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Azab B, Aburizeg D, Shaaban ST, Ji W, Mustafa L, Isbeih NJ, Al-Akily AS, Mohammad H, Jeffries L, Khokha M, Lakhani SA, Al-Ammouri I. Unraveling the genetic tapestry of pediatric sarcomeric cardiomyopathies and masquerading phenocopies in Jordan. Sci Rep 2024; 14:15141. [PMID: 38956129 PMCID: PMC11219879 DOI: 10.1038/s41598-024-64921-9] [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: 12/11/2023] [Accepted: 06/14/2024] [Indexed: 07/04/2024] Open
Abstract
Pediatric cardiomyopathies are mostly attributed to variants in sarcomere-related genes. Unfortunately, the genetic architecture of pediatric cardiomyopathies has never been previously studied in Jordan. We sought to uncover the genetic landscape of 14 patients from nine families with several subtypes of pediatric cardiomyopathies in Jordan using Exome sequencing (ES). Our investigation identified pathogenic and likely pathogenic variants in seven out of nine families (77.8%), clustering in sarcomere-related genes. Surprisingly, phenocopies of sarcomere-related hypertrophic cardiomyopathies were evident in probands with glycogen storage disorder and mitochondrial-related disease. Our study underscored the significance of streamlining ES or expanding cardiomyopathy-related gene panels to identify plausible phenocopies of sarcomere-related cardiomyopathies. Our findings also pointed out the need for genetic testing in patients with cardiomyopathy and their at-risk family members. This can potentially lead to better management strategies, enabling early interventions, and ultimately enhancing their prognosis. Finally, our findings provide an initial contribution to the currently absent knowledge about the molecular underpinnings of cardiomyopathies in Jordan.
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Affiliation(s)
- Bilal Azab
- Division of Pathology and Laboratory Medicine, Phoenix Children's Hospital, Phoenix, AZ, 85016, USA.
- Department of Pathology and Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942, Jordan.
| | - Dunia Aburizeg
- Department of Pathology and Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Sherin T Shaaban
- Department of Biology and Biotechnology, Faculty of Science, American University of Madaba, Madaba, 11821, Jordan
| | - Weizhen Ji
- Department of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Lina Mustafa
- Department of Pathology and Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Nooredeen Jamal Isbeih
- Department of Pathology and Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Amal Saleh Al-Akily
- Department of Pathology and Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Hashim Mohammad
- Department of Pathology and Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, 11942, Jordan
| | - Lauren Jeffries
- Department of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Mustafa Khokha
- Department of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, 06510, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Saquib A Lakhani
- Department of Pediatrics, Pediatric Genomics Discovery Program, Yale University School of Medicine, New Haven, CT, 06510, USA
| | - Iyad Al-Ammouri
- Department of Pediatrics, School of Medicine, The University of Jordan, Amman, 11942, Jordan.
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Tardieu M, Cudejko C, Cano A, Hoebeke C, Bernoux D, Goetz V, Pichard S, Brassier A, Schiff M, Feillet F, Rollier P, Mention K, Dobbelaere D, Fouilhoux A, Espil-Taris C, Eyer D, Huet F, Walther-Louvier U, Barth M, Chevret L, Kuster A, Lefranc J, Neveu J, Pitelet G, Ropars J, Rivier F, Roubertie A, Touati G, Vanhulle C, Tardieu E, Caillaud C, Froissart R, Champeaux M, Labarthe F, Chabrol B. Long-term follow-up of 64 children with classical infantile-onset Pompe disease since 2004: A French real-life observational study. Eur J Neurol 2023; 30:2828-2837. [PMID: 37235686 DOI: 10.1111/ene.15894] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 04/21/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023]
Abstract
BACKGROUND Classical infantile-onset Pompe disease (IOPD) is the most severe form of Pompe disease. Enzyme replacement therapy (ERT) has significantly increased survival but only a few studies have reported long-term outcomes. METHODS We retrospectively analyzed the outcomes of classical IOPD patients diagnosed in France between 2004 and 2020. RESULTS Sixty-four patients were identified. At diagnosis (median age 4 months) all patients had cardiomyopathy and most had severe hypotonia (57 of 62 patients, 92%). ERT was initiated in 50 (78%) patients and stopped later due to being ineffective in 10 (21%). Thirty-seven (58%) patients died during follow-up, including all untreated and discontinued ERT patients, and 13 additional patients. Mortality was higher during the first 3 years of life and after the age of 12 years. Persistence of cardiomyopathy during follow-up and/or the presence of heart failure were highly associated with an increased risk of death. In contrast, cross-reactive immunologic material (CRIM)-negative status (n = 16, 26%) was unrelated to increased mortality, presumably because immunomodulation protocols prevent the emergence of high antibody titers to ERT. Besides survival, decreased ERT efficacy appeared after the age of 6 years, with a progressive decline in motor and pulmonary functions for most survivors. CONCLUSIONS This study reports the long-term follow-up of one of the largest cohorts of classical IOPD patients and demonstrates high long-term mortality and morbidity rates with a secondary decline in muscular and respiratory functions. This decreased efficacy seems to be multifactorial, highlighting the importance of developing new therapeutic approaches targeting various aspects of pathogenesis.
