1
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Musri MM, Venturi V, Ferrer-Cortès X, Romero-Cortadellas L, Hernández G, Leoz P, Ricard Andrés MP, Morado M, Fernández Valle MDC, Beneitez Pastor D, Ortuño Cabrero A, Moreno Gamiz M, Senent Peris L, Perez-Valencia AI, Pérez-Montero S, Tornador C, Sánchez M. New Cases and Mutations in SEC23B Gene Causing Congenital Dyserythropoietic Anemia Type II. Int J Mol Sci 2023; 24:9935. [PMID: 37373084 DOI: 10.3390/ijms24129935] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 05/29/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
Congenital dyserythropoietic anemia type II (CDA II) is an inherited autosomal recessive blood disorder which belongs to the wide group of ineffective erythropoiesis conditions. It is characterized by mild to severe normocytic anemia, jaundice, and splenomegaly owing to the hemolytic component. This often leads to liver iron overload and gallstones. CDA II is caused by biallelic mutations in the SEC23B gene. In this study, we report 9 new CDA II cases and identify 16 pathogenic variants, 6 of which are novel. The newly reported variants in SEC23B include three missenses (p.Thr445Arg, p.Tyr579Cys, and p.Arg701His), one frameshift (p.Asp693GlyfsTer2), and two splicing variants (c.1512-2A>G, and the complex intronic variant c.1512-3delinsTT linked to c.1512-16_1512-7delACTCTGGAAT in the same allele). Computational analyses of the missense variants indicated a loss of key residue interactions within the beta sheet and the helical and gelsolin domains, respectively. Analysis of SEC23B protein levels done in patient-derived lymphoblastoid cell lines (LCLs) showed a significant decrease in SEC23B protein expression, in the absence of SEC23A compensation. Reduced SEC23B mRNA expression was only detected in two probands carrying nonsense and frameshift variants; the remaining patients showed either higher gene expression levels or no expression changes at all. The skipping of exons 13 and 14 in the newly reported complex variant c.1512-3delinsTT/c.1512-16_1512-7delACTCTGGAAT results in a shorter protein isoform, as assessed by RT-PCR followed by Sanger sequencing. In this work, we summarize a comprehensive spectrum of SEC23B variants, describe nine new CDA II cases accounting for six previously unreported variants, and discuss innovative therapeutic approaches for CDA II.
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Affiliation(s)
- Melina Mara Musri
- BloodGenetics S.L. Diagnostics in Inherited Blood Diseases, 08950 Esplugues de Llobregat, Spain
| | - Veronica Venturi
- Department of Basic Sciences, Iron Metabolism: Regulation and Diseases Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Xènia Ferrer-Cortès
- BloodGenetics S.L. Diagnostics in Inherited Blood Diseases, 08950 Esplugues de Llobregat, Spain
- Department of Basic Sciences, Iron Metabolism: Regulation and Diseases Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Lídia Romero-Cortadellas
- Department of Basic Sciences, Iron Metabolism: Regulation and Diseases Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Gonzalo Hernández
- BloodGenetics S.L. Diagnostics in Inherited Blood Diseases, 08950 Esplugues de Llobregat, Spain
- Department of Basic Sciences, Iron Metabolism: Regulation and Diseases Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
| | - Pilar Leoz
- Red Blood Cell Disorders Unit, Department of Hematology, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain
| | - María Pilar Ricard Andrés
- Hematology and Hemotherapy, Hospital Universitario Fundación Alcorcón, Avda Budapest, 28922 Alcorcon, Spain
| | - Marta Morado
- Department of Hematology, University Hospital La Paz, 28046 Madrid, Spain
| | | | - David Beneitez Pastor
- Red Blood Cell Disorders Unit, Hematology Department, Hospital Universitari Vall d'Hebron, VHIO, VHIR, 08035 Barcelona, Spain
| | - Ana Ortuño Cabrero
- Red Blood Cell Disorders Unit, Hematology Department, Hospital Universitari Vall d'Hebron, VHIO, VHIR, 08035 Barcelona, Spain
| | | | - Leonor Senent Peris
- Laboratory of Cytomorphology, Unity of Hematologic Diagnostic, Hospital Universitari i Politècnic La Fe, 46026 Valencia, Spain
| | | | - Santiago Pérez-Montero
- BloodGenetics S.L. Diagnostics in Inherited Blood Diseases, 08950 Esplugues de Llobregat, Spain
| | - Cristian Tornador
- BloodGenetics S.L. Diagnostics in Inherited Blood Diseases, 08950 Esplugues de Llobregat, Spain
| | - Mayka Sánchez
- BloodGenetics S.L. Diagnostics in Inherited Blood Diseases, 08950 Esplugues de Llobregat, Spain
- Department of Basic Sciences, Iron Metabolism: Regulation and Diseases Group, Universitat Internacional de Catalunya, 08195 Sant Cugat del Vallès, Spain
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2
