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Mancuso G, Bechi Genzano C, Fierabracci A, Fousteri G. Type 1 diabetes and inborn errors of immunity: Complete strangers or 2 sides of the same coin? J Allergy Clin Immunol 2023:S0091-6749(23)00427-X. [PMID: 37097271 DOI: 10.1016/j.jaci.2023.03.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/31/2023] [Accepted: 03/31/2023] [Indexed: 04/26/2023]
Abstract
Type 1 diabetes (T1D) is a polygenic disease and does not follow a mendelian pattern. Inborn errors of immunity (IEIs), on the other hand, are caused by damaging germline variants, suggesting that T1D and IEIs have nothing in common. Some IEIs, resulting from mutations in genes regulating regulatory T-cell homeostasis, are associated with elevated incidence of T1D. The genetic spectrum of IEIs is gradually being unraveled; consequently, molecular pathways underlying human monogenic autoimmunity are being identified. There is an appreciable overlap between some of these pathways and the genetic variants that determine T1D susceptibility, suggesting that after all, IEI and T1D are 2 sides of the same coin. The study of monogenic IEIs with a variable incidence of T1D has the potential to provide crucial insights into the mechanisms leading to T1D. These insights contribute to the definition of T1D endotypes and explain disease heterogeneity. In this review, we discuss the interconnected pathogenic pathways of autoimmunity, β-cell function, and primary immunodeficiency. We also examine the role of environmental factors in disease penetrance as well as the circumstantial evidence of IEI drugs in preventing and curing T1D in individuals with IEIs, suggesting the repositioning of these drugs also for T1D therapy.
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Affiliation(s)
- Gaia Mancuso
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Camillo Bechi Genzano
- Columbia Center for Translational Immunology, Department of Medicine, Columbia University Irving Medical Center, New York, NY
| | | | - Georgia Fousteri
- Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, Italy.
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2
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Polat R, Özdemir Ö. Spondyloenchondrodysplasia Due to Mutation in ACP5 Gene Presenting
with Nephrotic Syndrome: A Case Report. AKTUEL RHEUMATOL 2022. [DOI: 10.1055/a-1806-0918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
AbstractSpondyloenchondrodysplasia (SPENCD) with immune dysregulation (SPENCDI) is a rare
autosomal recessive inherited immuno-osseous dysplasia characterized by
spondylo-metaphyseal enchondromas, along with immune dysregulation ranging from
immunodeficiency to autoimmune disorder. Here, we present two cousins with
ACP5 gene mutation who had severe short stature with mild
hypogammaglobulinemia, nephrotic syndrome, autoimmune thyroiditis and cerebral
calcification (Case 1); and in the other (Case 2), there was no clinical
findings other than severe short stature, CD4+−T cell
lymphopenia and non-autoimmune compensated hypothyroidism. We wanted to
emphasize that monogenic causes should be considered in the etiology of
early-onset nephrotic syndrome due to the detection of a mutation in the
ACP5 gene (her actual diagnosis was changed to SPENCDI.) 5 years
after the diagnosis of nephrotic syndrome in the first case, and that the renal
involvement may occur without SLE in patients with ACP5 mutation. Severe
short stature was a common finding in both cases. We underlined that the clinic
can be different even in the same mutation, due to the absence of cerebral
calcification and renal involvement in the second case, which is a cousin with
Case 1. As a result, endocrinologists, immunologists, rheumatologists,
nephrologists and orthopedists should be aware of this syndrome, because SPENCDI
causes a pleiotropic (due to more than one phenotypic effect of a gene) clinical
picture. Severe short stature may be the only presenting sign of patients with
SPENCDI. In addition, in the presence of early-onset nephrotic syndrome and
autoimmune thyroiditis, the patient should be evaluated for this type of
monogenic disorders as well.
