1
|
Eker HK, Tekeli T. Further Clinical Delineation of Prolidase Deficiency Associated with c.1103T>G Variant. Mol Syndromol 2024; 15:289-296. [PMID: 39119447 PMCID: PMC11305661 DOI: 10.1159/000536434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/19/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Prolidase deficiency is a rare multisystemic disease associated with collagen metabolism. Clinical manifestations and age of onset are highly variable. Prolidase deficiency is caused by homozygous variants in the PEPD gene. In this report, three siblings with c.1103T>G (L368R) variant in the PEPD gene are presented. They had features not described in the literature and marked intrafamilial clinical heterogeneity. This is the first family of Syrian ancestral origin with prolidase deficiency. Case Presentation We performed whole-exome sequencing for the index case, and detected a homozygous c.1103T>G variant, in the PEPD gene. All family members were then screened for the same variant by Sanger sequencing analysis. Two siblings were found to be homozygous, and one of them had not yet developed clinical symptoms. Conclusion Our data expand the clinical spectrum of prolidase deficiency. It also improves our knowledge of phenotype and genotype relationships of prolidase deficiency patients.
Collapse
Affiliation(s)
| | - Tuğba Tekeli
- Genetic Diseases Evaluation Center, Konya City Hospital, Konya, Turkey
| |
Collapse
|
2
|
Basu S, Barman P, Das J, Kabeerdoss J, Attri SV, Mahajan R, Vignesh P, Rawat A. Expanding the clinical and immunological phenotype of prolidase deficiency: A case report. Pediatr Dermatol 2024; 41:115-118. [PMID: 37574707 DOI: 10.1111/pde.15413] [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: 05/11/2023] [Accepted: 07/30/2023] [Indexed: 08/15/2023]
Abstract
Prolidase deficiency (PD) is a rare autosomal recessive disorder associated with recurrent infections, immune dysregulation, and autoimmunity. PD is characterized by persistent dermatitis, skin fragility, and non-healing ulcerations on the lower limbs as its main dermatologic characteristics. Herein, we report a boy with PD due to a novel variant in PEPD who had abnormal facies, cognitive impairment, corneal opacity, recurrent infections, and persistent non-healing leg ulcers. Th17 lymphocyte counts and phosphorylated-STAT5 expression following IL-2 stimulation were reduced in our patient as compared to healthy control.
Collapse
Affiliation(s)
- Suprit Basu
- Pediatric Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Prabal Barman
- Pediatric Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jhumki Das
- Pediatric Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jayakanthan Kabeerdoss
- Pediatric Biochemistry Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Savita Verma Attri
- Pediatric Biochemistry Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Mahajan
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Pandiarajan Vignesh
- Pediatric Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amit Rawat
- Pediatric Allergy Immunology Unit, Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
3
|
Gopalakrishna H, Asif B, Rai A, Conjeevaram HS, Mironova M, Kleiner DE, Freeman AF, Heller T. Chronic Liver Disease in Patients with Prolidase Deficiency: A Case Series. Case Rep Gastroenterol 2024; 18:49-57. [PMID: 38304571 PMCID: PMC10834036 DOI: 10.1159/000536117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 01/03/2024] [Indexed: 02/03/2024] Open
Abstract
Introduction Prolidase deficiency is a rare autosomal recessive disorder caused by variants in the PEPD gene. Patients usually have multi-organ involvement and a wide range of clinical features including recurrent skin ulcers, dysmorphic facial features, recurrent infections, intellectual disability, and splenomegaly. Studies have shown that patients with prolidase deficiency may have hepatic manifestations including hepatomegaly and abnormal liver enzymes. However, there is no detailed description of liver disease in this patient population. Case Presentation Here, we present 3 patients with prolidase deficiency with varying extents of hepatic involvement. Conclusion Prolidase deficiency patients with liver disease should be followed up long term to understand more about the pathophysiology and the impact of liver disease on long-term outcomes.
Collapse
Affiliation(s)
- Harish Gopalakrishna
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Bilal Asif
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Anjali Rai
- Liver Diseases Branch, Translational Hepatology Section, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA
| | - Hari S. Conjeevaram
- Division of Gastroenterology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Maria Mironova
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD, USA
| | - David E. Kleiner
- Laboratory of Pathology, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Alexandra F. Freeman
- Laboratory of Clinical Immunology and Microbiology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Theo Heller
- Liver Diseases Branch, Translational Hepatology Section, National Institute of Diabetes and Digestive and Kidney Diseases, NIH, Bethesda, MD, USA
| |
Collapse
|
4
|
Harley ITW, Allison K, Scofield RH. Polygenic autoimmune disease risk alleles impacting B cell tolerance act in concert across shared molecular networks in mouse and in humans. Front Immunol 2022; 13:953439. [PMID: 36090990 PMCID: PMC9450536 DOI: 10.3389/fimmu.2022.953439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 07/19/2022] [Indexed: 11/23/2022] Open
Abstract
Most B cells produced in the bone marrow have some level of autoreactivity. Despite efforts of central tolerance to eliminate these cells, many escape to periphery, where in healthy individuals, they are rendered functionally non-responsive to restimulation through their antigen receptor via a process termed anergy. Broad repertoire autoreactivity may reflect the chances of generating autoreactivity by stochastic use of germline immunoglobulin gene segments or active mechanisms may select autoreactive cells during egress to the naïve peripheral B cell pool. Likewise, it is unclear why in some individuals autoreactive B cell clones become activated and drive pathophysiologic changes in autoimmune diseases. Both of these remain central questions in the study of the immune system(s). In most individuals, autoimmune diseases arise from complex interplay of genetic risk factors and environmental influences. Advances in genome sequencing and increased statistical power from large autoimmune disease cohorts has led to identification of more than 200 autoimmune disease risk loci. It has been observed that autoantibodies are detectable in the serum years to decades prior to the diagnosis of autoimmune disease. Thus, current models hold that genetic defects in the pathways that control autoreactive B cell tolerance set genetic liability thresholds across multiple autoimmune diseases. Despite the fact these seminal concepts were developed in animal (especially murine) models of autoimmune disease, some perceive a disconnect between human risk alleles and those identified in murine models of autoimmune disease. Here, we synthesize the current state of the art in our understanding of human risk alleles in two prototypical autoimmune diseases – systemic lupus erythematosus (SLE) and type 1 diabetes (T1D) along with spontaneous murine disease models. We compare these risk networks to those reported in murine models of these diseases, focusing on pathways relevant to anergy and central tolerance. We highlight some differences between murine and human environmental and genetic factors that may impact autoimmune disease development and expression and may, in turn, explain some of this discrepancy. Finally, we show that there is substantial overlap between the molecular networks that define these disease states across species. Our synthesis and analysis of the current state of the field are consistent with the idea that the same molecular networks are perturbed in murine and human autoimmune disease. Based on these analyses, we anticipate that murine autoimmune disease models will continue to yield novel insights into how best to diagnose, prognose, prevent and treat human autoimmune diseases.
