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Rossignol F, Duarte Moreno MS, Benoist JF, Boehm M, Bourrat E, Cano A, Chabrol B, Cosson C, Díaz JLD, D'Harlingue A, Dimmock D, Freeman AF, García MT, Garganta C, Goerge T, Halbach SS, de Laffolie J, Lam CT, Martin L, Martins E, Meinhardt A, Melki I, Ombrello AK, Pérez N, Quelhas D, Scott A, Slavotinek AM, Soares AR, Stein SL, Süßmuth K, Thies J, Ferreira CR, Schiff M. Quantitative analysis of the natural history of prolidase deficiency: description of 17 families and systematic review of published cases. Genet Med 2021; 23:1604-1615. [PMID: 34040193 DOI: 10.1038/s41436-021-01200-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Prolidase deficiency is a rare inborn error of metabolism causing ulcers and other skin disorders, splenomegaly, developmental delay, and recurrent infections. Most of the literature is constituted of isolated case reports. We aim to provide a quantitative description of the natural history of the condition by describing 19 affected individuals and reviewing the literature. METHODS Nineteen patients were phenotyped per local institutional procedures. A systematic review following PRISMA criteria identified 132 articles describing 161 patients. Main outcome analyses were performed for manifestation frequency, diagnostic delay, overall survival, symptom-free survival, and ulcer-free survival. RESULTS Our cohort presented a wide variability of severity. Autoimmune disorders were found in 6/19, including Crohn disease, systemic lupus erythematosus, and arthritis. Another immune finding was hemophagocytic lymphohistiocytosis (HLH). Half of published patients were symptomatic by age 4 and had a delayed diagnosis (mean delay 11.6 years). Ulcers were present initially in only 30% of cases, with a median age of onset at 12 years old. CONCLUSION Prolidase deficiency has a broad range of manifestations. Symptoms at onset may be nonspecific, likely contributing to the diagnostic delay. Testing for this disorder should be considered in any child with unexplained autoimmunity, lower extremity ulcers, splenomegaly, or HLH.
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Affiliation(s)
- Francis Rossignol
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Marvid S Duarte Moreno
- Reference Centre for Inherited Metabolic Diseases, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Robert-Debré, Université de Paris, Paris, France
| | - Jean-François Benoist
- Reference Centre for Inherited Metabolic Diseases, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Necker-Enfants malades, Université de Paris, Paris, France
| | - Manfred Boehm
- National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Emmanuelle Bourrat
- Reference Center for Genodermatoses MAGEC Saint Louis, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Saint Louis, Paris, France
| | - Aline Cano
- Reference Center for Inherited Metabolic Disorders, Assistance Publique Hôpitaux de Marseille, Centre Hospitalier Universitaire de La Timone Enfants, Marseille, France
| | - Brigitte Chabrol
- Reference Center for Inherited Metabolic Disorders, Assistance Publique Hôpitaux de Marseille, Centre Hospitalier Universitaire de La Timone Enfants, Marseille, France
| | - Claudine Cosson
- Laboratoire de Biochimie, Hôpital Bicêtre, Assistance Publique Hôpitaux de Paris, Le Kremlin-Bicêtre, France
| | | | - Arthur D'Harlingue
- Benioff Children's Hospital Oakland, University of California, San Francisco, Oakland, CA, USA
| | - David Dimmock
- Project Baby Bear, Rady Children's Institute for Genomic Medicine, San Diego, CA, USA
| | - Alexandra F Freeman
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - María Tallón García
- Hospital Álvaro Cunqueiro, Universidad de Santiago de Compostela, Vigo, Spain
| | - Cheryl Garganta
- Division of Genetics and Metabolism, Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Tobias Goerge
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Sara S Halbach
- University of Chicago Medicine, University of Chicago, Chicago, IL, USA
| | - Jan de Laffolie
- University Children's Hospital, Justus-Liebig-University, Giessen, Germany
| | - Christina T Lam
- Seattle Children's Hospital, Seattle, WA, USA.,Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Ludovic Martin
- Centre Hospitalier Universitaire d'Angers, Angers, France
| | | | - Andrea Meinhardt
- University Children's Hospital, Justus-Liebig-University, Giessen, Germany
| | - Isabelle Melki
- General Pediatrics, Infectious Disease and Internal Medicine Department, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Reference Center for Rheumatic, Autoimmune and Systemic Diseases in Children (RAISE), Paris, France.,Pediatric Hematology-Immunology and Rheumatology Department, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Reference Center for Rheumatic, Autoimmune and Systemic Diseases in Children (RAISE), Paris, France.,Laboratory of Neurogenetics and Neuroinflammation, Imagine Institute, Paris, France
| | - Amanda K Ombrello
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Noémie Pérez
- Centre Hospitalier de Valenciennes, Valenciennes, France
| | - Dulce Quelhas
- Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Unit for Multidisciplinary Research in Biomedicine, ICBAS, UP, Porto, Portugal
| | - Anna Scott
- Seattle Children's Hospital, Seattle, WA, USA.,Department of Pediatrics, School of Medicine, University of Washington, Seattle, WA, USA
| | - Anne M Slavotinek
- Division of Medical Genetics, Department of Pediatrics, Benioff Children's Hospital San Francisco, University of California, San Francisco, San Francisco, CA, USA
| | | | - Sarah L Stein
- University of Chicago Medicine, University of Chicago, Chicago, IL, USA
| | - Kira Süßmuth
- Department of Dermatology, University Hospital Münster, Münster, Germany
| | - Jenny Thies
- Seattle Children's Hospital, Seattle, WA, USA
| | - Carlos R Ferreira
- National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA.
