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Yan S, Fu F, Zhou H, Huang R, Wang Y, Liao C. Functional analysis of a novel splice site variant in the ASAH1 gene. Mol Genet Genomic Med 2024; 12:e2317. [PMID: 37962265 PMCID: PMC10767590 DOI: 10.1002/mgg3.2317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/11/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Acid ceramidase (ACDase) deficiency is an ultrarare autosomal recessive lysosomal disorder caused by pathogenic N-acylsphingosine amidohydrolase (ASAH1) variants. It presents with either Farber disease (FD) or spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME). OBJECTIVE The study aims to identify a novel splice site variant in a hydrops fetus that causes ASAH1-related disorder, aid genetic counseling, and accurate prenatal diagnosis. METHODS We report a case of hydrops fetalis with a novel homozygous mutation in ASAH1 inherited from non-consanguineous parents. We performed copy number variation sequencing (CNV-Seq) and whole exome sequencing (WES) on the fetus and family, respectively. Minigene splicing analyses were conducted to confirm the pathogenic variants. RESULTS WES data revealed a splice site variant of the ASAH1 (c.458-2A>T), which was predicted to affect RNA splicing. Minigene splicing analyses found that the c.458-2A>T variant abolished the canonical splicing of intron 6, thereby activating two cryptic splicing products (c.456_458ins56bp and c.458_503del). CONCLUSIONS Overall, we identified a novel splice site variant in the mutational spectrum of ASAH1 and its aberrant effect on splicing. These findings highlight the importance of ultrasonic manifestation and family history of fetal hydrops during ASAH1-related disorders and could also aid genetic counseling and accurate prenatal diagnosis. To the best of our knowledge, this is the shortest-lived account of ASAH1-related disorders in utero with severe hydrops fetalis.
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Affiliation(s)
- Shujuan Yan
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - Fang Fu
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - Hang Zhou
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - Ruibin Huang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - You Wang
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
| | - Can Liao
- Prenatal Diagnostic Center, Guangzhou Women and Children's Medical CenterGuangzhou Medical UniversityGuangzhouGuangdongChina
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2
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La Cognata V, Cavallaro S. Detection of Structural Variants by NGS: Revealing Missing Alleles in Lysosomal Storage Diseases. Biomedicines 2022; 10:biomedicines10081836. [PMID: 36009380 PMCID: PMC9405548 DOI: 10.3390/biomedicines10081836] [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: 06/17/2022] [Revised: 07/22/2022] [Accepted: 07/26/2022] [Indexed: 11/16/2022] Open
Abstract
Lysosomal storage diseases (LSDs) are a heterogeneous group of rare multisystem metabolic disorders occurring mostly in infancy and childhood, characterized by a gradual accumulation of non-degraded substrates inside the cells. Although biochemical enzymatic assays are considered the gold standard for diagnosis of symptomatic patients, genotyping is a requirement for inclusion in enzyme replacement programs and is a prerequisite for carrier tests in relatives and DNA-based prenatal diagnosis. The emerging next-generation sequencing (NGS) technologies are now offering a powerful diagnostic tool for genotyping LSDs patients by providing faster, cheaper, and higher-resolution testing options, and are allowing to unravel, in a single integrated workflow SNVs, small insertions and deletions (indels), as well as major structural variations (SVs) responsible for the pathology. Here, we summarize the current knowledge about the most recurrent and private SVs involving LSDs-related genes, review advantages and drawbacks related to the use of the NGS in the SVs detection, and discuss the challenges to bring this type of analysis in clinical diagnostics.
