1
|
Hu K, Zatyka M, Astuti D, Beer N, Dias RP, Kulkarni A, Ainsworth J, Wright B, Majander A, Yu-Wai-Man P, Williams D, Barrett T. WFS1 protein expression correlates with clinical progression of optic atrophy in patients with Wolfram syndrome. J Med Genet 2022; 59:65-74. [PMID: 34006618 PMCID: PMC8685651 DOI: 10.1136/jmedgenet-2020-107257] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 09/15/2020] [Accepted: 10/15/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Wolfram syndrome (WFS) is a rare disorder characterised by childhood-onset diabetes mellitus and progressive optic atrophy. Most patients have variants in the WFS1 gene. We undertook functional studies of WFS1 variants and correlated these with WFS1 protein expression and phenotype. METHODS 9 patients with a clinical diagnosis of WFS were studied with quantitative PCR for markers of endoplasmic reticulum (ER) stress and immunoblotting of fibroblast protein extracts for WFS1 protein expression. Luciferase reporter assay was used to assess ATF-6 dependent unfolded protein response (UPR) activation. RESULTS 6 patients with compound heterozygous nonsense mutations in WFS1 had no detectable WFS1 protein expression; 3 patients with missense variants had 4%, 45% and 48% WFS1 protein expression. One of these also had an OPA1 mutation and was reclassified as autosomal dominant optic atrophy-plus syndrome. There were no correlations between ER stress marker mRNA and WFS1 protein expression. ERSE-luciferase reporter indicated activation of the ATF6 branch of UPR in two patients tested. Patients with partial WFS1 expression showed milder visual acuity impairment (asymptomatic or colour blind only), compared with those with absent expression (registered severe vision impaired) (p=0.04). These differences remained after adjusting for duration of optic atrophy. CONCLUSIONS Patients with WFS who have partial WFS1 protein expression present with milder visual impairment. This suggests a protective effect of partial WFS1 protein expression on the severity and perhaps progression of vision impairment and that therapies to increase residual WFS1 protein expression may be beneficial.
Collapse
Affiliation(s)
- Kun Hu
- Institute of Cancer and Genomic Sciences, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Malgorzata Zatyka
- Institute of Cancer and Genomic Sciences, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Dewi Astuti
- Institute of Cancer and Genomic Sciences, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Nicola Beer
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Oxford University, Oxford, Oxfordshire, UK
| | - Renuka P Dias
- Institute of Metabolism and Systems Research, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
| | - Archana Kulkarni
- Department of Ophthalmology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - John Ainsworth
- Department of Ophthalmology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Benjamin Wright
- Department of Neurology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Anna Majander
- Department of Ophthalmology, Helsinki University Hospital, University of Helsinki Faculty of Medicine, Helsinki, Uusimaa, Finland
- National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, Greater London, UK
| | - Patrick Yu-Wai-Man
- National Institute for Health Research Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, Greater London, UK
- Cambridge Centre for Brain Repair, University of Cambridge, Cambridge, Cambridgeshire, UK
| | - Denise Williams
- Department of Clinical Genetics, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, Birmingham, UK
| | - Timothy Barrett
- Institute of Cancer and Genomic Sciences, University of Birmingham College of Medical and Dental Sciences, Birmingham, UK
- Department of Endocrinology, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| |
Collapse
|
2
|
Kytövuori L, Hannula S, Mäki-Torkko E, Sorri M, Majamaa K. A nonsynonymous mutation in the WFS1 gene in a Finnish family with age-related hearing impairment. Hear Res 2017; 355:97-101. [PMID: 28974383 DOI: 10.1016/j.heares.2017.09.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 03/12/2017] [Accepted: 09/23/2017] [Indexed: 12/01/2022]
Abstract
Wolfram syndrome (WS) is caused by recessive mutations in the Wolfram syndrome 1 (WFS1) gene. Sensorineural hearing impairment (HI) is a frequent feature in WS and, furthermore, certain mutations in WFS1 cause nonsyndromic dominantly inherited low-frequency sensorineural HI. These two phenotypes are clinically distinct indicating that WFS1 is a reasonable candidate for genetic studies in patients with other phenotypes of HI. Here we have investigated, whether the variation in WFS1 has a pathogenic role in age-related hearing impairment (ARHI). WFS1 gene was investigated in a population sample of 518 Finnish adults born in 1938-1949 and representing variable hearing phenotypes. Identified variants were evaluated with respect to pathogenic potential. A rare mutation predicted to be pathogenic was found in a family with many members with impaired hearing. Twenty members were recruited to a segregation study and a detailed clinical examination. Heterozygous p.Tyr528His variant segregated completely with late-onset HI in which hearing deteriorated first at high frequencies and progressed to mid and low frequencies later in life. We report the first mutation in the WFS1 gene causing late-onset HI with audiogram configurations typical for ARHI. Monogenic forms of ARHI are rare and our results add WFS1 to the short list of such genes.
