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Aguti S, Gallus GN, Bianchi S, Salvatore S, Rubegni A, Berti G, Formichi P, De Stefano N, Malandrini A, Lopergolo D. Novel Biomarkers for Limb Girdle Muscular Dystrophy (LGMD). Cells 2024; 13:329. [PMID: 38391941 PMCID: PMC10886967 DOI: 10.3390/cells13040329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 01/22/2024] [Accepted: 02/02/2024] [Indexed: 02/24/2024] Open
Abstract
OBJECTIVE To identify novel biomarkers as an alternative diagnostic tool for limb girdle muscular dystrophy (LGMD). BACKGROUND LGMD encompasses a group of muscular dystrophies characterized by proximal muscles weakness, elevated CK levels and dystrophic findings on muscle biopsy. Heterozygous CAPN3 mutations are associated with autosomal dominant LGMD-4, while biallelic mutations can cause autosomal recessive LGMD-1. Diagnosis is currently often based on invasive methods requiring muscle biopsy or blood tests. In most cases Western blotting (WB) analysis from muscle biopsy is essential for a diagnosis, as muscle samples are currently the only known tissues to express the full-length CAPN3 isoform. METHODS We analyzed CAPN3 in a cohort including 60 LGMD patients. Selected patients underwent a complete neurological examination, electromyography, muscle biopsy, and skin biopsies for primary fibroblasts isolation. The amount of CAPN3 was evaluated by WB analysis in muscle and skin tissues. The total RNA isolated from muscle, fibroblast and urine was processed, and cDNA was used for qualitative analysis. The expression of CAPN3 was investigated by qRT-PCR. The CAPN3 3D structure has been visualized and analyzed using PyMOL. RESULTS Among our patients, seven different CAPN3 mutations were detected, of which two were novel. After sequencing CAPN3 transcripts from fibroblast and urine, we detected different CAPN3 isoforms surprisingly including the full-length transcript. We found comparable protein levels from fibroblasts and muscle tissue; in particular, patients harboring a novel CAPN3 mutation showed a 30% reduction in protein compared to controls from both tissues. CONCLUSIONS Our findings showed for the first time the presence of the CAPN3 full-length transcript in urine and skin samples. Moreover, we demonstrated surprisingly comparable CAPN3 protein levels between muscle and skin samples, thus allowing us to hypothesize the use of skin biopsy and probably of urine samples as an alternative less invasive method to assess the amount of CAPN3 when molecular diagnosis turns out to be inconclusive.
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Affiliation(s)
- Sara Aguti
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Gian Nicola Gallus
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Silvia Bianchi
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Simona Salvatore
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Anna Rubegni
- Molecular Medicine for Neurodegenerative and Neuromuscular Disease Unit, IRCCS Stella Maris Foundation, 56128 Pisa, Italy;
| | - Gianna Berti
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Patrizia Formichi
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Nicola De Stefano
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Alessandro Malandrini
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
| | - Diego Lopergolo
- Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy; (S.A.); (G.N.G.); (S.B.); (S.S.); (G.B.); (P.F.); (N.D.S.); (A.M.)
- UOC Neurologia e Malattie Neurometaboliche, Azienda Ospedaliero-Universitaria Senese, Policlinico Le Scotte, Viale Bracci, 16, 53100 Siena, Italy
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Morel V, Audic F, Tardy C, Verschueren A, Attarian S, Nguyen K, Salort-Campana E, Krahn M, Chabrol B, Gorokhova S. Retrospective clinical and genetic analysis of COL6-RD patients with a long-term follow-up at a single French center. Front Genet 2023; 14:1242277. [PMID: 38155714 PMCID: PMC10753780 DOI: 10.3389/fgene.2023.1242277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 11/29/2023] [Indexed: 12/30/2023] Open
Abstract
Collagen type VI-related dystrophies (COL6-RD) are rare diseases with a wide phenotypic spectrum ranging from severe Ullrich's congenital muscular dystrophy Ullrich congenital muscular dystrophy to much milder Bethlem myopathy Both dominant and recessive forms of COL6-RD are caused by pathogenic variants in three collagen VI genes (COL6A1, COL6A2 and COL6A3). The prognosis of these diseases is variable and difficult to predict during early disease stages, especially since the genotype-phenotype correlation is not always clear. For this reason, studies with long-term follow-up of patients with genetically confirmed COL6-RD are still needed. In this study, we present phenotypic and genetic data from 25 patients (22 families) diagnosed with COL6-RD and followed at a single French center, in both adult and pediatric neurology departments. We describe three novel pathogenic variants and identify COL6A2:c.1970-9G>A as the most frequent variant in our series (29%). We also observe an accelerated progression of the disease in a subgroup of patients. This large series of rare disease patients provides essential information on phenotypic variability of COL6-RD patients as well as on frequency of pathogenic COL6A gene variants in Southern France, thus contributing to the phenotypic and genetic description of Collagen type VI-related dystrophies.
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Affiliation(s)
- Victor Morel
- Département de Génétique Médicale, Hôpital de la Timone, Marseille, Provence-Alpes-Côte d’Azur, France
| | - Frédérique Audic
- Service de Neuropédiatrie, Centre de Référence des Maladies Neuromusculaires de l’enfant PACARARE, CHU Timone, APHM, Marseille, France
- Inserm, U1251-MMG, Marseille Medical Genetics, Aix Marseille University, Marseille, France
| | - Charlotte Tardy
- Département de Génétique Médicale, Hôpital de la Timone, Marseille, Provence-Alpes-Côte d’Azur, France
| | - Annie Verschueren
- Centre de Référence des Maladies Neuromusculaires et de la SLA, ERN-NMD, CHU Timone, APHM, Marseille, France
| | - Shahram Attarian
- Inserm, U1251-MMG, Marseille Medical Genetics, Aix Marseille University, Marseille, France
- Centre de Référence des Maladies Neuromusculaires et de la SLA, ERN-NMD, CHU Timone, APHM, Marseille, France
| | - Karine Nguyen
- Département de Génétique Médicale, Hôpital de la Timone, Marseille, Provence-Alpes-Côte d’Azur, France
- Inserm, U1251-MMG, Marseille Medical Genetics, Aix Marseille University, Marseille, France
| | - Emmanuelle Salort-Campana
- Inserm, U1251-MMG, Marseille Medical Genetics, Aix Marseille University, Marseille, France
- Centre de Référence des Maladies Neuromusculaires et de la SLA, ERN-NMD, CHU Timone, APHM, Marseille, France
| | - Martin Krahn
- Département de Génétique Médicale, Hôpital de la Timone, Marseille, Provence-Alpes-Côte d’Azur, France
- Inserm, U1251-MMG, Marseille Medical Genetics, Aix Marseille University, Marseille, France
| | - Brigitte Chabrol
- Service de Neuropédiatrie, Centre de Référence des Maladies Neuromusculaires de l’enfant PACARARE, CHU Timone, APHM, Marseille, France
- Inserm, U1251-MMG, Marseille Medical Genetics, Aix Marseille University, Marseille, France
| | - Svetlana Gorokhova
- Département de Génétique Médicale, Hôpital de la Timone, Marseille, Provence-Alpes-Côte d’Azur, France
- Inserm, U1251-MMG, Marseille Medical Genetics, Aix Marseille University, Marseille, France
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Lambert MR, Gussoni E. Tropomyosin 3 (TPM3) function in skeletal muscle and in myopathy. Skelet Muscle 2023; 13:18. [PMID: 37936227 PMCID: PMC10629095 DOI: 10.1186/s13395-023-00327-x] [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: 08/11/2023] [Accepted: 10/10/2023] [Indexed: 11/09/2023] Open
Abstract
The tropomyosin genes (TPM1-4) contribute to the functional diversity of skeletal muscle fibers. Since its discovery in 1988, the TPM3 gene has been recognized as an indispensable regulator of muscle contraction in slow muscle fibers. Recent advances suggest that TPM3 isoforms hold more extensive functions during skeletal muscle development and in postnatal muscle. Additionally, mutations in the TPM3 gene have been associated with the features of congenital myopathies. The use of different in vitro and in vivo model systems has leveraged the discovery of several disease mechanisms associated with TPM3-related myopathy. Yet, the precise mechanisms by which TPM3 mutations lead to muscle dysfunction remain unclear. This review consolidates over three decades of research about the role of TPM3 in skeletal muscle. Overall, the progress made has led to a better understanding of the phenotypic spectrum in patients affected by mutations in this gene. The comprehensive body of work generated over these decades has also laid robust groundwork for capturing the multiple functions this protein plays in muscle fibers.
