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Andrews A, Nair SB, Singh D. Prenatal sonographic phenotype of Raine syndrome: detection of novel FAM20C gene mutation at 20 weeks. ULTRASOUND IN OBSTETRICS & GYNECOLOGY : THE OFFICIAL JOURNAL OF THE INTERNATIONAL SOCIETY OF ULTRASOUND IN OBSTETRICS AND GYNECOLOGY 2023; 62:300-302. [PMID: 36905680 DOI: 10.1002/uog.26200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/01/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Affiliation(s)
- A Andrews
- Department of Fetal Medicine, Lifeline Super Speciality Hospital, Adoor, Kerala, India
| | - S B Nair
- Department of Medical Genetics, Lifeline Super Speciality Hospital, Adoor, Kerala, India
| | - D Singh
- Department of Radio-diagnosis, Prime Imaging and Prenatal Diagnostics, Sector 24 D, Chandigarh, India
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Palma-Lara I, García Alonso-Themann P, Pérez-Durán J, Godínez-Aguilar R, Bonilla-Delgado J, Gómez-Archila D, Espinosa-García AM, Nolasco-Quiroga M, Victoria-Acosta G, López-Ornelas A, Serrano-Bello JC, Olguín-García MG, Palacios-Reyes C. Potential Role of Protein Kinase FAM20C on the Brain in Raine Syndrome, an In Silico Analysis. Int J Mol Sci 2023; 24:ijms24108904. [PMID: 37240249 DOI: 10.3390/ijms24108904] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/04/2023] [Accepted: 05/05/2023] [Indexed: 05/28/2023] Open
Abstract
FAM20C (family with sequence similarity 20, member C) is a serine/threonine-specific protein kinase that is ubiquitously expressed and mainly associated with biomineralization and phosphatemia regulation. It is mostly known due to pathogenic variants causing its deficiency, which results in Raine syndrome (RNS), a sclerosing bone dysplasia with hypophosphatemia. The phenotype is recognized by the skeletal features, which are related to hypophosphorylation of different FAM20C bone-target proteins. However, FAM20C has many targets, including brain proteins and the cerebrospinal fluid phosphoproteome. Individuals with RNS can have developmental delay, intellectual disability, seizures, and structural brain defects, but little is known about FAM20C brain-target-protein dysregulation or about a potential pathogenesis associated with neurologic features. In order to identify the potential FAM20C actions on the brain, an in silico analysis was conducted. Structural and functional defects reported in RNS were described; FAM20C targets and interactors were identified, including their brain expression. Gene ontology of molecular processes, function, and components was completed for these targets, as well as for potential involved signaling pathways and diseases. The BioGRID and Human Protein Atlas databases, the Gorilla tool, and the PANTHER and DisGeNET databases were used. Results show that genes with high expression in the brain are involved in cholesterol and lipoprotein processes, plus axo-dendritic transport and the neuron part. These results could highlight some proteins involved in the neurologic pathogenesis of RNS.
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Affiliation(s)
- Icela Palma-Lara
- Laboratorio de Morfología Celular y Molecular, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México 11340, Mexico
| | | | - Javier Pérez-Durán
- Instituto Nacional de Perinatología Isidro Espinosa de los Reyes, Ciudad de México 11000, Mexico
| | | | - José Bonilla-Delgado
- Unidad de Investigación, Hospital Regional de Ixtapaluca, Ixtapaluca 56530, Mexico
- Departamento de Biotecnología, Escuela de Ingeniería y Ciencias, Instituto Tecnológico de Monterrey, Toluca de Lerdo 50110, Mexico
| | - Damián Gómez-Archila
- Departamento de Oncología Quirúrgica, Hospital de Gineco-Obstetricia 3, Centro Médico Nacional "La Raza", Ciudad de México 02990, Mexico
| | | | - Manuel Nolasco-Quiroga
- Coordinación de Enseñanza e Investigación, Clínica Hospital Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Huauchinango 73177, Mexico
| | | | - Adolfo López-Ornelas
- División de Investigación, Hospital Juárez de México, Ciudad de México 11340, Mexico
| | - Juan Carlos Serrano-Bello
- Departamento de Patología Clínica y Experimental, Hospital Infantil de México Federico Gómez, Ciudad de México 06720, Mexico
| | | | - Carmen Palacios-Reyes
- División de Investigación, Hospital Juárez de México, Ciudad de México 11340, Mexico
