1
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The correlation between multiple congenital anomalies hypotonia seizures syndrome 2 and PIGA: a case of novel PIGA germline variant and literature review. Mol Biol Rep 2022; 49:10469-10477. [DOI: 10.1007/s11033-022-07614-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 11/29/2022]
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2
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Paprocka J, Hutny M, Hofman J, Tokarska A, Kłaniewska M, Szczałuba K, Stembalska A, Jezela-Stanek A, Śmigiel R. Spectrum of Neurological Symptoms in Glycosylphosphatidylinositol Biosynthesis Defects: Systematic Review. Front Neurol 2022; 12:758899. [PMID: 35058872 PMCID: PMC8763846 DOI: 10.3389/fneur.2021.758899] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Mutations of genes involved in the synthesis of glycosylphosphatidylinositol and glycosylphosphatidylinositol-anchored proteins lead to rare syndromes called glycosylphosphatidylinositol-anchored proteins biosynthesis defects. Alterations of their structure and function in these disorders impair often fundamental processes in cells, resulting in severe clinical image. This study aimed to provide a systematic review of GPIBD cases reports published in English-language literature. Methods: The browsing of open-access databases (PubMed, PubMed Central. and Medline) was conducted, followed by statistical analysis of gathered information concerning neurological symptomatology. The inclusion criteria were: studies on humans, age at onset (<18 y.o.), and report of GPIBD cases with adequate data on the genetic background and symptomatology. Exclusion criteria were: publication type (manuscripts, personal communication, review articles); reports of cases of GPI biosynthesis genes mutations in terms of other disorders; reports of GPIBD cases concentrating on non-neurological symptoms; or articles concentrating solely on the genetic issues of GPI biosynthesis. Risk of bias was assessed using Joanna Brigs Institute Critical Appraisal Checklists. Data synthesis was conducted using STATISTICA 13.3.721.1 (StatSoft Polska Sp. z.o.o.). Used tests were chi-square, Fisher's exact test (for differences in phenotype), and Mann-Whitney U test (for differences in onset of developmental delay). Results: Browsing returned a total of 973 articles which, after ruling out the repetitions and assessing the inclusion and exclusion criteria, led to final inclusion of 77 articles (337 GPIBD cases) in the analysis. The main outcomes were prevalence of neurological symptoms, onset and semiology of seizures and their response to treatment, and onset of developmental delay. Based on this data a synthesis of phenotypical differences between the groups of GPIBD cases and the general GPIBD cases population was made. Discussion: A synthetical analysis of neurological components in clinical image of GPIBD patients was presented. It highlights the main features of these disorders, which might be useful in clinical practice for consideration in differential diagnosis with children presenting with early-onset seizures and developmental delay. The limitation of this review is the scarcity of the specific data in some reports, concerning the semiology and onset of two main features of GPIBD.
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Affiliation(s)
- Justyna Paprocka
- Department of Pediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Michał Hutny
- Students' Scientific Society, Department of Pediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jagoda Hofman
- Students' Scientific Society, Department of Pediatric Neurology, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Agnieszka Tokarska
- Department of Pediatrics and Developmental Age Neurology, Upper Silesian Child Health Centre, Katowice, Poland
| | | | - Krzysztof Szczałuba
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
| | | | - Aleksandra Jezela-Stanek
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
| | - Robert Śmigiel
- Department of Pediatrics, Medical University of Wroclaw, Wroclaw, Poland
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3
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Kandasamy LC, Tsukamoto M, Banov V, Tsetsegee S, Nagasawa Y, Kato M, Matsumoto N, Takeda J, Itohara S, Ogawa S, Young LJ, Zhang Q. Limb-clasping, cognitive deficit and increased vulnerability to kainic acid-induced seizures in neuronal glycosylphosphatidylinositol deficiency mouse models. Hum Mol Genet 2021; 30:758-770. [PMID: 33607654 PMCID: PMC8161520 DOI: 10.1093/hmg/ddab052] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/04/2021] [Accepted: 02/11/2021] [Indexed: 11/26/2022] Open
Abstract
Posttranslational modification of a protein with glycosylphosphatidylinositol (GPI) is a conserved mechanism exists in all eukaryotes. Thus far, >150 human GPI-anchored proteins have been discovered and ~30 enzymes have been reported to be involved in the biosynthesis and maturation of mammalian GPI. Phosphatidylinositol glycan biosynthesis class A protein (PIGA) catalyzes the very first step of GPI anchor biosynthesis. Patients carrying a mutation of the PIGA gene usually suffer from inherited glycosylphosphatidylinositol deficiency (IGD) with intractable epilepsy and intellectual developmental disorder. We generated three mouse models with PIGA deficits specifically in telencephalon excitatory neurons (Ex-M-cko), inhibitory neurons (In-M-cko) or thalamic neurons (Th-H-cko), respectively. Both Ex-M-cko and In-M-cko mice showed impaired long-term fear memory and were more susceptible to kainic acid-induced seizures. In addition, In-M-cko demonstrated a severe limb-clasping phenotype. Hippocampal synapse changes were observed in Ex-M-cko mice. Our Piga conditional knockout mouse models provide powerful tools to understand the cell-type specific mechanisms underlying inherited GPI deficiency and to test different therapeutic modalities.
