51
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Gonorazky HD, Naumenko S, Ramani AK, Nelakuditi V, Mashouri P, Wang P, Kao D, Ohri K, Viththiyapaskaran S, Tarnopolsky MA, Mathews KD, Moore SA, Osorio AN, Villanova D, Kemaladewi DU, Cohn RD, Brudno M, Dowling JJ. Expanding the Boundaries of RNA Sequencing as a Diagnostic Tool for Rare Mendelian Disease. Am J Hum Genet 2019; 104:466-483. [PMID: 30827497 PMCID: PMC6407525 DOI: 10.1016/j.ajhg.2019.01.012] [Citation(s) in RCA: 138] [Impact Index Per Article: 27.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 01/22/2019] [Indexed: 02/06/2023] Open
Abstract
Gene-panel and whole-exome analyses are now standard methodologies for mutation detection in Mendelian disease. However, the diagnostic yield achieved is at best 50%, leaving the genetic basis for disease unsolved in many individuals. New approaches are thus needed to narrow the diagnostic gap. Whole-genome sequencing is one potential strategy, but it currently has variant-interpretation challenges, particularly for non-coding changes. In this study we focus on transcriptome analysis, specifically total RNA sequencing (RNA-seq), by using monogenetic neuromuscular disorders as proof of principle. We examined a cohort of 25 exome and/or panel "negative" cases and provided genetic resolution in 36% (9/25). Causative mutations were identified in coding and non-coding exons, as well as in intronic regions, and the mutational pathomechanisms included transcriptional repression, exon skipping, and intron inclusion. We address a key barrier of transcriptome-based diagnostics: the need for source material with disease-representative expression patterns. We establish that blood-based RNA-seq is not adequate for neuromuscular diagnostics, whereas myotubes generated by transdifferentiation from an individual's fibroblasts accurately reflect the muscle transcriptome and faithfully reveal disease-causing mutations. Our work confirms that RNA-seq can greatly improve diagnostic yield in genetically unresolved cases of Mendelian disease, defines strengths and challenges of the technology, and demonstrates the suitability of cell models for RNA-based diagnostics. Our data set the stage for development of RNA-seq as a powerful clinical diagnostic tool that can be applied to the large population of individuals with undiagnosed, rare diseases and provide a framework for establishing minimally invasive strategies for doing so.
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Affiliation(s)
- Hernan D Gonorazky
- Division of Neurology, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Program in Genetics and Genome Biology, Research Institute, the Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Sergey Naumenko
- Centre for Computational Medicine, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Arun K Ramani
- Centre for Computational Medicine, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Viswateja Nelakuditi
- Centre for Computational Medicine, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Pouria Mashouri
- Centre for Computational Medicine, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Peiqui Wang
- Centre for Computational Medicine, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Dennis Kao
- Centre for Computational Medicine, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Krish Ohri
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5G 1X8, Canada
| | | | - Mark A Tarnopolsky
- Department of Pediatrics, McMaster University, Hamilton, ON L8S 4L8, Canada
| | - Katherine D Mathews
- Departments of Pediatrics and Neurology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
| | - Steven A Moore
- Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA 52242, USA
| | - Andres N Osorio
- Neuromuscular Unit, Neuropaediatrics Department, Institut de Recerca Hospital Universitari Sant Joan de Deu, Barcelona 08950, Spain; Center for the Biomedical Research on Rare Diseases (CIBERER), Instituto de Salud Carlos III (ISCIII), Barcelona 08950, Spain
| | - David Villanova
- GenomicTales Parc de la Mola, 10, AD700 Escaldes-Engordany, Andorra
| | - Dwi U Kemaladewi
- Program in Genetics and Genome Biology, Research Institute, the Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Ronald D Cohn
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5G 1X8, Canada; Program in Genetics and Genome Biology, Research Institute, the Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
| | - Michael Brudno
- Centre for Computational Medicine, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Program in Genetics and Genome Biology, Research Institute, the Hospital for Sick Children, Toronto, ON M5G 0A4, Canada; Department of Computer Science, University of Toronto, Toronto, ON M5G 0A4, Canada.
| | - James J Dowling
- Division of Neurology, the Hospital for Sick Children, Toronto, ON M5G 1X8, Canada; Department of Molecular Genetics, University of Toronto, Toronto, ON M5G 1X8, Canada; Program in Genetics and Genome Biology, Research Institute, the Hospital for Sick Children, Toronto, ON M5G 0A4, Canada.
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52
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Alkhunaizi E, Shuster S, Shannon P, Siu VM, Darilek S, Mohila CA, Boissel S, Ellezam B, Fallet-Bianco C, Laberge AM, Zandberg J, Injeyan M, Hazrati LN, Hamdan F, Chitayat D. Homozygous/compound heterozygote RYR1 gene variants: Expanding the clinical spectrum. Am J Med Genet A 2019; 179:386-396. [PMID: 30652412 DOI: 10.1002/ajmg.a.61025] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 11/26/2018] [Accepted: 12/05/2018] [Indexed: 02/06/2023]
Abstract
The ryanodine receptor 1 (RYR1) is a calcium release channel essential for excitation-contraction coupling in the sarcoplasmic reticulum of skeletal muscles. Dominant variants in the RYR1 have been well associated with the known pharmacogenetic ryanodinopathy and malignant hyperthermia. With the era of next-generation gene sequencing and growing number of causative variants, the spectrum of ryanodinopathies has been evolving with dominant and recessive variants presenting with RYR1-related congenital myopathies such as central core disease, minicore myopathy with external ophthalmoplegia, core-rod myopathy, and congenital neuromuscular disease. Lately, the spectrum was broadened to include fetal manifestations, causing a rare recessive and lethal form of fetal akinesia deformation sequence syndrome (FADS)/arthrogryposis multiplex congenita (AMC) and lethal multiple pterygium syndrome. Here we broaden the spectrum of clinical manifestations associated with homozygous/compound heterozygous RYR1 gene variants to include a wide range of manifestations from FADS through neonatal hypotonia to a 35-year-old male with AMC and PhD degree. We report five unrelated families in which three presented with FADS. One of these families was consanguineous and had three affected fetuses with FADS, one patient with neonatal hypotonia who is alive, and one individual with AMC who is 35 years old with normal intellectual development and uses a wheelchair. Muscle biopsies on these cases demonstrated a variety of histopathological abnormalities, which did not assist with the diagnostic process. Neither the affected living individuals nor the parents who are obligate heterozygotes had history of malignant hyperthermia.
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Affiliation(s)
- Ebba Alkhunaizi
- The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Shirley Shuster
- The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Patrick Shannon
- Department of Pathology and Laboratory Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Victoria Mok Siu
- Division of Medical Genetics, Department of Pediatrics, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Sandra Darilek
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Carrie A Mohila
- Department of Pathology, Texas Children's Hospital, Houston, Texas.,Department of Pathology and Immunology, Baylor College of Medicine, Houston, Texas
| | - Sarah Boissel
- Department of Medical Genetics, CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Benjamin Ellezam
- Department of Medical Genetics, CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | | | - Anne-Marie Laberge
- Department of Medical Genetics, CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Julianne Zandberg
- Division of Medical Genetics, Department of Pediatrics, London Health Sciences Centre, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Marie Injeyan
- The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Lili-Naz Hazrati
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada
| | - Fadi Hamdan
- Department of Medical Genetics, CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - David Chitayat
- The Prenatal Diagnosis and Medical Genetics Program, Department of Obstetrics and Gynecology, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada.,Department of Pediatrics, Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
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53
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Ravenscroft G, Bryson-Richardson RJ, Nowak KJ, Laing NG. Recent advances in understanding congenital myopathies. F1000Res 2018; 7. [PMID: 30631434 PMCID: PMC6290972 DOI: 10.12688/f1000research.16422.1] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/29/2018] [Indexed: 12/18/2022] Open
Abstract
By definition, congenital myopathy typically presents with skeletal muscle weakness and hypotonia at birth. Traditionally, congenital myopathy subtypes have been predominantly distinguished on the basis of the pathological hallmarks present on skeletal muscle biopsies. Many genes cause congenital myopathies when mutated, and a burst of new causative genes have been identified because of advances in gene sequencing technology. Recent discoveries include extending the disease phenotypes associated with previously identified genes and determining that genes formerly known to cause only dominant disease can also cause recessive disease. The more recently identified congenital myopathy genes account for only a small proportion of patients. Thus, the congenital myopathy genes remaining to be discovered are predicted to be extremely rare causes of disease, which greatly hampers their identification. Significant progress in the provision of molecular diagnoses brings important information and value to patients and their families, such as possible disease prognosis, better disease management, and informed reproductive choice, including carrier screening of parents. Additionally, from accurate genetic knowledge, rational treatment options can be hypothesised and subsequently evaluated
in vitro and in animal models. A wide range of potential congenital myopathy therapies have been investigated on the basis of improved understanding of disease pathomechanisms, and some therapies are in clinical trials. Although large hurdles remain, promise exists for translating treatment benefits from preclinical models to patients with congenital myopathy, including harnessing proven successes for other genetic diseases.