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3
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Leyens J, Bender TTA, Mücke M, Stieber C, Kravchenko D, Dernbach C, Seidel MF. The combined prevalence of classified rare rheumatic diseases is almost double that of ankylosing spondylitis. Orphanet J Rare Dis 2021; 16:326. [PMID: 34294115 PMCID: PMC8296612 DOI: 10.1186/s13023-021-01945-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 07/02/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Rare diseases (RDs) affect less than 5/10,000 people in Europe and fewer than 200,000 individuals in the United States. In rheumatology, RDs are heterogeneous and lack systemic classification. Clinical courses involve a variety of diverse symptoms, and patients may be misdiagnosed and not receive appropriate treatment. The objective of this study was to identify and classify some of the most important RDs in rheumatology. We also attempted to determine their combined prevalence to more precisely define this area of rheumatology and increase awareness of RDs in healthcare systems. We conducted a comprehensive literature search and analyzed each disease for the specified criteria, such as clinical symptoms, treatment regimens, prognoses, and point prevalences. If no epidemiological data were available, we estimated the prevalence as 1/1,000,000. The total point prevalence for all RDs in rheumatology was estimated as the sum of the individually determined prevalences. RESULTS A total of 76 syndromes and diseases were identified, including vasculitis/vasculopathy (n = 15), arthritis/arthropathy (n = 11), autoinflammatory syndromes (n = 11), myositis (n = 9), bone disorders (n = 11), connective tissue diseases (n = 8), overgrowth syndromes (n = 3), and others (n = 8). Out of the 76 diseases, 61 (80%) are classified as chronic, with a remitting-relapsing course in 27 cases (35%) upon adequate treatment. Another 34 (45%) diseases were predominantly progressive and difficult to control. Corticosteroids are a therapeutic option in 49 (64%) syndromes. Mortality is variable and could not be determined precisely. Epidemiological studies and prevalence data were available for 33 syndromes and diseases. For an additional eight diseases, only incidence data were accessible. The summed prevalence of all RDs was 28.8/10,000. CONCLUSIONS RDs in rheumatology are frequently chronic, progressive, and present variable symptoms. Treatment options are often restricted to corticosteroids, presumably because of the scarcity of randomized controlled trials. The estimated combined prevalence is significant and almost double that of ankylosing spondylitis (18/10,000). Thus, healthcare systems should assign RDs similar importance as any other common disease in rheumatology.
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Affiliation(s)
- Judith Leyens
- Center for Rare Diseases Bonn (ZSEB), University Hospital, Bonn, Germany
- Department of Neonatology and Pediatric Care, Children's University Hospital, Bonn, Germany
| | - Tim Th A Bender
- Center for Rare Diseases Bonn (ZSEB), University Hospital, Bonn, Germany
- Institute of Human Genetics, University Hospital, Bonn, Germany
| | - Martin Mücke
- Center for Rare Diseases Bonn (ZSEB), University Hospital, Bonn, Germany
| | - Christiane Stieber
- Institute of General Practice and Family Medicine, University Hospital, Venusberg-Campus 1, 53127, Bonn, Germany
| | - Dmitrij Kravchenko
- Center for Rare Diseases Bonn (ZSEB), University Hospital, Bonn, Germany
- Department of Radiology, University Hospital, Bonn, Germany
| | - Christian Dernbach
- Division of Medical Psychology and Department of Psychiatry, University Hospital, Bonn, Germany
| | - Matthias F Seidel
- Department of Rheumatology, Spitalzentrum-Centre hospitalier, Biel-Bienne, Switzerland.
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4
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Kloska A, Węsierska M, Malinowska M, Gabig-Cimińska M, Jakóbkiewicz-Banecka J. Lipophagy and Lipolysis Status in Lipid Storage and Lipid Metabolism Diseases. Int J Mol Sci 2020; 21:E6113. [PMID: 32854299 PMCID: PMC7504288 DOI: 10.3390/ijms21176113] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/12/2020] [Accepted: 08/21/2020] [Indexed: 12/15/2022] Open
Abstract
This review discusses how lipophagy and cytosolic lipolysis degrade cellular lipids, as well as how these pathway ys communicate, how they affect lipid metabolism and energy homeostasis in cells and how their dysfunction affects the pathogenesis of lipid storage and lipid metabolism diseases. Answers to these questions will likely uncover novel strategies for the treatment of aforementioned human diseases, but, above all, will avoid destructive effects of high concentrations of lipids-referred to as lipotoxicity-resulting in cellular dysfunction and cell death.
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Affiliation(s)
- Anna Kloska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
| | - Magdalena Węsierska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
| | - Marcelina Malinowska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
| | - Magdalena Gabig-Cimińska
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
- Laboratory of Molecular Biology, Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Kładki 24, 80-822 Gdańsk, Poland
| | - Joanna Jakóbkiewicz-Banecka
- Department of Medical Biology and Genetics, Faculty of Biology, University of Gdańsk, Wita Stwosza 59, 80-308 Gdańsk, Poland; (A.K.); (M.W.); (M.M.)