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Affiliation(s)
- Lenin C Kandasamy
- Laboratory of Social Neural Networks, Center for Social Neural Networks, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Mina Tsukamoto
- Laboratory of Social Neural Networks, Center for Social Neural Networks, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Vitaliy Banov
- Laboratory for Behavioral Genetics, CBS, RIKEN, Wako 351-0198, Japan.,Institute of Neuroinformatics, University of Zürich, ETH Zürich, Zürich 8057, Switzerland
| | - Sambuu Tsetsegee
- Laboratory of Social Neural Networks, Center for Social Neural Networks, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Yutaro Nagasawa
- Laboratory of Social Neural Networks, Center for Social Neural Networks, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Mitsuhiro Kato
- Department of Pediatrics, Showa University School of Medicine, Tokyo 142-8555, Japan
| | - Naomichi Matsumoto
- Department of Human Genetics, Graduate School of Medicine, Yokohama City University, Yokohama 236-0004, Japan
| | - Junji Takeda
- Yabumoto Department of Intractable Disease Research, Research Institute for Microbial Diseases, Osaka University, Osaka 565-0871, Japan
| | | | - Sonoko Ogawa
- Laboratory of Behavioral Neuroendocrinology, Faculty of Human Sciences, University of Tsukuba, Tsukuba 305-8577, Japan
| | - Larry J Young
- Faculty of Human Sciences, Center for Social Neural Networks, University of Tsukuba, Tsukuba 305-8577, Japan.,Center for Translational Social Neuroscience, Department of Psychiatry and Behavioral Sciences, Yerkes National Primate Research Center, Emory University, Atlanta GA 30329, USA
| | - Qi Zhang
- Laboratory of Social Neural Networks, Center for Social Neural Networks, University of Tsukuba, Tsukuba 305-8577, Japan.,Laboratory for Behavioral Genetics, CBS, RIKEN, Wako 351-0198, Japan.,Faculty of Human Sciences, Center for Social Neural Networks, University of Tsukuba, Tsukuba 305-8577, Japan
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4
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Bayat A, Kløvgaard M, Johannesen KM, Barakat TS, Kievit A, Montomoli M, Parrini E, Pietrafusa N, Schelhaas J, van Slegtenhorst M, Miya K, Guerrini R, Tranebjærg L, Tümer Z, Rubboli G, Møller RS. Deciphering the premature mortality in PIGA-CDG - An untold story. Epilepsy Res 2020; 170:106530. [PMID: 33508693 DOI: 10.1016/j.eplepsyres.2020.106530] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Congenital disorder of glycosylation (CDG) due to a defective phosphatidylinositol glycan anchor biosynthesis class A protein (PIGA) is a severe X-linked developmental and epileptic encephalopathy. Seizures are often treatment refractory, and patients have intellectual disability and global developmental delay. Previous reports have suggested that patients with PIGA-CDG have a high risk of premature mortality. This study aimed to evaluate the observed high mortality and the causes of death in PIGA-CDG patients. METHODS We reviewed the literature and collected additional unpublished patients through an international network. RESULTS In total, we reviewed the data of 88 patients of whom 30 patients born alive were deceased, and the overall mortality before the age of 20 years was 30 % (26/88). Age at death ranged from 15 days to 48 years of life. The median age at death was two years and more than half of the patients deceased in early childhood. The PIGA-specific mortality rate/1000 person-years was 44.9/1000 person-years (95 %, CI 31.4-64.3). There were no cases of definite or probable sudden unexpected death in epilepsy (SUDEP) and half of the patients died due to respiratory failure (15/30, 50 %) or possible SUDEP (3/30, 10 %). Three patients (10 %) died from severe cardiomyopathy, liver failure and gastrointestinal bleeding, respectively. The cause of death was unclassified in nine patients (30 %). Autopsies were rarely performed and the true cause of death remains unknown for the majority of patients. SIGNIFICANCE Our data indicate an increased risk of premature death in patients with PIGA-CDG when compared to most monogenic developmental and epileptic encephalopathies.
