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Khabou B, Hsairi M, Gargouri L, Miled N, Barbu V, Fakhfakh F. Characterization of a novel ABCC2 mutation in infantile Dubin Johnson syndrome. Clin Chim Acta 2021; 518:43-50. [PMID: 33713692 DOI: 10.1016/j.cca.2021.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/06/2021] [Accepted: 03/07/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS The Dubin Johnson Syndrome (DJS) occurs mostly in young adults but an early-onset of the disease has been reported in less common forms (Neonatal DJS and Infantile DJS). In this case, the clinical findings are of limit for the DJS diagnosis. Hence, the genetic testing remains the method of choice to provide an accurate diagnosis. In our study, we aimed to perform a genetic analysis for two siblings presented with an intrahepatic cholestasis before the age of 1 year to provide a molecular explanation for the developed phenotype. PATIENTS & METHODS A Tunisian family, having two siblings, manifesting signs of a hepatopathy, was enrolled in our study. A molecular analysis was performed, using a panel-based next generation sequencing, supplying results that were the subject of computational analysis. Then, a clinical follow-up was carried out to assess the evolution of the disease. RESULTS The genetic analysis revealed the presence of a novel missense c.4179G > T, (p.M1393I) mutation in ABCC2 gene associated with a substitution c.2789G > A (R930Q) in ATP8B1 gene. Predictive results consolidated the pathogenic effect of both variants. These results confirmed the DJS diagnosis in the studied patients. The clinical course of both patients fit well with the benign nature of DJS. CONCLUSION We described here a novel ABCC2 mutation associated with a putative ATP8B1 modifier variant. This finding constituted the first report of a complex genotype in DJS. Hence, genetic analysis by a panel-based next generation sequencing permits an accurate diagnosis and the identification of putative variants that could influence the developed phenotype.
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Affiliation(s)
- Boudour Khabou
- Laboratory of Molecular and Functional Genetics, Faculty of Science, University of Sfax, Tunisia.
| | - Manel Hsairi
- Department of Pediatrics, Pediatric Emergency and Intensive Care, Hedi Chaker Hospital, Faculty of Medicine, Sfax, Tunisia
| | - Lamia Gargouri
- Department of Pediatrics, Pediatric Emergency and Intensive Care, Hedi Chaker Hospital, Faculty of Medicine, Sfax, Tunisia
| | - Nabil Miled
- University of Jeddah, College of Science, Department of Biological Sciences, Saudi Arabia; University of Sfax, Higher Institute of Biotechnology, Unit of Plant Physiology and Functional Genomics, Sfax, Tunisia
| | - Véronique Barbu
- LCBGM, Medical Biology and Pathology Department, APHP, HUEP, St Antoine Hospital, & Sorbonne University, 75012 Paris, France
| | - Faiza Fakhfakh
- Laboratory of Molecular and Functional Genetics, Faculty of Science, University of Sfax, Tunisia.
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2
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Wu H, Zhao XK, Zhu JJ. Clinical characteristics and ABCC2 genotype in Dubin-Johnson syndrome: A case report and review of the literature. World J Clin Cases 2021; 9:878-885. [PMID: 33585635 PMCID: PMC7852649 DOI: 10.12998/wjcc.v9.i4.878] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/20/2020] [Accepted: 12/06/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Dubin-Johnson syndrome (DJS) is a benign autosomal recessive liver disease involving mutations of the ABCC2 gene. It is characterized by chronic or intermittent conjugated hyperbilirubinemia, with chronic idiopathic jaundice as the main clinical manifestation. Genetic alterations of the ABCC2 gene are commonly used for diagnosing DJS; however, the causative ABCC2 point mutation in Chinese patients remains unknown. Research on ABCC2 mutations in Chinese DJS patients is extremely rare, and the diagnosis of DJS remains limited. The routine analysis of ABCC2 mutations is helpful for the diagnosis of DJS. Here, we report the clinical characteristics and ABCC2 genotype of an adult female DJS patient. This article is to expound the discovery of more potentially pathogenic ABCC2 variants will that contribute to DJS identification.
CASE SUMMARY This study investigated a woman referred for DJS and involved clinical and genetic analyses. ABCC2 mutations were identified by next-generation sequencing (NGS). The patient showed intermittent jaundice and conjugated hyper-bilirubinemia. Histopathological examinations were consistent with the typical phenotype of DJS. Genetic diagnostic analysis revealed an ABCC2 genotype exhibiting a pathogenic variant, namely c.2443C>T (p.Arg815*), which has not been reported previously in the domestic or foreign literature.