Collapse
Affiliation(s)
- Isaac T. W. Harley
- Division of Rheumatology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Human Immunology and Immunotherapy Initiative (HI3), Department of Immunology, University of Colorado School of Medicine, Aurora, CO, United States
- Rheumatology Section, Medicine Service, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, United States
- *Correspondence: Isaac T. W. Harley,
| | - Kristen Allison
- Division of Rheumatology, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, United States
- Human Immunology and Immunotherapy Initiative (HI3), Department of Immunology, University of Colorado School of Medicine, Aurora, CO, United States
| | - R. Hal Scofield
- Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, OK, United States
- Medical/Research Service, US Department of Veterans Affairs Medical Center, Oklahoma City, OK, United States
| |
Collapse
|
5
|
Tan CY, Kothandaraman E, Ghosh A. Prolidase deficiency in an infant with an incidental finding of methaemoglobinaemia. BMJ Case Rep 2021; 14:e244155. [PMID: 34794975 PMCID: PMC8603255 DOI: 10.1136/bcr-2021-244155] [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] [Accepted: 11/02/2021] [Indexed: 11/03/2022] Open
Abstract
A 4-week-old boy presented to the hospital with symptoms of diarrhoea and vomiting initially thought to be due to cow's milk allergy. He was discharged with extensively hydrolysed formula. The patient represented with worsening of symptoms with metabolic acidosis and was screened and treated for sepsis. However, his condition deteriorated further and he developed methaemoglobinaemia. He was transferred to the high dependency unit and was given two doses of methylene blue. Further investigations were carried out, including rapid trio exome sequencing, which identified a homozygous pathogenic Peptidase D (PEPD) variant (c.978G>A, p.(Trp326*)). This was consistent with a diagnosis of prolidase deficiency.
Collapse
Affiliation(s)
- Chern Yan Tan
- Metabolic Medicine, Royal Manchester Children's Hospital, Manchester, UK
| | | | - Arunabha Ghosh
- Metabolic Medicine, Royal Manchester Children's Hospital, Manchester, UK
| |
Collapse
|
6
|
Asly M, Eljazouly M. Osteoarticular Manifestations of Prolidase Deficiency and Disability: Case Reports of Two Moroccan Sisters. Cureus 2021; 13:e17875. [PMID: 34660074 PMCID: PMC8502436 DOI: 10.7759/cureus.17875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2021] [Indexed: 11/05/2022] Open
Abstract
Prolidase deficiency (PD) is a rare autosomal recessive disorder that has symptoms such as chronic skin ulcers, dysmorphic facies, cognitive retardation, hematological anomalies, splenomegaly, and chronic infections. Bone and joint abnormalities were referred occasionally and included the signs and symptoms of prolidase deficiency, but were not deeply investigated in PD patients. We report a case of two PD Moroccan sisters with osteoarticular deformities, some of them were never described before: toes deformities and equinovalgus with fusion and dislocation of a tarsal bone in radiography x-rays.
Collapse
Affiliation(s)
- Mouna Asly
- Physical Medicine and Rehabilitation, Cheikh Khalifa International University Hospital, Mohamed VI University of Health Sciences (UM6SS), Casablanca, MAR
| | - Madiha Eljazouly
- Dermatology Unit, Cheikh Khalifa International University Hospital, Mohammed VI University of Health Sciences (UM6SS), Casablanca, MAR
| |
Collapse
|
7
|
Eni-Aganga I, Lanaghan ZM, Balasubramaniam M, Dash C, Pandhare J. PROLIDASE: A Review from Discovery to its Role in Health and Disease. Front Mol Biosci 2021; 8:723003. [PMID: 34532344 PMCID: PMC8438212 DOI: 10.3389/fmolb.2021.723003] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/18/2021] [Indexed: 01/14/2023] Open
Abstract
Prolidase (peptidase D), encoded by the PEPD gene, is a ubiquitously expressed cytosolic metalloproteinase, the only enzyme capable of cleaving imidodipeptides containing C-terminal proline or hydroxyproline. Prolidase catalyzes the rate-limiting step during collagen recycling and is essential in protein metabolism, collagen turnover, and matrix remodeling. Prolidase, therefore plays a crucial role in several physiological processes such as wound healing, inflammation, angiogenesis, cell proliferation, and carcinogenesis. Accordingly, mutations leading to loss of prolidase catalytic activity result in prolidase deficiency a rare autosomal recessive metabolic disorder characterized by defective wound healing. In addition, alterations in prolidase enzyme activity have been documented in numerous pathological conditions, making prolidase a useful biochemical marker to measure disease severity. Furthermore, recent studies underscore the importance of a non-enzymatic role of prolidase in cell regulation and infectious disease. This review aims to provide comprehensive information on prolidase, from its discovery to its role in health and disease, while addressing the current knowledge gaps.