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Affiliation(s)
- Allan Bayat
- Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark; Department for Regional Health Services, University of Southern Denmark, Odense, Denmark.
| | - Marius Kløvgaard
- The Epilepsy Clinic, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - Katrine M Johannesen
- Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark; Department for Regional Health Services, University of Southern Denmark, Odense, Denmark
| | - Tahsin Stefan Barakat
- Department of Clinical Genetics, Erasmus MC - University Medical Center, Rotterdam, the Netherlands
| | - Anneke Kievit
- Department of Clinical Genetics, Erasmus MC - University Medical Center, Rotterdam, the Netherlands
| | - Martino Montomoli
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Elena Parrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Nicola Pietrafusa
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Pediatric Hospital, Rome, Italy
| | - Jurgen Schelhaas
- Stichting Epilepsie Instellingen Nederland (SEIN), the Netherlands
| | - Marjon van Slegtenhorst
- Department of Clinical Genetics, Erasmus MC - University Medical Center, Rotterdam, the Netherlands
| | - Kazushi Miya
- Department of Educational Sciences (Human Development and Welfare Course), University of Toyama, Faculty of Human Development, Toyama, Japan
| | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories, Meyer Children's Hospital, University of Florence, Florence, Italy
| | - Lisbeth Tranebjærg
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Zeynep Tümer
- Kennedy Center, Department of Clinical Genetics, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Guido Rubboli
- Department for Regional Health Services, University of Southern Denmark, Odense, Denmark; Department of Clinical Medicine, Faculty of Medical and Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Rikke S Møller
- Department of Epilepsy Genetics and Personalized Medicine, Danish Epilepsy Centre, Dianalund, Denmark; Department for Regional Health Services, University of Southern Denmark, Odense, Denmark
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5
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Bayat A, Knaus A, Pendziwiat M, Afenjar A, Barakat TS, Bosch F, Callewaert B, Calvas P, Ceulemans B, Chassaing N, Depienne C, Endziniene M, Ferreira CR, Moura de Souza CF, Freihuber C, Ganesan S, Gataullina S, Guerrini R, Guerrot A, Hansen L, Jezela‐Stanek A, Karsenty C, Kievit A, Kooy FR, Korff CM, Kragh Hansen J, Larsen M, Layet V, Lesca G, McBride KL, Meuwissen M, Mignot C, Montomoli M, Moore H, Naudion S, Nava C, Nougues M, Parrini E, Pastore M, Schelhaas JH, Skinner S, Szczałuba K, Thomas A, Thomassen M, Tranebjærg L, Slegtenhorst M, Wolfe LA, Lal D, Gardella E, Bomme Ousager L, Brünger T, Helbig I, Krawitz P, Møller RS. Lessons learned from 40 novel
PIGA
patients and a review of the literature. Epilepsia 2020; 61:1142-1155. [DOI: 10.1111/epi.16545] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 04/26/2020] [Accepted: 04/27/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Allan Bayat
- Institute for Regional Health Services University of Southern Denmark Odense Denmark
- Department of Epilepsy Genetics and Personalized Medicine Danish Epilepsy Center Dianalund Denmark
| | - Alexej Knaus
- Institute for Genomic Statistics and Bioinformatics University Hospital Bonn Rheinische Friedrich‐Wilhelms‐University Bonn Bonn Germany
| | - Manuela Pendziwiat
- Department of Neuropediatrics University Medical Center Schleswig‐Holstein Christian Albrechts University Kiel Germany