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Affiliation(s)
- Marine Tardieu
- Centre de Référence des Maladies Héréditaires du Métabolisme ToTeM, Service de Médecine Pédiatrique, Hôpital Clocheville, Tours, France
| | - Céline Cudejko
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Neurométabolisme Pédiatrique, Hôpital Timone Enfants, AP-HM, Marseille, France
| | - Aline Cano
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Neurométabolisme Pédiatrique, Hôpital Timone Enfants, AP-HM, Marseille, France
| | - Célia Hoebeke
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Neurométabolisme Pédiatrique, Hôpital Timone Enfants, AP-HM, Marseille, France
| | - Delphine Bernoux
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Neurométabolisme Pédiatrique, Hôpital Timone Enfants, AP-HM, Marseille, France
| | - Violette Goetz
- Centre de Référence des Maladies Héréditaires du Métabolisme ToTeM, Service de Médecine Pédiatrique, Hôpital Clocheville, Tours, France
| | - Samia Pichard
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Métabolisme Pédiatrique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Anaïs Brassier
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Métabolisme Pédiatrique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Manuel Schiff
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Métabolisme Pédiatrique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - François Feillet
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Médecine Infantile, Hôpital Brabois Enfants; Unité INSERM NGERE U 1256, Campus Babrois-Santé, Vandœuvre-lès-Nancy, France
| | - Paul Rollier
- Service de Génétique Clinique, Site Hôpital Sud, Rennes, France
| | - Karine Mention
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service Néphrologie, Endocrinologie, Maladies Métaboliques et Hématologie Pédiatrique, Hôpital Jeanne de Flandre, Lille, France
| | - Dries Dobbelaere
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service Néphrologie, Endocrinologie, Maladies Métaboliques et Hématologie Pédiatrique, Hôpital Jeanne de Flandre, Lille, France
| | - Alain Fouilhoux
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service d'Endocrinologie et de Diabétologie Pédiatriques et Maladies Héréditaires du Métabolisme, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Bron, France
| | - Caroline Espil-Taris
- Centre de Référence des Maladies Neuromusculaires AOC, Service de Neuropédiatrie, Hôpital des Enfants Pellegrin, Bordeaux, France
| | - Didier Eyer
- Service des Maladies Métaboliques, Hôpital de Hautepierre, Strasbourg, France
| | - Frédéric Huet
- Centre de Compétence des Maladies Héréditaires du Métabolisme, Service de Pédiatrie Multidisciplinaire, Hôpital d'Enfants, Dijon, France
| | - Ulrike Walther-Louvier
- Centre de Référence des Maladies Neuromusculaires AOC, Service de Neuropédiatrie, Hôpital Gui de Chauliac, Montpellier, France
| | - Magalie Barth
- Centre de Compétence des Maladies Héréditaires du Métabolisme, Service de Génétique, CHU Angers, Angers, France
| | - Laurent Chevret
- Service Pédiatrie et Urgences Pédiatriques, CH Saint-Brieuc, Saint-Brieuc, France
| | - Alice Kuster
- Centre de Compétence des Maladies Héréditaires du Métabolisme, Service de Réanimation Pédiatrique, CHU Nantes, Nantes, France
| | | | - Julien Neveu
- Service de Neuropédiatrie, Hôpitaux Pédiatriques de Nice, CHU Lenval, Nice, France
| | - Gaele Pitelet
- Service de Neuropédiatrie, Hôpitaux Pédiatriques de Nice, CHU Lenval, Nice, France
| | - Juliette Ropars
- Centre de Référence Maladies Neuromusculaires AOC, Service de Neuropédiatrie, Hôpital Morvan, Brest, France
| | - François Rivier
- Centre de Référence des Maladies Neuromusculaires AOC, Service de Neuropédiatrie, Hôpital Gui de Chauliac, Montpellier, France