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Rameh G, Megarbane A, Jalbout L, Snaifer E, Saliba S, Nassar A, Chalouhi G. Raine Syndrome: Report of a novel mutation and review of the different antenatal imaging modalities used to diagnose this disease. Prenat Diagn 2022; 42:589-600. [DOI: 10.1002/pd.6138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 03/21/2022] [Accepted: 03/27/2022] [Indexed: 11/09/2022]
Affiliation(s)
- Georges Rameh
- Department of Obstetrics and Gynecology American University of Beirut Medical Center Beirut Lebanon
| | - Andre Megarbane
- Department of Human Genetics Lebanese American University Medical Center Beirut Lebanon
| | - Liliane Jalbout
- Department of Obstetrics and Gynecology Mount Lebanon Hospital Beirut Lebanon
| | - Elie Snaifer
- Department of Obstetrics and Gynecology Saint Georges Hospital Beirut Lebanon
| | - Souha Saliba
- Department of Radiology Hotel Dieu de France Beirut Lebanon
| | - Anwar Nassar
- Department of Obstetrics and Gynecology American University of Beirut Medical Center Beirut Lebanon
| | - Gihad Chalouhi
- Department of Obstetrics and Gynecology American University of Beirut Medical Center Beirut Lebanon
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4
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FAM20C Overview: Classic and Novel Targets, Pathogenic Variants and Raine Syndrome Phenotypes. Int J Mol Sci 2021; 22:ijms22158039. [PMID: 34360805 PMCID: PMC8348777 DOI: 10.3390/ijms22158039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 12/24/2022] Open
Abstract
FAM20C is a gene coding for a protein kinase that targets S-X-E/pS motifs on different phosphoproteins belonging to diverse tissues. Pathogenic variants of FAM20C are responsible for Raine syndrome (RS), initially described as a lethal and congenital osteosclerotic dysplasia characterized by generalized atherosclerosis with periosteal bone formation, characteristic facial dysmorphisms and intracerebral calcifications. The aim of this review is to give an overview of targets and variants of FAM20C as well as RS aspects. We performed a wide phenotypic review focusing on clinical aspects and differences between all lethal (LRS) and non-lethal (NLRS) reported cases, besides the FAM20C pathogenic variant description for each. As new targets of FAM20C kinase have been identified, we reviewed FAM20C targets and their functions in bone and other tissues, with emphasis on novel targets not previously considered. We found the classic lethal and milder non-lethal phenotypes. The milder phenotype is defined by a large spectrum ranging from osteonecrosis to osteosclerosis with additional congenital defects or intellectual disability in some cases. We discuss our current understanding of FAM20C deficiency, its mechanism in RS through classic FAM20C targets in bone tissue and its potential biological relevance through novel targets in non-bone tissues.
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Non-lethal Raine Syndrome Report Lacking Characteristic Clinical Features. J Mol Neurosci 2021; 71:2482-2486. [PMID: 34259997 DOI: 10.1007/s12031-021-01873-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/11/2021] [Indexed: 10/20/2022]
Abstract
Raine syndrome is a rare, often lethal autosomal recessive condition marked by congenital malformations that range in severity. Considering that several case reports of this syndrome describe cases of stillbirth or perinatal death, information about the clinical presentation and development of this condition in mild, non-lethal cases is lacking. With that in mind, in this case report, we describe the clinical, oro-dental, and skeletal findings of a 14-year-old Brazilian patient diagnosed with a mild form of non-lethal Raine syndrome. This patient has very mild facial dysmorphia, not displaying hypoplastic nose, micrognathia, low set ears or depressed nasal bridge, which is uncommon even in other mild, non-lethal cases of RS. Furthermore, this patient has bilateral brain calcifications and a series of oro-dental abnormalities, such as amelogenesis imperfecta and recurrent periodontal abcesses. Sanger sequencing of genomic DNA identified a homozygous missense variant c.1487C > T at exon 9 of FAM20C (NM_020223.4) in the patient. The patient's mother carries the same variant but is heterozygous. This variant predicts a proline to leucine substitution in position 496 (p.P496L, NP_064608.2) previously reported, which allows for the phenotypic comparison between these cases. This way, this case report calls attention to how differently RS can appear, highlighting the importance of new non-lethal Raine syndrome case reports to help further determine the phenotypic spectrum of this condition.