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Affiliation(s)
- Recep Polat
- Department of Pediatric Endocrinology, Sakarya Training and Research
Hospital, Sakarya, Turkey
- Division of Allergy and Immunology, Department of Pediatrics, Sakarya
Training and Research Hospital, Sakarya, Turkey
| | - Öner Özdemir
- Division of Allergy and Immunology, Department of Pediatrics, Sakarya
Training and Research Hospital, Sakarya, Turkey
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3
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Abstract
RATIONALE Spondyloenchondrodysplasia (SPENCD) is an autosomal recessive skeletal dysplasia by biallelic mutations in ACP5 gene encoding tartrate-resistant acid phosphatase (TRAP). The extra-osseous phenotype of SPENCD is pleiotropic and involves neurological impairment and immune dysfunction. Dentofacial abnormalities and orofacial symptoms in SPENCD patients have been little discussed in the literature. PATIENTS CONCERNS Herein we present clinical and radiological data regarding 2 siblings with SPENCD. Both patients exhibited short stature, cervical platyspondyly, growth disturbance with multiple skeletal deformities of the wrist, and systemic lupus erythematosus related autoimmunity. They experienced prolonged pain in the temporomandibular joint (TMJ) area and exhibited delayed dental development. One patient presented with midface hypoplasia, retrognathic mandible, and anterior openbite. Computed tomographic images demonstrated delayed spheno-occipital synchondrosis, obtuse cranial base angle, overdeveloped and anteriorly displaced sphenoidal sinuses, and compressed ethmoidal sinuses. DIAGNOSIS The genetic analysis revealed heterozygous for a missense mutations at ACP5 in both probands. INTERVENTIONS Routine follow-up with conservative treatment were conducted for 12 months. OUTCOMES The elder sister's orofacial pain was relieved but the boy showed sustained masticatory and cervical muscle pain and TMJ arthralgia which had changed in accordance with systemic condition. No further teeth eruption or skeletal growth was observed in 2 siblings during the follow-up period. LESSONS These findings extend the phenotypic spectrum of SPENCD and indicate that compromised endochondral ossification and the loss of TRAP activity may affect altered dentofacial development and orofacial symptoms.
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Affiliation(s)
- Seok Woo Hong
- Department of Orthopedic Surgery, College of Medicine, Ewha Womans University
| | - Kyung-Hoe Huh
- Department of Oral and Maxillofacial Radiology, School of Dentistry and Dental Research Institute, Seoul National University
| | | | - Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Korea (ROK)
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4
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Flanagan AM, Lindsay D. A diagnostic approach to bone tumours. Pathology 2017; 49:675-687. [PMID: 29110879 DOI: 10.1016/j.pathol.2017.08.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 08/03/2017] [Accepted: 08/07/2017] [Indexed: 12/21/2022]
Abstract
In this review we discuss an approach to diagnosing primary bone tumours, namely the cartilaginous, bone-forming, giant cell-rich, fibro-osseous and round cell neoplasms. Less common lesions including chordoma are also discussed. The value of integrating clinical, histopathological and relevant radiological features is emphasised with a view to providing the general histopathologist with a methodical approach to reaching an accurate diagnosis.
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Affiliation(s)
- Adrienne M Flanagan
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, United Kingdom; UCL - Cancer Institute, London, United Kingdom.
| | - Daniel Lindsay
- Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, United Kingdom
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5
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Baker PJ, De Nardo D, Moghaddas F, Tran LS, Bachem A, Nguyen T, Hayman T, Tye H, Vince JE, Bedoui S, Ferrero RL, Masters SL. Posttranslational Modification as a Critical Determinant of Cytoplasmic Innate Immune Recognition. Physiol Rev 2017; 97:1165-1209. [DOI: 10.1152/physrev.00026.2016] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 02/27/2017] [Accepted: 02/28/2017] [Indexed: 12/21/2022] Open
Abstract
Cell surface innate immune receptors can directly detect a variety of extracellular pathogens to which cytoplasmic innate immune sensors are rarely exposed. Instead, within the cytoplasm, the environment is rife with cellular machinery and signaling pathways that are indirectly perturbed by pathogenic microbes to activate intracellular sensors, such as pyrin, NLRP1, NLRP3, or NLRC4. Therefore, subtle changes in key intracellular processes such as phosphorylation, ubiquitination, and other pathways leading to posttranslational protein modification are key determinants of innate immune recognition in the cytoplasm. This concept is critical to establish the “guard hypothesis” whereby otherwise homeostatic pathways that keep innate immune sensors at bay are released in response to alterations in their posttranslational modification status. Originally identified in plants, evidence that a similar guardlike mechanism exists in humans has recently been identified, whereby a mutation that prevents phosphorylation of the innate immune sensor pyrin triggers a dominantly inherited autoinflammatory disease. It is also noteworthy that even when a cytoplasmic innate immune sensor has a direct ligand, such as bacterial peptidoglycan (NOD1 or NOD2), RNA (RIG-I or MDA5), or DNA (cGAS or IFI16), it can still be influenced by posttranslational modification to dramatically alter its response. Therefore, due to their existence in the cytoplasmic milieu, posttranslational modification is a key determinant of intracellular innate immune receptor functionality.