- PhyMedExp, Université de Montpellier, INSERM, CNRS, Montpellier, France
| | - Agathe Roubertie
- Centre de Compétence des Maladies Héréditaires du Métabolisme, Service de Neurologie Pédiatrique, Hôpital Gui de Chauliac; INM, INSERM U 1298, Université de Montpellier, Montpellier, France
| | - Guy Touati
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Gastro-entérologie, Hépatologie, Nutrition et Maladies Héréditaires du Métabolisme Pédiatrique, Hôpital des Enfants, Toulouse, France
| | - Catherine Vanhulle
- Service de Néonatalogie et Réanimation Pédiatrique, Hôpital Charles Nicolle, Rouen, France
| | - Emilie Tardieu
- Service de Santé Universitaire, Université Lumière Lyon 2, Lyon, France
| | - Catherine Caillaud
- Service de Biochimie Métabolique, Hôpital Necker-Enfants Malades, APHP, Paris, France
| | - Roseline Froissart
- Service de Biochimie et Biologie Moléculaire, Centre de Biologie et de Pathologie Est, Hospices Civils de Lyon, Bron, France
| | - Murielle Champeaux
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Neurométabolisme Pédiatrique, Hôpital Timone Enfants, AP-HM, Marseille, France
| | - François Labarthe
- Centre de Référence des Maladies Héréditaires du Métabolisme ToTeM, Service de Médecine Pédiatrique, Hôpital Clocheville, Tours, France
- Inserm U1069, N2C, Université de Tours, Tours, France
| | - Brigitte Chabrol
- Centre de Référence des Maladies Héréditaires du Métabolisme, Service de Neurométabolisme Pédiatrique, Hôpital Timone Enfants, AP-HM, Marseille, France
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Al-Hassnan Z, Hashmi NA, Makhseed N, Omran TB, Al Jasmi F, Teneiji AA. Expert Group Consensus on early diagnosis and management of infantile-onset pompe disease in the Gulf Region. Orphanet J Rare Dis 2022; 17:388. [PMID: 36303251 PMCID: PMC9615381 DOI: 10.1186/s13023-022-02545-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 09/09/2022] [Accepted: 10/04/2022] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Infantile-onset Pompe disease (IOPD) is a rare and devastating, autosomal recessive lysosomal storage disorder that manifests immediately after birth. In severe IOPD cases, complete/almost-complete acid alpha-glucosidase enzyme deficiency is observed. Considering the rapid progression of the disease, timely diagnosis and treatment are important; even slight delays can remarkably alter the course of the disease. Enzyme replacement therapy (ERT) with recombinant human acid alpha-glucosidase is safe and beneficial for IOPD patients. However, there is heterogeneity in the patient response to ERT. The factors influencing treatment effectiveness include the patient's age at the time of treatment initiation, pre-existing muscle damage, and cross-reactive immunologic material (CRIM) status at baseline. Immunomodulation along with ERT is the recently developed therapeutic approach that has been included in the therapeutic armamentarium of IOPD for optimizing clinical benefits, particularly in CRIM-negative IOPD patients. However, there is a dearth of published data on the early diagnosis and clinical position of the immunomodulation protocol along with ERT in the treatment of IOPD in the Gulf region. METHODS AND RESULTS Expert panel meetings, involving six experts from the Kingdom of Saudi Arabia, Kuwait, Oman, Qatar, and the United Arab Emirates, were convened to develop consensus-based recommendations addressing current diagnostic and management challenges for patients with IOPD in the Gulf region. Furthermore, this consensus guideline may be implemented in clinical practice for the timely diagnosis and management of patients with IOPD. CONCLUSION The expert consensus will help clinicians to make appropriate and timely decisions regarding immunomodulation initiation and ERT treatment in IOPD patients in the Gulf region.