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The ABCs of the atypical Fam20 secretory pathway kinases. J Biol Chem 2021; 296:100267. [PMID: 33759783 PMCID: PMC7948968 DOI: 10.1016/j.jbc.2021.100267] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 01/05/2021] [Accepted: 01/06/2021] [Indexed: 12/12/2022] Open
Abstract
The study of extracellular phosphorylation was initiated in late 19th century when the secreted milk protein, casein, and egg-yolk protein, phosvitin, were shown to be phosphorylated. However, it took more than a century to identify Fam20C, which phosphorylates both casein and phosvitin under physiological conditions. This kinase, along with its family members Fam20A and Fam20B, defined a new family with altered amino acid sequences highly atypical from the canonical 540 kinases comprising the kinome. Fam20B is a glycan kinase that phosphorylates xylose residues and triggers peptidoglycan biosynthesis, a role conserved from sponges to human. The protein kinase, Fam20C, conserved from nematodes to humans, phosphorylates well over 100 substrates in the secretory pathway with overall functions postulated to encompass endoplasmic reticulum homeostasis, nutrition, cardiac function, coagulation, and biomineralization. The preferred phosphorylation motif of Fam20C is SxE/pS, and structural studies revealed that related member Fam20A allosterically activates Fam20C by forming a heterodimeric/tetrameric complex. Fam20A, a pseudokinase, is observed only in vertebrates. Loss-of-function genetic alterations in the Fam20 family lead to human diseases such as amelogenesis imperfecta, nephrocalcinosis, lethal and nonlethal forms of Raine syndrome with major skeletal defects, and altered phosphate homeostasis. Together, these three members of the Fam20 family modulate a diverse network of secretory pathway components playing crucial roles in health and disease. The overarching theme of this review is to highlight the progress that has been made in the emerging field of extracellular phosphorylation and the key roles secretory pathway kinases play in an ever-expanding number of cellular processes.
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El-Dessouky SH, Abdel-Hamid MS, Abdel-Ghafar SF, Aboulghar MM, Gaafar HM, Fouad M, Ahmed AH, Abdel-Salam GMH. Raine syndrome: Prenatal diagnosis based on recognizable fetal facial features and characteristic intracranial calcification. Prenat Diagn 2020; 40:1578-1597. [PMID: 32833257 DOI: 10.1002/pd.5818] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 08/20/2020] [Accepted: 08/20/2020] [Indexed: 01/21/2023]
Abstract
OBJECTIVE The purpose of this study was to elucidate the facial morphology and the pattern of internal malformations in three fetuses with RS born to first cousins of Egyptian decent. METHODS The fetal ultrasonography findings were highly suggestive of RS leading to targeted Sanger sequencing of FAM20C and postnatal assessment. RESULTS The prenatal ultrasound findings of osteosclerotic skull, exorbitism, hypoplastic nose, midface hypoplasia, small mouth with down-curved corners, and a distinct and recognizable pattern of intracranial calcification were identified in three fetuses with RS. The calcifications were evident specifically around the corpus callosum and/or ventricular walls. Ectopic renal and hepatic calcifications, pulmonary hypoplasia, mild rhizomelic shortening of the upper limbs, intrauterine fractures, and cerebellar hypoplasia were also noted. Molecular analysis identified three novel homozygous variants, two frameshift: [c.456delC (p.Gly153Alafs*34)] in exon 1 and [c.905delT (Phe302Serfs*35)] in exon 4 and one nonsense mutation in exon 10, [c.1557C>G(p.Tyrs519*)]. The three variants were segregated with the phenotype. This is the first description of a phenotype associated with homozygous truncating variants of FAM20C. CONCLUSION RS has characteristic prenatal ultrasound findings which can improve the prenatal identification of this condition and help in guiding the molecular diagnosis and counseling.