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King R, Gallagher PJ, Khoriaty R. The congenital dyserythropoieitic anemias: genetics and pathophysiology. Curr Opin Hematol 2022; 29:126-136. [PMID: 35441598 PMCID: PMC9021540 DOI: 10.1097/moh.0000000000000697] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE OF REVIEW The congenital dyserythropoietic anemias (CDA) are hereditary disorders characterized by ineffective erythropoiesis. This review evaluates newly developed CDA disease models, the latest advances in understanding the pathogenesis of the CDAs, and recently identified CDA genes. RECENT FINDINGS Mice exhibiting features of CDAI were recently generated, demonstrating that Codanin-1 (encoded by Cdan1) is essential for primitive erythropoiesis. Additionally, Codanin-1 was found to physically interact with CDIN1, suggesting that mutations in CDAN1 and CDIN1 result in CDAI via a common mechanism. Recent advances in CDAII (which results from SEC23B mutations) have also been made. SEC23B was found to functionally overlap with its paralogous protein, SEC23A, likely explaining the absence of CDAII in SEC23B-deficient mice. In contrast, mice with erythroid-specific deletion of 3 or 4 of the Sec23 alleles exhibited features of CDAII. Increased SEC23A expression rescued the CDAII erythroid defect, suggesting a novel therapeutic strategy for the disease. Additional recent advances included the identification of new CDA genes, RACGAP1 and VPS4A, in CDAIII and a syndromic CDA type, respectively. SUMMARY Establishing cellular and animal models of CDA is expected to result in improved understanding of the pathogenesis of these disorders, which may ultimately lead to the development of new therapies.
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Affiliation(s)
- Richard King
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
| | - Patrick J. Gallagher
- Department of Molecular, Cellular and Developmental Biology, University of Michigan, Ann Arbor, Michigan, USA
| | - Rami Khoriaty
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
- University of Michigan Rogel Cancer Center, Ann Arbor, Michigan, USA
- Cellular and Molecular Biology Program, University of Michigan, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, University of Michigan, Ann Arbor, Michigan, USA
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3
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Rangarajan HG, Stanek JR, Abdel-Azim H, Modi A, Haight A, McKinney CM, McKeone DJ, Buchbinder DK, Katsanis E, Abusin GA, Ahmed I, Law J, Silva JG, Mallhi KK, Burroughs LM, Shah N, Shaw PJ, Greiner R, Shenoy S, Pulsipher MA, Abu-Arja R. Hematopoietic Cell Transplantation for Congenital Dyserythropoietic Anemia. A Report from the Pediatric Transplant and Cellular Therapy Consortium (PTCTC). Transplant Cell Ther 2022; 28:329.e1-329.e9. [DOI: 10.1016/j.jtct.2022.03.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 03/04/2022] [Accepted: 03/07/2022] [Indexed: 11/25/2022]
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4
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Rosato BE, Marra R, D’Onofrio V, Del Giudice F, Della Monica S, Iolascon A, Andolfo I, Russo R. SEC23B Loss-of-Function Suppresses Hepcidin Expression by Impairing Glycosylation Pathway in Human Hepatic Cells. Int J Mol Sci 2022; 23:ijms23031304. [PMID: 35163229 PMCID: PMC8835815 DOI: 10.3390/ijms23031304] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 01/15/2023] Open
Abstract
Biallelic pathogenic variants in the SEC23B gene cause congenital dyserythropoietic anemia type II (CDA II), a rare hereditary disorder hallmarked by ineffective erythropoiesis, hemolysis, erythroblast morphological abnormalities, and hypo-glycosylation of some red blood cell membrane proteins. Abnormalities in SEC23B, which encodes the homonymous cytoplasmic COPII (coat protein complex II) component, disturb the endoplasmic reticulum to Golgi trafficking and affect different glycosylation pathways. The most harmful complication of CDA II is the severe iron overload. Within our case series (28 CDA II patients), approximately 36% of them exhibit severe iron overload despite mild degree of anemia and slightly increased levels of ERFE (the only erythroid regulator of hepcidin suppression). Thus, we hypothesized a direct role of SEC23B loss-of-function in the pathomechanism of hepatic iron overload. We established a hepatic cell line, HuH7, stably silenced for SEC23B. In silenced cells, we observed significant alterations of the iron status, due to both the alteration in BMP/SMADs pathway effectors and a reduced capability to sense BMP6 stimulus. We demonstrated that the loss-of-function of SEC23B is responsible of the impairment in glycosylation of the membrane proteins involved in the activation of the BMP/SMADs pathway with subsequent hepcidin suppression. Most of these data were confirmed in another hepatic cell line, HepG2, stably silenced for SEC23B. Our findings suggested that the pathogenic mechanism of iron overload in CDA II is associated to both ineffective erythropoiesis and to a specific involvement of SEC23B pathogenic variants at hepatic level. Finally, we demonstrated the ability of SEC23B paralog, i.e., SEC23A, to rescue the hepcidin suppression, highlighting the functional overlap between the two SEC23 paralogs in human hepatic cells.
