1
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Alsharhan H, Ng BG, Daniel EJP, Friedman J, Pivnick EK, Al-Hashem A, Faqeih EA, Liu P, Engelhardt NM, Keller KN, Chen J, Mazzeo PA, Rosenfeld JA, Bamshad MJ, Nickerson DA, Raymond KM, Freeze HH, He M, Edmondson AC, Lam C. Expanding the phenotype, genotype and biochemical knowledge of ALG3-CDG. J Inherit Metab Dis 2021; 44:987-1000. [PMID: 33583022 PMCID: PMC8282734 DOI: 10.1002/jimd.12367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 01/15/2021] [Accepted: 02/10/2021] [Indexed: 12/11/2022]
Abstract
Congenital disorders of glycosylation (CDGs) are a continuously expanding group of monogenic disorders of glycoprotein and glycolipid biosynthesis that cause multisystem diseases. Individuals with ALG3-CDG frequently exhibit severe neurological involvement (epilepsy, microcephaly, and hypotonia), ocular anomalies, dysmorphic features, skeletal anomalies, and feeding difficulties. We present 10 unreported individuals diagnosed with ALG3-CDG based on molecular and biochemical testing with 11 novel variants in ALG3, bringing the total to 40 reported individuals. In addition to the typical multisystem disease seen in ALG3-CDG, we expand the symptomatology of ALG3-CDG to now include endocrine abnormalities, neural tube defects, mild aortic root dilatation, immunodeficiency, and renal anomalies. N-glycan analyses of these individuals showed combined deficiencies of hybrid glycans and glycan extension beyond Man5 GlcNAc2 consistent with their truncated lipid-linked precursor oligosaccharides. This spectrum of N-glycan changes is unique to ALG3-CDG. These expanded features of ALG3-CDG facilitate diagnosis and suggest that optimal management should include baseline endocrine, renal, cardiac, and immunological evaluation at the time of diagnosis and with ongoing monitoring.
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Affiliation(s)
- Hind Alsharhan
- Department of Pediatrics, Division of Human Genetics,
Section of Metabolism, The Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
- Department of Pathology and Laboratory Medicine,
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, Faculty of Medicine, Kuwait
University, Kuwait City, Kuwait
| | - Bobby G. Ng
- Human Genetics Program, Sanford Burnham Prebys Medical
Discovery Institute, La Jolla, California
| | - Earnest James Paul Daniel
- Department of Pathology and Laboratory Medicine,
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jennifer Friedman
- Division of Neurosciences and Pediatrics, University of
California San Diego and Rady Children’s Hospital, San Diego,
California
| | - Eniko K. Pivnick
- Department of Pediatrics, Division of Medical Genetics,
University of Tennessee Health Science Center (UTHSC), Memphis, Tennessee
| | - Amal Al-Hashem
- Department of Pediatrics, Prince Sultan Military Medical
City, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi
Arabia
| | - Eissa Ali Faqeih
- Section of Medical Genetics, Children’s Specialist
Hospital King Fahad Medical City, Riyadh, Saudi Arabia
| | - Pengfei Liu
- Department of Molecular and Human Genetics, Baylor
College of Medicine, Houston, Texas
- Baylor Genetics Laboratories, Houston, Texas
| | - Nicole M. Engelhardt
- Department of Pediatrics, Division of Human Genetics,
Section of Metabolism, The Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
| | - Kierstin N. Keller
- Department of Pediatrics, Division of Human Genetics,
Section of Metabolism, The Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
| | - Jie Chen
- Department of Pathology and Laboratory Medicine,
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Pamela A. Mazzeo
- Department of Pediatrics, The Children’s Hospital
of Philadelphia, Philadelphia, Pennsylvania
| | | | - Jill A. Rosenfeld
- Department of Molecular and Human Genetics, Baylor
College of Medicine, Houston, Texas
- Baylor Genetics Laboratories, Houston, Texas
| | - Michael J. Bamshad
- Division of Genetic Medicine, Department of Pediatrics,
University of Washington School of Medicine, Seattle, Washington
- Department of Genome Sciences, University of Washington,
Seattle, Washington
- Brotman-Baty Institute, Seattle, Washington
| | - Deborah A. Nickerson
- Department of Genome Sciences, University of Washington,
Seattle, Washington