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Affiliation(s)
- Matthias R Lambert
- Division of Genetics and Genomics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA.
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA.
| | - Emanuela Gussoni
- Division of Genetics and Genomics, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, 02115, USA
- The Stem Cell Program, Boston Children's Hospital, Boston, MA, 02115, USA
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Zídková J, Kramářová T, Kopčilová J, Réblová K, Haberlová J, Mazanec R, Voháňka S, Gřegořová A, Langová M, Honzík T, Šoukalová J, Ošlejšková H, Solařová P, Vyhnálková E, Fajkusová L. Genetic findings in Czech patients with limb girdle muscular dystrophy. Clin Genet 2023; 104:542-553. [PMID: 37526466 DOI: 10.1111/cge.14407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/03/2023] [Accepted: 07/13/2023] [Indexed: 08/02/2023]
Abstract
Limb girdle muscular dystrophies (LGMD) are a genetically heterogeneous group of muscular dystrophies. The study presents an overview of molecular characteristics of a large cohort of LGMD patients who are representative of the Czech LGMD population. We present 226 LGMD probands in which 433 mutant alleles carrying 157 different variants with a supposed pathogenic effect were identified. Fifty-four variants have been described only in the Czech LGMD population so far. LGMD R1 caplain3-related is the most frequent subtype of LGMD involving 53.1% of patients with genetically confirmed LGMD, followed by LGMD R9 FKRP-related (11.1%), and LGMD R12 anoctamin5-related (7.1%). If we consider identified variants, then all but five were small-scale variants. One large gene deletion was identified in the LAMA2 gene and two deletions in each of CAPN3 and SGCG. We performed comparison our result with other published studies. The results obtained in the Czech LGMD population clearly differ from the outcome of other LGMD populations in two aspects-we have a more significant proportion of patients with LGMD R1 calpain3-related and a smaller proportion of LGMD R2 dysferlin-related.
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Affiliation(s)
- Jana Zídková
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Tereza Kramářová
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Johana Kopčilová
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Kamila Réblová
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Jana Haberlová
- Department of Paediatric Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Praha, Czech Republic
| | - Radim Mazanec
- Department of Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Stanislav Voháňka
- Department of Neurology, University Hospital Brno, Brno, Czech Republic
| | - Andrea Gřegořová
- Department of Medical Genetics, University Hospital Ostrava, Ostrava, Czech Republic
| | - Martina Langová
- Department of Medical Genetics, Thomayer University Hospital, Praha, Czech Republic
| | - Tomáš Honzík
- Department of Paediatrics and Inherited Metabolic Disorders, First Faculty of Medicine, Charles University and General University Hospital in Prague, Praha, Czech Republic
| | - Jana Šoukalová
- Institute of Medical Genetics and Genomics, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Hana Ošlejšková
- Department of Child Neurology, University Hospital Brno and Masaryk University, Brno, Czech Republic
| | - Pavla Solařová
- Department of Medical Genetics, University Hospital Hradec Králové, Hradec Králové, Czech Republic
| | - Emílie Vyhnálková
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Lenka Fajkusová
- Centre of Molecular Biology and Genetics, University Hospital Brno and Masaryk University, Brno, Czech Republic
- Laboratory of Functional Genomics and Proteomics, National Centre for Biomolecular Research, Faculty of Science, Masaryk University, Brno, Czech Republic
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A Schematic Approach to Defining the Prevalence of COL VI Variants in Five Years of Next-Generation Sequencing. Int J Mol Sci 2022; 23:ijms232314567. [PMID: 36498898 PMCID: PMC9735635 DOI: 10.3390/ijms232314567] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To define the prevalence of variants in collagen VI genes through a next-generation sequencing (NGS) approach in undiagnosed patients with suspected neuromuscular disease and to propose a diagnostic flowchart to assess the real pathogenicity of those variants. METHODS In the past five years, we have collected clinical and molecular information on 512 patients with neuromuscular symptoms referred to our center. To pinpoint variants in COLVI genes and corroborate their real pathogenicity, we sketched a multistep flowchart, taking into consideration the bioinformatic weight of the gene variants, their correlation with clinical manifestations and possible effects on protein stability and expression. RESULTS In Step I, we identified variants in COLVI-related genes in 48 patients, of which three were homozygous variants (Group 1). Then, we sorted variants according to their CADD score, clinical data and complementary studies (such as muscle and skin biopsy, study of expression of COLVI on fibroblast or muscle and muscle magnetic resonance). We finally assessed how potentially pathogenic variants (two biallelic and 12 monoallelic) destabilize COL6A1-A2-A3 subunits. Overall, 15 out of 512 patients were prioritized according to this pipeline. In seven of them, we confirmed reduced or absent immunocytochemical expression of collagen VI in cultured skin fibroblasts or in muscle tissue. CONCLUSIONS In a real-world diagnostic scenario applied to heterogeneous neuromuscular conditions, a multistep integration of clinical and molecular data allowed the identification of about 3% of those patients harboring pathogenetic collagen VI variants.
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Quijano-Roy S, Haberlova J, Castiglioni C, Vissing J, Munell F, Rivier F, Stojkovic T, Malfatti E, Gómez García de la Banda M, Tasca G, Costa Comellas L, Benezit A, Amthor H, Dabaj I, Gontijo Camelo C, Laforêt P, Rendu J, Romero NB, Cavassa E, Fattori F, Beroud C, Zídková J, Leboucq N, Løkken N, Sanchez-Montañez Á, Ortega X, Kynčl M, Metay C, Gómez-Andrés D, Carlier RY. Diagnostic interest of whole-body MRI in early- and late-onset LAMA2 muscular dystrophies: a large international cohort. J Neurol 2021; 269:2414-2429. [PMID: 34559299 DOI: 10.1007/s00415-021-10806-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 09/12/2021] [Accepted: 09/13/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND LAMA2-related muscular dystrophy (LAMA2-RD) encompasses a group of recessive muscular dystrophies caused by mutations in the LAMA2 gene, which codes for the alpha-2 chain of laminin-211 (merosin). Diagnosis is straightforward in the classic congenital presentation with no ambulation and complete merosin deficiency in muscle biopsy, but is far more difficult in milder ambulant individuals with partial merosin deficiency. OBJECTIVE To investigate the diagnostic utility of muscle imaging in LAMA2-RD using whole-body magnetic resonance imaging (WBMRI). RESULTS 27 patients (2-62 years, 21-80% with acquisition of walking ability and 6 never ambulant) were included in an international collaborative study. All carried two pathogenic mutations, mostly private missense changes. An intronic variant (c.909 + 7A > G) was identified in all the Chilean cases. Three patients (two ambulant) showed intellectual disability, epilepsy, and brain structural abnormalities. WBMRI T1w sequences or T2 fat-saturated images (Dixon) revealed abnormal muscle fat replacement predominantly in subscapularis, lumbar paraspinals, gluteus minimus and medius, posterior thigh (adductor magnus, biceps femoris, hamstrings) and soleus. This involvement pattern was consistent for both ambulant and non-ambulant patients. The degree of replacement was predominantly correlated to the disease duration, rather than to the onset or the clinical severity. A "COL6-like sandwich sign" was observed in several muscles in ambulant adults, but different involvement of subscapularis, gluteus minimus, and medius changes allowed distinguishing LAMA2-RD from collagenopathies. The thigh muscles seem to be the best ones to assess disease progression. CONCLUSION WBMRI in LAMA2-RD shows a homogeneous pattern of brain and muscle imaging, representing a supportive diagnostic tool.