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Affiliation(s)
- Barbara Eleni Rosato
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (B.E.R.); (R.M.); (V.D.); (S.D.M.); (A.I.)
- CEINGE Biotecnologie Avanzate, 80145 Napoli, Italy;
| | - Roberta Marra
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (B.E.R.); (R.M.); (V.D.); (S.D.M.); (A.I.)
- CEINGE Biotecnologie Avanzate, 80145 Napoli, Italy;
| | - Vanessa D’Onofrio
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (B.E.R.); (R.M.); (V.D.); (S.D.M.); (A.I.)
- CEINGE Biotecnologie Avanzate, 80145 Napoli, Italy;
| | | | - Simone Della Monica
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (B.E.R.); (R.M.); (V.D.); (S.D.M.); (A.I.)
- CEINGE Biotecnologie Avanzate, 80145 Napoli, Italy;
| | - Achille Iolascon
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (B.E.R.); (R.M.); (V.D.); (S.D.M.); (A.I.)
- CEINGE Biotecnologie Avanzate, 80145 Napoli, Italy;
| | - Immacolata Andolfo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (B.E.R.); (R.M.); (V.D.); (S.D.M.); (A.I.)
- CEINGE Biotecnologie Avanzate, 80145 Napoli, Italy;
- Correspondence: (I.A.); (R.R.)
| | - Roberta Russo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università degli Studi di Napoli Federico II, 80131 Napoli, Italy; (B.E.R.); (R.M.); (V.D.); (S.D.M.); (A.I.)
- CEINGE Biotecnologie Avanzate, 80145 Napoli, Italy;
- Correspondence: (I.A.); (R.R.)
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5
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Abstract
Congenital dyserythropoietic anemias (CDAs) are a heterogeneous group of inherited anemias that affect the normal differentiation-proliferation pathways of the erythroid lineage. They belong to the wide group of ineffective erythropoiesis conditions that mainly result in monolinear cytopenia. CDAs are classified into the 3 major types (I, II, III), plus the transcription factor-related CDAs, and the CDA variants, on the basis of the distinctive morphological, clinical, and genetic features. Next-generation sequencing has revolutionized the field of diagnosis of and research into CDAs, with reduced time to diagnosis, and ameliorated differential diagnosis in terms of identification of new causative/modifier genes and polygenic conditions. The main improvements regarding CDAs have been in the study of iron metabolism in CDAII. The erythroblast-derived hormone erythroferrone specifically inhibits hepcidin production, and its role in the mediation of hepatic iron overload has been dissected out. We discuss here the most recent advances in this field regarding the molecular genetics and pathogenic mechanisms of CDAs, through an analysis of the clinical and molecular classifications, and the complications and clinical management of patients. We summarize also the main cellular and animal models developed to date and the possible future therapies.
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De Rosa G, Andolfo I, Marra R, Manna F, Rosato BE, Iolascon A, Russo R. RAP-011 Rescues the Disease Phenotype in a Cellular Model of Congenital Dyserythropoietic Anemia Type II by Inhibiting the SMAD2-3 Pathway. Int J Mol Sci 2020; 21:ijms21155577. [PMID: 32759740 PMCID: PMC7432210 DOI: 10.3390/ijms21155577] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 07/29/2020] [Accepted: 07/30/2020] [Indexed: 01/12/2023] Open
Abstract
Congenital dyserythropoietic anemia type II (CDA II) is a hypo-productive anemia defined by ineffective erythropoiesis through maturation arrest of erythroid precursors. CDA II is an autosomal recessive disorder due to loss-of-function mutations in SEC23B. Currently, management of patients with CDA II is based on transfusions, splenectomy, or hematopoietic stem-cell transplantation. Several studies have highlighted benefits of ACE-011 (sotatercept) treatment of ineffective erythropoiesis, which acts as a ligand trap against growth differentiation factor (GDF)11. Herein, we show that GDF11 levels are increased in CDA II, which suggests sotatercept as a targeted therapy for treatment of these patients. Treatment of stable clones of SEC23B-silenced erythroleukemia K562 cells with the iron-containing porphyrin hemin plus GDF11 increased expression of pSMAD2 and reduced nuclear localization of the transcription factor GATA1, with subsequent reduced gene expression of erythroid differentiation markers. We demonstrate that treatment of these SEC23B-silenced K562 cells with RAP-011, a "murinized" ortholog of sotatercept, rescues the disease phenotype by restoring gene expression of erythroid markers through inhibition of the phosphorylated SMAD2 pathway. Our data also demonstrate the effect of RAP-011 treatment in reducing the expression of erythroferrone in vitro, thus suggesting a possible beneficial role of the use of sotatercept in the management of iron overload in patients with CDA II.