Collapse
Affiliation(s)
- Ireti Eni-Aganga
- Center for AIDS Health Disparities Research, Nashville, TN, United States
- School of Graduate Studies and Research, Nashville, TN, United States
- Department of Microbiology, Immunology and Physiology, Nashville, TN, United States
| | - Zeljka Miletic Lanaghan
- Center for AIDS Health Disparities Research, Nashville, TN, United States
- Pharmacology Graduate Program, Vanderbilt University, Nashville, TN, United States
| | - Muthukumar Balasubramaniam
- Center for AIDS Health Disparities Research, Nashville, TN, United States
- Department of Biochemistry, Cancer Biology, Pharmacology and Neuroscience, Meharry Medical College, Nashville, TN, United States
| | - Chandravanu Dash
- Center for AIDS Health Disparities Research, Nashville, TN, United States
- School of Graduate Studies and Research, Nashville, TN, United States
- Department of Biochemistry, Cancer Biology, Pharmacology and Neuroscience, Meharry Medical College, Nashville, TN, United States
| | - Jui Pandhare
- Center for AIDS Health Disparities Research, Nashville, TN, United States
- School of Graduate Studies and Research, Nashville, TN, United States
- Department of Microbiology, Immunology and Physiology, Nashville, TN, United States
| |
Collapse
|
8
|
Classical Xanthinuria in Nine Israeli Families and Two Isolated Cases from Germany: Molecular, Biochemical and Population Genetics Aspects. Biomedicines 2021; 9:biomedicines9070788. [PMID: 34356852 PMCID: PMC8301430 DOI: 10.3390/biomedicines9070788] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 06/23/2021] [Accepted: 07/01/2021] [Indexed: 11/17/2022] Open
Abstract
Classical xanthinuria is a rare autosomal recessive metabolic disorder caused by variants in the XDH (type I) or MOCOS (type II) genes. Thirteen Israeli kindred (five Jewish and eight Arab) and two isolated cases from Germany were studied between the years 1997 and 2013. Four and a branch of a fifth of these families were previously described. Here, we reported the demographic, clinical, molecular and biochemical characterizations of the remaining cases. Seven out of 20 affected individuals (35%) presented with xanthinuria-related symptoms of varied severity. Among the 10 distinct variants identified, six were novel: c.449G>T (p.(Cys150Phe)), c.1434G>A (p.(Trp478*)), c.1871C>G (p.(Ser624*)) and c.913del (p.(Leu305fs*1)) in the XDH gene and c.1046C>T (p.(Thr349Ileu)) and c.1771C>T (p.(Pro591Ser)) in the MOCOS gene. Heterologous protein expression studies revealed that the p.Cys150Phe variant within the Fe/S-I cluster-binding site impairs XDH biogenesis, the p.Thr349Ileu variant in the NifS-like domain of MOCOS affects protein stability and cysteine desulfurase activity, while the p.Pro591Ser and a previously described p.Arg776Cys variant in the C-terminal domain affect Molybdenum cofactor binding. Based on the results of haplotype analyses and historical genealogy findings, the potential dispersion of the identified variants is discussed. As far as we are aware, this is the largest cohort of xanthinuria cases described so far, substantially expanding the repertoire of pathogenic variants, characterizing structurally and functionally essential amino acid residues in the XDH and MOCOS proteins and addressing the population genetic aspects of classical xanthinuria.
Collapse
|
9
|
Rossignol F, Duarte Moreno MS, Benoist JF, Boehm M, Bourrat E, Cano A, Chabrol B, Cosson C, Díaz JLD, D'Harlingue A, Dimmock D, Freeman AF, García MT, Garganta C, Goerge T, Halbach SS, de Laffolie J, Lam CT, Martin L, Martins E, Meinhardt A, Melki I, Ombrello AK, Pérez N, Quelhas D, Scott A, Slavotinek AM, Soares AR, Stein SL, Süßmuth K, Thies J, Ferreira CR, Schiff M. Quantitative analysis of the natural history of prolidase deficiency: description of 17 families and systematic review of published cases. Genet Med 2021; 23:1604-1615. [PMID: 34040193 DOI: 10.1038/s41436-021-01200-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Prolidase deficiency is a rare inborn error of metabolism causing ulcers and other skin disorders, splenomegaly, developmental delay, and recurrent infections. Most of the literature is constituted of isolated case reports. We aim to provide a quantitative description of the natural history of the condition by describing 19 affected individuals and reviewing the literature. METHODS Nineteen patients were phenotyped per local institutional procedures. A systematic review following PRISMA criteria identified 132 articles describing 161 patients. Main outcome analyses were performed for manifestation frequency, diagnostic delay, overall survival, symptom-free survival, and ulcer-free survival. RESULTS Our cohort presented a wide variability of severity. Autoimmune disorders were found in 6/19, including Crohn disease, systemic lupus erythematosus, and arthritis. Another immune finding was hemophagocytic lymphohistiocytosis (HLH). Half of published patients were symptomatic by age 4 and had a delayed diagnosis (mean delay 11.6 years). Ulcers were present initially in only 30% of cases, with a median age of onset at 12 years old. CONCLUSION Prolidase deficiency has a broad range of manifestations. Symptoms at onset may be nonspecific, likely contributing to the diagnostic delay. Testing for this disorder should be considered in any child with unexplained autoimmunity, lower extremity ulcers, splenomegaly, or HLH.
Collapse
Affiliation(s)
- Francis Rossignol
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marvid S Duarte Moreno
- Reference Centre for Inherited Metabolic Diseases, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Robert-Debré, Université de Paris, Paris, France
| | - Jean-François Benoist
- Reference Centre for Inherited Metabolic Diseases, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Necker-Enfants malades, Université de Paris, Paris, France
| | - Manfred Boehm
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Emmanuelle Bourrat
- Reference Center for Genodermatoses MAGEC Saint Louis, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Saint Louis, Paris, France
| | - Aline Cano
- Reference Center for Inherited Metabolic Disorders, Assistance Publique Hôpitaux de Marseille, Centre Hospitalier Universitaire de La Timone Enfants, Marseille, France
| | - Brigitte Chabrol
- Reference Center for Inherited Metabolic Disorders, Assistance Publique Hôpitaux de Marseille, Centre Hospitalier Universitaire de La Timone Enfants, Marseille, France
| | - Claudine Cosson
- Laboratoire de Biochimie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Arthur D'Harlingue
- Benioff Children's Hospital Oakland, University of California, San Francisco, Oakland, CA, USA
| | - David Dimmock
- Project Baby Bear, Rady Children's Institute for Genomic Medicine, San Diego, CA, USA
| | - Alexandra F Freeman
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - María Tallón García
- Hospital Álvaro Cunqueiro, Universidad de Santiago de Compostela, Vigo, Spain
| | - Cheryl Garganta
- Division of Genetics and Metabolism, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Tobias Goerge
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Sara S Halbach
- University of Chicago Medicine, University of Chicago, Chicago, IL, USA
| | - Jan de Laffolie
- University Children's Hospital, Justus-Liebig-University, Giessen, Germany
