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Zhao X, Liu S, Yang Z, Li Y. Molecular mechanisms and genetic factors contributing to the developmental dysplasia of the hip. Front Genet 2024; 15:1413500. [PMID: 39156961 PMCID: PMC11327038 DOI: 10.3389/fgene.2024.1413500] [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: 04/07/2024] [Accepted: 07/16/2024] [Indexed: 08/20/2024] Open
Abstract
The most prevalent hip disease in neonates is developmental dysplasia of the hip (DDH). A timely and accurate diagnosis is required to provide the most effective treatment for pediatric patients with DDH. Heredity and gene variation have been the subject of increased attention and research worldwide as one of the factors contributing to the pathogenesis of DDH. Genome-wide association studies (GWAS), genome-wide linkage analyses (GWLA), and exome sequencing (ES) have identified variants in numerous genes and single-nucleotide polymorphisms (SNPs) as being associated with susceptibility to DDH in sporadic and DDH family patients. Furthermore, the DDH phenotype can be observed in animal models that exhibit susceptibility genes or loci, including variants in CX3CR1, KANSL1, and GDF5. The dentification of noncoding RNAs and de novo gene variants in patients with DDH-related syndrome has enhanced our understanding of the genes implicated in DDH. This article reviews the most recent molecular mechanisms and genetic factors that contribute to DDH.
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Affiliation(s)
- Xiaoming Zhao
- Department of Pediatric Orthopaedics, Shenyang Orthopaedic Hospital, Shenyang, China
| | - Shuai Liu
- College of Police Dog Technology, Criminal Investigation Police University of China, Shenyang, China
| | - Zhonghua Yang
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, China
- Key Laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yong Li
- Department of Pediatric Surgery, Shengjing Hospital of China Medical University, Shenyang, China
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Wen J, Ping H, Kong X, Chai W. Developmental dysplasia of the hip: A systematic review of susceptibility genes and epigenetics. Gene 2023; 853:147067. [PMID: 36435507 DOI: 10.1016/j.gene.2022.147067] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/29/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Developmental dysplasia of the hip (DDH) is a complex developmental deformity whose pathogenesis and susceptibility-related genes have yet to be elucidated. This systematic review summarizes the current literature on DDH-related gene mutations, animal model experiments, and epigenetic changes in DDH. METHODS We performed a comprehensive search of relevant documents in the Medline, Scopus, Cochrane, and ScienceDirect databases covering the period from October 1991 to October 2021. We analyzed basic information on the included studies and summarized the DDH-related mutation sites, animal model experiments, and epigenetic changes associated with DDH. RESULTS A total of 63 studies were included in the analysis, of which 54 dealt with the detection of gene mutations, 7 presented details of animal experiments, and 6 were epigenetic studies. No genetic mutations were clearly related to the pathogenesis of DDH, including the most frequently studied genes on chromosomes 1, 17, and 20. Most gene-related studies were performed in Han Chinese or North American populations, and the quality of these studies was medium or low. GDF5 was examined in the greatest number of studies, and mutation sites with odds ratios > 10 were located on chromosomes 3, 9, and 13. Six mutations were found in animal experiments (i.e., CX3CR1, GDF5, PAPPA2, TENM3, UFSP2, and WISP3). Epigenetics research on DDH has focused on GDF5 promoter methylation, three microRNAs (miRNAs), and long noncoding RNAs. In addition, there was also a genetic test for miRNA and mRNA sequencing. CONCLUSIONS DDH is a complex joint deformity with a considerable genetic component whose early diagnosis is significant for preventing disease. At present, no genes clearly involved in the pathogenesis of DDH have been identified. Research on mutations associated with this condition is progressing in the direction of in vivo experiments in animal models to identify DDH susceptibility genes and epigenetics analyses to provide novel insights into its pathogenesis. In the future, genetic profiling may improve matters.
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Affiliation(s)
- Jiaxin Wen
- School of Medicine, Nankai University, Tianjin, China
| | - Hangyu Ping
- School of Medicine, Nankai University, Tianjin, China
| | | | - Wei Chai
- School of Medicine, Nankai University, Tianjin, China.
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Whole exome sequencing of 28 families of Danish descent reveals novel candidate genes and pathways in developmental dysplasia of the hip. Mol Genet Genomics 2023; 298:329-342. [PMID: 36454308 PMCID: PMC9938029 DOI: 10.1007/s00438-022-01980-5] [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: 01/17/2022] [Accepted: 11/15/2022] [Indexed: 12/05/2022]
Abstract
Developmental dysplasia of the hip (DDH) is a common condition involving instability of the hip with multifactorial etiology. Early diagnosis and treatment are critical as undetected DDH is an important cause of long-term hip complications. Better diagnostics may be achieved through genetic methods, especially for patients with positive family history. Several candidate genes have been reported but the exact molecular etiology of the disease is yet unknown. In the present study, we performed whole exome sequencing of DDH patients from 28 families with at least two affected first-degree relatives. Four genes previously not associated with DDH (METTL21B, DIS3L2, PPP6R2, and TM4SF19) were identified with the same variants shared among affected family members, in more than two families. Among known association genes, we found damaging variants in DACH1, MYH10, NOTCH2, TBX4, EVC2, OTOG, and SHC3. Mutational burden analysis across the families identified 322 candidate genes, and enriched pathways include the extracellular matrix, cytoskeleton, ion-binding, and detection of mechanical stimulus. Taken altogether, our data suggest a polygenic mode of inheritance for DDH, and we propose that an impaired transduction of the mechanical stimulus is involved in the etiopathological mechanism. Our findings refine our current understanding of candidate causal genes in DDH, and provide a foundation for downstream functional studies.
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Xu X, Bi X, Wang J, Gui R, Li T, Li L, Wang B. Identification of KANSL1 as a novel pathogenic gene for developmental dysplasia of the hip. J Mol Med (Berl) 2022; 100:1159-1168. [PMID: 35727364 DOI: 10.1007/s00109-022-02220-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 05/29/2022] [Accepted: 06/07/2022] [Indexed: 01/02/2023]
Abstract
Developmental dysplasia of the hip (DDH) is a common anomaly leading to adult osteoarthritis. Environmental and genetic factors contribute to DDH, but its exact genetic mechanism is unclear. In this study, we used whole exome sequencing to identify the causative gene of a DDH pedigree. A rare missense variant in KANSL1 (c.C767T; p.S256F) was identified as the pathogenic cause of DDH. Subsequent mutation screening showed another missense variant in 1 of 200 sporadic patients. Kansl1-mutated mice showed reduced chondrocytes in the acetabulum and a decrease in the cartilage matrix, which may be DDH phenotype-related abnormalities. Furthermore, functional studies showed that cell proliferation was delayed and Mmp13 expression was abnormally upregulated in chondrocytes differentiated from Kansl1 mutant mouse embryonic stem cells. In conclusion, our findings suggest that KANSL1 is a novel pathogenic gene for DDH. The identification of KANSL1 variants has great diagnostic value for identifying individuals with DDH. KEY MESSAGES: Developmental dysplasia of the hip (DDH) is a common anomaly causing adult osteoarthritis. Environmental and genetic factors contribute to DDH, but its exact genetic mechanism is unclear. Using high-throughput whole exome sequencing, we found a novel variant in KANSL1 that was co-inherited by all severely affected individuals diagnosed with DDH from a three-generation family. Further analysis revealed that a Kansl1 variant in mice reduced the number of chondrocytes and decreased cartilage matrix, and mouse embryonic stem differentiation assay showed cartilage defects. These findings indicate a direct association between KANSL1 and hip development, expanding the pathogenic gene spectrum in DDH and providing insight into potential new targets for diagnosing and treating hip dysplasia.
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Affiliation(s)
- Xiaowen Xu
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Xinying Bi
- Center for Genetics, National Research Institute for Family Planning, Beijing, China
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jing Wang
- Department of Medical Genetics, The Capital Medical University, Beijing, China
| | - Ronghua Gui
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Tengyan Li
- Center for Genetics, National Research Institute for Family Planning, Beijing, China
| | - Lianyong Li
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, Shenyang, People's Republic of China.
| | - Binbin Wang
- Center for Genetics, National Research Institute for Family Planning, Beijing, China.
- Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
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Secondary (Late) Developmental Dysplasia of the Hip with Displacement: From Case Studies to a Proposition for a Modified Diagnostic Path. Diagnostics (Basel) 2022; 12:diagnostics12061472. [PMID: 35741282 PMCID: PMC9222041 DOI: 10.3390/diagnostics12061472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/25/2022] [Accepted: 06/10/2022] [Indexed: 12/04/2022] Open
Abstract
(1) Background. This paper presents a case of hip joints that were initially described as either normal or physiologically immature in four successive ultrasound examinations using the static method by Graf; however, the final treatment of the patient involved multiple hip reconstruction surgeries. (2) Case presentation. The patient was born with an Apgar score of 10 and did not exhibit neurological diseases that could deform and lead to pathological dislocation of the right hip joint. The subsequent analysis of medical data revealed that the hip luxation was due to secondary (late) developmental dysplasia of the right hip. (3) Conclusion. The article emphasizes the importance of early diagnosis and treatment standards for developmental dysplasia of the hip (DDH). The development of uniform international medical guidelines for the diagnosis, treatment, and prevention of hip dysplasia, along with the unification of DDH-related terminology, would allow for more effective management of DDH cases and reduce the cost of patient treatment.
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Topak D, Seyithanoğlu M, Doğar F, Karadeniz AA, Tanrıverdi B, Ozan F, Bilal Ö. Are vitamin D and vitamin D receptor levels different in children with developmental dysplasia of the hip? J Orthop Surg Res 2021; 16:24. [PMID: 33413534 PMCID: PMC7791744 DOI: 10.1186/s13018-020-02162-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/14/2020] [Indexed: 11/10/2022] Open
Abstract
INTRODUCTION Developmental dysplasia of the hip (DDH) is a common disorder and associated with significant morbidity of the hip joint. Several risk factors have been identified for DDH. The aim of this study is to investigate whether vitamin D and vitamin D receptor (VDR) levels differ in children with DDH and whether they have an effect on DDH development. MATERIALS AND METHODS A total of 40 (17 males, 23 females; 9 right hips, 16 left hips, 15 bilateral hips) children who were treated for developmental dysplasia and 40 (23 males, 17 females) healthy children without any musculoskeletal system and metabolic disorders were included in this study between January and June 2019. Blood samples from the DDH and control groups of children were collected to measure the serum levels of vitamin D, VDR, calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP). The levels of Ca, P, and ALP were analyzed using the automated standard spectrophotometric laboratory method. The levels of vitamin D and VDR in the samples were analyzed using enzyme-linked immunoassay. RESULTS There were no significant differences in the serum levels of Ca, P, ALP, and vitamin D between the DDH and healthy groups (Ca 9.96 ± 0.47 vs. 9.92 ± 0.48 mg/dL, respectively, p = 0.721; P 5.3 ± 0.94 vs. 4.82 ± 0.88 mg/dL, respectively, p = 0.23; ALP 252.22 ± 170.15 vs. 245.3 ± 130.93 U/L, respectively, p = 0.839). However, serum VDR levels were significantly lower in children in the DDH group (5.77 ± 3.51 ng/mL) than in the healthy control group (9.25 ± 6.43 ng/mL) (p = 0.004). CONCLUSIONS In conclusion, we believe that low VDR levels can affect DDH regardless of the serum levels of Ca, P, ALP, and vitamin D. More comprehensive studies involving parents are needed to understand whether VDR levels mediate genetic transmission in DDH or not.
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Affiliation(s)
- Duran Topak
- Faculty of Medicine, Department of Orthopaedic and Traumatology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey.
| | - Muhammet Seyithanoğlu
- Faculty of Medicine, Department of Biochemistry, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Fatih Doğar
- Faculty of Medicine, Department of Orthopaedic and Traumatology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Ali Aydın Karadeniz
- Faculty of Medicine, Department of Orthopaedic and Traumatology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Burak Tanrıverdi
- Faculty of Medicine, Department of Biochemistry, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
| | - Fırat Ozan
- Department of Orthopedics and Traumatology, Kayseri Training and Research Hospital, Kayseri, Turkey
| | - Ökkeş Bilal
- Faculty of Medicine, Department of Orthopaedic and Traumatology, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey
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Luo W, Dong Y, Hu T, Liu D, Wei X, Ma W, Yuan Z, Zhao Q. 25(OH)D status and expression of miR-140 in the serum of patients with developmental dysplasia of the hip. Nutrition 2020; 81:110896. [PMID: 32739657 DOI: 10.1016/j.nut.2020.110896] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/13/2020] [Accepted: 05/24/2020] [Indexed: 12/21/2022]
Abstract
OBJECTIVES Developmental dysplasia of the hip (DDH) is one of the most common orthopedic birth defects in newborn infants, for whom early detection and treatment are critical. MiR-140 plays an important role in bone development and was found to be regulated by vitamin D receptors in our previous study. This study aimed to investigate vitamin D status and miR-140 expression in the circulation of patients with orthopedic conditions, including DDH. METHODS The 25-hydroxyvitamin D (25[OH]D) status and miR-140 expression were determined in the serum of 120 patients with orthopedic conditions. Receiver operating characteristic curves were used to evaluate the potential diagnosis capability of 25(OH)D status and miR-140 expression in DDH. A DDH rat model was also used to verify miR-140 expression in vivo. RESULTS We found that most patients with orthopedic conditions have vitamin D insufficiency and deficiency, and patients with DDH are in the insufficiency range. MiR-140 was downregulated in the serum of patients with DDH patients and in the hip joints of rats with DDH. A panel of 25(OH)D and miR-140 showed robust performance in distinguishing DDH from controls. CONCLUSIONS Our results indicate that miR-140 may play an important role in DDH, with the potential capability of being a biomarker for the diagnosis of DDH.
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Affiliation(s)
- Wenting Luo
- Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Yaping Dong
- Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Tao Hu
- Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Dan Liu
- Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Xiaowei Wei
- Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Wei Ma
- Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Zhengwei Yuan
- Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China
| | - Qun Zhao
- Key Laboratory of Health Ministry for Congenital Malformation, Department of Pediatric Surgery, Shengjing Hospital, China Medical University, Shenyang, China.
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Kenanidis E, Gkekas NK, Karasmani A, Anagnostis P, Christofilopoulos P, Tsiridis E. Genetic Predisposition to Developmental Dysplasia of the Hip. J Arthroplasty 2020; 35:291-300.e1. [PMID: 31522852 DOI: 10.1016/j.arth.2019.08.031] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Revised: 07/14/2019] [Accepted: 08/12/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The etiopathogenesis of developmental dysplasia of the hip (DDH) has not been clarified. This systematic review evaluated current literature concerning all known chromosomes, loci, genes, and their polymorphisms that have been associated or not with the prevalence and severity of DDH. METHODS Following the established methodology of Meta-analysis of Observational Studies in Epidemiology guidelines, MEDLINE, EMBASE, and Cochrane Register of Controlled Trials were systematically searched from inception to January 2019. RESULTS Forty-five studies were finally included. The majority of genetic studies were candidate gene association studies assessing Chinese populations with moderate methodological quality. Among the most frequently studied are the first, third, 12th,17th, and 20th chromosomes. No gene was firmly associated with DDH phenotype. Studies from different populations often report conflicting results on the same single-nucleotide polymorphism (SNP). The SNP rs143384 of GDF5 gene on chromosome 20 demonstrated the most robust relationship with DDH phenotype in association studies. The highest odds of coinheritance in linkage studies have been reported for regions of chromosome 3 and 13. Five SNPs have been associated with the severity of DDH. Animal model studies validating previous human findings provided suggestive evidence of an inducing role of mutations of the GDF5, CX3CR1, and TENM3 genes in DDH etiopathogenesis. CONCLUSION DDH is a complex disorder with environmental and genetic causes. However, no firm correlation between genotype and DDH phenotype currently exists. Systematic genome evaluation in studies with larger sample size, better methodological quality, and assessment of DDH patients is necessary to clarify the DDH heredity. The role of next-generation sequencing techniques is promising.
