited human multisystem disorders and due to recessive mutations in EPG5 encoding a key autophagy regulator with a crucial role in autophagosome-lysosome fusion. The condition presents usually early in life, with features of severe global developmental delay, profound failure to thrive, (acquired) microcephaly, callosal agenesis, cataracts, cardiomyopathy, hypopigmentation, and combined immunodeficiency. Clinical course is variable but usually progressive and associated with high mortality. Here, we present a fetus, offspring of consanguineous parents, in whom callosal agenesis and other developmental brain abnormalities were detected on fetal ultrasound scan (US) and subsequent MRI scan in the second trimester. Postmortem examination performed after medically indicated termination of pregnancy confirmed CNS abnormalities and provided additional evidence for skin hypopigmentation, nascent cataracts, and hypertrophic cardiomyopathy. Genetic testing prompted by a suggestive combination of features revealed a homozygous EPG5 mutation (c.5870-1G>A) predicted to cause aberrant splicing of the EPG5 transcript. Our findings expand the phenotypical spectrum of EPG5-related Vici syndrome and suggest that this severe condition may already present in utero. While callosal agenesis is not an uncommon finding in fetal medicine, additional presence of hypopigmentation, cataracts and cardiomyopathy is rare and should prompt EPG5 testing.
Collapse
Affiliation(s)
- Renaud Touraine
- CHU-Hôpital Nord, Service de Génétique, Saint Etienne, France
| | - Annie Laquerrière
- Pathology Laboratory, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, NéoVasc, Rouen, France
| | | | - Florent Marguet
- Pathology Laboratory, Rouen University Hospital, Rouen, France
- Normandie Univ, UNIROUEN, NéoVasc, Rouen, France
| | - Susan Byrne
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
| | | | - Shu Yau
- GSTS Pathology, Guy's Hospital, London, UK
| | | | - Laurent Guibaud
- Imagerie Pédiatrique et Fœtale, Hôpital Femme Mère Enfant, Lyon-Bron, France
| | - Mathias Gautel
- Randall Division for Cell and Molecular Biophysics, Muscle Signaling Section, King's College, London, UK
| | - Heinz Jungbluth
- Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's & St. Thomas' Hospital NHS Foundation Trust, London, UK
- Randall Division for Cell and Molecular Biophysics, Muscle Signaling Section, King's College, London, UK
- Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
| |
Collapse
|
16
|
Sframeli M, Sarkozy A, Bertoli M, Astrea G, Hudson J, Scoto M, Mein R, Yau M, Phadke R, Feng L, Sewry C, Fen ANS, Longman C, McCullagh G, Straub V, Robb S, Manzur A, Bushby K, Muntoni F. Congenital muscular dystrophies in the UK population: Clinical and molecular spectrum of a large cohort diagnosed over a 12-year period. Neuromuscul Disord 2017; 27:793-803. [PMID: 28688748 DOI: 10.1016/j.nmd.2017.06.008] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [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: 02/09/2017] [Revised: 06/09/2017] [Accepted: 06/15/2017] [Indexed: 12/27/2022]
Abstract
Congenital muscular dystrophies (CMDs) are clinically and genetically heterogeneous conditions; some fatal in the first few years of life and with central nervous system involvement, whereas others present a milder course. We provide a comprehensive report of the relative frequency and clinical and genetic spectrum of CMD in the UK. Genetic analysis of CMD genes in the UK is centralised in London and Newcastle. Between 2001 and 2013, a genetically confirmed diagnosis of CMD was obtained for 249 unrelated individuals referred to these services. The most common CMD subtype was laminin-α2 related CMD (also known as MDC1A, 37.4%), followed by dystroglycanopathies (26.5%), Ullrich-CMD (15.7%), SEPN1 (11.65%) and LMNA (8.8%) gene related CMDs. The most common dystroglycanopathy phenotype was muscle-eye-brain-like disease. Fifteen patients carried mutations in the recently discovered ISPD, GMPPB and B3GALNT2 genes. Pathogenic allelic mutations in one of the CMD genes were also found in 169 unrelated patients with milder phenotypes, such as limb girdle muscular dystrophy and Bethlem myopathy. In all, we identified 362 mutations, 160 of which were novel. Our results provide one of the most comprehensive reports on genetics and clinical features of CMD subtypes and should help diagnosis and counselling of families with this group of conditions.