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Affiliation(s)
- Sara H El-Dessouky
- Department of Prenatal Diagnosis & Fetal Medicine, Division of Human Genetics and Genome Research, National Research Centre, Cairo, Egypt
| | - Mohamed S Abdel-Hamid
- Department of Medical & Molecular Genetics, Division of Human Genetics and Genome Research, National Research Centre, Cairo, Egypt
| | - Sherif F Abdel-Ghafar
- Department of Medical & Molecular Genetics, Division of Human Genetics and Genome Research, National Research Centre, Cairo, Egypt
| | | | | | - Mona Fouad
- Fetal Medicine Unit, Cairo University, Cairo, Egypt
| | - Adel H Ahmed
- Fetal Medicine Unit, Cairo University, Cairo, Egypt
| | - Ghada M H Abdel-Salam
- Department of Clinical Genetics, Division of Human Genetics and Genome Research, National Research Centre, Cairo, Egypt
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Hirose K, Ishimoto T, Usami Y, Sato S, Oya K, Nakano T, Komori T, Toyosawa S. Overexpression of Fam20C in osteoblast in vivo leads to increased cortical bone formation and osteoclastic bone resorption. Bone 2020; 138:115414. [PMID: 32416287 DOI: 10.1016/j.bone.2020.115414] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/10/2020] [Accepted: 05/11/2020] [Indexed: 01/03/2023]
Abstract
Fam20C, which phosphorylates many secretory proteins with S-x-E/pS motifs, is highly expressed in bone and tooth tissues, implying that Fam20C-mediated phosphorylation is critical for regulation of these mineralized tissues. Previous studies of Fam20C-deficient mice revealed that Fam20C plays important roles in bone formation and mineralization. However, Fam20C-deficient mice develop hypophosphatemia, a systemic factor that masks the local effect of Fam20C in the bone tissue; consequently, the local role of Fam20C remains unknown. To elucidate the local function of Fam20C in bone tissue, we studied osteoblast-specific Fam20C transgenic (Fam20C-Tg) mice, which have no alteration in serum calcium and phosphate levels. Fam20C-Tg mice had more highly phosphorylated proteins in bone tissue than wild-type mice. In cortical bone of Fam20C-Tg mice, bone volume, mineralization surface (MS/BS), and mineral apposition rate (MAR) were elevated; in addition, the transgenic mice had an elevated number of vascular canals, resulting in an increased cortical porosity. Osteocyte number was elevated in the transgenics, but osteoblast number was unchanged. The microstructure of bone matrix characterized by the preferential orientation of collagen and apatite, was degraded and thus the mechanical function of bone material was deteriorated. In trabecular bone of Fam20C-Tg mice, bone volume was reduced, whereas MS/BS and MAR were unchanged. Osteoclast number was elevated and eroded surface area was non-significantly elevated with an increased serum CTX-I level, whereas osteoblast number was unchanged. These findings indicated that Fam20C overexpression in osteoblasts promotes cortical bone formation by increasing MS/BS and MAR and promoting osteocyte differentiation, but does not affect trabecular bone formation. Furthermore, Fam20C overexpression indirectly promotes osteoclastic bone resorption in cortical and trabecular bones. Our findings show that osteoblastic Fam20C-mediated phosphorylation in bone tissue regulates bone formation and resorption, and bone material quality.
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Affiliation(s)
- Katsutoshi Hirose
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Takuya Ishimoto
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yu Usami
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Sunao Sato
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Kaori Oya
- Clinical Laboratory, Osaka University Dental Hospital, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Toshihisa Komori
- Basic and Translational Research Center for Hard Tissue Disease, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan.
| | - Satoru Toyosawa
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Eltan M, Alavanda C, Yavas Abali Z, Ergenekon P, Yalındag Ozturk N, Sakar M, Dagcinar A, Kirkgoz T, Kaygusuz SB, Gokdemir Y, Elcioglu HN, Guran T, Bereket A, Ata P, Turan S. A Rare Cause of Hypophosphatemia: Raine Syndrome Changing Clinical Features with Age. Calcif Tissue Int 2020; 107:96-103. [PMID: 32337609 PMCID: PMC7222149 DOI: 10.1007/s00223-020-00694-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 04/11/2020] [Indexed: 11/29/2022]
Abstract
Raine Syndrome (RS) is caused by biallelic loss-of-function mutations in FAM20C gene and characterized by hypophosphatemia, typical facial and skeletal features. Subperiosteal bone formation and generalized osteosclerosis are the most common radiological findings. Here we present a new case with RS. A 9-month-old male patient on a home-type ventilator was referred for hypophosphatemia. He was born with a weight of 3800 g to non-consanguineous parents. Prenatal ultrasound had demonstrated nasal bone agenesis. A large anterior fontanel, frontal bossing, exophthalmos, hypoplastic nose, high arched palate, low set ears, triangular mouth, and corneal opacification were detected on physical examination. Serial skeletal X-rays revealed diffuse osteosclerosis at birth which was gradually decreased by the age of 5 months with subperiosteal undermineralized bone formation and medullary space of long bone could be distinguishable with bone-within-a-bone appearance. At 9 months of age, hand X-ray revealed cupping of the ulna with loose radial bone margin with minimal fraying and osteopenia. Cranial computed tomography scan showed bilateral periventricular calcification and hydrocephalus in progress. The clinical, laboratory, and radiological examinations were consistent with RS. Molecular analyses revealed a compound heterozygous mutation in FAM20C gene (a known pathogenic mutation, c.1645C > T, p.Arg549Trp; and a novel c.863 + 5 G > C variant). The patient died due to respiratory failure at 17 months of age. This case allowed us to demonstrate natural progression of skeletal features in RS. Furthermore, we have described a novel FAM20C variant causing RS. Previous literature on RS is also reviewed.
