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Merlini L, Sabatelli P, Gualandi F, Redivo E, Di Martino A, Faldini C. New Clinical and Immunofluoresence Data of Collagen VI-Related Myopathy: A Single Center Cohort of 69 Patients. Int J Mol Sci 2023; 24:12474. [PMID: 37569848 PMCID: PMC10420187 DOI: 10.3390/ijms241512474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/30/2023] [Accepted: 08/04/2023] [Indexed: 08/13/2023] Open
Abstract
Pathogenetic mechanism recognition and proof-of-concept clinical trials were performed in our patients affected by collagen VI-related myopathies. This study, which included 69 patients, aimed to identify innovative clinical data to better design future trials. Among the patients, 33 had Bethlem myopathy (BM), 24 had Ullrich congenital muscular dystrophy (UCMD), 7 had an intermediate phenotype (INTM), and five had myosclerosis myopathy (MM). We obtained data on muscle strength, the degree of contracture, immunofluorescence, and genetics. In our BM group, only one third had a knee extension strength greater than 50% of the predicted value, while only one in ten showed similar retention of elbow flexion. These findings should be considered when recruiting BM patients for future trials. All the MM patients had axial and limb contractures that limited both the flexion and extension ranges of motion, and a limitation in mouth opening. The immunofluorescence analysis of collagen VI in 55 biopsies from 37 patients confirmed the correlation between collagen VI defects and the severity of the clinical phenotype. However, biopsies from the same patient or from patients with the same mutation taken at different times showed a progressive increase in protein expression with age. The new finding of the time-dependent modulation of collagen VI expression should be considered in genetic correction trials.
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Affiliation(s)
- Luciano Merlini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Patrizia Sabatelli
- Unit of Bologna, CNR-Institute of Molecular Genetics “Luigi Cavalli Sforza”, 40136 Bologna, Italy;
- IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Francesca Gualandi
- Department of Medical Sciences, Unit of Medical Genetics, Università degli Studi di Ferrara, 44100 Ferrara, Italy;
| | - Edoardo Redivo
- Department of Statistical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Alberto Di Martino
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Cesare Faldini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy;
- I Orthopedic and Traumatology Department, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
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Li M, Huang J, Liu M, Duan C, Guo H, Chen X, Wang Y. A novel variant of COL6A3 c.6817-2(IVS27)A>G causing Bethlem myopathy: A case report. Front Neurol 2023; 14:1063090. [PMID: 36779064 PMCID: PMC9911450 DOI: 10.3389/fneur.2023.1063090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Accepted: 01/05/2023] [Indexed: 01/28/2023] Open
Abstract
Bethlem myopathy (BM) is a disease that is caused by mutations in the collagen VI genes. It is a mildly progressive disease characterized by proximal muscle weakness and contracture of the fingers, the wrist, the elbow, and the ankle. BM is an autosomal dominant inheritance that is mainly caused by dominant COL6A1, COL6A2, or COL6A3 mutations. However, a few cases of collagen VI mutations with bilateral facial weakness and Beevor's sign have also been reported. This study presents a 50-year-old female patient with symptoms of facial weakness beginning in childhood and with the slow progression of the disease with age. At the age of 30 years, the patient presented with asymmetrical proximal muscle weakness, and the neurological examination revealed bilateral facial weakness and a positive Beevor's sign. Phosphocreatine kinase was slightly elevated with electromyography showing myopathic changes and magnetic resonance imaging (MRI) of the lower limb muscles showing the muscle MRI associated with collagen VI (COL6)-related myopathy (COL6-RM). The whole-genome sequencing technology identified the heterozygous mutation c.6817-2(IVS27)A>G in the COL6A3 gene, which was in itself a novel mutation. The present study reports yet another case of BM, which is caused by the recessive COL6A3 intron variation, widening the clinical spectrum and genetic heterogeneity of BM.