Collapse
Affiliation(s)
- Maria Sframeli
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK; Department of Clinical and Experimental Medicine and Nemo Sud Clinical Centre, University of Messina, Messina, Italy
| | - Anna Sarkozy
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Marta Bertoli
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, University of Newcastle, Central Parkway, Newcastle upon Tyne, UK
| | - Guja Astrea
- Department of Developmental Neuroscience, IRCCS Fondazione Stella Maris, Pisa, Italy
| | - Judith Hudson
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, University of Newcastle, Central Parkway, Newcastle upon Tyne, UK
| | - Mariacristina Scoto
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | | | | | - Rahul Phadke
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Lucy Feng
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Caroline Sewry
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Adeline Ngoh Seow Fen
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Cheryl Longman
- West of Scotland Regional Genetics Service, Southern General Hospital, Glasgow, UK
| | | | - Volker Straub
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, University of Newcastle, Central Parkway, Newcastle upon Tyne, UK
| | - Stephanie Robb
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Adnan Manzur
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK
| | - Kate Bushby
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, University of Newcastle, Central Parkway, Newcastle upon Tyne, UK
| | - Francesco Muntoni
- Dubowitz Neuromuscular Centre, UCL Great Ormond Street Institute of Child Health & Great Ormond Street Hospital, London, UK.
| |
Collapse
|
17
|
Torelli S, Sarkozy A, Mein R, Yau M, Hammans S, Radunovic A, Henderson M, Walker M, Marino S, Winder S, Feng L, Phadke R, Sewry C, Bushby K, Muntoni F, Barresi R. Mobility shift of beta-dystroglycan combined with reduced laminin alpha2 expression is a marker of genetic defects in the GMPPB gene. Neuromuscul Disord 2016. [DOI: 10.1016/j.nmd.2016.06.290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
18
|
Byrne S, Jansen L, U-King-Im JM, Siddiqui A, Lidov HGW, Bodi I, Smith L, Mein R, Cullup T, Dionisi-Vici C, Al-Gazali L, Al-Owain M, Bruwer Z, Al Thihli K, El-Garhy R, Flanigan KM, Manickam K, Zmuda E, Banks W, Gershoni-Baruch R, Mandel H, Dagan E, Raas-Rothschild A, Barash H, Filloux F, Creel D, Harris M, Hamosh A, Kölker S, Ebrahimi-Fakhari D, Hoffmann GF, Manchester D, Boyer PJ, Manzur AY, Lourenco CM, Pilz DT, Kamath A, Prabhakar P, Rao VK, Rogers RC, Ryan MM, Brown NJ, McLean CA, Said E, Schara U, Stein A, Sewry C, Travan L, Wijburg FA, Zenker M, Mohammed S, Fanto M, Gautel M, Jungbluth H. EPG5-related Vici syndrome: a paradigm of neurodevelopmental disorders with defective autophagy. Brain 2016; 139:765-81. [PMID: 26917586 PMCID: PMC4766378 DOI: 10.1093/brain/awv393] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 10/31/2015] [Accepted: 11/12/2015] [Indexed: 01/07/2023] Open
Abstract
Vici syndrome is a progressive neurodevelopmental multisystem disorder due to recessive mutations in the key autophagy gene EPG5. We report genetic, clinical, neuroradiological, and neuropathological features of 50 children from 30 families, as well as the neuronal phenotype of EPG5 knock-down in Drosophila melanogaster. We identified 39 different EPG5 mutations, most of them truncating and predicted to result in reduced EPG5 protein. Most mutations were private, but three recurrent mutations (p.Met2242Cysfs*5, p.Arg417*, and p.Gln336Arg) indicated possible founder effects. Presentation was mainly neonatal, with marked hypotonia and feeding difficulties. In addition to the five principal features (callosal agenesis, cataracts, hypopigmentation, cardiomyopathy, and immune dysfunction), we identified three equally consistent features (profound developmental delay, progressive microcephaly, and failure to thrive). The manifestation of all eight of these features has a specificity of 97%, and a sensitivity of 89% for the presence of an EPG5 mutation and will allow informed decisions about genetic testing. Clinical progression was relentless and many children died in infancy. Survival analysis demonstrated a median survival time of 24 months (95% confidence interval 0-49 months), with only a 10th of patients surviving to 5 years of age. Survival outcomes were significantly better in patients with compound heterozygous mutations (P = 0.046), as well as in patients with the recurrent p.Gln336Arg mutation. Acquired microcephaly and regression of skills in long-term survivors suggests a neurodegenerative component superimposed on the principal neurodevelopmental defect. Two-thirds of patients had a severe seizure disorder, placing EPG5 within the rapidly expanding group of genes associated with early-onset epileptic encephalopathies. Consistent neuroradiological features comprised structural abnormalities, in particular callosal agenesis and pontine hypoplasia, delayed myelination and, less frequently, thalamic signal intensity changes evolving over time. Typical muscle biopsy features included fibre size variability, central/internal nuclei, abnormal glycogen storage, presence of autophagic vacuoles and secondary mitochondrial abnormalities. Nerve biopsy performed in one case revealed subtotal absence of myelinated axons. Post-mortem examinations in three patients confirmed neurodevelopmental and neurodegenerative features and multisystem involvement. Finally, downregulation of epg5 (CG14299) in Drosophila resulted in autophagic abnormalities and progressive neurodegeneration. We conclude that EPG5-related Vici syndrome defines a novel group of neurodevelopmental disorders that should be considered in patients with suggestive features in whom mitochondrial, glycogen, or lysosomal storage disorders have been excluded. Neurological progression over time indicates an intriguing link between neurodevelopment and neurodegeneration, also supported by neurodegenerative features in epg5-deficient Drosophila, and recent implication of other autophagy regulators in late-onset neurodegenerative disease.
