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Salina A, Bassi M, Aloi C, Strati MF, Bocciardi R, d’Annunzio G, Maghnie M, Minuto N. "Pesto" Mutation: Phenotypic and Genotypic Characteristics of Eight GCK/MODY Ligurian Patients. Int J Mol Sci 2023; 24:ijms24044034. [PMID: 36835446 PMCID: PMC9961661 DOI: 10.3390/ijms24044034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/20/2023] [Accepted: 02/02/2023] [Indexed: 02/19/2023] Open
Abstract
Maturity Onset Diabetes of the Young (MODY) is a monogenic form of diabetes mellitus (DM) that accounts for around 2-5% of all types of diabetes. Autosomal dominant inheritance in pathogenic variations of 14 genes related to β-cell functions can lead to monogenic types of diabetes. In Italy, GCK/MODY is the most frequent form and it is caused by mutations of the glucokinase (GCK). Patients with GCK/MODY usually have stable mild fasting hyperglycaemia with mildly elevated HbA1c levels and rarely need pharmacological treatment. Molecular analysis of the GCK coding exons was carried out by Sanger sequencing in eight Italian patients. All the probands were found to be heterozygous carriers of a pathogenic gross insertion/deletion c.1279_1358delinsTTACA; p.Ser426_Ala454delinsLeuGln. It was previously described for the first time by our group in a large cohort of Italian GCK/MODY patients. The higher levels of HbA1c (6.57% vs. 6.1%), and the higher percentage of patients requiring insulin therapy (25% vs. 2%) compared to the previously studied Italian patients with GCK/MODY, suggest that the mutation discovered could be responsible for a clinically worse form of GCK/MODY. Moreover, as all the patients carrying this variant share an origin from the same geographic area (Liguria), we postulate a possible founder effect and we propose to name it the "pesto" mutation.
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Affiliation(s)
- Alessandro Salina
- LABSIEM (Laboratory for the Study of Inborn Errors of Metabolism), Pediatric Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Marta Bassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16100 Genoa, Italy
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Concetta Aloi
- LABSIEM (Laboratory for the Study of Inborn Errors of Metabolism), Pediatric Clinic, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
- Correspondence: ; Tel.: +39-01-05636-3786
| | - Marina Francesca Strati
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16100 Genoa, Italy
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Renata Bocciardi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16100 Genoa, Italy
- UOC Genetica Medica, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Giuseppe d’Annunzio
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Mohamad Maghnie
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, 16100 Genoa, Italy
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
| | - Nicola Minuto
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, 16147 Genoa, Italy
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Laver TW, Colclough K, Shepherd M, Patel K, Houghton JAL, Dusatkova P, Pruhova S, Morris AD, Palmer CN, McCarthy MI, Ellard S, Hattersley AT, Weedon MN. The Common p.R114W HNF4A Mutation Causes a Distinct Clinical Subtype of Monogenic Diabetes. Diabetes 2016; 65:3212-7. [PMID: 27486234 PMCID: PMC5035684 DOI: 10.2337/db16-0628] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Accepted: 07/26/2016] [Indexed: 12/21/2022]
Abstract
HNF4A mutations cause increased birth weight, transient neonatal hypoglycemia, and maturity onset diabetes of the young (MODY). The most frequently reported HNF4A mutation is p.R114W (previously p.R127W), but functional studies have shown inconsistent results; there is a lack of cosegregation in some pedigrees and an unexpectedly high frequency in public variant databases. We confirm that p.R114W is a pathogenic mutation with an odds ratio of 30.4 (95% CI 9.79-125, P = 2 × 10(-21)) for diabetes in our MODY cohort compared with control subjects. p.R114W heterozygotes did not have the increased birth weight of patients with other HNF4A mutations (3,476 g vs. 4,147 g, P = 0.0004), and fewer patients responded to sulfonylurea treatment (48% vs. 73%, P = 0.038). p.R114W has reduced penetrance; only 54% of heterozygotes developed diabetes by age 30 years compared with 71% for other HNF4A mutations. We redefine p.R114W as a pathogenic mutation that causes a distinct clinical subtype of HNF4A MODY with reduced penetrance, reduced sensitivity to sulfonylurea treatment, and no effect on birth weight. This has implications for diabetes treatment, management of pregnancy, and predictive testing of at-risk relatives. The increasing availability of large-scale sequence data is likely to reveal similar examples of rare, low-penetrance MODY mutations.