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Affiliation(s)
- Maohua Li
- Department of Neurology, The Second Affiliated Hospital (Xinqiao Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Jiandi Huang
- Department of Neurology, The Second Affiliated Hospital (Xinqiao Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Min Liu
- Department of Neurology, The Second Affiliated Hospital (Xinqiao Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Chunmei Duan
- Department of Neurology, The Second Affiliated Hospital (Xinqiao Hospital), Army Medical University (Third Military Medical University), Chongqing, China
| | - Hong Guo
- Department of Medical Genetics, College of Basic Medical Science, Army Medical University (Third Military Medical University), Chongqing, China,Hong Guo ✉
| | - Xiaoyan Chen
- Department of Neurology, The Second Affiliated Hospital (Xinqiao Hospital), Army Medical University (Third Military Medical University), Chongqing, China,Xiaoyan Chen ✉
| | - Yue Wang
- Department of Neurology, The Second Affiliated Hospital (Xinqiao Hospital), Army Medical University (Third Military Medical University), Chongqing, China,*Correspondence: Yue Wang ✉
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Sabatelli P, Merlini L, Di Martino A, Cenni V, Faldini C. Early Morphological Changes of the Rectus Femoris Muscle and Deep Fascia in Ullrich Congenital Muscular Dystrophy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031252. [PMID: 35162283 PMCID: PMC8834967 DOI: 10.3390/ijerph19031252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/07/2022] [Accepted: 01/18/2022] [Indexed: 11/16/2022]
Abstract
Ullrich congenital muscular dystrophy (UCMD) is a severe form of muscular dystrophy caused by the loss of function of collagen VI, a critical component of the muscle-tendon matrix. Magnetic resonance imaging of UCMD patients’ muscles shows a peculiar rim of abnormal signal at the periphery of each muscle, and a relative sparing of the internal part. The mechanism/s involved in the early fat substitution of muscle fiber at the periphery of muscles remain elusive. We studied a muscle biopsy of the rectus femoris/deep fascia (DF) of a 3-year-old UCMD patient, with a homozygous mutation in the COL6A2 gene. By immunohistochemical and ultrastructural analysis, we found a marked fatty infiltration at the interface of the muscle with the epimysium/DF and an atrophic phenotype, primarily in fast-twitch fibers, which has never been reported before. An unexpected finding was the widespread increase of interstitial cells with long cytoplasmic processes, consistent with the telocyte phenotype. Our study documents for the first time in a muscle biopsy the peculiar pattern of outside-in muscle degeneration followed by fat substitution as already shown by muscle imaging, and an increase of telocytes in the interstitium of the deep fascia, which highlights a potential involvement of this structure in the pathogenesis of UCMD.
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Affiliation(s)
- Patrizia Sabatelli
- Unit of Bologna, CNR-Institute of Molecular Genetics “Luigi Luca Cavalli-Sforza”, 40136 Bologna, Italy;
- IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Correspondence: ; Tel.: +39-051-6366755; Fax: +39-051-4689922
| | - Luciano Merlini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (L.M.); or (A.D.M.); (C.F.)
| | - Alberto Di Martino
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (L.M.); or (A.D.M.); (C.F.)
- Clinica Ortopedica e Traumatologica I, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
| | - Vittoria Cenni
- Unit of Bologna, CNR-Institute of Molecular Genetics “Luigi Luca Cavalli-Sforza”, 40136 Bologna, Italy;
- IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - Cesare Faldini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40126 Bologna, Italy; (L.M.); or (A.D.M.); (C.F.)
- Clinica Ortopedica e Traumatologica I, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
- Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA
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Aivazoglou LU, Guimarães JB, Link TM, Costa MAF, Cardoso FN, de Mattos Lombardi Badia B, Farias IB, de Rezende Pinto WBV, de Souza PVS, Oliveira ASB, de Siqueira Carvalho AA, Aihara AY, da Rocha Corrêa Fernandes A. MR imaging of inherited myopathies: a review and proposal of imaging algorithms. Eur Radiol 2021; 31:8498-8512. [PMID: 33881569 DOI: 10.1007/s00330-021-07931-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Revised: 02/05/2021] [Accepted: 03/23/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW The aims of this review are to discuss the imaging modalities used to assess muscle changes in myopathies, to provide an overview of the inherited myopathies focusing on their patterns of muscle involvement in magnetic resonance imaging (MR), and to propose up-to-date imaging-based diagnostic algorithms that can help in the diagnostic workup. CONCLUSION Familiarization with the most common and specific patterns of muscular involvement in inherited myopathies is very important for radiologists and neurologists, as imaging plays a significant role in diagnosis and follow-up of these patients. KEY POINTS • Imaging is an increasingly important tool for diagnosis and follow-up in the setting of inherited myopathies. • Knowledge of the most common imaging patterns of muscle involvement in inherited myopathies is valuable for both radiologists and neurologists. • In this review, we present imaging-based algorithms that can help in the diagnostic workup of myopathies.