Collapse
Affiliation(s)
- Susan Byrne
- 1 Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - Lara Jansen
- 2 Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
| | - Jean-Marie U-King-Im
- 3 Department of Neuroradiology, Evelina's Children Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - Ata Siddiqui
- 3 Department of Neuroradiology, Evelina's Children Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK
| | - Hart G W Lidov
- 4 Department of Pathology, Boston Children's Hospital, Boston MA 02115, USA
| | - Istvan Bodi
- 5 Department of Clinical Neuropathology, King's College Hospital, London, UK
| | - Luke Smith
- 6 Randall Division for Cell and Molecular Biophysics, Muscle Signalling Section, King's College, London, UK
| | | | - Thomas Cullup
- 8 Regional Molecular Genetics Laboratory, Great Ormond Street Hospital, London, UK
| | - Carlo Dionisi-Vici
- 9 Division of Metabolism, Department of Paediatric Medicine, Bambino Gesù Children's Research Hospital, Rome
| | - Lihadh Al-Gazali
- 10 Departments of Paediatrics, Faculty of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, UAE
| | - Mohammed Al-Owain
- 11 College of Medicine, Alfaisal University, Riyadh, Saudi Arabia 12 Department of Medical Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Zandre Bruwer
- 13 Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | - Khalid Al Thihli
- 13 Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Sultanate of Oman
| | | | - Kevin M Flanigan
- 15 Center for Gene Therapy, Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Kandamurugu Manickam
- 16 Center for Human and Molecular Genetics at The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Erik Zmuda
- 16 Center for Human and Molecular Genetics at The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Wesley Banks
- 16 Center for Human and Molecular Genetics at The Research Institute at Nationwide Children's Hospital, Columbus, Ohio, USA
| | - Ruth Gershoni-Baruch
- 17 Institute of Human Genetics, Rambam Health Care Campus and the Technion Faculty of Medicine, Haifa, Israel
| | - Hanna Mandel
- 18 Metabolic Disease Unit, Meyer Children's Hospital, Rambam Health Care Campus and the Technion Faculty of Medicine, Haifa, Israel
| | - Efrat Dagan
- 19 Department of Nursing, University of Haifa, Haifa, Israel
| | - Annick Raas-Rothschild
- 20 Institute of Rare Diseases, Institute of Genetics; Sheba Medical Centre, Tel Hashomer and the Sackler school of Medicine Tel Aviv University Ramat Aviv, Israel
| | - Hila Barash
- 20 Institute of Rare Diseases, Institute of Genetics; Sheba Medical Centre, Tel Hashomer and the Sackler school of Medicine Tel Aviv University Ramat Aviv, Israel
| | - Francis Filloux
- 21 Division of Pediatric Neurology, University of Utah School of Medicine and Primary Children's Medical Centre, Salt Lake City, Utah, USA
| | - Donnell Creel
- 22 University of Utah School of Medicine, Moran Eye Centre, Salt Lake City, Utah, USA
| | - Michael Harris
- 23 Innovation Center for Biomedical Informatics, Georgetown University Medical Center, Washington DC, USA
| | - Ada Hamosh
- 24 McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University, Baltimore, USA
| | - Stefan Kölker
- 25 Division of Child Neurology and Metabolic Medicine, University Children's Hospital, Heidelberg, Germany
| | - Darius Ebrahimi-Fakhari
- 25 Division of Child Neurology and Metabolic Medicine, University Children's Hospital, Heidelberg, Germany
| | - Georg F Hoffmann
- 25 Division of Child Neurology and Metabolic Medicine, University Children's Hospital, Heidelberg, Germany
| | - David Manchester
- 26 Department of Pediatrics, Section of Clinical Genetics and Metabolism, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, USA
| | - Philip J Boyer
- 27 Department of Pathology, East Carolina University, Brody School of Medicine, Brody Medical Sciences Building, Greenville, NC 27834, USA
| | | | | | - Daniela T Pilz
- 30 Institute of Medical Genetics, University Hospital of Wales, Cardiff, UK
| | - Arveen Kamath
- 30 Institute of Medical Genetics, University Hospital of Wales, Cardiff, UK
| | - Prab Prabhakar
- 31 Department of Paediatric Neurology, Great Ormond Street Children's Hospital, London, UK
| | - Vamshi K Rao
- 32 University of Nebraska Medical Center and Childrens Hospital and Medical Center, Omaha, Nebraska, USA
| | - R Curtis Rogers
- 33 Greenwood Genetic Center, Greenville, South Carolina, USA
| | - Monique M Ryan
- 34 Departments of Neurology, Royal Children's Hospital and Paediatrics, University of Melbourne, and Murdoch Childrens Research Institute, Melbourne Australia
| | - Natasha J Brown