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Affiliation(s)
- Mehmet Eltan
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Ceren Alavanda
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Zehra Yavas Abali
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Ergenekon
- Department of Pediatric Chest Disease, Marmara University School of Medicine, Istanbul, Turkey
| | - Nilufer Yalındag Ozturk
- Department of Pediatric Intensive Care Unit, Marmara University School of Medicine, Istanbul, Turkey
| | - Mustafa Sakar
- Department of Pediatric Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Adnan Dagcinar
- Department of Pediatric Neurosurgery, Marmara University School of Medicine, Istanbul, Turkey
| | - Tarik Kirkgoz
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Sare Betul Kaygusuz
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Yasemin Gokdemir
- Department of Pediatric Chest Disease, Marmara University School of Medicine, Istanbul, Turkey
| | - Huriye Nursel Elcioglu
- Department of Pediatric Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Tulay Guran
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Abdullah Bereket
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey
| | - Pinar Ata
- Department of Medical Genetics, Marmara University School of Medicine, Istanbul, Turkey
| | - Serap Turan
- Department of Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey.
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Mameli C, Zichichi G, Mahmood N, Elalaoui SC, Mirza A, Dharmaraj P, Burrone M, Cattaneo E, Sheth J, Gandhi A, Kochar GS, Alkuraya FS, Kabra M, Mercurio G, Zuccotti G. Natural history of non-lethal Raine syndrome during childhood. Orphanet J Rare Dis 2020; 15:93. [PMID: 32299476 PMCID: PMC7164176 DOI: 10.1186/s13023-020-01373-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 03/31/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Raine syndrome (RS) is a rare autosomal recessive disorder caused by biallelic loss-of-function mutations of FAM20C. The most common clinical features are microcephaly, exophthalmos, hypoplastic nose and severe midface hypoplasia, leading to choanal atresia. The radiological findings include generalized osteosclerosis and brain calcifications. RS is usually lethal during the neonatal period due to severe respiratory distress. However, there exists a non-lethal RS form, the phenotype of which is extremely heterogeneous. There is paucity of data about clinical course and life expectancy of these patients. RESULTS This is the first description of follow-up features of non-lethal RS patients. Moreover, we present three unpublished cases. There are five Asian and two Arab patients. All were born to consanguineous parents. The most common neonatal comorbidity was respiratory distress secondary to choanal atresia. A variable degree of neurodevelopmental delay was seen in the majority of our cases and seizures and hearing or vision involvement were also frequent. Neurological and orthopedic issues were the most frequent complications seen at follow-up in our group. Persistent hypophosphatemic rickets was the most striking endocrinological manifestation, which was scarcely responsive to therapy with phosphate salts and alfacalcidol. Life expectancy of our patients goes beyond childhood, with the oldest of those described being 18 years old at present. CONCLUSIONS Manifestations of RS in those surviving the neonatal period are being increasingly recognized. Our study supports previous findings and provides clinical and biochemical observations and data from longer follow up. Finally, we propose multidisciplinary follow up for patients with non-lethal RS.