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Affiliation(s)
- Susana Quijano-Roy
- APHP, GH Université Paris-Saclay, Neuromuscular Center, Child Neurology and ICU Department, Raymond Poincare Hospital, Garches, France
- Université de Versailles, U1179 INSERM-UVSQ, Versailles, France
| | - Jana Haberlova
- Department of Paediatric Neurology, Motol University Hospital, Prague, Czech Republic
| | - Claudia Castiglioni
- Pediatric Neurology Department, Clinica Las Condes, Santiago de Chile, Chile
- Instituto Nacional de Rehabilitación Pedro Aguirre Cerda, Santiago de Chile, Chile
| | - John Vissing
- Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Francina Munell
- Pediatric Neurology, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain, Passeig de la Vall d'Hebron 119-129, 08035
| | - François Rivier
- Department of Pediatric Neurology and Reference Center for Neuromuscular Diseases AOC, CHU Montpellier, Montpellier, France
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Tanya Stojkovic
- APHP, Neuromuscular Reference Center, Pitié-Salpêtrière Hospital, Institute of Myology, Paris, France
| | - Edoardo Malfatti
- Univ Paris Est UPE, INSERM, U955 IMRB, APHP, Centre de Référence de Pathologie Neuromusculaire Nord-Est-Ile-de-France, Hôpital Henri Mondor, Créteil, France
| | - Marta Gómez García de la Banda
- APHP, GH Université Paris-Saclay, Neuromuscular Center, Child Neurology and ICU Department, Raymond Poincare Hospital, Garches, France
| | - Giorgio Tasca
- Unità Operativa Complessa Di Neurologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italia
| | - Laura Costa Comellas
- Pediatric Neurology, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain, Passeig de la Vall d'Hebron 119-129, 08035
| | - Audrey Benezit
- APHP, GH Université Paris-Saclay, Neuromuscular Center, Child Neurology and ICU Department, Raymond Poincare Hospital, Garches, France
| | - Helge Amthor
- APHP, GH Université Paris-Saclay, Neuromuscular Center, Child Neurology and ICU Department, Raymond Poincare Hospital, Garches, France
- Université de Versailles, U1179 INSERM-UVSQ, Versailles, France
| | - Ivana Dabaj
- APHP, GH Université Paris-Saclay, Neuromuscular Center, Child Neurology and ICU Department, Raymond Poincare Hospital, Garches, France
- CHU de Rouen, Service de Néonatologie, Réanimation pédiatrique, Neuropédiatrie et Éducation Fonctionnelle de L'enfant, INSERM U 1245, ED497, 76000, Rouen, France
| | - Clara Gontijo Camelo
- Department of Neurology, Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil
| | - Pascal Laforêt
- Nord/Est/Ile de France Neuromuscular Reference Center, PHENIX FHU, Hôpital Raymond-Poincaré, AP-HP. INSERM U1179, Garches, France
| | - John Rendu
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, GIN, Grenoble, France
| | - Norma B Romero
- Sorbonne Université, Myology Institute, Neuromuscular Morphology Unit, Center for Research in Myology, GH Pitié-Salpêtrière, Paris, France
- Centre de Référence de Pathologie Neuromusculaire Paris-Est, GHU Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Eliana Cavassa
- APHP, GH Université Paris-Saclay, Neuromuscular Center, Child Neurology and ICU Department, Raymond Poincare Hospital, Garches, France
| | - Fabiana Fattori
- Unit for Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, Rome, Italy
| | - Christophe Beroud
- APHM, Laboratoire de Génétique Moléculaire, Hôpital TIMONE Enfants; Aix Marseille University, INSERM, MMG, Marseille, France
| | - Jana Zídková
- Centre of Molecular Biology and Genetics, University Hospital Brno, Brno, Czech Republic
| | | | - Nicoline Løkken
- Department of Neurology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Ángel Sanchez-Montañez
- Pediatric Neuroradiology, Radiology Department, Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Ximena Ortega
- Diagnostic Imaging Service, Clinica Las Condes, Santiago de Chile, Chile
| | - Martin Kynčl
- Department of Radiology, Motol University Hospital, Prague, Czech Republic
| | - Corinne Metay
- AP-HP, UF Cardiogénétique et Myogénétique Moléculaire et Cellulaire, Centre de Génétique Moléculaire et Chromosomique, GH Pitié Salpêtrière, Paris, France
- Sorbonne Université - Inserm UMRS974, Centre de Recherche en Myologie, GH Pitié-Salpêtrière, Paris, France
| | - David Gómez-Andrés
- Pediatric Neurology, Vall d'Hebron Institut de Recerca (VHIR), Hospital Universitari Vall d'Hebron, Vall d'Hebron Barcelona Hospital Campus, Barcelona, Spain, Passeig de la Vall d'Hebron 119-129, 08035.
| | - Robert Y Carlier
- APHP, GH Université Paris-Saclay, DMU Smart Imaging, Medical Imaging Department, Raymond Poincaré Teaching Hospital, Garches, France
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Biancalana V, Rendu J, Chaussenot A, Mecili H, Bieth E, Fradin M, Mercier S, Michaud M, Nougues MC, Pasquier L, Sacconi S, Romero NB, Marcorelles P, Authier FJ, Gelot Bernabe A, Uro-Coste E, Cances C, Isidor B, Magot A, Minot-Myhie MC, Péréon Y, Perrier-Boeswillwald J, Bretaudeau G, Dondaine N, Bouzenard A, Pizzimenti M, Eymard B, Ferreiro A, Laporte J, Fauré J, Böhm J. A recurrent RYR1 mutation associated with early-onset hypotonia and benign disease course. Acta Neuropathol Commun 2021; 9:155. [PMID: 34535181 PMCID: PMC8447513 DOI: 10.1186/s40478-021-01254-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/01/2021] [Indexed: 11/26/2022] Open
Abstract
The ryanodine receptor RyR1 is the main sarcoplasmic reticulum Ca2+ channel in skeletal muscle and acts as a connecting link between electrical stimulation and Ca2+-dependent muscle contraction. Abnormal RyR1 activity compromises normal muscle function and results in various human disorders including malignant hyperthermia, central core disease, and centronuclear myopathy. However, RYR1 is one of the largest genes of the human genome and accumulates numerous missense variants of uncertain significance (VUS), precluding an efficient molecular diagnosis for many patients and families. Here we describe a recurrent RYR1 mutation previously classified as VUS, and we provide clinical, histological, and genetic data supporting its pathogenicity. The heterozygous c.12083C>T (p.Ser4028Leu) mutation was found in thirteen patients from nine unrelated congenital myopathy families with consistent clinical presentation, and either segregated with the disease in the dominant families or occurred de novo. The affected individuals essentially manifested neonatal or infancy-onset hypotonia, delayed motor milestones, and a benign disease course differing from classical RYR1-related muscle disorders. Muscle biopsies showed unspecific histological and ultrastructural findings, while RYR1-typical cores and internal nuclei were seen only in single patients. In conclusion, our data evidence the causality of the RYR1 c.12083C>T (p.Ser4028Leu) mutation in the development of an atypical congenital myopathy with gradually improving motor function over the first decades of life, and may direct molecular diagnosis for patients with comparable clinical presentation and unspecific histopathological features on the muscle biopsy.
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8
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Cellular pathology of the human heart in Duchenne muscular dystrophy (DMD): lessons learned from in vitro modeling. Pflugers Arch 2021; 473:1099-1115. [DOI: 10.1007/s00424-021-02589-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 05/24/2021] [Accepted: 05/27/2021] [Indexed: 02/07/2023]
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9
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Nicolau S, Milone M, Liewluck T. Guidelines for genetic testing of muscle and neuromuscular junction disorders. Muscle Nerve 2021; 64:255-269. [PMID: 34133031 DOI: 10.1002/mus.27337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Accepted: 05/28/2021] [Indexed: 12/24/2022]
Abstract
Despite recent advances in the understanding of inherited muscle and neuromuscular junction diseases, as well as the advent of a wide range of genetic tests, patients continue to face delays in diagnosis of sometimes treatable disorders. These guidelines outline an approach to genetic testing in such disorders. Initially, a patient's phenotype is evaluated to identify myopathies requiring directed testing, including myotonic dystrophies, facioscapulohumeral muscular dystrophy, oculopharyngeal muscular dystrophy, mitochondrial myopathies, dystrophinopathies, and oculopharyngodistal myopathy. Initial investigation in the remaining patients is generally a comprehensive gene panel by next-generation sequencing. Broad panels have a higher diagnostic yield and can be cost-effective. Due to extensive phenotypic overlap and treatment implications, genes responsible for congenital myasthenic syndromes should be included when evaluating myopathy patients. For patients whose initial genetic testing is negative or inconclusive, phenotypic re-evaluation is warranted, along with consideration of genes and variants not included initially, as well as their acquired mimickers.