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Affiliation(s)
- Gianina Ravenscroft
- Centre for Medical Research, The University of Western Australia, Perth, WA, Australia.,Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia
| | | | - Kristen J Nowak
- Centre for Medical Research, The University of Western Australia, Perth, WA, Australia.,Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia.,School of Biological Sciences, Faculty of Health and Medical Sciences, The University of Western Australia, QEII Medical Centre, Nedlands, WA, Australia.,Office of Population Health Genomics, Western Australian Department of Health, East Perth, WA, Australia
| | - Nigel G Laing
- Centre for Medical Research, The University of Western Australia, Perth, WA, Australia.,Harry Perkins Institute of Medical Research, QEII Medical Centre, Nedlands, WA, Australia.,Department of Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia
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54
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Todd JJ, Sagar V, Lawal TA, Allen C, Razaqyar MS, Shelton MS, Chrismer IC, Zhang X, Cosgrove MM, Kuo A, Vasavada R, Jain MS, Waite M, Rajapakse D, Witherspoon JW, Wistow G, Meilleur KG. Correlation of phenotype with genotype and protein structure in RYR1-related disorders. J Neurol 2018; 265:2506-2524. [PMID: 30155738 PMCID: PMC6182665 DOI: 10.1007/s00415-018-9033-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 08/17/2018] [Accepted: 08/18/2018] [Indexed: 01/01/2023]
Abstract
Variants in the skeletal muscle ryanodine receptor 1 gene (RYR1) result in a spectrum of RYR1-related disorders. Presentation during infancy is typical and ranges from delayed motor milestones and proximal muscle weakness to severe respiratory impairment and ophthalmoplegia. We aimed to elucidate correlations between genotype, protein structure and clinical phenotype in this rare disease population. Genetic and clinical data from 47 affected individuals were analyzed and variants mapped to the cryo-EM RyR1 structure. Comparisons of clinical severity, motor and respiratory function and symptomatology were made according to the mode of inheritance and affected RyR1 structural domain(s). Overall, 49 RYR1 variants were identified in 47 cases (dominant/de novo, n = 35; recessive, n = 12). Three variants were previously unreported. In recessive cases, facial weakness, neonatal hypotonia, ophthalmoplegia/paresis, ptosis, and scapular winging were more frequently observed than in dominant/de novo cases (all, p < 0.05). Both dominant/de novo and recessive cases exhibited core myopathy histopathology. Clinically severe cases were typically recessive or had variants localized to the RyR1 cytosolic shell domain. Motor deficits were most apparent in the MFM-32 standing and transfers dimension, [median (IQR) 85.4 (18.8)% of maximum score] and recessive cases exhibited significantly greater overall motor function impairment compared to dominant/de novo cases [79.7 (18.8)% vs. 87.5 (17.7)% of maximum score, p = 0.03]. Variant mapping revealed patterns of clinical severity across RyR1 domains, including a structural plane of interest within the RyR1 cytosolic shell, in which 84% of variants affected the bridging solenoid. We have corroborated genotype-phenotype correlations and identified RyR1 regions that may be especially sensitive to structural modification.
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Affiliation(s)
- Joshua J Todd
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA.
| | - Vatsala Sagar
- Section on Molecular Structure and Functional Genomics, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Tokunbor A Lawal
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Carolyn Allen
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Muslima S Razaqyar
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Monique S Shelton
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Irene C Chrismer
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Xuemin Zhang
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Mary M Cosgrove
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Anna Kuo
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Ruhi Vasavada
- Mark O. Hatfield Clinical Research Center, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA
| | - Minal S Jain
- Mark O. Hatfield Clinical Research Center, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA
| | - Melissa Waite
- Mark O. Hatfield Clinical Research Center, Rehabilitation Medicine Department, National Institutes of Health, Bethesda, MD, USA
| | - Dinusha Rajapakse
- Section on Molecular Structure and Functional Genomics, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jessica W Witherspoon
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
| | - Graeme Wistow
- Section on Molecular Structure and Functional Genomics, National Eye Institute, National Institutes of Health, Bethesda, MD, USA
| | - Katherine G Meilleur
- Neuromuscular Symptoms Unit, Tissue Injury Branch, National Institute of Nursing Research, National Institutes of Health, 10 Center Drive, Room 2A07, Bethesda, MD, 20892, USA
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55
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Adam S, Coetzee M, Honey EM. Pena-Shokeir syndrome: current management strategies and palliative care. APPLICATION OF CLINICAL GENETICS 2018; 11:111-120. [PMID: 30498368 PMCID: PMC6207248 DOI: 10.2147/tacg.s154643] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Pena-Shokeir syndrome (PSS) type 1, also known as fetal akinesia deformation sequence, is a rare genetic syndrome that almost always results in intrauterine or early neonatal death. It is characterized by markedly decreased fetal movements, intrauterine growth restriction, joint contractures, short umbilical cord, and features of pulmonary hypoplasia. Antenatal diagnosis can be difficult. Ultrasound features are varied and may overlap with those of Trisomy 18. The poor prognosis of PSS is due to pulmonary hypoplasia, which is an important feature that distinguishes PSS from arthrogryposis multiplex congenital without pulmonary hypoplasia, which has a better prognosis. If diagnosed in the antenatal period, a late termination of pregnancy can be considered following ethical discussion (if the law allows). In most cases, a diagnosis is only made in the neonatal period. Parents of a baby affected with PSS require detailed counseling that includes information on the imprecise recurrence risks and a plan for subsequent pregnancies.
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Affiliation(s)
- Sumaiya Adam
- Department of Obstetrics and Gynaecology, Steve Biko Academic Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa,
| | - Melantha Coetzee
- Division of Neonatology, Department of Pediatrics and Child Health, Steve Biko Academic Hospital, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Engela Magdalena Honey
- Department of Biochemistry, Genetics and Microbiology, Faculty of Natural and Agricultural Sciences, University of Pretoria, Pretoria, South Africa
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56
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New Insights of a Neuronal Peptidase DINE/ECEL1: Nerve Development, Nerve Regeneration and Neurogenic Pathogenesis. Neurochem Res 2018; 44:1279-1288. [PMID: 30357652 DOI: 10.1007/s11064-018-2665-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/30/2018] [Accepted: 10/16/2018] [Indexed: 12/15/2022]
Abstract
Our understanding of the physiological relevance of unique Damage-induced neuronal endopeptidase (DINE) [also termed Endothelin-converting enzyme-like 1 (ECEL1)] has recently expanded. DINE/ECEL1 is a type II membrane-bound metalloprotease, belonging to a family including the neprilysin (NEP) and endothelin-converting enzyme (ECE). The family members degrade and/or process peptides such as amyloid β and big-endothelins, which are closely associated with pathological conditions. Similar to NEP and ECE, DINE has been expected to play an important role in injured neurons as well as in developing neurons, because of its remarkable transcriptional response to neuronal insults and predominant neuronal expression from the embryonic stage. However, the physiological significance of DINE has long remained elusive. In the last decade, a series of genetically manipulated mice have driven research progress to elucidate the physiological aspects of DINE. The mice ablating Dine fail to arborize the embryonic motor axons in some subsets of muscles, including the respiratory muscles, and die immediately after birth. The abnormal phenotype of motor axons is also caused by one amino acid exchanges of DINE/ECEL1, which are responsible for distal arthrogryposis type 5 in a group of human congenital movement disorders. Furthermore, the mature Dine-deficient mice in which the lethality is rescued by genetic manipulation have shown the involvement of DINE in central nervous system regeneration. Here we describe recent research advances that DINE-mediated proteolytic processes are critical for nerve development, regeneration and pathogenesis, and discuss the future potential for DINE as a therapeutic target for axonal degeneration/disorder.