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Affiliation(s)
- Chiara Mameli
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Department of Biomedical and Clinical Science L. Sacco, Università degli Studi di Milano, Milan, Italy.
| | - Giulia Zichichi
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy
| | - Nasim Mahmood
- Department of General Paediatrics, Alder Hey Children's Hospital, Liverpool, UK
| | - Siham Chafai Elalaoui
- Centre de Recherche en Génomique des Pathologies Humaines (GENOPATH), Faculté de Médecine et de Pharmacie, Mohammed V University of Rabat, 10100, Rabat, Morocco
| | - Adnan Mirza
- Faculty of Paediatrics, Aga Khan University Hospital, Karachi, Pakistan
| | - Poonam Dharmaraj
- Department of Paediatric Endocrinology, Alder Hey Children's Hospital, Liverpool, UK
| | - Marco Burrone
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy
| | - Elisa Cattaneo
- Clinical Genetics Service, V. Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy
| | - Jayesh Sheth
- FRIGE-Institute of Human Genetics, Dept of Biochemical and Molecular Genetics, Ahmadabad, Gujarat, and Unique Hospital, Solapur, India
| | - Ajit Gandhi
- FRIGE-Institute of Human Genetics, Dept of Biochemical and Molecular Genetics, Ahmadabad, Gujarat, and Unique Hospital, Solapur, India
| | | | - Fowzan Sami Alkuraya
- Department of Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Madhulika Kabra
- Division of Genetics, Department of Paediatrics, AIIMS, New Delhi, India
| | - Giuseppe Mercurio
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Università degli Studi di Milano, Milan, Italy
| | - Gianvincenzo Zuccotti
- Department of Pediatrics, Vittore Buzzi Children's Hospital, Department of Biomedical and Clinical Science L. Sacco, Università degli Studi di Milano, Milan, Italy
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Hernández-Zavala A, Cortés-Camacho F, Palma-Lara I, Godínez-Aguilar R, Espinosa AM, Pérez-Durán J, Villanueva-Ocampo P, Ugarte-Briones C, Serrano-Bello CA, Sánchez-Santiago PJ, Bonilla-Delgado J, Yáñez-López MA, Victoria-Acosta G, López-Ornelas A, García Alonso-Themann P, Moreno J, Palacios-Reyes C. Two Novel FAM20C Variants in A Family with Raine Syndrome. Genes (Basel) 2020; 11:genes11020222. [PMID: 32093234 PMCID: PMC7073523 DOI: 10.3390/genes11020222] [Citation(s) in RCA: 9] [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: 11/29/2019] [Revised: 01/30/2020] [Accepted: 02/14/2020] [Indexed: 12/14/2022] Open
Abstract
Two siblings from a Mexican family who carried lethal Raine syndrome are presented. A newborn term male (case 1) and his 21 gestational week brother (case 2), with a similar osteosclerotic pattern: generalized osteosclerosis, which is more evident in facial bones and cranial base. Prenatal findings at 21 weeks and histopathological features for case 2 are described. A novel combination of biallelic FAM20C pathogenic variants were detected, a maternal cytosine duplication at position 456 and a paternal deletion of a cytosine in position 474 in exon 1, which change the reading frame with a premature termination at codon 207 and 185 respectively. These changes are in concordance with a negative detection of the protein in liver and kidney as shown in case 2. Necropsy showed absence of pancreatic Langerhans Islets, which are reported here for the first time. Corpus callosum absence is added to the few reported cases of brain defects in Raine syndrome. This report shows two new FAM20C variants not described previously, and negative protein detection in the liver and the kidney. We highlight that lethal Raine syndrome is well defined as early as 21 weeks, including mineralization defects and craniofacial features. Pancreas and brain defects found here in FAM20C deficiency extend the functional spectrum of this protein to previously unknown organs.
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Affiliation(s)
- Araceli Hernández-Zavala
- Laboratory of Cellular and Molecular Morphology, Section of Postgraduate Studies and Research, Escuela Superior de Medicina, Instituto Politécnico Nacional, Salvador Díaz Mirón esq. Plan de San Luis S/N, Miguel Hidalgo, Casco de Santo Tomas, Mexico City 11340, Mexico; (A.H.-Z.); (F.C.-C.); (I.P.-L.)
| | - Fernando Cortés-Camacho
- Laboratory of Cellular and Molecular Morphology, Section of Postgraduate Studies and Research, Escuela Superior de Medicina, Instituto Politécnico Nacional, Salvador Díaz Mirón esq. Plan de San Luis S/N, Miguel Hidalgo, Casco de Santo Tomas, Mexico City 11340, Mexico; (A.H.-Z.); (F.C.-C.); (I.P.-L.)
