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Balta B, Erdoğan M, Kiraz A, Korkmaz S, Ağadayı A. Frequent Mutation in the FTL Gene Causing Hyperferritinemia Cataract Syndrome in Turkish Population Is c.-160A>G. Turk J Haematol 2019; 36:25-28. [PMID: 30401656 PMCID: PMC6373503 DOI: 10.4274/tjh.galenos.2018.2018.0194] [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] [Indexed: 12/01/2022] Open
Abstract
Objective: Hyperferritinemia cataract syndrome (HFCS) is an autosomal dominantly inherited disease characterized by increased serum ferritin levels and bilateral cataract formation in the early period of life. Heterozygote mutations in the 5’ untranslated region of the L-ferritin gene (FTL) have been reported to cause this disease. In this study, our purpose was to research the FTL gene mutations that cause HFCS in Central Anatolia and the clinical effects of these mutations. Materials and Methods: Seventeen patients from 6 families with high ferritin levels in performed serum measurements, those who were found to have cataracts in eye examinations, and families with vertical inheritance, since the disease is autosomal dominant, were included in the study. Exons, exon-intron boundaries, and 5’ and 3’ untranslated regions of FTL (NM_000146) were sequenced using the Sanger sequencing method. Results: The female/male ratio of the patients was 7/10. All of the patients were found to have c.-160A>G heterozygous mutation in the FTL gene. Conclusion: In the Turkish population, the prevalence of HFCS is about 1/100,000 and the commonly observed mutation is c.-160A>G mutation.
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Affiliation(s)
- Burhan Balta
- Kayseri Training and Research Hospital, Clinic of Medical Genetics, Kayseri, Turkey
| | - Murat Erdoğan
- Kayseri Training and Research Hospital, Clinic of Medical Genetics, Kayseri, Turkey
| | - Aslıhan Kiraz
- Kayseri Training and Research Hospital, Clinic of Medical Genetics, Kayseri, Turkey
| | - Serdal Korkmaz
- Kayseri Training and Research Hospital, Clinic of Hematology, Kayseri, Turkey
| | - Alperen Ağadayı
- Kayseri Training and Research Hospital, Clinic of Ophthalmology, Kayseri, Turkey
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Cadenas B, Fita-Torró J, Bermúdez-Cortés M, Hernandez-Rodriguez I, Fuster JL, Llinares ME, Galera AM, Romero JL, Pérez-Montero S, Tornador C, Sanchez M. L-Ferritin: One Gene, Five Diseases; from Hereditary Hyperferritinemia to Hypoferritinemia-Report of New Cases. Pharmaceuticals (Basel) 2019; 12:ph12010017. [PMID: 30678075 PMCID: PMC6469184 DOI: 10.3390/ph12010017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 01/18/2019] [Accepted: 01/19/2019] [Indexed: 01/13/2023] Open
Abstract
Ferritin is a multimeric protein composed of light (L-ferritin) and heavy (H-ferritin) subunits that binds and stores iron inside the cell. A variety of mutations have been reported in the L-ferritin subunit gene (FTL gene) that cause the following five diseases: (1) hereditary hyperferritinemia with cataract syndrome (HHCS), (2) neuroferritinopathy, a subtype of neurodegeneration with brain iron accumulation (NBIA), (3) benign hyperferritinemia, (4) L-ferritin deficiency with autosomal dominant inheritance, and (5) L-ferritin deficiency with autosomal recessive inheritance. Defects in the FTL gene lead to abnormally high levels of serum ferritin (hyperferritinemia) in HHCS and benign hyperferritinemia, while low levels (hypoferritinemia) are present in neuroferritinopathy and in autosomal dominant and recessive L-ferritin deficiency. Iron disturbances as well as neuromuscular and cognitive deficits are present in some, but not all, of these diseases. Here, we identified two novel FTL variants that cause dominant L-ferritin deficiency and HHCS (c.375+2T > A and 36_42delCAACAGT, respectively), and one previously reported variant (Met1Val) that causes dominant L-ferritin deficiency. Globally, genetic changes in the FTL gene are responsible for multiple phenotypes and an accurate diagnosis is useful for appropriate treatment. To help in this goal, we included a diagnostic algorithm for the detection of diseases caused by defects in FTL gene.
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Affiliation(s)
- Beatriz Cadenas
- Whole Genix SL., 08021 Barcelona, Spain.
- Iron Metabolism: Regulation and Diseases Group, Josep Carreras Leukemia Research Institute (IJC), Campus Can Ruti, Badalona, 08916 Barcelona, Spain.
