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Jönsson ÅLM, Hilberg O, Simonsen U, Christensen JH, Bendstrup E. New insights in the genetic variant spectrum of SLC34A2 in pulmonary alveolar microlithiasis; a systematic review. Orphanet J Rare Dis 2023; 18:130. [PMID: 37259144 DOI: 10.1186/s13023-023-02712-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/30/2023] [Indexed: 06/02/2023] Open
Abstract
Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive lung disease caused by variants in the SLC34A2 gene encoding the sodium-dependent phosphate transport protein 2B, NaPi-2b. PAM is characterized by deposition of calcium phosphate crystals in the alveoli. Onset and clinical course vary considerably; some patients remain asymptomatic while others develop severe respiratory failure with a significant symptom burden and compromised survival. It is likely that PAM is under-reported due to lack of recognition, misdiagnosis, and mild clinical presentation. Most patients are genetically uncharacterized as the diagnostic confirmation of PAM has traditionally not included a genetic analysis. Genetic testing may in the future be the preferred tool for diagnostics instead of invasive methods. This systematic review aims to provide an overview of the growing knowledge of PAM genetics. Rare variants in SLC34A2 are found in almost all genetically tested patients. So far, 34 allelic variants have been identified in at least 68 patients. A majority of these are present in the homozygous state; however, a few are found in the compound heterozygous form. Most of the allelic variants involve only a single nucleotide. Half of the variants are either nonsense or frameshifts, resulting in premature termination of the protein or decay of the mRNA. There is currently no cure for PAM, and the only effective treatment is lung transplantation. Management is mainly symptomatic, but an improved understanding of the underlying pathophysiology will hopefully result in development of targeted treatment options. More standardized data on PAM patients, including a genetic diagnosis covering larger international populations, would support the design and implementation of clinical studies to the benefit of patients. Further genetic characterization and understanding of how the molecular changes influence disease phenotype will hopefully allow earlier diagnosis and treatment of the disease in the future.
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Affiliation(s)
- Åsa Lina M Jönsson
- Department of Clinical Genetics, Aarhus University Hospital, Aarhus, Denmark.
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
| | - Ole Hilberg
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
- Department of Medicine, Lillebaelt Hospital, Vejle, Denmark.
| | - Ulf Simonsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | | | - Elisabeth Bendstrup
- Centre for Rare Lung Diseases, Department of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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Buschulte K, Cottin V, Wijsenbeek M, Kreuter M, Diesler R. The world of rare interstitial lung diseases. Eur Respir Rev 2023; 32:32/167/220161. [PMID: 36754433 PMCID: PMC9910344 DOI: 10.1183/16000617.0161-2022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 12/21/2022] [Indexed: 02/10/2023] Open
Abstract
The world of rare interstitial lung diseases (ILDs) is diverse and complex. Diagnosis and therapy usually pose challenges. This review describes a selection of rare and ultrarare ILDs including pulmonary alveolar proteinosis, pulmonary alveolar microlithiasis and pleuroparenchymal fibroelastosis. In addition, monogenic ILDs or ILDs in congenital syndromes and various multiple cystic lung diseases will be discussed. All these conditions are part of the scope of the European Reference Network on rare respiratory diseases (ERN-LUNG). Epidemiology, pathogenesis, diagnostics and treatment of each disease are presented.