- Brotman-Baty Institute, Seattle, Washington
| | - Kimiyo M. Raymond
- Department of Laboratory Medicine and Pathology, Mayo
Clinic, Rochester, Minnesota
| | - Hudson H. Freeze
- Human Genetics Program, Sanford Burnham Prebys Medical
Discovery Institute, La Jolla, California
| | - Miao He
- Department of Pathology and Laboratory Medicine,
Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Andrew C. Edmondson
- Department of Pediatrics, Division of Human Genetics,
Section of Metabolism, The Children’s Hospital of Philadelphia, Philadelphia,
Pennsylvania
| | - Christina Lam
- Division of Genetic Medicine, Department of Pediatrics,
University of Washington School of Medicine, Seattle, Washington
- Center of Integrated Brain Research, Seattle
Children’s Research Institute, Seattle, Washington
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2
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ALG3-CDG: a patient with novel variants and review of the genetic and ophthalmic findings. BMC Ophthalmol 2021; 21:249. [PMID: 34090370 PMCID: PMC8180164 DOI: 10.1186/s12886-021-02013-2] [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] [Received: 03/03/2021] [Accepted: 05/26/2021] [Indexed: 12/01/2022] Open
Abstract
Background ALG3-CDG is a rare autosomal recessive disease. It is characterized by deficiency of alpha-1,3-mannosyltransferase caused by pathogenic variants in the ALG3 gene. Patients manifest with severe neurologic, cardiac, musculoskeletal and ophthalmic phenotype in combination with dysmorphic features, and almost half of them die before or during the neonatal period. Case presentation A 23 months-old girl presented with severe developmental delay, epilepsy, cortical atrophy, cerebellar vermis hypoplasia and ocular impairment. Facial dysmorphism, clubfeet and multiple joint contractures were observed already at birth. Transferrin isoelectric focusing revealed a type 1 pattern. Funduscopy showed hypopigmentation and optic disc pallor. Profound retinal ganglion cell loss and inner retinal layer thinning was documented on spectral-domain optical coherence tomography imaging. The presence of optic nerve hypoplasia was also supported by magnetic resonance imaging. A gene panel based next-generation sequencing and subsequent Sanger sequencing identified compound heterozygosity for two novel variants c.116del p.(Pro39Argfs*40) and c.1060 C > T p.(Arg354Cys) in ALG3. Conclusions Our study expands the spectrum of pathogenic variants identified in ALG3. Thirty-three variants in 43 subjects with ALG3-CDG have been reported. Literature review shows that visual impairment in ALG3-CDG is most commonly linked to optic nerve hypoplasia.
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3
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PAKETCI C, EDEM P, HIZ S, SONMEZLER E, SOYDEMIR D, UZAN GS, OKTAY Y, O’HEIR E, BELTRAN S, LAURIE S, TÖPF A, LOCHMULLER H, HORVATH R, YIS U. Successful treatment of intractable epilepsy with ketogenic diet therapy in twins with ALG3-CDG. Brain Dev 2020; 42:539-545. [PMID: 32389449 PMCID: PMC7906126 DOI: 10.1016/j.braindev.2020.04.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/23/2020] [Accepted: 04/19/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Congenital disorders of glycosylation (CDG) is a heterogeneous group of congenital metabolic diseases with multisystem clinical involvement. ALG3-CDG is a very rare subtype with only 24 cases reported so far. CASE Here, we report two siblings with dysmorphic features, growth retardation, microcephaly, intractable epilepsy, and hemangioma in the frontal, occipital and lumbosacral regions. RESULTS We studied two siblings by whole exome sequencing. A pathogenic variant in ALG3 (NM_005787.6: c.165C > T; p.Gly55=) that had been previously associated with congenital glycolysis defect type 1d was identified. Their intractable seizures were controlled by ketogenic diet. CONCLUSION Although prominent findings of growth retardation and microcephaly seen in our patients have been extensively reported before, presence of hemangioma is a novel finding that may be used as an indication for ALG3-CDG diagnosis. Our patients are the first reported cases whose intractable seizures were controlled with ketogenic diet. This report adds ketogenic diet as an option for treatment of intractable epilepsy in ALG3-CDG.