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Affiliation(s)
- Paul J. Baker
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Dominic De Nardo
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Fiona Moghaddas
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Le Son Tran
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Annabell Bachem
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Tan Nguyen
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Thomas Hayman
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Hazel Tye
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - James E. Vince
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Sammy Bedoui
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Richard L. Ferrero
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
| | - Seth L. Masters
- Inflammation Division, The Walter and Eliza Hall Institute of Medical Research, Parkville, Australia; Hudson Institute of Medical Research, Monash University, Centre for Innate Immunity and Infectious Diseases, Clayton, Victoria, Australia; The Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia; and Departments of Medical Biology and of Microbiology and Immunology, The University of Melbourne, Parkville, Australia
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Utsumi T, Okada S, Izawa K, Honda Y, Nishimura G, Nishikomori R, Okano R, Kobayashi M. A Case with Spondyloenchondrodysplasia Treated with Growth Hormone. Front Endocrinol (Lausanne) 2017; 8:157. [PMID: 28740483 PMCID: PMC5502255 DOI: 10.3389/fendo.2017.00157] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 06/22/2017] [Indexed: 11/25/2022] Open
Abstract
Spondyloenchondrodysplasia (SPENCD) is an autosomal recessive skeletal dysplasia caused by loss of function mutations in acid phosphatase 5, tartrate resistant (ACP5). Hypomorphic ACP5 mutations impair endochondral bone growth and create an interferon (INF) signature, which lead to distinctive spondylar and metaphyseal dysplasias, and extraskeletal morbidity, such as neurological involvement and immune dysregulation, respectively. We report an affected boy with novel ACP5 mutations, a splice-site mutation (736-2 A>C) and a nonsense mutation (R176X). He presented with postnatal short stature, which led to a diagnosis of partial growth hormone (GH) deficiency at 3 years of age. GH therapy was beneficial in accelerating his growth velocity. At 6 years of age, however, metaphyseal abnormalities of the knee attracted medical attention, and subsequent assessment ascertained the typical skeletal phenotype of SPENCD, brain calcifications, and an INF signature. This anecdotal experience indicates the potential efficacy of GH for growth failure in SPENCD.