- 35 Victorian Clinical Genetics Services, Murdoch Childrens Research Institute Parkville, Australia 36 Department of Paediatrics, University of Melbourne, Parkville, Australia 37 Department of Clinical Genetics, Austin Health, Australia
| | | | - Edith Said
- 39 Department of Anatomy and Cell Biology, University of Malta, Msida, Malta 40 Section of Medical Genetics, Mater dei Hospital, Msida, Malta
| | - Ulrike Schara
- 41 Pediatric Neurology, University Childrens Hospital, University of Duisburg-Essen University of Duisburg-Essen, Essen, Germany
| | - Anja Stein
- 42 Department of Neonatology, University Childrens Hospital, University of Duisburg-Essen, Essen, Germany
| | - Caroline Sewry
- 43 Dubowitz Neuromuscular Centre, Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK
| | - Laura Travan
- 44 Institute for Maternal and Child Health, IRCCS 'Burlo Garofolo', Trieste, Italy
| | - Frits A Wijburg
- 45 Department of Paediatrics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - Martin Zenker
- 46 Institute of Human Genetics, University Hospital Magdeburg, Germany
| | - Shehla Mohammed
- 47 Department of Clinical Genetics, Guy's Hospital, London, UK
| | - Manolis Fanto
- 2 Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
| | - Mathias Gautel
- 6 Randall Division for Cell and Molecular Biophysics, Muscle Signalling Section, King's College, London, UK
| | - Heinz Jungbluth
- 1 Department of Paediatric Neurology, Neuromuscular Service, Evelina's Children Hospital, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, UK 6 Randall Division for Cell and Molecular Biophysics, Muscle Signalling Section, King's College, London, UK 48 Department of Basic and Clinical Neuroscience, IoPPN, King's College London, London, UK
| |
Collapse
|
19
|
Sframeli M, Sarkozy A, Bertoli M, Astrea G, Hudson J, Scoto M, Mein R, Yau M, Phadke R, Feng L, Sewry C, Robb S, Manzur A, Messina S, Bushby K, Muntoni F. Congenital muscular dystrophies in the UK population: Update of clinical and molecular spectrum of patients diagnosed over a 12-year period. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.303] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
20
|
Sarkozy A, Torelli S, Barresi R, Bertoli M, Sframeli M, Mein R, Yau M, Sewry C, Phadke R, Feng L, Ala P, Manzur A, Bushby K, Lochmüller H, Willis T, Norwood F, Rakowicz R, Muntoni F. Eight novel UK families further expand current knowledge on GMPPB-gene related dystroglycanopathies. Neuromuscul Disord 2015. [DOI: 10.1016/j.nmd.2015.06.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Abstract
OBJECTIVE To examine the genetic mutations in the first UK cohort of patients with cystinuria with preliminary genotype/phenotype correlation. PATIENTS AND METHODS DNA sequencing and multiplex ligation-dependent probe amplification (MLPA) were used to identify the mutations in 74 patients in a specialist cystinuria clinic in the UK. Patients with type A cystinuria were classified into two groups: Group M patients had at least one missense mutation and Group N patients had two alleles of all other types of mutations including frameshift, splice site, nonsense, deletions and duplications. The levels of urinary dibasic amino acids, age at presentation of disease, number of stone episodes and interventions were compared between patients in the two groups using the Mann-Whitney U-test. RESULTS In all, 41 patients had type A cystinuria, including one patient with a variant of unknown significance and 23 patients had type B cystinuria, including six patients with variants of unknown significance. One patient had three sequence variants in SLC7A9; however, two are of unknown significance. Three patients had type AB cystinuria. Three had a single mutation in SLC7A9. No identified mutations were found in three patients in either gene. There were a total of 88 mutations in SLC3A1 and 55 mutations in SLC7A9. There were 23 pathogenic mutations identified in our UK cohort of patients not previously published. In patients with type A cystinuria, the presence of a missense mutation correlated to lower levels of urinary lysine (mean [SE] 611.9 [22.65] vs 752.3 [46.39] millimoles per mole of creatinine [mM/MC]; P=0.02), arginine (194.8 [24.83] vs 397.7 [15.32] mM/MC; P<0.001) and ornithine (109.2 [7.40] vs 146.6 [12.7] mM/MC; P=0.02). There was no difference in the levels of urinary cystine (182.1 [8.89] vs 207.2 [19.23] mM/MC; P=0.23). CONCLUSIONS We have characterised the genetic diversity of cystinuria in a UK population including 23 pathogenic mutations not previously published. Patients with at least one missense mutation in SLC3A1 had significantly lower levels of lysine, arginine, and ornithine but not cystine than patients with all other combinations of mutations.