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Affiliation(s)
- Eustathios Kenanidis
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece; Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Nifon K Gkekas
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece; Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
| | - Areti Karasmani
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece
| | - Panagiotis Anagnostis
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece
| | | | - Eleftherios Tsiridis
- Centre of Orthopaedic and Regenerative Medicine (CORE), Center for Interdisciplinary Research and Innovation (CIRI)-Aristotle University of Thessaloniki (AUTH), Thessaloniki, Balkan Center, Greece; Academic Orthopaedic Department, Aristotle University Medical School, General Hospital Papageorgiou, Thessaloniki, Greece
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Zamborsky R, Kokavec M, Harsanyi S, Attia D, Danisovic L. Developmental Dysplasia of Hip: Perspectives in Genetic Screening. Med Sci (Basel) 2019; 7:medsci7040059. [PMID: 30979092 PMCID: PMC6524033 DOI: 10.3390/medsci7040059] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Revised: 02/16/2019] [Accepted: 04/10/2019] [Indexed: 12/18/2022] Open
Abstract
Development dysplasia of the hip (DDH) is a complex developmental disorder despite being a relatively common condition mainly caused by incompatibility of the femoral head and the abnormal joint socket. Development dysplasia of the hip describes a wide spectrum of disorders ranging from minor acetabular dysplasia to irreducible dislocation of the hip. Modern medicine still suffers from lack of information about screening and precise genetic examination. Genome wide linkage and association studies have brought significant progress to DDH diagnosis. Association studies managed to identify many candidate (susceptible) genes, such as PAPPA2, COL2A1, HOXD9, GDF-5, and TGFB1, which play a considerable role in the pathogenesis of DDH. Early detection of DDH has a big chance to help in preventing further disability and improve the psychological health and quality of life in those children. This emphasizes the importance to establish a universal screening program along with the genetic counseling.
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Affiliation(s)
- Radoslav Zamborsky
- Department of Orthopaedics, Faculty of Medicine, Comenius University and National Institute of Children's Diseases, Limbova 1, 833 40 Bratislava, Slovakia.
| | - Milan Kokavec
- Department of Orthopaedics, Faculty of Medicine, Comenius University and National Institute of Children's Diseases, Limbova 1, 833 40 Bratislava, Slovakia.
| | - Stefan Harsanyi
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia.
| | - Doaa Attia
- Department of Internal Medicine, Faculty of Medicine, Alexandria University, Chamblion St., Azarita, 21131 Alexandria, Egypt.
| | - Lubos Danisovic
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University, Sasinkova 4, 811 08 Bratislava, Slovakia.
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Yan W, Hao Z, Tang S, Dai J, Zheng L, Yu P, Yan W, Han X, Xu X, Shi D, Ikegawa S, Teng H, Jiang Q. A genome-wide association study identifies new genes associated with developmental dysplasia of the hip. Clin Genet 2019; 95:345-355. [PMID: 30511388 DOI: 10.1111/cge.13483] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Revised: 11/03/2018] [Accepted: 11/17/2018] [Indexed: 11/30/2022]
Abstract
Developmental dysplasia of the hip (DDH) is one of the most common congenital malformations and covers a spectrum of hip disorders from mild dysplasia to irreducible dislocation. The pathological mechanisms of DDH are poorly understood, which hampers the development of diagnostic tools and treatments. To gain insight into its disease mechanism, we explored the potential biological processes that underlie DDH by integrating pathway analysis tools and performing a genome-wide association study (GWAS). A total of 406 DDH-associated genes (P < 0.001) were identified by our GWAS using a Chinese Han cohort consisting of 386 DDH cases and 500 healthy controls (Set A). We verified the significant loci (P < 10-5 ) in another Chinese Han cohort consisting of 574 DDH patients and 569 healthy controls (Set B). An intronic Single Nucleotide Polymorphism (SNP) (rs61930502) showed significant association in Set A and Set B (P = 2.65 × 10-7 and 2.0 × 10-4 , respectively). The minor allele, rs61930502-A, which tended to prevent DDH showed a dominant effect. Heat shock 70 kDa protein 8 (HSPA8) showed the most direct interactions with other proteins which were coded by DDH-associated genes in the protein-protein interaction analysis. Interestingly, Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis suggested a relation between DDH and the genes involved in type II diabetes mellitus pathway (P = 0.0067). Our genetic and protein interaction evidence could open avenues for future studies of DDH.
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Affiliation(s)
- Wenjin Yan
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Zheng Hao
- Center of Diagnosis and Treatment for Developmental Dysplasia of the Hip, Nanjing Zhongyangmen Community Health Service Center, Kang'ai Hospital, Nanjing, China
| | - Shuyan Tang
- Obstetrics and Gynecology Hospital, Institute of Metabolism and Integrative Biology, School of Life Sciences, Fudan University, Shanghai, China
| | - Jin Dai
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Liming Zheng
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Pengjun Yu
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Wenqiang Yan
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiao Han
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Xingquan Xu
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Dongquan Shi
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Shiro Ikegawa
- Laboratory of Bone and Joint Diseases, Center for Integrative Medical Sciences, RIKEN, Tokyo, Japan
| | - Huajian Teng
- Laboratory for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, China
| | - Qing Jiang
- State Key Laboratory of Pharmaceutical Biotechnology, Department of Sports Medicine and Adult Reconstructive Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.,Laboratory for Bone and Joint Disease, Model Animal Research Center (MARC), Nanjing University, Nanjing, China
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Feldman G, Kappes D, Mookerjee-Basu J, Freeman T, Fertala A, Parvizi J. Novel mutation in Teneurin 3 found to co-segregate in all affecteds in a multi-generation family with developmental dysplasia of the hip. J Orthop Res 2019; 37:171-180. [PMID: 30273960 DOI: 10.1002/jor.24148] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 09/04/2018] [Indexed: 02/04/2023]
Abstract
DDH is a debilitating condition characterized by incomplete formation of the acetabulum leading to dislocation of the hip, suboptimal joint function and accelerated wear of the articular cartilage resulting in early onset crippling arthritis of the hip in 20-40 year olds. Current diagnostic tests in newborns using physical manipulation of the femur or ultrasound either under or over-diagnose this condition. Developing an accurate, cost effective diagnostic test is a goal of this study. To better understand the biologic pathways involved in acetabular development, DNA from severely affected individuals in a four generation family that showed inter-generational transmission of the disorder was isolated and whole exome sequenced. A novel A to C transversion at position 183721398 on human chromosome four was found to co-segregate with the affected phenotype in this family. This mutation encodes a glutamine to proline change at position 2665 in the Teneurin 3 (TENM3) gene and was judged damaging by four prediction programs. Eight week old knock-in mutant mice show delayed development of the left acetabulum and the left glenoid fossa as shown by the presence of more Alcian blue staining on the socket rims of both the hip and the shoulder. We hypothesize that mutated TENM3 will slow chondrogenesis. MMP13 has been shown to impair extracellular matrix remodeling and suppress differentiation. Bone marrow cells from the knock-in mouse were found to overexpress MMP13 with or without BMP2 stimulation. This variant may elucidate pathways responsible for normal hip development and become part of an accurate test for DDH. © 2018 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res.
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Affiliation(s)
- George Feldman
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, Pennsylvania
| | | | | | - Theresa Freeman
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, Pennsylvania
| | - Andrzej Fertala
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, Pennsylvania
| | - Javad Parvizi
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, Pennsylvania.,Rothman Institute of Orthopaedics, Philadelphia, Pennsylvania
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12
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Jawadi AH, Wakeel A, Tamimi W, Nasr A, Iqbal Z, Mashhour A, Fattah MA, Alkhanein N, Abu Jaffal AS. Association analysis between four vitamin D receptor gene polymorphisms and developmental dysplasia of the hip. J Genet 2018; 97:925-930. [PMID: 30262704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Developmental dysplasia of the hip (DDH) is a congenital condition characterized by abnormality in acetabulum size and/or shape. The incidence rate of DDH differs between different populations with risk factors including positive family history, breech presentation, sex, firstborn status, side of the hip, mode of delivery and oligohydramnios. It is recognized that DDH has a genetic component that exhibit autosomal dominant patterns. Many candidate genes have been studied and found to be associated with the disease; most of them are normally involved in cartilage development and joint metabolism. In this study, the association of four single-nucleotide polymorphisms (SNPs) (rs731236, rs1544410, rs7975232 and rs2228570) in the vitamin D receptor (VDR) gene was studied by a case-control analysis. The study sample involves 50 cases with confirmed DDH presentation and 50 nonDDH controls. SNPs were genotyped using conventional polymerase chain reaction (PCR) and restriction fragment-length polymorphism (RFLP) techniques. Genotype and allele frequencies were analysed using SPSS software. No significant associations were found between the VDR polymorphisms analysed and DDH. Further work need to be performed using genomewide analysis to elucidate the genetic basis of DDH.