| | - Christina T Lam
- Seattle Children's Hospital, Seattle, WA, USA.,Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ludovic Martin
- Centre Hospitalier Universitaire d'Angers, Angers, France
| | | | - Andrea Meinhardt
- University Children's Hospital, Justus-Liebig-University, Giessen, Germany
| | - Isabelle Melki
- General Pediatrics, Infectious Disease and Internal Medicine Department, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Reference Center for Rheumatic, Autoimmune and Systemic Diseases in Children (RAISE), Paris, France.,Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Reference Center for Rheumatic, Autoimmune and Systemic Diseases in Children (RAISE), Paris, France.,Laboratory of Neurogenetics and Neuroinflammation, Imagine Institute, Paris, France
| | - Amanda K Ombrello
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Noémie Pérez
- Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Dulce Quelhas
- Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Unit for Multidisciplinary Research in Biomedicine, ICBAS, UP, Porto, Portugal
| | - Anna Scott
- Seattle Children's Hospital, Seattle, WA, USA.,Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Anne M Slavotinek
- Division of Medical Genetics, Department of Pediatrics, Benioff Children's Hospital San Francisco, University of California, San Francisco, San Francisco, CA, USA
| | | | - Sarah L Stein
- University of Chicago Medicine, University of Chicago, Chicago, IL, USA
| | - Kira Süßmuth
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Jenny Thies
- Seattle Children's Hospital, Seattle, WA, USA
| | - Carlos R Ferreira
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Manuel Schiff
- Reference Centre for Inherited Metabolic Diseases, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Robert-Debré, Université de Paris, Paris, France.,Reference Centre for Inherited Metabolic Diseases, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Necker-Enfants malades, Université de Paris, Paris, France.,INSERM U1163, Institut Imagine, Paris, France
| |
Collapse
|
10
|
Linhares ND, Wilk P, Wątor E, Tostes MA, Weiss MS, Pena SDJ. Structural analysis of new compound heterozygous variants in PEPD gene identified in a patient with Prolidase Deficiency diagnosed by exome sequencing. Genet Mol Biol 2021; 44:e20200393. [PMID: 33877262 PMCID: PMC8056889 DOI: 10.1590/1678-4685-gmb-2020-0393] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/21/2021] [Indexed: 11/22/2022] Open
Abstract
Prolidase Deficiency (PD) is an autosomal recessive rare disorder caused by loss or reduction of prolidase enzymatic activity due to variants in the PEPD gene. PD clinical features vary among affected individuals: skin ulcerations, recurrent infections, and developmental delay are common. In this study, we describe a 16-year-old boy with a mild PD phenotype comprising chronic eczema, recurrent infections and elevated IgE. Whole exome sequencing analysis revealed three PEPD variants: c.575T>C p.(Leu192Pro) inherited from the mother, and c.692_694del p.(Tyr231del) and c.1409G>A p.(Arg470His), both inherited from the father. The variant p.(Tyr231del) has been previously characterized by high-resolution X-ray structure analysis as altering protein dynamics/flexibility. In order to study the effects of the other two prolidase variants, we performed site directed mutagenesis purification and crystallization studies. A high-resolution X-ray structure could only be obtained for the p.(Arg470His) variant, which showed no significant structural differences in comparison to WT prolidase. On the other hand, the p.(Leu192Pro) variant led to significant protein destabilization. Hence, we conclude that the maternal p.(Leu192Pro) variant was likely causally associated with the proband´s disease, together with the known pathogenic paternal variant p.(Tyr231del). Our results demonstrated the utility of exome sequencing to perform diagnosis in PD cases with mild phenotype.
Collapse
Affiliation(s)
- Natália D Linhares
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Genômica Clínica, Belo Horizonte, MG, Brazil.,Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Bioquímica e Imunologia, Belo Horizonte, MG, Brazil
| | - Piotr Wilk
- Helmholtz-Zentrum Berlin, Macromolecular Crystallography (HZB-MX), Berlin, Germany.,Jagiellonian University, Malopolska Centre of Biotechnology, Kraków, Poland
| | - Elżbieta Wątor
- Helmholtz-Zentrum Berlin, Macromolecular Crystallography (HZB-MX), Berlin, Germany.,Jagiellonian University, Malopolska Centre of Biotechnology, Kraków, Poland
| | - Meire A Tostes
- Hospital das Clínicas da Universidade Federal de Minas Gerais, Serviço de Hematologia, Belo Horizonte, MG, Brazil
| | - Manfred S Weiss
- Helmholtz-Zentrum Berlin, Macromolecular Crystallography (HZB-MX), Berlin, Germany
| | - Sergio D J Pena
- Universidade Federal de Minas Gerais, Faculdade de Medicina, Laboratório de Genômica Clínica, Belo Horizonte, MG, Brazil.,Universidade Federal de Minas Gerais, Instituto de Ciências Biológicas, Departamento de Bioquímica e Imunologia, Belo Horizonte, MG, Brazil.,Laboratório Gene - Núcleo de Genética Médica, Belo Horizonte, MG, Brazil
| |
Collapse
|
11
|
Razmi T M, Jindal AK, Arora K, Joshi V, Suri D, De D. Refractory leg ulcers in prolidase deficiency with antiphospholipid antibody positivity responding to aspirin-hydroxychloroquine-vitamin C combination therapy. Dermatol Ther 2020; 33:e14156. [PMID: 32927500 DOI: 10.1111/dth.14156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/29/2020] [Accepted: 08/02/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Muhammed Razmi T
- Department Dermatology, IQRAA International Hospital and Research Centre, Calicut, India
| | - Ankur Kumar Jindal
- Allergy Immunology Unit, Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Kanika Arora
- Allergy Immunology Unit, Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vibhu Joshi
- Allergy Immunology Unit, Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepti Suri
- Allergy Immunology Unit, Departments of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Dipankar De
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
12
|
Spodenkiewicz M, Spodenkiewicz M, Cleary M, Massier M, Fitsialos G, Cottin V, Jouret G, Poirsier C, Doco-Fenzy M, Lèbre AS. Clinical Genetics of Prolidase Deficiency: An Updated Review. BIOLOGY 2020; 9:E108. [PMID: 32455636 PMCID: PMC7285180 DOI: 10.3390/biology9050108] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 01/27/2023]
Abstract
Prolidase is a ubiquitous enzyme that plays a major role in the metabolism of proline-rich proteins. Prolidase deficiency is a rare autosomal recessive inborn metabolic and multisystemic disease, characterized by a protean association of symptoms, namely intellectual disability, recurrent infections, splenomegaly, skin lesions, auto-immune disorders and cytopenia. To our knowledge, no published review has assembled the different clinical data and research studies over prolidase deficiency. The aim of this study is to summarize the actual state of the art from the descriptions of all the patients with a molecular diagnosis of prolidase deficiency reported to date regarding the clinical, biological, histopathological features, therapeutic options and functional studies.