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Affiliation(s)
- Laís Uyeda Aivazoglou
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil.,Laboratório Delboni Auriemo - Grupo DASA, Av Juruá, 434, Barueri, SP, 06455-010, Brazil
| | - Julio Brandão Guimarães
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil. .,Musculoskeletal and Quantitative Imaging Research Group (MQIR), Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, USA.
| | - Thomas M Link
- Musculoskeletal and Quantitative Imaging Research Group (MQIR), Department of Radiology and Biomedical Imaging, University of California, San Francisco, 505 Parnassus Ave, San Francisco, CA, 94143, USA
| | - Maria Alice Freitas Costa
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil.,Laboratório Delboni Auriemo - Grupo DASA, Av Juruá, 434, Barueri, SP, 06455-010, Brazil
| | - Fabiano Nassar Cardoso
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil
| | - Bruno de Mattos Lombardi Badia
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Igor Braga Farias
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Wladimir Bocca Vieira de Rezende Pinto
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Paulo Victor Sgobbi de Souza
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Acary Souza Bulle Oliveira
- Division of Neuromuscular Diseases, Department of Neurology and Neurosurgery, Universidade Federal de São Paulo (UNIFESP), Rua Embaú, 67, São Paulo, SP, 04039-060, Brazil
| | - Alzira Alves de Siqueira Carvalho
- Laboratório de Doenças Neuromusculares da Faculdade de Medicina do ABC - Departamento de Neurociências, Av. Lauro Gomes, 2000, Santo André, SP, 09060-870, Brazil
| | - André Yui Aihara
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil.,Laboratório Delboni Auriemo - Grupo DASA, Av Juruá, 434, Barueri, SP, 06455-010, Brazil
| | - Artur da Rocha Corrêa Fernandes
- Department of Radiology and Diagnostic Imaging, Universidade Federal de São Paulo (UNIFESP), Rua Napoleão de Barros, 800, São Paulo, SP, 04024-002, Brazil
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5
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Martínez-Martín Á, Díaz-Maroto Cicuéndez I, Simón Sánchez J, García-García J. Muscle weakness, joint laxity and keloids. A more than suggestive association. NEUROLOGÍA (ENGLISH EDITION) 2021. [DOI: 10.1016/j.nrleng.2020.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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6
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Villar-Quiles RN, Donkervoort S, de Becdelièvre A, Gartioux C, Jobic V, Foley AR, McCarty RM, Hu Y, Menassa R, Michel L, Gousse G, Lacour A, Petiot P, Streichenberger N, Choumert A, Declerck L, Urtizberea JA, Sole G, Furby A, Cérino M, Krahn M, Campana-Salort E, Ferreiro A, Eymard B, Bönnemann CG, Bharucha-Goebel D, Sumner CJ, Connolly AM, Richard P, Allamand V, Métay C, Stojkovic T. Clinical and Molecular Spectrum Associated with COL6A3 c.7447A>G p.(Lys2483Glu) Variant: Elucidating its Role in Collagen VI-related Myopathies. J Neuromuscul Dis 2021; 8:633-645. [PMID: 33749658 DOI: 10.3233/jnd-200577] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Dominant and recessive autosomal pathogenic variants in the three major genes (COL6A1-A2-A3) encoding the extracellular matrix protein collagen VI underlie a group of myopathies ranging from early-onset severe conditions (Ullrich congenital muscular dystrophy) to milder forms maintaining independent ambulation (Bethlem myopathy). Diagnosis is based on the combination of clinical presentation, muscle MRI, muscle biopsy, analysis of collagen VI secretion, and COL6A1-A2-A3 genetic analysis, the interpretation of which can be challenging. OBJECTIVE To refine the phenotypical spectrum associated with the frequent COL6A3 missense variant c.7447A>G (p.Lys2483Glu). METHODS We report the clinical and molecular findings in 16 patients: 12 patients carrying this variant in compound heterozygosity with another COL6A3 variant, and four homozygous patients. RESULTS Patients carrying this variant in compound heterozygosity with a truncating COL6A3 variant exhibit a phenotype consistent with COL6-related myopathies (COL6-RM), with joint contractures, proximal weakness and skin abnormalities. All remain ambulant in adulthood and only three have mild respiratory involvement. Most show typical muscle MRI findings. In five patients, reduced collagen VI secretion was observed in skin fibroblasts cultures. All tested parents were unaffected heterozygous carriers. Conversely, two out of four homozygous patients did not present with the classical COL6-RM clinical and imaging findings. Collagen VI immunolabelling on cultured fibroblasts revealed rather normal secretion in one and reduced secretion in another. Muscle biopsy from one homozygous patient showed myofibrillar disorganization and rimmed vacuoles. CONCLUSIONS In light of our results, we postulate that the COL6A3 variant c.7447A>G may act as a modulator of the clinical phenotype. Thus, in patients with a typical COL6-RM phenotype, a second variant must be thoroughly searched for, while for patients with atypical phenotypes further investigations should be conducted to exclude alternative causes. This works expands the clinical and molecular spectrum of COLVI-related myopathies.