| | - Alexandra Afenjar
- CRMR Congenital Malformations and Diseases of the Cerebellum and Rare Causes of Intellectual Disabilities Department of Genetics Sorbonne University, AP‐HP, Trousseau Hospital Paris France
| | - Tahsin Stefan Barakat
- Department of Clinical Genetics Erasmus MC, University Medical Center Rotterdam the Netherlands
| | | | - Bert Callewaert
- Center for Medical Genetics Ghent University Hospital Ghent Belgium
- Department of Biomolecular Medicine Ghent University Ghent Belgium
| | - Patrick Calvas
- UMR1056 INSERM‐Université de Toulouse, Department of Genetics University Hospital of Toulouse Toulouse France
| | - Berten Ceulemans
- Department of Pediatric Neurology University Hospital and University of Antwerp Antwerp Belgium
| | - Nicolas Chassaing
- UMR1056 INSERM‐Université de Toulouse, Department of Genetics University Hospital of Toulouse Toulouse France
| | - Christel Depienne
- Institute of Human Genetics University Hospital Essen University of Duisburg‐Essen Essen Germany
- UMR S1127, Inserm U1127, CNRS UMR 7225 Institute of brain and spinal cord Sorbonne University Paris France
| | - Milda Endziniene
- Neurology Department Medical Academy Lithuanian University of Health Sciences Kaunas Lithuania
| | - Carlos R. Ferreira
- Medical Genomics and Metabolic Genetics Branch National Human Genome Research Institute, National Institutes of Health Bethesda MarylandUSA
| | | | - Cécile Freihuber
- Department of Pediatric Neurology AP‐HP, GHUEP Armand Trousseau University Hospital Paris France
- GRC ConCer‐LD Sorbonne University, UPMC University of Paris 06 Paris France
| | - Shiva Ganesan
- Division of Neurology Children’s Hospital of Philadelphia Philadelphia PennsylvaniaUSA
- Epilepsy NeuroGenetics Initiative Children's Hospital of Philadelphia Philadelphia PennsylvaniaUSA
- Department of Biomedical and Health Informatics Children’s Hospital of Philadelphia Philadelphia PennsylvaniaUSA
| | - Svetlana Gataullina
- Sleep Disorders Center AP‐HP, Antoine‐Béclère Hospital Clamart France
- Department of Pediatrics and Neonatal Intensive Care André Grégoire Hospital Montreuil France
| | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories Department of Neuroscience, A. Meyer Children's Hospital University of Florence Florence Italy
| | - Anne‐Marie Guerrot
- Department of Genetics and Reference Center for Developmental Disorders Normandy Center for Genomic and Personalized Medicine Normandy University, UNIROUEN Inserm U1245 and Rouen University Hospital Rouen France
| | - Lars Hansen
- Department of Cellular and Molecular Medicine Faculty of Health Science Copenhagen Center for Glycomics Copenhagen Denmark
| | - Aleksandra Jezela‐Stanek
- Department of Genetics and Clinical Immunology National Institute of Tuberculosis and Lung Diseases Warsaw Poland
| | - Caroline Karsenty
- Neuropediatrics Department University Hospital of Toulouse Toulouse France
| | - Anneke Kievit
- Department of Clinical Genetics Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - Frank R. Kooy
- Department of Medical Genetics University of Antwerp Antwerp Belgium
| | - Christian M. Korff
- Pediatric Neurology Unit Department of the Woman, Child, and Adolescent University Hospitals Geneva Geneva Switzerland
| | | | - Martin Larsen
- Department of Clinical Genetics Odense University Hospital Odense Denmark
- Human Genetics Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Valérie Layet
- Department of Genetics Du Havre Hospital Le Havre France
| | - Gaetan Lesca
