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Rezaie N, Mansour Samaei N, Ghorbani A, Gholipour N, Vosough S, Rafigh M, Amini A. A novel start-loss mutation of the SLC29A3 gene in a consanguineous family with H syndrome: clinical characteristics, in silico analysis and literature review. BMC Med Genomics 2024; 17:178. [PMID: 38965556 PMCID: PMC11225203 DOI: 10.1186/s12920-024-01949-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024] Open
Abstract
BACKGROUND The SLC29A3 gene, which encodes a nucleoside transporter protein, is primarily located in intracellular membranes. The mutations in this gene can give rise to various clinical manifestations, including H syndrome, dysosteosclerosis, Faisalabad histiocytosis, and pigmented hypertrichosis with insulin-dependent diabetes. The aim of this study is to present two Iranian patients with H syndrome and to describe a novel start-loss mutation in SLC29A3 gene. METHODS In this study, we employed whole-exome sequencing (WES) as a method to identify genetic variations that contribute to the development of H syndrome in a 16-year-old girl and her 8-year-old brother. These siblings were part of an Iranian family with consanguineous parents. To confirmed the pathogenicity of the identified variant, we utilized in-silico tools and cross-referenced various databases to confirm its novelty. Additionally, we conducted a co-segregation study and verified the presence of the variant in the parents of the affected patients through Sanger sequencing. RESULTS In our study, we identified a novel start-loss mutation (c.2T > A, p.Met1Lys) in the SLC29A3 gene, which was found in both of two patients. Co-segregation analysis using Sanger sequencing confirmed that this variant was inherited from the parents. To evaluate the potential pathogenicity and novelty of this mutation, we consulted various databases. Additionally, we employed bioinformatics tools to predict the three-dimensional structure of the mutant SLC29A3 protein. These analyses were conducted with the aim of providing valuable insights into the functional implications of the identified mutation on the structure and function of the SLC29A3 protein. CONCLUSION Our study contributes to the expanding body of evidence supporting the association between mutations in the SLC29A3 gene and H syndrome. The molecular analysis of diseases related to SLC29A3 is crucial in understanding the range of variability and raising awareness of H syndrome, with the ultimate goal of facilitating early diagnosis and appropriate treatment. The discovery of this novel biallelic variant in the probands further underscores the significance of utilizing genetic testing approaches, such as WES, as dependable diagnostic tools for individuals with this particular condition.
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Affiliation(s)
- Nahid Rezaie
- Department of Medical Genetics, School of Advanced Technologies in Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Nader Mansour Samaei
- Department of Medical Genetics, School of Advanced Technologies in Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
- Gorgan Congenital Malformations Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
- Department of Cytogenetics, Genome Genetics Laboratory, Gorgan, Golestan, Iran.
| | - Ayda Ghorbani
- Department of Molecular Genetics, Faculty of Biological Science, Tarbiat Modares University, Tehran, Iran
| | - Naghmeh Gholipour
- Department of Cytogenetics, Genome Genetics Laboratory, Gorgan, Golestan, Iran
| | - Shohreh Vosough
- Department of Obstetrics and Gynecology, School of Medicine, Sayyad Shirazi Hospital, Golestan University of Medical Sciences, Gorgan, Iran
| | - Mahboobeh Rafigh
- Medical Genetics Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Abolfazl Amini
- Laboratory Sciences Research Center, Golestan University of Medical Sciences, Gorgan, Iran.
- Department of Medical Biotechnology, Faculty of Advanced Technologies in Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
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Funck-Brentano T, Zillikens MC, Clunie G, Siggelkow H, Appelman-Dijkstra NM, Cohen-Solal M. Osteopetrosis and related osteoclast disorders in adults: A review and knowledge gaps On behalf of the European calcified tissue society and ERN BOND. Eur J Med Genet 2024; 69:104936. [PMID: 38593953 DOI: 10.1016/j.ejmg.2024.104936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 12/13/2023] [Accepted: 04/01/2024] [Indexed: 04/11/2024]
Abstract
Osteopetrosis refers to a group of related rare bone diseases characterized by a high bone mass due to impaired bone resorption by osteoclasts. Despite the high bone mass, skeletal strength is compromised and the risk of fracture is high, particularly in the long bones. Osteopetrosis was classically categorized by inheritance pattern into autosomal recessive forms (ARO), which are severe and diagnosed within the first years of life, an intermediate form and an autosomal dominant (ADO) form; the latter with variable clinical severity and typically diagnosed during adolescence or in young adulthood. Subsequently, the AD form was shown to be a result of mutations in the gene CLCN7 encoding for the ClC-7 chloride channel). Traditionally, the diagnosis of osteopetrosis was made on radiograph appearance alone, but recent molecular and genetic advances have enabled a greater fidelity in classification of osteopetrosis subtypes. In the more severe ARO forms (e.g., malignant infantile osteopetrosis MIOP) typical clinical features have severe consequences and often result in death in early childhood. Major complications of ADO are atypical fractures with delay or failure of repair and challenge in orthopedic management. Bone marrow failure, dental abscess, deafness and visual loss are often underestimated and neglected in relation with lack of awareness and expertise. Accordingly, the care of adult patients with osteopetrosis requires a multidisciplinary approach ideally in specialized centers. Apart from hematopoietic stem cell transplantation in certain infantile forms, the treatment of patients with osteopetrosis, has not been standardized and remains supportive. Further clinical studies are needed to improve our knowledge of the natural history, optimum management and impact of osteopetrosis on the lives of patients living with the disorder.