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Affiliation(s)
- Gianluca De Rosa
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy; (G.D.R.); (R.M.); (B.E.R.); (A.I.)
- Ceinge Biotecnologie Avanzate, 80145 Naples, Italy;
| | - Immacolata Andolfo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy; (G.D.R.); (R.M.); (B.E.R.); (A.I.)
- Ceinge Biotecnologie Avanzate, 80145 Naples, Italy;
- Correspondence: (I.A.); (R.R.); Tel.: +39-081-3737736 (I.A.); +39-081-3737736 (R.R.)
| | - Roberta Marra
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy; (G.D.R.); (R.M.); (B.E.R.); (A.I.)
- Ceinge Biotecnologie Avanzate, 80145 Naples, Italy;
| | | | - Barbara Eleni Rosato
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy; (G.D.R.); (R.M.); (B.E.R.); (A.I.)
- Ceinge Biotecnologie Avanzate, 80145 Naples, Italy;
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy; (G.D.R.); (R.M.); (B.E.R.); (A.I.)
- Ceinge Biotecnologie Avanzate, 80145 Naples, Italy;
| | - Roberta Russo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, 80131 Naples, Italy; (G.D.R.); (R.M.); (B.E.R.); (A.I.)
- Ceinge Biotecnologie Avanzate, 80145 Naples, Italy;
- Correspondence: (I.A.); (R.R.); Tel.: +39-081-3737736 (I.A.); +39-081-3737736 (R.R.)
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7
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Hematopoietic Stem Cell Transplantation in Congenital Dyserythropetic Anemia Type II: A Case Report and Review of the Literature. J Pediatr Hematol Oncol 2020; 42:e507-e510. [PMID: 31593005 DOI: 10.1097/mph.0000000000001612] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Currently, there is no guideline for the treatment of patients with congenital dyserythropoietic anemia (CDA) type II. One approach is to follow-up patients with transfusions, on the basis of individually determined target hemoglobin levels, and iron chelation according to the thalassemia guidelines. In some transfusion-dependent CDA II patients, splenectomy reduces the number of transfusions; however, the only known curative option for CDA II patients is hematopoietic stem cell transplantation (HSCT). Only a few published case reports of allogeneic HSCT in CDA II patients are available. Here, we review the literature and add our data of a CDA II patient who developed transfusion dependence and was cured with HSCT.
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8
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Macaraeg M, Proytcheva M, Katsanis E. Transfusion independence after repeated haploidentical hematopoietic cell transplants in a patient with congenital dyserythropoietic anemia type II and hemosiderosis. Pediatr Transplant 2019; 23:e13587. [PMID: 31529567 DOI: 10.1111/petr.13587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 08/12/2019] [Accepted: 08/22/2019] [Indexed: 11/30/2022]
Abstract
Matched related or unrelated donor allogeneic HCT has occasionally been applied in patients with severe CDA type II and proven to be curative. We report on the first patient with CDA to undergo haploidentical bone marrow transplantation with PT-CY. A 12-year-old boy with severe hemosiderosis, and a, consequently, disturbed BM microenvironment, developed recurrent graft failures and required salvage with two additional haploidentical HCTs. He achieved complete donor chimerism and transfusion independence after the third HCT. Our case underscores the risks associated with performing haploidentical HCT in older pediatric patients with CDA and severe chronic iron overload.
