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Vela-Amieva M, Alcántara-Ortigoza MA, Ibarra-González I, González-del Angel A, Fernández-Hernández L, Guillén-López S, López-Mejía L, Carrillo-Nieto RI, Belmont-Martínez L, Fernández-Lainez C. An Updated PAH Mutational Spectrum of Phenylketonuria in Mexican Patients Attending a Single Center: Biochemical, Clinical-Genotyping Correlations. Genes (Basel) 2021; 12:genes12111676. [PMID: 34828281 PMCID: PMC8620669 DOI: 10.3390/genes12111676] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 11/21/2022] Open
Abstract
Establishing the genotypes of patients with hyperphenylalaninemia (HPA)/phenylketonuria (PKU, MIM#261600) has been considered a cornerstone for rational medical management. However, knowledge of the phenylalanine hydroxylase gene (PAH) mutational spectrum in Latin American populations is still limited. Herein, we aim to update the mutational PAH spectrum in the largest cohort of HPA/PKU Mexican patients (N = 124) reported to date. The biallelic PAH genotype was investigated by Sanger automated sequencing, and genotypes were correlated with documented biochemical phenotypes and theoretical tetrahydrobiopterin (BH4) responsiveness. Patients were biochemically classified as having classic PKU (50%, 62/124), mild PKU (20.2%, 25/124) and mild HPA (29.8%, 37/124). Furthermore, 78.2% of the included patients (97/124) were identified by newborn screening. A total of 60 different pathogenic variants were identified, including three novel ones (c. 23del, c. 625_626insC and c. 1315 + 5_1315 + 6insGTGTAACAG), the main categories being missense changes (58%, 35/60) and those affecting the catalytic domain (56.6%, 34/60), and c. 60 + 5G > T was the most frequent variant (14.5%, 36/248) mainly restricted (69.2%) to patients from the central and western parts of Mexico. These 60 types of variants constituted 100 different biallelic PAH genotypes, with the predominance of compound-heterozygous ones (96/124, 77%). The expected BH4 responsiveness based on the PAH genotype was estimated in 52% of patients (65/124), mainly due to the p. (Val388Met) (rs62516101) allele. Instead, our study identified 27 null variants with an allelic phenotype value of zero, with a predominance of c. 60 + 5G > T, which predicts the absence of BH4 responsiveness. An identical genotype reported in BIOPKUdb was found in 92/124 (74%) of our patients, leading to a genotype–phenotype concordance in 80/92 (86.9%) of them. The high number of variants found confirms the heterogeneous and complex mutational landscape of HPA/PKU in Mexico.
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Affiliation(s)
- Marcela Vela-Amieva
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.V.-A.); (S.G.-L.); (L.L.-M.); (R.I.C.-N.); (L.B.-M.)
| | - Miguel Angel Alcántara-Ortigoza
- Laboratorio de Biología Molecular, Subdirección de Investigación Médica, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.A.A.-O.); (A.G.-d.A.); (L.F.-H.)
| | - Isabel Ibarra-González
- Unidad de Genética de la Nutrición, Instituto de Investigaciones Biomédicas, UNAM/Instituto Nacional de Pediatría, Ciudad de Mexico 04530, Mexico;
| | - Ariadna González-del Angel
- Laboratorio de Biología Molecular, Subdirección de Investigación Médica, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.A.A.-O.); (A.G.-d.A.); (L.F.-H.)
| | - Liliana Fernández-Hernández
- Laboratorio de Biología Molecular, Subdirección de Investigación Médica, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.A.A.-O.); (A.G.-d.A.); (L.F.-H.)
| | - Sara Guillén-López
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.V.-A.); (S.G.-L.); (L.L.-M.); (R.I.C.-N.); (L.B.-M.)
| | - Lizbeth López-Mejía
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.V.-A.); (S.G.-L.); (L.L.-M.); (R.I.C.-N.); (L.B.-M.)
| | - Rosa Itzel Carrillo-Nieto
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.V.-A.); (S.G.-L.); (L.L.-M.); (R.I.C.-N.); (L.B.-M.)
| | - Leticia Belmont-Martínez
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.V.-A.); (S.G.-L.); (L.L.-M.); (R.I.C.-N.); (L.B.-M.)
| | - Cynthia Fernández-Lainez
- Laboratorio de Errores Innatos del Metabolismo y Tamiz, Subdirección de Medicina Experimental, Instituto Nacional de Pediatría, Secretaría de Salud, Ciudad de Mexico 04530, Mexico; (M.V.-A.); (S.G.-L.); (L.L.-M.); (R.I.C.-N.); (L.B.-M.)