Collapse
Affiliation(s)
- Marta Spodenkiewicz
- Service de génétique, AMH2, CHU Reims, UFR de médecine, 51100 Reims, France; (M.M.); (C.P.); (M.D.-F.)
- SFR CAP SANTE, UFR de médecine, 51100 Reims, France;
| | - Michel Spodenkiewicz
- CESM—Pôle de Santé Mentale, CRIA, CIC-EC 1410 CHU de La Réunion, 97448 Saint-Pierre CEDEX, La Réunion, France;
- Equipe MOODS Inserm U1178, CESP, 94807 Villejuif, France
| | - Maureen Cleary
- Great Ormond Street Hospital NHS Foundation Trust and NIHR Biomedical Research Centre, London WC1N 3JH, UK;
| | - Marie Massier
- Service de génétique, AMH2, CHU Reims, UFR de médecine, 51100 Reims, France; (M.M.); (C.P.); (M.D.-F.)
| | - Giorgos Fitsialos
- The European Center for Genetics and DNA Identification, DNAlogy. 98 Vouliagmenis Ave. Glyfada, 16674 Athens, Greece;
| | - Vincent Cottin
- Department of Respiratory Medicine, National Reference Coordinating Center for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University, Lyon 1, UMR754, IVPC, F-69008 Lyon, France;
| | - Guillaume Jouret
- National Center of Genetics—Laboratoire National de Santé, L-3555 Dudelange, Luxembourg;
| | - Céline Poirsier
- Service de génétique, AMH2, CHU Reims, UFR de médecine, 51100 Reims, France; (M.M.); (C.P.); (M.D.-F.)
| | - Martine Doco-Fenzy
- Service de génétique, AMH2, CHU Reims, UFR de médecine, 51100 Reims, France; (M.M.); (C.P.); (M.D.-F.)
- SFR CAP SANTE, UFR de médecine, 51100 Reims, France;
- EA3801, 51100 Reims, France
| | - Anne-Sophie Lèbre
- SFR CAP SANTE, UFR de médecine, 51100 Reims, France;
- Pôle de Biologie Territoriale, CHU Reims, Service de Génétique, 51100 Reims, France
| |
Collapse
|
13
|
Insolia V, Priori EC, Gasperini C, Coppa F, Cocchia M, Iervasi E, Ferrari B, Besio R, Maruelli S, Bernocchi G, Forlino A, Bottone MG. Prolidase enzyme is required for extracellular matrix integrity and impacts on postnatal cerebellar cortex development. J Comp Neurol 2019; 528:61-80. [PMID: 31246278 DOI: 10.1002/cne.24735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 06/11/2019] [Accepted: 06/20/2019] [Indexed: 12/12/2022]
Abstract
The extracellular matrix is essential for brain development, lamination, and synaptogenesis. In particular, the basement membrane below the pial meninx (pBM) is required for correct cortical development. The last step in the catabolism of the most abundant protein in pBM, collagen Type IV, requires prolidase, an exopeptidase cleaving the imidodipeptides containing pro or hyp at the C-terminal end. Mutations impairing prolidase activity lead in humans to the rare disease prolidase deficiency characterized by severe skin ulcers and mental impairment. Thus, the dark-like (dal) mouse, in which the prolidase is knocked-out, was used to investigate whether the deficiency of prolidase affects the neuronal maturation during development of a brain cortex area. Focusing on the cerebellar cortex, thinner collagen fibers and disorganized pBM were found. Aberrant cortical granule cell proliferation and migration occurred, associated to defects in brain lamination, and in particular in maturation of Purkinje neurons and formation of synaptic contacts. This study deeply elucidates a link between prolidase activity and neuronal maturation shedding new light on the molecular basis of functional aspects in the prolidase deficiency.
Collapse
Affiliation(s)
- Violetta Insolia
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Erica C Priori
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Caterina Gasperini
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Federica Coppa
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Marco Cocchia
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Erika Iervasi
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Beatrice Ferrari
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| | - Roberta Besio
- Department of Molecular Medicine, Biochemistry Unit, University of Pavia, Pavia, Italy
| | - Silvia Maruelli
- Department of Molecular Medicine, Biochemistry Unit, University of Pavia, Pavia, Italy
| | | | - Antonella Forlino
- Department of Molecular Medicine, Biochemistry Unit, University of Pavia, Pavia, Italy
| | - Maria G Bottone
- Department of Biology and Biotechnology, University of Pavia, Pavia, Italy
| |
Collapse
|
14
|
Kiratli Nalbant E, Karaosmanoglu N, Kutlu O, Ceylaner S, Eksioglu HM. A rare case of prolidase deficiency with situs inversus totalis, identified by a novel mutation in the PEPD gene. JAAD Case Rep 2019; 5:436-438. [PMID: 31192996 PMCID: PMC6510937 DOI: 10.1016/j.jdcr.2019.03.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Esra Kiratli Nalbant
- Department of Dermatology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Nermin Karaosmanoglu
- Department of Dermatology, Ankara Training and Research Hospital, Ankara, Turkey
| | - Omer Kutlu
- Dermatology Clinic, Develi State Hospital, Ankara, Turkey
| | | | | |
Collapse
|
15
|
Rayment JH, Jobling R, Bowdin S, Cutz E, Dell SD. Prolidase deficiency diagnosed by whole exome sequencing in a child with pulmonary capillaritis. ERJ Open Res 2019; 5:00205-2018. [PMID: 31041317 PMCID: PMC6484094 DOI: 10.1183/23120541.00205-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/28/2019] [Indexed: 12/01/2022] Open
Abstract
Diffuse alveolar haemorrhage (DAH) is rare in the paediatric population and the biological mechanisms remain poorly understood [1]. We retrospectively studied 12 children at our centre, identified from our pathology database, with idiopathic DAH between 2005–2017 who had undergone lung biopsy (SickKids ethics approval number: 1000029185). Two children in this cohort were offered clinical whole exome sequencing (WES) as an investigational diagnostic procedure based on a family history of lung disease. Both children who underwent WES, including the one presented here and one who we had previously reported [2], had single gene mutations that explained the pathogenesis of their pulmonary haemorrhage. The case of a young boy with pulmonary haemorrhage who was ultimately diagnosed on whole exome sequencing with a rare condition called prolidase deficiency. This case demonstrates the utility of modern genomic testing in paediatric rare lung disease.http://ow.ly/rDGz30o8pcd
Collapse
Affiliation(s)
- Jonathan H Rayment
- Division of Respiratory Medicine, BC Children's Hospital, Vancouver, BC, Canada.,Dept of Paediatrics, University of British Columbia, Vancouver, BC, Canada
| | - Rebekah Jobling