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Affiliation(s)
- Rocío N Villar-Quiles
- AP-HP, Reference Center for Neuromuscular Disorders, Pitié-Salpêtrière Hospital, Paris, France.,Centre de Recherche en Myologie, Institut de Myologie, Sorbonne Université, Inserm, Paris, France
| | - Sandra Donkervoort
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Alix de Becdelièvre
- AP-HP, Département de Génétique, Hôpital Henri Mondor, Créteil, France.,AP-HP, Centre de Génétique Moléculaire et Chromosomique, UF Cardiogénétique et Myogénétique Moléculaire et Cellulaire, GH Pitié-Salpêtrière, Paris, France
| | - Corine Gartioux
- Centre de Recherche en Myologie, Institut de Myologie, Sorbonne Université, Inserm, Paris, France
| | - Valérie Jobic
- AP-HP, Centre de Génétique Moléculaire et Chromosomique, UF Cardiogénétique et Myogénétique Moléculaire et Cellulaire, GH Pitié-Salpêtrière, Paris, France
| | - A Reghan Foley
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Riley M McCarty
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Ying Hu
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Rita Menassa
- Hospices Civils de Lyon, LBMMS, Service Biochimie Biologie Moléculaire Grand Est, Groupement Hospitalier Est, CBPE, Bron, France
| | - Laurence Michel
- Hospices Civils de Lyon, LBMMS, Service Biochimie Biologie Moléculaire Grand Est, Groupement Hospitalier Est, CBPE, Bron, France
| | - Gaelle Gousse
- Service de Neuropédiatrie, CHU Saint-Étienne, Saint-Étienne, France
| | - Arnaud Lacour
- Service de Neurologie, CHU Saint-Étienne, Saint-Étienne, France
| | - Philippe Petiot
- Neurologie et Explorations Fonctionnelles Neurologiques, Centre de Référence Maladies Neuromusculaires de la Région Rhône-Alpes Hôpital de la Croix-Rousse, Lyon, France
| | - Nathalie Streichenberger
- Centre de Pathologie et Neuropathologie Est, Hospices Civils de Lyon, Groupement Hospitalier Est, Bron, France
| | - Ariane Choumert
- Centre des Maladies Rares Neurologiques, CHU Sud Réunion, Saint-Pierre, France
| | - Léa Declerck
- Centre des Maladies Rares Neurologiques, CHU Sud Réunion, Saint-Pierre, France
| | - J A Urtizberea
- Hôpital Marin, Centre de Compétence Neuromusculaire, Hendaye, France
| | - Guilhem Sole
- Centre de Référence des Maladies Neuromusculaires AOC, Hôpital Pellegrin, CHU Bordeaux, Bordeaux, France
| | - Alain Furby
- Centre de Référence des Maladies Neuromusculaires Rares Rhônes-Alpes, Hôpital Nord, CHU de Saint-Étienne, Saint-Étienne, France
| | - Matthieu Cérino
- AP-HM, Département de Génétique Médicale, Hôpital Timone Enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | - Martin Krahn
- AP-HM, Département de Génétique Médicale, Hôpital Timone Enfants, Assistance Publique Hôpitaux de Marseille, Marseille, France
| | | | - Ana Ferreiro
- AP-HP, Reference Center for Neuromuscular Disorders, Pitié-Salpêtrière Hospital, Paris, France.,Basic and Translational Myology Lab, UMR8251, University Paris Diderot/CNRS, Paris, France
| | - Bruno Eymard
- AP-HP, Reference Center for Neuromuscular Disorders, Pitié-Salpêtrière Hospital, Paris, France
| | - Carsten G Bönnemann
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Diana Bharucha-Goebel
- Neuromuscular and Neurogenetic Disorders of Childhood Section, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA.,Division of Neurology, Children's National Hospital, Washington, DC, USA
| | - Charlotte J Sumner
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Anne M Connolly
- Department of Pediatrics, Neurology Division, Nationwide Children's Hospital, Ohio State University, Columbus, OH, USA
