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Uribe‐Ardila A, Ramirez‐Borda J, Ayala A. Twenty years of Colombian experience with enzymatic screening in patients with features of mucopolysaccharidosis. JIMD Rep 2022; 63:475-483. [PMID: 36101826 PMCID: PMC9458599 DOI: 10.1002/jmd2.12313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 06/08/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
Mucopolysaccharidoses (MPSs) are a group of genetic alterations whose effect is the progressive intralysosomal accumulation of glycosaminoglycans. Affected individuals are deficient in one or more lysosomal enzymes which, depending on the MPS, may cause coarse facial features, short stature, multiple skeletal dysplasia, joint stiffness, or developmental delay. Their diagnosis is mostly performed late or incorrectly, and it represents a challenge since it requires specialized tests only performed in major cities. This makes it difficult for patients to have access to physicians since their geographical location is distant and therefore, the use of samples collected in solid‐phase represents an advantage for the study of high‐risk populations. In addition, epidemiological information about rare diseases, especially in Latin America, is scarce or inconsistent. Our aim was to report the experience of 20 years of selective screening by assessing enzyme activity and reporting incidence values of MPS in Colombia. This study validated a group of fluorometric endpoint techniques in 8239 patients. The samples were dried blood spots (DBS) collected on filter paper and leukocyte extracts. Reference values in the Colombian population for α‐l‐iduronidase, iduronate 2‐sulfatase, α‐N‐acetylglucosaminidase, N‐acetylglucosamine‐6‐sulfate sulfatase, β‐galactosidase, arylsulfatase B, and β‐glucuronidase were established in leukocyte extracts, and patients reference ranges were updated in the case of DBS samples. Incidence values were calculated for each MPS and the distribution of cases across the country is also shown. This study offers very useful information for the health system, the scientific community, and it facilitates the diagnosis of these disorders. This is indispensable when seeking to develop new diagnostic or treatment approaches for patients.
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Affiliation(s)
- Alfredo Uribe‐Ardila
- Faculty of Sciences, Biochemistry Research Center Universidad de Los Andes Bogota Colombia
| | - Johana Ramirez‐Borda
- Faculty of Sciences, Biochemistry Research Center Universidad de Los Andes Bogota Colombia
| | - Adis Ayala
- Faculty of Sciences and Education, Biochemistry and Molecular Biology Group Universidad Distrital Francisco José de Caldas Bogota Colombia
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Zahoor MY, Cheema HA, Ijaz S, Anjum MN, Ramzan K, Bhinder MA. Mapping of IDUA gene variants in Pakistani patients with mucopolysaccharidosis type 1. J Pediatr Endocrinol Metab 2019; 32:1221-1227. [PMID: 31473686 DOI: 10.1515/jpem-2019-0188] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 07/28/2019] [Indexed: 12/26/2022]
Abstract
Background Mucopolysaccharidosis type 1 (MPS1) is a rare debilitating multisystem lysosomal disorder resulting due to the deficiency of α-L-iduronidase enzyme (IDUA), caused by recessive mutations in the IDUA gene. Lack or improper amount of the IDUA enzyme results in the improper metabolism of mucopolysaccharides or glycosaminoglycans (GAGs). These large sugar molecules accumulate in lysosomes within cells leading to different systemic complications. The estimated global incidence of MPS1 is 1:100,000 live births for the Hurler and 1:800,000 for the Scheie phenotypes. Methods Thirteen MPS1-affected children from 12 unrelated cohorts were enrolled. All coding and flanking regions of the IDUA gene were sequenced. Bioinformatics tools were used for data analysis and protein prediction for clinical correlations. Results Six IDUA gene mutations were mapped co-segregating with the recessive pattern of inheritance including a novel variant. A novel missense variant c.908T > C (p.L303P) was mapped in two affected siblings in a cohort in the homozygous form. The variant c.1469T > C (p.L490P) was mapped in five unrelated patients and c.784delC (p.H262Tfs*55) was mapped in three unrelated patients, while mutations c.1598C > G (p.P533R), c.314G > A (p.R105Q) and c.1277ins9 (p.[A394-L395-L396]) were mapped in a single patient each. Conclusions Multisystem disorders and a wide range of clinical presentation impede the evaluation of patients as well as make it difficult to differentiate between different phenotypes of MPS. Early and accurate diagnosis is crucial for the disease management and implementation of an expanded new-born genetic screening program for inborn errors of metabolism including MPS1. We recommend c.784delC (p.H262Tfs*55) and c.1469T > C (p.L490P) as first-line genetic markers for the molecular diagnosis of MPS1 in Pakistan.