- Dept of Paediatrics, University of Toronto, Toronto, ON, Canada.,Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sarah Bowdin
- Dept of Clinical Genetics, Addenbrooke's Treatment Centre, Cambridge University Hospitals, Cambridge, UK
| | - Ernest Cutz
- Division of Pathology, Dept of Paediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sharon D Dell
- Dept of Paediatrics, University of Toronto, Toronto, ON, Canada.,Division of Respiratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada.,Institute of Health Policy, Management and Education, University of Toronto, Toronto, ON, Canada.,Child Health Evaluative Sciences, The Hospital for Sick Children Research Institute, Toronto, ON, Canada
| |
Collapse
|
16
|
Hintze JP, Kirby A, Torti E, Batanian JR. Prolidase Deficiency in a Mexican-American Patient Identified by Array CGH Reveals a Novel and the Largest PEPD Gene Deletion. Mol Syndromol 2016; 7:80-6. [PMID: 27385964 DOI: 10.1159/000445397] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2016] [Indexed: 12/20/2022] Open
Abstract
Prolidase deficiency (PD) is a rare genetic disorder caused by mutations in the peptidase D (PEPD) gene, affecting collagen degradation. Features include lower extremity ulcers, facial dysmorphism, frequent respiratory infections, and intellectual disability, though there is significant intra- and interfamilial variability. Twenty-eight mutations have been previously reported, all either small deletions/duplications or point mutations discovered by enzyme or DNA assays. PD has been reported in patients of various ethnic backgrounds, but never in the Mexican-American population. We describe the first Mexican-American patient with PD, who presented with typical facial features, developmental delay, microcephaly, and xerosis. Chromosome microarray analysis (CMA) revealed a homozygous deletion in the region of 19q13.11, estimated to be between 124.79 and 195.72 kb in size, representing the largest PEPD gene deletion reported to date and the first discovered by CMA.
Collapse
Affiliation(s)
| | - Amelia Kirby
- Division of Medical Genetics, St. Louis University, St. Louis, Mo., USA
| | - Erin Torti
- Division of Medical Genetics, St. Louis University, St. Louis, Mo., USA
| | - Jacqueline R Batanian
- Department of Pediatrics and Molecular Cytogenetics, SSM Health Cardinal Glennon Children's Hospital, St. Louis University School of Medicine, St. Louis, Mo., USA
| |
Collapse
|
17
|
Lubick KJ, Robertson SJ, McNally KL, Freedman BA, Rasmussen AL, Taylor RT, Walts AD, Tsuruda S, Sakai M, Ishizuka M, Boer EF, Foster EC, Chiramel AI, Addison CB, Green R, Kastner DL, Katze MG, Holland SM, Forlino A, Freeman AF, Boehm M, Yoshii K, Best SM. Flavivirus Antagonism of Type I Interferon Signaling Reveals Prolidase as a Regulator of IFNAR1 Surface Expression. Cell Host Microbe 2016; 18:61-74. [PMID: 26159719 DOI: 10.1016/j.chom.2015.06.007] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2014] [Revised: 04/08/2015] [Accepted: 06/16/2015] [Indexed: 11/25/2022]
Abstract
Type I interferon (IFN-α/β or IFN-I) signals through two receptor subunits, IFNAR1 and IFNAR2, to orchestrate sterile and infectious immunity. Cellular pathways that regulate IFNAR1 are often targeted by viruses to suppress the antiviral effects of IFN-I. Here we report that encephalitic flaviviruses, including tick-borne encephalitis virus and West Nile virus, antagonize IFN-I signaling by inhibiting IFNAR1 surface expression. Loss of IFNAR1 was associated with binding of the viral IFN-I antagonist, NS5, to prolidase (PEPD), a cellular dipeptidase implicated in primary immune deficiencies in humans. Prolidase was required for IFNAR1 maturation and accumulation, activation of IFNβ-stimulated gene induction, and IFN-I-dependent viral control. Human fibroblasts derived from patients with genetic prolidase deficiency exhibited decreased IFNAR1 surface expression and reduced IFNβ-stimulated signaling. Thus, by understanding flavivirus IFN-I antagonism, prolidase is revealed as a central regulator of IFN-I responses.
Collapse
Affiliation(s)
- Kirk J Lubick
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA
| | - Shelly J Robertson
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA
| | - Kristin L McNally
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA
| | - Brett A Freedman
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA
| | - Angela L Rasmussen
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
| | - R Travis Taylor
- Department of Medical Microbiology and Immunology, College of Medicine, University of Toledo Health Science Campus, Toledo, OH 43614, USA
| | - Avram D Walts
- Translational Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20892, USA
| | - Seitaro Tsuruda
- Laboratory of Public Health, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, 060-0818, Japan
| | - Mizuki Sakai
- Laboratory of Public Health, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, 060-0818, Japan
| | - Mariko Ishizuka
- Laboratory of Public Health, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, 060-0818, Japan
| | - Elena F Boer
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA
| | - Erin C Foster
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA
| | - Abhilash I Chiramel
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA
| | - Conrad B Addison
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA
| | - Richard Green
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
| | - Daniel L Kastner
- Metabolic, Cardiovascular and Inflammatory Disease Genomics Branch, National Human Genome Research Institute, NIH, Bethesda, MD 20892, USA
| | - Michael G Katze
- Department of Microbiology, University of Washington, Seattle, WA 98109, USA
| | - Steven M Holland
- Immunopathogenesis Section, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20814, USA
| | - Antonella Forlino
- Department of Molecular Medicine, Biochemistry Unit, University of Pavia, 27100 Pavia, Italy
| | - Alexandra F Freeman
- Immunopathogenesis Section, Laboratory of Clinical Infectious Diseases, National Institute of Allergy and Infectious Diseases, NIH, Bethesda, MD 20814, USA
| | - Manfred Boehm
- Translational Medicine Branch, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD 20892, USA
| | - Kentaro Yoshii
- Laboratory of Public Health, Graduate School of Veterinary Medicine, Hokkaido University, Sapporo, Hokkaido, 060-0818, Japan
| | - Sonja M Best
- Laboratory of Virology, Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH, Hamilton, MT 59840, USA.
