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Rueda-Nieto S, Mondejar-Lopez P, Mira-Escolano MP, Cutillas-Tolín A, Maceda-Roldán LA, Arense-Gonzalo JJ, Palomar-Rodríguez JA. Analysis of the genotypic profile and its relationship with the clinical manifestations in people with cystic fibrosis: study from a rare disease registry. Orphanet J Rare Dis 2022; 17:222. [PMID: 35698092 PMCID: PMC9195274 DOI: 10.1186/s13023-022-02373-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 05/29/2022] [Indexed: 11/10/2022] Open
Abstract
Background Cystic fibrosis (CF) has a vast and heterogeneous mutational spectrum in Europe. This variability has also been described in Spain, and there are numerous studies linking CFTR variants with the symptoms of the disease. Most of the studies analysed determinate clinical manifestations or specific sequence variants in patients from clinical units. Others used registry data without addressing the genotype–phenotype relationship. Therefore, the objective of this study is to describe the genetic and clinical characteristics of people with CF and to analyse the relationship between both using data from the rare disease registry of a region in southeastern Spain. Methods A cross-sectional study was carried out in people with a confirmed diagnosis of CF registered in the Rare Diseases Information System (SIER) of the Region of Murcia (Spain). The patients were classified into two genotypes according to the functional consequence that the genetic variants had on the CFTR protein. Results There were 192 people diagnosed with CF reported in the Region of Murcia as of 31 December 2018. Seventy-six genotypes and 49 different variants were described, with c.1521_1523delCTT (p. Phe508del) being the most common in 58.3% of the CF patients and 37.0% of the alleles. In addition, 67% of the patients were classified as a high-risk genotype, which was associated with a lower percentage of FEV1 (OR: 5.3; 95% CI: 1.2, 24.4), an increased risk of colonization by Pseudomonas aeruginosa (OR: 7.5; 95% CI: 1.7, 33.0) and the presence of pancreatic insufficiency (OR: 28.1; 95% CI: 9.3, 84.4) compared to those with a low-risk genotype. Conclusions This is the first study in Spain that describes the mutational spectrum and its association with clinical manifestations in patients with CF using data from a rare disease registry. The results obtained allow planning for the health resources needed by people with this disease, thus contributing to the development of personalized medicine that helps to optimize health care in CF patients. Supplementary Information The online version contains supplementary material available at 10.1186/s13023-022-02373-y.
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Affiliation(s)
- Senay Rueda-Nieto
- Teaching Unit of Preventive Medicine and Public Health, 30100, Murcia, Spain.
| | - Pedro Mondejar-Lopez
- Paediatric Pulmonology and Cystic Fibrosis Unit, Virgen de La Arrixaca Clinic University Hospital (Murcia), 30120, Murcia, Spain
| | - María-Pilar Mira-Escolano
- Rare Diseases Information System, Planning and Health Financing Department, Regional Health Council, 30001, Murcia, Spain
| | - Ana Cutillas-Tolín
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100, Murcia, Spain.,Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120, El Palmar, Murcia, Spain
| | - Luis Alberto Maceda-Roldán
- Rare Diseases Information System, Planning and Health Financing Department, Regional Health Council, 30001, Murcia, Spain
| | - Julián Jesús Arense-Gonzalo
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, University of Murcia School of Medicine, 30100, Murcia, Spain.,Institute for Biomedical Research of Murcia, IMIB-Arrixaca, 30120, El Palmar, Murcia, Spain
| | - Joaquín A Palomar-Rodríguez
- Rare Diseases Information System, Planning and Health Financing Department, Regional Health Council, 30001, Murcia, Spain