- Correspondence: ; Tel.: +52-1-55-10840900 (ext. 1332)
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2
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Ferreira F, Azevedo L, Neiva R, Sousa C, Fonseca H, Marcão A, Rocha H, Carmona C, Ramos S, Bandeira A, Martins E, Campos T, Rodrigues E, Garcia P, Diogo L, Ferreira AC, Sequeira S, Silva F, Rodrigues L, Gaspar A, Janeiro P, Amorim A, Vilarinho L. Phenylketonuria in Portugal: Genotype-phenotype correlations using molecular, biochemical, and haplotypic analyses. Mol Genet Genomic Med 2021; 9:e1559. [PMID: 33465300 PMCID: PMC8104178 DOI: 10.1002/mgg3.1559] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 10/29/2020] [Indexed: 11/12/2022] Open
Abstract
Background The impairment of the hepatic enzyme phenylalanine hydroxylase (PAH) causes elevation of phenylalanine levels in blood and other body fluids resulting in the most common inborn error of amino acid metabolism (phenylketonuria). Persistently high levels of phenylalanine lead to irreversible damage to the nervous system. Therefore, early diagnosis of the affected individuals is important, as it can prevent clinical manifestations of the disease. Methods In this report, the biochemical and genetic findings performed in 223 patients diagnosed through the Portuguese Neonatal Screening Program (PNSP) are presented. Results Overall, the results show that a high overlap exists between different types of variants and phenylalanine levels. Molecular analyses reveal a wide mutational spectrum in our population with a total of 56 previously reported variants, most of them found in compound heterozygosity (74% of the patients). Intragenic polymorphic markers were used to assess the haplotypic structure of mutated chromosomes for the most frequent variants found in homozygosity in our population (p.Ile65Thr, p.Arg158Gln, p.Leu249Phe, p.Arg261Gln, p.Val388Met, and c.1066‐11G>A). Conclusion Our data reveal high heterogeneity at the biochemical and molecular levels and are expected to provide a better understanding of the molecular basis of this disease and to provide clues to elucidate genotype–phenotype correlations.
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Affiliation(s)
- Filipa Ferreira
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Luísa Azevedo
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal.,FCUP - Faculty of Sciences, University of Porto, Porto, Portugal
| | - Raquel Neiva
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Carmen Sousa
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Helena Fonseca
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Ana Marcão
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Hugo Rocha
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Célia Carmona
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Sónia Ramos
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
| | - Anabela Bandeira
- Inherited Metabolic Disease Reference Center, Pediatric Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Esmeralda Martins
- Inherited Metabolic Disease Reference Center, Pediatric Department, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Teresa Campos
- Metabolic Diseases Unit, Pediatric Department, University Center São João Hospital - HSJ, Porto, Portugal
| | - Esmeralda Rodrigues
- Metabolic Diseases Unit, Pediatric Department, University Center São João Hospital - HSJ, Porto, Portugal
| | - Paula Garcia
- Inherited Metabolic Disease Reference Center, Pediatric Hospital, Hospital and University Center of Coimbra, Coimbra, Portugal
| | - Luísa Diogo
- Inherited Metabolic Disease Reference Center, Pediatric Hospital, Hospital and University Center of Coimbra, Coimbra, Portugal
| | - Ana Cristina Ferreira
- Metabolic Unit, Hospital Dona Estefânia, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Silvia Sequeira
- Metabolic Unit, Hospital Dona Estefânia, Centro Hospitalar Universitário Lisboa Central, Lisbon, Portugal
| | - Francisco Silva
- Pediatric Department, Hospital Central of Funchal, Funchal, Portugal
| | - Luísa Rodrigues
- Pediatrics Department, Hospital of Divino Espírito Santo of Ponta Delgada, EPE, Ponta Delgada, Azores, Portugal
| | - Ana Gaspar
- Inherited Metabolic Disease Reference Center, Lisbon North University Hospital Center (CHULN), EPE, Lisboa, Portugal
| | - Patrícia Janeiro
- Inherited Metabolic Disease Reference Center, Lisbon North University Hospital Center (CHULN), EPE, Lisboa, Portugal
| | - António Amorim
- i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal.,IPATIMUP - Instituto de Patologia e Imunologia Molecular da Universidade do Porto, Porto, Portugal.,FCUP - Faculty of Sciences, University of Porto, Porto, Portugal
| | - Laura Vilarinho
- Newborn Screening, Metabolic and Genetics Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal.,Research and Development Unit, Department of Human Genetics, National Institute of Health Dr Ricardo Jorge, Porto, Portugal
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Phenylketonuria Diagnosis by Massive Parallel Sequencing and Genotype-Phenotype Association in Brazilian Patients. Genes (Basel) 2020; 12:genes12010020. [PMID: 33375644 PMCID: PMC7824641 DOI: 10.3390/genes12010020] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 12/04/2022] Open
Abstract
Phenylketonuria (PKU) is a common inborn error of amino acid metabolism in which the enzyme phenylalanine hydroxylase, which converts phenylalanine to tyrosine, is functionally impaired due to pathogenic variants in the PAH gene. Thirty-four Brazilian patients with a biochemical diagnosis of PKU, from 33 unrelated families, were analyzed through next-generation sequencing in the Ion Torrent PGM™ platform. Phenotype–genotype correlations were made based on the BioPKU database. Three patients required additional Sanger sequencing analyses. Twenty-six different pathogenic variants were identified. The most frequent variants were c.1315+1G>A (n = 8/66), c.473G>A (n = 6/66), and c.1162G>A (n = 6/66). One novel variant, c.524C>G (p.Pro175Arg), was found in one allele and was predicted as likely pathogenic by the American College of Medical Genetics and Genomics (ACMG) criteria. The molecular modeling of p.Pro175Arg indicated that this substitution can affect monomers binding in the PAH tetramer, which could lead to a change in the stability and activity of this enzyme. Next-generation sequencing was a fast and effective method for diagnosing PKU and is useful for patient phenotype prediction and genetic counseling.