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Affiliation(s)
- Thomas Funck-Brentano
- Reference Center for Rare Bone Diseases and Department of Rheumatology, Hôpital Lariboisière, APHP, Université Paris Cité, Paris, France; INSERM UMR1132 BIOSCAR, Paris, France.
| | - M Carola Zillikens
- Bone Center, Department of Internal Medicine. Erasmus MC, University Medical Center Rotterdam, the Netherlands
| | - Gavin Clunie
- Metabolic Bone Physician, Cambridge University Hospitals, Box 204, Hills Rd, Cambridge, CB2 0QQ, UK
| | - Heide Siggelkow
- MVZ Endokrinologikum, Göttingen, Germany; Clinic of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center, 37075, Göttingen, Germany
| | - Natasha M Appelman-Dijkstra
- Center for Bone Quality, Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
| | - Martine Cohen-Solal
- Reference Center for Rare Bone Diseases and Department of Rheumatology, Hôpital Lariboisière, APHP, Université Paris Cité, Paris, France; INSERM UMR1132 BIOSCAR, Paris, France.
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Tüysüz B, Usluer E, Uludağ Alkaya D, Ocak S, Saygılı S, Şeker A, Apak H. The molecular spectrum of Turkish osteopetrosis and related osteoclast disorders with natural history, including a candidate gene, CCDC120. Bone 2023; 177:116897. [PMID: 37704070 DOI: 10.1016/j.bone.2023.116897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 08/21/2023] [Accepted: 09/08/2023] [Indexed: 09/15/2023]
Abstract
BACKGROUND Osteopetrosis and related osteoclastic disorders are a heterogeneous group of inherited diseases characterized by increased bone density. The aim of this study is to investigate the molecular spectrum and natural history of the clinical and radiological features of these disorders. METHODS 28 patients from 20 families were enrolled in the study; 20 of them were followed for a period of 1-16 years. Targeted gene analysis and whole-exome sequencing (WES) were performed. RESULTS Biallelic mutations in CLCN7 and TCIRG1 were detected in three families each, in TNFRSF11A and CA2 in two families each, and in SNX10 in one family in the osteopetrosis group. A heterozygous variant in CLCN7 was also found in one family. In the osteopetrosis and related osteoclast disorders group, three different variants in CTSK were detected in five families with pycnodysostosis and a SLC29A3 variant causing dysosteosclerosis was detected in one family. In autosomal recessive osteopetrosis (ARO), a malignant infantile form, four patients died during follow-up, two of whom had undergone hematopoietic stem cell transplantation. Interestingly, all patients had osteopetrorickets of the long bone metaphyses in infancy, typical skeletal features such as Erlenmeyer flask deformity and bone-in-bone appearance that developed toward the end of early childhood. Two siblings with a biallelic missense mutation in CLCN7 and one patient with the compound heterozygous novel splicing variants in intron 15 and 17 in TCIRG1 corresponded to the intermediate form of ARO (IARO); there was intrafamilial clinical heterogeneity in the family with the CLCN7 variant. One of two patients with IARO and distal tubular acidosis was found to have a large deletion in CA2. In one family, two siblings with a heterozygous mutation in CLCN7 were affected, whereas the father with the same mutation was asymptomatic. In WES analysis of three brothers from a family without mutations in osteopetrosis genes, a hemizygous missense variant in CCDC120, a novel gene, was found to be associated with high bone mass. CONCLUSION This study extended the natural history of the different types of osteopetrosis and also introduced a candidate gene, CCDC120, potentially causing osteopetrosis.