CONCLUSION Pathogenic ABCC2 mutations play an important role in the diagnosis of DJS, especially in patients with atypical presentations. Currently, NGS is used in the routine analysis of DJS cases and such tests of further cases will better illuminate the relationship between various genotypes and phenotypes of DJS.
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Affiliation(s)
- Huan Wu
- Department of Infectious Diseases, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Xue-Ke Zhao
- Department of Infectious Diseases, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
| | - Juan-Juan Zhu
- Department of Infectious Diseases, The Affiliated Hospital of Guizhou Medical University, Guiyang 550001, Guizhou Province, China
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3
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Wu L, Li Y, Song Y, Zhou D, Jia S, Xu A, Zhang W, You H, Jia J, Huang J, Ou X. A recurrent ABCC2 p.G693R mutation resulting in loss of function of MRP2 and hyperbilirubinemia in Dubin-Johnson syndrome in China. Orphanet J Rare Dis 2020; 15:74. [PMID: 32183854 PMCID: PMC7079413 DOI: 10.1186/s13023-020-1346-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 03/02/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Dubin-Johnson syndrome (DJS) is a rare autosomal recessive disorder characterized by predominantly conjugated hyperbilirubinemia that is caused by pathogenic mutations in the adenosine triphosphate-binding cassette subfamily C member 2 (ABCC2) gene, which encodes multidrug resistance-associated protein 2 (MRP2). However, little is known about the causative mutation of DJS in China. Recently, we have reported ABCC2 p.G693R mutation in two unrelated cases. In the present study, we investigated the pathogenicity of the ABCC2 p.G693R mutation in DJS in China. METHODS Clinical and genetic analysis was conducted for the two patients with the ABCC2 p.G693R mutation. Whole exome sequencing for mutations in other known hyperbilirubinemia-related genes was conducted for the cases with ABCC2 p.G693R. Expression and cellular localization of the mutant MRP2 p.G693R were analyzed by Western blotting and immunofluorescence assay, respectively. Organic anion transport activity was evaluated by the analysis of glutathione-conjugated-monochlorobimane. RESULTS The two DJS patients with ABCC2 p.G693R mutation, which was conserved among different species, showed typical hyperbilirubinemia phenotype. No pathogenic mutation was identified in the other known hyperbilirubinemia related genes. Functional studies in three cell lines showed that the expression, localization and the organic anion transport activity were significantly compromised by MRP2 p.G693R mutation compared with wild-type MRP2. CONCLUSIONS The recurrent ABCC2 p.G693R mutation is associated with loss of function of the MRP2 protein and may result in hyperbilirubinemia in DJS in China.
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Affiliation(s)
- Lina Wu
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China
| | - Yanmeng Li
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China
| | - Yi Song
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China
| | - Donghu Zhou
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China
| | - Siyu Jia
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China
| | - Anjian Xu
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China
| | - Wei Zhang
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China
| | - Hong You
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China
| | - Jidong Jia
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China.
| | - Jian Huang
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China.
| | - Xiaojuan Ou
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, 95 Yong-An Road, Beijing, 100050, China.