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5
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Elsea SH, Solyom A, Martin K, Harmatz P, Mitchell J, Lampe C, Grant C, Selim L, Mungan NO, Guelbert N, Magnusson B, Sundberg E, Puri R, Kapoor S, Arslan N, DiRocco M, Zaki M, Ozen S, Mahmoud IG, Ehlert K, Hahn A, Gokcay G, Torcoletti M, Ferreira CR. ASAH1 pathogenic variants associated with acid ceramidase deficiency: Farber disease and spinal muscular atrophy with progressive myoclonic epilepsy. Hum Mutat 2020; 41:1469-1487. [PMID: 32449975 DOI: 10.1002/humu.24056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 04/28/2020] [Accepted: 05/16/2020] [Indexed: 11/12/2022]
Abstract
Farber disease and spinal muscular atrophy with progressive myoclonic epilepsy are a spectrum of rare lysosomal storage disorders characterized by acid ceramidase deficiency (ACD), resulting from pathogenic variants in N-acylsphingosine amidohydrolase 1 (ASAH1). Other than simple listings provided in literature reviews, a curated, comprehensive list of ASAH1 mutations associated with ACD clinical phenotypes has not yet been published. This publication includes mutations in ASAH1 collected through the Observational and Cross-Sectional Cohort Study of the Natural History and Phenotypic Spectrum of Farber Disease (NHS), ClinicalTrials.gov identifier NCT03233841, in combination with an up-to-date curated list of published mutations. The NHS is the first to collect retrospective and prospective data on living and deceased patients with ACD presenting as Farber disease, who had or had not undergone hematopoietic stem cell transplantation. Forty-five patients representing the known clinical spectrum of Farber disease (living patients aged 1-28 years) were enrolled. The curation of known ASAH1 pathogenic variants using a single reference transcript includes 10 previously unpublished from the NHS and 63 that were previously reported. The publication of ASAH1 variants will be greatly beneficial to patients undergoing genetic testing in the future by providing a significantly expanded reference list of disease-causing variants.
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Affiliation(s)
- Sarah H Elsea
- Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | | | - Kirt Martin
- Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Paul Harmatz
- Pediatric Gastroenterolgy and Nutrition, UCSF Benioff Children's Hospital Oakland, Oakland, California
| | | | | | | | - Laila Selim
- Cairo University Children's Hospital, Cairo, Egypt
| | | | | | - Bo Magnusson
- Karolinska University Hospital, Stockholm, Sweden
| | | | - Ratna Puri
- Sir Ganga Ram Hospital, New Delhi, India
| | - Seema Kapoor
- Lok Nayak Hospital and Maulana Azad Medical College, New Delhi, India
| | - Nur Arslan
- Dokuz Eylul University Hospital, Izmir, Turkey
| | - Maja DiRocco
- Metabolic Diseases, Istituto Giannina Gaslini, Genoa, Italy
| | - Maha Zaki
- Clinical Genetics Department, National Research Center, Cairo, Egypt
| | - Seza Ozen
- Pediatric Rheumatology, Hacettepe University Hospital, Ankara, Turkey
| | | | | | - Andreas Hahn
- UKGM Universitätsklinikum Giessen, Giessen, Germany
| | | | | | - Carlos R Ferreira
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
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6
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Ordóñez YF, Abad JL, Aseeri M, Casas J, Garcia V, Casasampere M, Schuchman EH, Levade T, Delgado A, Triola G, Fabrias G. Activity-Based Imaging of Acid Ceramidase in Living Cells. J Am Chem Soc 2019; 141:7736-7742. [PMID: 31030513 DOI: 10.1021/jacs.8b11687] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Acid ceramidase (AC) hydrolyzes ceramides into sphingoid bases and fatty acids. The enzyme is overexpressed in several types of cancer and Alzheimer's disease, and its genetic defect causes different incurable disorders. The availability of a method for the specific visualization of catalytically active AC in intracellular compartments is crucial for diagnosis and follow-up of therapeutic strategies in diseases linked to altered AC activity. This work was undertaken to develop activity-based probes for the detection of AC. Several analogues of the AC inhibitor SABRAC were synthesized and found to act as very potent (two-digit nM range) irreversible AC inhibitors by reaction with the active site Cys143. Detection of active AC in cell-free systems was achieved either by using fluorescent SABRAC analogues or by click chemistry with an azide-substituted analogue. The compound affording the best features allowed the unprecedented labeling of active AC in living cells.