| | - Pascale Richard
- AP-HP, Centre de Génétique Moléculaire et Chromosomique, UF Cardiogénétique et Myogénétique Moléculaire et Cellulaire, GH Pitié-Salpêtrière, Paris, France
| | - Valérie Allamand
- Centre de Recherche en Myologie, Institut de Myologie, Sorbonne Université, Inserm, Paris, France.,Unit of Muscle Biology, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Corinne Métay
- AP-HP, Centre de Génétique Moléculaire et Chromosomique, UF Cardiogénétique et Myogénétique Moléculaire et Cellulaire, GH Pitié-Salpêtrière, Paris, France.,Centre de Recherche en Myologie, Institut de Myologie, Sorbonne Université, Inserm, Paris, France
| | - Tanya Stojkovic
- AP-HP, Reference Center for Neuromuscular Disorders, Pitié-Salpêtrière Hospital, Paris, France.,Centre de Recherche en Myologie, Institut de Myologie, Sorbonne Université, Inserm, Paris, France
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Mihaylova V, Chablais F, Bremer J, Guggenberger R, Rushing EJ, Bethge T, Spiegel R, Jung HH. Collagen VI-Related Myopathy Caused by Compound Heterozygous Mutations of COL6A3 in a Consanguineous Kurdish Family. J Clin Neuromuscul Dis 2021; 22:173-179. [PMID: 33596003 DOI: 10.1097/cnd.0000000000000320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Collagen VI-related myopathies are caused by mutations of COL6A1, COL6A2, and COL6A3 and present with a wide phenotypic spectrum ranging from severe Ulrich congenital muscular dystrophy to mild Bethlem myopathy. Here, we report a consanguineous Kurdish family with 3 siblings affected by autosomal-recessive Bethlem myopathy caused by compound heterozygous mutations of COL6A3. We found the previously described missense mutation c.7447A > G/p.(Lys2483Glu) and a novel large deletion encompassing the exon 1-39 of the COL6A3 gene. Apart from the classical clinical symptoms, all patients had keratoconus, which expands the phenotype of the collagen VI-related myopathies.
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Affiliation(s)
- Violeta Mihaylova
- Department of Neurology, University Hospital and University of Zurich, Zürich, Switzerland
| | - Fabian Chablais
- Genetica, Human Genetics and Genetic Counselling Unit, Zurich, Switzerland
| | - Juliane Bremer
- Institute of Neuropathology, University Hospital and University of Zurich, Zürich, Switzerland
- Institute of Neuropathology, University Hospital RWTH Aachen, Aachen, Germany ; and
| | - Roman Guggenberger
- Department of Radiology, University Hospital and University of Zurich, Zürich, Switzerland
| | - Elisabeth J Rushing
- Institute of Neuropathology, University Hospital and University of Zurich, Zürich, Switzerland
| | - Tobias Bethge
- Genetica, Human Genetics and Genetic Counselling Unit, Zurich, Switzerland
| | - Roland Spiegel
- Genetica, Human Genetics and Genetic Counselling Unit, Zurich, Switzerland
| | - Hans-Heinrich Jung
- Department of Neurology, University Hospital and University of Zurich, Zürich, Switzerland
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8
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Martínez-Martín Á, Díaz-Maroto Cicuéndez I, Simón Sánchez J, García-García J. [Muscle weakness, joint laxity and keloids. A more than suggestive association]. Neurologia 2020; 36:243-245. [PMID: 32553462 DOI: 10.1016/j.nrl.2020.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 05/04/2020] [Indexed: 11/25/2022] Open
Affiliation(s)
- Á Martínez-Martín
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España.