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Affiliation(s)
- Muhammad Yasir Zahoor
- Molecular Biology and Forensic Laboratory, Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Huma Arshad Cheema
- Department of Pediatric Gastroenterology and Hepatology, The Children's Hospital and The Institute for Child Health, Lahore, Pakistan
| | - Sadaqat Ijaz
- Molecular Biology and Forensic Laboratory, Institute of Biochemistry and Biotechnology, University of Veterinary and Animal Sciences, Lahore, Pakistan
| | - Muhammad Nadeem Anjum
- Department of Pediatric Gastroenterology and Hepatology, The Children's Hospital and The Institute for Child Health, Lahore, Pakistan
| | - Khushnooda Ramzan
- Department of Genetics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Munir Ahmad Bhinder
- Department of Human Genetics and Molecular Biology, University of Health Sciences, Lahore, Pakistan
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Kılıç M, Dursun A, Coşkun T, Tokatlı A, Özgül RK, Yücel-Yılmaz D, Karaca M, Doğru D, Alehan D, Kadayıfçılar S, Genç A, Turan-Dizdar H, Gönüldaş B, Savcı S, Sağlam M, Aksoy C, Arslan U, Sivri HS. Genotypic-phenotypic features and enzyme replacement therapy outcome in patients with mucopolysaccharidosis VI from Turkey. Am J Med Genet A 2017; 173:2954-2967. [PMID: 28884960 DOI: 10.1002/ajmg.a.38459] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 06/07/2017] [Accepted: 08/02/2017] [Indexed: 01/14/2023]
Abstract
Mucopolysaccharidosis type VI (MPS VI) is a lysosomal storage disorder (LSD) characterized by a chronic, progressive course with multiorgan involvement. In our study, clinical, biochemical, molecular findings, and response to enzyme replacement therapy (ERT) for at least 6 months were evaluated in 20 patients with MPS VI. Treatment effects on clinical findings such as liver and spleen sizes, cardiac and respiratory parameters, visual and auditory changes, joints' range of motions, endurance tests and changes in urinary glycosaminoglycan excretions, before and after ERT were analyzed. ERT caused increased physical endurance and decreased urinary dermatan sulfate/chondroitin sulfate ratios. Changes in growth parameters, cardiac, respiratory, visual, auditory findings, and joint mobility were not significant. All patients and parents reported out an increased quality of life, which were not correlated with clinical results. The most prevalent mutation was p.L321P, accounting for 58.8% of the mutant alleles and two novel mutations (p.G79E and p.E390 K) were found. ERT was a safe but expensive treatment for MPS VI, with mild benefits in severely affected patients. Early treatment with ERT is mandatory before many organs and systems are involved.
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Affiliation(s)
- Mustafa Kılıç
- Sami Ulus Children Hospital, Division of Metabolism, Ankara, Turkey
| | - Ali Dursun
- Hacettepe University Children Hospital, Division of Metabolism, Ankara, Turkey
| | - Turgay Coşkun
- Hacettepe University Children Hospital, Division of Metabolism, Ankara, Turkey
| | - Ayşegül Tokatlı
- Hacettepe University Children Hospital, Division of Metabolism, Ankara, Turkey
| | - Rıza K Özgül
- Hacettepe University Children Hospital, Division of Metabolism, Ankara, Turkey
| | - Didem Yücel-Yılmaz
- Hacettepe University Children Hospital, Division of Metabolism, Ankara, Turkey
| | - Mehmet Karaca
- Faculty of Science and Arts, Department of Biology, Aksaray University, Aksaray, Turkey
| | - Deniz Doğru
- Hacettepe University Children Hospital, Division of Pediatric Pulmonology, Ankara, Turkey
| | - Dursun Alehan
- Hacettepe University Children Hospital, Division of Pediatric Cardiology, Ankara, Turkey
| | - Sibel Kadayıfçılar
- Faculty of Medicine, Department of Ophthalmology, Hacettepe University, Ankara, Turkey
| | - Aydan Genç
- Faculty of Medicine, Department of Ear Nose Throat, Division of Audiology, Hacettepe University, Ankara, Turkey
| | - Handan Turan-Dizdar
- Faculty of Medicine, Department of Ear Nose Throat, Division of Audiology, Hacettepe University, Ankara, Turkey
| | - Burhanettin Gönüldaş
- Faculty of Medicine, Department of Ear Nose Throat, Hacettepe University, Ankara, Turkey
| | - Sema Savcı
- Faculty of Health Sciences, Department of Physiotheraphy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Melda Sağlam
- Faculty of Health Sciences, Department of Physiotheraphy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Cemalettin Aksoy
- Faculty of Medicine, Department of Orthopaedics and Traumatology, Hacettepe University, Ankara, Turkey
| | - Umut Arslan
- Faculty of Medicine, Department of Biostatistics, Hacettepe University, Ankara, Turkey
| | - Hatice-Serap Sivri
- Hacettepe University Children Hospital, Division of Metabolism, Ankara, Turkey
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