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Affiliation(s)
- Yadira F Ordóñez
- Research Unit on Bioactive Molecules (RUBAM), Department of Biological Chemistry , Institute for Advanced Chemistry of Catalonia (IQAC-CSIC) , Jordi Girona, 18 , 08034 Barcelona , Spain
| | - José Luís Abad
- Research Unit on Bioactive Molecules (RUBAM), Department of Biological Chemistry , Institute for Advanced Chemistry of Catalonia (IQAC-CSIC) , Jordi Girona, 18 , 08034 Barcelona , Spain
| | - Mazen Aseeri
- Research Unit on Bioactive Molecules (RUBAM), Department of Biological Chemistry , Institute for Advanced Chemistry of Catalonia (IQAC-CSIC) , Jordi Girona, 18 , 08034 Barcelona , Spain
| | - Josefina Casas
- Research Unit on Bioactive Molecules (RUBAM), Department of Biological Chemistry , Institute for Advanced Chemistry of Catalonia (IQAC-CSIC) , Jordi Girona, 18 , 08034 Barcelona , Spain.,Liver and Digestive Diseases Networking Biomedical Research Centre (CIBER-EHD) , 28029 Madrid , Spain
| | | | - Mireia Casasampere
- Research Unit on Bioactive Molecules (RUBAM), Department of Biological Chemistry , Institute for Advanced Chemistry of Catalonia (IQAC-CSIC) , Jordi Girona, 18 , 08034 Barcelona , Spain
| | - Edward H Schuchman
- Department of Genetics and Genomic Sciences , Icahn School of Medicine at Mount Sinai , New York 10029 , United States
| | - Thierry Levade
- INSERM, UMR1037 CRCT , 31037 Toulouse , France.,Laboratoire de Biochimie Métabolique , Institut Fédératif de Biologie, CHU Purpan , 31300 Toulouse , France
| | - Antonio Delgado
- Research Unit on Bioactive Molecules (RUBAM), Department of Biological Chemistry , Institute for Advanced Chemistry of Catalonia (IQAC-CSIC) , Jordi Girona, 18 , 08034 Barcelona , Spain.,Unit of Pharmaceutical Chemistry (Associated Unit to CSIC), Department of Pharmacology, Toxicology and Medicinal Chemistry, Faculty of Pharmacy and Food Sciences , University of Barcelona , 08028 Barcelona , Spain
| | - Gemma Triola
- Chemical Biology group, Department of Biological Chemistry , Institute for Advanced Chemistry of Catalonia (IQAC-CSIC) , Jordi Girona, 18 , 08034 Barcelona , Spain
| | - Gemma Fabrias
- Research Unit on Bioactive Molecules (RUBAM), Department of Biological Chemistry , Institute for Advanced Chemistry of Catalonia (IQAC-CSIC) , Jordi Girona, 18 , 08034 Barcelona , Spain.,Liver and Digestive Diseases Networking Biomedical Research Centre (CIBER-EHD) , 28029 Madrid , Spain
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7
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Ehlert K, Levade T, Di Rocco M, Lanino E, Albert MH, Führer M, Jarisch A, Güngör T, Ayuk F, Vormoor J. Allogeneic hematopoietic cell transplantation in Farber disease. J Inherit Metab Dis 2019; 42:286-294. [PMID: 30815900 DOI: 10.1002/jimd.12043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Farber disease (FD) is a rare, lysosomal storage disorder caused by deficient acid ceramidase activity. FD has long been considered a fatal disorder with death in the first three decades of life resulting either from respiratory insufficiency as a consequence of airway involvement or from progressive neurodegeneration because of nervous system involvement. Peripheral symptoms associated with FD, including inflammatory joint disease, have been described to improve relatively rapidly after hematopoietic cell transplantation (HCT). AIMS To evaluate the disease-specific status and limitations in the long-term follow-up after HCT, investigate genotype/phenotype correlations and the benefit of allogeneic HCT in FD patients with nervous system involvement. PATIENTS AND METHODS Transplant- and disease-related information of ten FD patients was obtained by using a questionnaire, physicians' letters and additional telephone surveys. ASAH1 gene mutations were identified to search for genotype/phenotype correlations. RESULTS After mainly busulfan-based preparative regimens, all patients engrafted with one late graft loss. The inflammatory symptoms resolved completely in all patients. Abnormal neurologic findings were present pre-transplant in 4/10 patients, post-transplant in 6/10 patients. Mutational analyses revealed new mutations in the ASAH1 gene and a broad diversity of phenotypes without a genotype/phenotype correlation. With a median follow-up of 10.4 years, overall survival was 80% with two transplant-related deaths. CONCLUSION Allogeneic HCT leads to complete and persistent resolution of the inflammatory aspects in FD patients. It appears to have no beneficial effect on progression of nervous system involvement. New mutations in the acid ceramidase gene were identified. A genotype/phenotype correlation could not be established.
