1
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Radenkovic S, Bleukx S, Engelhardt N, Eklund E, Mercimek-Andrews S, Edmondson AC, Morava E. Coagulation abnormalities and vascular complications are common in PGM1-CDG. Mol Genet Metab 2024; 142:108530. [PMID: 38968673 DOI: 10.1016/j.ymgme.2024.108530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 06/27/2024] [Accepted: 06/28/2024] [Indexed: 07/07/2024]
Abstract
Phosphoglucomutase-1-congenital disorder of glycosylation (PGM1-CDG) is a rare genetic disorder caused by biallelic variants in the PGM1 gene, leading to the deficiency of the PGM1 enzyme. The most common clinical presentations include muscle involvement, failure to thrive, cleft palate, and cardiac involvement. Abnormal serum N-glycosylation, hypoglycemia, and liver function abnormalities including coagulation abnormalities are the most common laboratory abnormalities. While PGM1-CDG has been extensively studied, little is known about the extent of the coagulation abnormalities in individuals with PGM1-CDG. Unlike most CDG, some symptoms of PGM1-CDG are treatable with D-galactose (D-gal) supplementation, though reliable clinical endpoints are necessary to appropriately evaluate the potential improvement with D-gal in PGM1-CDG. Here, we aimed to describe the incidence of coagulation abnormalities in PGM1-CDG and their evolution, their relation to clinical events, and the ability of D-gal treatment to improve them. A retrospective analysis was conducted on 73 reported individuals. All individuals had a molecularly confirmed PGM1-CDG diagnosis. All incidences of antithrombin (AT), aPTT, PT, factor (F) XI, FX, FIX, FVII, protein C and protein S data and major clinical events related to coagulation abnormalities, were collected. Coagulation information was available for only 58.9 % of the reported individuals, out of which 67.4 % of PGM1-CDG individuals were reported to have abnormalities. The most frequently observed abnormality was AT (mean: 30.8% R:80-120 %) deficiency. Four individuals had major thrombotic events. Coagulation status on D-gal treatment, were reported in 19 individuals. Several factors showed improvement including AT (mean: 64.5 %), indicating galactose is beneficial in treating coagulation abnormalities in PGM1-CDG. Due to the scarcity of the reported data on coagulation parameters, we also evaluated data collected in sixteen PGM1-CDG individuals enrolled in the FCDGC Natural History Study. Longitudinal data showed improvements in several coagulant parameters and disease severity improved for almost all patients of whom we had multiple datapoints on D-gal. AT showed significant improvement on D-gal. We conclude that coagulation abnormalities are frequently present in PGM1-CDG and show improvement on D-gal. We recommend coagulation parameters should be routinely checked in individuals with PGM1-CDG or suspected of having PGM1-CDG. Finally, AT may be used as a primary or secondary clinical endpoint for upcoming clinical trials in PGM1-CDG individuals.
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Affiliation(s)
- Silvia Radenkovic
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA; Department of Genetics, Section Metabolic Diagnostics, UMC Utrecht, Utrecht, NL.
| | - Sofie Bleukx
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - Nicole Engelhardt
- Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, PA, USA
| | - Erik Eklund
- Departement of Clinical Sciences, Lund, Pediatrics, Lund University, Lund, Sweden; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Saadet Mercimek-Andrews
- Department of Medical Genetics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada
| | - Andrew C Edmondson
- Division of Human Genetics, Department of Pediatrics, Children's Hospital of Philadelphia, PA, USA
| | - Eva Morava
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA; Department of Genetics and Genomics Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Biophysics, University of Pécs Medical School, 7624 Pécs, Hungary.
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2
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Gouliaev F, Jonsson N, Gersing S, Lisby M, Lindorff-Larsen K, Hartmann-Petersen R. Destabilization and Degradation of a Disease-Linked PGM1 Protein Variant. Biochemistry 2024; 63:1423-1433. [PMID: 38743592 DOI: 10.1021/acs.biochem.4c00042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
PGM1-linked congenital disorder of glycosylation (PGM1-CDG) is an autosomal recessive disease characterized by several phenotypes, some of which are life-threatening. Research focusing on the disease-related variants of the α-D-phosphoglucomutase 1 (PGM1) protein has shown that several are insoluble in vitro and expressed at low levels in patient fibroblasts. Due to these observations, we hypothesized that some disease-linked PGM1 protein variants are structurally destabilized and subject to protein quality control (PQC) and rapid intracellular degradation. Employing yeast-based assays, we show that a disease-associated human variant, PGM1 L516P, is insoluble, inactive, and highly susceptible to ubiquitylation and rapid degradation by the proteasome. In addition, we show that PGM1 L516P forms aggregates in S. cerevisiae and that both the aggregation pattern and the abundance of PGM1 L516P are chaperone-dependent. Finally, using computational methods, we perform saturation mutagenesis to assess the impact of all possible single residue substitutions in the PGM1 protein. These analyses identify numerous missense variants with predicted detrimental effects on protein function and stability. We suggest that many disease-linked PGM1 variants are subject to PQC-linked degradation and that our in silico site-saturated data set may assist in the mechanistic interpretation of PGM1 variants.