Collapse
Affiliation(s)
- Kathie A Wong
- The Urology Centre, Guys and St. Thomas' NHS Foundation Trust, London, UK
| | | | - Mark Wass
- School of Biosciences, University of Kent, Canterbury, Kent, UK
| | | | - Caroline Pardy
- The Urology Centre, Guys and St. Thomas' NHS Foundation Trust, London, UK
| | - Matthew Bultitude
- The Urology Centre, Guys and St. Thomas' NHS Foundation Trust, London, UK
| | - Kay Thomas
- The Urology Centre, Guys and St. Thomas' NHS Foundation Trust, London, UK
| |
Collapse
|
22
|
Forrest KM, Foulds N, Millar JS, Sutherland PD, Pappachan VJ, Holden S, Mein R, Hopkins PM, Jungbluth H. RYR1-related malignant hyperthermia with marked cerebellar involvement – A paradigm of heat-induced CNS injury? Neuromuscul Disord 2015; 25:138-40. [DOI: 10.1016/j.nmd.2014.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 10/19/2014] [Accepted: 10/27/2014] [Indexed: 10/24/2022]
|
23
|
Sframeli M, Sarkozy A, Astrea G, Scoto M, Feng L, Mein R, Yau M, Phadke R, Sewry C, Messina S, Robb S, Muntoni F. G.P.207. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
24
|
Sframeli M, Sarkozy A, Longman C, Feng L, Robb S, Manzur A, Mein R, Yau M, Barresi R, Phadke R, Sewry C, Muntoni F. G.P.314. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
25
|
Clement EM, Feng L, Mein R, Sewry CA, Robb SA, Manzur AY, Mercuri E, Godfrey C, Cullup T, Abbs S, Muntoni F. Relative frequency of congenital muscular dystrophy subtypes: analysis of the UK diagnostic service 2001-2008. Neuromuscul Disord 2012; 22:522-7. [PMID: 22480491 DOI: 10.1016/j.nmd.2012.01.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [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: 11/29/2011] [Accepted: 01/26/2012] [Indexed: 11/17/2022]
Abstract
The Dubowitz Neuromuscular Centre is the UK National Commissioning Group referral centre for congenital muscular dystrophy (CMD). This retrospective review reports the diagnostic outcome of 214 UK patients referred to the centre for assessment of 'possible CMD' between 2001 and 2008 with a view to commenting on the variety of disorders seen and the relative frequency of CMD subtypes in this patient population. A genetic diagnosis was reached in 53 of 116 patients fulfilling a strict criteria for the diagnosis of CMD. Within this group the most common diagnoses were collagen VI related disorders (19%), dystroglycanopathy (12%) and merosin deficient congenital muscular dystrophy (10%). Among the patients referred as 'possible CMD' that did not meet our inclusion criteria, congenital myopathies and congenital myasthenic syndromes were the most common diagnoses. In this large study on CMD the diagnostic outcomes compared favourably with other CMD population studies, indicating the importance of an integrated clinical and pathological assessment of this group of patients.
Collapse
Affiliation(s)
- E M Clement
- Dubowitz Neuromuscular Centre, Institute of Child Health and Great Ormond Street Hospital, London WC1N 1EH, United Kingdom
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Wong K, Pardy C, Mein R, Kabia M, Flinter F, Thomas K. 2116 GENETIC PROFILE OF CYSTINURIA IN A UK POPULATION – THE DETECTION OF NEW PATHOLOGICAL MUTATIONS. J Urol 2012. [DOI: 10.1016/j.juro.2012.02.2285] [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: 11/16/2022]
|
27
|
Scoto M, Cirak S, Mein R, Feng L, Manzur AY, Robb S, Childs AM, Quinlivan RM, Roper H, Jones DH, Longman C, Chow G, Pane M, Main M, Hanna MG, Bushby K, Sewry C, Abbs S, Mercuri E, Muntoni F. SEPN1-related myopathies: clinical course in a large cohort of patients. Neurology 2011; 76:2073-8. [PMID: 21670436 DOI: 10.1212/wnl.0b013e31821f467c] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To assess the clinical course and genotype-phenotype correlations in patients with selenoprotein-related myopathy (SEPN1-RM) due to selenoprotein N1 gene (SEPN1) mutations for a retrospective cross-sectional study. METHODS Forty-one patients aged 1-60 years were included. Clinical data including scoliosis, respiratory function, and growth measurements were collected by case note review. RESULTS Mean age at onset was 2.7 years, ranging from birth to the second decade of life. All but 2 remained independently ambulant: one lost ambulation at age 5 years and another in his late 50s. The mean age of starting nocturnal noninvasive ventilation (NIV) was 13.9 years. One child required full-time NIV at the age of 1 year while in 2 cases NIV was started at 33 years. Two patients died from respiratory failure at the age of 10 and 22 years, respectively. The mean age at scoliosis onset was 10 years, in most cases preceded by rigidity of the spine. Fourteen patients had successful spinal surgery (mean age 13.9 years). Twenty-one were underweight; however, overt feeding difficulties were not a feature. CONCLUSIONS This study describes the largest population affected by SEPN1-RM reported so far. Our findings show that the spectrum of severity is wider than previously reported. Respiratory insufficiency generally develops by 14 years but may occur as early as in infancy or not until the fourth decade. Motor abilities remain essentially static over time even in patients with early presentation. Most adult patients remain ambulant and fully employed.