| |
Collapse
|
18
|
Kurien BT, D'Sousa A, Bruner BF, Gross T, James JA, Targoff IN, Maier-Moore JS, Harley ITW, Wang H, Scofield RH. Prolidase deficiency breaks tolerance to lupus-associated antigens. Int J Rheum Dis 2013; 16:674-80. [PMID: 24330273 DOI: 10.1111/1756-185x.12254] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
AIM Prolidase deficiency is a rare autosomal recessive disease in which one of the last steps of collagen metabolism, cleavage of proline-containing dipeptides, is impaired. Only about 93 patients have been reported with about 10% also having systemic lupus erythematosus (SLE). METHODS We studied a large extended Amish pedigree with four prolidase deficiency patients and three heterozygous individuals for lupus-associated autoimmunity. Eight unaffected Amish children served as normal controls. Prolidase genetics and enzyme activity were confirmed. Antinuclear antibodies (ANA) were determined using indirect immunofluorescence and antibodies against extractable nuclear antigens were determined by various methods, including double immunodiffusion, immunoprecipitation and multiplex bead assay. Serum C1q levels were determined by enzyme-linked immunosorbent assay. RESULTS Two of the four homozygous prolidase deficiency subjects had a positive ANA. One had anti-double-stranded DNA, while another had precipitating anti-Ro. By the simultaneous microbead assay, three of the four had anti-Sm and anti-chromatin. One of the three heterozygous subjects had a positive ANA and immunoprecipitation of a 75 000 molecular weight protein. The unaffected controls had normal prolidase activity and were negative for autoantibodies. CONCLUSIONS Prolidase deficiency may be associated with the loss of immune tolerance to lupus-associated autoantigens even without clinical SLE.
Collapse
Affiliation(s)
- Biji T Kurien
- Arthritis & Clinical Immunology Program, Oklahoma Medical Research Foundation, Oklahoma City, Oklahoma, USA
| | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Falik Zaccai TC, Kalfon L, Klar A, Elisha MB, Hurvitz H, Weingarten G, Chechik E, Fleisher Sheffer V, Haj Yahya R, Meidan G, Gross-Kieselstein E, Bauman D, Hershkovitz S, Yaron Y, Orr-Urtreger A, Wertheimer E. Two novel mutations identified in familial cases with Donohue syndrome. Mol Genet Genomic Med 2013; 2:64-72. [PMID: 24498630 PMCID: PMC3907912 DOI: 10.1002/mgg3.43] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 09/24/2013] [Indexed: 12/29/2022] Open
Abstract
Donohue syndrome (DS) is a rare and lethal autosomal recessive disease caused by mutations in the insulin receptor (INSR) gene, manifesting marked insulin resistance, severe growth retardation, hypertrichosis, and characteristic dysmorphic features. We report the clinical, molecular, and biochemical characterization of three new patients with DS, and address genotype–phenotype issues playing a role in the pathophysiology of DS. A female infant born to first-degree cousins Muslim Arab parents and two brothers born to first-degree cousins Druze parents presented classical features of DS with hypertrophic cardiomyopathy and died in infancy. Each patient was found homozygous for one missense mutation within the extracellular domain of the INSR gene. Western blot analysis identified the proreceptor of INSR, but not its mature subunits alpha and beta. Of 95 healthy Muslims, no heterozygous was found and of 52 healthy Druze from the same village, one was heterozygous. This study presents two novel familial mutations in the alpha subunit of the INSR which appear to impair post-translational processing of the INSR, resulting loss of its function. Both mutations cause DS with hypertrophic cardiomyopathy and early death. Identification of the causative mutation enables prevention of this devastating disease.
Collapse
Affiliation(s)
- Tzipora C Falik Zaccai
- Institute of Human Genetics, Western Galilee Medical Center Naharia, Israel ; Faculty of Medicine in Galilee, Bar-Ilan University Safed, Israel
| | - Limor Kalfon
- Institute of Human Genetics, Western Galilee Medical Center Naharia, Israel
| | - Aharon Klar
- Department of Pediatrics, Bikur Cholim General Hospital, affiliated with the Hebrew University-Hadassah Medical School Jerusalem, Israel
| | | | - Haggit Hurvitz
- Department of Pediatrics, Bikur Cholim General Hospital, affiliated with the Hebrew University-Hadassah Medical School Jerusalem, Israel
| | - Galina Weingarten
- Department of Pathology, Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
| | | | | | - Raid Haj Yahya
- Department of Pediatrics, Bikur Cholim General Hospital, affiliated with the Hebrew University-Hadassah Medical School Jerusalem, Israel
| | - Gal Meidan
- Department of Pathology, Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
| | - Eva Gross-Kieselstein
- Department of Pediatrics, Bikur Cholim General Hospital, affiliated with the Hebrew University-Hadassah Medical School Jerusalem, Israel
| | - Dvora Bauman
- Department of Obstetrics and Gynecology, Bikur Cholim General Hospital Jerusalem, Israel
| | - Sylvia Hershkovitz
- Department of Neonatology, Western Galilee Medical Center Naharia, Israel
| | - Yuval Yaron
- Genetics Institute, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
| | - Avi Orr-Urtreger
- Genetics Institute, Tel Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
| | - Efrat Wertheimer
- Department of Pathology, Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
| |
Collapse
|
20
|
Yang L, Li Y, Ding Y, Choi KS, Kazim AL, Zhang Y. Prolidase directly binds and activates epidermal growth factor receptor and stimulates downstream signaling. J Biol Chem 2012; 288:2365-75. [PMID: 23212918 DOI: 10.1074/jbc.m112.429159] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Prolidase, also known as Xaa-Pro dipeptidase or peptidase D (PEPD), is a ubiquitously expressed cytosolic enzyme that hydrolyzes dipeptides with proline or hydroxyproline at the carboxyl terminus. In this article, however, we demonstrate that PEPD directly binds to and activates epidermal growth factor receptor (EGFR), leading to stimulation of signaling proteins downstream of EGFR, and that such activity is neither cell-specific nor dependent on the enzymatic activity of PEPD. In line with the pro-survival and pro-proliferation activities of EGFR, PEPD stimulates DNA synthesis. We further show that PEPD activates EGFR only when it is present in the extracellular space, but that PEPD is released from injured cells and tissues and that such release appears to result in EGFR activation. PEPD differs from all known EGFR ligands in that it does not possess an epidermal growth factor (EGF) motif and is not synthesized as a transmembrane precursor, but PEPD binding to EGFR can be blocked by EGF. In conclusion, PEPD is a ligand of EGFR and presents a novel mechanism of EGFR activation.