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Affiliation(s)
- Frederik Gouliaev
- Department of Biology, University of Copenhagen, Ole Maalo̷es Vej 5, DK2200N Copenhagen, Denmark
| | - Nicolas Jonsson
- Department of Biology, University of Copenhagen, Ole Maalo̷es Vej 5, DK2200N Copenhagen, Denmark
| | - Sarah Gersing
- Department of Biology, University of Copenhagen, Ole Maalo̷es Vej 5, DK2200N Copenhagen, Denmark
| | - Michael Lisby
- Department of Biology, University of Copenhagen, Ole Maalo̷es Vej 5, DK2200N Copenhagen, Denmark
| | - Kresten Lindorff-Larsen
- Department of Biology, University of Copenhagen, Ole Maalo̷es Vej 5, DK2200N Copenhagen, Denmark
| | - Rasmus Hartmann-Petersen
- Department of Biology, University of Copenhagen, Ole Maalo̷es Vej 5, DK2200N Copenhagen, Denmark
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3
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Zhao W, Cai Z, Wei C, Ma X, Yu B, Fu X, Zhang T, Gu Y, Zhang J. Functional identification of PGM1 in the regulating development and depositing of inosine monophosphate specific for myoblasts. Front Vet Sci 2023; 10:1276582. [PMID: 38164393 PMCID: PMC10758172 DOI: 10.3389/fvets.2023.1276582] [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: 08/23/2023] [Accepted: 11/21/2023] [Indexed: 01/03/2024] Open
Abstract
Background Inosine monophosphate (IMP) is naturally present in poultry muscle and plays a key role in improving meat flavour. However, IMP deposition is regulated by numerous genes and complex molecular networks. In order to excavate key candidate genes that may regulate IMP synthesis, we performed proteome and metabolome analyses on the leg muscle, compared to the breast muscle control of 180-day-old Jingyuan chickens (hens), which had different IMP content. The key candidate genes identified by a differential analysis were verified to be associated with regulation of IMP-specific deposition. Results The results showed that the differentially expressed (DE) proteins and metabolites jointly involve 14 metabolic pathways, among which the purine metabolic pathway closely related to IMP synthesis and metabolism is enriched with four DE proteins downregulated (with higher expression in breast muscles than in leg muscles), including adenylate kinase 1 (AK1), adenosine monophosphate deaminase 1 (AMPD1), pyruvate kinase muscle isoenzyme 2 (PKM2) and phosphoglucomutase 1 (PGM1), six DE metabolites, Hypoxanthine, Guanosine, L-Glutamine, AICAR, AMP and Adenylsuccinic acid. Analysis of PGM1 gene showed that the high expression of PGM1 promoted the proliferation and differentiation of myoblasts and inhibited the apoptosis of myoblasts. ELISA tests have shown that PGM1 reduced adenosine triphosphate (ATP) and IMP and uric acid (UA), while enhancing the biosynthesis of hypoxanthine (HX). In addition, up-regulation of PGM1 inhibited the expression of purine metabolism pathway related genes, and promoted the IMP de novo and salvage synthesis pathways. Conclusion This study preliminarily explored the mechanism of action of PGM1 in regulating the growth and development of myoblasts and specific IMP deposition in Jingyuan chickens, which provided certain theoretical basis for the development and utilization of excellent traits in Jingyuan chickens.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Juan Zhang
- College of Animal Science and Technology, Ningxia University, Yinchuan, China
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4
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Conte F, Sam JE, Lefeber DJ, Passier R. Metabolic Cardiomyopathies and Cardiac Defects in Inherited Disorders of Carbohydrate Metabolism: A Systematic Review. Int J Mol Sci 2023; 24:ijms24108632. [PMID: 37239976 DOI: 10.3390/ijms24108632] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 05/28/2023] Open
Abstract
Heart failure (HF) is a progressive chronic disease that remains a primary cause of death worldwide, affecting over 64 million patients. HF can be caused by cardiomyopathies and congenital cardiac defects with monogenic etiology. The number of genes and monogenic disorders linked to development of cardiac defects is constantly growing and includes inherited metabolic disorders (IMDs). Several IMDs affecting various metabolic pathways have been reported presenting cardiomyopathies and cardiac defects. Considering the pivotal role of sugar metabolism in cardiac tissue, including energy production, nucleic acid synthesis and glycosylation, it is not surprising that an increasing number of IMDs linked to carbohydrate metabolism are described with cardiac manifestations. In this systematic review, we offer a comprehensive overview of IMDs linked to carbohydrate metabolism presenting that present with cardiomyopathies, arrhythmogenic disorders and/or structural cardiac defects. We identified 58 IMDs presenting with cardiac complications: 3 defects of sugar/sugar-linked transporters (GLUT3, GLUT10, THTR1); 2 disorders of the pentose phosphate pathway (G6PDH, TALDO); 9 diseases of glycogen metabolism (GAA, GBE1, GDE, GYG1, GYS1, LAMP2, RBCK1, PRKAG2, G6PT1); 29 congenital disorders of glycosylation (ALG3, ALG6, ALG9, ALG12, ATP6V1A, ATP6V1E1, B3GALTL, B3GAT3, COG1, COG7, DOLK, DPM3, FKRP, FKTN, GMPPB, MPDU1, NPL, PGM1, PIGA, PIGL, PIGN, PIGO, PIGT, PIGV, PMM2, POMT1, POMT2, SRD5A3, XYLT2); 15 carbohydrate-linked lysosomal storage diseases (CTSA, GBA1, GLA, GLB1, HEXB, IDUA, IDS, SGSH, NAGLU, HGSNAT, GNS, GALNS, ARSB, GUSB, ARSK). With this systematic review we aim to raise awareness about the cardiac presentations in carbohydrate-linked IMDs and draw attention to carbohydrate-linked pathogenic mechanisms that may underlie cardiac complications.