- Direction and Division of Research, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (R.G.-A.); (J.B.-D.); (G.V.-A.); (A.L.-O.); (J.M.)
| | - Icela Palma-Lara
- Laboratory of Cellular and Molecular Morphology, Section of Postgraduate Studies and Research, Escuela Superior de Medicina, Instituto Politécnico Nacional, Salvador Díaz Mirón esq. Plan de San Luis S/N, Miguel Hidalgo, Casco de Santo Tomas, Mexico City 11340, Mexico; (A.H.-Z.); (F.C.-C.); (I.P.-L.)
| | - Ricardo Godínez-Aguilar
- Direction and Division of Research, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (R.G.-A.); (J.B.-D.); (G.V.-A.); (A.L.-O.); (J.M.)
| | - Ana María Espinosa
- Service of Clinical Pharmacology, Hospital General de México, Dr. Balmis 148, Doctores, Cuauhtémoc, Mexico City 06720, Mexico;
| | - Javier Pérez-Durán
- National Institute of Perinatology, Calle Montes Urales 800, Lomas - Virreyes, Lomas de Chapultepec IV Section, Miguel Hidalgo, Mexico City 11000, Mexico; (J.P.-D.); (P.G.A.-T.)
| | - Patricia Villanueva-Ocampo
- Deparment of Ginecology, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico;
| | - Carlos Ugarte-Briones
- Department of Pathology, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (C.U.-B.); (C.A.S.-B.); (P.J.S.-S.)
| | - Carlos Alberto Serrano-Bello
- Department of Pathology, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (C.U.-B.); (C.A.S.-B.); (P.J.S.-S.)
| | - Paula Jesús Sánchez-Santiago
- Department of Pathology, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (C.U.-B.); (C.A.S.-B.); (P.J.S.-S.)
| | - José Bonilla-Delgado
- Direction and Division of Research, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (R.G.-A.); (J.B.-D.); (G.V.-A.); (A.L.-O.); (J.M.)
| | - Marco Antonio Yáñez-López
- Department of Radiology & Imagenology, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico;
| | - Georgina Victoria-Acosta
- Direction and Division of Research, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (R.G.-A.); (J.B.-D.); (G.V.-A.); (A.L.-O.); (J.M.)
| | - Adolfo López-Ornelas
- Direction and Division of Research, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (R.G.-A.); (J.B.-D.); (G.V.-A.); (A.L.-O.); (J.M.)
| | - Patricia García Alonso-Themann
- National Institute of Perinatology, Calle Montes Urales 800, Lomas - Virreyes, Lomas de Chapultepec IV Section, Miguel Hidalgo, Mexico City 11000, Mexico; (J.P.-D.); (P.G.A.-T.)
| | - José Moreno
- Direction and Division of Research, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (R.G.-A.); (J.B.-D.); (G.V.-A.); (A.L.-O.); (J.M.)
| | - Carmen Palacios-Reyes
- Direction and Division of Research, Hospital Juárez de México, Av. Instituto Politécnico Nacional 5160, Magdalena de las Salinas, Gustavo A. Madero, Mexico City 07760, Mexico; (R.G.-A.); (J.B.-D.); (G.V.-A.); (A.L.-O.); (J.M.)
- Correspondence:
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Mamedova E, Dimitrova D, Przhiyalkovskaya E, Buryakina S, Vasilyev E, Tiulpakov A, Belaya Z. Non-lethal Raine Syndrome in a Middle-Aged Woman Caused by a Novel FAM20C Mutation. Calcif Tissue Int 2019; 105:567-572. [PMID: 31471673 DOI: 10.1007/s00223-019-00599-w] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 08/16/2019] [Indexed: 12/21/2022]
Abstract
Raine syndrome is a rare hereditary disease caused by mutations in the FAM20C gene. Only 18 non-lethal cases have been reported, the majority of them being children and young adults aged up to 30. Due to the rarity of the disease, genotype-phenotype correlations are not available and patient life expectancy is unknown, thus making descriptions of each novel case of particular importance. In this article, we describe a case of an Armenian woman, living in Russia, who was followed-up from age 36 to 39, presenting with pain in the extremities, osteosclerosis with periosteal bone formation, multiple calcifications in solid organs, midface hypoplasia, exophthalmos, amelogenesis imperfecta, shortening of distal phalanges, pectus excavatum, and hypophosphatemia due to renal phosphate wasting. Whole exome sequencing was performed on NextSeq 550 (Illumina, USA) and compound heterozygous variants were identified in the FAM20C gene (reference sequence NM_020223): a frameshift insertion c.1107_1108insTACTG (p.Tyr369fs) and a missense substitution c.1375C > G (p.Arg459Gly). This is the first reported case of a middle-aged patient presenting classical symptoms of Raine syndrome caused by novel compound heterozygous mutations in the conserved C-terminal domain of FAM20C gene.