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Affiliation(s)
- Karoline Ehlert
- Department of Pediatric Hematology and Oncology, University Medicine Greifswald, Ferdinand, Sauerbruch-Strasse, D-17475 Greifswald, Germany
| | - Thierry Levade
- Cancer Research Centre of Toulouse, INSERM UMR1037, Toulouse, France
- Laboratoire de Biochimie, Institut Fédératif de Biologie, CHU Toulouse, Toulouse, France
| | - Maja Di Rocco
- Department Unit of Rare Diseases, Gaslini Institute, Genoa, Italy
| | - Edoardo Lanino
- Department Unit of Rare Diseases, Gaslini Institute, Genoa, Italy
| | - Michael H Albert
- Department of Stem Cell Transplantation, Children's Hospital at Dr von Haunersches Kinderspital, University of München, Munich, Germany
| | - Monika Führer
- Department of Pediatric Palliative Care, Children's Hospital at Dr von Haunersches Kinderspita, University of München, Munich, Germany
| | - Andrea Jarisch
- Department for Children and Adolescents, Division for Stem Cell Transplantation and Immunology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Tayfun Güngör
- Department of Stem Cell Transplantation, University Children's Hospital Zürich, Zürich, Switzerland
| | - Francis Ayuk
- Department of Stem Cell Transplantation, University Hospital Hamburg-Eppendorf, Hamburg, Germany
| | - Josef Vormoor
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, UK
- Great North Children's Hospital, Newcastle upon Tyne Hospitals NHS Foundations Trust, Newcastle upon Tyne, UK
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8
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Abstract
Inborn errors of metabolism, also known as inherited metabolic diseases, constitute an important group of conditions presenting with neurologic signs in newborns. They are individually rare but collectively common. Many are treatable through restoration of homeostasis of a disrupted metabolic pathway. Given their frequency and potential for treatment, the clinician should be aware of this group of conditions and learn to identify the typical manifestations of the different inborn errors of metabolism. In this review, we summarize the clinical, laboratory, electrophysiologic, and neuroimaging findings of the different inborn errors of metabolism that can present with florid neurologic signs and symptoms in the neonatal period.
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MESH Headings
- Adult
- Female
- Humans
- Infant, Newborn
- Infant, Newborn, Diseases/diagnosis
- Infant, Newborn, Diseases/diagnostic imaging
- Infant, Newborn, Diseases/physiopathology
- Infant, Newborn, Diseases/therapy
- Metabolism, Inborn Errors/diagnosis
- Metabolism, Inborn Errors/diagnostic imaging
- Metabolism, Inborn Errors/physiopathology
- Metabolism, Inborn Errors/therapy
- Neuroimaging
- Pregnancy
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Affiliation(s)
- Carlos R Ferreira
- Medical Genetics Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, United States; Rare Disease Institute, Children's National Health System, Washington, DC, United States
| | - Clara D M van Karnebeek
- Departments of Pediatrics and Clinical Genetics, Amsterdam University Medical Centers, Amsterdam, The Netherlands; Department of Pediatrics, Centre for Molecular Medicine and Therapeutics, University of British Columbia, Vancouver, BC, Canada.