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Affiliation(s)
- Stefan Nicolau
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Teerin Liewluck
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
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10
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ALG3-CDG: a patient with novel variants and review of the genetic and ophthalmic findings. BMC Ophthalmol 2021; 21:249. [PMID: 34090370 PMCID: PMC8180164 DOI: 10.1186/s12886-021-02013-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Accepted: 05/26/2021] [Indexed: 12/01/2022] Open
Abstract
Background ALG3-CDG is a rare autosomal recessive disease. It is characterized by deficiency of alpha-1,3-mannosyltransferase caused by pathogenic variants in the ALG3 gene. Patients manifest with severe neurologic, cardiac, musculoskeletal and ophthalmic phenotype in combination with dysmorphic features, and almost half of them die before or during the neonatal period. Case presentation A 23 months-old girl presented with severe developmental delay, epilepsy, cortical atrophy, cerebellar vermis hypoplasia and ocular impairment. Facial dysmorphism, clubfeet and multiple joint contractures were observed already at birth. Transferrin isoelectric focusing revealed a type 1 pattern. Funduscopy showed hypopigmentation and optic disc pallor. Profound retinal ganglion cell loss and inner retinal layer thinning was documented on spectral-domain optical coherence tomography imaging. The presence of optic nerve hypoplasia was also supported by magnetic resonance imaging. A gene panel based next-generation sequencing and subsequent Sanger sequencing identified compound heterozygosity for two novel variants c.116del p.(Pro39Argfs*40) and c.1060 C > T p.(Arg354Cys) in ALG3. Conclusions Our study expands the spectrum of pathogenic variants identified in ALG3. Thirty-three variants in 43 subjects with ALG3-CDG have been reported. Literature review shows that visual impairment in ALG3-CDG is most commonly linked to optic nerve hypoplasia.
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11
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Saat H, Sahin I. Mutation spectrum of hereditary myopathies in Turkish patients and novel variants. Ann Hum Genet 2021; 85:178-185. [PMID: 33963534 DOI: 10.1111/ahg.12429] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/28/2022]
Abstract
Hereditary myopathies are a heterogeneous disorder known to be associated with more than 100 genes. Although hereditary myopathy subgroups can be partially described with traditional methods such as muscle biopsy, next-generation sequencing (NGS) is essential to reveal the disease's underlying genetic etiology and molecular mechanisms. In this study, we performed clinical exome sequencing or whole-exome sequencing (CES/WES) in 20 unrelated Turkish patients. Thirteen pathogenic or likely pathogenic variants, including five novel variantswere detected in the 16 known hereditary myopathy genes. We achieved a high rate of diagnosis (65%) compared to previous studies. The most common condition noticed was limb-girdle muscular dystrophy (LGMD), which should not be ignored in patients diagnosed with myopathy. CES or WES provides a certain molecular diagnosis from a broad perspective to demonstrate underlying genetic causes in heterogeneous disorders. Therefore, exome sequencing offers a higher and more complete diagnosis than the gene panel.
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Affiliation(s)
- Hanife Saat
- Department of Medical Genetics, University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
| | - Ibrahim Sahin
- Department of Medical Genetics, University of Health Sciences, Dışkapı Yıldırım Beyazıt Research and Training Hospital, Ankara, Turkey
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12
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Sun H, Shen XR, Fang ZB, Jiang ZZ, Wei XJ, Wang ZY, Yu XF. Next-Generation Sequencing Technologies and Neurogenetic Diseases. Life (Basel) 2021; 11:life11040361. [PMID: 33921670 PMCID: PMC8072598 DOI: 10.3390/life11040361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/05/2021] [Accepted: 04/16/2021] [Indexed: 12/18/2022] Open
Abstract
Next-generation sequencing (NGS) technology has led to great advances in understanding the causes of Mendelian and complex neurological diseases. Owing to the complexity of genetic diseases, the genetic factors contributing to many rare and common neurological diseases remain poorly understood. Selecting the correct genetic test based on cost-effectiveness, coverage area, and sequencing range can improve diagnosis, treatments, and prevention. Whole-exome sequencing and whole-genome sequencing are suitable methods for finding new mutations, and gene panels are suitable for exploring the roles of specific genes in neurogenetic diseases. Here, we provide an overview of the classifications, applications, advantages, and limitations of NGS in research on neurological diseases. We further provide examples of NGS-based explorations and insights of the genetic causes of neurogenetic diseases, including Charcot-Marie-Tooth disease, spinocerebellar ataxias, epilepsy, and multiple sclerosis. In addition, we focus on issues related to NGS-based analyses, including interpretations of variants of uncertain significance, de novo mutations, congenital genetic diseases with complex phenotypes, and single-molecule real-time approaches.
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Affiliation(s)
| | | | | | | | | | | | - Xue-Fan Yu
- Correspondence: ; Tel.: +86-157-5430-1836
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13
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Potulska-Chromik A, Jędrzejowska M, Gos M, Rosiak E, Kierdaszuk B, Maruszak A, Opuchlik A, Zekanowski C, Fichna JP. Pathogenic Mutations and Putative Phenotype-Affecting Variants in Polish Myofibrillar Myopathy Patients. J Clin Med 2021; 10:jcm10050914. [PMID: 33652732 PMCID: PMC7956316 DOI: 10.3390/jcm10050914] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/06/2021] [Accepted: 02/17/2021] [Indexed: 02/07/2023] Open
Abstract
Myofibrillar myopathies (MFM) are heterogeneous hereditary muscle diseases with characteristic myopathological features of Z-disk dissolution and aggregates of its degradation products. The onset and progression of the disease are variable, with an elusive genetic background, and around half of the cases lacking molecular diagnosis. Here, we attempted to establish possible genetic foundations of MFM by performing whole exome sequencing (WES) in eleven unrelated families of 13 patients clinically diagnosed as MFM spectrum. A filtering strategy aimed at identification of variants related to the disease was used and included integrative analysis of WES data and human phenotype ontology (HPO) terms, analysis of muscle-expressed genes, and analysis of the disease-associated interactome. Genetic diagnosis was possible in eight out of eleven cases. Putative causative mutations were found in the DES (two cases), CRYAB, TPM3, and SELENON (four cases) genes, the latter typically presenting with a rigid spine syndrome. Moreover, a variety of additional, possibly phenotype-affecting variants were found. These findings indicate a markedly heterogeneous genetic background of MFM and show the usefulness of next generation sequencing in the identification of disease-associated mutations. Finally, we discuss the emerging concept of variant load as the basis of phenotypic heterogeneity.
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Affiliation(s)
- Anna Potulska-Chromik
- Department of Neurology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland; (A.P.-C.); (B.K.); (A.O.)
| | - Maria Jędrzejowska
- Neuromuscular Unit, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego St., 02-106 Warsaw, Poland;
| | - Monika Gos
- Department of Medical Genetics, Institute of Mother and Child, 17a Kasprzaka St, 01-211 Warsaw, Poland;
| | - Edyta Rosiak
- II Department of Radiology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland;
| | - Biruta Kierdaszuk
- Department of Neurology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland; (A.P.-C.); (B.K.); (A.O.)
| | - Aleksandra Maruszak
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego St., 02-106 Warsaw, Poland; (A.M.); (C.Z.)
| | - Andrzej Opuchlik
- Department of Neurology, Medical University of Warsaw, 1a Banacha St., 02-097 Warsaw, Poland; (A.P.-C.); (B.K.); (A.O.)
| | - Cezary Zekanowski
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego St., 02-106 Warsaw, Poland; (A.M.); (C.Z.)
| | - Jakub P. Fichna
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Institute, Polish Academy of Sciences, 5 Pawinskiego St., 02-106 Warsaw, Poland; (A.M.); (C.Z.)