Collapse
Affiliation(s)
- Laura Kytövuori
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Department of Neurology, Oulu University Hospital, P.O. Box 20, FI-90029 Oulu, Finland.
| | - Samuli Hannula
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, P.O. Box 21, FI-90029 Oulu, Finland; PEDEGO Research Unit, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - Elina Mäki-Torkko
- Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, P.O. Box 21, FI-90029 Oulu, Finland; Department of Clinical and Experimental Medicine/Technical Audiology, Faculty of Health Sciences, Linköping University, S-581 85 Linköping, Sweden; Department of ENT-Head Neck Surgery, Region Östergötland, Sweden
| | - Martti Sorri
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, P.O. Box 21, FI-90029 Oulu, Finland; PEDEGO Research Unit, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland
| | - Kari Majamaa
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland; Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FI-90014 Oulu, Finland; Department of Neurology, Oulu University Hospital, P.O. Box 20, FI-90029 Oulu, Finland
| |
Collapse
|
4
|
Valencia CA, Husami A, Holle J, Johnson JA, Qian Y, Mathur A, Wei C, Indugula SR, Zou F, Meng H, Wang L, Li X, Fisher R, Tan T, Hogart Begtrup A, Collins K, Wusik KA, Neilson D, Burrow T, Schorry E, Hopkin R, Keddache M, Harley JB, Kaufman KM, Zhang K. Clinical Impact and Cost-Effectiveness of Whole Exome Sequencing as a Diagnostic Tool: A Pediatric Center's Experience. Front Pediatr 2015; 3:67. [PMID: 26284228 PMCID: PMC4522872 DOI: 10.3389/fped.2015.00067] [Citation(s) in RCA: 135] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 07/13/2015] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND There are limited reports of the use of whole exome sequencing (WES) as a clinical diagnostic tool. Moreover, there are no reports addressing the cost burden associated with genetic tests performed prior to WES. OBJECTIVE We demonstrate the performance characteristics of WES in a pediatric setting by describing our patient cohort, calculating the diagnostic yield, and detailing the patients for whom clinical management was altered. Moreover, we examined the potential cost-effectiveness of WES by examining the cost burden of diagnostic workups. METHODS To determine the clinical utility of our hospital's clinical WES, we performed a retrospective review of the first 40 cases. We utilized dual bioinformatics analyses pipelines based on commercially available software and in-house tools. RESULTS Of the first 40 clinical cases, we identified genetic defects in 12 (30%) patients, of which 47% of the mutations were previously unreported in the literature. Among the 12 patients with positive findings, seven have autosomal dominant disease and five have autosomal recessive disease. Ninety percent of the cohort opted to receive secondary findings and of those, secondary medical actionable results were returned in three cases. Among these positive cases, there are a number of novel mutations that are being reported here. The diagnostic workup included a significant number of genetic tests with microarray and single-gene sequencing being the most popular tests. Significantly, genetic diagnosis from WES led to altered patient medical management in positive cases. CONCLUSION We demonstrate the clinical utility of WES by establishing the clinical diagnostic rate and its impact on medical management in a large pediatric center. The cost-effectiveness of WES was demonstrated by ending the diagnostic odyssey in positive cases. Also, in some cases it may be most cost-effective to directly perform WES. WES provides a unique glimpse into the complexity of genetic disorders.
Collapse
Affiliation(s)
- C Alexander Valencia
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Ammar Husami
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Jennifer Holle
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Judith A Johnson
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Yaping Qian
- Myriad Genetics Laboratories, Inc. , Salt Lake City, UT , USA
| | - Abhinav Mathur
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Chao Wei
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Subba Rao Indugula
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Fanggeng Zou
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Haiying Meng
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Lijun Wang
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Xia Li
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Rachel Fisher
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Tony Tan
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Amber Hogart Begtrup
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Kathleen Collins
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Katie A Wusik
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Derek Neilson
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Thomas Burrow
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Elizabeth Schorry
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Robert Hopkin
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - Mehdi Keddache
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| | - John Barker Harley
- Center for Autoimmune Genomics and Etiology (CAGE), Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA ; US Department of Veterans Affairs Medical Center , Cincinnati, OH , USA
| | - Kenneth M Kaufman
- Center for Autoimmune Genomics and Etiology (CAGE), Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA ; US Department of Veterans Affairs Medical Center , Cincinnati, OH , USA
| | - Kejian Zhang
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine , Cincinnati, OH , USA
| |
Collapse
|
6
|
Johnson AK, Gaudio DD. Clinical utility of next-generation sequencing for the molecular diagnosis of monogenic diabetes. Per Med 2014; 11:155-165. [PMID: 29751380 DOI: 10.2217/pme.13.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Monogenic diabetes resulting from mutations that primarily reduce insulin-secreting pancreatic β-cell function accounts for 1-2% of all cases of diabetes, and is genetically and clinically heterogeneous. Currently, genetic testing for monogenic diabetes relies on selection of the appropriate gene for analysis based on the availability of comprehensive phenotypic information, which can be time consuming, costly and can limit the differential diagnosis to a few selected genes. In recent years, the exponential growth in the field of high-throughput capture and sequencing technology has made it possible and cost effective to sequence many genes simultaneously, making it an efficient diagnostic tool for clinically and genetically heterogeneous disorders such as monogenic diabetes. Making a diagnosis of monogenic diabetes is important as it enables more appropriate treatment, better prediction of disease prognosis and progression, and counseling and screening of family members. We provide a concise overview of the genetic etiology of some forms of monogenic diabetes, as well as a discussion of the clinical utility of genetic testing by comprehensive multigene panel using next-generation sequencing methodologies.
Collapse
Affiliation(s)
- Amy Knight Johnson
- Department of Human Genetics, University of Chicago, 5841 S Maryland MC0077, Chicago, IL 60637, USA
| | - Daniela Del Gaudio
- Department of Human Genetics, University of Chicago, 5841 S Maryland MC0077, Chicago, IL 60637, USA
| |
Collapse
|