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Mondejar-Lopez P, Zolin A, Garcia-Marcos PW, Pastor-Vivero MD, Rosa-Silvestre M, de Asis Sanchez-Martinez F, Salvatore D, Cimino G, Majo F, Sole-Jover A, Asensio de la Cruz O, Calderazzo MA, Pizzamiglio G, Castillo-Corullon S, Alvarez-Fernandez A, Gartner S, Padoan R, Carnovale V, Salvatore M, Moya-Quiles MR, Orenti A, Glover G, Sanchez-Solis M. Geographic distribution and phenotype of European people with cystic fibrosis carrying A1006E mutation. Respir Med 2022; 192:106736. [PMID: 35032736 DOI: 10.1016/j.rmed.2022.106736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2021] [Revised: 01/03/2022] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND A1006E is a Cystic Fibrosis (CF) mutation that is still not widely known. We report phenotypic features and geographic distribution of the largest cohort of people with CF (pwCF) carrying A1006E to date. METHODS Study of European pwCF carrying A1006E mutation, included in the European CF Society Patient Registry (ECFSPR). Genotype, ancestries and all variables recorded were compared to a cohort of F508del/F508del patients. Rate of decline in percentage-of-predicted FEV1 (ppFEV1) was also analyzed using the 2010-2017 ECFSPR. RESULTS 44 pwCF carrying A1006E were reported (59% males), median age 33 years old (3-58), 54.5% Spanish and 40.9% Italian, most with ancestry in Murcia (Spain) and Lazio (Italy) regions. Compared to F508del homozygous, A1006E-pwCF were significantly older (75% vs. 52.5% ≥ 18 years old) and diagnosed at later median age (6.98 vs. 0.29 years); showed lower rates of meconium ileus (2.33% vs. 17.7%), pancreatic insufficiency (27.91% vs. 99.26%), diabetes (2.33% vs. 21.98%), liver disease (6.98% vs. 36.72%) and Pseudomonas aeruginosa chronic colonization (30.95% vs. 42.51%); and presented better nutrition (BMI z-score 0.44 vs. -0.43) and ppFEV1 (90.8% vs. 78.6%), with 18.9% (most >40 years old) having a ppFEV1<70%. Additional ppFEV1 decline (0.96% per year) was attributed to F508del/F508del genotype (p = 0.0007). None died or needed organ transplantation during the study period. CONCLUSIONS A1006E-pwCF are mainly of Western Mediterranean Spanish and Italian descent. When compared with F508del/F508del-pwCF, they usually have a milder form of the disease, associated with pancreatic sufficiency and slower FEV1 decline. However, some will develop progressive respiratory impairment during adulthood.
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Affiliation(s)
- Pedro Mondejar-Lopez
- Pediatric Pulmonology and Cystic Fibrosis Unit, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain; Department of Surgery, Paediatrics, Obstetrics and Genecology, Universidad de Murcia, Spain. Biomedical Research Institute of Murcia (IMIB), Murcia, Spain.
| | - Anna Zolin
- Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Epidemiology and Biometry G. A. Maccacaro, University of Milan, Milan, Italy
| | - Patricia W Garcia-Marcos
- Pediatric Pulmonology and Cystic Fibrosis Unit, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Mª Dolores Pastor-Vivero
- Osakidetza. Organizacion Sanitaria Integrada Ezkerraldea-Enkarterri-Cruces, Hospital Universitario Cruces, Paediatrics, Cystic Fibrosis Unit, Bizkaia, Spain
| | - Maria Rosa-Silvestre
- Pediatric Pulmonology and Cystic Fibrosis Unit, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain
| | | | | | - Giuseppe Cimino
- Lazio Reference Center for Cystic Fibrosis, Policlinico Umberto I University Hospital, Rome, Italy
| | - Fabio Majo
- Cystic Fibrosis Centre, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Amparo Sole-Jover
- Lung Transplantation and Cystic Fibrosis Unit, Hospital Universitario La Fe, Universidad de Valencia, Valencia, Spain
| | - Oscar Asensio de la Cruz
- Cystic Fibrosis Unit, Pediatric Pulmonology and Allergy Unit, Hospital Universitari Parc Tauli, Sabadell, Barcelona, Spain
| | | | - Giovanna Pizzamiglio
- Cystic Fibrosis Center - Adult Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Antonio Alvarez-Fernandez
- Adult Cystic Fibrosis Unit, Pulmonology Service, Hospital Universitari Vall D'Hebron, Barcelona, Spain
| | - Silvia Gartner
- Pediatric Pulmonology and Cystic Fibrosis Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Rita Padoan
- Department of Paediatrics, Cystic Fibrosis Regional Support Centre, University of Brescia, ASST Spedali Civili Brescia, Brescia, Italy
| | - Vincenzo Carnovale