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Affiliation(s)
- Takanori Utsumi
- Department of Pediatrics, Onomichi General Hospital, Hiroshima, Japan
- *Correspondence: Takanori Utsumi,
| | - Satoshi Okada
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
| | - Kazushi Izawa
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshitaka Honda
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Gen Nishimura
- Department of Pediatric Imaging, Tokyo Metropolitan Children’s Medical Center, Tokyo, Japan
| | - Ryuta Nishikomori
- Department of Pediatrics, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Rika Okano
- Department of Pediatrics, Onomichi General Hospital, Hiroshima, Japan
| | - Masao Kobayashi
- Department of Pediatrics, Hiroshima University Graduate School of Biomedical & Health Sciences, Hiroshima, Japan
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7
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Briggs TA, Rice GI, Adib N, Ades L, Barete S, Baskar K, Baudouin V, Cebeci AN, Clapuyt P, Coman D, De Somer L, Finezilber Y, Frydman M, Guven A, Heritier S, Karall D, Kulkarni ML, Lebon P, Levitt D, Le Merrer M, Linglart A, Livingston JH, Navarro V, Okenfuss E, Puel A, Revencu N, Scholl-Bürgi S, Vivarelli M, Wouters C, Bader-Meunier B, Crow YJ. Spondyloenchondrodysplasia Due to Mutations in ACP5: A Comprehensive Survey. J Clin Immunol 2016; 36:220-34. [PMID: 26951490 PMCID: PMC4792361 DOI: 10.1007/s10875-016-0252-y] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 02/22/2016] [Indexed: 02/06/2023]
Abstract
Purpose Spondyloenchondrodysplasia is a rare immuno-osseous dysplasia caused by biallelic mutations in ACP5. We aimed to provide a survey of the skeletal, neurological and immune manifestations of this disease in a cohort of molecularly confirmed cases. Methods We compiled clinical, genetic and serological data from a total of 26 patients from 18 pedigrees, all with biallelic ACP5 mutations. Results We observed a variability in skeletal, neurological and immune phenotypes, which was sometimes marked even between affected siblings. In total, 22 of 26 patients manifested autoimmune disease, most frequently autoimmune thrombocytopenia and systemic lupus erythematosus. Four patients were considered to demonstrate no clinical autoimmune disease, although two were positive for autoantibodies. In the majority of patients tested we detected upregulated expression of interferon-stimulated genes (ISGs), in keeping with the autoimmune phenotype and the likely immune-regulatory function of the deficient protein tartrate resistant acid phosphatase (TRAP). Two mutation positive patients did not demonstrate an upregulation of ISGs, including one patient with significant autoimmune disease controlled by immunosuppressive therapy. Conclusions Our data expand the known phenotype of SPENCD. We propose that the OMIM differentiation between spondyloenchondrodysplasia and spondyloenchondrodysplasia with immune dysregulation is no longer appropriate, since the molecular evidence that we provide suggests that these phenotypes represent a continuum of the same disorder. In addition, the absence of an interferon signature following immunomodulatory treatments in a patient with significant autoimmune disease may indicate a therapeutic response important for the immune manifestations of spondyloenchondrodysplasia.
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Affiliation(s)
- Tracy A Briggs
- Manchester Centre for Genomic Medicine, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK. .,St Mary's Hospital, Central Manchester University Hospitals NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
| | - Gillian I Rice
- Manchester Centre for Genomic Medicine, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK
| | - Navid Adib
- Department of Rheumatology, The Lady Cilento Children's Hospital, Brisbane, Australia
| | - Lesley Ades
- Department of Clinical Genetics, The Children's Hospital at Westmead, Sydney, Australia.,Discipline of Paedatrics and Child Health, The University of Sydney, Sydney, Australia
| | - Stephane Barete
- Dermatology Department, Pitie-Salpetriere Hospital, Paris, France
| | - Kannan Baskar
- Creighton University, 2500 California Plaza, NE 68178, Omaha, USA
| | - Veronique Baudouin
- Pediatric Nephrology Department, Robert Debré University Hospital - APHP, 48 boulevard Sérurier, 75019, Paris, France
| | - Ayse N Cebeci
- Goztepe Educational and Research Hospital Pediatric Endocrinology Clinic, Istanbul, Türkiye
| | - Philippe Clapuyt
- Pediatric Imaging Unit, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - David Coman
- Neuroscience Department, The Lady Cilento Children's Hospital, Brisbane, Australia.,School of Medicine, Griffith University, Gold Coast, Australia
| | - Lien De Somer
- Pediatric Rheumatology, Department of Pediatrics, University Hospitals Leuven, B-3000, Leuven, Belgium
| | - Yael Finezilber
- Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center, Tel Aviv, Israel