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Affiliation(s)
- C PAKETCI
- Department of Paediatric Neurology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - P EDEM
- Department of Paediatric Neurology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - S HIZ
- Department of Paediatric Neurology, School of Medicine, Dokuz Eylul University, Izmir, Turkey.,Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey
| | - E SONMEZLER
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey.,Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, Izmir, Turkey
| | - D SOYDEMIR
- Department of Paediatric Neurology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - GS UZAN
- Department of Paediatric Neurology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Y OKTAY
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey.,Izmir International Biomedicine and Genome Institute, Dokuz Eylul University, Izmir, Turkey
| | - E O’HEIR
- Center for Mendelian Genomics and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, Massachusetts.,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - S BELTRAN
- CNAG-CRG, Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - S LAURIE
- CNAG-CRG, Centre for Genomic Regulation, Barcelona Institute of Science and Technology, Barcelona, Spain
| | - A TÖPF
- John Walton Muscular Dystrophy Research Centre, Institute of Translational and Clinical Research, Newcastle University and Newcastle Hospitals, Newcastle upon Tyne, UK
| | - H LOCHMULLER
- Department of Neuropediatrics and Muscle Disorders, Medical Center – University of Freiburg, Faculty of Medicine, Freiburg, Germany,Centro Nacional de Análisis Genómico (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Catalonia, Spain,Children’s Hospital of Eastern Ontario Research Institute; Division of Neurology, Department of Medicine, The Ottawa Hospital; and Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - R HORVATH
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - U YIS
- Department of Paediatric Neurology, School of Medicine, Dokuz Eylul University, Izmir, Turkey
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4
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ALG3-CDG: lethal phenotype and novel variants in Chinese siblings. J Hum Genet 2020; 65:1129-1134. [PMID: 32655146 DOI: 10.1038/s10038-020-0798-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 06/17/2020] [Accepted: 06/28/2020] [Indexed: 11/08/2022]
Abstract
Congenital disorders of glycosylation (CDG) are a group of genetic, mostly multisystem disorders, which often involve the central nervous system. ALG3-CDG is one the some 130 known CDG. Here we report two siblings with a severe phenotype and intrauterine death. Whole-exome sequencing revealed two novel variants in ALG3: NM_005787.6:c.512G>T (p.Arg171Leu) inherited from the mother and NM_005787.6:c.511C>T (p.Arg171Trp) inherited from the father.