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57
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Extending the phenotype and an ECEL1 gene mutation in distal arthrogryposis type 5D. Clin Dysmorphol 2018; 27:130-134. [DOI: 10.1097/mcd.0000000000000236] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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58
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Suzumori N, Inagaki H, Ohtani A, Kumagai K, Takeda E, Yoshihara H, Sawada Y, Inuzuka S, Iwagaki S, Takahashi Y, Kurahashi H, Sugiura-Ogasawara M. Compound heterozygous RYR1 mutations by whole exome sequencing in a family with three repeated affected fetuses with fetal akinesia. Eur J Obstet Gynecol Reprod Biol 2018; 230:200-202. [PMID: 30236493 DOI: 10.1016/j.ejogrb.2018.09.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Accepted: 09/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Nobuhiro Suzumori
- Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Division of Molecular and Clinical Genetics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
| | - Hidehito Inagaki
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Aichi, Japan
| | - Ayano Ohtani
- Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Kyoko Kumagai
- Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Division of Molecular and Clinical Genetics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Eri Takeda
- Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan; Division of Molecular and Clinical Genetics, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hiroyuki Yoshihara
- Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Yuki Sawada
- Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Saki Inuzuka
- Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shigenori Iwagaki
- Department of Fetal-Maternal Medicine, Nagara Medical Center, Gifu, Japan
| | - Yuichiro Takahashi
- Department of Fetal-Maternal Medicine, Nagara Medical Center, Gifu, Japan
| | - Hiroki Kurahashi
- Division of Molecular Genetics, Institute for Comprehensive Medical Science, Fujita Health University, Aichi, Japan
| | - Mayumi Sugiura-Ogasawara
- Department of Obstetrics & Gynecology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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59
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Savarese M, Torella A, Musumeci O, Angelini C, Astrea G, Bello L, Bruno C, Comi GP, Di Fruscio G, Piluso G, Di Iorio G, Ergoli M, Esposito G, Fanin M, Farina O, Fiorillo C, Garofalo A, Giugliano T, Magri F, Minetti C, Moggio M, Passamano L, Pegoraro E, Picillo E, Sampaolo S, Santorelli FM, Semplicini C, Udd B, Toscano A, Politano L, Nigro V. Targeted gene panel screening is an effective tool to identify undiagnosed late onset Pompe disease. Neuromuscul Disord 2018; 28:586-591. [DOI: 10.1016/j.nmd.2018.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 03/12/2018] [Accepted: 03/29/2018] [Indexed: 10/17/2022]
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60
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ECEL1 gene related contractural syndrome: Long-term follow-up and update on clinical and pathological aspects. Neuromuscul Disord 2018; 28:741-749. [PMID: 30131190 DOI: 10.1016/j.nmd.2018.05.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Revised: 05/21/2018] [Accepted: 05/29/2018] [Indexed: 12/14/2022]
Abstract
Autosomal recessive mutations in the ECEL1 gene have recently been associated with a wide phenotypic spectrum including severe congenital contractural syndromes and distal arthrogryposis type 5D (DA5D). Here, we describe four novel families with ECEL1 gene mutations, reporting 15 years of follow-up for four patients and detailed muscle pathological description for three individuals. In particular, we observed mild myopathic features, prominent core-like areas in one individual, and presence of nCAM positive fibres in three patients from 2 unrelated families suggesting a possible problem with innervation. Our findings expand current knowledge concerning the phenotypic and pathological spectrum associated with ECEL1 gene mutations and may suggest novel insights regarding the underlying pathomechanism of the disease.
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61
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Mattick JS, Dinger M, Schonrock N, Cowley M. Whole genome sequencing provides better diagnostic yield and future value than whole exome sequencing. Med J Aust 2018; 209:197-199. [DOI: 10.5694/mja17.01176] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Accepted: 03/08/2018] [Indexed: 12/21/2022]
Affiliation(s)
- John S Mattick
- Garvan Institute of Medical Research, Sydney, NSW
- St Vincentˈs Clinical School, UNSW Sydney, Sydney, NSW
| | - Marcel Dinger
- Kinghorn Centre of Clinical Genomics, Garvan Institute of Medical Research, Sydney, NSW
| | - Nicole Schonrock
- Kinghorn Centre of Clinical Genomics, Garvan Institute of Medical Research, Sydney, NSW
| | - Mark Cowley
- Kinghorn Centre of Clinical Genomics, Garvan Institute of Medical Research, Sydney, NSW
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62
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Nilipour Y, Nafissi S, Tjust AE, Ravenscroft G, Hossein Nejad Nedai H, Taylor RL, Varasteh V, Pedrosa Domellöf F, Zangi M, Tonekaboni SH, Olivé M, Kiiski K, Sagath L, Davis MR, Laing NG, Tajsharghi H. Ryanodine receptor type 3 (RYR3) as a novel gene associated with a myopathy with nemaline bodies. Eur J Neurol 2018; 25:841-847. [PMID: 29498452 DOI: 10.1111/ene.13607] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 02/26/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND AND PURPOSE Nemaline myopathy (NEM) has been associated with mutations in 12 genes to date. However, for some patients diagnosed with NEM, definitive mutations are not identified in the known genes, suggesting that there are other genes involved. This study describes compound heterozygosity for rare variants in ryanodine receptor type 3 (RYR3) gene in one such patient. METHODS AND RESULTS Clinical examination of the patient at 22 years of age revealed a long narrow face, high arched palate and bilateral facial weakness. She had proximal weakness in all four limbs, mild scapular winging but no scoliosis. Muscle biopsy revealed wide variation in fibre size with type 1 fibre predominance and atrophy. Abundant nemaline bodies were located in perinuclear and subsarcolemmal areas, and within the cytoplasm. No likely pathogenic mutations in known NEM genes were identified. Copy number variation in known NEM genes was excluded by NEM-targeted comparative genomic hybridization array. Next-generation sequencing revealed compound heterozygous missense variants in the RYR3 gene. RYR3 transcripts are expressed in human fetal and adult skeletal muscle as well as in human brain and cauda equina samples. Immunofluorescence of human skeletal muscle revealed a 'single-row' appearance of RYR3, interspersed between the 'double rows' of ryanodine receptor type 1 (RYR1) at each A-I junction. CONCLUSION The results suggest that variants in RYR3 may cause a recessive muscle disease with pathological features including nemaline bodies. We characterize the expression pattern of RYR3 in human skeletal muscle and brain, and the subcellular localization of RYR1 and RYR3 in human skeletal muscle.
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Affiliation(s)
- Y Nilipour
- Pediatric Pathology Research Centre, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran
| | - S Nafissi
- Department of Neurology, Tehran University of Medical Sciences, Tehran, Iran
| | - A E Tjust
- Department of Integrative Medical Biology, Umeå University, Umeå.,Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - G Ravenscroft
- Centre for Medical Research, University of Western Australia and Harry Perkins Institute for Medical Research, Nedlands, WA, Australia
| | | | - R L Taylor
- Centre for Medical Research, University of Western Australia and Harry Perkins Institute for Medical Research, Nedlands, WA, Australia
| | - V Varasteh
- Department of Pathology, Shahid Beheshti University of Medical Sciences, Tehran
| | - F Pedrosa Domellöf
- Department of Integrative Medical Biology, Umeå University, Umeå.,Department of Clinical Sciences, Umeå University, Umeå, Sweden
| | - M Zangi
- Tracheal Diseases Research Center (TDRC), National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - S H Tonekaboni
- Pediatric Pathology Research Centre, Mofid Children's Hospital, Shahid Beheshti University of Medical Sciences, Tehran
| | - M Olivé
- Department of Pathology and Neuromuscular Unit, IDIBELL-Hospital de Bellvitge, Barcelona, Spain
| | - K Kiiski
- Department of Medical and Clinical Genetics, Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - L Sagath
- Department of Medical and Clinical Genetics, Folkhälsan Institute of Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - M R Davis
- Department of Diagnostic Genomics, Pathwest, QEII Medical Centre, Nedlands, WA, Australia
| | - N G Laing
- Centre for Medical Research, University of Western Australia and Harry Perkins Institute for Medical Research, Nedlands, WA, Australia
| | - H Tajsharghi
- Centre for Medical Research, University of Western Australia and Harry Perkins Institute for Medical Research, Nedlands, WA, Australia.,Division of Biomedicine, School of Health and Education, University of Skövde, Skövde, Sweden
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Toma C, Shaw AD, Allcock RJN, Heath A, Pierce KD, Mitchell PB, Schofield PR, Fullerton JM. An examination of multiple classes of rare variants in extended families with bipolar disorder. Transl Psychiatry 2018; 8:65. [PMID: 29531218 PMCID: PMC5847564 DOI: 10.1038/s41398-018-0113-y] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Bipolar disorder (BD) is a complex psychiatric condition with high heritability, the genetic architecture of which likely comprises both common variants of small effect and rare variants of higher penetrance, the latter of which are largely unknown. Extended families with high density of illness provide an opportunity to map novel risk genes or consolidate evidence for existing candidates, by identifying genes carrying pathogenic rare variants. We performed whole-exome sequencing (WES) in 15 BD families (117 subjects, of whom 72 were affected), augmented with copy number variant (CNV) microarray data, to examine contributions of multiple classes of rare genetic variants within a familial context. Linkage analysis and haplotype reconstruction using WES-derived genotypes enabled exclusion of false-positive single-nucleotide variants (SNVs), CNV inheritance estimation, de novo variant identification and candidate gene prioritization. We found that rare predicted pathogenic variants shared among ≥3 affected relatives were overrepresented in postsynaptic density (PSD) genes (P = 0.002), with no enrichment in unaffected relatives. Genome-wide burden of likely gene-disruptive variants was no different in affected vs. unaffected relatives (P = 0.24), but correlated significantly with age of onset (P = 0.017), suggesting that a high disruptive variant burden may expedite symptom onset. The number of de novo variants was no different in affected vs. unaffected offspring (P = 0.89). We observed heterogeneity within and between families, with the most likely genetic model involving alleles of modest effect and reduced penetrance: a possible exception being a truncating X-linked mutation in IRS4 within a family-specific linkage peak. Genetic approaches combining WES, CNV and linkage analyses in extended families are promising strategies for gene discovery.