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Affiliation(s)
- Federica Conte
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Department of Applied Stem Cell Technologies, TechMed Centre, University of Twente, 7522 NH Enschede, The Netherlands
| | - Juda-El Sam
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Dirk J Lefeber
- Department of Neurology, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
- Translational Metabolic Laboratory, Department of Laboratory Medicine, Radboud Institute for Molecular Life Sciences, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands
| | - Robert Passier
- Department of Applied Stem Cell Technologies, TechMed Centre, University of Twente, 7522 NH Enschede, The Netherlands
- Department of Anatomy and Embryology, Leiden University Medical Center, 2333 ZA Leiden, The Netherlands
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5
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Altassan R, Albert‐Brotons DC, Alowain M, Al‐Halees Z, Jaeken J, Morava E. Successful heart transplantation in an infant with phosphoglucomutase 1 deficiency (PGM1-CDG). JIMD Rep 2023; 64:123-128. [PMID: 36873091 PMCID: PMC9981415 DOI: 10.1002/jmd2.12350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/09/2022] [Accepted: 11/11/2022] [Indexed: 11/24/2022] Open
Abstract
We report successful heart transplantation in a phosphoglucomutase 1 deficient (PGM1-CDG) patient. She presented with facial dysmorphism, bifid uvula and structural heart defects. Newborn screening was positive for classic galactosemia. The patient was on a galactose-free diet for 8 months. Eventually, whole exome sequencing excluded the galactosemia and revealed PGM1-CDG. Oral D-galactose therapy was started. Rapid deterioration of the progressive dilated cardiomyopathy prompted heart transplantation at the age of 12 months. Cardiac function was stable in the first 18 months of follow-up, and hematologic, hepatic, and endocrine laboratory findings improved during D-galactose therapy. The latter therapy improves several systemic symptoms and biochemical abnormalities in PGM1-CDG but does not correct the heart failure related to cardiomyopathy. Heart transplantation has so far only been described in DOLK-CDG.
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Affiliation(s)
- Ruqaiah Altassan
- Department of Medical Genomics, Centre for Genomic MedicineKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
- College of MedicineAlfasial UniversityRiyadhSaudi Arabia
- Department of Clinical GenomicsMayo ClinicRochesterMinnesotaUSA
| | - Dimpna C. Albert‐Brotons
- Department of Cardiology, Heart CentreKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
| | - Mohammad Alowain
- Department of Medical Genomics, Centre for Genomic MedicineKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
- College of MedicineAlfasial UniversityRiyadhSaudi Arabia
| | - Zohair Al‐Halees
- Department of Cardiology, Heart CentreKing Faisal Specialist Hospital and Research CentreRiyadhSaudi Arabia
| | - Jaak Jaeken
- Department of PediatricsUniversity Hospitals LeuvenLeuvenBelgium
| | - Eva Morava
- Department of Clinical GenomicsMayo ClinicRochesterMinnesotaUSA
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6
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Radenkovic S, Johnsen C, Schulze A, Lail G, Guilder L, Schwartz K, Schultz M, Mercimek-Andrews S, Boyer S, Morava E. Novel insights into the phenotype and long-term D-gal treatment in PGM1-CDG: a case series. THERAPEUTIC ADVANCES IN RARE DISEASE 2023; 4:26330040221150269. [PMID: 37181075 PMCID: PMC10032428 DOI: 10.1177/26330040221150269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/20/2022] [Indexed: 05/16/2023]
Abstract
Phosphoglucomutase-1-congenital disorder of glycosylation (PGM1-CDG) (OMIM: 614921) is a rare autosomal recessive inherited metabolic disease caused by the deficiency of the PGM1 enzyme. Like other CDGs, PGM1-CDG has a multisystemic presentation. The most common clinical findings include liver involvement, rhabdomyolysis, hypoglycemia, and cardiac involvement. Phenotypic severity can vary, though cardiac presentation is usually part of the most severe phenotype, often resulting in early death. Unlike the majority of CDGs, PGM1-CDG has a treatment: oral D-galactose (D-gal) supplementation, which significantly improves many aspects of the disorder. Here, we describe five PGM1-CDG patients treated with D-gal and report both on novel clinical symptoms in PGM1-CDG as well as the effects of the D-gal treatment. D-gal resulted in notable clinical improvement in four patients, though the efficacy of treatment varied between the