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Corpechot C, Barbu V, Chazouillères O, Broué P, Girard M, Roquelaure B, Chrétien Y, Dong C, Lascols O, Housset C, Jéru I. Genetic contribution of ABCC2 to Dubin-Johnson syndrome and inherited cholestatic disorders. Liver Int 2020; 40:163-174. [PMID: 31544333 DOI: 10.1111/liv.14260] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/27/2019] [Accepted: 09/10/2019] [Indexed: 01/18/2023]
Abstract
BACKGROUND AND AIMS The ABCC2 gene is implicated in Dubin-Johnson syndrome (DJS), a rare autosomal recessive liver disorder. The primary aim of this study was to determine the diagnostic value of ABCC2 genetic testing in the largest cohort of DJS reported to date. The high number of patients with cholestatic manifestations in this series prompted us to evaluate the genetic contribution of rare, potentially pathogenic ABCC2 variants to other inherited cholestatic disorders. METHODS The cohort study included 32 patients with clinical DJS diagnosis, and 372 patients referred for the following disorders: low phospholipid-associated cholelithiasis (LPAC) syndrome, intrahepatic cholestasis of pregnancy (ICP) and benign recurrent intrahepatic cholestasis (BRIC). ABCC2 was screened by next-generation sequencing. RESULTS Most patients with clinical DJS had positive genetic diagnosis (n = 30; 94%), with a great diversity of point mutations and copy number variations in ABCC2. Strikingly, eight (27%) of these patients showed transient cholestatic features at presentation: four neonatal cholestasis, two ICP, one contraceptive-induced cholestasis and one sporadic cholestasis. Conversely, the frequency of rare, heterozygous, potentially pathogenic ABCC2 variants in patients with LPAC, ICP or BRIC did not differ significantly from that of the general population. CONCLUSIONS This large series reveals that DJS is a highly homogeneous Mendelian disorder involving a large spectrum of ABCC2 variants. Genetic testing is crucial to establish early DJS diagnosis in patients with atypical presentations, such as neonatal cholestasis. This study also provides no evidence for the contribution of rare, potentially pathogenic ABCC2 variants to other inherited cholestatic disorders.
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Affiliation(s)
- Christophe Corpechot
- Centre de Référence des Maladies Inflammatoires des Voies Biliaires et des Hépatites Auto-Immunes (MIVB-H), Filière de Santé des Maladies Rares du Foie de l'enfant et de l'adulte (FILFOIE), Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.,INSERM, Centre de Recherche Saint-Antoine (CRSA), Institut Hospitalo-Universitaire de Cardio-métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, France
| | - Véronique Barbu
- INSERM, Centre de Recherche Saint-Antoine (CRSA), Institut Hospitalo-Universitaire de Cardio-métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, France.,Laboratoire Commun de Biologie et Génétique Moléculaires, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Olivier Chazouillères
- Centre de Référence des Maladies Inflammatoires des Voies Biliaires et des Hépatites Auto-Immunes (MIVB-H), Filière de Santé des Maladies Rares du Foie de l'enfant et de l'adulte (FILFOIE), Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.,INSERM, Centre de Recherche Saint-Antoine (CRSA), Institut Hospitalo-Universitaire de Cardio-métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, France
| | - Pierre Broué
- Centres de compétences maladies rares du foie de l'enfant et Centre de référence constitutif maladies héréditaires du métabolisme, Hépatologie Pédiatrique et Maladies Héréditaires du Métabolisme, Hôpitaux de Toulouse, Hôpital des Enfants, Toulouse, France
| | - Muriel Girard
- Service d'Hépato-Gastroentérologie et Nutrition Pédiatrique, Assistance Publique-Hôpitaux de Paris, Hôpital Necker Enfants-Malades, Paris, France.,INSERM U1151, Institut Necker Enfants-Malades, Université Paris Descartes, Paris, France
| | - Bertrand Roquelaure
- Service d'Hépato-Gastroentérologie et Nutrition Pédiatrique, Assistance Publique-Hôpitaux de Marseille, Hôpital de la Timone Enfants, Marseille, France
| | - Yves Chrétien
- Centre de Référence des Maladies Inflammatoires des Voies Biliaires et des Hépatites Auto-Immunes (MIVB-H), Filière de Santé des Maladies Rares du Foie de l'enfant et de l'adulte (FILFOIE), Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Catherine Dong
- Centre de Référence des Maladies Inflammatoires des Voies Biliaires et des Hépatites Auto-Immunes (MIVB-H), Filière de Santé des Maladies Rares du Foie de l'enfant et de l'adulte (FILFOIE), Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Olivier Lascols
- INSERM, Centre de Recherche Saint-Antoine (CRSA), Institut Hospitalo-Universitaire de Cardio-métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, France.,Laboratoire Commun de Biologie et Génétique Moléculaires, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
| | - Chantal Housset
- Centre de Référence des Maladies Inflammatoires des Voies Biliaires et des Hépatites Auto-Immunes (MIVB-H), Filière de Santé des Maladies Rares du Foie de l'enfant et de l'adulte (FILFOIE), Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France.,INSERM, Centre de Recherche Saint-Antoine (CRSA), Institut Hospitalo-Universitaire de Cardio-métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, France
| | - Isabelle Jéru
- INSERM, Centre de Recherche Saint-Antoine (CRSA), Institut Hospitalo-Universitaire de Cardio-métabolisme et Nutrition (ICAN), Sorbonne Université, Paris, France.,Laboratoire Commun de Biologie et Génétique Moléculaires, Assistance Publique-Hôpitaux de Paris, Hôpital Saint-Antoine, Paris, France
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5
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Li Y, Li Y, Yang Y, Yang WR, Li JP, Peng GX, Song L, Fan HH, Ye L, Xiong YZ, Wu ZJ, Zhou K, Zhao X, Jing LP, Zhang FK, Zhang L. Next generation sequencing reveals co-existence of hereditary spherocytosis and Dubin–Johnson syndrome in a Chinese gril: A case report. World J Clin Cases 2019; 7:3303-3309. [PMID: 31667183 PMCID: PMC6819282 DOI: 10.12998/wjcc.v7.i20.3303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 08/21/2019] [Accepted: 09/09/2019] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Hereditary spherocytosis (HS) is a hereditary disease of hemolytic anemia that occurs due to the erythrocyte membrane defects. Dubin–Johnson syndrome (DJS), which commonly results in jaundice, is a benign hereditary disorder of bilirubin clearance that occurs only rarely. The co-occurrence of HS and DJS is extremely rare. We recently diagnosed and treated a case of co-occurring HS and DJS.