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Affiliation(s)
- Claudio Toma
- 0000 0000 8900 8842grid.250407.4Neuroscience Research Australia, Sydney, Australia ,0000 0004 4902 0432grid.1005.4School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Alex D. Shaw
- 0000 0000 8900 8842grid.250407.4Neuroscience Research Australia, Sydney, Australia ,0000 0004 4902 0432grid.1005.4School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Richard J. N. Allcock
- 0000 0004 1936 7910grid.1012.2School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
| | - Anna Heath
- 0000 0000 8900 8842grid.250407.4Neuroscience Research Australia, Sydney, Australia
| | - Kerrie D. Pierce
- 0000 0000 8900 8842grid.250407.4Neuroscience Research Australia, Sydney, Australia
| | - Philip B. Mitchell
- 0000 0004 4902 0432grid.1005.4School of Psychiatry, University of New South Wales, Sydney, Australia ,grid.415193.bBlack Dog Institute, Prince of Wales Hospital, Sydney, Australia
| | - Peter R. Schofield
- 0000 0000 8900 8842grid.250407.4Neuroscience Research Australia, Sydney, Australia ,0000 0004 4902 0432grid.1005.4School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Janice M. Fullerton
- 0000 0000 8900 8842grid.250407.4Neuroscience Research Australia, Sydney, Australia ,0000 0004 4902 0432grid.1005.4School of Medical Sciences, University of New South Wales, Sydney, Australia
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Congenital myopathies: disorders of excitation-contraction coupling and muscle contraction. Nat Rev Neurol 2018; 14:151-167. [PMID: 29391587 DOI: 10.1038/nrneurol.2017.191] [Citation(s) in RCA: 178] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The congenital myopathies are a group of early-onset, non-dystrophic neuromuscular conditions with characteristic muscle biopsy findings, variable severity and a stable or slowly progressive course. Pronounced weakness in axial and proximal muscle groups is a common feature, and involvement of extraocular, cardiorespiratory and/or distal muscles can implicate specific genetic defects. Central core disease (CCD), multi-minicore disease (MmD), centronuclear myopathy (CNM) and nemaline myopathy were among the first congenital myopathies to be reported, and they still represent the main diagnostic categories. However, these entities seem to belong to a much wider phenotypic spectrum. To date, congenital myopathies have been attributed to mutations in over 20 genes, which encode proteins implicated in skeletal muscle Ca2+ homeostasis, excitation-contraction coupling, thin-thick filament assembly and interactions, and other mechanisms. RYR1 mutations are the most frequent genetic cause, and CCD and MmD are the most common subgroups. Next-generation sequencing has vastly improved mutation detection and has enabled the identification of novel genetic backgrounds. At present, management of congenital myopathies is largely supportive, although new therapeutic approaches are reaching the clinical trial stage.
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65
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Fernández-Marmiesse A, Gouveia S, Couce ML. NGS Technologies as a Turning Point in Rare Disease Research , Diagnosis and Treatment. Curr Med Chem 2018; 25:404-432. [PMID: 28721829 PMCID: PMC5815091 DOI: 10.2174/0929867324666170718101946] [Citation(s) in RCA: 96] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 06/19/2017] [Accepted: 07/14/2017] [Indexed: 01/17/2023]
Abstract
Approximately 25-50 million Americans, 30 million Europeans, and 8% of the Australian population have a rare disease. Rare diseases are thus a common problem for clinicians and account for enormous healthcare costs worldwide due to the difficulty of establishing a specific diagnosis. In this article, we review the milestones achieved in our understanding of rare diseases since the emergence of next-generation sequencing (NGS) technologies and analyze how these advances have influenced research and diagnosis. The first half of this review describes how NGS has changed diagnostic workflows and provided an unprecedented, simple way of discovering novel disease-associated genes. We focus particularly on metabolic and neurodevelopmental disorders. NGS has enabled cheap and rapid genetic diagnosis, highlighted the relevance of mosaic and de novo mutations, brought to light the wide phenotypic spectrum of most genes, detected digenic inheritance or the presence of more than one rare disease in the same patient, and paved the way for promising new therapies. In the second part of the review, we look at the limitations and challenges of NGS, including determination of variant causality, the loss of variants in coding and non-coding regions, and the detection of somatic mosaicism variants and epigenetic mutations, and discuss how these can be overcome in the near future.
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Affiliation(s)
- Ana Fernández-Marmiesse
- Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - Sofía Gouveia
- Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
| | - María L. Couce
- Unit of Diagnosis and Treatment of Congenital Metabolic Diseases, Department of Pediatrics, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain
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Abstract
PURPOSE OF REVIEW Congenital myasthenic syndromes (CMS) are a group of heterogeneous inherited disorders caused by mutations in genes encoding proteins essential for the integrity of neuromuscular transmission. This review updates the reader on recent findings that have expanded the phenotypic spectrum and suggested improved treatment strategies. RECENT FINDINGS The use of next-generation sequencing is continuing to unearth new genes in which mutations can give rise to defective neuromuscular transmission. The defective transmission may be part of an overall more complex phenotype in which there may be muscle, central nervous system or other involvement. Notably, mutations in series of genes encoding presynaptic proteins are being identified. Further work on mutations found in the AGRN-MUSK acetylcholine receptor clustering pathway has helped characterize the role of LRP4 and broadened the phenotypic spectrum for AGRN mutations. Mutations in another extracellular matrix protein, collagen 13A1 and in GMPPB have also been found to cause a CMS. Finally, there are an increasing number of reports for the beneficial effects of treatment with β2-adrenergic receptor agonists. SUMMARY Recent studies of the CMS illustrate the increasing complexity of the genetics, pathophysiological mechanisms and the need to tailor therapy for the genetic disorders of the neuromuscular junction.
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Abstract
PURPOSE OF REVIEW The development of next-generation sequencing (NGS) technologies is transforming the practice of medical genetics and revolutionizing the approach to heterogeneous hereditary conditions, including skeletal muscle disorders. Here, we review the different NGS approaches described in the literature so far for the characterization of myopathic patients and the results obtained from the implementation of such approaches in a clinical setting. RECENT FINDINGS The overall diagnostic rate of NGS strategies for patients affected by skeletal muscle disorders is higher than the success rate obtained using the traditional gene-by-gene approach. Moreover, many recent articles have been expanding the clinical phenotypes associated with already known disease genes. SUMMARY NGS applications will soon be the first-tier test for skeletal muscle disorders. They will improve the diagnosis in myopathic patients, promoting their inclusion into novel therapeutic trials. At the same time, they will improve our knowledge about the molecular mechanisms causing skeletal muscle disorders, favoring the development of novel therapeutic approaches.
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68
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Abstract
This article reviews advancements in the genetics of malignant hyperthermia, new technologies and approaches for its diagnosis, and the existing limitations of genetic testing for malignant hyperthermia. It also reviews the various RYR1-related disorders and phenotypes, such as myopathies, exertional rhabdomyolysis, and bleeding disorders, and examines the connection between these disorders and malignant hyperthermia.