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Costa RD, Galera BB, Rezende BC, Venâncio AC, Galera MF. IDENTIFICATION OF MUTATIONS IN THE PAH GENE IN PKU PATIENTS IN THE STATE OF MATO GROSSO. REVISTA PAULISTA DE PEDIATRIA 2020; 38:e2018351. [PMID: 32074228 PMCID: PMC7025444 DOI: 10.1590/1984-0462/2020/38/2018351] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 04/21/2019] [Indexed: 11/21/2022]
Abstract
Objective: To identify phenylalanine hydroxylase (PAH) mutations in
patients with phenylketonuria (PKU) from the Newborn Screening Service in
Mato Grosso, Midwest Brazil. Methods: This is a cross-sectional descriptive study. The sample consisted of 19 PKU
patients diagnosed by newborn screening. Molecular analysis: DNA extraction
using the “salting-out” method. Detection of IVS10nt-11G>A, V388M, R261Q,
R261X, R252W, and R408W mutations by the restriction fragment length
polymorphism (RFLP) technique. Results: Two mutant alleles were identified in four patients (21.1%), one allele in
five patients (26.2%), and none in the remaining ten patients (52.6%). A
total of 13/38 alleles were detected, corresponding to 34.2% of the
PAH alleles present. The most prevalent variant was
V388M (13.2% of the alleles), followed by R261Q (10.1%) and IVS10nt-11G>A
(7.9%). Three variants (R261X, R252W, and R408W) were not found. The most
frequent mutation types were: missense mutation in eight alleles (18.4%) and
splicing in four alleles (10.5%). The model proposed by Guldberg to
determine a genotype/phenotype correlation was applied to four classical PKU
patients with two identified mutations. In three of them, the predicted
moderate/moderate or moderate PKU phenotype did not coincide with the actual
diagnosis. The prediction coincided with the diagnosis of one classic PKU
patient. The estimated incidence of PKU for Mato Grosso, Brazil, was
1:33,342 live births from 2003 to 2015. Conclusion: The only mutations found in the analyzed samples were the IVS10nt-11G>A,
V388M, and R261Q. The genotype/phenotype correlation only occurred in four
(5.3%) patients.
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Vieira Neto E, Laranjeira F, Quelhas D, Ribeiro I, Seabra A, Mineiro N, d. M. Carvalho L, Lacerda L, G. Ribeiro M. Mutation analysis of the PAH gene in phenylketonuria patients from Rio de Janeiro, Southeast Brazil. Mol Genet Genomic Med 2018; 6:575-591. [PMID: 29749107 PMCID: PMC6081236 DOI: 10.1002/mgg3.408] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 03/29/2018] [Accepted: 04/06/2018] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Phenylketonuria (PKU) is an autosomal recessive disease resulting from mutations in the PAH gene. Most of the patients are compound heterozygotes, and genotype is a major factor in determining the phenotypic variability of PKU. More than 1,000 variants have been described in the PAH gene. Rio de Janeiro's population has a predominance of Iberian, followed by African and Amerindian ancestries. It is expected that most PKU variants in this Brazilian state have originated in the Iberian Peninsula. However, rare European, African or pathogenic variants that are characteristic of the admixed population of the state might also be found. METHODS A total of 102 patients were included in this study. Genomic DNA was isolated from dried blood spots. Sanger sequencing was used for PAH gene variant identification. Deletions and duplications were also screened using MLPA analysis. Haplotypes were also determined. RESULTS Nine (8.8%) homozygous and 93 (91.2%) compound heterozygous patients were found. The spectrum included 37 causative mutations. Missense, nonsense, and splicing pathogenic variants corresponded to 63.7%, 2.9%, and 22.6% of the mutant alleles, respectively. Large (1.5%), and small deletions, inframe (5.4%) and with frameshift (3.9%), comprised the remainder. The most frequent pathogenic variants were: p.V388M (12.7%), p.R261Q (11.8%), IVS10-11G>A (10.3%), IVS2+5G>C (6.4%), p.S349P (6.4%), p.R252W (5.4%), p.I65T (4.4%), p.T323del (4.4%), and p.P281L (3.4%). One novel variant was detected: c.934G>T (p.G312C) [rs763115697]. CONCLUSION The three most frequent pathogenic variants in our study (34.8% of the alleles) were also the most common in other Brazilian states, Portugal, and Spain (p.V388M, p.R261Q, IVS10-11G>A), corroborating that the Iberian Peninsula is the major source of PAH mutations in Rio de Janeiro. Pathogenic variants that have other geographical origins, such IVS2+5G>C, p.G352Vfs*48, and IVS12+1G>A were also detected. Genetic drift and founder effect may have also played a role in the mutation spectrum we observed.