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Affiliation(s)
- Ayman H Jawadi
- Pediatric Orthopedic Surgery Department, King Abdullah Specialized Children Hospital (KASCH), P.O. Box 22490, Riyadh 11426, Saudi Arabia.
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13
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Jawadi AH, Wakeel A, Tamimi W, Nasr A, Iqbal Z, Mashhour A, Fattah MA, Alkhanein N, Jaffal ASA. Association analysis between four vitamin D receptor gene polymorphisms and developmental dysplasia of the hip. J Genet 2018. [DOI: 10.1007/s12041-018-0984-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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14
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Feldman G, Offemaria A, Sawan H, Parvizi J, Freeman TA. A murine model for developmental dysplasia of the hip: ablation of CX3CR1 affects acetabular morphology and gait. J Transl Med 2017; 15:233. [PMID: 29126427 PMCID: PMC5681830 DOI: 10.1186/s12967-017-1335-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Accepted: 10/30/2017] [Indexed: 01/16/2023] Open
Abstract
Background Developmental dysplasia of the hip (DDH) is a debilitating condition whose distinguishing signs include incomplete formation of the acetabulum leading to dislocation of the femur, accelerated wear of the articular cartilage and joint laxity resulting in osteoarthritis. It is a complex disorder having environmental and genetic causes. Existing techniques fail to detect milder forms of DDH in newborns leading to hip osteoarthritis in young adults. A sensitive, specific and cost effective test would allow identification of newborns that could be non-invasively corrected by the use of a Pavlik harness. Previously, we identified a 2.5 MB candidate region on human chromosome 3 by using linkage analysis of a 4 generation, 72 member family. Whole exome sequencing of the DNA of 4 severely affected members revealed a single nucleotide polymorphism variant, rs3732378 co-inherited by all 11 affected family members. This variant causes a threonine to methionine amino acid change in the coding sequence of the CX3CR1 chemokine receptor and is predicted to be harmful to the function of the protein To gain further insight into the function of this mutation we examined the effect of CX3CR1 ablation on the architecture of the mouse acetabulum and on the murine gait. Methods The hips of 5 and 8 weeks old wild type and CX3CR1 KO mice were analyzed using micro-CT to measure acetabular diameter and ten additional dimensional parameters. Eight week old mice were gait tested using an inclined treadmill with and without load and then underwent micro-CT analysis. Results (1) KO mice showed larger a 5–17% larger diameter left acetabula than WT mice at both ages. (2) At 8 weeks the normalized area of space (i.e. size discrepancy) between the femur head and acetabulum is significantly larger [38% (p = 0.001)–21% (p = 0.037)] in the KO mice. (3) At 8 weeks gait analysis of these same mice shows several metrics that are consistent with impairment in the KO but not the WT mice. These deficits are often seen in mice and humans who develop hip OA. Conclusion The effect of CX3CR1 deletion on murine acetabular development provides suggestive evidence of a susceptibility inducing role of the CX3CR1 gene on DDH. Electronic supplementary material The online version of this article (10.1186/s12967-017-1335-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- George Feldman
- Division of Orthopaedic Research, Thomas Jefferson University, Philadelphia, USA.
| | - Arlene Offemaria
- Division of Orthopaedic Research, Thomas Jefferson University, Philadelphia, USA
| | - Hind Sawan
- Division of Orthopaedic Research, Thomas Jefferson University, Philadelphia, USA
| | | | - Theresa A Freeman
- Division of Orthopaedic Research, Thomas Jefferson University, Philadelphia, USA
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15
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Wang CL, Wang H, Xiao F, Wang CD, Hu GL, Zhu JF, Shen C, Zuo B, Cui YM, Li D, Yuan-Gao, Zhang XL, Chen XD. Cyclic compressive stress-induced scinderin regulates progress of developmental dysplasia of the hip. Biochem Biophys Res Commun 2017; 485:400-408. [DOI: 10.1016/j.bbrc.2017.02.065] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 02/12/2017] [Indexed: 02/07/2023]
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16
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Basit S, Albalawi AM, Alharby E, Khoshhal KI. Exome sequencing identified rare variants in genes HSPG2 and ATP2B4 in a family segregating developmental dysplasia of the hip. BMC MEDICAL GENETICS 2017; 18:34. [PMID: 28327142 PMCID: PMC5361705 DOI: 10.1186/s12881-017-0393-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 03/07/2017] [Indexed: 12/26/2022]
Abstract
Background Developmental dysplasia of the hip (DDH) is a common pathological condition of the musculoskeletal system in infants which results in a congenital and developmental malformation of the hip joint. DDH is a spectrum of pathologies affecting the infant hip ranging from asymptomatic subtle radiographic signs through mild instability to frank dislocations with acetabular dysplasia. A Saudi family with three affected individuals with DDH was identified and genetic analysis was performed to detect the possible genetic defect(s) underlying DDH in the affected members of the family. Methods We performed whole genome genotyping using Illumina HumanOmni 2.5 M array and whole exome sequencing (WES) using Nextera Rapid capture kit and Illumina NextSeq500 instrument in four individuals of a family with DDH. Results SNP data analysis did not identify any runs of homozygosity and copy number variations. Identity-by-descent (IBD) analysis on whole genome genotyping data identified a shared haplotypes on chromosome 1 in affected individuals. An analysis of the WES data identified rare heterozygous variants in HSPG2 and ATP2B4 genes in the affected individuals. Multiple prediction software predicted that the variants identified are damaging. Moreover, in silico analysis showed that HSPG2 regulates ATP2B4 expression using a variety of transcription factors. Conclusion Our results indicate that there might be a functional epistatic interaction between HSPG2 and ATP2B4, and DDH in the family studied is due to a combined effect of both variants. These variants are also present in the asymptomatic mother suggesting that the variants in HSPG2 and ATP2B4 are incompletely penetrant. This study provides the first evidence of digenic inheritance of DDH in a family and extends the spectrum of genetic heterogeneity in this human disorder. Electronic supplementary material The online version of this article (doi:10.1186/s12881-017-0393-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sulman Basit
- Centre for Genetics and Inherited Diseases, Taibah University, Almadinah Almunawwarah, 30001, Saudi Arabia.
| | - Alia M Albalawi
- Centre for Genetics and Inherited Diseases, Taibah University, Almadinah Almunawwarah, 30001, Saudi Arabia
| | - Essa Alharby
- Centre for Genetics and Inherited Diseases, Taibah University, Almadinah Almunawwarah, 30001, Saudi Arabia
| | - Khalid I Khoshhal
- Department of Orthopedic Surgery, College of Medicine, Taibah University, Almadinah Almunawwarah, Saudi Arabia
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17
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Zhao L, Zhou Z, Wang S, Jiao Q, Wu J, Ma F, Fan L, Chen M, Ying H. A recurrent mutation in bone morphogenetic proteins-2-inducible kinase gene is associated with developmental dysplasia of the hip. Exp Ther Med 2017; 13:1773-1778. [PMID: 28565766 PMCID: PMC5443164 DOI: 10.3892/etm.2017.4191] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2015] [Accepted: 12/23/2016] [Indexed: 12/24/2022] Open
Abstract
Developmental dysplasia of the hip (DDH) is a complex disorder of the hip joint affecting 1-5‰ of newborns. While genetic influence on DDH has been long known, DDH has not been ascribed to any specific genetic event. The present study reported on variants contributing to DDH susceptibility in a family with four individuals affected across three generations. Whole-exome sequencing was performed in three affected and two unaffected individuals of a pedigree with DDH. Candidate variants were confirmed by Sanger sequencing and then validated in available family members and 37 sporadic DDH patients. Two novel heterozygous, inframe mutations causing multi-nucleotide substitution polymorphisms (c.1432_1440delCAGCAGCAG corresponding with p.Gln478_480del and c.1440_1441insCAG corresponding with p.Gln480ins) in exon 11 of chromosome 4 in bone morphogenetic proteins-2-inducible kinase (BMP2K) were identified; these were found in members of the pedigree affected by DDH and in the unaffected grandmother of the proband, who was deemed to be the carrier of potential mutations, but not in the unaffected normal control saunt of the proband. These two variants shared the same genomic coordinate but with different types of mutation in BMP2K. BMP2K is known to be associated with bone and cartridge development and heterozygous mutations were found to be present in 4/4 (100%) of the affected family members, 4/15 (26.7%) of the unaffected family members and 0/7 (0%) of the unaffected unrelated family members. Genotyping of 37 unrelated, sporadic DDH patients showed that three cases were positive for the BMP2K c.1432_1440delCAGCAGCAG variants (8.12%). These findings provided strong evidence for the role of BMP2K variants in causing DDH and demonstrated that the combination of pedigree information and next-generation sequencing is an effective method for identifying pathogenic sites associated with DDH.