| | - Moshe Frydman
- Danek Gertner Institute of Human Genetics, Chaim Sheba Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ayla Guven
- Goztepe Educational and Research Hospital Pediatric Endocrinology Clinic, Istanbul, Türkiye.,Amasya University Medical Faculty, Department of Pediatric Endocrinology, Istanbul, Türkiye
| | - Sébastien Heritier
- Department of Pediatric Hematology and Oncology, Trousseau Hospital, Assistance Publique-Hôpitaux de Paris (APHP), Paris, France
| | - Daniela Karall
- Clinic for Pediatrics I, Inherited Metabolic Disorders, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria
| | | | - Pierre Lebon
- Service de Virologie, AP-HP Hôpital Cochin, Paris, France
| | - David Levitt
- Department of Paediatrics, The Lady Cilento Children's Hospital, Brisbane, Australia
| | - Martine Le Merrer
- Centre de Référence des Maladies Osseuses Constitutionnelles et Institut Imagine, Hopital Necker 149 rue de Sevres, 75015, Paris, France
| | - Agnes Linglart
- APHP, Bicêtre Paris Sud, Department of Pediatric Endocrinology and Diabetology for Children, 94270, Le Kremlin Bicêtre, France.,Reference Center for Rare Disorders of the Mineral Metabolism and Plateforme d'expertise Paris Sud Maladies Rares, APHP, 94270, Le Kremlin Bicêtre, France
| | - John H Livingston
- Department of Paediatric Neurology, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - Ericka Okenfuss
- Kaiser Permanente - Genetics, 1650 Response Rd, Sacramento, CA, 95815, USA
| | - Anne Puel
- Génétique Humaine des Maladies Infectieuses, INSERM UMR 1163, Université Paris Descartes Sorbonne Paris Cité, Institut Imagine, Pièce 421-B1, 24 boulevard du Montparnasse, 75015, Paris, France
| | - Nicole Revencu
- Centre for Human Genetics, Cliniques universitaires Saint-Luc, Université catholique de Louvain, Brussels, Belgium
| | - Sabine Scholl-Bürgi
- Clinic for Pediatrics I, Inherited Metabolic Disorders, Medical University of Innsbruck, Anichstr. 35, A-6020, Innsbruck, Austria
| | - Marina Vivarelli
- Division of Nephrology, IRCCS Bambino Gesu' Pediatric Hospital, Rome, Italy
| | - Carine Wouters
- Department of Microbiology and Immunology, Pediatric Immunology, KU Leuven, University of Leuven, Leuven, Belgium
| | - Brigitte Bader-Meunier
- Pediatric Immunology and Rheumatology Unit, Hôpital Necker, APHP, Paris, France.,Institut Imagine, Paris, France
| | - Yanick J Crow
- Manchester Centre for Genomic Medicine, Institute of Human Development, Faculty of Medical and Human Sciences, University of Manchester, Manchester, UK.,Laboratory of Neurogenetics and Neuroinflammation, Institut Imagine, 24 boulevard du Montparnasse, 75015, Paris, France
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8
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Amyere M, Dompmartin A, Wouters V, Enjolras O, Kaitila I, Docquier PL, Godfraind C, Mulliken JB, Boon LM, Vikkula M. Common somatic alterations identified in maffucci syndrome by molecular karyotyping. Mol Syndromol 2014; 5:259-67. [PMID: 25565925 DOI: 10.1159/000365898] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2014] [Indexed: 01/07/2023] Open
Abstract
Maffucci syndrome (MS) is a rare congenital disorder characterized by multiple central cartilaginous tumors (enchondromas) in association with cutaneous spindle cell hemangiomas. These patients have a high incidence of malignant transformation. No familial case is known and the etiopathogenic cause remains unknown. In enchondromatosis (Ollier disease, OD), which is comprised of enchondromas only, 4 mutations in the PTHR1 gene have been identified in 4 patients; 3 were somatic and 1 was germline. No PTHR1 mutations have been detected in MS, whereas somatic IDH1 and, more rarely, IDH2 mutations have been observed in 77% of patients with MS and 81% of patients with OD. These genetic alterations are shared with other tumors, including glioma, leukemia and carcinoma. To search for underlying somatic genomic causes, we screened MS tissues using Affymetrix SNP-chips. We looked for CNVs, LOH and uniparental isodisomy (UPID) by performing pairwise analyses between allelic intensities in tumoral DNA versus the corresponding blood-extracted DNA. While common chromosomal anomalies were absent in constitutional DNA, several shared CNVs were identified in MS-associated tumors. The most frequently encountered somatic alterations were localized in 2p22.3, 2q24.3 and 14q11.2, implicating these chromosomal rearrangements in the formation of enchondromas and spindle cell hemangiomas in MS. In one chondrosarcoma specimen, large amplifications and/or deletions were observed in chromosomes 3, 6, 9, 10, 12, 13, and 19. Some of these genetic changes have been reported in other chondrosarcomas suggesting an etiopathogenic role. No LOH/UPID was observed in any Maffucci tissue. Our findings identify frequent somatic chromosomal rearrangements on 2p22.3, 2q24.3 and 14q11.2, which may unmask mutations leading to the lesions pathognomonic of MS.