Collapse
Affiliation(s)
- Lu Yang
- Department of Chemoprevention, Roswell Park Cancer Institute, Buffalo, New York 14263, USA
| | | | | | | | | | | |
Collapse
|
21
|
Butbul Aviel Y, Mandel H, Avitan Hersh E, Bergman R, Adiv OE, Luder A, Brik R. Prolidase deficiency associated with systemic lupus erythematosus (SLE): single site experience and literature review. Pediatr Rheumatol Online J 2012; 10:18. [PMID: 22726576 PMCID: PMC3623899 DOI: 10.1186/1546-0096-10-18] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2011] [Accepted: 06/07/2012] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Prolidase deficiency (PD) is a rare autosomal recessive disorder which may have a wide spectrum of clinical features. These features include a characteristic facies, cognitive impairment, rashes or skin ulceration, splenomegaly, recurrent infections involving mainly the respiratory system, and iminodipeptiduria. The disorder is caused by a mutation in the PEPD gene. OBJECTIVE To describe a cohort of unrelated PD patients from Northern Israel whose inborn error of metabolism was associated with systemic lupus erythematosus (SLE) and to identify in the medical literature all PD cases mimicked by and/or associated with SLE. METHODS Three patients with PD associated with SLE were clinically, biochemically and genetically investigated. These patients were from 3 unrelated consanguineous families residing in Northern Israel. A computer-assisted (PubMed) search of the medical literature from 1975 to 2011 was performed using the following key words: Prolidase deficiency, SLE, and systemic lupus erythematosus. RESULTS An association between PD and SLE was found in 10 PD patients. These 10 patients included three from our cohort of 23 PD patients, and seven out of just under 70 PD patients previously reported in the literature. CONCLUSION The present findings underscore the relatively high incidence of the association between SLE and PD, suggesting that this association may not be coincidental. The phenotypic similarities between SLE and PD might suggest that the PEPD gene constitutes a modifier gene or a genetic risk factor in the causation of SLE.
Collapse
Affiliation(s)
| | - Hana Mandel
- Department of Pediatrics B, Haifa, Israel,Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel,Metabolic Unit, Haifa, Israel
| | - Emily Avitan Hersh
- Rappaport Faculty of Medicine, Technion-lsrael Institute of Technology, Haifa, Israel,Department of Dermatology, Haifa, Israel,Rambam Medical Center, Haifa, Israel
| | - Reuven Bergman
- Rappaport Faculty of Medicine, Technion-lsrael Institute of Technology, Haifa, Israel,Department of Dermatology, Haifa, Israel,Rambam Medical Center, Haifa, Israel
| | - Orly Eshach Adiv
- Department of Pediatrics B, Haifa, Israel,Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel,Pediatric Gastroenterology and Nutrition Unit, Haifa, Israel
| | - Anthony Luder
- Rappaport Faculty of Medicine, Technion-lsrael Institute of Technology, Haifa, Israel,Department of Pediatrics and Genetics Service, Ziv Medical Centre, Safed, Israel
| | - Riva Brik
- Department of Pediatrics B, Haifa, Israel,Pediatric Rheumatology service, Haifa, Israel,Meyer Children's Hospital, Rambam Medical Center, Haifa, Israel,Rappaport Faculty of Medicine, Technion-lsrael Institute of Technology, Haifa, Israel
| |
Collapse
|
22
|
Sezen Y, Bas M, Altiparmak H, Yildiz A, Buyukhatipoglu H, Faruk Dag O, Kaya Z, Aksoy N. Serum prolidase activity in idiopathic and ischemic cardiomyopathy patients. J Clin Lab Anal 2010; 24:213-8. [PMID: 20626024 DOI: 10.1002/jcla.20388] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Idiopathic and ischemic dilated cardiomyopathies (DCM) are the most common types of DCM, and both exhibit the same histopathological feature of fibrosis. Prolidase is an enzyme that serves a rate-limiting function in collagen turnover. Several studies have shown increased prolidase activity in fibrosis, though controversy persists. In this study, we measured prolidase enzyme activity in patients with idiopathic or ischemic DCM and in healthy controls, making this, to our knowledge, the first study to do so. What we found is that serumprolidase activity was significantly lower in both DCM groups relative to healthy volunteers and lower in ischemic DCM than idiopathic. These intriguing results could be attributed either to decreased collagen turnover in the heart tissues in which DCM develops, a result of diminished functional heart tissue, or to decreased physical activity levels among DCM patients stemming from their heart failure. Either way, further studies are needed to verify and clarify our results.
Collapse
Affiliation(s)
- Yusuf Sezen
- Department of Cardiology, Harran University School of Medicine, Sanliurfa, Turkey.
| | | | | | | | | | | | | | | |
Collapse
|
23
|
Prolidase deficiency: it looks like systemic lupus erythematosus but it is not. Eur J Pediatr 2010; 169:727-32. [PMID: 19937054 DOI: 10.1007/s00431-009-1102-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Accepted: 10/27/2009] [Indexed: 10/20/2022]
Abstract
Three siblings with recalcitrant leg ulceration, splenomegaly, photosensitive rash, and autoantibodies were suspected of having prolidase deficiency. Urine was checked for iminodipeptiduria, fibroblasts were cultured and analyzed for prolidase activity, and DNA was extracted for identifying the causative mutation. Glycyl proline was found as the dominant dipeptide in the urine. The activity of proline dipeptidase in fibroblasts was 2.5% of control fibroblasts. Sequence analysis of the PEPD gene revealed a homozygous nonsense C-->G transition at nucleotide 768. In conclusion, prolidase deficiency was diagnosed in siblings with skin ulceration autoantibodies and a lupus-like disease. A novel nonsense mutation was found, associated with the severe outcome of our patients.
Collapse
|