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Affiliation(s)
- Eduardo Vieira Neto
- Gerência de Monitoramento AssistencialAgência Nacional de Saúde SuplementarRio de JaneiroBrazil
- Serviço de Genética MédicaInstituto de Puericultura e Pediatria Martagão GesteiraUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
| | - Francisco Laranjeira
- Centro de Genética Médica Doutor Jacinto MagalhãesUnidade de Bioquímica GenéticaPortoPortugal
| | - Dulce Quelhas
- Centro de Genética Médica Doutor Jacinto MagalhãesUnidade de Bioquímica GenéticaPortoPortugal
| | - Isaura Ribeiro
- Centro de Genética Médica Doutor Jacinto MagalhãesUnidade de Bioquímica GenéticaPortoPortugal
| | - Alexandre Seabra
- Centro de Genética Médica Doutor Jacinto MagalhãesUnidade de Bioquímica GenéticaPortoPortugal
| | - Nicole Mineiro
- Centro de Genética Médica Doutor Jacinto MagalhãesUnidade de Bioquímica GenéticaPortoPortugal
| | - Lilian d. M. Carvalho
- Serviço de MetabologiaInstituto de Diabetes e Endocrinologia Luiz CapriglioneRio de JaneiroBrazil
| | - Lúcia Lacerda
- Centro de Genética Médica Doutor Jacinto MagalhãesUnidade de Bioquímica GenéticaPortoPortugal
| | - Márcia G. Ribeiro
- Serviço de Genética MédicaInstituto de Puericultura e Pediatria Martagão GesteiraUniversidade Federal do Rio de JaneiroRio de JaneiroBrazil
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Wang R, Shen N, Ye J, Han L, Qiu W, Zhang H, Liang L, Sun Y, Fan Y, Wang L, Wang Y, Gong Z, Liu H, Wang J, Yan H, Blau N, Gu X, Yu Y. Mutation spectrum of hyperphenylalaninemia candidate genes and the genotype-phenotype correlation in the Chinese population. Clin Chim Acta 2018; 481:132-138. [PMID: 29499199 DOI: 10.1016/j.cca.2018.02.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 02/10/2018] [Accepted: 02/27/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hyperphenylalaninemia (HPA) is an inherited metabolic disorder that is caused by a deficiency of phenylalanine hydroxylase (PAH) or tetrahydrobiopterin. The prevalence of HPA varies widely around the world. METHODS A spectrum of HPA candidate genes in 1020 Chinese HPA patients was reported. Sanger sequencing, next generation sequencing (NGS), multiplex ligation-dependent probe amplification (MLPA) and quantitative real-time PCR (qRT-PCR) were applied to precisely molecular diagnose HPA patients. The allelic phenotype values (APV) and genotypic phenotype values (GPV) were calculated in PAH-deficient patients based on a recently developed formula. RESULTS Apart from genetic diagnoses confirmed in 915 HPA patients (89.7%) by Sanger sequencing, pathogenic variants were discovered in another 57 patients (5.6%) through deep detections (NGS, MLPA and qRT-PCR). We identified 196, 42, 10 and 2 variants in PAH, PTS, QDPR and GCH1, respectively. And a total of 47 novel variants were found in these genes. Through the APV and GPV calculations, it was found that the new GPV system was well correlated with metabolic phenotypes in most PAH-deficient patients. CONCLUSIONS More HPA candidate variants were identified using new molecular diagnostic methods. The new APV and GPV system is likely to be highly beneficial for predicting clinical phenotypes for PAH-deficient patients.
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Affiliation(s)
- Ruifang Wang
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Nan Shen
- Department of Rehabilitation Medicine, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Jun Ye
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Lianshu Han
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Wenjuan Qiu
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Huiwen Zhang
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Lili Liang
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Yu Sun
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Yanjie Fan
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Lili Wang
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Yu Wang
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Zhuwen Gong
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Huili Liu
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Jianguo Wang
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Hui Yan
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Nenad Blau
- Dietmar-Hopp Metabolic Center, University Children's Hospital, 69120 Heidelberg, Germany.
| | - Xuefan Gu
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.
| | - Yongguo Yu
- Department of Pediatric Endocrinology and Genetic Metabolism, Shanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.
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7
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Wang ZW, Jiang SW, Zhou BC. PAH mutation spectrum and correlation with PKU manifestation in north Jiangsu province population. Kaohsiung J Med Sci 2017; 34:89-94. [PMID: 29413232 DOI: 10.1016/j.kjms.2017.09.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/08/2017] [Accepted: 09/15/2017] [Indexed: 01/16/2023] Open
Abstract
Phenylketonuria (PKU) is a common autosomal recessive disorder of phenylalanine metabolism and mainly results a deficiency of phenylalanine hydroxylase gene (PAH). The incidence of various PAH mutations have race and ethnicity differences. We report a spectrum of PAH mutations complied from 35 PKU children who are all Chinese Han population from north Jiangsu in this study. All 13 exons and their flanking intron sequences of PAH were determined by Ion Torrent PGM™ sequencing. The relationship of genotype and phenotype was analyzed based on the sum of the arbitrary value (AV) values of the two alleles. We identified 61 mutations, with a frequency of 87.14%, among 70 alleles of 35 patients. The most prevalent mutations were R243Q (26.23%), R241C (9.84%) and V399V (8.20%). Furthermore, the consistency between prediction of the biochemical phenotype and the observed phenotype was 81.25%, with the highest consistency observed in classic PKU (87.50%). A significant correlation was found between pretreatment levels of phenylalanine and AV sum (r = -0.87, P < 0.05). Finally, our study constructs PAH mutation spectrum by next generation sequencing (NGS), and reveals that the PAH genotypes and biochemical phenotypes were significantly correlated. These offers facilitate the provision of appropriate genetic counseling for PKU patients.
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Affiliation(s)
- Zhen-Wen Wang
- Department of Medical Laboratory, Lianyungang Maternal and Child Health Hospital, Lianyungang, Jiangsu, China
| | - Shi-Wen Jiang
- Department of Biomedical Science, Mercer University School of Medicine, Macon, GA, USA
| | - Bao-Cheng Zhou
- Department of Medical Laboratory, Lianyungang Maternal and Child Health Hospital, Lianyungang, Jiangsu, China.