CASE SUMMARY A 21-year-old female patient presented to our department because of severe jaundice, severe splenomegaly, and mild anemia since birth. We eventually confirmed the diagnosis of co-occurring DJS and HS by next generation sequencing (NGS). The treatment of ursodeoxycholic acid in combination with phenobarbital successfully increased hemoglobin and reduced total bilirubin and direct bilirubin.
CONCLUSION The routine application of NGS can efficiently render a definite diagnosis when inherited disorders are suspected.
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Affiliation(s)
- Yuan Li
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Yang Li
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Yang Yang
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Wen-Rui Yang
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Jian-Ping Li
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Guang-Xin Peng
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Lin Song
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Hui-Hui Fan
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Lei Ye
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - You-Zhen Xiong
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Zhi-Jie Wu
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Kang Zhou
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Xin Zhao
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Li-Ping Jing
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Feng-Kui Zhang
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
| | - Li Zhang
- Anemia Therapeutic Center, Institute of Hematology and Blood Diseases Hospital, CAMS and PUMC, Tianjin 300020, China
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Wu L, Zhang W, Jia S, Zhao X, Zhou D, Xu A, Duan W, Wu Z, Li H, Zheng S, Nan Y, Jia J, Huang J, Ou X. Mutation analysis of the ABCC2 gene in Chinese patients with Dubin-Johnson syndrome. Exp Ther Med 2018; 16:4201-4206. [PMID: 30344695 DOI: 10.3892/etm.2018.6682] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2018] [Accepted: 07/13/2018] [Indexed: 12/17/2022] Open
Abstract
Dubin-Johnson syndrome (DJS) is a rare, autosomal recessive disorder characterized by predominantly conjugated hyperbilirubinemia, caused by a mutation in the adenosine triphosphate-binding cassette subfamily C member 2 (ABCC2) gene coding the multidrug resistance-associated protein 2 (MRP2) protein. ABCC2 mutations have been identified in patients with DJS worldwide; however, the mutation pattern of ABCC2 in China is not well studied. In the present study, the mutation pattern of the ABCC2 gene in Chinese patients with DJS was investigated. A total of 7 clinically confirmed patients with DJS were enrolled, and mutation analysis of the ABCC2 gene was performed by Sanger sequencing of genomic DNA extracted from whole blood. All 32 exons and the adjacent splice junction areas were sequenced. All cases were identified to harbor at least one non-synonymous variant in the ABCC2 gene, including three known mutations in 3 cases and three novel variants (p.G693R, p.G808V and p.E647X) in the other 4 cases, with the known p.R393W and the novel p.G693R and p.E647X variants identified in 2 of the 7 cases (28.6%), respectively. All the identified mutations were heterozygous, and 1 case presented with a compound heterozygous mutation, namely p.G693R/p.G808V, while the other cases carried only one single mutation. The loss of membrane expression of MRP2 caused by the novel nonsense variant, p.E647X, was confirmed by immunohistochemical analysis of liver biopsy. The present study provided the first report on the mutation patterns of the ABCC2 gene in Chinese patients with DJS, and the clinical association of these mutations with the syndrome.