Collapse
Affiliation(s)
- M Scoto
- The Dubowitz Neuromuscular Centre, UCL Institute of Child Health, London, WC1N 1EH, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Scoto M, Cirak S, Mein R, Feng L, Manzur A, Robb S, Childs AM, Quinlivan R, Roper H, Hilton-Jones D, Longman C, Chow G, Pane M, Main M, Hanna M, Bushby K, Sewry C, Abbs S, Mercuri E, Muntoni F. P67 SEPN1 related myopathies: Clinical course in a large cohort of patients. Neuromuscul Disord 2011. [DOI: 10.1016/s0960-8966(11)70086-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
29
|
Geranmayeh F, Clement E, Feng LH, Sewry C, Pagan J, Mein R, Abbs S, Brueton L, Childs AM, Jungbluth H, De Goede CG, Lynch B, Lin JP, Chow G, Sousa CD, O'Mahony O, Majumdar A, Straub V, Bushby K, Muntoni F. Genotype-phenotype correlation in a large population of muscular dystrophy patients with LAMA2 mutations. Neuromuscul Disord 2010; 20:241-50. [PMID: 20207543 DOI: 10.1016/j.nmd.2010.02.001] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2009] [Revised: 01/09/2010] [Accepted: 02/01/2010] [Indexed: 11/25/2022]
Abstract
Merosin deficient congenital muscular dystrophy 1A (MDC1A) results from mutations in the LAMA2 gene. We report 51 patients with MDC1A and examine the relationship between degree of merosin expression, genotype and clinical features. Thirty-three patients had absence of merosin and 13 showed some residual merosin. Compared to the residual merosin group, patients with absent merosin had an earlier presentation (<7days) (P=0.0073), were more likely to lack independent ambulation (P=0.0215), or require enteral feeding (P=0.0099) and ventilatory support (P=0.0354). We identified 33 novel LAMA2 mutations; these were distributed throughout the gene in patients with absent merosin, with minor clusters in exon 27, 14, 25 and 26 (55% of mutations). Patients with residual merosin often carried at least one splice site mutation and less frequently frameshift mutations. This large study identified novel LAMA2 mutations and highlights the role of immunohistochemical studies for merosin status in predicting clinical severity of MDC1A.
Collapse
Affiliation(s)
- Fatemeh Geranmayeh
- Dubowitz Neuromuscular Centre, Institute of Child Health & Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
30
|
Clement E, Mercuri E, Godfrey C, Smith J, Robb S, Kinali M, Straub V, Bushby K, Manzur A, Talim B, Cowan F, Quinlivan R, Klein A, Longman C, McWilliam R, Topaloglu H, Mein R, Abbs S, North K, Barkovich AJ, Rutherford M, Muntoni F. Brain involvement in muscular dystrophies with defective dystroglycan glycosylation. Ann Neurol 2008; 64:573-82. [DOI: 10.1002/ana.21482] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
|
31
|
Jimenez-Mallebrera C, Torelli S, Feng L, Kim J, Godfrey C, Clement E, Mein R, Abbs S, Brown SC, Campbell KP, Kröger S, Talim B, Topaloglu H, Quinlivan R, Roper H, Childs AM, Kinali M, Sewry CA, Muntoni F. A comparative study of alpha-dystroglycan glycosylation in dystroglycanopathies suggests that the hypoglycosylation of alpha-dystroglycan does not consistently correlate with clinical severity. Brain Pathol 2008; 19:596-611. [PMID: 18691338 PMCID: PMC2860390 DOI: 10.1111/j.1750-3639.2008.00198.x] [Citation(s) in RCA: 82] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Hypoglycosylation of alpha-dystroglycan underpins a subgroup of muscular dystrophies ranging from congenital onset of weakness, severe brain malformations and death in the perinatal period to mild weakness in adulthood without brain involvement. Mutations in six genes have been identified in a proportion of patients. POMT1, POMT2 and POMGnT1 encode for glycosyltransferases involved in the mannosylation of alpha-dystroglycan but the function of fukutin, FKRP and LARGE is less clear. The pathological hallmark is reduced immunolabeling of skeletal muscle with antibodies recognizing glycosylated epitopes on alpha-dystroglycan. If the common pathway of these conditions is the hypoglycosyation of alpha-dystroglycan, one would expect a correlation between clinical severity and the extent of hypoglycosylation. By studying 24 patients with mutations in these genes, we found a good correlation between reduced alpha-dystroglycan staining and clinical course in patients with mutations in POMT1, POMT2 and POMGnT1. However, this was not always the case in patients with defects in fukutin and FKRP, as we identified patients with mild limb-girdle phenotypes without brain involvement with profound depletion of alpha-dystroglycan. These data indicate that it is not always possible to correlate clinical course and alpha-dystroglycan labeling and suggest that there might be differences in alpha-dystroglycan processing in these disorders.