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Affiliation(s)
- Lihua Zhao
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, P.R. China
| | - Zaiwei Zhou
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, P.R. China
| | - Sun Wang
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, P.R. China
| | - Qing Jiao
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, P.R. China
| | - Jing Wu
- Laboratory of Translational Research, Institute of Pediatric Translational Medicine, Shanghai Children's Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai 200071, P.R. China
| | - Feng Ma
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, P.R. China
| | - Lingyan Fan
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, P.R. China
| | - Mengjie Chen
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, P.R. China
| | - Hao Ying
- Department of Orthopedics, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai 200062, P.R. China
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18
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Li L, Wang X, Zhao Q, Wang E, Wang L, Cheng J, Zhang L, Wang B. CX3CR1 polymorphisms associated with an increased risk of developmental dysplasia of the hip in human. J Orthop Res 2017; 35:377-380. [PMID: 27176135 DOI: 10.1002/jor.23294] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Accepted: 05/10/2016] [Indexed: 02/04/2023]
Abstract
Developmental dysplasia of the hip, also termed congenital hip dislocation, is one of the major causes of children disability and early onset osteoarthritis. Previous study has identified a variant of CX3CR1 underlying this disorder in a large family. However, genetic evidence from population was still lacking. Here, we performed a case-control association study by genotyping two SNPs of CX3CR1, rs3732378, and rs3732379, in 689 unrelated hip dislocation patients and 689 normal controls. Genotyping results showed significant difference in genotype distributions of both two polymorphisms (p = 0.003 for rs3732378 and p = 0.017 for rs3732379). The minor allele frequency of rs3732378 was higher in cases (4.79%) than in controls (2.47%), predisposing carriers to hip dislocation with a 2.25-fold risk (OR = 2.25, 95%CI 1.42-3.56) after adjustment for gender. Another SNP, rs3732379, was also significantly associated with an increased risk of hip dislocation (adjusted OR = 1.84, 95%CI 1.19-2.84). Through the population study, we demonstrated that CX3CR1 was candidate for the pathogenesis of the disorder, and identified rs3732378 and rs3732379 as susceptibility loci instead of disease-causing mutations. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 35:377-380, 2017.
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Affiliation(s)
- Lianyong Li
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Xi Wang
- Graduate School of Peking Union Medical College, Beijing, 100730, China.,National Research Institute for Family Planning, 12 Dahuisi Road, Haidian, Beijing, 100081, China
| | - Qun Zhao
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Enbo Wang
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Lili Wang
- Key laboratory of Health Ministry for Congenital Malformation, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Jinshan Cheng
- Department of Pediatric Orthopedics, Red Cross Children's Hospital of Qingfeng, Qingfeng County, Henan, 457300, China
| | - Lijun Zhang
- Department of Pediatric Orthopedics, Shengjing Hospital of China Medical University, No. 36 Sanhao Street, Heping District, Shenyang, 110004, China
| | - Binbin Wang
- Graduate School of Peking Union Medical College, Beijing, 100730, China.,National Research Institute for Family Planning, 12 Dahuisi Road, Haidian, Beijing, 100081, China
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19
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Basit S, Hannan MA, Khoshhal KI. Developmental dysplasia of the hip: usefulness of next generation genomic tools for characterizing the underlying genes - a mini review. Clin Genet 2016; 90:16-20. [DOI: 10.1111/cge.12755] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Revised: 01/19/2016] [Accepted: 02/01/2016] [Indexed: 01/13/2023]
Affiliation(s)
- S. Basit
- Centre for Genetics and Inherited Diseases; Almadinah Almunawwarah Kingdom of Saudi Arabia
| | - M. A. Hannan
- Centre for Genetics and Inherited Diseases; Almadinah Almunawwarah Kingdom of Saudi Arabia
| | - K. I. Khoshhal
- College of Medicine; Taibah University; Almadinah Almunawwarah Kingdom of Saudi Arabia
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20
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Zhang X, Meng Q, Ma R, Chen G, Cheng L, Shen J. Early acetabular cartilage degeneration in a rabbit model of developmental dysplasia of the hip. Int J Clin Exp Med 2015; 8:14505-14512. [PMID: 26550441 PMCID: PMC4613126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2015] [Accepted: 07/06/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Mild developmental dysplasia of hip (DDH) causes high morbidity of osteoarthritis (OA) on adult. It is thought that change of collagen and proteoglycans in cartilage may be the direct reasons for osteoarthritis. OBJECTIVE To detect the changes of the expressions of type II collagen of acetabular cartilage in early DDH and to investigate the relevance between type II collagen and the degeneration mechanism of the acetabular cartilage. METHODS The rabbit model of DDH was successfully established by applying the method of knee extending and fixing with cylinder cast in which left lower extremity as experimental group and right one as control group, checking with X-ray after 5 weeks. The stains of H&E and toluidine blue were applied on the samples of acetabular cartilage to observe the morphological changes of chondrocytes and extracellular matrix (ECM). The immunohistochemical staining and Western-blot were employed to respectively qualify and quantitate the expression of type II collagen. RESULTS Pathohistology observing indicated the signs of retrogressive changes of acetabular cartilage in experimental group. Also, the positive stained cells in type II collagen in experimental group was higher based on immunohistochemiscal staining. The quantitative amounts of type II collagen by Western-blot in experimental group was higher significant difference existed between two groups (t = 2.18, P < 0.05). CONCLUSIONS The expression of type II collagen is correlated to a degeneration of acetabular cartilage and increase obviously in early DDH.
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Affiliation(s)
- Xiangxin Zhang
- Department of Orthopedics, Nanjing Medical University Affiliated Suzhou Hospital (Suzhou Municipal Hospital)Suzhou 215002, China
| | - Qingxia Meng
- Department of Orthopedics, Nanjing Medical University Affiliated Suzhou Hospital (Suzhou Municipal Hospital)Suzhou 215002, China
| | - Ruixue Ma
- Department of Pediatric Orthopedics, Children’s Hospital of Fudan UniversityShanghai 201102, China
| | - Guangxiang Chen
- Department of Orthopedics, Nanjing Medical University Affiliated Suzhou Hospital (Suzhou Municipal Hospital)Suzhou 215002, China
| | - Liang Cheng
- Department of Orthopedics, Nanjing Medical University Affiliated Suzhou Hospital (Suzhou Municipal Hospital)Suzhou 215002, China
| | - Jun Shen
- Department of Orthopedics, Nanjing Medical University Affiliated Suzhou Hospital (Suzhou Municipal Hospital)Suzhou 215002, China
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21
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Feldman GJ, Parvizi J, Sawan H, Erickson JA, Peters CL. Linkage mapping and whole exome sequencing identify a shared variant in CX3CR1 in a large multi-generation family. J Arthroplasty 2014; 29:238-41. [PMID: 24998320 DOI: 10.1016/j.arth.2014.05.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Revised: 04/02/2014] [Accepted: 05/10/2014] [Indexed: 02/01/2023] Open
Abstract
Developmental dysplasia of the hip (DDH) is a crippling condition that affects children and adults, with an average incidence of 1-1.5 cases per 1000 live births. It results in disabling arthritis of the hip in up to 60% patients in the 20-40 year age group. There is no accurate diagnostic test available for newborns. The purpose of our study is to develop a sensitive and specific genetic test for DDH by identifying causative mutations. Linkage analysis and whole exome sequencing of 4 severely affected individuals of a 4 generation 71 member family was performed. The damaging rs3732378 variant in the CX3CR1 chemokine receptor was shared by all affected family members and by 15% of 28 sporadic dysplastics.