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8
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Naslavsky MS, Yamamoto GL, Almeida TF, Ezquina SAM, Sunaga DY, Pho N, Bozoklian D, Sandberg TOM, Brito LA, Lazar M, Bernardo DV, Amaro E, Duarte YAO, Lebrão ML, Passos‐Bueno MR, Zatz M. Exomic variants of an elderly cohort of Brazilians in the ABraOM database. Hum Mutat 2017; 38:751-763. [DOI: 10.1002/humu.23220] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 03/14/2017] [Accepted: 03/19/2017] [Indexed: 01/03/2023]
Affiliation(s)
- Michel Satya Naslavsky
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
- Hospital Israelita Albert Einstein São Paulo Brazil
| | - Guilherme Lopes Yamamoto
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
- Department of Clinical Genetics Children's Hospital Medical School University of São Paulo São Paulo Brazil
| | - Tatiana Ferreira Almeida
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
| | - Suzana A. M. Ezquina
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
| | - Daniele Yumi Sunaga
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
| | - Nam Pho
- Department of Biomedical Informatics Harvard Medical School Boston Massachusetts
| | - Daniel Bozoklian
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
| | | | - Luciano Abreu Brito
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
| | - Monize Lazar
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
| | - Danilo Vicensotto Bernardo
- Laboratório de Estudos em Antropologia Biológica Bioarqueologia e Evolução Humana, Instituto de Ciências Humanas e da Informação, Universidade Federal do Rio Grande Rio Grande Rio Grande de Sul Brazil
| | - Edson Amaro
- Hospital Israelita Albert Einstein São Paulo Brazil
- Radiology Institute Medical School, University of São Paulo São Paulo Brazil
| | - Yeda A. O. Duarte
- Department of Epidemiology Public Health School University of São Paulo São Paulo Brazil
- School of Nursing University of São Paulo São Paulo Brazil
| | - Maria Lúcia Lebrão
- Department of Epidemiology Public Health School University of São Paulo São Paulo Brazil
| | - Maria Rita Passos‐Bueno
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
| | - Mayana Zatz
- Human Genome and Stem Cell Research Center Biosciences Institute, University of São Paulo São Paulo Brazil
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9
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Biglari A, Saffari F, Rashvand Z, Alizadeh S, Najafipour R, Sahmani M. Mutations of the phenylalanine hydroxylase gene in Iranian patients with phenylketonuria. SPRINGERPLUS 2015; 4:542. [PMID: 26413448 PMCID: PMC4579200 DOI: 10.1186/s40064-015-1309-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 09/04/2015] [Indexed: 11/30/2022]
Abstract
Phenylketonuria (PKU) is an autosomal recessive disease which results from mutations in the phenylalanine hydroxylase (PAH) gene. The aim of this study was the identification of sixteen different mutations in Iranian patients with hyperphenylalaninemia. The mutations were detected during the characterization of PAH genotypes of 39 PKU patients from Qazvin and Zanjan provinces of Iran. PAH mutations have been analyzed by PCR and direct sequencing of PCR products of the promoter region and all 13 exons of PAH gene, including the splicing sites. A mutation detection rate of 74.3 % was realized. Two mutations were found at high frequencies: R176X (10.25 %) and p.P281L (10.25 %). The frequencies of the other mutations were: IVS2+5G>A (2.56 %), IVS2+5G>C (2.56 %), p.L48S (2.56 %), p.R243Q (2.56 %), p.R252Q (5.12 %), p.R261Q (7.69 %), p.R261X (5.12 %), p.E280K (2.56 %), p.I283N (2.56 %), IVS9+5G>A (2.56 %), IVS9+1G>A (1.28 %), IVS11+1G>C (1.28 %), p.C357R (1.28 %), c.632delC (2.56 %). The present results confirm the high heterogeneity of the PAH locus and contribute to information about the distribution and frequency of PKU mutations in the Iranian population.
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Affiliation(s)
- Alireza Biglari
- Department of Molecular Medicine and Genetics, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fatemeh Saffari
- Department of Pediatrics, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahra Rashvand
- Faculty of Medicine, The Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Safarali Alizadeh
- Faculty of Medicine, The Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Reza Najafipour
- Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Mehdi Sahmani
- Department of Clinical Biochemistry and Genetics, Faculty of Medicine, Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran
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10
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Li J, Hu X, Guan P, Zhang X, Qian L, Song R, Du C, Wang C. Preparation of molecularly imprinted polymers using ion-pair dummy template imprinting and polymerizable ionic liquids. RSC Adv 2015. [DOI: 10.1039/c5ra10455f] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
New IL-based MIPs were prepared using ion-pair dummy template imprinting which confined charged monomers in the imprinting cavities.