patients. Furthermore, there was a significant improvement or normalization in transferrin glycosylation, liver transaminases and coagulation factors in three patients, creatine kinase (CK) levels in two, while hypoglycemia resolved in two patients. One patient discontinued the treatment due to urinary frequency and lack of clinical improvement. Furthermore, one patient experienced recurrent episodes of rhabdomyolysis and tachycardia even on higher doses of therapy. D-gal also failed to improve the cardiac function, which was initially abnormal in three patients, and remains the biggest challenge in treating PGM1-CDG. Together, our findings expand the phenotype of PGM1-CDG and underline the importance of developing novel therapies that would specifically treat the cardiac phenotype in PGM1-CDG.
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Affiliation(s)
- Silvia Radenkovic
- Department of Clinical Genomics, Mayo Clinic,
55905 Rochester, MN, USA
| | - Christin Johnsen
- Department of Clinical Genomics, Mayo Clinic,
Rochester, MN, USA
| | - Andreas Schulze
- Department of Biochemistry, University of
Toronto, Toronto, ON, Canada
- Hospital for Sick Children and Department of
Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Gurnoor Lail
- Hospital for Sick Children and Department of
Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Laura Guilder
- Hospital for Sick Children and Department of
Pediatrics, University of Toronto, Toronto, ON, Canada
| | - Kaitlin Schwartz
- Department of Clinical Genomics, Mayo Clinic,
Rochester, MN, USA
| | - Matthew Schultz
- Biochemical Genetics Laboratory, Department of
Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN USA
| | | | - Suzanne Boyer
- Department of Clinical Genomics, Mayo Clinic,
Rochester, MN, USA
| | - Eva Morava
- Department of Clinical Genomics, Mayo Clinic,
Rochester, MN, USA
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7
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Zheng Z, Zhang X, Bai J, Long L, Liu D, Zhou Y. PGM1 suppresses colorectal cancer cell migration and invasion by regulating the PI3K/AKT pathway. Cancer Cell Int 2022; 22:201. [PMID: 35614441 PMCID: PMC9134613 DOI: 10.1186/s12935-022-02545-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 03/08/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Phosphoglucomutase 1 (PGM1) is known for its involvement in cancer pathogenesis. However, its biological role in colorectal cancer (CRC) has remained unknown. Here, we studied the functions and mechanisms of PGM1 in CRC. METHODS We verified PGM-1 as a differentially expressed gene (DEG) by employing a comprehensive strategy of TCGA-COAD dataset mining and computational biology. Relative levels of PGM-1 in CRC tumors and adjoining peritumoral tissues were determined by qRT-PCR, western blotting (WB), and immunohistochemical (IHC) staining in a tissue microarray. PGM1 functions were analyzed by CCK8, EdU, colony formation, cell cycle, apoptosis, and Transwell migration and invasion assays. The influence of PGM1 was further investigated by studying tumor formation in vivo. RESULTS The levels of PGM1 mRNA and protein were both reduced in CRC tissues, and the reductions were related to CRC pathology and overall survival. PGM1 knockdown stimulated both cell proliferation and colony formation, and inhibited cell cycle arrest and apoptosis, while overexpression of PGM1 produced the opposite effects in CRC cells both in vivo and in vitro. Furthermore, the effects of PGM1 were related to the PI3K/ AKT pathway. CONCLUSION We verified that PGM1 suppresses CRC progression via the PI3K/AKT pathway. These results suggest the potential for targeting PGM1 in treatment of CRC.
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Affiliation(s)
- Zhewen Zheng
- Department of Radiation Oncology and Medical Oncology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, Hubei, People's Republic of China
| | - Xue Zhang
- Department of General Practice, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, People's Republic of China
| | - Jian Bai
- Department of Anesthesiology, Peking University Third Hospital, Beijing, 100191, People's Republic of China
| | - Long Long
- Department of Radiation Oncology and Medical Oncology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, Hubei, People's Republic of China
| | - Di Liu
- Department of Radiation Oncology and Medical Oncology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, Hubei, People's Republic of China
| | - Yunfeng Zhou
- Department of Radiation Oncology and Medical Oncology, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan, Hubei, People's Republic of China.