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Affiliation(s)
- Marci Macaraeg
- Department of Pediatrics, University of Arizona, Tucson, Arizona.,Banner University Medical Center, Tucson, Arizona
| | - Maria Proytcheva
- Banner University Medical Center, Tucson, Arizona.,Department of Pathology, University of Arizona, Tucson, Arizona
| | - Emmanuel Katsanis
- Department of Pediatrics, University of Arizona, Tucson, Arizona.,Banner University Medical Center, Tucson, Arizona.,Department of Pathology, University of Arizona, Tucson, Arizona.,Department of Medicine, University of Arizona, Tucson, Arizona.,Department of Immunobiology, University of Arizona, Tucson, Arizona
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9
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Tornador C, Sánchez-Prados E, Cadenas B, Russo R, Venturi V, Andolfo I, Hernández-Rodriguez I, Iolascon A, Sánchez M. CoDysAn: A Telemedicine Tool to Improve Awareness and Diagnosis for Patients With Congenital Dyserythropoietic Anemia. Front Physiol 2019; 10:1063. [PMID: 31572203 PMCID: PMC6753183 DOI: 10.3389/fphys.2019.01063] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/02/2019] [Indexed: 01/09/2023] Open
Abstract
Congenital Dyserythropoietic Anemia (CDA) is a heterogeneous group of hematological disorders characterized by chronic hyporegenerative anemia and distinct morphological abnormalities of erythroid precursors in the bone marrow. In many cases, a final diagnosis is not achieved due to different levels of awareness for the diagnosis of CDAs and lack of use of advanced diagnostic procedures. Researchers have identified five major types of CDA: types I, II, III, IV, and X-linked dyserythropoietic anemia and thrombocytopenia (XLDAT). Proper management in CDA is still unsatisfactory, as the different subtypes of CDA have different genetic causes and different but overlapping patterns of signs and symptoms. For this reason, we developed a new telemedicine tool that will help doctors to achieve a faster diagnostic for this disease. Using open access code, we have created a responsive webpage named CoDysAn (Congenital Dyserythropoietic Anemia) that includes practical information for CDA awareness and a step-by-step diagnostic tool based on a CDA algorithm. The site is currently available in four languages (Catalan, Spanish, Italian, and English). This telemedicine webpage is available at http://www.codysan.eu.
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Affiliation(s)
- Cristian Tornador
- BloodGenetics S.L., Barcelona, Spain.,Teresa Moreto Foundation, Barcelona, Spain
| | - Edgar Sánchez-Prados
- Bioinformatics for Health Sciences Master Programme, Universitat Pompeu Fabra, Barcelona, Spain
| | - Beatriz Cadenas
- Whole Genix SL., Barcelona, Spain.,Universitat de Vic-Universitat Central de Catalunya, Vic, Spain.,Iron Metabolism: Regulation and Diseases Group, Josep Carreras Leukaemia Research Institute, Campus Can Ruti, Barcelona, Spain
| | - Roberta Russo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Veronica Venturi
- Iron Metabolism: Regulation and Diseases Group, Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Immacolata Andolfo
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Ines Hernández-Rodriguez
- Haematology Service, Hospital Germans Trias i Pujol University Hospital, Oncology Catalan Institute, Barcelona, Spain
| | - Achille Iolascon
- Department of Molecular Medicine and Medical Biotechnologies, University of Naples Federico II, Naples, Italy.,CEINGE-Biotecnologie Avanzate, Naples, Italy
| | - Mayka Sánchez
- BloodGenetics S.L., Barcelona, Spain.,Iron Metabolism: Regulation and Diseases Group, Department of Basic Sciences, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
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10
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Chang LX, Zhu XF, Wang YW, Dong SX, Zhao SX, Ru YX. [New mutation site of SEC23B gene in type Ⅱ congenital erythrocythememia anemia: one case report and literatures review]. ZHONGHUA XUE YE XUE ZA ZHI = ZHONGHUA XUEYEXUE ZAZHI 2019; 40:317-320. [PMID: 31104444 PMCID: PMC7343017 DOI: 10.3760/cma.j.issn.0253-2727.2019.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Indexed: 11/05/2022]
Abstract
Objective: To enrich the gene mutation sites and accumulate treatment experience of congenital dyserythropoietic anemia (CDA) type Ⅱ by reporting one case of CDA patient with new mutation site of SEC23B and was successfully treated by homozygous allogeneic hematopoietic stem cell transplantation (allo-HSCT) . Methods: The mutation within SEC23B gene in a child case with the reduced hemoglobin for more than 3 months, and his family were analyzed in combination with literatures review. Results: A 3-day 5-month female child was admitted due to "decreasing hemoglobin for more than 3 months" , blood routine test showed HGB 44 g/L, positive for acid hemolysis test (Ham test) . Bone marrow showed that the proportion of erythroid line was 69%, mainly middle and late juvenile erythrocytes, binuclear and odd nucleated erythrocytes could be observed, and nuclear fragmentation and nuclear budding could be seen occasionally in nucleated erythrocytes, transmission electron microscopy disclosed that bone marrow harbored the typical double-layer membrane structure of nuclear erythrocytes. There were two unreported new mutation sites in the SEC23B gene, including 1504 G>C/wt and c. 2254-2255 insert A/wt. The two mutations were derived from the father and mother of the child respectively. At the late stage, the child was successfully treated with allo-HSCT, the original mutation turned negative. Conclusion: This study reported the mutation type of SEC23B gene insertion for the first time in China. Allo-HSCT could be utilized as a treatment for CDA.