- Correspondence: ; Tel.: +48-226-086-485
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14
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Masárová L, Mojica-Pisciotti ML, Panovský R, Kincl V, Pešl M, Opatřil L, Máchal J, Novák J, Holeček T, Juříková L, Feitová V. Decreased Global Strains of LV in Asymptomatic Female Duchenne Muscular Dystrophy Gene Carriers Using CMR-FT. JACC Cardiovasc Imaging 2020; 14:1070-1072. [PMID: 33221218 DOI: 10.1016/j.jcmg.2020.09.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 01/29/2023]
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15
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Savarese M, Johari M, Johnson K, Arumilli M, Torella A, Töpf A, Rubegni A, Kuhn M, Giugliano T, Gläser D, Fattori F, Thompson R, Penttilä S, Lehtinen S, Gibertini S, Ruggieri A, Mora M, Maver A, Peterlin B, Mankodi A, Lochmüller H, Santorelli FM, Schoser B, Fajkusová L, Straub V, Nigro V, Hackman P, Udd B. Improved Criteria for the Classification of Titin Variants in Inherited Skeletal Myopathies. J Neuromuscul Dis 2020; 7:153-166. [PMID: 32039858 DOI: 10.3233/jnd-190423] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Extensive genetic screening results in the identification of thousands of rare variants that are difficult to interpret. Because of its sheer size, rare variants in the titin gene (TTN) are detected frequently in any individual. Unambiguous interpretation of molecular findings is almost impossible in many patients with myopathies or cardiomyopathies. OBJECTIVE To refine the current classification framework for TTN-associated skeletal muscle disorders and standardize the interpretation of TTN variants. METHODS We used the guidelines issued by the American College of Medical Genetics and Genomics (ACMG) and the Association for Molecular Pathology (AMP) to re-analyze TTN genetic findings from our patient cohort. RESULTS We identified in the classification guidelines three rules that are not applicable to titin-related skeletal muscle disorders; six rules that require disease-/gene-specific adjustments and four rules requiring quantitative thresholds for a proper use. In three cases, the rule strength need to be modified. CONCLUSIONS We suggest adjustments are made to the guidelines. We provide frequency thresholds to facilitate filtering of candidate causative variants and guidance for the use and interpretation of functional data and co-segregation evidence. We expect that the variant classification framework for TTN-related skeletal muscle disorders will be further improved along with a better understanding of these diseases.
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Affiliation(s)
- Marco Savarese
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Mridul Johari
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Katherine Johnson
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Meharji Arumilli
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Annalaura Torella
- Dipartimento di Medicina di Precisione, Universitá degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Ana Töpf
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | | | | | - Teresa Giugliano
- Dipartimento di Medicina di Precisione, Universitá degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | | | - Fabiana Fattori
- Unit for Neuromuscular and Neurodegenerative Disorders, Bambino Gesù Children's Hospital, Rome, Italy
| | - Rachel Thompson
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Sini Penttilä
- Neuromuscular Research Center, Department of Genetics, Fimlab Laboratories, Tampere, Finland
| | - Sara Lehtinen
- Neuromuscular Research Center, Department of Genetics, Fimlab Laboratories, Tampere, Finland
| | - Sara Gibertini
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Alessandra Ruggieri
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy.,Department of Molecular and Translation Medicine, Unit of Biology and Genetics, University of Brescia, Brescia, Italy
| | - Marina Mora
- Neuromuscular Diseases and Neuroimmunology Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
| | - Ales Maver
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Borut Peterlin
- Clinical Institute of Medical Genetics, University Medical Centre Ljubljana, Ljubljana, Slovenia
| | - Ami Mankodi
- Neurogenetics Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, Unites States
| | - Hanns Lochmüller
- 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, Spain.,Children's Hospital of Eastern Ontario Research Institute, University of Ottawa, Ottawa, Canada.,Division of Neurology, Department of Medicine, The Ottawa Hospital, Ottawa, Canada
| | | | - Benedikt Schoser
- Friedrich-Baur-Institut, Neurologische Klinik Ludwig-Maximilians-Universität München, Munich, Germany
| | - Lenka Fajkusová
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno and Masaryk University Brno, Brno, Czech Republic
| | - Volker Straub
- The John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - Vincenzo Nigro
- Dipartimento di Medicina di Precisione, Universitá degli Studi della Campania "Luigi Vanvitelli", Naples, Italy.,Telethon Institute of Genetics and Medicine, Pozzuoli, Italy
| | - Peter Hackman
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland
| | - Bjarne Udd
- Folkhälsan Research Center, Helsinki, Finland.,Department of Medical Genetics, Medicum, University of Helsinki, Helsinki, Finland.,Department of Neurology, Vaasa Central Hospital, Vaasa, Finland.,Neuromuscular Research Center, Tampere University and University Hospital, Tampere, Finland
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16
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Chakravorty S, Nallamilli BRR, Khadilkar SV, Singla MB, Bhutada A, Dastur R, Gaitonde PS, Rufibach LE, Gloster L, Hegde M. Clinical and Genomic Evaluation of 207 Genetic Myopathies in the Indian Subcontinent. Front Neurol 2020; 11:559327. [PMID: 33250842 PMCID: PMC7674836 DOI: 10.3389/fneur.2020.559327] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/23/2020] [Indexed: 12/13/2022] Open
Abstract
Objective: Inherited myopathies comprise more than 200 different individually rare disease-subtypes, but when combined together they have a high prevalence of 1 in 6,000 individuals across the world. Our goal was to determine for the first time the clinical- and gene-variant spectrum of genetic myopathies in a substantial cohort study of the Indian subcontinent. Methods: In this cohort study, we performed the first large clinical exome sequencing (ES) study with phenotype correlation on 207 clinically well-characterized inherited myopathy-suspected patients from the Indian subcontinent with diverse ethnicities. Results: Clinical-correlation driven definitive molecular diagnosis was established in 49% (101 cases; 95% CI, 42–56%) of patients with the major contributing pathogenicity in either of three genes, GNE (28%; GNE-myopathy), DYSF (25%; Dysferlinopathy), and CAPN3 (19%; Calpainopathy). We identified 65 variant alleles comprising 37 unique variants in these three major genes. Seventy-eight percent of the DYSF patients were homozygous for the detected pathogenic variant, suggesting the need for carrier-testing for autosomal-recessive disorders like Dysferlinopathy that are common in India. We describe the observed clinical spectrum of myopathies including uncommon and rare subtypes in India: Sarcoglycanopathies (SGCA/B/D/G), Collagenopathy (COL6A1/2/3), Anoctaminopathy (ANO5), telethoninopathy (TCAP), Pompe-disease (GAA), Myoadenylate-deaminase-deficiency-myopathy (AMPD1), myotilinopathy (MYOT), laminopathy (LMNA), HSP40-proteinopathy (DNAJB6), Emery-Dreifuss-muscular-dystrophy (EMD), Filaminopathy (FLNC), TRIM32-proteinopathy (TRIM32), POMT1-proteinopathy (POMT1), and Merosin-deficiency-congenital-muscular-dystrophy-type-1 (LAMA2). Thirteen patients harbored pathogenic variants in >1 gene and had unusual clinical features suggesting a possible role of synergistic-heterozygosity/digenic-contribution to disease presentation and progression. Conclusions: Application of clinically correlated ES to myopathy diagnosis has improved our understanding of the clinical and genetic spectrum of different subtypes and their overlaps in Indian patients. This, in turn, will enhance the global gene-variant-disease databases by including data from developing countries/continents for more efficient clinically driven molecular diagnostics.