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Affiliation(s)
- Beyhan Tüysüz
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Genetics, Istanbul, Turkey.
| | - Esra Usluer
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Genetics, Istanbul, Turkey
| | - Dilek Uludağ Alkaya
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Genetics, Istanbul, Turkey
| | - Süheyla Ocak
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Hematology, Istanbul, Turkey
| | - Seha Saygılı
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Nephrology, Istanbul, Turkey
| | - Ali Şeker
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Orthopedics and Traumatology, Istanbul, Turkey
| | - Hilmi Apak
- Istanbul University-Cerrahpasa, Cerrahpasa Faculty of Medicine, Department of Pediatric Hematology, Istanbul, Turkey
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Roth DM, Piña JO, MacPherson M, Budden C, Graf D. Physiology and Clinical Manifestations of Pathologic Cranial Suture Widening. Cleft Palate Craniofac J 2023:10556656231178438. [PMID: 37271984 DOI: 10.1177/10556656231178438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Cranial sutures are complex structures integrating mechanical forces with osteogenesis which are often affected in craniofacial syndromes. While premature fusion is frequently described, rare pathological widening of cranial sutures is a comparatively understudied phenomenon. This narrative review aims to bring to light the biologically variable underlying causes of widened sutures and persistent fontanelles leading to a common outcome. The authors herein present four syndromes, selected from a literature review, and their identified biological mechanisms in the context of altered suture physiology, exploring the roles of progenitor cell differentiation, extracellular matrix production, mineralization, and bone resorption. This article illustrates the gaps in understanding of complex craniofacial disorders, and the potential for further unification of genetics, cellular biology, and clinical pillars of health science research to improve treatment outcomes for patients.
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Affiliation(s)
- Daniela M Roth
- School of Dentistry, University of Alberta, Edmonton, Canada
| | - Jeremie Oliver Piña
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, Maryland, USA
| | | | - Curtis Budden
- Department of Surgery, University of Alberta, Edmonton, Canada
| | - Daniel Graf
- School of Dentistry, University of Alberta, Edmonton, Canada
- Department of Medical Genetics, University of Alberta, Edmonton, Canada
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Turan S. Osteopetrosis: Gene-based nosology and significance Dysosteosclerosis. Bone 2023; 167:116615. [PMID: 36402365 DOI: 10.1016/j.bone.2022.116615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 11/09/2022] [Accepted: 11/12/2022] [Indexed: 11/18/2022]
Abstract
Dysosteosclerosis (DSS) refers to skeletal dysplasias that radiographically feature focal appendicular osteosclerosis with variable platyspondyly. Genetic heterogeneity is increasingly reported for the DSS phenotype and now involves mutations of SLC29A3, TNFRSF11A, TCIRG1, LRRK1, and CSF1R. Typical radiological findings are widened radiolucent long bones with thin cortices yet dense irregular metaphyses, flattened vertebral bodies, dense ribs, and multiple fractures. However, the radiographic features of DSS evolve, and the metaphyseal and/or appendicular osteosclerosis variably fades with increasing patient age, likely due to some residual osteoclast function. Fractures are the principal presentation of DSS, and may even occur in infancy with SLC29A3-associated DSS. Cranial base sclerosis can lead to cranial nerve palsies such as optic atrophy, and may be the initial presentation, though not observed with SLC29A3-associated DSS. Gene-specific extra-skeletal features can be the main complication in some forms of DSS such as CSF1R- associated DSS. Further genetic heterogeneity is likely, especially for X-linked recessive DSS and cases currently with an unknown genetic defect. Distinguishing DSS can be challenging due to variable clinical and radiological features and an evolving phenotype. However, defining the DSS phenotype is important for predicting complications, prognosis, and instituting appropriate health surveillance and treatment.
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Affiliation(s)
- Serap Turan
- Pediatric Endocrinology and Diabetes, Marmara University School of Medicine, Istanbul, Turkey.