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Affiliation(s)
- George J Feldman
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, PA
| | - Javad Parvizi
- Thomas Jefferson University Division of Orthopaedic Research, Philadelphia, PA; Rothman Institute of Orthopaedics, Philadelphia, PA
| | - Hind Sawan
- Rothman Institute of Orthopaedics, Philadelphia, PA
| | - Jill A Erickson
- University Orthopaedic Center, University of Utah, Salt Lake City, UT
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22
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Nowlan NC, Chandaria V, Sharpe J. Immobilized chicks as a model system for early-onset developmental dysplasia of the hip. J Orthop Res 2014; 32:777-85. [PMID: 24590854 DOI: 10.1002/jor.22606] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 02/03/2014] [Indexed: 02/04/2023]
Abstract
We have almost no understanding of how our joints take on their range of distinctive shapes, despite the clinical relevance of joint morphogenesis to postnatal skeletal malformations such as developmental dysplasia of the hip (DDH). In this study, we investigate the role of spontaneous prenatal movements in joint morphogenesis using pharmacological immobilization of developing chicks, and assess the system as a suitable model for early-onset hip dysplasia. We show that, prior to joint cavitation, the lack of dynamic muscle contractions has little impact on the shape of the hip joint. However, after the timepoint at which cavitation occurs, a dramatic effect on hip joint morphogenesis was observed. Effects in the immobilized chicks included flattening of the proximal femur, abnormal orientation of the pelvis relative to the femur and abnormal placement and coverage of the acetabulum. Although many clinical case studies have identified reduced or restricted movement as a risk factor for DDH, this study provides the first experimental evidence of the role of prenatal movements in early hip joint development. We propose that the immobilized chick embryo serves as a suitable model system for the type of early-onset DDH which arises due to neuromuscular conditions such as spinal muscular atrophy.
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Affiliation(s)
- Niamh C Nowlan
- EMBL-CRG Systems Biology Program, Centre for Genomic Regulation, UPF, Dr. Aiguader 88, 08003, Barcelona, Spain; Department of Bioengineering, Imperial College London, London, United Kingdom
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23
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Liu H, He H, Li S, Yang L, Wang P, Liu C, Wei X, Wu T, He C. Vitamin D receptor gene polymorphisms and risk of osteoarthritis: A meta-analysis. Exp Biol Med (Maywood) 2014; 239:559-67. [PMID: 24603077 DOI: 10.1177/1535370213514920] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The vitamin D receptor (VDR) gene polymorphisms have been reported to be involved in the development of many musculoskeletal disorders, including osteoarthritis (OA). However, results were inconsistent and there is no definite conclusion regarding the association between any VDR polymorphism and the risk of OA. In this study, we conducted a meta-analysis to determine whether BsmI, TaqI, and ApaI polymorphisms in the VDR gene are associated with OA susceptibility. Literature research was performed using PubMed and EMBASE databases. Studies illustrating the association between the three VDR polymorphisms and OA were included, and their qualities were assessed using Newcastle–Ottawa scale. Eight eligible studies, recruiting 1626 cases and 2024 controls were identified. Their methodological qualities were generally good, with scores ranging from 6 to 8 points. However, throughout all summary analyses, which were performed for multiple categories and on four contrasts (allele contrast, contrast of homozygotes, recessive and dominant models), none of the VDR BsmI, TaqI, and ApaI gene polymorphisms were found to be significantly associated with the risk of OA. On the other hand, there was no significant publication bias. Results from this meta-analysis suggested that the VDR BsmI, TaqI, and ApaI gene polymorphisms might not be important predictors of OA. More studies further investigating these associations, especially taking into account of gene–gene, gene–environment interactions, and other confounding factors are warranted.
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Affiliation(s)
- Huifang Liu
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Hongchen He
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Shasha Li
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Lin Yang
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Pu Wang
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Chuan Liu
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Xiaofei Wei
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Taixiang Wu
- Chinese Evidence-Based Medicine Centre/Cochrane Center, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
| | - Chengqi He
- Department of Rehabilitation Medicine, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
- Rehabilitation Key Laboratory of Sichuan Province, West Chinese Hospital, Sichuan University, Chengdu, Sichuan 610041, People’s Republic of China
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24
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Eytan O, Sarig O, Israeli S, Mevorah B, Basel-Vanagaite L, Sprecher E. A novel splice-site mutation in theAAGABgene segregates with hereditary punctate palmoplantar keratoderma and congenital dysplasia of the hip in a large family. Clin Exp Dermatol 2013; 39:182-6. [DOI: 10.1111/ced.12213] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/28/2013] [Indexed: 02/07/2023]
Affiliation(s)
- O. Eytan
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
- Department of Human Molecular Genetics and Biochemistry; Sackler Faculty of Medicine; Tel Aviv University; Ramat Aviv Israel
| | - O. Sarig
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - S. Israeli
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - B. Mevorah
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
| | - L. Basel-Vanagaite
- Department of Human Molecular Genetics and Biochemistry; Sackler Faculty of Medicine; Tel Aviv University; Ramat Aviv Israel
- Schneider Children's Medical Center of Israel and Raphael Recanati Genetics Institute; Petah Tikva Israel
- Felsenstein Medical Research Center; Rabin Medical Center; Petah Tikva Israel
| | - E. Sprecher
- Department of Dermatology; Tel Aviv Sourasky Medical Center; Tel Aviv Israel
- Department of Human Molecular Genetics and Biochemistry; Sackler Faculty of Medicine; Tel Aviv University; Ramat Aviv Israel
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25
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Feldman GJ, Parvizi J, Levenstien M, Scott K, Erickson JA, Fortina P, Devoto M, Peters CL. Developmental dysplasia of the hip: linkage mapping and whole exome sequencing identify a shared variant in CX3CR1 in all affected members of a large multigeneration family. J Bone Miner Res 2013; 28:2540-9. [PMID: 23716478 DOI: 10.1002/jbmr.1999] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 04/24/2013] [Accepted: 05/09/2013] [Indexed: 11/09/2022]
Abstract
Developmental dysplasia of the hip (DDH) is a debilitating condition characterized by incomplete formation of the acetabulum leading to dislocation of the femur, suboptimal joint function, and accelerated wear of the articular cartilage resulting in arthritis. DDH affects 1 in 1000 newborns in the United States; there are well-defined "pockets" of high prevalence in Japan, and in Italy and other Mediterranean countries. Although reasonably accurate for detecting gross forms of hip dysplasia, existing techniques fail to find milder forms of dysplasia. Undetected hip dysplasia is the leading cause of osteoarthritis of the hip in young individuals, causing over 40% of cases in this age group. A sensitive and specific test for DDH has remained a desirable yet elusive goal in orthopedics for a long time. A 72-member, four-generation affected family has been recruited, and DNA from its members retrieved. Genomewide linkage analysis revealed a 2.61-Mb candidate region (38.7-41.31 Mb from the p term of chromosome 3) co-inherited by all affected members with a maximum logarithm (base 10) of odds (LOD) score of 3.31. Whole exome sequencing and analysis of this candidate region in four severely affected family members revealed one shared variant, rs3732378, that causes a threonine (polar) to methionine (non-polar) alteration at position 280 in the transmembrane domain of CX3CR1. This mutation is predicted to have a deleterious effect on its encoded protein, which functions as a receptor for the ligand fractalkine. By Sanger sequencing this variant was found to be present in the DNA of all affected individuals and obligate heterozygotes. CX3CR1 mediates cellular adhesive and migratory functions and is known to be expressed in mesenchymal stem cells destined to become chondrocytes. A genetic risk factor that might be among the etiologic factors for the family in this study has been identified, along with other possible aggravating mutations shared by four severely affected family members. These findings might illuminate the molecular pathways affecting chondrocyte maturation and bone formation.
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Affiliation(s)
- George J Feldman
- Division of Orthopaedic Research, Thomas Jefferson University, Philadelphia, PA, USA
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Zhao L, Tian W, Pan H, Zhu X, Wang J, Cheng Z, Cheng L, Ma X, Wang B. Variations of the COL1A1 gene promoter and the relation to developmental dysplasia of the hip. Genet Test Mol Biomarkers 2013; 17:840-3. [PMID: 23941072 DOI: 10.1089/gtmb.2013.0179] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIM Developmental dysplasia of the hip (DDH) is one of the most common hip deformities in children. Since the COL1A1 gene is located in the DDH relating region, we investigated the COL1A1 promoter variations in the development of DDH. RESULTS We collected 154 unrelated female patients and 180 matched healthy female children, and then sequenced the COL1A1 gene promoter for detection of variations. Three variations in the COL1A1 gene promoter were detected in ten patients (T-139C, C-106T, and C-35T [rs113647555]), but none of the 180 health controls. The chi-square test showed that the rate of total variations in COL1A1 gene contributed to DDH (p=0.0016). CONCLUSION We detected three variations in the COL1A1 gene promoter in patients and first demonstrated that the higher rate of total variations of COL1A1 gene contributed to DDH in Chinese female children; thus, the COL1A1 gene is a new candidate gene for DDH disease.