- Department of Medical Genetics Lyon University Hospital Lyon France
- Institut Neuromyogene University Claude Bernard Lyon 1, Lyon University Lyon France
| | - Kim L. McBride
- Division of Genetic and Genomic Medicine Nationwide Children's Hospital Columbus OhioUSA
- Center for Cardiovascular Research Nationwide Children's Hospital Columbus OhioUSA
- Department of Pediatrics Ohio State University Columbus OhioUSA
| | - Marije Meuwissen
- Department of Medical Genetics University of Antwerp Antwerp Belgium
| | - Cyril Mignot
- APHP Department of Genetics Pitié‐Salpêtrière Hospital Reference Center for Rare Causes of Intellectual Disabilities Paris France
- Department of Genetics Inserm U1127, CNRS UMR 7225 Institute for brain and spinal cord ICM, AP‐HP De la Pitié Salpêtrière Hospital, Sorbonne University Paris France
| | - Martino Montomoli
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories Department of Neuroscience, A. Meyer Children's Hospital University of Florence Florence Italy
| | - Hannah Moore
- Greenwood Genetic Center Greenwood South CarolinaUSA
| | - Sophie Naudion
- Department of Genetics, University of Bordeaux Bordeaux France
| | - Caroline Nava
- Department of Genetics Inserm U1127, CNRS UMR 7225 Institute for brain and spinal cord ICM, AP‐HP De la Pitié Salpêtrière Hospital, Sorbonne University Paris France
| | | | - Elena Parrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and Laboratories Department of Neuroscience, A. Meyer Children's Hospital University of Florence Florence Italy
| | - Matthew Pastore
- Division of Genetic and Genomic Medicine Nationwide Children's Hospital Columbus OhioUSA
- Department of Pediatrics Ohio State University Columbus OhioUSA
| | | | | | | | - Ashley Thomas
- Department of Neurology University of Alabama at Birmingham Birmingham AlabamaUSA
| | - Mads Thomassen
- Department of Clinical Genetics Odense University Hospital Odense Denmark
- Human Genetics Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Lisbeth Tranebjærg
- Department of Clinical Genetics Rigshospitalet/Kennedy Center Glostrup Denmark
- Institute of Clinical Medicine University of Copenhagen Copenhagen Denmark
| | - Marjon Slegtenhorst
- Department of Clinical Genetics Erasmus MC, University Medical Center Rotterdam the Netherlands
| | - Lynne A. Wolfe
- Undiagnosed Diseases Program, Common Fund National Institutes of Health Bethesda MarylandUSA
- Section of Human Biochemical Genetics National Human Genome Research Institute Bethesda MarylandUSA
| | - Dennis Lal
- Cologne Center for Genomics University Hospital Cologne, University of Cologne Cologne Germany
- Stanley Center for Psychiatric Research Broad Institute of Massachusetts Institute of Technology and Harvard Cambridge MassachusettsUSA
- Analytic and Translational Genetics Unit Massachusetts General Hospital Boston MassachusettsUSA
- Epilepsy Center Neurological Institute Cleveland Clinic Cleveland OhioUSA
- Genomic Medicine Institute Lerner Research Institute Cleveland Clinic Cleveland OhioUSA
| | - Elena Gardella
- Institute for Regional Health Services University of Southern Denmark Odense Denmark
- Department of Epilepsy Genetics and Personalized Medicine Danish Epilepsy Center Dianalund Denmark
- Department of Clinical Neurophysiology Danish Epilepsy Center Dianalund Denmark
| | - Lilian Bomme Ousager
- Department of Clinical Genetics Odense University Hospital Odense Denmark
- Human Genetics Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Tobias Brünger
- Cologne Center for Genomics University Hospital Cologne, University of Cologne Cologne Germany