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5
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Himmelreich N, Dimitrov B, Geiger V, Zielonka M, Hutter AM, Beedgen L, Hüllen A, Breuer M, Peters V, Thiemann KC, Hoffmann GF, Sinning I, Dupré T, Vuillaumier-Barrot S, Barrey C, Denecke J, Kölfen W, Düker G, Ganschow R, Lentze MJ, Moore S, Seta N, Ziegler A, Thiel C. Novel variants and clinical symptoms in four new ALG3-CDG patients, review of the literature, and identification of AAGRP-ALG3 as a novel ALG3 variant with alanine and glycine-rich N-terminus. Hum Mutat 2019; 40:938-951. [PMID: 31067009 DOI: 10.1002/humu.23764] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Revised: 04/03/2019] [Accepted: 04/09/2019] [Indexed: 12/20/2022]
Abstract
ALG3-CDG is one of the very rare types of congenital disorder of glycosylation (CDG) caused by variants in the ER-mannosyltransferase ALG3. Here, we summarize the clinical, biochemical, and genetic data of four new ALG3-CDG patients, who were identified by a type I pattern of serum transferrin and the accumulation of Man5 GlcNAc2 -PP-dolichol in LLO analysis. Additional clinical symptoms observed in our patients comprise sensorineural hearing loss, right-descending aorta, obstructive cardiomyopathy, macroglossia, and muscular hypertonia. We add four new biochemically confirmed variants to the list of ALG3-CDG inducing variants: c.350G>C (p.R117P), c.1263G>A (p.W421*), c.1037A>G (p.N346S), and the intron variant c.296+4A>G. Furthermore, in Patient 1 an additional open-reading frame of 141 bp (AAGRP) in the coding region of ALG3 was identified. Additionally, we show that control cells synthesize, to a minor degree, a hybrid protein composed of the polypeptide AAGRP and ALG3 (AAGRP-ALG3), while in Patient 1 expression of this hybrid protein is significantly increased due to the homozygous variant c.160_196del (g.165C>T). By reviewing the literature and combining our findings with previously published data, we further expand the knowledge of this rare glycosylation defect.
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Affiliation(s)
- Nastassja Himmelreich
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Bianca Dimitrov
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Virginia Geiger
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Matthias Zielonka
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Anna-Marlen Hutter
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Lars Beedgen
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Andreas Hüllen
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Maximilian Breuer
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Verena Peters
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Kai-Christian Thiemann
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Georg F Hoffmann
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Irmgard Sinning
- Biochemistry Center (BZH), Heidelberg University, Heidelberg, Germany
| | - Thierry Dupré
- Department Biochimie, AP-HP, Hôpital Bichat, Biochimie, Paris, France.,Faculté de Médecine Xavier Bichat, INSERM U1149, Université Paris Diderot, Paris, France
| | - Sandrine Vuillaumier-Barrot
- Department Biochimie, AP-HP, Hôpital Bichat, Biochimie, Paris, France.,Faculté de Médecine Xavier Bichat, INSERM U1149, Université Paris Diderot, Paris, France
| | | | - Jonas Denecke
- Department of Pediatrics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Kölfen
- Zentrum für Kinder und Jugendmedizin, Städtischen Kliniken Mönchengladbach, Mönchengladbach, Germany
| | - Gesche Düker
- Department of Pediatrics, Children's Hospital Medical Center, University Hospitals Bonn, Bonn, Germany
| | - Rainer Ganschow
- Department of Pediatrics, Children's Hospital Medical Center, University Hospitals Bonn, Bonn, Germany
| | - Michael J Lentze
- Department of Pediatrics, Children's Hospital Medical Center, University Hospitals Bonn, Bonn, Germany
| | - Stuart Moore
- Faculté de Médecine Xavier Bichat, INSERM U1149, Université Paris Diderot, Paris, France
| | - Nathalie Seta
- Department Biochimie, AP-HP, Hôpital Bichat, Biochimie, Paris, France
| | - Andreas Ziegler
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
| | - Christian Thiel
- Center for Child and Adolescent Medicine, Department Pediatrics I, University of Heidelberg, Heidelberg, Germany
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6
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Hacker B, Schultheiß C, Kurzik-Dumke U. Sequential cleavage of the proteins encoded by HNOT/ALG3, the human counterpart of the Drosophila NOT and yeast ALG3 gene, results in products acting in distinct cellular compartments. Hum Mol Genet 2018; 27:4231-4248. [PMID: 30192950 DOI: 10.1093/hmg/ddy315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 09/04/2018] [Indexed: 11/12/2022] Open