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Turan S, Mumm S, Alavanda C, Kaygusuz BS, Gurpinar Tosun B, Arman A, Huskey M, Guran T, Duan S, Bereket A, Whyte MP. Dysosteosclerosis: Clinical and Radiological Evolution Reflecting Genetic Heterogeneity. JBMR Plus 2022; 6:e10663. [PMID: 35991533 PMCID: PMC9382861 DOI: 10.1002/jbm4.10663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/27/2022] [Indexed: 11/12/2022] Open
Affiliation(s)
- Serap Turan
- Pediatric Endocrinology and Diabetes Marmara University Faculty of Medicine Istanbul Turkey
| | - Steven Mumm
- Division of Bone and Mineral Diseases, Department of Internal Medicine Washington University School of Medicine; St Louis Missouri USA
- Center for Metabolic Bone Disease and Molecular Research Shriners Hospitals for Children – St. Louis St. Louis Missouri USA
| | - Ceren Alavanda
- Medical Genetics Marmara University Faculty of Medicine Istanbul Turkey
| | - Betul Sare Kaygusuz
- Pediatric Endocrinology and Diabetes Marmara University Faculty of Medicine Istanbul Turkey
| | - Busra Gurpinar Tosun
- Pediatric Endocrinology and Diabetes Marmara University Faculty of Medicine Istanbul Turkey
| | - Ahmet Arman
- Medical Genetics Marmara University Faculty of Medicine Istanbul Turkey
| | - Margaret Huskey
- Division of Bone and Mineral Diseases, Department of Internal Medicine Washington University School of Medicine; St Louis Missouri USA
| | - Tulay Guran
- Pediatric Endocrinology and Diabetes Marmara University Faculty of Medicine Istanbul Turkey
| | - Shenghui Duan
- Division of Bone and Mineral Diseases, Department of Internal Medicine Washington University School of Medicine; St Louis Missouri USA
| | - Abdullah Bereket
- Pediatric Endocrinology and Diabetes Marmara University Faculty of Medicine Istanbul Turkey
| | - Michael P. Whyte
- Division of Bone and Mineral Diseases, Department of Internal Medicine Washington University School of Medicine; St Louis Missouri USA
- Center for Metabolic Bone Disease and Molecular Research Shriners Hospitals for Children – St. Louis St. Louis Missouri USA
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Kırkgöz T, Özkan B, Hazan F, Acar S, Nalbantoğlu Ö, Özkaya B, Kulalı MA, Gürsoy S, Ikegawa S, Guo L. A Null Mutation of TNFRSF11A Causes Dysosteosclerosis, Not Osteopetrosis. Front Genet 2022; 13:938814. [PMID: 35812760 PMCID: PMC9263543 DOI: 10.3389/fgene.2022.938814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2022] [Accepted: 06/06/2022] [Indexed: 11/15/2022] Open
Abstract
Dysosteosclerosis (DOS) is a rare sclerosing bone dysplasia characterized by unique osteosclerosis of the long tubular bones and platyspondyly. DOS is inherited in an autosomal recessive manner and is genetically and clinically heterogeneous. To date, four individuals with DOS who have five different TNFRSF11A mutations have been reported. Based on their data, it is hypothesized that mutations producing aberrant mutant RANK proteins (missense or truncated or elongated) cause DOS, while null mutations lead to osteopetrosis, autosomal recessive 7 (OPTB7). Herein, we present the fifth case of TNFRSF11A-associated DOS with a novel homozygous frame-shift mutation (c.19_31del; p.[Arg7CysfsTer172]). The mutation is predicted to cause nonsense mutation-mediated mRNA decay (NMD) in all RANK isoform transcripts, resulting in totally null allele. Our findings suggest genotype-phenotype relationship in TNFRSF11A-associated OPTB7 and DOS remains unclear, and that the deficiency of TNFRSF11A functions might cause DOS, rather than osteopetrosis. More data are necessary to understand the phenotypic spectrum caused by TNFRSF11A mutations.
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Affiliation(s)
- Tarık Kırkgöz
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children’s Education and Research Hospital, Izmir, Turkey
| | - Behzat Özkan
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children’s Education and Research Hospital, Izmir, Turkey
| | - Filiz Hazan
- Department of Medical Genetics, Dr. Behçet Uz Children’s Education and Research Hospital, Izmir, Turkey
| | - Sezer Acar
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children’s Education and Research Hospital, Izmir, Turkey
- *Correspondence: Sezer Acar, ; Long Guo,
| | - Özlem Nalbantoğlu
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children’s Education and Research Hospital, Izmir, Turkey
| | - Beyhan Özkaya
- Division of Pediatric Endocrinology, Dr. Behçet Uz Children’s Education and Research Hospital, Izmir, Turkey
| | - Melike Ataseven Kulalı
- Division of Pediatric Genetics, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
| | - Semra Gürsoy
- Division of Pediatric Genetics, Dr. Behçet Uz Children’s Education and Research Hospital, Izmir, Turkey
| | - Shiro Ikegawa
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Long Guo
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
- *Correspondence: Sezer Acar, ; Long Guo,
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