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Affiliation(s)
- L X Chang
- Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin 300020, China
| | - X F Zhu
- Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin 300020, China
| | - Y W Wang
- State Key Laboratory of Biological Macromolecules, Institute of Biophysics, Chinese Academy of Sciences, Beijing 100101, China
| | - S X Dong
- Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin 300020, China
| | - S X Zhao
- Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin 300020, China
| | - Y X Ru
- Institute of Hematology, Chinese Academy of Medical Sciences, Tianjin 300020, China
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11
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Miano M, Eikema DJ, Aljurf M, Van't Veer PJ, Öztürk G, Wölfl M, Smiers F, Schulz A, Socié G, Vettenranta K, de Heredia CD, Zecca M, Maertens J, Rovira M, Sierra J, Uckan-Cetinkaya D, Skorobogatova E, Antmen AB, Dalle JH, Markiewicz M, Hamladji RM, Kitra-Roussou V, La Nasa G, Kriván G, Al-Seiraihy A, Giardino S, Risitano AM, de Latour RP, Dufour C. Stem cell transplantation for congenital dyserythropoietic anemia: an analysis from the European Society for Blood and Marrow Transplantation. Haematologica 2019; 104:e335-e339. [PMID: 30679331 DOI: 10.3324/haematol.2018.206623] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Maurizio Miano
- Hematology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | - Mahmoud Aljurf
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | | | - Gülyüz Öztürk
- Acibadem University Atakent Hospital, Istanbul, Turkey
| | - Matthias Wölfl
- University Children's Hospital, Würzburg, Würzburg, Germany
| | - Frans Smiers
- Leiden University Hospital, Leiden, the Netherlands
| | - Angsar Schulz
- Klinik für Kinder-und Jugend medizin Ulm, Ulm, Germany
| | | | | | | | - Marco Zecca
- Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | | | - Montserrat Rovira
- Hospital Clinic Institute of Hematology and Oncology, Barcelona, Spain
| | - Jorge Sierra
- Hospital Santa Creu I Sant Pau, Barcelona, Spain
| | | | | | | | | | | | | | | | | | - Gergely Kriván
- Central Hospital of Southern Pest-National Institute of Hematology and Infectious Disease, Budapest, Hungary
| | - Amal Al-Seiraihy
- King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Stefano Giardino
- Stem Cell Transplantation Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | | | | | - Carlo Dufour
- Hematology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
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12
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Moreno-Carralero MI, Horta-Herrera S, Morado-Arias M, Ricard-Andrés MP, Lemes-Castellano A, Abio-Calvete M, Cedena-Romero MT, González-Fernández FA, Llorente-González L, Periago-Peralta AM, de-la-Iglesia-Íñigo S, Méndez M, Morán-Jiménez MJ. Clinical and genetic features of congenital dyserythropoietic anemia (CDA). Eur J Haematol 2018; 101:368-378. [PMID: 29901818 DOI: 10.1111/ejh.13112] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2018] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Congenital dyserythropoietic anemias (CDA) are characterized by hyporegenerative anemia with inadequate reticulocyte values, ineffective erythropoiesis, and hemolysis. Distinctive morphology of bone marrow erythroblasts and identification of causative genes allow classification into 4 types caused by variants in CDAN1, c15orf41, SEC23B, KIF23, and KLF1 genes. OBJECTIVE Identify pathogenic variants in CDA patients. METHODS Massive parallel sequencing with a targeted gene panel, Sanger sequencing, Comparative Genome Hybridization (CGH), and in silico predictive analysis of pathogenicity. RESULTS Pathogenic variants were found in 21 of 53 patients studied from 44 unrelated families. Six variants were found in CDAN1: two reported, p.Arg714Trp and p.Arg725Trp and, four novel, p.Arg623Trp, p.Arg946Trp, p.Phe1125Ser and p.Ser1227Gly. Twelve variants were found in SEC23B: seven reported, p.Arg14Trp, p.Glu109Lys, p.Arg217Ter, c.835-2A>G, p.Arg535Ter, p.Arg550Ter and p.Arg718Ter and, five novel, p.Val164Leu, p.Arg190Gln, p.Gln521Ter, p.Arg546Trp, and p.Arg611Gln. The variant p.Glu325Lys in KLF1 was found in one patient and p.Tyr365Cys in ALAS2 in an other. Moreover, we identified genomic rearrangements by CGH in some SEC23B-monoallelic patients. CONCLUSIONS New technologies for genetic studies will help to find variants in other genes, in addition to those known, that contribute to or modulate the CDA phenotype or support the correct diagnosis.