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69
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Ahmed AA, Skaria P, Safina NP, Thiffault I, Kats A, Taboada E, Habeebu S, Saunders C. Arthrogryposis and pterygia as lethal end manifestations of genetically defined congenital myopathies. Am J Med Genet A 2017; 176:359-367. [DOI: 10.1002/ajmg.a.38577] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 11/16/2017] [Accepted: 11/17/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Atif A. Ahmed
- Department of PathologyChildren's Mercy HospitalKansas CityMissouri
- University of Missouri‐Kansas City School of MedicineKansas CityMissouri
| | - Priya Skaria
- University of Missouri‐Kansas City School of MedicineKansas CityMissouri
| | - Nicole P. Safina
- University of Missouri‐Kansas City School of MedicineKansas CityMissouri
- Center for Pediatric Genomic MedicineChildren's Mercy HospitalKansas CityMissouri
- Division of Clinical GeneticsChildren's Mercy HospitalKansas CityMissouri
| | - Isabelle Thiffault
- Department of PathologyChildren's Mercy HospitalKansas CityMissouri
- University of Missouri‐Kansas City School of MedicineKansas CityMissouri
- Center for Pediatric Genomic MedicineChildren's Mercy HospitalKansas CityMissouri
| | - Alex Kats
- Department of PathologyChildren's Mercy HospitalKansas CityMissouri
- University of Missouri‐Kansas City School of MedicineKansas CityMissouri
| | - Eugenio Taboada
- Department of PathologyChildren's Mercy HospitalKansas CityMissouri
- University of Missouri‐Kansas City School of MedicineKansas CityMissouri
| | - Sultan Habeebu
- Department of PathologyChildren's Mercy HospitalKansas CityMissouri
- University of Missouri‐Kansas City School of MedicineKansas CityMissouri
| | - Carol Saunders
- Department of PathologyChildren's Mercy HospitalKansas CityMissouri
- University of Missouri‐Kansas City School of MedicineKansas CityMissouri
- Center for Pediatric Genomic MedicineChildren's Mercy HospitalKansas CityMissouri
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Kuznetsova MV, Trofimov DY, Shubina ES, Kochetkova TO, Karetnikova NA, Barkov IY, Bakharev VA, Gusev OA, Sukhikh GT. Two Novel Mutations Associated With Ataxia-Telangiectasia Identified Using an Ion AmpliSeq Inherited Disease Panel. Front Neurol 2017; 8:570. [PMID: 29163336 PMCID: PMC5670107 DOI: 10.3389/fneur.2017.00570] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 10/11/2017] [Indexed: 11/16/2022] Open
Abstract
Ataxia-telangiectasia (A-T), or Louis-Bar syndrome, is a rare neurodegenerative disorder associated with immunodeficiency. For families with at least one affected child, timely A-T genotyping during any subsequent pregnancy allows the parents to make an informed decision about whether to continue to term when the fetus is affected. Mutations in the ATM gene, which is 150 kb long, give rise to A-T; more than 600 pathogenic variants in ATM have been characterized since 1990 and new mutations continue to be discovered annually. Therefore, limiting genetic screening to previously known SNPs by PCR or hybridization with microarrays may not identify the specific pathogenic genotype in ATM for a given A-T family. However, recent developments in next-generation sequencing technology offer prompt high-throughput full-length sequencing of genomic fragments of interest. This allows the identification of the whole spectrum of mutations in a gene, including any novel ones. We report two A-T families with affected children and current pregnancies. Both families are consanguineous and originate from Caucasian regions of Russia and Azerbaijan. Before our study, no ATM mutations had been identified in the older children of these families. We used ion semiconductor sequencing and an Ion AmpliSeq™ Inherited Disease Panel to perform complete ATM gene sequencing in a single member of each family. Then we compared the experimentally determined genotype with the affected/normal phenotype distribution in the whole family to provide unambiguous evidence of pathogenic mutations responsible for A-T. A single novel SNP was allocated to each family. In the first case, we found a mononucleotide deletion, and in the second, a mononucleotide insertion. Both mutations lead to truncation of the ATM protein product. Identification of the pathogenic mutation in each family was performed in a timely fashion, allowing the fetuses to be tested and diagnosed. The parents chose to continue with both pregnancies as both fetuses had a healthy genotype and thus were not at risk of A-T.
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Affiliation(s)
- Maria V Kuznetsova
- Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
| | - Dmitry Yu Trofimov
- Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
| | | | | | | | - Ilya Yu Barkov
- Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
| | | | - Oleg A Gusev
- Institute of Fundamental Medicine and Biology, Kazan Federal University, Kazan, Russia.,RIKEN Innovation Center, RIKEN, Yokohama, Japan.,Preventive Medicine and Diagnosis Innovation Program, Center for Life Science Technologies, Yokohama, Japan
| | - Gennady T Sukhikh
- Research Center for Obstetrics, Gynecology and Perinatology, Moscow, Russia
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Brackmann F, Türk M, Gratzki N, Rompel O, Jungbluth H, Schröder R, Trollmann R. Compound heterozygous RYR1 mutations in a preterm with arthrogryposis multiplex congenita and prenatal CNS bleeding. Neuromuscul Disord 2017; 28:54-58. [PMID: 29169929 DOI: 10.1016/j.nmd.2017.09.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2017] [Revised: 08/28/2017] [Accepted: 09/18/2017] [Indexed: 01/23/2023]
Abstract
RYR1 mutations, the most common cause of non-dystrophic neuromuscular disorders, are associated with the malignant hyperthermia susceptibility (MHS) trait as well as congenital myopathies with widely variable clinical and histopathological manifestations. Recently, bleeding anomalies have been reported in association with certain RYR1 mutations. Here we report a preterm infant born at 32 weeks gestation with arthrogryposis multiplex congenita due to compound heterozygous, previously MHS-associated RYR1 mutations, with additional signs of prenatal hemorrhage. The patient presented at birth with multiple joint contractures, scoliosis, severe thoracic rigidity and respiratory failure. He continued to depend on mechanical ventilation and tube feeding. Muscle histopathology showed a marked myopathic pattern with eccentric cores. Interestingly, the patient had additional unusual prenatal intraventricular hemorrhage, resulting in post-hemorrhagic hydrocephalus as well as epidural hemorrhage affecting the spinal cord. This report adds to the phenotypic variability associated with RYR1 mutations, and highlights possible bleeding complications in affected individuals.
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Affiliation(s)
- Florian Brackmann
- Department of Pediatrics, Neuropediatrics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Federal Republic of Germany.
| | - Matthias Türk
- Department of Neurology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Federal Republic of Germany
| | - Nils Gratzki
- Department of Pediatrics, Neonatology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Federal Republic of Germany
| | - Oliver Rompel
- Department of Radiology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Federal Republic of Germany
| | - Heinz Jungbluth
- Department of Pediatric Neurology, Neuromuscular Service, Evelina Children's Hospital, St Thomas' Hospital, London, UK; Randall Division of Cell and Molecular, Biophysics Muscle Signalling Section, King's College, London, UK; Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College, London, UK
| | - Rolf Schröder
- Department of Neuropathology, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Federal Republic of Germany
| | - Regina Trollmann
- Department of Pediatrics, Neuropediatrics, Friedrich-Alexander-University of Erlangen-Nürnberg, Erlangen, Federal Republic of Germany
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Winters L, Van Hoof E, De Catte L, Van Den Bogaert K, de Ravel T, De Waele L, Corveleyn A, Breckpot J. Massive parallel sequencing identifies RAPSN and PDHA1 mutations causing fetal akinesia deformation sequence. Eur J Paediatr Neurol 2017; 21:745-753. [PMID: 28495245 DOI: 10.1016/j.ejpn.2017.04.641] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Revised: 04/12/2017] [Accepted: 04/19/2017] [Indexed: 02/07/2023]
Abstract
INTRODUCTION Fetal akinesia deformation sequence (FADS) or arthrogryposis multiplex congenita (AMC) is characterized by clinical ambiguity and genetic heterogeneity, hampering genetic diagnosis via traditional sequencing methods. Next generation sequencing (NGS) of all known disease-causing genes offers an elegant solution to identify the genetic etiology of AMC/FADS in a diagnostic setting. METHODS An in-house developed disease-associated gene panel was conducted in two unrelated fetuses with FADS. First, a de novo analysis was performed on the entire disease-associated gene panel. If no pathogenic mutation was identified, analysis of variants retained in a specific subpanel with arthrogryposis/fetal akinesia-causing genes was performed. RESULTS In the first family, FADS relates to a homozygous c.484G > A (p.Glu162Lys) mutation in the gene RAPSN. The second case concerns a sporadic patient with brain anomalies and arthrogryposis due to a de novo hemizygous c.498C > T splice-site mutation in the pyruvate dehydrogenase-alpha 1 (PDHA1) gene. DISCUSSION NGS facilitated genetic diagnosis, and hence genetic counseling, for both families with AMC/FADS. Biallelic RAPSN mutations typically result in congenital myasthenia syndrome, or occasionally in FADS. This is the first report attributing the RAPSN mutation c.484G > A, identified in a homozygous state in patient 1, to FADS. The second patient represents the first case of AMC due to a PDHA1 mutation, advocating that pyruvate dehydrogenase deficiency should be considered in the differential diagnosis of fetal akinesia. This study illustrates the relevance of a disease-associated-gene panel as a diagnostic tool in pregnancies complicated by this genetically heterogeneous condition.