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Affiliation(s)
- Ji Li
- Key Laboratory of Space Applied Physics and Chemistry
- Ministry of Education
- Department of Chemistry
- School of Natural and Applied Science
- Northwestern Polytechnical University
| | - Xiaoling Hu
- Key Laboratory of Space Applied Physics and Chemistry
- Ministry of Education
- Department of Chemistry
- School of Natural and Applied Science
- Northwestern Polytechnical University
| | - Ping Guan
- Key Laboratory of Space Applied Physics and Chemistry
- Ministry of Education
- Department of Chemistry
- School of Natural and Applied Science
- Northwestern Polytechnical University
| | - Xiaoyan Zhang
- Key Laboratory of Space Applied Physics and Chemistry
- Ministry of Education
- Department of Chemistry
- School of Natural and Applied Science
- Northwestern Polytechnical University
| | - Liwei Qian
- Key Laboratory of Space Applied Physics and Chemistry
- Ministry of Education
- Department of Chemistry
- School of Natural and Applied Science
- Northwestern Polytechnical University
| | - Renyuan Song
- Key Laboratory of Space Applied Physics and Chemistry
- Ministry of Education
- Department of Chemistry
- School of Natural and Applied Science
- Northwestern Polytechnical University
| | - Chunbao Du
- Key Laboratory of Space Applied Physics and Chemistry
- Ministry of Education
- Department of Chemistry
- School of Natural and Applied Science
- Northwestern Polytechnical University
| | - Chaoli Wang
- Key Laboratory of Space Applied Physics and Chemistry
- Ministry of Education
- Department of Chemistry
- School of Natural and Applied Science
- Northwestern Polytechnical University
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11
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Ho G, Alexander I, Bhattacharya K, Dennison B, Ellaway C, Thompson S, Wilcken B, Christodoulou J. The Molecular Bases of Phenylketonuria (PKU) in New South Wales, Australia: Mutation Profile and Correlation with Tetrahydrobiopterin (BH4) Responsiveness. JIMD Rep 2013; 14:55-65. [PMID: 24368688 DOI: 10.1007/8904_2013_284] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 11/20/2013] [Accepted: 11/22/2013] [Indexed: 12/24/2022] Open
Abstract
Phenylketonuria (PKU) is an autosomal recessive inborn error of phenylalanine metabolism predominantly caused by mutations in the phenylalanine hydroxylase (PAH) gene. Mutation screening was carried out in a large cohort of PKU patients from New South Wales, Australia. Pathogenic mutations were identified in 99% of the alleles screened, with the two most common mutations (p.R408W and IVS12+1G>A) accounting for 30.7% of alleles. Most individuals were compound heterozygotes for previously reported mutations, but four novel mutations (c.163+1G>T, c.164-2A>G, c.461A>T [p.Y154F], and c.510-1G>A) and a novel polymorphism (c.60+62C>T) were also identified. A number of patients have been previously tested for their response to dietary supplementation of tetrahydrobiopterin (BH4), the cofactor of PAH. Correlation between genotype and the responses revealed that although genotype is a major determinant of BH4 responsiveness, patients with the same genotype may also show disparate responses to this treatment. A clinical and biochemical evaluation should be undertaken to determine the effectiveness of PKU treatment by supplementation of BH4.
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Affiliation(s)
- Gladys Ho
- Genetic Metabolic Disorders Research Unit, Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, 2145, Australia
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12
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Zhu T, Ye J, Han L, Qiu W, Zhang H, Liang L, Gu X. Variations in genotype–phenotype correlations in phenylalanine hydroxylase deficiency in Chinese Han population. Gene 2013; 529:80-7. [DOI: 10.1016/j.gene.2013.07.079] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 07/19/2013] [Accepted: 07/22/2013] [Indexed: 11/16/2022]
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13
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Moradi K, Alibakhshi R, Ghadiri K, Khatami SR, Galehdari H. Molecular analysis of exons 6 and 7 of phenylalanine hydroxylase gene mutations in Phenylketonuria patients in Western Iran. INDIAN JOURNAL OF HUMAN GENETICS 2013; 18:290-3. [PMID: 23716935 PMCID: PMC3656516 DOI: 10.4103/0971-6866.107978] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND: Phenylketonuria (PKU) is an inborn error of amino acid metabolism that results from a deficiency of phenylalanine hydroxylase (PAH). According to PAH database, exons 6 and 7 and their flanking introns of PAH gene contain the greatest number of mutant alleles. Therefore, as a preliminary study, nucleotide sequence analysis of exons 6 and 7 of the PAH gene has been performed in 25 PKU patients whose ancestors lived in Kermanshah province of Iran. To date, there has been no mutation data describing the genotypes of the PKU disease in this Kurdish ethnic region background. MATERIALS AND METHODS: Twenty-five patients (aged between 2 and 23 years) participated in this study. The DNA fragments containing two exons of the PAH gene [6 and 7] and their exon-flanking intronic sequences were amplified and sequenced. RESULTS: The total of detected mutations were R261X (8%), R176X (4%), R243Q (4%), R243X (2%) and R261Q (2%), as they accounted for 20% of all mutant alleles in this study. The identified polymorphisms are: IVS5 -54 G > A (22%), Q232Q (8%) and V245V (4%). All of the detected mutations in this study are related to CpG dinucleotides in the PAH gene sequence. CONCLUSION: The frequency of R261X, the most common mutation in our study, in Iranian population is <5%. Furthermore, there is no report of detection of R176X and R243Q in Isfahan and Azeri Turkish populations. These findings confirm the common Mediterranean mutations in this local population, although with more or lower frequencies than those reported in other related studies in Iran. Therefore, it may be necessary to study the PAH gene mutations in other provinces of Iran separately.
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Affiliation(s)
- Keyvan Moradi
- Department of Genetics, Faculty of Science, Shahid Chamran University of Ahvaz, Ahvaz, Iran
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14
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Amorim T, Boa-Sorte N, Leite MEQ, Acosta AX. Aspectos clínicos e demográficos da fenilcetonúria no Estado da Bahia. REVISTA PAULISTA DE PEDIATRIA 2011. [DOI: 10.1590/s0103-05822011000400022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Descrever as características clínicas e demográficas dos pacientes com diagnóstico de hiperfenilalaninemia acompanhados no Serviço de Referência em Triagem Neonatal da Bahia. MÉTODOS: Estudo transversal de 99 famílias (111 afetados) com fenótipo bioquímico de hiperfenilalaninemia, com coleta de dados em prontuários e em banco de dados laboratorial, incluindo aspectos demográficos e clínicos. RESULTADOS: A incidência de hiperfenilalaninemia na Bahia foi de um caso a cada 16.334 nascidos vivos, com cobertura de 91%. Dentre os pacientes acompanhados, 82% foram diagnosticados pela triagem neonatal e, em 11 famílias, havia mais de um caso. O fenótipo clássico da fenilcetonúria foi diagnosticado em 63 (57%) pacientes. Entre os triados, a mediana de idade na primeira consulta foi 39,5 dias e, deles, 34% apresentavam sintomatologia nesse momento; nenhum com atraso no desenvolvimento neuropsicomotor. A consanguinidade foi descrita em 32% dos casos e houve predomínio de pacientes classificados como brancos (63%). Os pais tinham baixa escolaridade e baixa renda. Dos 417 municípios da Bahia, 15% apresentavam pelo menos um caso, com concentração na região nordeste (10%) e na capital do Estado (14%). CONCLUSÕES: Os resultados evidenciaram idade tardia ao início do tratamento, o que pode comprometer os resultados do programa. Observou-se também presença de consanguinidade e recorrência familiar, reforçando a importância da investigação familiar para diagnosticar indivíduos com deficiência mental de etiologia não esclarecida que podem se beneficiar de tratamento.