Collapse
Affiliation(s)
- Cecilia Jimenez-Mallebrera
- Dubowitz Neuromuscular Centre, Institute of Child Health and Great Ormond Street Hospital for Children, UCL, London, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Clement EM, Godfrey C, Tan J, Brockington M, Torelli S, Feng L, Brown SC, Jimenez-Mallebrera C, Sewry CA, Longman C, Mein R, Abbs S, Vajsar J, Schachter H, Muntoni F. Mild POMGnT1 mutations underlie a novel limb-girdle muscular dystrophy variant. ACTA ACUST UNITED AC 2008; 65:137-41. [PMID: 18195152 DOI: 10.1001/archneurol.2007.2] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Mutations in protein-O-mannose-beta1,2-N-acetylglucosaminyltransferase 1 (POMGnT1) have been found in muscle-eye-brain disease, a congenital muscular dystrophy with structural eye and brain defects and severe mental retardation. OBJECTIVE To investigate whether mutations in POMGnT1 could be responsible for milder allelic variants of muscular dystrophy. DESIGN Screening for mutations in POMGnT1. SETTING Tertiary neuromuscular unit. PATIENT A patient with limb-girdle muscular dystrophy phenotype, with onset at 12 years of age, severe myopia, normal intellect, and decreased alpha-dystroglycan immunolabeling in skeletal muscle. RESULTS A homozygous POMGnT1 missense mutation (c.1666G>A, p.Asp556Asn) was identified. Enzyme studies of the patient's fibroblasts showed an altered kinetic profile, less marked than in patients with muscle-eye-brain disease and in keeping with the relatively mild phenotype in our patient. CONCLUSIONS Our findings widen the spectrum of disorders known to result from mutations in POMGnT1 to include limb-girdle muscular dystrophy with no mental retardation. We propose that this condition be known as LGMD2M. The enzyme assay used to diagnose muscle-eye-brain disease may not detect subtle abnormalities of POMGnT1 function, and additional kinetic studies must be carried out in such cases.
Collapse
Affiliation(s)
- Emma M Clement
- Dubowitz Neuromuscular Unit, Department of Paediatrics, Hammersmith Hospital, Imperial College London, Du Cane Road, London W12 ONN, England
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
33
|
Godfrey C, Clement E, Tan J, Brockington M, Torelli S, Feng L, Brown S, Jimenez-Mallebrera C, Sewry C, Longman C, Mein R, Abbs S, Vajsar J, Schachter H, Muntoni F. C.P.3.04 Mild POMGnT1 mutations underlie a novel limb girdle muscular dystrophy variant. Neuromuscul Disord 2007. [DOI: 10.1016/j.nmd.2007.06.364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
34
|
Godfrey C, Clement E, Mein R, Brockington M, Smith J, Talim B, Straub V, Robb S, Quinlivan R, Feng L, Jimenez-Mallebrera C, Mercuri E, Manzur AY, Kinali M, Torelli S, Brown SC, Sewry CA, Bushby K, Topaloglu H, North K, Abbs S, Muntoni F. Refining genotype phenotype correlations in muscular dystrophies with defective glycosylation of dystroglycan. Brain 2007; 130:2725-35. [PMID: 17878207 DOI: 10.1093/brain/awm212] [Citation(s) in RCA: 277] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Muscular dystrophies with reduced glycosylation of alpha-dystroglycan (alpha-DG), commonly referred to as dystroglycanopathies, are a heterogeneous group of autosomal recessive conditions which include a wide spectrum of clinical severity. Reported phenotypes range from severe congenital onset Walker-Warburg syndrome (WWS) with severe structural brain and eye involvement, to relatively mild adult onset limb girdle muscular dystrophy (LGMD). Specific clinical syndromes were originally described in association with mutations in any one of six demonstrated or putative glycosyltransferases. Work performed on patients with mutations in the FKRP gene has identified that the spectrum of phenotypes due to mutations in this gene is much wider than originally assumed. To further define the mutation frequency and phenotypes associated with mutations in the other five genes, we studied a large cohort of patients with evidence of a dystroglycanopathy. Exclusion of mutations in FKRP was a prerequisite for participation in this study. Ninety-two probands were screened for mutations in POMT1, POMT2, POMGnT1, fukutin and LARGE. Homozygous and compound heterozygous mutations were detected in a total of 31 probands (34 individuals from 31 families); 37 different mutations were identified, of which 32 were novel. Mutations in POMT2 were the most prevalent in our cohort with nine cases, followed by POMT1 with eight cases, POMGnT1 with seven cases, fukutin with six cases and LARGE with only a single case. All patients with POMT1 and POMT2 mutations had evidence of either structural or functional central nervous system involvement including four patients with mental retardation and a LGMD phenotype. In contrast mutations in fukutin and POMGnT1 were detected in four patients with LGMD and no evidence of brain involvement. The majority of patients (six out of nine) with mutations in POMT2 had a Muscle-Eye-Brain (MEB)-like condition. In addition we identified a mutation in the gene LARGE in a patient with WWS. Our data expands the clinical phenotypes associated with POMT1, POMT2, POMGnT1, fukutin and LARGE mutations. Mutations in these five glycosyltransferase genes were detected in 34% of patients indicating that, after the exclusion of FKRP, the majority of patients with a dystroglycanopathy harbour mutations in novel genes.