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Affiliation(s)
- Lore Winters
- Department of Pediatrics, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium
| | - Evelien Van Hoof
- Center for Human Genetics, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium
| | - Luc De Catte
- Division of Woman and Child, Clinical Department of Obstetrics and Gynecology, Fetal Medicine Unit, University Hospitals Leuven, Leuven, Belgium
| | - Kris Van Den Bogaert
- Center for Human Genetics, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium
| | - Thomy de Ravel
- Center for Human Genetics, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium
| | - Liesbeth De Waele
- Department of Pediatric Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Anniek Corveleyn
- Center for Human Genetics, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium
| | - Jeroen Breckpot
- Center for Human Genetics, University Hospitals Leuven, Catholic University Leuven, Leuven, Belgium.
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73
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Chen Q, Bao H, Wu H, Zhao S, Huang S, Zhao F. Diagnosis of cobalamin C deficiency with renal abnormality from onset in a Chinese child by next generation sequencing: A case report. Exp Ther Med 2017; 14:3637-3643. [PMID: 29042959 PMCID: PMC5639280 DOI: 10.3892/etm.2017.4970] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 04/11/2017] [Indexed: 12/22/2022] Open
Abstract
The aim of the present study was to present the diagnosis and treatment course of a patient with cobalamin C deficiency (cblC) hospitalized with renal function abnormality from the onset. A female, 7-year-old patient who presented with a cough and progressive dyspnea for 1 day was admitted to the Children's Hospital of Nanjing Medical University (Nanjing, China). A routine clinical examination was performed, including physical examination, routine blood and urine tests, blood gas analysis, computed tomography scans of the head, chest and abdomen, electrocardiogram, echocardiography and abdominal ultrasonography. In addition, laboratory tests were performed, including tests for viral infection and markers of autoimmunity, humoral immunity, myocardial enzymes and tumors. Tandem mass analysis and renal biopsy were conducted. Next generation sequencing (NGS) was performed to identify mutated genes, and structural investigation was conducted to identify the key residue mutations in the patient. Routine clinical examination revealed that the patient had multiple organ failure, indicating the presence of metabolic disease. Tandem mass analysis and renal biopsy also indicated that the patient had methylmalonic acidemia (MMA) and thrombotic microangiopathy combined with focal renal cortical necrosis. Furthermore, next-generation sequencing identified the presence of two heterozygous mutations in the MMA cblC type with homocystinuria (MMACHC) gene. Structural analysis demonstrated that the two mutations were in key components of the MMACHC protein. The patient was finally diagnosed with cblC according to the results obtained. In conclusion, NGS may aid in the diagnosis and therapeutic management of cblC with renal abnormality from the onset in children.
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Affiliation(s)
- Qiuxia Chen
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Huaying Bao
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Hongmei Wu
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Sanlong Zhao
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Songming Huang
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
| | - Fei Zhao
- Department of Nephrology, Children's Hospital of Nanjing Medical University, Nanjing, Jiangsu 210008, P.R. China
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Abdalla E, Ravenscroft G, Zayed L, Beecroft SJ, Laing NG. Lethal multiple pterygium syndrome: A severe phenotype associated with a novel mutation in the nebulin gene. Neuromuscul Disord 2017; 27:537-541. [DOI: 10.1016/j.nmd.2017.01.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 11/21/2016] [Accepted: 01/15/2017] [Indexed: 11/27/2022]
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75
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Westerfield LE, Braxton AA, Walkiewicz M. Prenatal Diagnostic Exome Sequencing: a Review. CURRENT GENETIC MEDICINE REPORTS 2017. [DOI: 10.1007/s40142-017-0120-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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76
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Oliveira J, Martins M, Pinto Leite R, Sousa M, Santos R. The new neuromuscular disease related with defects in the ASC-1 complex: report of a second case confirms ASCC1 involvement. Clin Genet 2017; 92:434-439. [PMID: 28218388 DOI: 10.1111/cge.12997] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/13/2017] [Accepted: 02/14/2017] [Indexed: 12/25/2022]
Abstract
Next-generation sequencing technology aided the identification of the underlying genetic cause in a female newborn with a severe neuromuscular disorder. The patient presented generalized hypotonia, congenital bone fractures, lack of spontaneous movements and poor respiratory effort. She died within the first days of life. Karyotyping and screening for several genes related with neuromuscular diseases all tested negative. A male sibling was subsequently born with the same clinical presentation. Whole-exome sequencing was performed with variant filtering assuming a recessive disease model. Analysis focused on genes known to be related firstly with congenital myopathies, extended to muscle diseases and finally to other neuromuscular disorders. No disease-causing variants were identified. A similar disorder was described in patients with recessive variants in two genes: TRIP4 (three families) and ASCC1 (one family), both encoding subunits of the nuclear activating signal cointegrator 1 (ASC-1) complex. Our patient was also found to have a homozygous frameshift variant (c.157dupG, p.Glu53Glyfs*19) in ASCC1 , thereby representing the second known case. This confirms ASCC1 involvement in a severe neuromuscular disease lying within the spinal muscular atrophy or primary muscle disease spectra.
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Affiliation(s)
- J Oliveira
- Unidade de Genética Molecular, Centro de Genética Médica Dr. Jacinto Magalhães, Centro Hospitalar do Porto, Porto, Portugal.,Unidade Multidisciplinar de Investigação Biomédica (UMIB), Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal
| | - M Martins
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Unidade de Genética, Vila Real, Portugal
| | - R Pinto Leite
- Centro Hospitalar de Trás-os-Montes e Alto Douro, Unidade de Genética, Vila Real, Portugal
| | - M Sousa
- Unidade Multidisciplinar de Investigação Biomédica (UMIB), Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal.,Laboratório de Biologia Celular, Departamento de Microscopia, Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal.,Centro de Genética da Reprodução Prof. Alberto Barros, Porto, Portugal
| | - R Santos
- Unidade de Genética Molecular, Centro de Genética Médica Dr. Jacinto Magalhães, Centro Hospitalar do Porto, Porto, Portugal.,Unidade Multidisciplinar de Investigação Biomédica (UMIB), Instituto de Ciências Biomédicas Abel Salazar (ICBAS), Universidade do Porto, Porto, Portugal.,UCIBIO\REQUIMTE, Departamento de Ciências Biológicas, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
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77
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Schofield D, Alam K, Douglas L, Shrestha R, MacArthur DG, Davis M, Laing NG, Clarke NF, Burns J, Cooper ST, North KN, Sandaradura SA, O'Grady GL. Cost-effectiveness of massively parallel sequencing for diagnosis of paediatric muscle diseases. NPJ Genom Med 2017; 2. [PMID: 29152331 PMCID: PMC5677979 DOI: 10.1038/s41525-017-0006-7] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Childhood-onset muscle disorders are genetically heterogeneous. Diagnostic workup has traditionally included muscle biopsy, protein-based studies of muscle specimens, and candidate gene sequencing. High throughput or massively parallel sequencing is transforming the approach to diagnosis of rare diseases; however, evidence for cost-effectiveness is lacking. Patients presenting with suspected congenital muscular dystrophy or nemaline myopathy were ascertained over a 15-year period. Patients were investigated using traditional diagnostic approaches. Undiagnosed patients were investigated using either massively parallel sequencing of a panel of neuromuscular disease genes panel, or whole exome sequencing. Cost data were collected for all diagnostic investigations. The diagnostic yield and cost effectiveness of a molecular approach to diagnosis, prior to muscle biopsy, were compared with the traditional approach. Fifty-six patients were analysed. Compared with the traditional invasive muscle biopsy approach, both the neuromuscular disease panel and whole exome sequencing had significantly increased diagnostic yields (from 46 to 75% for the neuromuscular disease panel, and 79% for whole exome sequencing), and reduced the cost per diagnosis from USD$16,495 (95% CI: $12,413–$22,994) to USD$3706 (95% CI: $3086–$4453) for the neuromuscular disease panel and USD$5646 (95% CI: $4501–$7078) for whole exome sequencing. The neuromuscular disease panel was the most cost-effective, saving USD$17,075 (95% CI: $10,654–$30,064) per additional diagnosis, over the traditional diagnostic pathway. Whole exome sequencing saved USD$10,024 (95% CI: $5795–$17,135) per additional diagnosis. This study demonstrates the cost-effectiveness of investigation using massively parallel sequencing technologies in paediatric muscle disease. The findings emphasise the value of implementing these technologies in clinical practice, with particular application for diagnosis of Mendelian diseases, and provide evidence crucial for government subsidy and equitable access.