Abstract
This study provides first insights into the biosynthesis, structure, biochemistry and complex processing of the proteins encoded by hNOT/ALG3, the human counterpart of the Drosophila Neighbour of TID (NOT) and the yeast asparagine linked glycosylation 3 gene (ALG3), which encodes a mannosyltransferase. Unambiguous evidence that both the fly and human proteins act as mannosyltransferases has not been provided yet. Previously, we showed that hNOT/ALG3 encodes two alternatively spliced main transcripts, hNOT-1/ALG3-1 and hNOT-4/ALG3-4, and their 15 truncated derivatives that lack diverse sets of exons and/or carry point mutations that result in premature termination codons. Here we show that the truncated transcripts are not translated. The two main forms hNOT-1/ALG3-1 and -4, distinguishable by alternative exon 1, encode full-length precursors that undergo a complex posttranslational processing. To specifically detect the two full-length hNOT/ALG3 proteins and their distinct derivatives and to examine their expression profiles and cellular location we generated polyclonal antibodies against diverse parts of the putative full-length proteins. We provide experimental evidence for the N-glycosylation of the two precursors. This modification seems to be a prerequisite for their sequential cleavage resulting in derivatives destined to distinct cellular compartments and links them with the N-glycosylation machinery not as its functional component but as molecules functionally dependent on its action. We present the expression profiles and subcellular location of the two full-length proteins, their N-glycosylated forms and distinct cleavage products. Furthermore, using diverse bioinformatics tools, we characterize the properties and predict the 2D and 3D structure of the two proteins and, for comparative purposes, of their Drosophila counterpart.
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Affiliation(s)
- Benedikt Hacker
- Institute of Medical Microbiology and Hygiene, Laboratory for Comparative Tumour Biology, University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher, Mainz, Germany
| | - Christoph Schultheiß
- Institute of Medical Microbiology and Hygiene, Laboratory for Comparative Tumour Biology, University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher, Mainz, Germany
| | - Ursula Kurzik-Dumke
- Institute of Medical Microbiology and Hygiene, Laboratory for Comparative Tumour Biology, University Medical Centre, Johannes Gutenberg University, Obere Zahlbacher, Mainz, Germany
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7
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Hacker B, Schultheiß C, Döring M, Kurzik-Dumke U. Molecular partners of hNOT/ALG3, the human counterpart of the Drosophila NOT and yeast ALG3 gene, suggest its involvement in distinct cellular processes relevant to congenital disorders of glycosylation, cancer, neurodegeneration and a variety of further pathologies. Hum Mol Genet 2018; 27:1858-1878. [DOI: 10.1093/hmg/ddy087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 03/06/2018] [Indexed: 01/04/2023] Open
Affiliation(s)
- Benedikt Hacker
- Laboratory for Comparative Tumour Biology, Institute of Medical Microbiology and Hygiene, University Medical Centre, Johannes Gutenberg University, 55131 Mainz, Germany
| | - Christoph Schultheiß
- Laboratory for Comparative Tumour Biology, Institute of Medical Microbiology and Hygiene, University Medical Centre, Johannes Gutenberg University, 55131 Mainz, Germany
| | - Michael Döring
- Laboratory for Comparative Tumour Biology, Institute of Medical Microbiology and Hygiene, University Medical Centre, Johannes Gutenberg University, 55131 Mainz, Germany
| | - Ursula Kurzik-Dumke
- Laboratory for Comparative Tumour Biology, Institute of Medical Microbiology and Hygiene, University Medical Centre, Johannes Gutenberg University, 55131 Mainz, Germany
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8