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9
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Yu FPS, Amintas S, Levade T, Medin JA. Acid ceramidase deficiency: Farber disease and SMA-PME. Orphanet J Rare Dis 2018; 13:121. [PMID: 30029679 PMCID: PMC6053731 DOI: 10.1186/s13023-018-0845-z] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/14/2018] [Indexed: 12/29/2022] Open
Abstract
Acid ceramidase (ACDase) deficiency is a spectrum of disorders that includes a rare lysosomal storage disorder called Farber disease (FD) and a rare epileptic disorder called spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME). Both disorders are caused by mutations in the ASAH1 gene that encodes the lysosomal hydrolase that breaks down the bioactive lipid ceramide. To date, there have been fewer than 200 reported cases of FD and SMA-PME in the literature. Typical textbook manifestations of classical FD include the formation of subcutaneous nodules, accumulation of joint contractures, and development of a hoarse voice. In reality, however, the clinical presentation is much broader. Patients may develop severe pathologies leading to death in infancy or may develop attenuated forms of the disorder wherein they are often misdiagnosed or not diagnosed until adulthood. A clinical variability also exists for SMA-PME, in which patients develop progressive muscle weakness and seizures. Currently, there is no known cure for FD or for SMA-PME. The main treatment is symptom management. In rare cases, treatment may include surgery or hematopoietic stem cell transplantation. Research using disease models has provided insights into the pathology as well as the role of ACDase in the development of these conditions. Recent studies have highlighted possible biomarkers for an effective diagnosis of ACDase deficiency. Ongoing work is being conducted to evaluate the use of recombinant human ACDase (rhACDase) for the treatment of FD. Finally, gene therapy strategies for the treatment of ACDase deficiency are actively being pursued. This review highlights the broad clinical definition and outlines key studies that have improved our understanding of inherited ACDase deficiency-related conditions.
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Affiliation(s)
- Fabian P. S. Yu
- Institute of Medical Science, University of Toronto, Toronto, ON Canada
| | - Samuel Amintas
- Laboratoire de Biochimie Métabolique, Institut Fédératif de Biologie, CHU Purpan, Toulouse, France
| | - Thierry Levade
- Laboratoire de Biochimie Métabolique, Institut Fédératif de Biologie, CHU Purpan, Toulouse, France
- INSERM UMR1037 CRCT, Université de Toulouse, Toulouse, France
| | - Jeffrey A. Medin
- Institute of Medical Science, University of Toronto, Toronto, ON Canada
- Departments of Pediatrics and Biochemistry, Medical College of Wisconsin, Milwaukee, WI USA
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10
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Schuchman EH, Mitchell J, Solyom A. Morbidity and mortality associated with Farber disease and prospects for therapy. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1359086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Edward H. Schuchman
- Genetic Disease Foundation-Francis Crick Professor, Department of Genetics & Genomic Sciences, Icahn School of Medicine, New York, NY, USA
| | - John Mitchell
- Division of Pediatric Endocrinology, Montreal Children’s Hospital, Montreal, QC, Canada
| | - Alex Solyom
- Clinical Research & Patient Affairs, Enzyvant, Basel, Switzerland
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11
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Identification of ASAH1 as a susceptibility gene for familial keloids. Eur J Hum Genet 2017; 25:1155-1161. [PMID: 28905881 DOI: 10.1038/ejhg.2017.121] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Revised: 06/20/2017] [Accepted: 06/27/2017] [Indexed: 01/22/2023] Open
Abstract
Keloids result from abnormal proliferative scar formation with scar tissue expanding beyond the margin of the original wound and are mostly found in individuals of sub-Saharan African descent. The etiology of keloids has not been resolved but previous studies suggest that keloids are a genetically heterogeneous disorder. Although possible candidate genes have been suggested by genome-wide association studies using common variants, by upregulation in keloids or their involvement in syndromes that include keloid formation, rare coding variants that contribute to susceptibility in non-syndromic keloid formation have not been previously identified. Through analysis of whole-genome data we mapped a locus to chromosome 8p23.3-p21.3 with a statistically significant maximum multipoint LOD score of 4.48. This finding was followed up using exome sequencing and led to the identification of a c.1202T>C (p.(Leu401Pro)) variant in the N-acylsphingosine amidohydrolase (ASAH1) gene that co-segregates with the keloid phenotype in a large Yoruba family. ASAH1 is an acid ceramidase known to be involved in tumor formation by controlling the ratio of ceramide and sphingosine. ASAH1 is also involved in cell proliferation and inflammation, and may affect the development of keloids via multiple mechanisms. Functional studies need to clarify the role of the ASAH1 variant in wound healing.
