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Sartorelli J, Travaglini L, Macchiaiolo M, Garone G, Gonfiantini MV, Vecchio D, Sinibaldi L, Frascarelli F, Ceccatelli V, Petrillo S, Piemonte F, Piccolo G, Novelli A, Longo D, Pro S, D’Amico A, Bertini ES, Nicita F. Spectrum of ERCC6-Related Cockayne Syndrome (Type B): From Mild to Severe Forms. Genes (Basel) 2024; 15:508. [PMID: 38674442 PMCID: PMC11050085 DOI: 10.3390/genes15040508] [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: 03/19/2024] [Revised: 04/16/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
(1) Background: Cockayne syndrome (CS) is an ultra-rare multisystem disorder, classically subdivided into three forms and characterized by a clinical spectrum without a clear genotype-phenotype correlation for both the two causative genes ERCC6 (CS type B) and ERCC8 (CS type A). We assessed this, presenting a series of patients with genetically confirmed CSB. (2) Materials and Methods: We retrospectively collected demographic, clinical, genetic, neuroimaging, and serum neurofilament light-chain (sNFL) data about CSB patients; diagnostic and severity scores were also determined. (3) Results: Data of eight ERCC6/CSB patients are presented. Four patients had CS I, three patients CS II, and one patient CS III. Various degrees of ataxia and spasticity were cardinal neurologic features, with variably combined systemic characteristics. Mean age at diagnosis was lower in the type II form, in which classic CS signs were more evident. Interestingly, sNFL determination appeared to reflect clinical classification. Two novel premature stop codon and one novel missense variants were identified. All CS I subjects harbored the p.Arg735Ter variant; the milder CS III subject carried the p.Leu764Ser missense change. (4) Conclusion: Our work confirms clinical variability also in the ERCC6/CSB type, where manifestations may range from severe involvement with prenatal or neonatal onset to normal psychomotor development followed by progressive ataxia. We propose, for the first time in CS, sNFL as a useful peripheral biomarker, with increased levels compared to currently available reference values and with the potential ability to reflect disease severity.
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Affiliation(s)
- Jacopo Sartorelli
- Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Lorena Travaglini
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Marina Macchiaiolo
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Giacomo Garone
- Neurology, Epilepsy and Movement Disorder Unit, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
- Department of Neuroscience, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy
| | | | - Davide Vecchio
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Lorenzo Sinibaldi
- Rare Diseases and Medical Genetics Unit, Bambino Gesù Children’s Hospital, IRCCS, 00165 Rome, Italy
| | - Flaminia Frascarelli
- Rehabilitation Unit, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Viola Ceccatelli
- Rehabilitation Unit, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Sara Petrillo
- Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Fiorella Piemonte
- Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Gabriele Piccolo
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Antonio Novelli
- Laboratory of Medical Genetics, Translational Cytogenomics Research Unit, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Daniela Longo
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children’s Hospital, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Stefano Pro
- Developmental Neurology Unit, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Adele D’Amico
- Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Enrico Silvio Bertini
- Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
| | - Francesco Nicita
- Unit of Neuromuscular and Neurodegenerative Disease, Bambino Gesù Children’s Hospital, IRCCS, P.zza Sant’Onofrio 4, 00165 Rome, Italy
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Paccosi E, Balajee AS, Proietti-De-Santis L. A matter of delicate balance: Loss and gain of Cockayne syndrome proteins in premature aging and cancer. FRONTIERS IN AGING 2022; 3:960662. [PMID: 35935726 PMCID: PMC9351357 DOI: 10.3389/fragi.2022.960662] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/04/2022] [Indexed: 12/26/2022]
Abstract
DNA repair genes are critical for preserving genomic stability and it is well established that mutations in DNA repair genes give rise to progeroid diseases due to perturbations in different DNA metabolic activities. Cockayne Syndrome (CS) is an autosomal recessive inheritance caused by inactivating mutations in CSA and CSB genes. This review will primarily focus on the two Cockayne Syndrome proteins, CSA and CSB, primarily known to be involved in Transcription Coupled Repair (TCR). Curiously, dysregulated expression of CS proteins has been shown to exhibit differential health outcomes: lack of CS proteins due to gene mutations invariably leads to complex premature aging phenotypes, while excess of CS proteins is associated with carcinogenesis. Thus it appears that CS genes act as a double-edged sword whose loss or gain of expression leads to premature aging and cancer. Future mechanistic studies on cell and animal models of CS can lead to potential biological targets for interventions in both aging and cancer development processes. Some of these exciting possibilities will be discussed in this review in light of the current literature.
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Affiliation(s)
- Elena Paccosi
- Unit of Molecular Genetics of Aging, Department of Ecology and Biology, University of Tuscia, Viterbo, Italy
- *Correspondence: Elena Paccosi, ; Adayabalam S. Balajee, ; Luca Proietti-De-Santis,
| | - Adayabalam S. Balajee
- Cytogenetic Biodosimetry Laboratory, Radiation Emergency Assistance Center/Training Site, Oak Ridge Institute of Science and Education, Oak Ridge Associated Universities, Oak Ridge, TN, United States
- *Correspondence: Elena Paccosi, ; Adayabalam S. Balajee, ; Luca Proietti-De-Santis,
| | - Luca Proietti-De-Santis
- Unit of Molecular Genetics of Aging, Department of Ecology and Biology, University of Tuscia, Viterbo, Italy
- *Correspondence: Elena Paccosi, ; Adayabalam S. Balajee, ; Luca Proietti-De-Santis,
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