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Al Teneiji A, Bruun TUJ, Sidky S, Cordeiro D, Cohn RD, Mendoza-Londono R, Moharir M, Raiman J, Siriwardena K, Kyriakopoulou L, Mercimek-Mahmutoglu S. Phenotypic and genotypic spectrum of congenital disorders of glycosylation type I and type II. Mol Genet Metab 2017; 120:235-242. [PMID: 28122681 DOI: 10.1016/j.ymgme.2016.12.014] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/28/2016] [Accepted: 12/29/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND Congenital disorders of glycosylation (CDG) are inborn defects of glycan metabolism. They are multisystem disorders. Analysis of transferrin isoforms is applied as a screening test for CDG type I (CDG-I) and type II (CDG-II). We performed a retrospective cohort study to determine spectrum of phenotype and genotype and prevalence of the different subtypes of CDG-I and CDG-II. MATERIAL AND METHODS All patients with CDG-I and CDG-II evaluated in our institution's Metabolic Genetics Clinics were included. Electronic and paper patient charts were reviewed. We set-up a high performance liquid chromatography transferrin isoelectric focusing (TIEF) method to measure transferrin isoforms in our Institution. We reviewed the literature for the rare CDG-I and CDG-II subtypes seen in our Institution. RESULTS Fifteen patients were included: 9 with PMM2-CDG and 6 with non-PMM2-CDG (one ALG3-CDG, one ALG9-CDG, two ALG11-CDG, one MPDU1-CDG and one ATP6V0A2-CDG). All patients with PMM2-CDG and 5 patients with non-PMM2-CDG showed abnormal TIEF suggestive of CDG-I or CDG-II pattern. In all patients, molecular diagnosis was confirmed either by single gene testing, targeted next generation sequencing for CDG genes, or by whole exome sequencing. CONCLUSION We report 15 new patients with CDG-I and CDG-II. Whole exome sequencing will likely identify more patients with normal TIEF and expand the phenotypic spectrum of CDG-I and CDG-II.
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Affiliation(s)
- Amal Al Teneiji
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Theodora U J Bruun
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada; Genetics and Genome Biology Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Department of Biochemistry, University of Oxford, Oxford, United Kingdom
| | - Sarah Sidky
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Dawn Cordeiro
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Ronald D Cohn
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada; Genetics and Genome Biology Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Roberto Mendoza-Londono
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada; Genetics and Genome Biology Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mahendranath Moharir
- Division of Neurology, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | - Lianna Kyriakopoulou
- Division of Genome Diagnostics, Department of Paediatric Laboratory Medicine, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Saadet Mercimek-Mahmutoglu
- Division of Clinical and Metabolic Genetics, Department of Paediatrics, University of Toronto, The Hospital for Sick Children, Toronto, Ontario, Canada; Genetics and Genome Biology Program, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada.
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9
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Maratha A, Colhoun HO, Knerr I, Coss KP, Doran P, Treacy EP. Classical Galactosaemia and CDG, the N-Glycosylation Interface. A Review. JIMD Rep 2016; 34:33-42. [PMID: 27502837 PMCID: PMC5509556 DOI: 10.1007/8904_2016_5] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2015] [Revised: 06/21/2016] [Accepted: 06/23/2016] [Indexed: 12/11/2022] Open
Abstract
Classical galactosaemia is a rare disorder of carbohydrate metabolism caused by galactose-1-phosphate uridyltransferase (GALT) deficiency (EC 2.7.7.12). The disease is life threatening if left untreated in neonates and the only available treatment option is a long-term galactose restricted diet. While this is lifesaving in the neonate, complications persist in treated individuals, and the cause of these, despite early initiation of treatment, and shared GALT genotypes remain poorly understood. Systemic abnormal glycosylation has been proposed to contribute substantially to the ongoing pathophysiology. The gross N-glycosylation assembly defects observed in the untreated neonate correct over time with treatment. However, N-glycosylation processing defects persist in treated children and adults.Congenital disorders of glycosylation (CDG) are a large group of over 100 inherited disorders affecting largely N- and O-glycosylation.In this review, we compare the clinical features observed in galactosaemia with a number of predominant CDG conditions.We also summarize the N-glycosylation abnormalities, which we have described in galactosaemia adult and paediatric patients, using an automated high-throughput HILIC-UPLC analysis of galactose incorporation into serum IgG with analysis of the corresponding N-glycan gene expression patterns and the affected pathways.