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Affiliation(s)
- Samya Chakravorty
- Emory University Department of Pediatrics, Atlanta, GA, United States.,Emory University Department of Human Genetics, Atlanta, GA, United States.,Division of Neurosciences, Children's Healthcare of Atlanta, Atlanta, GA, United States.,School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | | | - Satish Vasant Khadilkar
- Department of Neurology, Bombay Hospital, Mumbai, India.,Department of Neurology, Sir J J Group of Hospitals, Grant Medical College, Mumbai, India.,Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | - Madhu Bala Singla
- Department of Neurology, Bombay Hospital, Mumbai, India.,Department of Neurology, Sir J J Group of Hospitals, Grant Medical College, Mumbai, India.,Bombay Hospital Institute of Medical Sciences, Mumbai, India
| | | | - Rashna Dastur
- Centre for Advanced Molecular Diagnostics in Neuromuscular Disorders (CAMDND), Mumbai, India
| | - Pradnya Satish Gaitonde
- Centre for Advanced Molecular Diagnostics in Neuromuscular Disorders (CAMDND), Mumbai, India
| | | | - Logan Gloster
- Emory University Department of Pediatrics, Atlanta, GA, United States.,School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States
| | - Madhuri Hegde
- School of Biological Sciences, Georgia Institute of Technology, Atlanta, GA, United States.,PerkinElmer Genomics, Global Laboratory Services, Waltham, MA, United States
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17
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Jelinkova S, Vilotic A, Pribyl J, Aimond F, Salykin A, Acimovic I, Pesl M, Caluori G, Klimovic S, Urban T, Dobrovolna H, Soska V, Skladal P, Lacampagne A, Dvorak P, Meli AC, Rotrekl V. DMD Pluripotent Stem Cell Derived Cardiac Cells Recapitulate in vitro Human Cardiac Pathophysiology. Front Bioeng Biotechnol 2020; 8:535. [PMID: 32656189 PMCID: PMC7325914 DOI: 10.3389/fbioe.2020.00535] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 05/04/2020] [Indexed: 12/17/2022] Open
Abstract
Duchenne muscular dystrophy (DMD) is a severe genetic disorder characterized by the lack of functional dystrophin. DMD is associated with progressive dilated cardiomyopathy, eventually leading to heart failure as the main cause of death in DMD patients. Although several molecular mechanisms leading to the DMD cardiomyocyte (DMD-CM) death were described, mostly in mouse model, no suitable human CM model was until recently available together with proper clarification of the DMD-CM phenotype and delay in cardiac symptoms manifestation. We obtained several independent dystrophin-deficient human pluripotent stem cell (hPSC) lines from DMD patients and CRISPR/Cas9-generated DMD gene mutation. We differentiated DMD-hPSC into cardiac cells (CC) creating a human DMD-CC disease model. We observed that mutation-carrying cells were less prone to differentiate into CCs. DMD-CCs demonstrated an enhanced cell death rate in time. Furthermore, ion channel expression was altered in terms of potassium (Kir2.1 overexpression) and calcium handling (dihydropyridine receptor overexpression). DMD-CCs exhibited increased time of calcium transient rising compared to aged-matched control, suggesting mishandling of calcium release. We observed mechanical impairment (hypocontractility), bradycardia, increased heart rate variability, and blunted β-adrenergic response connected with remodeling of β-adrenergic receptors expression in DMD-CCs. Overall, these results indicated that our DMD-CC models are functionally affected by dystrophin-deficiency associated and recapitulate functional defects and cardiac wasting observed in the disease. It offers an accurate tool to study human cardiomyopathy progression and test therapies in vitro.
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Affiliation(s)
- Sarka Jelinkova
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia.,International Clinical Research Center ICRC, St. Anne's University Hospital Brno, Brno, Czechia
| | - Aleksandra Vilotic
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Jan Pribyl
- CEITEC, Masaryk University, Brno, Czechia
| | - Franck Aimond
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Anton Salykin
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Ivana Acimovic
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Martin Pesl
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia.,International Clinical Research Center ICRC, St. Anne's University Hospital Brno, Brno, Czechia.,First Department of Internal Medicine-Cardioangiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Guido Caluori
- International Clinical Research Center ICRC, St. Anne's University Hospital Brno, Brno, Czechia.,First Department of Internal Medicine-Cardioangiology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Simon Klimovic
- Department of Biochemistry, Faculty of Science, Masaryk University, Brno, Czechia
| | - Tomas Urban
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia
| | - Hana Dobrovolna
- Department of Clinical Biochemistry, St. Anne's University Hospital of Brno, Brno, Czechia
| | - Vladimir Soska
- Department of Clinical Biochemistry, St. Anne's University Hospital of Brno, Brno, Czechia.,Second Clinic of Internal Medicine, Masaryk University of Brno, Brno, Czechia
| | - Petr Skladal
- First Department of Internal Medicine-Cardioangiology, Faculty of Medicine, Masaryk University, Brno, Czechia.,Department of Biochemistry, Faculty of Science, Masaryk University, Brno, Czechia
| | - Alain Lacampagne
- PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Petr Dvorak
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia.,International Clinical Research Center ICRC, St. Anne's University Hospital Brno, Brno, Czechia
| | - Albano C Meli
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia.,PhyMedExp, University of Montpellier, INSERM, CNRS, Montpellier, France
| | - Vladimir Rotrekl
- Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czechia.,International Clinical Research Center ICRC, St. Anne's University Hospital Brno, Brno, Czechia
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18
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Thuriot F, Gravel E, Buote C, Doyon M, Lapointe E, Marcoux L, Larue S, Nadeau A, Chénier S, Waters PJ, Jacques PÉ, Gravel S, Lévesque S. Molecular diagnosis of muscular diseases in outpatient clinics: A Canadian perspective. NEUROLOGY-GENETICS 2020; 6:e408. [PMID: 32337335 PMCID: PMC7164974 DOI: 10.1212/nxg.0000000000000408] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Accepted: 01/24/2020] [Indexed: 12/18/2022]
Abstract
Objective To evaluate the diagnostic yield of an 89-gene panel in a large cohort of patients with suspected muscle disorders and to compare the diagnostic yield of gene panel and exome sequencing approaches. Methods We tested 1,236 patients from outpatient clinics across Canada using a gene panel and performed exome sequencing for 46 other patients with sequential analysis of 89 genes followed by all mendelian genes. Sequencing and analysis were performed in patients with muscle weakness or symptoms suggestive of a muscle disorder and showing at least 1 supporting clinical laboratory. Results We identified a molecular diagnosis in 187 (15.1%) of the 1,236 patients tested with the 89-gene panel. Diagnoses were distributed across 40 different genes, but 6 (DMD, RYR1, CAPN3, PYGM, DYSF, and FKRP) explained about half of all cases. Cardiac anomalies, positive family history, age <60 years, and creatine kinase >1,000 IU/L were all associated with increased diagnostic yield. Exome sequencing identified a diagnosis in 10 (21.7%) of the 46 patients tested. Among these, 3 were attributed to genes not included in the 89-gene panel. Despite differences in median coverage, only 1 of the 187 diagnoses that were identified on gene panel in the 1,236 patients could have been potentially missed if exome sequencing had been performed instead. Conclusions Our study supports the use of gene panel testing in patients with suspected muscle disorders from outpatient clinics. It also shows that exome sequencing has a low risk of missing diagnoses compared with gene panel, while potentially increasing the diagnostic yield of patients with muscle disorders.