| | - Manuel Schiff
- Reference Centre for Inherited Metabolic Diseases, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Robert-Debré, Université de Paris, Paris, France.,Reference Centre for Inherited Metabolic Diseases, Assistance Publique Hôpitaux de Paris, Hôpital universitaire Necker-Enfants malades, Université de Paris, Paris, France.,INSERM U1163, Institut Imagine, Paris, France
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Chasset F, Richez C, Martin T, Belot A, Korganow AS, Arnaud L. Rare diseases that mimic Systemic Lupus Erythematosus (Lupus mimickers). Joint Bone Spine 2018; 86:165-171. [PMID: 30837156 DOI: 10.1016/j.jbspin.2018.10.007] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2018] [Indexed: 12/13/2022]
Abstract
Several conditions have clinical and laboratory features that can mimic those present in Systemic Lupus Erythematosus (SLE). Some of these "SLE mimickers" are very common, such as rosacea which can be mistaken for the butterfly rash, while others such as Kikuchi disease, type-1 interferonopathies, Castleman's disease, prolidase deficiency, angioimmunoblastic T-cell lymphoma, Evans' syndrome in the context of primary immune deficiencies and the autoimmune lymphoproliferative syndrome are exceptionally uncommon. A proper diagnosis of SLE must therefore be based upon a complete medical history as well as on the adequate constellation of clinical or laboratory findings. While there is no single test that determines whether a patient has lupus or not, the search for auto-antibodies towards nuclear antigens is a key step in the diagnosis strategy, keeping in mind that ANAs are not specific for SLE. In case of persistent doubt, patients should be referred to reference centers with experience in the management of the disease.
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Affiliation(s)
- François Chasset
- Service de dermatologie et d'allergologie, hôpital Tenon, AP-HP, 75020, Paris, France
| | - Christophe Richez
- Immunoconcept, CNRS-UMR 5164, université de Bordeaux, 146, rue Léo-Saignat, 33076, Bordeaux, France; Centre hospitalier universitaire de Bordeaux, FHU ACRONIM, place Amélie-Raba-Léon, 33076, Bordeaux, France; Centre national de référence des maladies autoimmunes et systémiques rares Est Sud-Ouest (RESO)-LUPUS, 67000 Strasbourg, France
| | - Thierry Martin
- Centre national de référence des maladies autoimmunes et systémiques rares Est Sud-Ouest (RESO)-LUPUS, 67000 Strasbourg, France; Service d'immunologie clinique nouvel hôpital civil, 1, place de l'hôpital 67091 Strasbourg cedex, France
| | - Alexandre Belot
- Service de nephrologie, rhumatologie et dermatologie pédiatriques, hôpital Femme Mère-Enfant, hospices civils de Lyon, Lyon, France; Université de Lyon, 59, boulevard Pinel, 69677 Bron cedex, France; Inserm U1111, 69007 Lyon, France; Filière des maladies autoimmunes et autoinflammatoires rares (FAI2R), 69677 Lyon, France
| | - Anne-Sophie Korganow
- Centre national de référence des maladies autoimmunes et systémiques rares Est Sud-Ouest (RESO)-LUPUS, 67000 Strasbourg, France; Service d'immunologie clinique nouvel hôpital civil, 1, place de l'hôpital 67091 Strasbourg cedex, France
| | - Laurent Arnaud
- Centre national de référence des maladies autoimmunes et systémiques rares Est Sud-Ouest (RESO)-LUPUS, 67000 Strasbourg, France; Service de rhumatologie, hôpitaux universitaires de Strasbourg, 67098 Strasbourg, France; Université de Strasbourg, Inserm UMR-S 1109, 67000 Strasbourg, France.
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Baspinar S, Kırnap M, Baspınar O, Dizdar OS, Kocer D. Serum prolidase level in ankylosing spondylitis: low serum levels as a new potential gold standard biomarker for disease activity. Rheumatol Int 2016; 36:1609-1616. [PMID: 27443556 DOI: 10.1007/s00296-016-3536-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Accepted: 07/13/2016] [Indexed: 01/17/2023]
Abstract
Ankylosing spondylitis (AS) is a chronic inflammatory disorder that mainly affects the sacroiliac joints and axial skeleton. The aim of this study was to assess serum prolidase level (SPL) and its association with disease activity in patients with AS. This prospective study included 75 AS patients. Thirty age- and gender-matched healthy controls were enrolled. AS patients were considered as active if BASDAI score was ≥4 or inactive if BASDAI score was <4. There were 34 AS patients in the active group and 41 AS patients in the inactive group. Anti-TNF-monoclonal antibody treatment was started in patients in the active group. These active patients were reassessed 6 months later. BASDAI, ASDAS, visual analogue scale, short-form-general health survey questionnaire, C-reactive protein, erythrocyte sedimentation rate and SPL were measured in all AS patients before and after treatment. The SPL was significantly lower in inactive AS patients than in control group, and also, SPL was significantly lower in active AS patients than in inactive patients. All activity parameters were successful in separating active and inactive AS patients. However, the only parameter that could distinguish active patients from inactive patients was prolidase. The optimum cutoff point of SPL to identify patients with active AS was 23.13 ng/mL with sensitivity, specificity, positive predictive value and negative predictive value of 100 %. Serum prolidase level was successful in measuring disease activity and had as high sensitivity and specificity as BASDAI and was superior to other activity parameters.