| | - Ingo Helbig
- Department of Neuropediatrics University Medical Center Schleswig‐Holstein Christian Albrechts University Kiel Germany
- Division of Neurology Children’s Hospital of Philadelphia Philadelphia PennsylvaniaUSA
- Epilepsy NeuroGenetics Initiative Children's Hospital of Philadelphia Philadelphia PennsylvaniaUSA
- Department of Biomedical and Health Informatics Children’s Hospital of Philadelphia Philadelphia PennsylvaniaUSA
- Department of Neurology University of Pennsylvania, Perelman School of Medicine Philadelphia PennsylvaniaUSA
| | - Peter Krawitz
- Institute for Genomic Statistics and Bioinformatics University Hospital Bonn Rheinische Friedrich‐Wilhelms‐University Bonn Bonn Germany
| | - Rikke S. Møller
- Institute for Regional Health Services University of Southern Denmark Odense Denmark
- Department of Epilepsy Genetics and Personalized Medicine Danish Epilepsy Center Dianalund Denmark
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6
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Analyzing clinical and genetic characteristics of a cohort with multiple congenital anomalies-hypotonia-seizures syndrome (MCAHS). Orphanet J Rare Dis 2020; 15:78. [PMID: 32220244 PMCID: PMC7099766 DOI: 10.1186/s13023-020-01365-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/18/2020] [Indexed: 12/28/2022] Open
Abstract
Objective To summarize and extend the phenotypic characterization of Multiple Congenital Anomalies-Hypotonia-Seizures Syndrome, and to discuss genotype-phenotype correlations. Methods Collecting clinical information of 17 patients with pathogenic variants in PIGN, PIGA, and PIGT. Genetic studies were performed on all patients. Results There were 7 patients with 15 PIGN mutations (one patient carrying 3 mutations), 8 patients with 8 PIGA mutations, and 2 patients with 5 PIGT mutations (one patient carrying 3 mutations). All patients had epilepsy and developmental delay, with 71% of them showed hypotonia. And among these patients’ various seizure types, the focal seizure was the most common one. Eighty-two percent patients showed a significant relationship between seizures and fever. Serum ALP was elevated in one patient with PIGN mutations and in two patients with PIGA mutations. Brain MRI showed enlarged subarachnoid space in 56% of patients. Some other different characteristics had also been found in our patients: First, atypical absence seizures presented in three patients with PIGN mutations; Second, diffuse slow waves mixed with focal or multifocal discharges of interictal EEG in 88% cases with PIGA-deficient; Third, phenotypes of seven out of eight patients with PIGA mutations were difficult to be classified as severe or less severe group; Last, mild neurological symptoms and developmental status rather than severe conditions occurred in one patient with PIGT mutations. Conclusion With epilepsy, developmental delay, and/or hypotonia as common features, the knowledge of MCAHS in terms of phenotype and genotype has been expanded. In cases with PIGN-deficient, we expanded the types of atypical absence seizures, and described one patient with elevated serum ALP. Focal seizures with diffuse slow waves mixed with focal or multifocal discharges on EEG rather than infantile spasms with hypsarrhythmia, which as previously reported were often seen in our patients with PIGA mutations. The classifications of phenotypes caused by PIGA mutations should be more continuous than discrete. The mild phenotype of one patient with PIGT mutations expanded the clinical presentation of MCAHS3.