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8
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Delanne J, Bruel AL, Huet F, Moutton S, Nambot S, Grisval M, Houcinat N, Kuentz P, Sorlin A, Callier P, Jean-Marcais N, Mosca-Boidron AL, Mau-Them FT, Denommé-Pichon AS, Vitobello A, Lehalle D, El Chehadeh S, Francannet C, Lebrun M, Lambert L, Jacquemont ML, Gerard-Blanluet M, Alessandri JL, Willems M, Thevenon J, Chouchane M, Darmency V, Fatus-Fauconnier C, Gay S, Bournez M, Masurel A, Leguy V, Duffourd Y, Philippe C, Feillet F, Faivre L, Thauvin-Robinet C. The diagnostic rate of inherited metabolic disorders by exome sequencing in a cohort of 547 individuals with developmental disorders. Mol Genet Metab Rep 2021; 29:100812. [PMID: 34712575 PMCID: PMC8528787 DOI: 10.1016/j.ymgmr.2021.100812] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/07/2021] [Accepted: 10/09/2021] [Indexed: 11/24/2022] Open
Abstract
Considering that some Inherited Metabolic Disorders (IMDs) can be diagnosed in patients with no distinctive clinical features of IMDs, we aimed to evaluate the power of exome sequencing (ES) to diagnose IMDs within a cohort of 547 patients with unspecific developmental disorders (DD). IMDs were diagnosed in 12% of individuals with causative diagnosis (177/547). There are clear benefits of using ES in DD to diagnose IMD, particularly in cases where biochemical studies are unavailable. Synopsis Exome sequencing and diagnostic rate of Inherited Metabolic Disorders in individuals with developmental disorders.
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Affiliation(s)
- Julian Delanne
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
| | - Ange-Line Bruel
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - Frédéric Huet
- Centre de Compétence Maladies Héréditaires du Métabolisme, CHU Dijon Bourgogne, France
| | - Sébastien Moutton
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
| | - Sophie Nambot
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
| | - Margot Grisval
- Centre de Compétence Maladies Héréditaires du Métabolisme, CHU Dijon Bourgogne, France
| | - Nada Houcinat
- CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
| | - Paul Kuentz
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France.,Biologie moléculaire, CHU Besançon, Besançon, France
| | - Arthur Sorlin
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - Patrick Callier
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Laboratoire de cytogénétique et génétique moléculaire, CHU Dijon Bourgogne, France
| | - Nolwenn Jean-Marcais
- CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
| | | | - Frédéric Tran Mau-Them
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - Anne-Sophie Denommé-Pichon
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - Antonio Vitobello
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - Daphné Lehalle
- CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
| | - Salima El Chehadeh
- CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
| | - Christine Francannet
- Service de Génétique Médicale, Centre de Référence Déficiences Intellectuelles de causes rares, CHU Clermont Ferrand, France
| | - Marine Lebrun
- Laboratoire de génétique, CHU de Saint-Etienne, Saint-Etienne, France
| | | | - Marie-Line Jacquemont
- Unité de Génétique Médicale, Pole Femme-Mère-Enfant, Groupe Hospitalier Sud Réunion, CHU de La Réunion, La Réunion, France
| | | | - Jean-Luc Alessandri
- Service de Réanimation Néonatale, Pole Femme-Mère-Enfant, CH Felix Guyon, CHU de La Réunion, Saint-Denis, La Réunion, France
| | - Marjolaine Willems
- Department of Medical Genetics, Reference Center for Rare Diseases, Developmental Disorders and Multiple Congenital Anomalies, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Julien Thevenon
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - Mondher Chouchane
- Centre de Compétence Maladies Héréditaires du Métabolisme, CHU Dijon Bourgogne, France
| | - Véronique Darmency
- Centre de Compétence Maladies Héréditaires du Métabolisme, CHU Dijon Bourgogne, France
| | | | - Sébastien Gay
- Service de Pédiatrie, CH William Morey, Chalon-Sur-Saône, France
| | - Marie Bournez
- Centre de Compétence Maladies Héréditaires du Métabolisme, CHU Dijon Bourgogne, France
| | - Alice Masurel
- CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
| | - Vanessa Leguy
- Centre de Compétence Maladies Héréditaires du Métabolisme, CHU Dijon Bourgogne, France
| | - Yannis Duffourd
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - Christophe Philippe
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - François Feillet
- Department of Medical Genetics, Reference Center for Rare Diseases, Developmental Disorders and Multiple Congenital Anomalies, Arnaud de Villeneuve Hospital, Montpellier, France
| | - Laurence Faivre
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,CHU Dijon, Centre de référence maladies rares Anomalies du Développement et Syndromes Malformatifs, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France
| | - Christel Thauvin-Robinet
- INSERM - University of Bourgogne Franche-Comté, UMR 1231 GAD Team, Genetics of Developmental Disorders, FHU TRANSLAD, CHU Dijon Bourgogne, France.,Unité Fonctionnelle d'Innovation diagnostique dans les maladies rares, Laboratoire de Génétique chromosomique moléculaire, CHU Dijon Bourgogne, France.,Centre de référence maladies rares Déficiences Intellectuelles de causes rares, Centre de Génétique, FHU TRANSLAD, CHU Dijon Bourgogne, France
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9
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Liver Involvement in Congenital Disorders of Glycosylation: A Systematic Review. J Pediatr Gastroenterol Nutr 2021; 73:444-454. [PMID: 34173795 PMCID: PMC9255677 DOI: 10.1097/mpg.0000000000003209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Abstract