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15
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Rapid screening of phenylketonuria using a CD microfluidic device. J Chromatogr A 2011; 1218:1907-12. [DOI: 10.1016/j.chroma.2011.02.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Revised: 01/19/2011] [Accepted: 02/01/2011] [Indexed: 11/19/2022]
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16
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Santos L, Fonseca C, Starling A, Janu�rio J, Aguiar M, Peixoto M, Carvalho M. Variations in genotype-phenotype correlations in phenylketonuria patients. GENETICS AND MOLECULAR RESEARCH 2010; 9:1-8. [DOI: 10.4238/vol9-1gmr670] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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17
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De Lucca M, Arias I, Casique L, Araujo K, Merzon RM. Improving phenylketonuria genotyping by screening for the IVS4+5g>t mutation in the PAH gene. Clin Chim Acta 2009; 402:206-8. [DOI: 10.1016/j.cca.2008.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2008] [Revised: 10/24/2008] [Accepted: 10/25/2008] [Indexed: 10/21/2022]
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18
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Mutation characteristics of the PAH gene in four nationality groups in Xinjiang of China. J Genet 2008; 87:293-7. [DOI: 10.1007/s12041-008-0047-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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19
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Santos LL, Castro-Magalhães M, Fonseca CG, Starling ALP, Januário JN, Aguiar MJB, Carvalho MRS. PKU in Minas Gerais State, Brazil: mutation analysis. Ann Hum Genet 2008; 72:774-9. [PMID: 18798839 DOI: 10.1111/j.1469-1809.2008.00476.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
This work was undertaken in order to ascertain the PKU mutational spectrum in Minas Gerais, Brazil, the relative frequency of the mutations in the State and the origin of these mutations by haplotype determination. Minas Gerais is a trihybrid population formed by miscegenation from Europeans, Africans and Amerindians. All 13 exons of the PAH gene from 78 PKU patients were analyzed, including splicing sites and the promoter region. We identified 30 different mutations and 98% of the PAH alleles were established. A new mutation (Q267X) was identified as well. The most common mutations found were V388M (21.2), R261Q (16.0%), IVS10-11G>A (15.3%), I65T (5.8%), IVS2+5G>C (5.8%), R252W (5.1%), IVS2+5G>A (4.5%), P281L (3.8%) and L348V (3.2%). These nine mutations correspond to 80% of the PKU alleles in the state. Haplotypes were determined to characterize the origin of the PAH alleles. The majority of the mutations found, with respective haplotypes, are frequent in the Iberian Peninsula. However, there were some mutations that are rare in Europe and four previously unreported mutation-haplotype associations. I65T and Q267X were found in association with haplotype 38 and may be African in origin or the result of miscegenation in the Brazilian population.
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Affiliation(s)
- L L Santos
- Departamento de Biologia, Universidade Federal de Minas Gerais-Instituto de Ciências Biológicas, Belo Horizonte, MG, Brazil
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20
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Connecting Mutant Phenylalanine Hydroxylase With Phenylketonuria. J Clin Monit Comput 2008; 22:333-42. [DOI: 10.1007/s10877-008-9139-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2008] [Accepted: 08/12/2008] [Indexed: 11/30/2022]
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21
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Steiner CE, Acosta AX, Guerreiro MM, Marques-de-Faria AP. Genotype and natural history in unrelated individuals with phenylketonuria and autistic behavior. ARQUIVOS DE NEURO-PSIQUIATRIA 2008; 65:202-5. [PMID: 17607414 DOI: 10.1590/s0004-282x2007000200003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2006] [Accepted: 12/05/2006] [Indexed: 11/22/2022]
Abstract
We describe three unrelated individuals, two males (ages 35 and 9) and a female (age 8) presenting with late diagnosed phenylketonuria (PKU) and autistic behavior, all showing poor adhesion to the dietary treatment resulting in high plasmatic phenylalanine levels, particularly in the oldest subject. Clinical findings included hair hypopigmentation, microcephaly, severe mental retardation with absent development of verbal language and autistic symptoms in all three patients, whereas variable neurological signs such as seizures, spasticity, ataxia, aggressivity, and hyperactivity were individually found. Homozygosity for the IVS10nt11g/a (IVS10nt546) was found in all. This is the first report of molecular findings in subjects with PKU also presenting with autistic features. The authors discuss if this mutation is particularly involved in the association of autistic symptoms in untreated PKU individuals.
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Affiliation(s)
- Carlos Eduardo Steiner
- Departamento de Genética Médica, Faculdade de Ciências Médicas, Universidade Estadual de Campinas, Campinas, SP, Brazil.