| | | | - J Simón Sánchez
- Departamento Clínico - Área de Neurología, Health in Code S.L., A Coruña, España
| | - J García-García
- Servicio de Neurología, Complejo Hospitalario Universitario de Albacete, Albacete, España
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9
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Coexistence of digenic mutations in the collagen VI genes (COL6A1 and COL6A3) leads to Bethlem myopathy. Clin Chim Acta 2020; 508:28-32. [PMID: 32389683 DOI: 10.1016/j.cca.2020.05.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 03/31/2020] [Accepted: 05/07/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Bethlem myopathy is a kind of collagen VI related myopathy which affects proximal skeletal muscles and leads to gait disturbance and multiple joint contractures with an onset in the first two decades of life. Lung function impairment (respiratory muscle and diaphragmatic weakness, ventilatory restriction, hypoxaemia and hypercapnia) and respiratory failure are part of the clinical spectrum and can occur in ambulatory patients. METHODOLOGY We carried out whole exome sequencing (WES) in combination with neuromuscular diseases-associated genes-filtering to detect the possible causative mutation(s) in a Korean family with Bethlem myopathy. An electrodiagnostic study showed myopathic pattern (normal nerve conduction study, and early recruitment and short amplitude muscle unit action potentials) in the proband. RESULTS Coexistence of digenic mutations in the collagen VI genes (COL6A1 and COL6A3) was identified by WES in the proband only: heterozygous missense mutations of the COL6A1 (NM_001848.2: c.823G > T, p.Gly275Trp; rs1556425467) and of the COL6A3 genes (NM_004369.3: c.9349G > A, p.Asp3117Asn; rs1226664855). COL6A3 mutation may be candidate as disease-associated variant, as far as it was found only in the proband harboring another heterozygous mutation in COL6A1 gene, previously reported as different pathogenic mutations (p.Gly275Arg and p.Gly275Glu) at the same codon in Bethlem myopathy. CONCLUSION Our findings suggest that the coexistence of these digenic mutations is rare, but it may be used for the risk evaluation of individuals with a possible susceptibility to Bethlem myopathy. Taken together, genetic diagnosis using WES is a useful approach for the identification of pathogenic mutations associated with Bethlem myopathy.
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Panadés-de Oliveira L, Bermejo-Guerrero L, de Fuenmayor-Fernández de la Hoz CP, Cantero Montenegro D, Hernández Lain A, Martí P, Muelas N, Vilchez JJ, Domínguez-González C. Persistent asymptomatic or mild symptomatic hyperCKemia due to mutations in ANO5: the mildest end of the anoctaminopathies spectrum. J Neurol 2020; 267:2546-2555. [PMID: 32367299 DOI: 10.1007/s00415-020-09872-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND The ANO5 gene encodes for anoctamin-5, a chloride channel involved in muscle cell membrane repair. Recessive mutations in ANO5 are associated with muscular diseases termed anoctaminopathies, which are characterized by proximal or distal weakness, or isolated hyperCKemia. We present the largest series of patients with asymptomatic/paucisymptomatic anoctaminopathy reported so far, highlighting their clinical and radiological characteristics. METHODS Twenty subjects were recruited retrospectively from the Neuromuscular Disorders Units database of two national reference centers. All had a confirmed genetic diagnosis (mean age of diagnosis was 48 years) established between 2015 and 2019. Clinical and complementary data were evaluated through clinical records. RESULTS None of the patients complained about weakness or showed abnormal muscular balance. Among paucisymptomatic patients, the main complaints or findings were generalized myalgia, exercise intolerance and calf hypertrophy, occasionally associated with calf pain. All patients showed persistent hyperCKemia, ranging from mild-moderate to severe. Muscle biopsy revealed inflammatory changes in three cases. Muscle magnetic resonance imaging revealed typical signs (preferential involvement of adductor and gastrocnemius muscles) in all but one patient. In two cases, abnormal findings were detectable only in STIR sequences (not in T1). Three patients showed radiological progression despite remaining asymptomatic. Twelve different mutations in ANO5 were detected, of which seven are novel. CONCLUSIONS Recessive mutations in ANO5 are a frequent cause of undiagnosed asymptomatic/paucisymptomatic hyperCKemia. Patients with an apparent indolent phenotype may show muscle involvement in complementary tests (muscle biopsy and imaging), which may progress over time. Awareness of anoctaminopathy as the cause of nonspecific muscular complaints or of isolated hyperCKemia is essential to correctly diagnose affected patients.