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Affiliation(s)
- Mustapha Amyere
- Laboratory of Human Molecular Genetics, de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - Anne Dompmartin
- Department of Dermatology, Université de Caen Basse Normandie, CHU Caen, Caen, France
| | - Vinciane Wouters
- Laboratory of Human Molecular Genetics, de Duve Institute, Université catholique de Louvain, Brussels, Belgium
| | - Odile Enjolras
- Consultation des Angiomes, Hôpital Lariboisière, Paris, France
| | - Ilkka Kaitila
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland
| | - Pierre-Louis Docquier
- Division of Orthopedic Surgery, Division of Plastic Surgery, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Catherine Godfraind
- Laboratory of Pathology, Division of Plastic Surgery, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - John Butler Mulliken
- Department of Plastic and Oral Surgery, Children's Hospital and Harvard Medical School, Boston, Mass., USA
| | - Laurence Myriam Boon
- Laboratory of Human Molecular Genetics, de Duve Institute, Université catholique de Louvain, Brussels, Belgium ; Center for Vascular Anomalies, Division of Plastic Surgery, Cliniques Universitaires St-Luc, Brussels, Belgium
| | - Miikka Vikkula
- Laboratory of Human Molecular Genetics, de Duve Institute, Université catholique de Louvain, Brussels, Belgium ; Walloon Excellence in Lifesciences and Biotechnology (WELBIO), Université catholique de Louvain, Brussels, Belgium
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9
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Al Kaissi A, Ben Chehida F, Ben Ghachem M, Klaushofer K, Grill F. Dysmorphic facies and diffuse posterior spine ankylosis in a patient with unusual form of spondyloenchondrodysplasia (Spranger type IV). EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2012; 22 Suppl 3:S409-15. [PMID: 23053755 DOI: 10.1007/s00586-012-2518-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2012] [Revised: 08/09/2012] [Accepted: 09/16/2012] [Indexed: 11/26/2022]
Abstract
We describe a male patient, who was seen for the first time at the age of 8 years because of short trunk dwarfism. Spine radiographs showed platyspondyly with irregular areas of increased and decreased mineralization (irregular spotted appearance within lytic lesions located along the posterior vertebral bodies of the entire spine). Skeletal survey showed no enchondromatous lesions of the short/long tubular bones. At the age of 17, progressive spine stiffness associated with stooping posture developed. 3DCT scanning showed pathological transformation of the spinal enchondromas into generalized ossification and thickening of the posterior vertebral elements (vertebral laminae, supraspinal, and interspinal ligaments, respectively) causing effectively the development of a diffuse posterior spinal ankylosis. We report what might be a unique subtype of spondyloenchondrodysplasia (Spranger type IV).
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Affiliation(s)
- Ali Al Kaissi
- First Medical Department, Ludwig Boltzmann Institute of Osteology, Hanusch Hospital of WGKK and AUVA Trauma Center Meidling, Heinrich Collin Str. 30, 1140, Vienna, Austria.