Collapse
Affiliation(s)
- Caroline Godfrey
- Dubowitz Neuromuscular Unit, Hammersmith Hospital, Imperial College, London, UK
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Godfrey C, Escolar D, Brockington M, Clement EM, Mein R, Jimenez-Mallebrera C, Torelli S, Feng L, Brown SC, Sewry CA, Rutherford M, Shapira Y, Abbs S, Muntoni F. Fukutin gene mutations in steroid-responsive limb girdle muscular dystrophy. Ann Neurol 2006; 60:603-610. [PMID: 17044012 DOI: 10.1002/ana.21006] [Citation(s) in RCA: 116] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Defects in glycosylation of alpha-dystroglycan are associated with several forms of muscular dystrophy, often characterized by congenital onset and severe structural brain involvement, collectively known as dystroglycanopathies. Six causative genes have been identified in these disorders including fukutin. Mutations in fukutin cause Fukuyama congenital muscular dystrophy. This is the second most common form of muscular dystrophy in Japan and is invariably associated with mental retardation and structural brain defects. The aim of this study was to determine the genetic defect in two white families with a dystroglycanopathy. METHODS The six genes responsible for dystroglycanopathies were studied in three children with a severe reduction of alpha-dystroglycan in skeletal muscle. RESULTS We identified pathogenic fukutin mutations in these two families. Affected children had normal intelligence and brain structure and shared a limb girdle muscular dystrophy (LGMD) phenotype, had marked elevation of serum creatine kinase, and were all ambulant with remarkable steroid responsiveness. INTERPRETATION Our data suggest that fukutin mutations occur outside Japan and can be associated with much milder phenotypes than Fukuyama congenital muscular dystrophy. These findings significantly expand the spectrum of phenotypes associated with fukutin mutations to include this novel form of limb girdle muscular dystrophy that we propose to name LGMD2L.
Collapse
Affiliation(s)
- Caroline Godfrey
- DNA Laboratory, Genetics Centre, Guy's Hospital, London, United Kingdom
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Godfrey C, Mein R, Brockington M, Elson E, Topaloglu H, Smith J, Escolar D, Bertini E, Merlini I, Mercuri E, Bushby K, Straub V, North K, Abbs S, Muntoni F. P.O.1 Molecular genetic analysis of 6 glycosyltransferases in a large population of dystroglycanopathy patients significantly widens the spectrum of phenotypes resulting from POMT1, POMGnT1 and Fukutin mutations. Neuromuscul Disord 2006. [DOI: 10.1016/j.nmd.2006.05.133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
37
|
Vainzof M, Richard P, Herrmann R, Jimenez-Mallebrera C, Talim B, Yamamoto LU, Ledeuil C, Mein R, Abbs S, Brockington M, Romero NB, Zatz M, Topaloglu H, Voit T, Sewry C, Muntoni F, Guicheney P, Tomé FMS. Prenatal diagnosis in laminin α2 chain (merosin)-deficient congenital muscular dystrophy: A collective experience of five international centers. Neuromuscul Disord 2005; 15:588-94. [PMID: 16084089 DOI: 10.1016/j.nmd.2005.04.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 02/02/2005] [Revised: 03/30/2005] [Accepted: 04/22/2005] [Indexed: 10/25/2022]
Abstract
The congenital muscular dystrophies (CMD) are clinically and genetically heterogeneous. The merosin (laminin alpha2 chain) deficient form (MDC1A), is characterized clinically by neonatal hypotonia, delayed motor milestones and associated contractures. It is caused by deficiency in the basal lamina of muscle fibers of the alpha2 chain of laminins 2 and 4 (LAMA2 gene at 6q22-23). Laminin alpha2 chain is also expressed in fetal trophoblast, which provides a suitable tissue for prenatal diagnosis in families where the index case has total deficiency of the protein. This article reports the collective experience of five centers over the past 10 years in 114 prenatal diagnostic studies using either protein analysis of the chorionic villus (CV) of the trophoblast plus DNA molecular studies with markers flanking the 6q22-23 region and intragenic polymorphisms (n=58), or using only DNA (n=44) or only protein (n=12) approaches. Of the 102 fetuses studied by molecular genetics, 27 (26%) were predicted to be affected while 75 (74%) were considered as unaffected, with 52 (51%) being heterozygous, thus conforming closely to an autosomal recessive inheritance. In 18 of the 27 affected fetuses, the trophoblast was studied by immunocytochemistry and there was a total or only traces deficiency of the protein in CV basement membrane in all. In 10 cases material from the presumably affected fetus was available for analysis after termination of the pregnancy and immunohistochemical study confirmed the diagnosis in all of them. Prenatal studies of 'at risk' pregnancies in the five centers produced neither false negative (merosin-deficiency in CVs in a normal fetus), nor false positive (normal merosin expression in CVs and affected child), indicating the reliability of the technique, when all the necessary controls are done. Our experience suggests that protein and DNA analysis can be used either independently or combined, according to the facilities of each center, to provide accurate prenatal diagnosis of the MDC1A, and have an essential role in genetic counseling.
Collapse
Affiliation(s)
- Mariz Vainzof
- Department of Genetics Biology, Human Genome Research Center, IB-USP, R. Matão, 106, Cidade Universitária, São Paulo, SP-CEP 05508-900, Brazil
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|