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Pey AL, Stricher F, Serrano L, Martinez A. Predicted effects of missense mutations on native-state stability account for phenotypic outcome in phenylketonuria, a paradigm of misfolding diseases. Am J Hum Genet 2007; 81:1006-24. [PMID: 17924342 PMCID: PMC2265664 DOI: 10.1086/521879] [Citation(s) in RCA: 140] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2007] [Accepted: 07/25/2007] [Indexed: 12/15/2022] Open
Abstract
Phenylketonuria (PKU) is a genetic disease caused by mutations in human phenylalanine hydroxylase (PAH). Most missense mutations result in misfolding of PAH, increased protein turnover, and a loss of enzymatic function. We studied the prediction of the energetic impact on PAH native-state stability of 318 PKU-associated missense mutations, using the protein-design algorithm FoldX. For the 80 mutations for which expression analyses have been performed in eukaryote systems, in most cases we found substantial overall correlations between the mutational energetic impact and both in vitro residual activities and patient metabolic phenotype. This finding confirmed that the decrease in protein stability is the main molecular pathogenic mechanism in PKU and the determinant for phenotypic outcome. Metabolic phenotypes have been shown to be better predicted than in vitro residual activities, probably because of greater stringency in the phenotyping process. Finally, all the remaining 238 PKU missense mutations compiled at the PAH locus knowledgebase (PAHdb) were analyzed, and their phenotypic outcomes were predicted on the basis of the energetic impact provided by FoldX. Residues in exons 7-9 and in interdomain regions within the subunit appear to play an important structural role and constitute hotspots for destabilization. FoldX analysis will be useful for predicting the phenotype associated with rare or new mutations detected in patients with PKU. However, additional factors must be considered that may contribute to the patient phenotype, such as possible effects on catalysis and interindividual differences in physiological and metabolic processes.
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Affiliation(s)
- Angel L Pey
- Department of Biomedicine, University of Bergen, Bergen, Norway
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23
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Richardson MA, Read LL, Clelland JD, Chao HM, Reilly MA, Romstad A, Suckow RF. Phenylalanine hydroxylase gene in psychiatric patients: screening and functional assay of mutations. Biol Psychiatry 2003; 53:543-53. [PMID: 12644360 DOI: 10.1016/s0006-3223(02)01528-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
BACKGROUND Reports relating phenylalanine kinetics and metabolism to psychiatric disorders led us to undertake the comprehensive screening of the phenylalanine hydroxylase (PAH) coding region and functional testing of discovered mutations in a sample of psychiatric patients and healthy control subjects. METHODS Genomic DNA from psychiatric patients and control subjects was assayed for sequence variants in all PAH coding regions and splice junctions. In vivo functional analysis of mutations was conducted by assessing the kinetics and conversion to tyrosine of a standardized phenylalanine dose and by measuring fasting pterin levels. RESULTS A known missense mutation was observed in a schizoaffective subject, and a novel missense mutation was discovered in four subjects with schizophrenia and one normal subject. The schizoaffective patient heterozygous for the known A403V mutation showed the lowest rate of phenylalanine kinetics and lowest conversion to tyrosine in the patient sample. The four schizophrenic patients heterozygous for the novel K274E mutation showed significantly decreased phenylalanine kinetics, reduced conversion to tyrosine, and increased synthesis of the PAH cofactor tetrahydrobiopterin compared with schizophrenic subjects without the mutation. CONCLUSIONS The study findings suggest that larger scale studies are warranted to test the relationship of the PAH genotype with a psychiatric phenotype.
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Affiliation(s)
- Mary Ann Richardson
- Nathan S. Kline Institute for Psychiatric Research, New York State Office of Mental Health, Orangeburg 10962, USA
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24
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Chao HM, Richardson MA. Aromatic amino acid hydroxylase genes and schizophrenia. AMERICAN JOURNAL OF MEDICAL GENETICS 2002; 114:626-30. [PMID: 12210276 DOI: 10.1002/ajmg.10606] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Phenylalanine hydroxylase (PAH), which catalyzes the conversion of phenylalanine to tyrosine, shares physical, structural and catalytic properties with tyrosine hydroxylase (TH) and tryptophan hydroxylase (TPH) that catalyze the rate-limiting steps in the biosynthesis of the neurotransmitters dopamine, noradrenaline, and serotonin. Because these neurotransmitter systems have all been implicated in the pathophysiology of schizophrenia, the aromatic amino acid hydroxylases are among the likely candidates for genes associated with schizophrenia. A mutation in the functionally critical tetrahydrobiopterin cofactor binding domain of the PAH gene had been identified in African-American patients with the diagnosis of schizophrenia, and biochemical analyses suggested that this mutation has physiological consequences related to amine neurotransmitter function. DNA sequencing of the highly conserved cofactor binding domain of the PAH, TH, and TPH genes in African-American subjects with schizophrenia and unrelated, never mentally ill subjects from the NIMH Schizophrenia Genetics Initiative, was undertaken to assess the concordance of mutant genotype with psychiatric phenotype. The K274E mutation was observed in the PAH gene cofactor binding domain, and several polymorphisms were identified in adjacent intronic regions of the PAH, TH, and TPH genes. All of the genetic variants observed were represented in the schizophrenia group and in the never mentally ill group. Genetic evaluation of the family members of subjects with the PAH K274E mutation showed that all individuals with the K274E mutation also exhibited the PAH L321L polymorphism in the catalytic domain of the PAH enzyme.
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Affiliation(s)
- Helen M Chao
- The Nathan S. Kline Institute for Psychiatric Research, New York State Office of Mental Health, Orangeburg, New York 10962, USA.
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