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Affiliation(s)
- Luísa Panadés-de Oliveira
- Department of Neurology, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n, 28041, Madrid, Spain.
| | - Laura Bermejo-Guerrero
- Department of Neurology, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n, 28041, Madrid, Spain
| | - Carlos Pablo de Fuenmayor-Fernández de la Hoz
- Department of Neurology, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n, 28041, Madrid, Spain.,Department of Neurology, Neuromuscular Disorders Unit, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - Pilar Martí
- Department of Neurology and IIS La Fe, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Neuromuscular Reference Center ERN-EURO-NMD, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Nuria Muelas
- Department of Neurology and IIS La Fe, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Neuromuscular Reference Center ERN-EURO-NMD, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Juan J Vilchez
- Department of Neurology and IIS La Fe, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Neuromuscular Reference Center ERN-EURO-NMD, Hospital Universitari I Politècnic La Fe, Valencia, Spain
| | - Cristina Domínguez-González
- Department of Neurology, Hospital Universitario 12 de Octubre, Avda. de Córdoba, s/n, 28041, Madrid, Spain.,Department of Neurology, Neuromuscular Disorders Unit, Hospital Universitario 12 de Octubre, Madrid, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain.,Hospital 12 de Octubre Research Institute (imas12), Madrid, Spain
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11
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Stavusis J, Micule I, Wright NT, Straub V, Topf A, Panadés-de Oliveira L, Domínguez-González C, Inashkina I, Kidere D, Chrestian N, Lace B. Collagen VI-related limb-girdle syndrome caused by frequent mutation in COL6A3 gene with conflicting reports of pathogenicity. Neuromuscul Disord 2020; 30:483-491. [PMID: 32448721 DOI: 10.1016/j.nmd.2020.03.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Revised: 03/26/2020] [Accepted: 03/30/2020] [Indexed: 11/28/2022]
Abstract
Recently the scientific community has started to view Bethlem myopathy 1 and Ullrich congenital muscular dystrophy as two extremes of a collagen VI-related myopathy spectrum rather than two separate entities, as both are caused by mutations in one of the collagen VI genes. Here we report three individuals in two families who are homozygous for a COL6A3 mutation (c.7447A> G; p.Lys2483Glu), and compare their clinical features with seven previously published cases. Individuals carrying homozygous or compound heterozygous c.7447A> G, (p.Lys2483Glu) mutation exhibit mild phenotype without loss of ambulation, similar to the cases described previously as Collagen VI-related limb-girdle syndrome. The phenotype could arise due to an aberrant assembly of Von Willebrand factor A domains. Based on these data, we propose that c.7447A> G, (p.Lys2483Glu) is a common pathogenic mutation.
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Affiliation(s)
- Janis Stavusis
- Latvian Biomedical Research and Study Centre, Ratsupites 1, Riga LV-1067, Latvia.
| | - Ieva Micule
- Latvian Biomedical Research and Study Centre, Ratsupites 1, Riga LV-1067, Latvia
| | - Nathan T Wright
- Department of Chemistry and Biochemistry, James Madison University, Harrisonburg, VA 22807, United States
| | - Volker Straub
- Institute of Genetic Medicine, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Central Parkway, Newcastle upon Tyne, UK
| | - Ana Topf
- Institute of Genetic Medicine, Newcastle University and Newcastle Hospitals NHS Foundation Trust, Central Parkway, Newcastle upon Tyne, UK
| | - Luísa Panadés-de Oliveira
- Department of Neurology, Hospital Universitario 12 de Octubre, Av. de Córdoba, s/n, 28,041, Madrid, Spain
| | | | - Inna Inashkina
- Latvian Biomedical Research and Study Centre, Ratsupites 1, Riga LV-1067, Latvia
| | - Dita Kidere
- Latvian Biomedical Research and Study Centre, Ratsupites 1, Riga LV-1067, Latvia
| | - Nicolas Chrestian
- Child neurology department, CHUQ, Laval University, 2325 Rue de l'Université, Quebec City, Canada
| | - Baiba Lace
- Latvian Biomedical Research and Study Centre, Ratsupites 1, Riga LV-1067, Latvia; Medical Genetics department, CHUQ, 2705 Blvd Laurier, Quebec City, Canada
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12
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Westra D, Schouten MI, Stunnenberg BC, Kusters B, Saris CGJ, Erasmus CE, van Engelen BG, Bulk S, Verschuuren-Bemelmans CC, Gerkes EH, de Geus C, van der Zwaag PA, Chan S, Chung B, Barge-Schaapveld DQCM, Kriek M, Sznajer Y, van Spaendonck-Zwarts K, van der Kooi AJ, Krause A, Schönewolf-Greulich B, de Die-Smulders C, Sallevelt SCEH, Krapels IPC, Rasmussen M, Maystadt I, Kievit AJA, Witting N, Pennings M, Meijer R, Gillissen C, Kamsteeg EJ, Voermans NC. Panel-Based Exome Sequencing for Neuromuscular Disorders as a Diagnostic Service. J Neuromuscul Dis 2019; 6:241-258. [PMID: 31127727 DOI: 10.3233/jnd-180376] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