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Affiliation(s)
- Fanny Thuriot
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Elaine Gravel
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Caroline Buote
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Marianne Doyon
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Elvy Lapointe
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Lydia Marcoux
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Sandrine Larue
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Amélie Nadeau
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Sébastien Chénier
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Paula J Waters
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Pierre-Étienne Jacques
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Serge Gravel
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
| | - Sébastien Lévesque
- Department of Pediatrics (F.T., E.G., C.B., M.D., L.M., A.N., S.C., P.J.W., S.G., S. Lévesque), Université de Sherbrooke; Sherbrooke Genomic Medicine (F.T., E.G., C.B., S.G., S. Lévesque); RNomic's Platform (E.L.), Université de Sherbrooke; Department of Neurology (S. Larue), Notre-Dame Hospital, Université de Montréal; Department of Biology (P.-É.J.), Université de Sherbrooke; and Department of Computer Sciences (P.-É.J.), Université de Sherbrooke, Quebec, Canada
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19
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Winder TL, Tan CA, Klemm S, White H, Westbrook JM, Wang JZ, Entezam A, Truty R, Nussbaum RL, McNally EM, Aradhya S. Clinical utility of multigene analysis in over 25,000 patients with neuromuscular disorders. NEUROLOGY-GENETICS 2020; 6:e412. [PMID: 32337338 PMCID: PMC7164976 DOI: 10.1212/nxg.0000000000000412] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 12/30/2019] [Indexed: 11/29/2022]
Abstract
Objective Molecular genetic testing for hereditary neuromuscular disorders is increasingly used to identify disease subtypes, determine prevalence, and inform management and prognosis, and although many small disease-specific studies have demonstrated the utility of genetic testing, comprehensive data sets are better positioned to assess the complexity of genetic analysis. Methods Using high depth-of-coverage next-generation sequencing (NGS) with simultaneous detection of sequence variants and copy number variants (CNVs), we tested 25,356 unrelated individuals for subsets of 266 genes. Results A definitive molecular diagnosis was obtained in 20% of this cohort, with yields ranging from 4% among individuals with congenital myasthenic syndrome to 33% among those with a muscular dystrophy. CNVs accounted for as much as 39% of all clinically significant variants, with 10% of them occurring as rare, private pathogenic variants. Multigene testing successfully addressed differential diagnoses in at least 6% of individuals with positive results. Even for classic disorders like Duchenne muscular dystrophy, at least 49% of clinically significant results were identified through gene panels intended for differential diagnoses rather than through single-gene analysis. Variants of uncertain significance (VUS) were observed in 53% of individuals. Only 0.7% of these variants were later reclassified as clinically significant, most commonly in RYR1, GDAP1, SPAST, and MFN2, providing insight into the types of evidence that support VUS resolution and informing expectations of reclassification rates. Conclusions These data provide guidance for clinicians using genetic testing to diagnose neuromuscular disorders and represent one of the largest studies demonstrating the utility of NGS-based testing for these disorders.
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Affiliation(s)
- Thomas L Winder
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Christopher A Tan
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Sarah Klemm
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Hannah White
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Jody M Westbrook
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - James Z Wang
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Ali Entezam
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Rebecca Truty
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Robert L Nussbaum
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Elizabeth M McNally
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
| | - Swaroop Aradhya
- Invitae Corporation (T.L.W., C.A.T., S.K., H.W., J.M.W., J.Z.W., A.E., R.T., R.L.N., S.A.), San Francisco, CA; Volunteer Faculty (R.L.N.), University of California, San Francisco; and Center for Genetic Medicine (E.M.M.), Northwestern University, Evanston, IL
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20
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Bevilacqua JA, Guecaimburu Ehuletche MDR, Perna A, Dubrovsky A, Franca MC, Vargas S, Hegde M, Claeys KG, Straub V, Daba N, Faria R, Periquet M, Sparks S, Thibault N, Araujo R. The Latin American experience with a next generation sequencing genetic panel for recessive limb-girdle muscular weakness and Pompe disease. Orphanet J Rare Dis 2020; 15:11. [PMID: 31931849 PMCID: PMC6958675 DOI: 10.1186/s13023-019-1291-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/27/2019] [Indexed: 02/08/2023] Open
Abstract
Background Limb-girdle muscular dystrophy (LGMD) is a group of neuromuscular disorders of heterogeneous genetic etiology with more than 30 directly related genes. LGMD is characterized by progressive muscle weakness involving the shoulder and pelvic girdles. An important differential diagnosis among patients presenting with proximal muscle weakness (PMW) is late-onset Pompe disease (LOPD), a rare neuromuscular glycogen storage disorder, which often presents with early respiratory insufficiency in addition to PMW. Patients with PMW, with or without respiratory symptoms, were included in this study of Latin American patients to evaluate the profile of variants for the included genes related to LGMD recessive (R) and LOPD and the frequency of variants in each gene among this patient population. Results Over 20 institutions across Latin America (Brazil, Argentina, Peru, Ecuador, Mexico, and Chile) enrolled 2103 individuals during 2016 and 2017. Nine autosomal recessive LGMDs and Pompe disease were investigated in a 10-gene panel (ANO5, CAPN3, DYSF, FKRP, GAA, SGCA, SGCB, SGCD, SGCG, TCAP) based on reported disease frequency in Latin America. Sequencing was performed with Illumina’s NextSeq500 and variants were classified according to ACMG guidelines; pathogenic and likely pathogenic were treated as one category (P) and variants of unknown significance (VUS) are described. Genetic variants were identified in 55.8% of patients, with 16% receiving a definitive molecular diagnosis; 39.8% had VUS. Nine patients were identified with Pompe disease. Conclusions The results demonstrate the effectiveness of this targeted genetic panel and the importance of including Pompe disease in the differential diagnosis for patients presenting with PMW.
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Affiliation(s)
- Jorge A Bevilacqua
- Departamento de Neurología y Neurocirugía, Hospital Clínico, Universidad de Chile, Santiago, Chile.,Departamento de Anatomía y Medicina Legal, Facultad de Medicina, Universidad de Chile, Santiago, Chile.,Departamento de Neurología y Neurocirugía, Clínica Dávila, Santiago, Chile
| | | | - Abayuba Perna
- Institute of Neurology, Hospital de Clínicas, School of Medicine, UDELAR, Montevideo, Uruguay
| | - Alberto Dubrovsky
- Institute of Neuroscience, Favaloro Foundation, Buenos Aires, Argentina
| | - Marcondes C Franca
- Department of Neurology, University of Campinas-UNICAMP, Campinas, Sao Paulo, Brazil
| | - Steven Vargas
- Center of Neurology and Neurosurgery, Mexico City, Mexico
| | - Madhuri Hegde
- Global Laboratory Services, Diagnostics, PerkinElmer, Waltham, MA, USA
| | - Kristl G Claeys
- Department of Neurology, University Hospitals Leuven, Leuven, Belgium.,Laboratory for Muscle Diseases and Neuropathies, Department of Neurosciences, KU Leuven, Campus Gasthuisberg, Leuven, Belgium
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre, Institute of Genetic Medicine, Newcastle University, Centre for Life, Newcastle, United Kingdom
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21
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Jourdain A, Petit F, Odou M, Balduyck M, Brunelle P, Dufour W, Boussion S, Brischoux‐Boucher E, Colson C, Dieux A, Gérard M, Ghoumid J, Giuliano F, Goldenberg A, Khau Van Kien P, Lehalle D, Morin G, Moutton S, Smol T, Vanlerberghe C, Manouvrier‐Hanu S, Escande F. Multiplex targeted high‐throughput sequencing in a series of 352 patients with congenital limb malformations. Hum Mutat 2019; 41:222-239. [DOI: 10.1002/humu.23912] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 08/31/2019] [Accepted: 09/05/2019] [Indexed: 12/15/2022]
Affiliation(s)
- Anne‐Sophie Jourdain
- Service de Biochimie et Biologie MoléculaireCHU LilleLille France
- EA7364 RADEMEUniv. LilleLille France
| | - Florence Petit
- EA7364 RADEMEUniv. LilleLille France
- Clinique de Génétique Guy FontaineCHU LilleLille France
| | - Marie‐Françoise Odou
- Service de Biochimie et Biologie MoléculaireCHU LilleLille France