- Experimental Sciences and Technology Department, Universitat de Vic-Universitat Central de Catalunya, 08500 Vic, Spain.
| | - Josep Fita-Torró
- BloodGenetics SL, Esplugues de Llobregat, 08950 Barcelona, Spain.
| | - Mar Bermúdez-Cortés
- Pediatric OncoHematology Service, Clinic University Hospital Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB), 30120 Murcia, Spain.
| | - Inés Hernandez-Rodriguez
- Hematology Service, University Hospital Germans Trias i Pujol (HGTiP), Institut Català d'Oncologia (ICO), Badalona, 08916 Barcelona, Spain.
| | - José Luis Fuster
- Pediatric OncoHematology Service, Clinic University Hospital Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB), 30120 Murcia, Spain.
| | - María Esther Llinares
- Pediatric OncoHematology Service, Clinic University Hospital Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB), 30120 Murcia, Spain.
| | - Ana María Galera
- Pediatric OncoHematology Service, Clinic University Hospital Virgen de la Arrixaca, Instituto Murciano de Investigación Biosanitaria (IMIB), 30120 Murcia, Spain.
| | - Julia Lee Romero
- Biomedical Engineering Department, University of Texas at Austin, Austin, TX 78712, USA.
| | | | - Cristian Tornador
- Whole Genix SL., 08021 Barcelona, Spain.
- BloodGenetics SL, Esplugues de Llobregat, 08950 Barcelona, Spain.
| | - Mayka Sanchez
- BloodGenetics SL, Esplugues de Llobregat, 08950 Barcelona, Spain.
- Program of Predictive and Personalised Medicine of Cancer (PMPPC), Institut d'Investigació Germans Trias i Pujol (IGTP), Campus Can Ruti, Badalona, 08916 Barcelona, Spain.
- Iron Metabolism: Regulation and Diseases Group, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya (UIC), 08195 Barcelona, Spain.
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Van de Sompele S, Pécheux L, Couso J, Meunier A, Sanchez M, De Baere E. Functional characterization of a novel non-coding mutation "Ghent +49A > G" in the iron-responsive element of L-ferritin causing hereditary hyperferritinaemia-cataract syndrome. Sci Rep 2017; 7:18025. [PMID: 29269865 PMCID: PMC5740175 DOI: 10.1038/s41598-017-18326-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Accepted: 12/08/2017] [Indexed: 02/07/2023] Open
Abstract
Hereditary hyperferritinaemia-cataract syndrome (HHCS) is a rare disorder usually caused by heterozygous mutations in the iron-responsive element (IRE) in the 5′ untranslated region (5′UTR) of the L-ferritin gene (FTL), disturbing the binding of iron regulatory proteins (IRPs) and the post-transcriptional regulation of ferritin expression. Here, the proband of a consanguineous family displayed moderate bilateral cataracts and elevated serum ferritin in the absence of iron overload. The parents and siblings showed variable degrees of mild bilateral cataracts combined with elevated levels of circulating ferritin. Sequencing of FTL identified a novel 5′UTR mutation c.-151A > G, also named “Ghent +49A > G”. The zygosity of the mutation, occurring in homozygous and heterozygous state in the proband and other affected family members respectively, correlated well with severity of ophthalmological and hematological manifestations. The substitution is expected to impair the secondary structure of the upper IRE stem. Functional characterization of +49A > G by electrophoretic mobility shift assays demonstrated a reduced binding affinity for IRP1 compared to the wild-type IRE of FTL. Overall, we have expanded the repertoire of deleterious biallelic FTL IRE mutations in HHCS with this novel +49A > G mutation, the zygosity of which correlated well with the disease expression.
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Affiliation(s)
| | - Lucie Pécheux
- Department of Pediatrics, Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | - Jorge Couso
- Program of Predictive and Personalized Medicine of Cancer, Germans Trias and Pujol Research Institute (PMPPC-IGTP), Campus Can Ruti, Badalona, Spain.,Iron metabolism: regulation and diseases group, Josep Carreras Leukaemia Research Institute (IJC), Campus ICO - Germans Trias i Pujol, Badalona, Spain
| | - Audrey Meunier
- Department of Ophthalmology, Centre Hospitalier Universitaire Saint-Pierre, Brussels, Belgium
| | - Mayka Sanchez
- Program of Predictive and Personalized Medicine of Cancer, Germans Trias and Pujol Research Institute (PMPPC-IGTP), Campus Can Ruti, Badalona, Spain. .,Iron metabolism: regulation and diseases group, Josep Carreras Leukaemia Research Institute (IJC), Campus ICO - Germans Trias i Pujol, Badalona, Spain.
| | - Elfride De Baere
- Department of Medical Genetics, Ghent University Hospital, Ghent, Belgium.