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Affiliation(s)
- Lina Wu
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Wei Zhang
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Siyu Jia
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Xinyan Zhao
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Donghu Zhou
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Anjian Xu
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Weijia Duan
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Zhen Wu
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Hai Li
- Department of Hepatopancreatobiliary and Splenic Medicine, The Affiliated Hospital of Medical College of Chinese People's Armed Police Force, Tianjin 300192, P.R. China
| | - Sujun Zheng
- Artificial Liver Center, Beijing Youan Hospital, Capital Medical University, Beijing 100069, P.R. China
| | - Yuemin Nan
- Department of Traditional and Western Medical Hepatology, Third Hospital of Hebei Medical University, Shijiazhuang, Hebei 050051, P.R. China
| | - Jidong Jia
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Jian Huang
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
| | - Xiaojuan Ou
- Liver Research Center, Experimental Center, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, P.R. China
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7
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Togawa T, Mizuochi T, Sugiura T, Kusano H, Tanikawa K, Sasaki T, Ichinose F, Kagimoto S, Tainaka T, Uchida H, Saitoh S. Clinical, Pathologic, and Genetic Features of Neonatal Dubin-Johnson Syndrome: A Multicenter Study in Japan. J Pediatr 2018; 196:161-167.e1. [PMID: 29499989 DOI: 10.1016/j.jpeds.2017.12.058] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/09/2017] [Accepted: 12/19/2017] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To clarify the clinical, pathologic, and genetic features of neonatal Dubin-Johnson syndrome. STUDY DESIGN Ten patients with neonatal Dubin-Johnson syndrome were recruited from 6 pediatric centers in Japan between September 2013 and October 2016. Clinical and laboratory course, macroscopic and microscopic liver findings, and molecular genetic findings concerning ATP-binding cassette subfamily C member 2 (ABCC2) were retrospectively and prospectively examined. RESULTS All neonates exhibited cholestasis, evident as prolonged jaundice with or without acholic stools and elevations of serum direct bilirubin as well as γ-glutamyltransferase or total bile acids. Only 38% (3 of 8) of patients who underwent liver biopsy showed a grossly black liver or melanin-like pigment deposits in hepatocytes; their biopsies were performed in early infancy. Immunohistochemically, all liver specimens showed no expression of multidrug resistance-associated protein 2 but increased expression of the bile salt export pump protein. Homozygous or compound heterozygous pathogenic variants of ABCC2 were identified in all patients, representing 11 distinct pathogenic variants including 2 not previously reported. CONCLUSIONS Immunohistochemical staining of the liver for multidrug resistance-associated protein 2 and molecular genetic analysis of ABCC2 are crucial for accurate diagnosis of neonatal Dubin-Johnson syndrome.
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Affiliation(s)
- Takao Togawa
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Tatsuki Mizuochi
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Japan.
| | - Tokio Sugiura
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Hironori Kusano
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Ken Tanikawa
- Department of Pathology, Kurume University School of Medicine, Kurume, Japan
| | - Takato Sasaki
- Department of Pediatric Surgery, Ibaraki Children's Hospital, Ibaraki, Japan
| | - Fumio Ichinose
- Department of Pediatrics, Saga Medical Center Koseikan, Saga, Japan
| | - Seiichi Kagimoto
- Division of General Pediatrics, Saitama Children's Medical Center, Saitama, Japan
| | - Takahisa Tainaka
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroo Uchida
- Department of Pediatric Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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8
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Xiang R, Li JJ, Fan LL, Jin JY, Xia K, Wang F. Identification of a compound heterozygous mutation of ABCC2 in a patient with hyperbilirubinemia. Mol Med Rep 2017; 16:2830-2834. [PMID: 28713894 DOI: 10.3892/mmr.2017.6926] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 04/19/2017] [Indexed: 11/06/2022] Open
Abstract
Bilirubin is the end product of heme catabolism, which is produced primarily from the breakdown of erythrocyte hemoglobin in the reticuloendothelial system. Hyperbilirubinemia is induced not only by increased bilirubin synthesis, but can also be caused by decreased bilirubin clearance. There are several disorders, which can contribute to hyperbilirubinemia, including Dubin‑Johnson syndrome (DJS). DJS is a rare autosomal recessive disorder, which is characterized by predominantly conjugated hyperbilirubinemia without progression to end‑stage liver disease. Previous studies have demonstrated that defects in multidrug resistance proteins ATP‑binding cassette C2 (ABCC2)/multidrug resistance‑associated protein 2 (MRP2) contribute to DJS. In the present study, a case of a patient with hyperbilirubinemia was examined and identified a compound heterozygous mutation in the ABCC2 gene (p.T435P and W442X). These were predicted to be deleterious by three bioinformatics programs (Polymorphism Phenotyping‑2, Sorting Intolerant From Tolerant and MutationTaster). These finding expand on the spectrum of ABCC2 mutations and provide additional evidence that ABCC2 is key in the development of DJS.