- Faculty of Pharmacy, UMR995, LIRIC (Lille Inflammation Research International Center)University of LilleLille France
| | - Malika Balduyck
- Service de Biochimie et Biologie MoléculaireCHU LilleLille France
- EA7364 RADEMEUniv. LilleLille France
| | - Perrine Brunelle
- Service de Biochimie et Biologie MoléculaireCHU LilleLille France
- Clinique de Génétique Guy FontaineCHU LilleLille France
| | | | | | | | | | - Anne Dieux
- Clinique de Génétique Guy FontaineCHU LilleLille France
| | | | - Jamal Ghoumid
- EA7364 RADEMEUniv. LilleLille France
- Clinique de Génétique Guy FontaineCHU LilleLille France
| | | | | | | | - Daphné Lehalle
- Reference Center for Developmental Anomalies, Department of Medical GeneticsDijon University HospitalDijon France
| | - Gilles Morin
- Centre d'activité de Génétique et d'OncogénétiqueCHU Amiens PicardieAmiens France
| | - Sébastien Moutton
- Reference Center for Developmental Anomalies, Department of Medical GeneticsDijon University HospitalDijon France
| | - Thomas Smol
- EA7364 RADEMEUniv. LilleLille France
- Institut de Génétique MédicaleCHU LilleLille France
| | - Clémence Vanlerberghe
- EA7364 RADEMEUniv. LilleLille France
- Clinique de Génétique Guy FontaineCHU LilleLille France
| | - Sylvie Manouvrier‐Hanu
- EA7364 RADEMEUniv. LilleLille France
- Clinique de Génétique Guy FontaineCHU LilleLille France
| | - Fabienne Escande
- Service de Biochimie et Biologie MoléculaireCHU LilleLille France
- EA7364 RADEMEUniv. LilleLille France
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22
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Panovský R, Pešl M, Holeček T, Máchal J, Feitová V, Mrázová L, Haberlová J, Slabá A, Vít P, Stará V, Kincl V. Cardiac profile of the Czech population of Duchenne muscular dystrophy patients: a cardiovascular magnetic resonance study with T1 mapping. Orphanet J Rare Dis 2019; 14:10. [PMID: 30626423 PMCID: PMC6327529 DOI: 10.1186/s13023-018-0986-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Accepted: 12/21/2018] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The progressive cardiomyopathy that develops in boys with Duchenne and Becker muscular dystrophy (DMD/BMD) is presumed to be a secondary consequence of the fibrosis within the myocardium. There are only limited data on using parametric imaging in these patients. The purpose of this study was to assess native T1 and extracellular volume (ECV) values in DMD patients. METHODS The Czech population of males with DMD/BMD was screened. All eligible patients fulfilling the inclusion criteria were included. Forty nine males underwent cardiac magnetic resonance (MR) examination including T1 native and post-contrast mapping measurements. One DMD patient and all BMD patients were excluded from statistical analysis. Three groups were compared - Group D1 - DMD patients without late gadolinium enhancement (LGE) (n = 23), Group D2 - DMD patients with LGE (n = 20), and Group C - gender matched controls (n = 13). RESULTS Compared to controls, both DMD groups had prolonged T1 native relaxation time. These results are concordant in all 6 segments as well as in global values (1041 ± 31 ms and 1043 ± 37 ms vs. 983 ± 15 ms, both p < 0.05). Group D2 had significantly increased global ECV (0.28 ± 0.044 vs. 0.243 ± 0.013, p < 0.05) and segmental ECV in inferolateral and anterolateral segments in comparison with controls. The results were also significant after adjustment for subjects' age. CONCLUSION DMD males had increased native T1 relaxation time independent of the presence or absence of myocardial fibrosis. Cardiac MR may provide clinically useful information even without contrast media administration.
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Affiliation(s)
- Roman Panovský
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic. .,1st Department of Internal Medicine/Cardioangiology, St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic.
| | - Martin Pešl
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,1st Department of Internal Medicine/Cardioangiology, St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,Department of Biology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Tomáš Holeček
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,Department of Medical Imaging, St. Anne's University Hospital, Brno, Czech Republic
| | - Jan Máchal
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,Department of Pathophysiology, Faculty of Medicine, Masaryk University, Brno, Czech Republic
| | - Věra Feitová
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,Department of Medical Imaging, St. Anne's University Hospital, Brno, Czech Republic
| | - Lenka Mrázová
- Department of Pediatric Neurology, University Hospital Brno, Brno, Czech Republic
| | - Jana Haberlová
- Department of Pediatric Neurology, University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Alžběta Slabá
- Department of Pediatric Neurology, University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavel Vít
- Pediatric Clinic, University Hospital Brno, Brno, Czech Republic
| | - Veronika Stará
- Department of Pediatrics, University Hospital Motol, Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Vladimír Kincl
- International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,1st Department of Internal Medicine/Cardioangiology, St. Anne's University Hospital, Faculty of Medicine, Masaryk University, Brno, Czech Republic
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23
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Fichna JP, Macias A, Piechota M, Korostyński M, Potulska-Chromik A, Redowicz MJ, Zekanowski C. Whole-exome sequencing identifies novel pathogenic mutations and putative phenotype-influencing variants in Polish limb-girdle muscular dystrophy patients. Hum Genomics 2018; 12:34. [PMID: 29970176 PMCID: PMC6029161 DOI: 10.1186/s40246-018-0167-1] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Accepted: 06/25/2018] [Indexed: 12/16/2022] Open
Abstract
Background Limb girdle muscular dystrophies (LGMD) are a group of heterogeneous hereditary myopathies with similar clinical symptoms. Disease onset and progression are highly variable, with an elusive genetic background, and around 50% cases lacking molecular diagnosis. Methods Whole exome sequencing (WES) was performed in 73 patients with clinically diagnosed LGMD. A filtering strategy aimed at identification of variants related to the disease included integrative analysis of WES data and human phenotype ontology (HPO) terms, analysis of genes expressed in muscle, analysis of the disease-associated interactome and copy number variants analysis. Results Genetic diagnosis was possible in 68.5% of cases. On average, 36.3 rare variants in genes associated with various muscle diseases per patient were found that could relate to the clinical phenotype. The putative causative mutations were mostly in LGMD-associated genes, but also in genes not included in the current LGMD classification (DMD, COL6A2, and COL6A3). In three patients, mutations in two genes were suggested as the joint cause of the disease (CAPN3+MYH7, COL6A3+CACNA1S, DYSF+MYH7). Moreover, a variety of phenotype-influencing variants were postulated, including in patients with an identified already known primary pathogenic mutation. Conclusions We hypothesize that LGMD could be better described as oligogenic disorders in which dominant clinical presentation can result from the combined effect of mutations in a set of genes. In this view, the inter- and intrafamilial variability could reflect a specific genetic background and the presence of sets of phenotype-influencing or co-causative mutations in genes that either interact with the known LGMD-associated genes or are a part of the same pathways or structures. Electronic supplementary material The online version of this article (10.1186/s40246-018-0167-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Jakub Piotr Fichna
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawinskiego St., 02-106, Warsaw, Poland.
| | - Anna Macias
- Department of Neurology, Medical University of Warsaw, 1a Banacha St., 02-097, Warsaw, Poland
| | - Marcin Piechota
- Department of Molecular Neuropharmacology, Institute of Pharmacology, Polish Academy of Sciences, 31-344, Krakow, Poland
| | - Michał Korostyński
- Department of Molecular Neuropharmacology, Institute of Pharmacology, Polish Academy of Sciences, 31-344, Krakow, Poland
| | - Anna Potulska-Chromik
- Department of Neurology, Medical University of Warsaw, 1a Banacha St., 02-097, Warsaw, Poland
| | - Maria Jolanta Redowicz
- Laboratory of Molecular Basis of Cell Motility, Department of Biochemistry, Nencki Institute of Experimental Biology, 3 Pasteur St., 02-093, Warsaw, Poland
| | - Cezary Zekanowski
- Department of Neurodegenerative Disorders, Mossakowski Medical Research Centre, Polish Academy of Sciences, 5 Pawinskiego St., 02-106, Warsaw, Poland
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Angelini C, Fanin M. Limb girdle muscular dystrophies: clinical-genetical diagnostic update and prospects for therapy. Expert Opin Orphan Drugs 2017. [DOI: 10.1080/21678707.2017.1367283] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Corrado Angelini
- Department of Neurodegenerative Disorders, Neuromuscular Center, San Camillo Hospital IRCCS, Venice, Italy
| | - Marina Fanin
- Department of Neurosciences, University of Padova, Padova, Italy
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