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Yazar S, Franchina M, Craig JE, Burdon KP, Mackey DA. Ferritin light chain gene mutation in a large Australian family with hereditary hyperferritinemia-cataract syndrome. Ophthalmic Genet 2016; 38:171-174. [PMID: 27096259 DOI: 10.3109/13816810.2016.1164195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Hereditary hyperferritinemia-cataract syndrome (HHCS) is an autosomal dominant Mendelian disorder characterized by early onset cataracts and elevated levels of serum ferritin in the absence of iron overload. Numerous mutations associated with the development of HHCS have been reported in the 5' non-coding region of the ferritin light chain (FTL) gene in family studies. We present an FTL mutation in an Australian family with 10 HHCS-affected members spanning three generations. MATERIALS AND METHODS Blood and saliva samples were collected from affected and unaffected family members and DNA was extracted using commercially available kits (Qiagen). The complete sequencing of the iron-responsive element (IRE) of the FTL gene was analyzed using bi-directional genomic sequencing. RESULTS A heterozygous single nucleotide substitution (c.-167 C>T) was identified in the proband and five affected family members (logarithm of the odds score [Z] = 3.61, recombination distance [θ = 0]). All affected individuals had previously been found to have high ferritin levels and early onset cataracts. CONCLUSION This is the first Australian report of the c.-167 C>T mutation in a large family with multiple affected individuals. This finding raises the possibility that identification of HHCS mutations may be an effective means of disease detection and may aid in facilitating appropriate genetic counseling.
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Affiliation(s)
- Seyhan Yazar
- a Centre for Ophthalmology and Visual Science/Lions Eye Institute, University of Western Australia , Perth , Western Australia , Australia
| | - Maria Franchina
- a Centre for Ophthalmology and Visual Science/Lions Eye Institute, University of Western Australia , Perth , Western Australia , Australia
| | - Jamie E Craig
- b Department of Ophthalmology , Flinders University , Adelaide , South Australia , Australia
| | - Kathryn P Burdon
- c Cancer, Immunology and Genetics Group, Menzies Institute for Medical Research, University of Tasmania , Hobart , Tasmania , Australia
| | - David A Mackey
- a Centre for Ophthalmology and Visual Science/Lions Eye Institute, University of Western Australia , Perth , Western Australia , Australia
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Silva B, Faustino P. An overview of molecular basis of iron metabolism regulation and the associated pathologies. Biochim Biophys Acta Mol Basis Dis 2015; 1852:1347-59. [PMID: 25843914 DOI: 10.1016/j.bbadis.2015.03.011] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Revised: 03/05/2015] [Accepted: 03/27/2015] [Indexed: 12/18/2022]
Abstract
Iron is essential for several vital biological processes. Its deficiency or overload drives to the development of several pathologies. To maintain iron homeostasis, the organism controls the dietary iron absorption by enterocytes, its recycling by macrophages and storage in hepatocytes. These processes are mainly controlled by hepcidin, a liver-derived hormone which synthesis is regulated by iron levels, inflammation, infection, anemia and erythropoiesis. Besides the systemic regulation of iron metabolism mediated by hepcidin, cellular regulatory processes also occur. Cells are able to regulate themselves the expression of the iron metabolism-related genes through different post-transcriptional mechanisms, such as the alternative splicing, microRNAs, the IRP/IRE system and the proteolytic cleavage. Whenever those mechanisms are disturbed, due to genetic or environmental factors, iron homeostasis is disrupted and iron related pathologies may arise.
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Affiliation(s)
- Bruno Silva
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal
| | - Paula Faustino
- Departamento de Genética Humana, Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisboa, Portugal.