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Affiliation(s)
- Thomas W Laver
- Institute of Biomedical & Clinical Science, University of Exeter, Exeter, U.K
| | - Kevin Colclough
- Institute of Biomedical & Clinical Science, University of Exeter, Exeter, U.K. Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, U.K
| | - Maggie Shepherd
- Institute of Biomedical & Clinical Science, University of Exeter, Exeter, U.K
| | - Kashyap Patel
- Institute of Biomedical & Clinical Science, University of Exeter, Exeter, U.K
| | - Jayne A L Houghton
- Institute of Biomedical & Clinical Science, University of Exeter, Exeter, U.K. Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, U.K
| | - Petra Dusatkova
- Department of Paediatrics, Second Faculty of Medicine, Charles University
and University Hospital Motol, Prague, Czech Republic
| | - Stepanka Pruhova
- Department of Paediatrics, Second Faculty of Medicine, Charles University
and University Hospital Motol, Prague, Czech Republic
| | - Andrew D Morris
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, U.K
| | - Colin N Palmer
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, Dundee, U.K
| | - Mark I McCarthy
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, U.K. Oxford Centre for Diabetes, Endocrinology & Metabolism, University of Oxford, Oxford, U.K. National Institute for Health Research Oxford Biomedical Research Centre, Churchill Hospital, Oxford, U.K
| | - Sian Ellard
- Institute of Biomedical & Clinical Science, University of Exeter, Exeter, U.K. Department of Molecular Genetics, Royal Devon & Exeter NHS Foundation Trust, Exeter, U.K
| | - Andrew T Hattersley
- Institute of Biomedical & Clinical Science, University of Exeter, Exeter, U.K
| | - Michael N Weedon
- Institute of Biomedical & Clinical Science, University of Exeter, Exeter, U.K.
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Genesis of two most prevalent PROP1 gene variants causing combined pituitary hormone deficiency in 21 populations. Eur J Hum Genet 2015; 24:415-20. [PMID: 26059845 DOI: 10.1038/ejhg.2015.126] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 03/11/2015] [Accepted: 05/12/2015] [Indexed: 11/08/2022] Open
Abstract
Two variants (c.[301_302delAG];[301_302delAG] and c.[150delA];[150delA]) in the PROP1 gene are the most common genetic causes of recessively inherited combined pituitary hormones deficiency (CPHD). Our objective was to analyze in detail the origin of the two most prevalent variants. In the multicentric study were included 237 patients with CPHD and their 15 relatives carrying c.[301_302delAG];[301_302delAG] or c.[150delA];[150delA] or c.[301_302delAG];[ 150delA]. They originated from 21 different countries worldwide. We genotyped 21 single-nucleotide variant markers flanking the 9.6-Mb region around the PROP1 gene that are not in mutual linkage disequilibrium in the general populations--a finding of a common haplotype would be indicative of ancestral origin of the variant. Haplotypes were reconstructed by Phase and Haploview software, and the variant age was estimated using an allelic association method. We demonstrated the ancestral origin of both variants--c.[301_302delAG] was carried on 0.2 Mb-long haplotype in a majority of European patients arising ~101 generations ago (confidence interval 90.1-116.4). Patients from the Iberian Peninsula displayed a different haplotype, which was estimated to have emerged 23.3 (20.1-29.1) generations ago. Subsequently, the data indicated that both the haplotypes were transmitted to Latin American patients ~13.8 (12.2-17.0) and 16.4 (14.4-20.1) generations ago, respectively. The c.[150delA] variant that was carried on a haplotype spanning about 0.3 Mb was estimated to appear 43.7 (38.4-52.7) generations ago. We present strong evidence that the most frequent variants in the PROP1 gene are not a consequence of variant hot spots as previously assumed, but are founder variants.
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Colclough K, Saint-Martin C, Timsit J, Ellard S, Bellanné-Chantelot C. Clinical utility gene card for: Maturity-onset diabetes of the young. Eur J Hum Genet 2014; 22:ejhg201414. [PMID: 24518839 DOI: 10.1038/ejhg.2014.14] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Affiliation(s)
- Kevin Colclough
- Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK
| | - Cécile Saint-Martin
- Department of Genetics, AP-HP Hôpitaux Universitaires Pitie-Salpétrière-Charles Foix, Université Pierre et Marie Curie, Paris, France
| | - José Timsit
- Department of Diabetology and Endocrinology, AP-HP Groupe Hospitalier Cochin-Hôtel Dieu, Université Paris Descartes, Paris, France
| | - Sian Ellard
- 1] Department of Molecular Genetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK [2] Institute of Biomedical and Clinical Science, University of Exeter Medical School, Exeter, UK
| | - Christine Bellanné-Chantelot
- Department of Genetics, AP-HP Hôpitaux Universitaires Pitie-Salpétrière-Charles Foix, Université Pierre et Marie Curie, Paris, France
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