BACKGROUND Neuromuscular disorders (NMDs) are clinically and genetically heterogeneous. Accurate molecular genetic diagnosis can improve clinical management, provides appropriate genetic counseling and testing of relatives, and allows potential therapeutic trials. OBJECTIVE To establish the clinical utility of panel-based whole exome sequencing (WES) in NMDs in a population with children and adults with various neuromuscular symptoms. METHODS Clinical exome sequencing, followed by diagnostic interpretation of variants in genes associated with NMDs, was performed in a cohort of 396 patients suspected of having a genetic cause with a variable age of onset, neuromuscular phenotype, and inheritance pattern. Many had previously undergone targeted gene testing without results. RESULTS Disease-causing variants were identified in 75/396 patients (19%), with variants in the three COL6-genes (COL6A1, COL6A2 and COL6A3) as the most common cause of the identified muscle disorder, followed by variants in the RYR1 gene. Together, these four genes account for almost 25% of cases in whom a definite genetic cause was identified. Furthermore, likely pathogenic variants and/or variants of uncertain significance were identified in 95 of the patients (24%), in whom functional and/or segregation analysis should be used to confirm or reject the pathogenicity. In 18% of the cases with a disease-causing variant of which we received additional clinical information, we identified a genetic cause in genes of which the associated phenotypes did not match that of the patients. Hence, the advantage of panel-based WES is its unbiased approach. CONCLUSION Whole exome sequencing, followed by filtering for NMD genes, offers an unbiased approach for the genetic diagnostics of NMD patients. This approach could be used as a first-tier test in neuromuscular disorders with a high suspicion of a genetic cause. With uncertain results, functional testing and segregation analysis are needed to complete the evidence.
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Affiliation(s)
- Dineke Westra
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Meyke I Schouten
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bas C Stunnenberg
- Department of Neurology, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Benno Kusters
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christiaan G J Saris
- Department of Neurology, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Corrie E Erasmus
- Department of Pediatric Neurology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Baziel G van Engelen
- Department of Neurology, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Saskia Bulk
- Service de Génétique Humaine, CHU de Liège, Liège, Belgium
| | | | - E H Gerkes
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Christa de Geus
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - P A van der Zwaag
- Department of Genetics, University Medical Center Groningen, Groningen, The Netherlands
| | - Sophelia Chan
- Department of Pediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Brian Chung
- Department of Pediatrics and Adolescent Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | | | - Marjolein Kriek
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Yves Sznajer
- Center de Génétique Humaine, Clinique Universitaires Saint Luc, Bruxelles, Belgium
| | | | - Anneke J van der Kooi
- Department of Neurology, Amsterdam Medical Center, Amsterdam UMC, University of Amsterdam, Neuroscience institute, Amsterdam, The Netherlands
| | - Amanda Krause
- Division of Human Genetics, National Health Laboratory Service and School of Pathology, Faculty of Health Sciences, The University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Suzanne C E H Sallevelt
- Department of Clinical Genetics, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ingrid P C Krapels
- Department of Clinical Genetics, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Magnhild Rasmussen
- Department of Child Neurology and Unit for Congenital and Inherited Neuromuscular Disorders, Oslo University Hospital, Oslo, Norway
| | - Isabelle Maystadt
- Center de Génétique Humaine, Institut de Pathologie et de Génétique, Gosselies, Belgium
| | - Anneke J A Kievit
- Department of Clinical Genetics, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Nanna Witting
- Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Maartje Pennings
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rowdy Meijer
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Christian Gillissen
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Erik-Jan Kamsteeg
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Nicol C Voermans
- Department of Neurology, Donders Institute for Brain, Cognition, and Behavior, Radboud University Medical Center, Nijmegen, The Netherlands
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