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Affiliation(s)
- Rong Xiang
- Department of Endocrinology, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
| | - Jing-Jing Li
- Department of Cellular Biology, School of Life Sciences, Central South University and State Key Laboratory of Medical Genetics, Changsha, Hunan 410013, P.R. China
| | - Liang-Liang Fan
- Department of Cellular Biology, School of Life Sciences, Central South University and State Key Laboratory of Medical Genetics, Changsha, Hunan 410013, P.R. China
| | - Jie-Yuan Jin
- Department of Cellular Biology, School of Life Sciences, Central South University and State Key Laboratory of Medical Genetics, Changsha, Hunan 410013, P.R. China
| | - Kun Xia
- Department of Cellular Biology, School of Life Sciences, Central South University and State Key Laboratory of Medical Genetics, Changsha, Hunan 410013, P.R. China
| | - Fang Wang
- Department of Endocrinology, The Third Xiangya Hospital of Central South University, Changsha, Hunan 410013, P.R. China
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Rudashevskaya EL, Stockner T, Trauner M, Freissmuth M, Chiba P. Pharmacological correction of misfolding of ABC proteins. DRUG DISCOVERY TODAY. TECHNOLOGIES 2015; 12:e87-94. [PMID: 25027379 PMCID: PMC4039138 DOI: 10.1016/j.ddtec.2014.03.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
The endoplasmic reticulum (ER) quality control system distinguishes between correctly and incorrectly folded proteins to prevent processing of aberrantly folded conformations along the secretory pathway. Non-synonymous mutations can lead to misfolding of ABC proteins and associated disease phenotypes. Specific phenotypes may at least partially be corrected by small molecules, so-called pharmacological chaperones. Screening for folding correctors is expected to open an avenue for treatment of diseases such as cystic fibrosis and intrahepatic cholestasis.
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Affiliation(s)
- Elena L Rudashevskaya
- Institute of Medical Chemistry, Medical University of Vienna, Waehringerstrasse 10, Vienna, Austria
| | - Thomas Stockner
- Institute of Pharmacology, Medical University of Vienna, Waehringerstrasse 13, Vienna, Austria
| | - Michael Trauner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18-20, Austria
| | - Michael Freissmuth
- Institute of Pharmacology, Medical University of Vienna, Waehringerstrasse 13, Vienna, Austria
| | - Peter Chiba
- Institute of Medical Chemistry, Medical University of Vienna, Waehringerstrasse 10, Vienna, Austria
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Okada H, Kusaka T, Fuke N, Kunikata J, Kondo S, Iwase T, Nan W, Hirota T, Ieiri I, Itoh S. Neonatal Dubin-Johnson syndrome: novel compound heterozygous mutation in the ABCC2 gene. Pediatr Int 2014; 56:e62-4. [PMID: 25336012 DOI: 10.1111/ped.12404] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Revised: 04/21/2014] [Accepted: 05/01/2014] [Indexed: 12/20/2022]
Abstract
Dubin-Johnson syndrome (DJS) is an autosomal recessive inherited disorder characterized by conjugated hyperbilirubinemia. Neonatal-onset DJS is rare. It is caused by dysfunction of adenosine triphosphate-binding cassette, sub-family C, member 2 (ABCC2). We found a novel compound heterozygous mutation of DJS-related gene: W709R (T2145C): a missense mutation in exon 17, and R768W (C2302T), a missense mutation in exon 18. Serum diglucuronosyl bilirubin/monoglucuronosyl bilirubin ratio was high. ABCC2 may excrete diglucuronosyl bilirubin preferentially over monoglucuronosyl bilirubin.
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Affiliation(s)
- Hitoshi Okada
- Department of Pediatrics, Faculty of Medicine, Kagawa University, Kagawa, Japan
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