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12
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Cozma C, Iurașcu MI, Eichler S, Hovakimyan M, Brandau O, Zielke S, Böttcher T, Giese AK, Lukas J, Rolfs A. C26-Ceramide as highly sensitive biomarker for the diagnosis of Farber Disease. Sci Rep 2017; 7:6149. [PMID: 28733637 PMCID: PMC5522391 DOI: 10.1038/s41598-017-06604-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 06/15/2017] [Indexed: 12/31/2022] Open
Abstract
Farber disease (FD) is a rare autosomal recessive disease caused by mutations in the acid ceramidase gene (ASAH1). Low ceramidase activity results in the accumulation of fatty substances, mainly ceramides. Hallmark symptoms at clinical level are periarticular nodules, lipogranulomas, swollen and painful joints and a hoarse voice. FD phenotypes are heterogeneous varying from mild to very severe cases, with the patients not surviving past their first year of life. The diagnostic aspects of FD are poorly developed due to the rarity of the disease. In the present study, the screening for ceramides and related molecules was performed in Farber affected patients (n = 10), carriers (n = 11) and control individuals (n = 192). This study has the highest number of enrolled Farber patients and carriers reported to present. Liquid chromatography multiple reaction mass spectrometry (LC/MRM-MS) studies revealed that the ceramide C26:0 and especially its isoform 1 is a highly sensitive and specific biomarker for FD (p < 0.0001). The new biomarker can be determined directly in the dried blood spot extracts with low sample consumption. This allows for easy sample preparation, high reproducibility and use in high throughput screenings.
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Affiliation(s)
- Claudia Cozma
- Centogene AG, Schillingallee 68, 18057, Rostock, Germany.
| | | | | | | | - Oliver Brandau
- Centogene AG, Schillingallee 68, 18057, Rostock, Germany
| | - Susanne Zielke
- Albrecht-Kossel-Institute for Neurodegeneration, Rostock University Medical Centre, Gehlsheimerstraße 20, 18147, Rostock, Germany
| | - Tobias Böttcher
- Albrecht-Kossel-Institute for Neurodegeneration, Rostock University Medical Centre, Gehlsheimerstraße 20, 18147, Rostock, Germany
| | - Anne-Katrin Giese
- Albrecht-Kossel-Institute for Neurodegeneration, Rostock University Medical Centre, Gehlsheimerstraße 20, 18147, Rostock, Germany
| | - Jan Lukas
- Albrecht-Kossel-Institute for Neurodegeneration, Rostock University Medical Centre, Gehlsheimerstraße 20, 18147, Rostock, Germany
| | - Arndt Rolfs
- Centogene AG, Schillingallee 68, 18057, Rostock, Germany.,Albrecht-Kossel-Institute for Neurodegeneration, Rostock University Medical Centre, Gehlsheimerstraße 20, 18147, Rostock, Germany
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13
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Schuchman EH. Acid ceramidase and the treatment of ceramide diseases: The expanding role of enzyme replacement therapy. Biochim Biophys Acta Mol Basis Dis 2016; 1862:1459-71. [PMID: 27155573 DOI: 10.1016/j.bbadis.2016.05.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Revised: 04/18/2016] [Accepted: 05/03/2016] [Indexed: 01/20/2023]
Abstract
Ceramides are a diverse group of sphingolipids that play important roles in many biological processes. Acid ceramidase (AC) is one key enzyme that regulates ceramide metabolism. Early research on AC focused on the fact that it is the enzyme deficient in the rare genetic disorder, Farber Lipogranulomatosis. Recent research has revealed that deficiency of the same enzyme is responsible for a rare form of spinal muscular atrophy associated with myoclonic epilepsy (SMA-PME). Due to their diverse role in biology, accumulation of ceramides also has been implicated in the pathobiology of many other common diseases, including infectious lung diseases, diabetes, cancers and others. This has revealed the potential of AC as a therapy for many of these diseases. This review will focus on the biology of AC and the potential role of this enzyme in the treatment of human disease.