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Affiliation(s)
| | | | - Marta Morado-Arias
- Servicio de Hematología y Hemoterapia, Hospital Universitario La Paz, Madrid, Spain
| | | | - Angelina Lemes-Castellano
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Gran Canaria, Spain
| | - Mariola Abio-Calvete
- Servicio de Hematología y Hemoterapia, Hospital Virgen de la Salud, Complejo Hospitalario de Toledo, Toledo, Spain
| | | | | | - Laura Llorente-González
- Servicio de Hematología y Hemoterapia, Hospital Universitario Puerta de Hierro, Majadahonda, Spain
| | | | - Silvia de-la-Iglesia-Íñigo
- Servicio de Hematología y Hemoterapia, Hospital Universitario de Gran Canaria Doctor Negrín, Las Palmas de Gran Canaria, Gran Canaria, Spain
| | - Manuel Méndez
- Instituto de Investigación Hospital 12 de Octubre, Madrid, Spain
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13
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Oh A, Patel PR, Aardsma N, Mehendale SR, Chowdhery R, Sweiss K, Rondelli D. Non-myeloablative allogeneic stem cell transplant with post-transplant cyclophosphamide cures the first adult patient with congenital dyserythropoietic anemia. Bone Marrow Transplant 2017; 52:905-906. [PMID: 28319077 DOI: 10.1038/bmt.2017.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- A Oh
- Division of Hematology/Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - P R Patel
- Division of Hematology/Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.,University of Illinois Cancer Center, Chicago, IL, USA
| | - N Aardsma
- Department of Pathology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - S R Mehendale
- Department of Pathology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - R Chowdhery
- Division of Hematology/Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - K Sweiss
- Division of Hematology/Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA
| | - D Rondelli
- Division of Hematology/Oncology, University of Illinois Hospital and Health Sciences System, Chicago, IL, USA.,University of Illinois Cancer Center, Chicago, IL, USA
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14
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Demircioğlu F, Erkoçoğlu M, Dilek M, Bekdaş M, Göksügür S, Büyükkorkmaz S, Açar S. Diagnosis: Congenital Dyserythropoietic Anemia Type 2 Due to Compound Heterozygote Mutation in SEC23B Gene. Turk J Haematol 2017; 32:283-4. [PMID: 25912935 PMCID: PMC4563211 DOI: 10.4274/tjh.2014.0478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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15
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Bianchi P, Schwarz K, Högel J, Fermo E, Vercellati C, Grosse R, van Wijk R, van Zwieten R, Barcellini W, Zanella A, Heimpel H. Analysis of a cohort of 101 CDAII patients: description of 24 new molecular variants and genotype-phenotype correlations. Br J Haematol 2016; 175:696-704. [PMID: 27471141 DOI: 10.1111/bjh.14271] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/10/2016] [Indexed: 01/21/2023]
Abstract
Congenital dyserythropoietic anaemia type II (CDAII) is a rare autosomal recessive disease characterized by ineffective erythropoiesis, haemolysis, erythroblast morphological abnormalities, hypoglycosylation of some red blood cell membrane proteins, particularly band 3, and mutations in the SEC23B gene. We report the analysis of 101 patients from 91 families with a median follow-up of 23 years (range 0-65); 68 patients are newly reported. Clinical and haematological parameters were separately analysed in early infancy and thereafter, when feasible. Molecular analysis of the SEC23B gene confirmed the high heterogeneity of the defect, leading to the identification of 54 different mutations, 24 of which are newly described. To evaluate the genotype-phenotype correlation, patients were grouped according to their genotype (two missense mutations vs. one missense/one drastic mutation) and assigned to two different severity gradings based on laboratory data and on therapeutic needs; by this approach only a weak genotype-phenotype correlation was observed in the analysed groups.