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Affiliation(s)
- Deborah Schofield
- Faculty of Pharmacy, University of Sydney, Sydney, NSW, Australia.,Murdoch Childrens Research Institute, Melbourne, VIC, Australia.,Garvan Institute for Medical Research, Darlinghurst, NSW, Australia
| | - Khurshid Alam
- Murdoch Childrens Research Institute, Melbourne, VIC, Australia.,Faculty of Medicine, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Lyndal Douglas
- Department of Clinical Genetics, Children's Hospital at Westmead, Locked Bag 4001, Sydney, NSW, Australia.,Institute for Neuroscience and Muscle Research, Kids Research Institute, Children's Hospital at Westmead, Sydney, NSW, Australia
| | | | - Daniel G MacArthur
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Mark Davis
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia
| | - Nigel G Laing
- Department of Diagnostic Genomics, PathWest Laboratory Medicine, QEII Medical Centre, Nedlands, WA, Australia.,Centre for Medical Research University of Western Australia, Harry Perkins Institute of Medical Research, Nedlands, WA, Australia
| | - Nigel F Clarke
- Institute for Neuroscience and Muscle Research, Kids Research Institute, Children's Hospital at Westmead, Sydney, NSW, Australia.,Faculty of Medicine, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia
| | - Joshua Burns
- Institute for Neuroscience and Muscle Research, Kids Research Institute, Children's Hospital at Westmead, Sydney, NSW, Australia.,Faculty of Medicine, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia.,Sydney Children's Hospitals Network (Randwick and Westmead), University of Sydney, Sydney, NSW, Australia
| | - Sandra T Cooper
- Institute for Neuroscience and Muscle Research, Kids Research Institute, Children's Hospital at Westmead, Sydney, NSW, Australia.,Faculty of Medicine, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia
| | - Kathryn N North
- Murdoch Childrens Research Institute, Melbourne, VIC, Australia.,Faculty of Medicine, Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.,Institute for Neuroscience and Muscle Research, Kids Research Institute, Children's Hospital at Westmead, Sydney, NSW, Australia
| | - Sarah A Sandaradura
- Department of Clinical Genetics, Children's Hospital at Westmead, Locked Bag 4001, Sydney, NSW, Australia.,Institute for Neuroscience and Muscle Research, Kids Research Institute, Children's Hospital at Westmead, Sydney, NSW, Australia.,Faculty of Medicine, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia
| | - Gina L O'Grady
- Institute for Neuroscience and Muscle Research, Kids Research Institute, Children's Hospital at Westmead, Sydney, NSW, Australia.,Faculty of Medicine, Discipline of Paediatrics and Child Health, University of Sydney, Sydney, NSW, Australia.,Paediatric Neuroservices, Starship Children's Health, Auckland, New Zealand
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78
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Hamzeh AR, Nair P, Mohamed M, Saif F, Tawfiq N, Khalifa M, Al-Ali MT, Bastaki F. A Novel Variant in the Endothelin-Converting Enzyme-Like 1 (ECEL1) Gene in an Emirati Child. Med Princ Pract 2017; 26:195-198. [PMID: 28114145 PMCID: PMC5588382 DOI: 10.1159/000456034] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 01/12/2017] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The aim of this work was to report a case of an Emirati child who presented with developmental delay and multiple congenital abnormalities that are consistent with distal arthrogryposis type 5D. CLINICAL PRESENTATION AND INTERVENTION The clinical presentation comprised contractures of the shoulders, elbows, and knees in addition to camptodactyly and neck pterygium. The facial dysmorphic features noted include ptosis and microretrognathia. Importantly, left orchidopexy was also observed and corrected surgically. Whole exome sequencing revealed that the patient is homozygous for the novel c.1184+1G>T variant in endothelin-converting enzyme-like 1 (ECEL1). CONCLUSION This is a case of a novel homozygous splice site mutation in the ECEL1 gene in a child with a phenotype consistent with distal arthrogryposis type 5D. The child was born to consanguineous Emirati parents heterozygous for the novel ECEL1 mutation.
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Affiliation(s)
| | - Pratibha Nair
- Centre for Arab Genomic Studies, Dubai, United Arab Emirates
- *Pratibha Nair, Centre for Arab Genomic Studies, PO Box 22252, Dubai (United Arab Emirates), E-Mail
| | - Madiha Mohamed
- Department of Pediatrics, Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Fatima Saif
- Department of Pediatrics, Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Nafisa Tawfiq
- Department of Pediatrics, Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | - Mohamed Khalifa
- Department of Pediatrics, Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
| | | | - Fatma Bastaki
- Department of Pediatrics, Latifa Hospital, Dubai Health Authority, Dubai, United Arab Emirates
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79
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Huynh W, Davis MR. Facial weakness and eyelid ptosis: Expanding the clinical heterogeneity of Bethlem myopathy from a novel gene mutation. Muscle Nerve 2017; 55:E2-E3. [DOI: 10.1002/mus.25254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 07/09/2016] [Accepted: 07/13/2016] [Indexed: 11/10/2022]
Affiliation(s)
- William Huynh
- Brain and Mind CentreUniversity of SydneySydney New South Wales Australia
- Prince of Wales Clinical SchoolUniversity of New South WalesSydney New South Wales Australia
| | - Mark R. Davis
- Department of Diagnostic Genomics, PathWestNedlands Western Australia Australia
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80
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Chen TH, Tian X, Kuo PL, Pan HP, Wong LJC, Jong YJ. Identification ofKLHL40mutations by targeted next-generation sequencing facilitated a prenatal diagnosis in a family with three consecutive affected fetuses with fetal akinesia deformation sequence. Prenat Diagn 2016; 36:1135-1138. [PMID: 27762439 DOI: 10.1002/pd.4949] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/07/2016] [Accepted: 10/12/2016] [Indexed: 11/11/2022]
Affiliation(s)
- Tai-Heng Chen
- Division of Pediatric Emergency, Department of Emergency; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
| | | | - Pao-Lin Kuo
- Departments of Obstetrics and Gynecology; National Cheng Kung University Hospital; Tainan Taiwan
| | - Hui-Ping Pan
- Center for Medical Genetics; National Cheng Kung University Hospital; Tainan Taiwan
| | - Lee-Jun C. Wong
- Baylor Genetics; Houston TX USA
- Department of Molecular and Human Genetics; Baylor College of Medicine; Houston TX USA
| | - Yuh-Jyh Jong
- Departments of Pediatrics and Laboratory Medicine; Kaohsiung Medical University Hospital, Kaohsiung Medical University; Kaohsiung Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine; Kaohsiung Medical University; Kaohsiung Taiwan
- Department of Biological Science and Technology, Institute of Molecular Medicine and Bioengineering, College of Biological Science and Technology; National Chiao Tung University; Hsinchu Taiwan
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81
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Stehlíková K, Skálová D, Zídková J, Haberlová J, Voháňka S, Mazanec R, Mrázová L, Vondráček P, Ošlejšková H, Zámečník J, Honzík T, Zeman J, Magner M, Šišková D, Langová M, Gregor V, Godava M, Smolka V, Fajkusová L. Muscular dystrophies and myopathies: the spectrum of mutated genes in the Czech Republic. Clin Genet 2016; 91:463-469. [PMID: 27447704 DOI: 10.1111/cge.12839] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Revised: 07/12/2016] [Accepted: 07/14/2016] [Indexed: 01/12/2023]
Abstract
Inherited neuromuscular disorder (NMD) is a wide term covering different genetic disorders affecting muscles, nerves, and neuromuscular junctions. Genetic and clinical heterogeneity is the main drawback in a routine gene-by-gene diagnostics. We present Czech NMD patients with a genetic cause identified using targeted next-generation sequencing (NGS) and the spectrum of these causes. Overall 167 unrelated patients presenting NMD falling into categories of muscular dystrophies, congenital muscular dystrophies, congenital myopathies, distal myopathies, and other myopathies were tested by targeted NGS of 42 known NMD-related genes. Pathogenic or probably pathogenic sequence changes were identified in 79 patients (47.3%). In total, 37 novel and 51 known disease-causing variants were detected in 23 genes. In addition, variants of uncertain significance were suspected in 7 cases (4.2%), and in 81 cases (48.5%) sequence changes associated with NMD were not found. Our results strongly indicate that for molecular diagnostics of heterogeneous disorders such as NMDs, targeted panel testing has a high-clinical yield and should therefore be the preferred first-tier approach. Further, we show that in the genetic diagnostic practice of NMDs, it is necessary to take into account different types of inheritance including the occurrence of an autosomal recessive disorder in two generations of one family.