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7
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Neuhofer CM, Funke R, Wilken B, Knaus A, Altmüller J, Nürnberg P, Li Y, Wollnik B, Burfeind P, Pauli S. A Novel Mutation in PIGA Associated with Multiple Congenital Anomalies-Hypotonia-Seizure Syndrome 2 (MCAHS2) in a Boy with a Combination of Severe Epilepsy and Gingival Hyperplasia. Mol Syndromol 2020; 11:30-37. [PMID: 32256299 DOI: 10.1159/000505797] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2019] [Indexed: 01/25/2023] Open
Abstract
Multiple congenital anomalies-hypotonia-seizures syndrome 2 (MCAHS2) is a rare disease caused by mutations in the X chromosomal PIGA gene. Clinically it is characterized by early-onset epilepsy, hypotonia, dysmorphic features, and variable congenital anomalies. PIGA codes for the phosphatidylinositol glycan-class A protein, which forms a subunit of an enzymatic complex involved in glycophosphatidylinositol (GPI) biosynthesis. We present a new case of MCAHS2 and perform a comprehensive review of the available literature to delineate the phenotypical traits associated with germline PIGA mutations. Furthermore, we provide functional evidence of pathogenicity of the novel missense mutation, c.154C>T; (p.His52Tyr), in the PIGA gene causative of MCAHS2 in our patient. By flow cytometry, we observed reduced expression of GPI-anchored surface proteins in patient granulocytes compared to control samples, proving GPI-biogenesis impairment. The patient's severe epilepsy with several daily attacks was refractory to treatment, but the frequency of seizures reduced temporarily under triple therapy with perampanel, rufinamide and vigabatrin. Our study delineates the known MCAHS2 phenotype and discusses challenges of diagnosis and clinical management in this complex, rare disease. Furthermore, we present a novel mutation with functional evidence of pathogenicity.
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Affiliation(s)
- Christiane M Neuhofer
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Rudolf Funke
- Department of Pediatric Neurology, Klinikum Kassel, Kassel, Germany
| | - Bernd Wilken
- Department of Pediatric Neurology, Klinikum Kassel, Kassel, Germany
| | - Alexej Knaus
- Institute for Genomic Statistics and Bioinformatics, University Hospital Bonn, Germany
| | - Janine Altmüller
- Cologne Center for Genomics (CCG), University of Köln, Köln, Germany
| | - Peter Nürnberg
- Cologne Center for Genomics (CCG), University of Köln, Köln, Germany
| | - Yun Li
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Bernd Wollnik
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Peter Burfeind
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
| | - Silke Pauli
- Institute of Human Genetics, University Medical Center Göttingen, Göttingen, Germany
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8
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PIGA related disorder as a range of phenotypes rather than two distinct subtypes. Brain Dev 2020; 42:205-210. [PMID: 31704190 DOI: 10.1016/j.braindev.2019.10.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 09/26/2019] [Accepted: 10/01/2019] [Indexed: 11/21/2022]
Abstract
Patients with germline phosphatidylinositol glycan biosynthesis class A (PIGA) related disorder have historically been categorized into one of two distinct subtypes: a severe form which is often fatal, and a less severe form. However, the increasing number of cases with features indicative of both subtypes raise the possibility of a phenotypic spectrum associated with PIGA disorder. In order to further characterize this phenotypic spectrum, we present two patients with features of both the severe and less severe subtypes with a review of phenotypes reported to date in the literature. In eight year old patient 1, a maternally inherited PIGA likely pathogenic variant was discovered using exome sequencing. He presented with myoclonic epilepsy, mild intellectual disability, spastic diplegia, developmental motor delay, and autism spectrum disorder. Patient 2 is a 13 year old with focal epilepsy, profound developmental delay, coarse facial features, severe intellectual disability and autism spectrum disorder. A de novo PIGA likely pathogenic variant was found through exome sequencing. Both patients had normal alkaline phosphatase levels and are without related organ abnormalities. We conclude that pathogenic PIGA variants cause a spectrum of phenotypes rather than the categories of "severe" and "less severe" as previously posited.
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9
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Starr LJ, Spranger JW, Rao VK, Lutz R, Yetman AT. PIGQ glycosylphosphatidylinositol-anchored protein deficiency: Characterizing the phenotype. Am J Med Genet A 2019; 179:1270-1275. [PMID: 31148362 DOI: 10.1002/ajmg.a.61185] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Revised: 03/04/2019] [Accepted: 04/23/2019] [Indexed: 12/30/2022]
Abstract
PIGQ (OMIM *605754) encodes phosphatidylinositol glycan biosynthesis class Q (PIGQ) and is required for proper functioning of an N-acetylglucosamine transferase complex in a similar manner to the more established PIGA, PIGC, and PIGH. There are two previous patients reported with homozygous and apparently deleterious PIGQ mutations. Here, we provide the first detailed clinical report of a patient with heterozygous deleterious mutations associated with glycosylphosphatidylinositol-anchored protein (GPI-AP) biosynthesis deficiency. Our patient died at 10 months of age. The rare skeletal findings in this disorder expand the differential diagnosis of long bone radiolucent lesions and sphenoid wing dysplasia. This clinical report describes a new and rare disorder-PIGQ GPI-AP biosynthesis deficiency syndrome.