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Affiliation(s)
- Paola Bianchi
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, UO Oncoematologia, UOS Fisiopatologia delle Anemie, Milan, Italy
| | - Klaus Schwarz
- Institute for Clinical Transfusion Medicine and Immunogenetics, German Red Cross Blood Service Baden-Wuerttemberg - Hessen and Institute for Transfusion Medicine, University of Ulm, Ulm, Germany
| | - Josef Högel
- Institute for Human Genetics, University Ulm, Ulm, Germany
| | - Elisa Fermo
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, UO Oncoematologia, UOS Fisiopatologia delle Anemie, Milan, Italy
| | - Cristina Vercellati
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, UO Oncoematologia, UOS Fisiopatologia delle Anemie, Milan, Italy
| | - Regine Grosse
- Klinik für Pädiatrische Hämatologie und Onkologie, Universität Hamburg, Hamburg, Germany
| | | | - Rob van Zwieten
- Laboratory of Red Blood Cell Diagnostics, Department of Blood Cell Research, Sanquin Blood Supply Foundation, Amsterdam, The Netherlands
| | - Wilma Barcellini
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, UO Oncoematologia, UOS Fisiopatologia delle Anemie, Milan, Italy
| | - Alberto Zanella
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, UO Oncoematologia, UOS Fisiopatologia delle Anemie, Milan, Italy
| | - Hermann Heimpel
- Department Internal Medicine III, University Hospital Ulm, Ulm, Germany
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16
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Gambale A, Iolascon A, Andolfo I, Russo R. Diagnosis and management of congenital dyserythropoietic anemias. Expert Rev Hematol 2016; 9:283-96. [PMID: 26653117 DOI: 10.1586/17474086.2016.1131608] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Congenital dyserythropoietic anemias (CDAs) are inherited disorders hallmarked by chronic hyporegenerative anemia, relative reticulocytopenia, hemolytic component and iron overload. They represent a subtype of the inherited bone marrow failure syndromes, characterized by impaired differentiation and proliferation of the erythroid lineage. Three classical types were defined by marrow morphology, even if the most recent classification recognized six different genetic types. The pathomechanisms of CDAs are different, but all seem to involve the regulation of DNA replication and cell division. CDAs are often misdiagnosed, since either morphological abnormalities or clinical features can be commonly identified in other clinically-related anemias. However, differential diagnosis is essential for guiding both follow up and management of the patients.
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Affiliation(s)
- Antonella Gambale
- a Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Napoli , Italy.,b CEINGE Biotecnologie Avanzate , Napoli , Italy
| | - Achille Iolascon
- a Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Napoli , Italy.,b CEINGE Biotecnologie Avanzate , Napoli , Italy
| | - Immacolata Andolfo
- a Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Napoli , Italy.,b CEINGE Biotecnologie Avanzate , Napoli , Italy
| | - Roberta Russo
- a Dipartimento di Medicina Molecolare e Biotecnologie Mediche , Università degli Studi di Napoli Federico II , Napoli , Italy.,b CEINGE Biotecnologie Avanzate , Napoli , Italy
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17
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Russo R, Gambale A, Langella C, Andolfo I, Unal S, Iolascon A. Retrospective cohort study of 205 cases with congenital dyserythropoietic anemia type II: definition of clinical and molecular spectrum and identification of new diagnostic scores. Am J Hematol 2014; 89:E169-75. [PMID: 25044164 DOI: 10.1002/ajh.23800] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 07/03/2014] [Indexed: 12/13/2022]
Abstract
Congenital Dyserythropoietic Anemia II (CDA II) is a rare hyporegenerative anemia of variable degree, whose causative gene is SEC23B. More than 60 causative mutations in 142 independent pedigrees have been described so far. However, the prevalence of the CDA II is probably underestimated, since its clinical spectrum was not yet well-defined and thus it is often misdiagnosed with more frequent clinically-related anemias. This study represents the first meta-analysis on clinical and molecular spectrum of CDA II from the largest cohort of cases ever described. We characterized 41 new cases and 18 mutations not yet associated to CDA II, thus expanding the global series to 205 cases (172 unrelated) and the total number of causative variants to 84. The 68.3% of patients are included in our International Registry of CDA II (Napoli, Italy). A genotype-phenotype correlation in three genotypic groups of patients was assessed. To quantify the degree of severity in each patient, a method based on ranking score was performed. We introduced a clinical index to easily discriminate patients with a well-compensated hemolytic anemia from those with ineffective erythropoiesis. Finally, the worldwide geographical distribution of SEC23B alleles highlighted the presence of multiple founder effects in different areas of the world.
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Affiliation(s)
- Roberta Russo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche; Università degli Studi di Napoli Federico II; Napoli Italy
- CEINGE Biotecnologie Avanzate; Napoli Italy
| | - Antonella Gambale
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche; Università degli Studi di Napoli Federico II; Napoli Italy
- CEINGE Biotecnologie Avanzate; Napoli Italy
| | - Concetta Langella
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche; Università degli Studi di Napoli Federico II; Napoli Italy
- CEINGE Biotecnologie Avanzate; Napoli Italy
| | - Immacolata Andolfo
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche; Università degli Studi di Napoli Federico II; Napoli Italy
- CEINGE Biotecnologie Avanzate; Napoli Italy
| | - Sule Unal
- Division of Pediatric Hematology; Hacettepe University; Ankara Turkey
| | - Achille Iolascon
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche; Università degli Studi di Napoli Federico II; Napoli Italy
- CEINGE Biotecnologie Avanzate; Napoli Italy
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