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Affiliation(s)
- K Stehlíková
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - D Skálová
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - J Zídková
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - J Haberlová
- Department of Child Neurology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - S Voháňka
- Department of Neurology, University Hospital Brno, Brno, Czech Republic
| | - R Mazanec
- Department of Neurology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - L Mrázová
- Department of Child Neurology, University Hospital Brno, Brno, Czech Republic
| | - P Vondráček
- Department of Child Neurology, University Hospital Brno, Brno, Czech Republic
| | - H Ošlejšková
- Department of Child Neurology, University Hospital Brno, Brno, Czech Republic
| | - J Zámečník
- Department of Pathology and Molecular Medicine, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czech Republic
| | - T Honzík
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - J Zeman
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - M Magner
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - D Šišková
- Child Neurology, Thomayer's Hospital, Prague, Czech Republic
| | - M Langová
- Department of Medical Genetics, Thomayer's Hospital, Prague, Czech Republic
| | - V Gregor
- Department of Medical Genetics, Thomayer's Hospital, Prague, Czech Republic
| | - M Godava
- Centre of Fetal Medicine and Genetics, Olomouc, Czech Republic
| | - V Smolka
- Department of Paediatrics, University Hospital Olomouc, Olomouc, Czech Republic
| | - L Fajkusová
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno and Masaryk University, Brno, Czech Republic.,Central European Institute of Technology, Masaryk University, Brno, Czech Republic.,Laboratory of Functional Genomics and Proteomics, NCBR, Faculty of Science, Masaryk University, Brno, Czech Republic
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82
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Ravenscroft G, Davis MR, Lamont P, Forrest A, Laing NG. New era in genetics of early-onset muscle disease: Breakthroughs and challenges. Semin Cell Dev Biol 2016; 64:160-170. [PMID: 27519468 DOI: 10.1016/j.semcdb.2016.08.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Revised: 08/07/2016] [Accepted: 08/08/2016] [Indexed: 10/21/2022]
Abstract
Early-onset muscle disease includes three major entities that present generally at or before birth: congenital myopathies, congenital muscular dystrophies and congenital myasthenic syndromes. Almost exclusively there is weakness and hypotonia, although cases manifesting hypertonia are increasingly being recognised. These diseases display a wide phenotypic and genetic heterogeneity, with the uptake of next generation sequencing resulting in an unparalleled extension of the phenotype-genotype correlations and "diagnosis by sequencing" due to unbiased sequencing. Perhaps now more than ever, detailed clinical evaluations are necessary to guide the genetic diagnosis; with arrival at a molecular diagnosis frequently occurring following dialogue between the molecular geneticist, the referring clinician and the pathologist. There is an ever-increasing blurring of the boundaries between the congenital myopathies, dystrophies and myasthenic syndromes. In addition, many novel disease genes have been described and new insights have been gained into skeletal muscle development and function. Despite the advances made, a significant percentage of patients remain without a molecular diagnosis, suggesting that there are many more human disease genes and mechanisms to identify. It is now technically- and clinically-feasible to perform next generation sequencing for severe diseases on a population-wide scale, such that preconception-carrier screening can occur. Newborn screening for selected early-onset muscle diseases is also technically and ethically-achievable, with benefits to the patient and family from early management of these diseases and should also be implemented. The need for world-wide Reference Centres to meticulously curate polymorphisms and mutations within a particular gene is becoming increasingly apparent, particularly for interpretation of variants in the large genes which cause early-onset myopathies: NEB, RYR1 and TTN. Functional validation of candidate disease variants is crucial for accurate interpretation of next generation sequencing and appropriate genetic counseling. Many published "pathogenic" variants are too frequent in control populations and are thus likely rare polymorphisms. Mechanisms need to be put in place to systematically update the classification of variants such that accurate interpretation of variants occurs. In this review, we highlight the recent advances made and the challenges ahead for the molecular diagnosis of early-onset muscle diseases.
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Affiliation(s)
- Gianina Ravenscroft
- Harry Perkins Institute of Medical Research and the Centre for Medical Research, University of Western Australia, Nedlands, Australia
| | - Mark R Davis
- Department of Diagnostic Genomics, Pathwest, QEII Medical Centre, Nedlands, Australia
| | - Phillipa Lamont
- Harry Perkins Institute of Medical Research and the Centre for Medical Research, University of Western Australia, Nedlands, Australia; Neurogenetic unit, Dept of Neurology, Royal Perth Hospital and The Perth Children's Hospital, Western Australia, Australia
| | - Alistair Forrest
- Harry Perkins Institute of Medical Research and the Centre for Medical Research, University of Western Australia, Nedlands, Australia
| | - Nigel G Laing
- Harry Perkins Institute of Medical Research and the Centre for Medical Research, University of Western Australia, Nedlands, Australia; Department of Diagnostic Genomics, Pathwest, QEII Medical Centre, Nedlands, Australia.
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83
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AKINESIA/HIPOKINESIA FETAL: UNA VENTANA AL MOVIMIENTO FETAL DURANTE EL DESARROLLO. ORIENTACIÓN CLÍNICA, ETIOLOGÍA Y DIAGNÓSTICO. REVISTA MÉDICA CLÍNICA LAS CONDES 2016. [DOI: 10.1016/j.rmclc.2016.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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84
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Massalska D, Zimowski JG, Bijok J, Kucińska-Chahwan A, Łusakowska A, Jakiel G, Roszkowski T. Prenatal diagnosis of congenital myopathies and muscular dystrophies. Clin Genet 2016; 90:199-210. [PMID: 27197572 DOI: 10.1111/cge.12801] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2016] [Revised: 05/05/2016] [Accepted: 05/08/2016] [Indexed: 12/14/2022]
Abstract
Congenital myopathies and muscular dystrophies constitute a genetically and phenotypically heterogeneous group of rare inherited diseases characterized by muscle weakness and atrophy, motor delay and respiratory insufficiency. To date, curative care is not available for these diseases, which may severely affect both life-span and quality of life. We discuss prenatal diagnosis and genetic counseling for families at risk, as well as diagnostic possibilities in sporadic cases.
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Affiliation(s)
- D Massalska
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - J G Zimowski
- Department of Genetics, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - J Bijok
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - A Kucińska-Chahwan
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - A Łusakowska
- Department of Neurology, Medical University of Warsaw, Poland
| | - G Jakiel
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - T Roszkowski
- Department of Obstetrics and Gynecology, Centre of Postgraduate Medical Education, Warsaw, Poland
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85
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Dua Puri R. Next Generation Sequencing in the Clinic. Indian J Pediatr 2016; 83:281-2. [PMID: 26872684 DOI: 10.1007/s12098-016-2035-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Accepted: 01/11/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Ratna Dua Puri
- Center of Medical Genetics, Sir Ganga Ram Hospital, New Delhi, 110060, India.
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86
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Abstract
Investigators from the University of Western Australia report the diagnostic yield of performing next generation sequencing (NGS; whole exome and targeted capture of 277 neuromuscular genes) in a heterogenous cohort of patients with neuromuscular disorders (NMD) presenting at or before birth.
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Affiliation(s)
- Radhika Dhamija
- Division of Pediatric Neurology, Department of Neurology, University of Virginia, Charlottesville, VA
| | - Chelsea Chambers
- Division of Pediatric Neurology, Department of Neurology, University of Virginia, Charlottesville, VA
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87
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Lambrughi M, Lucchini M, Pignataro M, Sola M, Bortolotti CA. The dynamics of the β-propeller domain in Kelch protein KLHL40 changes upon nemaline myopathy-associated mutation. RSC Adv 2016. [DOI: 10.1039/c6ra06312h] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
The nemaline myopathy-associated E528K mutation in the KLHL40 alters the communication between the Kelch propeller blades.
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Affiliation(s)
- Matteo Lambrughi
- Department of Life Sciences
- University of Modena and Reggio Emilia
- Modena
- Italy
| | - Matteo Lucchini
- Department of Life Sciences
- University of Modena and Reggio Emilia
- Modena
- Italy
| | - Marcello Pignataro
- Department of Chemical and Geological Sciences
- University of Modena and Reggio Emilia
- Modena
- Italy
| | - Marco Sola
- Department of Life Sciences
- University of Modena and Reggio Emilia
- Modena
- Italy
| | - Carlo Augusto Bortolotti
- Department of Life Sciences
- University of Modena and Reggio Emilia
- Modena
- Italy
- CNR-Nano Institute of Nanoscience
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