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Affiliation(s)
- Lois J Starr
- Department of Pediatrics, Children's Hospital and Medical Center, University of Nebraska Medical Center, Omaha, Nebraska
| | | | - Vamshi K Rao
- Division of Neurology, Department of Pediatrics, Ann and Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Richard Lutz
- Department of Pediatrics, Children's Hospital and Medical Center, University of Nebraska Medical Center, Omaha, Nebraska
| | - Anji T Yetman
- Department of Pediatrics, Children's Hospital and Medical Center, University of Nebraska Medical Center, Omaha, Nebraska
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Yang J, Wang Q, Zhuo Q, Tian H, Li W, Luo F, Zhang J, Bi D, Peng J, Zhou D, Xin H. A likely pathogenic variant putatively affecting splicing of PIGA identified in a multiple congenital anomalies hypotonia-seizures syndrome 2 (MCAHS2) family pedigree via whole-exome sequencing. Mol Genet Genomic Med 2018; 6:739-748. [PMID: 29974678 PMCID: PMC6160699 DOI: 10.1002/mgg3.428] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 04/25/2018] [Accepted: 06/11/2018] [Indexed: 12/18/2022] Open
Abstract
Background Glycosylphosphatidylinositol (GPI) anchoring is a special type of protein posttranslational modification, by which proteins with diverse function are attached to cell membrane through a covalent linkage between the protein and the glycolipid. Phosphatidylinositol glycan anchor biosynthesis class A (PIGA) is a key enzyme in GPI anchor biosynthesis, somatic mutations or genetic variants of which have been associated with paroxysmal nocturnal hemoglobinuria (PNH), or PIGA deficiency, respectively. More than 10 PIGA pathogenic or likely pathogenic variants have been reported in a wide spectrum of clinical syndromes of PIGA deficiency, including multiple congenital anomalies hypotonia‐seizures syndrome 2 (MCAHS2). Methods Whole‐exome sequencing (WES) was performed on two trios, that is., the proband's family and his affected maternal cousin's family, from a nonconsanguineous Chinese family pedigree with hypotonia‐encephalopathy‐seizures disease history and putative X‐linked recessive inheritance. Sanger sequencing for PIGA variant was performed on affected members as well as unaffected members in the family pedigree to verify its familial segregation. Results A novel likely pathogenic variant in PIGA was identified through comparative WES analysis of the two affected families. The single‐nucleotide substitution (NC_000023.9:g.15343279T>C) is located in intron 3 of the PIGA gene and within the splice acceptor consensus sequence (NM_002641.3:c.849‐5A>G). Even though we have not performed RNA studies, in silico tools predict that this intronic variant may alter normal splicing, causing a four base pair insertion which creates a frameshift and a premature stop codon at position 297 (NP_002632.1:p.(Arg283Serfs*15)). Sanger sequencing analysis of the extended family members confirmed the presence of the variant and its X‐linked inheritance. Conclusion WES data analysis along with familial segregation of a rare intronic variant are suggestive of a diagnosis of X‐liked PIGA deficiency with clinical features of MCAHS2.
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Affiliation(s)
- Junli Yang
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Qiong Wang
- Institute for Biology and Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Qingcui Zhuo
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Huiling Tian
- Children Rehabilitation Center of Linyi Women and Children's Hospital, Linyi, China
| | - Wen Li
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Fang Luo
- MyGenostics Inc., Beijing, China
| | - Jinghui Zhang
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Dan Bi
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Jing Peng
- Institute for Biology and Medicine, Wuhan University of Science and Technology, Wuhan, China
| | - Dong Zhou
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Huawei Xin
- Institute for Biology and Medicine, Wuhan University of Science and Technology, Wuhan, China.,School of Pharmacy, Linyi University, Linyi, China
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