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Affiliation(s)
- Sevgi Baspinar
- Department of Physical Treatment and Rehabilitation, Erciyes University Medical School, 38039, Kayseri, Turkey
| | - Mehmet Kırnap
- Department of Physical Treatment and Rehabilitation, Erciyes University Medical School, 38039, Kayseri, Turkey
| | - Osman Baspınar
- Department of Internal Medicine, Kayseri Training and Research Hospital, 38010, Kayseri, Turkey
| | - Oguzhan Sıtkı Dizdar
- Department of Internal Medicine and Clinical Nutrition, Kayseri Training and Research Hospital, Atatürk Avenue Hastane street No:78, Kocasinan, 38010, Kayseri, Turkey.
| | - Derya Kocer
- Department of Biochemistry, Kayseri Training and Research Hospital, 38010, Kayseri, Turkey
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Besio R, Maruelli S, Gioia R, Villa I, Grabowski P, Gallagher O, Bishop NJ, Foster S, De Lorenzi E, Colombo R, Diaz JLD, Moore-Barton H, Deshpande C, Aydin HI, Tokatli A, Kwiek B, Kasapkara CS, Adisen EO, Gurer MA, Di Rocco M, Phang JM, Gunn TM, Tenni R, Rossi A, Forlino A. Lack of prolidase causes a bone phenotype both in human and in mouse. Bone 2015; 72:53-64. [PMID: 25460580 DOI: 10.1016/j.bone.2014.11.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/29/2014] [Accepted: 11/14/2014] [Indexed: 12/22/2022]
Abstract
The degradation of the main fibrillar collagens, collagens I and II, is a crucial process for skeletal development. The most abundant dipeptides generated from the catabolism of collagens contain proline and hydroxyproline. In humans, prolidase is the only enzyme able to hydrolyze dipeptides containing these amino acids at their C-terminal end, thus being a key player in collagen synthesis and turnover. Mutations in the prolidase gene cause prolidase deficiency (PD), a rare recessive disorder. Here we describe 12 PD patients, 9 of whom were molecularly characterized in this study. Following a retrospective analysis of all of them a skeletal phenotype associated with short stature, hypertelorism, nose abnormalities, microcephaly, osteopenia and genu valgum, independent of both the type of mutation and the presence of the mutant protein was identified. In order to understand the molecular basis of the bone phenotype associated with PD, we analyzed a recently identified mouse model for the disease, the dark-like (dal) mutant. The dal/dal mice showed a short snout, they were smaller than controls, their femurs were significantly shorter and pQCT and μCT analyses of long bones revealed compromised bone properties at the cortical and at the trabecular level in both male and female animals. The differences were more pronounce at 1 month being the most parameters normalized by 2 months of age. A delay in the formation of the second ossification center was evident at postnatal day 10. Our work reveals that reduced bone growth was due to impaired chondrocyte proliferation and increased apoptosis rate in the proliferative zone associated with reduced hyperthrophic zone height. These data suggest that lack of prolidase, a cytosolic enzyme involved in the final stage of protein catabolism, is required for normal skeletogenesis especially at early age when the requirement for collagen synthesis and degradation is the highest.
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Affiliation(s)
- Roberta Besio
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Silvia Maruelli
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Roberta Gioia
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Isabella Villa
- Bone Metabolic Unit, San Raffaele Scientific Institute, Milan, Italy
| | | | | | | | | | | | | | - Josè Luis Dapena Diaz
- Pediatric Hematology and Oncology, Hospital Universitario Vall d'Hebron, Barcelona, Spain
| | - Haether Moore-Barton
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Charu Deshpande
- Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - Aysegul Tokatli
- Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | | | | | | | - Mehmet Ali Gurer
- Gazi University Hospital, Pediatric Metabolic Unit, Ankara, Turkey
| | - Maja Di Rocco
- Unit of Rare Diseases, Department of Pediatrics, Gaslini Institute, Genoa, Italy
| | - James M Phang
- Basic Research Laboratory, Center for Cancer Research, NCI at Frederick, Frederick, MD, USA
| | | | - Ruggero Tenni
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Antonio Rossi
- Department of Molecular Medicine, University of Pavia, Pavia, Italy
| | - Antonella Forlino
- Department of Molecular Medicine, University of Pavia, Pavia, Italy.
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