An ever-increasing number of disturbances in glycosylation have been described to underlie certain unexplained liver diseases presenting either almost isolated or in a multi-organ context. We aimed to update previous literature screenings which had identified up to 23 forms of congenital disorders of glycosylation (CDG) with associated liver disease. We conducted a comprehensive literature search of three scientific electronic databases looking at articles published during the last 20 years (January 2000-October 2020). Eligible studies were case reports/series reporting liver involvement in CDG patients. Our systematic review led us to point out 41 forms of CDG where the liver is primarily affected (n = 7) or variably involved in a multisystem disease with mandatory neurological abnormalities (n = 34). Herein we summarize individual clinical and laboratory presentation characteristics of these 41 CDG and outline their main presentation and diagnostic cornerstones with the aid of two synoptic tables. Dietary supplementation strategies have hitherto been investigated only in seven of these CDG types with liver disease, with a wide range of results. In conclusion, the systematic review recognized a liver involvement in a somewhat larger number of CDG variants corresponding to about 30% of the total of CDG so far reported, and it is likely that the number may increase further. This information could assist in an earlier correct diagnosis and a possibly proper management of these disorders.
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10
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Donoghue SE, White SM, Tan TY, Kowalski R, Morava E, Yaplito‐Lee J. Galactose treatment of a PGM1 patient presenting with restrictive cardiomyopathy. JIMD Rep 2021; 57:29-37. [PMID: 33473337 PMCID: PMC7802629 DOI: 10.1002/jmd2.12177] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/11/2020] [Accepted: 10/13/2020] [Indexed: 12/04/2022] Open
Abstract
We report a patient diagnosed with PGM1-CDG at 11 years of age after two biallelic likely pathogenic variants in PGM1 were found on research genomic sequencing. To our knowledge, he is the first patient with PGM1-CDG to be reported with a restrictive cardiomyopathy. Other clinical manifestations included cleft palate, asymptomatic elevated transaminases, intellectual disability and myopathy resulting in exercise intolerance. He was trialed on oral galactose therapy in increasing doses for 18 weeks to assess if there was any biochemical and clinical benefit. His galactose was continued for a further 9 months beyond the initial galactose treatment period due to improvements in exercise tolerance and myopathy. Treatment with galactose demonstrated an improvement in liver function and myopathy with improved exercise tolerance. Treatment with galactose for 15 months did not change heart function and exercise stress test results were stable.
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Affiliation(s)
- Sarah E. Donoghue
- Department of Metabolic MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneVictoriaAustralia
| | - Susan M. White
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Tiong Yang Tan
- Victorian Clinical Genetics ServicesMurdoch Children's Research InstituteMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
| | - Remi Kowalski
- Department of CardiologyRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Eva Morava
- Department of Clinical GenomicsMayo ClinicRochesterMinnesotaUSA
- Department of PediatricsUniversity Hospitals LeuvenLeuvenBelgium
| | - Joy Yaplito‐Lee
- Department of Metabolic MedicineRoyal Children's HospitalMelbourneVictoriaAustralia
- Department of PaediatricsUniversity of MelbourneMelbourneVictoriaAustralia
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11
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Altassan R, Radenkovic S, Edmondson AC, Barone R, Brasil S, Cechova A, Coman D, Donoghue S, Falkenstein K, Ferreira V, Ferreira C, Fiumara A, Francisco R, Freeze H, Grunewald S, Honzik T, Jaeken J, Krasnewich D, Lam C, Lee J, Lefeber D, Marques-da-Silva D, Pascoal C, Quelhas D, Raymond KM, Rymen D, Seroczynska M, Serrano M, Sykut-Cegielska J, Thiel C, Tort F, Vals MA, Videira P, Voermans N, Witters P, Morava E. International consensus guidelines for phosphoglucomutase 1 deficiency (PGM1-CDG): Diagnosis, follow-up, and management. J Inherit Metab Dis 2021; 44:148-163. [PMID: 32681750 PMCID: PMC7855268 DOI: 10.1002/jimd.12286] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 12/13/2022]
Abstract
Phosphoglucomutase 1 (PGM1) deficiency is a rare genetic disorder that affects glycogen metabolism, glycolysis, and protein glycosylation. Previously known as GSD XIV, it was recently reclassified as a congenital disorder of glycosylation, PGM1-CDG. PGM1-CDG usually manifests as a multisystem disease. Most patients present as infants with cleft palate, liver function abnormalities and hypoglycemia, but some patients present in adulthood with isolated muscle involvement. Some patients develop life-threatening cardiomyopathy. Unlike most other CDG, PGM1-CDG has an effective treatment option, d-galactose, which has been shown to improve many of the patients' symptoms. Therefore, early diagnosis and initiation of treatment for PGM1-CDG patients are crucial decisions. In this article, our group of international experts suggests diagnostic, follow-up, and management guidelines for PGM1-CDG. These guidelines are based on the best available evidence-based data and experts' opinions aiming to provide a practical resource for health care providers to facilitate successful diagnosis and optimal management of PGM1-CDG patients.