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Affiliation(s)
- Elizaveta Mamedova
- Department of Neuroendocrinology and Bone Diseases, Endocrinology Research Centre, Ulitsa Dmitriya Ulianova, 11, Moscow, 117036, Russian Federation.
| | - Diana Dimitrova
- Department of Neuroendocrinology and Bone Diseases, Endocrinology Research Centre, Ulitsa Dmitriya Ulianova, 11, Moscow, 117036, Russian Federation
| | - Elena Przhiyalkovskaya
- Department of Neuroendocrinology and Bone Diseases, Endocrinology Research Centre, Ulitsa Dmitriya Ulianova, 11, Moscow, 117036, Russian Federation
| | - Svetlana Buryakina
- Department of Radiology, Endocrinology Research Centre, Ulitsa Dmitriya Ulianova, 11, Moscow, 117036, Russian Federation
| | - Evgeny Vasilyev
- Department and Laboratory of Inherited Endocrine Disorders, Endocrinology Research Centre, Ulitsa Dmitriya Ulianova, 11, Moscow, 117036, Russian Federation
| | - Anatoly Tiulpakov
- Department and Laboratory of Inherited Endocrine Disorders, Endocrinology Research Centre, Ulitsa Dmitriya Ulianova, 11, Moscow, 117036, Russian Federation
| | - Zhanna Belaya
- Department of Neuroendocrinology and Bone Diseases, Endocrinology Research Centre, Ulitsa Dmitriya Ulianova, 11, Moscow, 117036, Russian Federation
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Hung CY, Rodriguez M, Roberts A, Bauer M, Mihalek I, Bodamer O. A novel FAM20C mutation causes a rare form of neonatal lethal Raine syndrome. Am J Med Genet A 2019; 179:1866-1871. [PMID: 31297960 DOI: 10.1002/ajmg.a.61291] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Revised: 05/08/2019] [Accepted: 06/23/2019] [Indexed: 02/06/2023]
Abstract
Raine syndrome is a rare, autosomal recessive, osteosclerotic bone dysplasia due to pathogenic variants in FAM20C. The clinical phenotype is characterized by generalized osteosclerosis affecting all bones, cerebral calcifications, and craniofacial dysmorphism. Most cases present during the neonatal period with early lethality due to pulmonary hypoplasia and respiratory compromise while only few affected individuals have been reported to survive into adulthood. FAM20C is a ubiquitously expressed protein kinase that contains five functional domains including a catalytic domain, a binding pocket for FAM20A and three distinct N-glycosylation sites. We report a newborn infant with a history of prenatal onset fractures, generalized osteosclerosis, and craniofacial dysmorphism and early lethality. The clinical presentation was highly suggestive of Raine syndrome. A homozygous, novel missense variant in exon 5 of FAM20C (c.1007T>G; p.Met336Arg) was identified by targeted Sanger sequencing. Following in silico analysis and mapping of the variant on a three-dimensional (3D) model of FAM20C it is predicted to be deleterious and to affect N-glycosylation, protein folding, and subsequent secretion of FAM20C. In addition, we reviewed all published FAM20C mutations and observed that most pathogenic variants affect functional regions within the protein establishing evidence for an emerging genotype-phenotype correlation.
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Affiliation(s)
- Christina Y Hung
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts
| | - Mario Rodriguez
- Hussmann Institute of Genomics, University of Miami, Miami, Florida
| | - Abra Roberts
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts
| | - Mislen Bauer
- Division of Clinical Genetics and Metabolism, Nicklas Children's Hospital, Miami, Florida
| | - Ivana Mihalek
- Department of Molecular Medicine and Biotechnology, University of Rijeka, Rijeka, Croatia
| | - Olaf Bodamer
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, Massachusetts
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