- Department of Translational Medical Science, Cystic Fibrosis Centre, Adult Unit, University of Naples "Federico II", Italy
| | - Marco Salvatore
- Italian Cystic Fibrosis Registry, Rome, Italy, National Centre for Rare Diseases, Undiagnosed Rare Diseases Unit, Istituto Superiore di Sanità, Rome, Italy
| | - Mª Rosa Moya-Quiles
- Immunology Service, University Clinical Hospital Virgen de la Arrixaca-Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
| | - Annalisa Orenti
- Department of Clinical Sciences and Community Health, Laboratory of Medical Statistics, Epidemiology and Biometry G. A. Maccacaro, University of Milan, Milan, Italy
| | - Guillermo Glover
- Biochemistry and Clinical Genetic Centre. Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain
| | - Manuel Sanchez-Solis
- Pediatric Pulmonology and Cystic Fibrosis Unit, Hospital Clinico Universitario Virgen de la Arrixaca, Murcia, Spain; Department of Surgery, Paediatrics, Obstetrics and Genecology, Universidad de Murcia, Spain. Biomedical Research Institute of Murcia (IMIB), Murcia, Spain
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Awatade NT, Uliyakina I, Farinha CM, Clarke LA, Mendes K, Solé A, Pastor J, Ramos MM, Amaral MD. Measurements of Functional Responses in Human Primary Lung Cells as a Basis for Personalized Therapy for Cystic Fibrosis. EBioMedicine 2014; 2:147-53. [PMID: 26137539 PMCID: PMC4484512 DOI: 10.1016/j.ebiom.2014.12.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 12/16/2014] [Accepted: 12/16/2014] [Indexed: 01/08/2023] Open
Abstract
Background The best investigational drug to treat cystic fibrosis (CF) patients with the most common CF-causing mutation (F508del) is VX-809 (lumacaftor) which recently succeeded in Phase III clinical trial in combination with ivacaftor. This corrector rescues F508del-CFTR from its abnormal intracellular localization to the cell surface, a traffic defect shared by all Class II CFTR mutants. Our goal here is to test the efficacy of lumacaftor in other Class II mutants in primary human bronchial epithelial (HBE) cells derived from CF patients. Methods The effect of lumacaftor was investigated in primary HBE cells from non-CF and CF patients with F508del/F508del, A561E/A561E, N1303K/G542X, F508del/G542X and F508del/Y1092X genotypes by measurements of Forskolin plus Genistein-inducible equivalent short-circuit current (Ieq-SC-Fsk + Gen) in perfused open-circuit Ussing chambers. Efficacy of corrector C18 was also assessed on A561E/A561E and F508del/F508del cells. Results Our data indicate that A561E (when present in both alleles) responds positively to lumacaftor treatment at equivalent efficacy of F508del in primary HBE cells. Similarly, lumacaftor has a positive impact on Y1092X, but not on N1303K. Our data also show that cells with only one copy of F508del-CFTR respond less to VX-809. Moreover, there is great variability in lumacaftor responses among F508del-homozygous cells from different donors. Compound C18 failed to rescue A561E-CFTR but not in F508del-CFTR, thus plausibly it has a different mechanism of action distinct from lumacaftor. Conclusions CF patients with A561E (and likely also those with Y1029X) can potentially benefit from lumacaftor. Moreover, the methodology used here exemplifies how ex vivo approaches may apply personalized therapies to CF and possibly other respiratory diseases. A561E and Y1092X CFTR mutations (but not N1303K) respond positively to lumacaftor treatment. One copy of F508del-CFTR responds less to lumacaftor than 2 copies and F508del-responses vary greatly. CF patients with A561E (and likely also those with Y1029X) can potentially benefit from lumacaftor. The methodology used here exemplifies how ex vivo approaches may apply personalized therapies to CF and possibly other respiratory diseases.
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Key Words
- (ΔIeq-sc), equivalent short-circuit currents
- CF, cystic fibrosis
- CFTR, cystic fibrosis transmembrane conductance regulator
- ENaC, epithelial Na+ channel
- Fsk, forskolin
- Gen, Genistein
- HBE (cells), human bronchial epithelial cells
- Innovative treatments
- Mutation-specific therapies
- Personalized medicine
- Rare diseases
- Rte, transepithelial resistance.