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Superti-Furga A, Spranger J, Nishimura G. Enchondromatosis revisited: new classification with molecular basis. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2012; 160C:154-64. [PMID: 22791316 DOI: 10.1002/ajmg.c.31331] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The so-called "enchondromatoses" are skeletal disorders defined by the presence of ectopic cartilaginous tissue within bone tissue. The clinical and radiographic features of the different enchondromatoses are distinct, and grouping them does not reflect a common pathogenesis but simply a similar radiographic appearance and thus the need for a differential diagnosis. Recent advances in the understanding of their molecular and cellular bases confirm the heterogeneous nature of the different enchondromatoses. Some, like Ollier disease, Maffucci disease, metaphyseal chondromatosis with hydroxyglutaric aciduria, and metachondromatosis are produced by a dysregulation of chondrocyte proliferation, while others (such as spondyloenchondrodysplasia or dysspondyloenchondromatosis) are caused by defects in structure or metabolism of cartilage or bone matrix. In other forms (e.g., the dominantly inherited genochondromatoses), the basic defect remains to be determined. The classification, proposed by Spranger and associates in 1978 and tentatively revised twice, was based on the radiographic appearance, the anatomic sites involved, and the mode of inheritance. The new classification proposed here integrates the molecular genetic advances and delineates phenotypic families based on the molecular defects. Reference radiographs are provided to help in the diagnosis of the well-defined forms. In spite of advances, many cases remain difficult to diagnose and classify, implying that more variants remain to be defined at both the clinical and molecular levels.
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Affiliation(s)
- Andrea Superti-Furga
- Department of Pediatrics, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
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Navarro V, Scott C, Briggs T, Barete S, Frances C, Lebon P, Maisonobe T, Rice G, Wouters C, Crow Y. Two further cases of spondyloenchondrodysplasia (SPENCD) with immune dysregulation. Am J Med Genet A 2008; 146A:2810-5. [DOI: 10.1002/ajmg.a.32518] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Renella R, Schaefer E, LeMerrer M, Alanay Y, Kandemir N, Eich G, Costa T, Ballhausen D, Boltshauser E, Bonafé L, Giedion A, Unger S, Superti-Furga A. Spondyloenchondrodysplasia with spasticity, cerebral calcifications, and immune dysregulation: clinical and radiographic delineation of a pleiotropic disorder. Am J Med Genet A 2006; 140:541-50. [PMID: 16470600 DOI: 10.1002/ajmg.a.31081] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Enchondromas are a feature of several constitutional disorders of bone, and the classification of different nosologic entities is still provisional. Among these disorders, spondyloenchondrodysplasia (SPENCD), as outlined by Schorr et al. [1976], is defined by the presence of radiolucent spondylar and metaphyseal lesions that represent persistence of islands of chondroid tissue within bone. Careful review of radiographic findings is needed to distinguish SPENCD from the many other disorders combining enchondromas with spinal lesions. Even when strict criteria are applied, it appears that SPENCD is clinically heterogeneous, as some SPENCD patients are neurologically intact while others present with spasticity, mental retardation, and cerebral calcifications in different combinations, and it has been suggested that SPENCD should be divided in two types. We herein report ten individuals from six families with SPENCD and illustrate the radiographic changes. Seven individuals had CNS manifestations including spasticity, developmental delay, and late-onset cerebral calcifications. We also noted that six individuals had clinical manifestations of autoimmunity (auto-immune thrombocytopenic purpura, auto-immune hemolytic anemia, auto-immune thyroiditis, and SLE) and one had been diagnosed with immune deficiency. Neurological and autoimmune manifestations were seen in different combinations within one single family. These observations suggest that SPENCD may be a single entity defined by specific radiographic features, but with remarkably pleiotropic manifestations that include CNS disease (spasticity, mental retardation, and calcifications), as well as immune dysregulation ranging from autoimmunity to immunodeficiency. The notion of recessive inheritance hitherto assumed is challenged by the observation of two apparently dominant pedigrees.
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Affiliation(s)
- Raffaele Renella
- Division of Molecular Pediatrics, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
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