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Affiliation(s)
- Zuhair Al-Hassnan
- Department of Medical Genetics, MBC-75 King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.
| | - Nadia Al Hashmi
- Department of Child Health, National Genetic Center, Royal Hospital, Muscat, Sultanate of Oman
| | - Nawal Makhseed
- Pediatric Department, Al-Farwaniya Hospital, and Maternity Hospital, Al-Jahra Hospital, Kuwait, Kuwait
| | - Tawfeg Ben Omran
- Division of Genetic and Genomic Medicine, Sidra Medicine, Doha, Qatar
- Department of Medical Genetics, Hamad Medical Corporation, Doha, Qatar
| | - Fatma Al Jasmi
- Department of Genetics and Genomic Medicine, United Arab Emirates University, Abu Dhabi, United Arab Emirates
- Division of Metabolic Genetics, Department of Pediatrics, Tawam Hospital, Al Ain, United Arab Emirates
| | - Amal Al Teneiji
- Division of Metabolic Genetics, Department of Pediatrics, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
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Manta A, Spendiff S, Lochmüller H, Thompson R. Targeted Therapies for Metabolic Myopathies Related to Glycogen Storage and Lipid Metabolism: a Systematic Review and Steps Towards a 'Treatabolome'. J Neuromuscul Dis 2021; 8:401-417. [PMID: 33720849 PMCID: PMC8203237 DOI: 10.3233/jnd-200621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Metabolic myopathies are a heterogenous group of muscle diseases typically characterized by exercise intolerance, myalgia and progressive muscle weakness. Effective treatments for some of these diseases are available, but while our understanding of the pathogenesis of metabolic myopathies related to glycogen storage, lipid metabolism and β-oxidation is well established, evidence linking treatments with the precise causative genetic defect is lacking. OBJECTIVE The objective of this study was to collate all published evidence on pharmacological therapies for the aforementioned metabolic myopathies and link this to the genetic mutation in a format amenable to databasing for further computational use in line with the principles of the "treatabolome" project. METHODS A systematic literature review was conducted to retrieve all levels of evidence examining the therapeutic efficacy of pharmacological treatments on metabolic myopathies related to glycogen storage and lipid metabolism. A key inclusion criterion was the availability of the genetic variant of the treated patients in order to link treatment outcome with the genetic defect. RESULTS Of the 1,085 articles initially identified, 268 full-text articles were assessed for eligibility, of which 87 were carried over into the final data extraction. The most studied metabolic myopathies were Pompe disease (45 articles), multiple acyl-CoA dehydrogenase deficiency related to mutations in the ETFDH gene (15 articles) and systemic primary carnitine deficiency (8 articles). The most studied therapeutic management strategies for these diseases were enzyme replacement therapy, riboflavin, and carnitine supplementation, respectively. CONCLUSIONS This systematic review provides evidence for treatments of metabolic myopathies linked with the genetic defect in a computationally accessible format suitable for databasing in the treatabolome system, which will enable clinicians to acquire evidence on appropriate therapeutic options for their patient at the time of diagnosis.
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Affiliation(s)
- A. Manta
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - S. Spendiff
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - H. Lochmüller
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
- Department of Neuropediatrics and Muscle Disorders, Medical Center –University of Freiburg, Faculty of Medicine, Freiburg, Germany
- Centro Nacional de Análisis Genómico (CNAG-CRG), Center for Genomic Regulation, Barcelona Institute of Science and Technology (BIST), Barcelona, Catalonia, Spain
- Division of Neurology, Department of Medicine, The Ottawa Hospital, University of Ottawa, Ottawa, Canada
- Brain and Mind Research Institute, University of Ottawa, Ottawa, Canada
| | - R. Thompson
- Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
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