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Affiliation(s)
- Ashwini Maratha
- National Centre for Inherited Metabolic Disorders, Children's University Hospital, Temple Street, Dublin, Ireland
- University College Dublin Clinical Research Centre, Eccles Street, Dublin, Ireland
| | | | - Ina Knerr
- National Centre for Inherited Metabolic Disorders, Children's University Hospital, Temple Street, Dublin, Ireland
| | - Karen P Coss
- Faculty of Life Sciences and Medicine, Department of Infectious Diseases, King's College London, Guy's Hospital, London, UK
| | - Peter Doran
- University College Dublin Clinical Research Centre, Eccles Street, Dublin, Ireland
| | - Eileen P Treacy
- National Centre for Inherited Metabolic Disorders, Children's University Hospital, Temple Street, Dublin, Ireland.
- University College Dublin Clinical Research Centre, Eccles Street, Dublin, Ireland.
- Trinity College, Dublin, Ireland.
- Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
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10
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Lepais L, Cheillan D, Frachon SC, Hays S, Matthijs G, Panagiotakaki E, Abel C, Edery P, Rossi M. ALG3-CDG: Report of two siblings with antenatal features carrying homozygous p.Gly96Arg mutation. Am J Med Genet A 2015; 167A:2748-54. [PMID: 26126960 DOI: 10.1002/ajmg.a.37232] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 06/15/2015] [Indexed: 01/20/2023]
Abstract
Congenital disorders of glycosylation (CDG) are a group of inborn errors of metabolism presenting with heterogeneous multisystemic clinical manifestations. To date, more than 60 different types of CDG have been reported. ALG3-CDG is very rare, with only nine patients described so far. We report two affected siblings presenting prenatally with skeletal abnormalities associated with dysmorphic features, cerebellar vermis hypoplasia, corpus callosum agenesis, hepatic fibrosis and poor prognosis. This is the first detailed report of an affected fetus including clinical, radiographic and pathological findings. The patients showed some clinical features previously unreported in ALG3-CDG, such as bone dysplasia, cataract, corneal opacities, and pons hypoplasia. Both patients were homozygous for the previously unreported p.Gly96Arg mutation of the ALG3 gene. One patient showed chondrodysplasia punctata (CDP), which has not been previously reported in CDG. An exhaustive genetic and metabolic assessment, performed in order to rule out other possible causes of CDP, showed abnormally raised levels of anti-nuclear antibodies in the mother who, nevertheless, did not show any clinical sign of autoimmune disease during a 7 years follow-up. We speculate that the observed CDP may be explained by the maternal anti-nuclear antibodies; alternatively, a possible link to the underlying metabolic disorder cannot be ruled out. In conclusion, we report the clinical, pathological, biochemical and molecular characterization of two further patients affected by ALG3-CDG, expanding the phenotypic spectrum of this very rare disease.