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Kell DB, Pretorius E. Serum ferritin is an important inflammatory disease marker, as it is mainly a leakage product from damaged cells. Metallomics 2014; 6:748-73. [PMID: 24549403 DOI: 10.1039/c3mt00347g] [Citation(s) in RCA: 368] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
"Serum ferritin" presents a paradox, as the iron storage protein ferritin is not synthesised in serum yet is to be found there. Serum ferritin is also a well known inflammatory marker, but it is unclear whether serum ferritin reflects or causes inflammation, or whether it is involved in an inflammatory cycle. We argue here that serum ferritin arises from damaged cells, and is thus a marker of cellular damage. The protein in serum ferritin is considered benign, but it has lost (i.e. dumped) most of its normal complement of iron which when unliganded is highly toxic. The facts that serum ferritin levels can correlate with both disease and with body iron stores are thus expected on simple chemical kinetic grounds. Serum ferritin levels also correlate with other phenotypic readouts such as erythrocyte morphology. Overall, this systems approach serves to explain a number of apparent paradoxes of serum ferritin, including (i) why it correlates with biomarkers of cell damage, (ii) why it correlates with biomarkers of hydroxyl radical formation (and oxidative stress) and (iii) therefore why it correlates with the presence and/or severity of numerous diseases. This leads to suggestions for how one might exploit the corollaries of the recognition that serum ferritin levels mainly represent a consequence of cell stress and damage.
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Affiliation(s)
- Douglas B Kell
- School of Chemistry and The Manchester Institute of Biotechnology, The University of Manchester, 131, Princess St, Manchester M1 7DN, Lancs, UK.
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Luscieti S, Tolle G, Aranda J, Campos CB, Risse F, Morán É, Muckenthaler MU, Sánchez M. Novel mutations in the ferritin-L iron-responsive element that only mildly impair IRP binding cause hereditary hyperferritinaemia cataract syndrome. Orphanet J Rare Dis 2013; 8:30. [PMID: 23421845 PMCID: PMC3585816 DOI: 10.1186/1750-1172-8-30] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2012] [Accepted: 02/14/2013] [Indexed: 12/18/2022] Open
Abstract
Background Hereditary Hyperferritinaemia Cataract Syndrome (HHCS) is a rare autosomal dominant disease characterized by increased serum ferritin levels and early onset of bilateral cataract. The disease is caused by mutations in the Iron-Responsive Element (IRE) located in the 5′ untranslated region of L-Ferritin (FTL) mRNA, which post-transcriptionally regulates ferritin expression. Methods We describe two families presenting high serum ferritin levels and juvenile cataract with novel mutations in the L-ferritin IRE. The mutations were further characterized by in vitro functional studies. Results We have identified two novel mutations in the IRE of L-Ferritin causing HHCS: the Badalona +36C > U and the Heidelberg +52 G > C mutation. Both mutations conferred reduced binding affinity on recombinant Iron Regulatory Proteins (IPRs) in EMSA experiments. Interestingly, the Badalona +36C > U mutation was found not only in heterozygosity, as expected for an autosomal dominant disease, but also in the homozygous state in some affected subjects. Additionally we report an update of all mutations identified so far to cause HHCS. Conclusions The Badalona +36C > U and Heidelberg +52 G > C mutations within the L-ferritin IRE only mildly alter the binding capacity of the Iron Regulatory Proteins but are still causative for the disease.
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Affiliation(s)
- Sara Luscieti
- Institute of Predictive and Personalized Medicine of Cancer IMPPC, Ctra. de Can Ruti, Camí de les Escoles s/n, 08916, Badalona, Barcelona, Spain
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Giansily-Blaizot M, Cunat S, Moulis G, Schved JF, Aguilar-Martinez P. Homozygous mutation of the 5'UTR region of the L-Ferritin gene in the hereditary hyperferritinemia cataract syndrome and its impact on the phenotype. Haematologica 2013; 98:e42-3. [PMID: 23300176 DOI: 10.3324/haematol.2012.077198] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Muñoz-Muñoz J, Cuadrado-Grande N, Moreno-Carralero MI, Hoyos-Sanabria B, Manubes-Guarch A, González AF, Tejada-Palacios P, Del-Castillo-Rueda A, Morán-Jiménez MJ. Hereditary hyperferritinemia cataract syndrome in four patients with mutations in the IRE of the FTL gene. Clin Genet 2012; 83:491-3. [PMID: 22881709 DOI: 10.1111/j.1399-0004.2012.01934.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2012] [Revised: 06/21/2012] [Accepted: 07/06/2012] [Indexed: 11/26/2022]
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Hiperferritinemia, ferropenia y síndrome metabólico en un paciente con una nueva mutación en el gen TFR2 y otra en el gen FTL. Estudio familiar. Med Clin (Barc) 2011; 137:68-72. [DOI: 10.1016/j.medcli.2011.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2010] [Revised: 02/09/2011] [Accepted: 02/15/2011] [Indexed: 12/24/2022]
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