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Affiliation(s)
- Ruqaiah Altassan
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Silvia Radenkovic
- Metabolomics Expertise Center, Center for Cancer Biology, VIB, Leuven, Belgium
- Metabolomics Expertise Center, Department of Oncology, KU Leuven, Leuven, Belgium
- Laboratory of Hepatology, Department CHROMETA, KU Leuven, Leuven, Belgium
- Department of Clinical Genomics and Laboratory of Medical Pathology, Mayo Clinic, Rochester, Minnesota
| | - Andrew C. Edmondson
- Department of Pediatrics, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Rita Barone
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandra Brasil
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Anna Cechova
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - David Coman
- Metabolic Medicine, Queensland Children’s Hospital, Brisbane, Australia
| | - Sarah Donoghue
- Department of Metabolic Medicine, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Kristina Falkenstein
- Center for Child and Adolescent Medicine, Department, University of Heidelberg, Heidelberg, Germany
| | - Vanessa Ferreira
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
| | - Carlos Ferreira
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Agata Fiumara
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rita Francisco
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Hudson Freeze
- Sanford Children’s Health Research Center, Sanford-Burnham-Prebys Medical Discovery Institute, La Jolla, California
| | - Stephanie Grunewald
- Metabolic Department, Great Ormond Street Hospital NHS Foundation Trust and Institute for Child Health, NIHR Biomedical Research Center (BRC), University College London, London, UK
| | - Tomas Honzik
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jaak Jaeken
- Center for Metabolic Diseases, KU Leuven, Leuven, Belgium
| | - Donna Krasnewich
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Christina Lam
- Division of Genetic Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Joy Lee
- Department of Metabolic Medicine, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Dirk Lefeber
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Dorinda Marques-da-Silva
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Carlota Pascoal
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Dulce Quelhas
- Centro de Genética Médica Doutor Jacinto Magalhães, Unidade de Bioquímica Genética, Porto, Portugal
| | - Kimiyo M. Raymond
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Daisy Rymen
- Department of Paediatrics and Metabolic Center, University Hospitals Leuven, Leuven, Belgium
| | - Malgorzata Seroczynska
- Department of Inborn Errors of Metabolism and Paediatrics, the Institute of Mother and Child, Warsaw, Poland
| | - Mercedes Serrano
- Neurology Department, Hospital Sant Joan de Déu, U-703 Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Jolanta Sykut-Cegielska
- Department of Inborn Errors of Metabolism and Paediatrics, the Institute of Mother and Child, Warsaw, Poland
| | - Christian Thiel
- Center for Child and Adolescent Medicine, Department, University of Heidelberg, Heidelberg, Germany
| | - Frederic Tort
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - Mari-Anne Vals
- Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Paula Videira
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Nicol Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Peter Witters
- Department of Paediatrics and Metabolic Center, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Eva Morava
- Department of Clinical Genomics and Laboratory of Medical Pathology, Mayo Clinic, Rochester, Minnesota
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12
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Lipiński P, Tylki-Szymańska A. Congenital Disorders of Glycosylation: What Clinicians Need to Know? Front Pediatr 2021; 9:715151. [PMID: 34540767 PMCID: PMC8446601 DOI: 10.3389/fped.2021.715151] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/10/2021] [Indexed: 12/27/2022] Open
Abstract
Congenital disorders of glycosylation (CDG) are a group of clinically heterogeneous disorders characterized by defects in the synthesis of glycans and their attachment to proteins and lipids. This manuscript aims to provide a classification of the clinical presentation, diagnostic methods, and treatment of CDG based on the literature review and our own experience (referral center in Poland). A diagnostic algorithm for CDG was also proposed. Isoelectric focusing (IEF) of serum transferrin (Tf) is still the method of choice for diagnosing N-glycosylation disorders associated with sialic acid deficiency. Nowadays, high-performance liquid chromatography, capillary zone electrophoresis, and mass spectrometry techniques are used, although they are not routinely available. Since next-generation sequencing became more widely available, an improvement in diagnostics has been observed, with more patients and novel CDG subtypes being reported. Early and accurate diagnosis of CDG is crucial for timely implementation of appropriate therapies and improving clinical outcomes. However, causative treatment is available only for few CDG types.