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Affiliation(s)
- Edward H Schuchman
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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14
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Acid ceramidase deficiency associated with spinal muscular atrophy with progressive myoclonic epilepsy. Neuromuscul Disord 2015; 25:959-63. [PMID: 26526000 DOI: 10.1016/j.nmd.2015.09.007] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2015] [Revised: 09/03/2015] [Accepted: 09/07/2015] [Indexed: 11/22/2022]
Abstract
Spinal muscular atrophy with progressive myoclonic epilepsy (SMA-PME) is an extremely rare disorder related to the lysosomal storage disease, Farber lipogranulomatosis. Both disorders are autosomal recessive conditions caused by mutations in the ASAH1 gene encoding acid ceramidase. Farber disease is associated with joint deformities, lipomatous skin nodules, and often is fatal by 2-3 years of age; while SMA-PME is characterized by childhood-onset motor neuron disease and progressive myoclonic epilepsy. We report a case of SMA-PME with a novel mutation in the ASAH1 gene encoding acid ceramidase. The proband presented with childhood-onset of diffuse muscle atrophy and hypotonia. He also had diffuse weakness with greater proximal than distal involvement. Tongue fasciculations were present and his reflexes were either diminished or absent. He ambulated with an unsteady and hesitant gait. He subsequently developed myoclonic epilepsy along with other associated features including tremor, polymyoclonus, and sensorineural hearing loss. Neurophysiological studies revealed a motor neuron disorder and generalized epilepsy. Exome sequencing analysis identified compound heterozygous variants and biochemical analysis indicated acid ceramidase activity was approximately 12 percent of normal controls. Our proband was phenotypically similar to other cases of SMA-PME, albeit with somewhat lesser severity, slower progression, and greater longevity. As lysosomal disorders are sometimes amendable to early interventions, it is important to make early diagnoses in these cases. The combination of motor neuron disease and progressive myoclonic epilepsy should prompt genetic evaluation of ASAH1.
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Bashyam M, Chaudhary A, Kiran M, Reddy V, Nagarajaram H, Dalal A, Bashyam L, Suri D, Gupta A, Gupta N, Kabra M, Puri R, RamaDevi R, Kapoor S, Danda S. Molecular analyses of novelASAH1mutations causing Farber lipogranulomatosis: analyses of exonic splicing enhancer inactivating mutation. Clin Genet 2013; 86:530-8. [DOI: 10.1111/cge.12316] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 10/23/2013] [Accepted: 10/24/2013] [Indexed: 11/28/2022]
Affiliation(s)
- M.D. Bashyam
- Laboratory of Molecular Oncology; Centre for DNA Fingerprinting and Diagnostics; Hyderabad India
| | - A.K. Chaudhary
- Laboratory of Molecular Oncology; Centre for DNA Fingerprinting and Diagnostics; Hyderabad India
| | - M. Kiran
- Laboratory of Computational Biology; Centre for DNA Fingerprinting and Diagnostics; Hyderabad India
| | - V. Reddy
- Laboratory of Computational Biology; Centre for DNA Fingerprinting and Diagnostics; Hyderabad India
| | - H.A. Nagarajaram
- Laboratory of Computational Biology; Centre for DNA Fingerprinting and Diagnostics; Hyderabad India
| | - A. Dalal
- Diagnostics Division; Centre for DNA Fingerprinting and Diagnostics; Hyderabad India
| | - L. Bashyam
- School of Life Sciences; University of Hyderabad; Hyderabad India
| | - D. Suri
- Department of Pediatrics; Post Graduate Institute of Medical Education and Research; Chandigarh India
| | - A. Gupta
- Department of Pediatrics; Post Graduate Institute of Medical Education and Research; Chandigarh India
| | - N. Gupta
- Department of Pediatrics; All India Institute of Medical Sciences; New Delhi India
| | - M. Kabra
- Department of Pediatrics; All India Institute of Medical Sciences; New Delhi India
| | - R.D. Puri
- Deparment of Genetic Medicine; Sir Ganga Ram Hospital; Delhi India
| | | | - S. Kapoor
- Division of Genetics; Lok Nayak Hospital & Maulana Azad Medical College; New Delhi India
| | - S. Danda
- Department of Clinical Genetics; Christian Medical College and Hospital; Vellore India
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