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Affiliation(s)
- Lixi Zhao
- 1 Graduate School of Peking Union Medical College , Beijing, China
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Abstract
BACKGROUND Developmental dysplasia of the hip (DDH) is a developmental disorder of the hip joint that results in an abnormal socket of the femoral head, ranging from instability, subluxation and complete dislocation of the hip joint. DDH has a considerable genetic component. DESIGN We reviewed the recent progress on genetic study of DDH. RESULTS By linkage and case-control association studies, DDH loci have been identified with several susceptibility genes that involve in bone and joint biology; however, no unequivocal genes with global significance have been detected. The current problem of the association study in DDH is discussed. CONCLUSIONS By advanced technologies and international collaboration, we need to find more susceptibility genes and bridge the gap between genetic evidence and molecular mechanisms.
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Affiliation(s)
- Dongquan Shi
- The Center of Diagnosis and Treatment for Joint Disease, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
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Feldman GJ, Peters CL, Erickson JA, Hozack BA, Jaraha R, Parvizi J. Variable expression and incomplete penetrance of developmental dysplasia of the hip: clinical challenge in a 71-member multigeneration family. J Arthroplasty 2012; 27:527-32. [PMID: 22177793 DOI: 10.1016/j.arth.2011.10.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 10/16/2011] [Indexed: 02/01/2023] Open
Abstract
Developmental dysplasia of the hip is a crippling condition that affects children and adults. Identical twin studies support a strong causative genetic component. Although clinical tests for newborns can detect gross malformations, it is the subtle malformations that are often not detected, resulting in early onset osteoarthritis of the hip in adults. As a first step in identifying the causative mutation, we have recruited the largest documented affected family with 71 members spanning generations. Clinical and radiographic signs of developmental dysplasia of the hip are described, and the diagnostic challenge of identifying affected family members is discussed.Variable expression of disease allele is evident in several members of the family and greatly contributes to the diagnostic challenge facing clinicians.
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Affiliation(s)
- George J Feldman
- Thomas Jefferson University and the Rothman Institute of Orthopaedics, Philadelphia, PA, USA
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Abstract
Osteoarthritis (OA) has a considerable hereditary component and is considered to be a polygenic disease. Data derived from genetic analyses and genome-wide screening of individuals with this disease have revealed a surprising trend: genes associated with OA tend to be related to the process of synovial joint development. Mutations in these genes might directly cause OA. In addition, they could also determine the age at which OA becomes apparent, the joint sites involved, the severity of the disease and how rapidly it progresses. In this Review, I propose that genetic mutations associated with OA can be placed on a continuum. Early-onset OA is caused by mutations in matrix molecules often associated with chondrodysplasias, whereas less destructive structural abnormalities or mutations confer increased susceptibility to injury or malalignment that can result in middle-age onset. Finally, mutations in molecules that regulate subtle aspects of joint development and structure lead to late-onset OA. In this Review, I discuss the genetics of OA in general, but focus on the potential effect of genetic mutations associated with OA on joint structure, the role of joint structure in the development of OA--using hip abnormalities as a model--and how understanding the etiology of the disease could influence treatment.
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Loder RT, Skopelja EN. The epidemiology and demographics of hip dysplasia. ISRN ORTHOPEDICS 2011; 2011:238607. [PMID: 24977057 PMCID: PMC4063216 DOI: 10.5402/2011/238607] [Citation(s) in RCA: 165] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2011] [Accepted: 06/17/2011] [Indexed: 12/18/2022]
Abstract
The etiology of developmental dysplasia of the hip (DDH) is unknown. There are many insights, however, from epidemiologic/demographic information. A systematic medical literature review regarding DDH was performed. There is a predominance of left-sided (64.0%) and unilateral disease (63.4%). The incidence per 1000 live births ranges from 0.06 in Africans in Africa to 76.1 in Native Americans. There is significant variability in incidence within each racial group by geographic location. The incidence of clinical neonatal hip instability at birth ranges from 0.4 in Africans to 61.7 in Polish Caucasians. Predictors of DDH are breech presentation, positive family history, and gender (female). Children born premature, with low birth weights, or to multifetal pregnancies are somewhat protected from DDH. Certain HLA A, B, and D types demonstrate an increase in DDH. Chromosome 17q21 is strongly associated with DDH. Ligamentous laxity and abnormalities in collagen metabolism, estrogen metabolism, and pregnancy-associated pelvic instability are well-described associations with DDH. Many studies demonstrate an increase of DDH in the winter, both in the northern and southern hemispheres. Swaddling is strongly associated with DDH. Amniocentesis, premature labor, and massive radiation exposure may increase the risk of DDH. Associated conditions are congenital muscular torticollis and congenital foot deformities. The opposite hip is frequently abnormal when using rigorous radiographic assessments. The role of acetabular dysplasia and adult hip osteoarthritis is complex. Archeological studies demonstrate that the epidemiology of DDH may be changing.
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Affiliation(s)
- Randall T. Loder
- Section of Orthopedic Surgery, Riley Hospital for Children, ROC 4250, 705 Riley Hospital Drive, Indianapolis, IN 46202, USA
- Department of Orthopaedic Surgery, Indiana University, Indianapolis, IN 46202, USA
| | - Elaine N. Skopelja
- Ruth Lilly Medical Library, Indiana University School of Medicine, Indianapolis, IN 46202, USA
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Kolundžić R, Trkulja V, Mikolaučić M, Kolundžić MJ, Pavelić SK, Pavelić K. Association of interleukin-6 and transforming growth factor-β1 gene polymorphisms with developmental hip dysplasia and severe adult hip osteoarthritis: a preliminary study. Cytokine 2011; 54:125-8. [PMID: 21353594 DOI: 10.1016/j.cyto.2011.02.004] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 01/04/2011] [Accepted: 02/01/2011] [Indexed: 12/11/2022]
Abstract
Developmental hip dysplasia (DDH) greatly contributes to occurrence of severe hip osteoarthritis (OA) in adulthood, but the association between the two is not a perfect one. Both conditions are known to have a strong genetic component. Transforming growth factor β1 (TGF-β1) and interleukin-6 (IL-6) are two pro-inflammatory cytokines included in pathogenesis of OA, bone remodeling and development of bone and joint tissues. TGF-β1 gene has a polymorphic site in the signal sequence ((29)T→C) and "C allele carriage" is associated with higher circulating TGF-β1 levels. IL-6 gene has several polymorphic sites in the promoter region including -572T→C transition associated with higher circulating IL-6 levels. As a preliminary investigation on possible association between these polymorphisms and severe adult hip OA secondary to DDH, 28 consecutive patients and 20 healthy controls were genotyped at these loci. With adjustment for sex, "C allele carriage" in the TGF-β1 signal sequence and CC genotype ("transition homozygous") at locus -572 in the IL-6 promoter were each associated with severe OA secondary to DDH (OR=13.4, p=0.016 and OR=6.2, p=0.024, respectively). The combination of these genotypes was particularly strongly associated with the disease (OR=11.1, p<0.001). Data support feasibility of larger-scale studies on potential association between TGF-β1 signal sequence and IL-6 promoter polymorphisms and occurrence of DDH and (un)related severe OA.
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Affiliation(s)
- Robert Kolundžić
- Department of Orthopedic Surgery, Zagreb University Hospital Center and School of Medicine, Zagreb, Croatia.