- SEM, standard error of the mean
- TEER, transepithelial electrical resistance
- Vte, transepithelial voltage
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Affiliation(s)
- Nikhil T Awatade
- University of Lisboa, Faculty of Sciences, BioFIG-Center for Biodiversity, Functional and Integrative Genomics, Campo Grande, C8 bdg, 1749-016 Lisboa, Portugal
| | - Inna Uliyakina
- University of Lisboa, Faculty of Sciences, BioFIG-Center for Biodiversity, Functional and Integrative Genomics, Campo Grande, C8 bdg, 1749-016 Lisboa, Portugal
| | - Carlos M Farinha
- University of Lisboa, Faculty of Sciences, BioFIG-Center for Biodiversity, Functional and Integrative Genomics, Campo Grande, C8 bdg, 1749-016 Lisboa, Portugal
| | - Luka A Clarke
- University of Lisboa, Faculty of Sciences, BioFIG-Center for Biodiversity, Functional and Integrative Genomics, Campo Grande, C8 bdg, 1749-016 Lisboa, Portugal
| | - Karina Mendes
- University of Lisboa, Faculty of Sciences, BioFIG-Center for Biodiversity, Functional and Integrative Genomics, Campo Grande, C8 bdg, 1749-016 Lisboa, Portugal
| | - Amparo Solé
- Adult Cystic Fibrosis Unit, University Hospital la Fe, Boulevar Sur, 46026 Valencia, Spain
| | - Juan Pastor
- Thoracic Surgery Service, University Hospital la Fe, Av. Campanar 21, 46009 Valencia, Spain
| | - Maria Margarida Ramos
- University of Lisboa, Faculty of Sciences, BioFIG-Center for Biodiversity, Functional and Integrative Genomics, Campo Grande, C8 bdg, 1749-016 Lisboa, Portugal
| | - Margarida D Amaral
- University of Lisboa, Faculty of Sciences, BioFIG-Center for Biodiversity, Functional and Integrative Genomics, Campo Grande, C8 bdg, 1749-016 Lisboa, Portugal
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Muro M, Mondejar-López P, Moya-Quiles MR, Salgado G, Pastor-Vivero MD, Lopez-Hernandez R, Boix F, Campillo JA, Minguela A, Garcia-Alonso A, Sánchez-Solís M, Álvarez-López MR. HLA-DRB1 and HLA-DQB1 genes on susceptibility to and protection from allergic bronchopulmonary aspergillosis in patients with cystic fibrosis. Microbiol Immunol 2013; 57:193-7. [PMID: 23278646 DOI: 10.1111/1348-0421.12020] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Revised: 12/17/2012] [Accepted: 12/17/2012] [Indexed: 01/17/2023]
Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is a hypersensitivity pulmonary disease that affects both patients with cystic fibrosis (CF) and those with asthma. HLA-DRB1 alleles have previously been associated with ABPA-CF susceptibility; however, HLA-DQB1 allele associations have not been clearly established. The aim of the present study was to investigate HLA class II associations in patients with ABPA-CF and determine their roles in susceptibility or protection. Patients with ABPA-CF, patients with CF without ABPA, patients with asthma without ABPA (AST), and healthy controls were included in this study. DNA was extracted by automatic extractor. HLA-DRB1 and -DQB1 genotyping was performed by the Luminex PCR-SSOP method (One Lambda, Canoga Park, CA, USA). Allele specific PCR-SSP was also performed by high-resolution analysis (One Lambda). Statistical analysis was performed with SSPS and Arlequin software. Both HLA-DRB1*5:01 and -DRB1*11:04 alleles occurred with greater frequency in patients with ABPA-CF than in those with AST and CF and control subjects, corroborating previously published data. On the other hand, analysis of haplotypes revealed that almost all patients with ABPA-CF lacking DRB1*15:01 or DRB1*11:04 carry either DRB1*04, DRB1*11:01, or DRB1*07:01 alleles. In the HLA-DQB1 region, the HLA-DQB1*06:02 allele occurred more frequently in patients with ABPA-CF than in those with AST and CF and healthy controls, whereas HLA-DQB1*02:01 occurred less frequently in patients with ABPA-CF. These data confirm that there is a correlation between HLA-DRB1*15:01, -DRB1*11:04, DRB1*11:01, -DRB1*04 and -DRB1*07:01 alleles and ABPA-CF susceptibility and suggest that HLA-DQB1*02:01 is an ABPA-CF resistance allele.
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Affiliation(s)
- Manuel Muro
- Immunology Service, University Hospital Virgen Arrixaca, Madrid-Cartagena Rd, 30120, El Palmar, Murcia, Spain.
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