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Affiliation(s)
- Patryk Lipiński
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland
| | - Anna Tylki-Szymańska
- Department of Pediatrics, Nutrition and Metabolic Diseases, The Children's Memorial Health Institute, Warsaw, Poland
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13
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Fernlund E, Kissopoulou A, Green H, Karlsson JE, Ellegård R, Årstrand HK, Jonasson J, Gunnarsson C. Hereditary Hypertrophic Cardiomyopathy in Children and Young Adults-The Value of Reevaluating and Expanding Gene Panel Analyses. Genes (Basel) 2020; 11:genes11121472. [PMID: 33302605 PMCID: PMC7764692 DOI: 10.3390/genes11121472] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/27/2020] [Accepted: 12/04/2020] [Indexed: 12/31/2022] Open
Abstract
Introduction: Sudden cardiac death (SCD) and early onset cardiomyopathy (CM) in the young will always lead to suspicion of an underlying genetic disorder. Incited by the rapid advances in genetic testing for disease we have revisited families, which previously tested “gene-negative” for familial predominantly pediatric CM, in hopes of finding a causative gene variant. Methods: 10 different families with non-syndromic pediatric CM or hypertrophic cardiomyopathy (HCM) with severe disease progression and/or heredity for HCM/CM related SCD with “gene-negative” results were included. The index patient underwent genetic testing with a recently updated gene panel for CM and SCD. In case of failure to detect a pathogenic variant in a relevant gene, the index patient and both parents underwent clinical (i.e., partial) exome sequencing (trio-exome) in order to catch pathogenic variants linked to the disease in genes that were not included in the CM panel. Results: The mean age at clinical presentation of the 10 index cases was 12.5 years (boys 13.4 years, n = 8; girls 9 years, n = 2) and the family history burden was 33 HCM/CM cases including 9 HCM-related SCD and one heart transplantation. In 5 (50%) families we identified a genetic variant classified as pathogenic or likely pathogenic, in accordance with the American College of Medical Genetics and Genomics (ACMG) criteria, in MYH7 (n = 2), RBM20, ALPK3, and PGM1, respectively, and genetic variants of unknown significance (VUS) segregating with the disease in an additional 3 (30%) families, in MYBPC3, ABCC9, and FLNC, respectively. Conclusion: Our results show the importance of renewed thorough clinical assessment and the necessity to challenge previous genetic test results with more comprehensive updated gene panels or exome sequencing if the initial test failed to identify a causative gene for early onset CM or SCD in children. In pediatric cardiomyopathy cases when the gene panel still fails to detect a causative variant, a trio exome sequencing strategy might resolve some unexplained cases, especially if a multisystemic condition is clinically missed.
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Affiliation(s)
- Eva Fernlund
- Crown Princess Victoria Children’s Hospital, and Department of Biomedical and Clinical Sciences, Department of Pediatrics, Linköping University, 581 83 Linköping, Sweden;
- Department of Clinical Sciences Lund, Pediatric Heart Center, Skåne University Hospital, Lund University, 221 00 Lund, Sweden
| | - Antheia Kissopoulou
- Department of Internal Medicine, County Council of Jönköping, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden;
- Correspondence:
| | - Henrik Green
- Division of Drug Research, Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden;
- Department of Forensic Genetics and Forensic Toxicology, National Board of Forensic Medicine, 111 64 Stockholm, Sweden
| | - Jan-Erik Karlsson
- Department of Internal Medicine, County Council of Jönköping, Department of Health, Medicine and Caring Sciences, Linköping University, 581 83 Linköping, Sweden;
| | - Rada Ellegård
- Department of Clinical Genetics, and Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (R.E.); (H.K.Å.); (J.J.); (C.G.)
| | - Hanna Klang Årstrand
- Department of Clinical Genetics, and Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (R.E.); (H.K.Å.); (J.J.); (C.G.)
| | - Jon Jonasson
- Department of Clinical Genetics, and Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (R.E.); (H.K.Å.); (J.J.); (C.G.)
| | - Cecilia Gunnarsson
- Department of Clinical Genetics, and Department of Biomedical and Clinical Sciences, Linköping University, 581 83 Linköping, Sweden; (R.E.); (H.K.Å.); (J.J.); (C.G.)
- Centre for Rare Diseases in South East Region of Sweden, Linköping University, 581 83 Linköping, Sweden
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