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Rouault K, Scotet V, Autret S, Gaucher F, Dubrana F, Tanguy D, El Rassi CY, Fenoll B, Férec C. Evidence of association between GDF5 polymorphisms and congenital dislocation of the hip in a Caucasian population. Osteoarthritis Cartilage 2010; 18:1144-9. [PMID: 20633687 DOI: 10.1016/j.joca.2010.05.018] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2010] [Revised: 05/06/2010] [Accepted: 05/29/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Congenital dislocation of the hip (CDH) is a multifactorial disease which involves genetic factors that are still unidentified. Recently, a functional polymorphism (rs143383) of the 5'-untranslated region of GDF5 (Growth/Differentiation Factor 5) - previously reported to be associated with osteoarthritis - has been associated with CDH in a Chinese population. The aim of our study was to determine whether GDF5, known to be involved in bone, joint and cartilage morphogenesis, is also associated with CDH in Caucasians. DESIGN We genotyped three tagSNPs (rs224334, rs143384, rs143383) in 239 cases and 239 controls from western Brittany (France) where CDH is frequent, and tested the association using both single-locus and haplotype-based approaches. RESULTS The most significant association was observed with rs143384. The T allele of this SNP was overrepresented in cases (65.9% vs 55.9%, P=0.002). Under a recessive model, carriers of the TT genotype had a 1.71-fold higher risk of developing CDH than carriers of the other genotypes (OR(TT vs CT+CC)=1.71, 95% CI: [1.18-2.48], P=0.005). At a nominal level, the association was also significant with rs143383 (OR(TT vs CT+CC)=1.52, 95% CI: [1.05-2.19], P=0.026). The haplotype carrying the susceptibility alleles of these SNPs was also more frequent in cases (65.9% vs 55.9%, OR=1.53, 95% CI: [1.18-1.98], P=0.002). CONCLUSION This study reports, for the first time, the association between GDF5 polymorphisms and CDH in Caucasians, and points out another polymorphism of interest that requires further investigation. Reduction in GDF5 expression might lead to developmental deficiency of ligaments and capsule in hip joint, and therefore contribute to CDH pathogenesis.
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Feldman G, Dalsey C, Fertala K, Azimi D, Fortina P, Devoto M, Pacifici M, Parvizi J. The Otto Aufranc Award: Identification of a 4 Mb region on chromosome 17q21 linked to developmental dysplasia of the hip in one 18-member, multigeneration family. Clin Orthop Relat Res 2010; 468:337-44. [PMID: 19756907 PMCID: PMC2807013 DOI: 10.1007/s11999-009-1073-6] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2008] [Accepted: 08/19/2009] [Indexed: 01/31/2023]
Abstract
Developmental dysplasia of the hip (DDH) is a disabling condition that, depending on geography, can afflict between 20% and 80% of patients with end-stage arthritis of the hip. Despite its prevalence, the etiology of this disease remains unknown. DDH is a complex disorder with both environmental and genetic causes. Based on the literature the candidate genes for the disease are HOXB9, collagen type I alpha1, and DLX 3. The purpose of our study was to map and characterize the gene or genes responsible for this disorder by family linkage analysis. We recruited one 18-member, multigeneration affected family to provide cheek swabs and blood samples for isolation of DNA. Amplified DNA underwent a total genome scan using GeneChip Mapping 250 K Assay (Affymetrix, Santa Clara, CA). We observed only one region with a LOD score greater than 1.5: a 4 Mb region on chromosome 17q21.32, yielding a LOD score of 1.82. While a LOD score of 1.82 does not meet the accepted standard for linkage we interpret these data as suggesting the responsible gene could be linked to this region, which includes a cluster of homeobox genes (HOX genes) that are part of the developmental regulatory system providing cells with specific positional identities along the developing joint and spine. Discovering the genetic basis of the disease would be an important step in understanding the etiology of this disabling condition.
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Affiliation(s)
- George Feldman
- Thomas Jefferson University and the Rothman Institute of Orthopaedics, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107 USA
| | - Chelsea Dalsey
- Thomas Jefferson University and the Rothman Institute of Orthopaedics, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107 USA
| | - Kasia Fertala
- Thomas Jefferson University and the Rothman Institute of Orthopaedics, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107 USA
| | - David Azimi
- Thomas Jefferson University and the Rothman Institute of Orthopaedics, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107 USA
| | - Paolo Fortina
- Department of Cancer Biology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107 USA
| | - Marcella Devoto
- Division of Human Genetics, The Children’s Hospital of Philadelphia, Philadelphia, PA 19104 USA
| | - Maurizio Pacifici
- Thomas Jefferson University and the Rothman Institute of Orthopaedics, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107 USA
| | - Javad Parvizi
- Thomas Jefferson University and the Rothman Institute of Orthopaedics, 925 Chestnut Street, 5th Floor, Philadelphia, PA 19107 USA
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Rouault K, Scotet V, Autret S, Gaucher F, Dubrana F, Tanguy D, Yaacoub El Rassi C, Fenoll B, Férec C. Do HOXB9 and COL1A1 genes play a role in congenital dislocation of the hip? Study in a Caucasian population. Osteoarthritis Cartilage 2009; 17:1099-105. [PMID: 19341834 DOI: 10.1016/j.joca.2008.12.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2008] [Revised: 11/18/2008] [Accepted: 12/27/2008] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Congenital dislocation of the hip (CDH), which is one of the most common congenital skeletal disorders, corresponds to an abnormal seating of the femoral head in the acetabulum. It is commonly admitted that CDH presents a genetic component. However, little is known about the genetic factors involved. This study aimed to determine the role of two potential candidate genes on chromosome 17 in CDH: HOXB9 (involved in limb embryonic development) and COL1A1 (involved in joint laxity). METHOD We set up a case-control association study (239 cases and 239 controls) in western Brittany (France) where CDH is particularly frequent. The set of informative single nucleotide polymorphisms (SNPs) in each gene was selected using Tagger and genotyped using the SNaPshot method (n=2 and n=10, respectively). The association was tested both through single-locus and haplotype-based analyses, using SAS and Haploview softwares. In addition, we carried out the transmission disequilibrium test (TDT) with the same polymorphisms from a sample of 81 trios (i.e., 81 patients included in the case-control study and their both parents). RESULTS The case-control study revealed no significant association between CDH and the tagSNPs selected in both HOXB9 and COL1A1. Moreover, the TDT did not reveal distortion in allelic and haplotype transmission of the studied markers. CONCLUSION Our study did not support an association between HOXB9 and COL1A1 and CDH in our population. These negative findings were obtained by population- and family-based designs. Analysis of the genetic component of CDH should focus on other candidate genes.
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Affiliation(s)
- K Rouault
- Inserm, U613, Univ Brest, UMR-S613, Brest F-29200, France
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Dai J, Shi D, Zhu P, Qin J, Ni H, Xu Y, Yao C, Zhu L, Zhu H, Zhao B, Wei J, Liu B, Ikegawa S, Jiang Q, Ding Y. Association of a single nucleotide polymorphism in growth differentiate factor 5 with congenital dysplasia of the hip: a case-control study. Arthritis Res Ther 2008; 10:R126. [PMID: 18947434 PMCID: PMC2592816 DOI: 10.1186/ar2540] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2008] [Revised: 10/09/2008] [Accepted: 10/24/2008] [Indexed: 12/19/2022] Open
Abstract
Introduction Congenital dysplasia of the hip is an abnormal seating of the femoral head in the acetabulum, mainly caused by shallow acetabulum and lax joint capsule. Genetic factors play a considerable role in the pathogenesis of congenital dysplasia of the hip. The gene growth differentiate factor 5 (GDF5) has been implicated in skeletal development and joint morphogenesis in humans and mice. A functional single nucleotide polymorphism (SNP) in the 5'-untranslated region of GDF5 (rs143383) was reported to be associated with osteoarthritis susceptibility. As a key regulator in morphogenesis of skeletal components and soft tissues in and around the joints, GDF5 may be involved in the aetiology and pathogenesis of congenital dysplasia of the hip. Our objective is to evaluate if the GDF5 SNP is associated with congenital dysplasia of the hip in people of Han Chinese origin. Methods The GDF5 SNP was genotyped in 338 children with congenital dysplasia of the hip and 622 control subjects. Results The SNP was significantly associated with congenital dysplasia of the hip (p = 0.0037; odds ration (OR) = 1.40; 95% confidence interval (CI) = 1.11 to 1.75). A significant difference was detected in female samples when stratified by gender (p = 0.0053; OR = 1.46; 95% CI = 1.21 to 1.91), and in hip dislocation when stratified by severity (p = 0.0078; OR = 1.43; 95% CI = 1.11 to 1.85). Conclusions Our results indicate that GDF5 is important in the aetiology of congenital dysplasia of the hip. To the authors' knowledge this is the first time that a definite association with the congenital dysplasia of the hip susceptibility has been detected.
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Affiliation(s)
- Jin Dai
- The Center of Diagnosis and Treatment for Joint Disease, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing 210008, Jiangsu, PR China.
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