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Affiliation(s)
- Laureline Lepais
- Centre de Référence des Anomalies du Développement, Service de Génétique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - David Cheillan
- Service des Maladies Héréditaires du Métabolisme et Dépistage Néonatal, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France.,INSERM U1060/Université Lyon-1, Lyon, France
| | - Sophie Collardeau Frachon
- Service d'Anatomie Pathologique, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France.,Université Lyon 1, Lyon, France
| | - Stéphane Hays
- Service de Réanimation Néonatale et Néonatologie, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Lyon, France
| | - Gert Matthijs
- Center for Human Genetics, UZ Gasthuisberg, Leuven, Belgium
| | - Eleni Panagiotakaki
- Service Epilepsie, Sommeil, Explorations Fonctionnelles Neuropédiatriques (ESEFNP), Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Carine Abel
- Centre de Référence des Anomalies du Développement, Service de Génétique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France
| | - Patrick Edery
- Centre de Référence des Anomalies du Développement, Service de Génétique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,Université Lyon 1, Lyon, France.,INSERM U1028, CNRS UMR5292, CRNL TIGER Team, Bron, France
| | - Massimiliano Rossi
- Centre de Référence des Anomalies du Développement, Service de Génétique, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Bron, France.,INSERM U1028, CNRS UMR5292, CRNL TIGER Team, Bron, France
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Riess S, Reddihough DS, Howell KB, Dagia C, Jaeken J, Matthijs G, Yaplito-Lee J. ALG3-CDG (CDG-Id): clinical, biochemical and molecular findings in two siblings. Mol Genet Metab 2013; 110:170-5. [PMID: 23791010 DOI: 10.1016/j.ymgme.2013.05.020] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 05/30/2013] [Accepted: 05/31/2013] [Indexed: 12/01/2022]
Abstract
Congenital disorders of glycosylation (CDG) represent an expanding family of metabolic disorders with a wide range of biochemical, molecular and clinical phenotypes. ALG3-CDG (CDG-Id), due to a defect in endoplasmic reticulum (ER) mannosyltransferase VI, is one of the less common types of CDG-I. We describe two Vietnamese siblings with confirmed ALG3-CDG (CDG-Id) by molecular testing. As far as we are aware, they are the oldest reported patients in the literature at 15 and 21years. They share similar clinical features with previously reported patients including facial dysmorphism, severe psychomotor retardation, microcephaly, seizures, and gastrointestinal symptoms. Furthermore, our sibling pair highlights the intrafamilial variability, the natural clinical course of ALG3-CDG (CDG-Id) and the benefit of reassessing patients with undiagnosed and complex syndromes, particularly when they present with neurological deterioration.
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Affiliation(s)
- Suzi Riess
- Developmental Medicine, Royal Children's Hospital, Melbourne, Australia
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12
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Goreta SS, Dabelic S, Dumic J. Insights into complexity of congenital disorders of glycosylation. Biochem Med (Zagreb) 2012; 22:156-70. [PMID: 22838182 PMCID: PMC4062342 DOI: 10.11613/bm.2012.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Biochemical and biological properties of glycoconjugates are strongly determined by the specific structure of its glycan parts. Glycosylation, the covalent attachment of sugars to proteins and lipids, is very complex and highly-coordinated process involving > 250 gene products. Deficiency of glycosylation enzymes or transporters results in impaired glycosylation, and consequently pathological modulation of many physiological processes. Inborn defects of glycosylation enzymes, caused by the specific mutations, lead to the development of rare, but severe diseases – congenital disorders of glycosylation (CDGs). Up today, there are more than 45 known CDGs. Their clinical manifestations range from very mild to extremely severe (even lethal) and unfortunately, only three of them can be eff ectively treated nowadays. CDG symptoms highly vary, though some are common for several CDG types but also for other unrelated diseases, especially neurological ones, leaving the possibility that many CDGs cases are under- or mis-diagnosed. Glycan analysis of serum transferrin (by isoelectric focusing or more sophisticated methods, such as HPLC (high-performance liquid chromatography) or MALDI (matrix-assisted laser desorption/ionization)) or serum N-glycans (by MS), enzyme activity assays and DNA sequence analysis are the most frequently used methods for CDG screening and identification, since no specific tests are available yet. In this review we summarize the current knowledge on the clinical, biochemical and genetic characteristic of distinct CDGs, as well as existing diagnostic and therapeutic procedures, aiming to contribute to the awareness on the existence of these rare diseases and encourage the eff orts to elucidate its genetic background, improve diagnostics and develop new strategies for their treatment.
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Affiliation(s)
- Sandra Supraha Goreta
- University of Zagreb, Faculty of Pharmacy and Biochemistry, Department of Biochemistry and Molecular Biology, Zagreb, Croatia.
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