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Affiliation(s)
- Katharina Buschulte
- Center for Interstitial and Rare Lung Diseases, Thoraxklinik, University of Heidelberg, German Center for Lung Research (DZL), ERN-LUNG, Heidelberg, Germany
| | - Vincent Cottin
- National Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, UMR 754, Claude Bernard University Lyon 1, ERN-LUNG, Lyon, France
| | - Marlies Wijsenbeek
- Center for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus MC-University Medical Center, ERN-LUNG, Rotterdam, The Netherlands
| | - Michael Kreuter
- Center for Interstitial and Rare Lung Diseases, Thoraxklinik, University of Heidelberg, German Center for Lung Research (DZL), ERN-LUNG, Heidelberg, Germany
| | - Rémi Diesler
- National Reference Centre for Rare Pulmonary Diseases, Louis Pradel Hospital, Hospices Civils de Lyon, UMR 754, Claude Bernard University Lyon 1, ERN-LUNG, Lyon, France
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Bendstrup E, Jönsson ÅLM. Pulmonary alveolar microlithiasis: no longer in the stone age. ERJ Open Res 2020; 6:00289-2020. [PMID: 32964001 PMCID: PMC7487355 DOI: 10.1183/23120541.00289-2020] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 06/16/2020] [Indexed: 01/18/2023] Open
Abstract
Pulmonary alveolar microlithiasis (PAM) is a rare parenchymal lung disease caused by variants in the SCL34A2 gene and characterised by the accumulation of intra-alveolar microliths. PAM has been reported in fewer than 1100 cases throughout the world. It is an autosomal recessive hereditary disease and often associated with consanguinity. Progress with respect to the genetic background and pathophysiology has resulted in an increased understanding of the disease in recent years. Until now, 30 genetic different SLC34A2 variants have been reported, which all are considered significant for disease development. There is no sex difference and the majority of cases are diagnosed at the age of 30–40 years. Many patients are asymptomatic and the diagnosis is made at random. When symptomatic, dyspnoea, cough, chest pain and fatigue are common complaints. The diagnosis of PAM can confidently be based on typical radiographic findings and genetic testing proving rare biallelic SCL34A2 gene variants. Bronchoalveolar lavage and histopathology may show microliths. There is no disease-specific treatment and management is supportive. Lung transplantation should be considered in advanced cases. Pulmonary alveolar microlithiasis is a rare, autosomal recessive lung disease. Formation of alveolar microliths is caused by SCL34A2 variants. The prognosis is severe; respiratory failure is common. Lung transplantation is the only effective therapy.https://bit.ly/3dpkbRw
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Affiliation(s)
- Elisabeth Bendstrup
- Center for Rare Lung Diseases, Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
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Samrah S, Shraideh H, Rawashdeh S, Khassawneh B. Tricuspid valve calcification in familial pulmonary alveolar microlithiasis: A case report. Ann Med Surg (Lond) 2020; 55:256-259. [PMID: 32528675 PMCID: PMC7281303 DOI: 10.1016/j.amsu.2020.05.039] [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: 05/01/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 01/05/2023] Open
Abstract
Background Pulmonary Alveolar Microlithiasis (PAM) is an uncommon, gradually progressive and eventually fatal hereditary disease that affects young population. Familial cases account for up to 50% of reported cases. There are few described cases of extrapulmonary manifestations of PAM and rare reports of cardiac involvement. Case report A 45-year-old male patient presented to our center with progressive shortness of breath and dry cough. On physical examination, he was tachypneic and chest examination revealed diminished breath sounds with bilateral early inspiratory crackles. Further workup revealed the diagnosis of PAM. Echocardiography revealed calcifications covering the tricuspid valve with elevated right ventricular systolic pressure. He reported having two sisters with similar illnesses and chest radiographic abnormalities, one died at the age of 38 years from respiratory failure and the other is 42-year-old and still alive and was diagnosed with PAM. Another 35 member of his family were diagnosed with PAM. Unfortunately, few days after discharge, he arrested at home. Conclusions Recently, type-II sodium/phosphate co-transporter has been identified in a human aortic valve. Studies have suggested penetrance of mutations of SLC34A2 gene might explain such variability of pulmonary and extrapulmonary involvement. Our case reports a familial cluster of PAM, and the first case of concomitant tricuspid calcification. This finding might be a useful in the investigation for a future genetic targeted therapy. PAM is a fatal hereditary disease that affects young population. There are few described cases of extrapulmonary manifestations of PAM. Mutations of SLC34A2 gene might explain variability of extrapulmonary involvement.
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Affiliation(s)
- Shaher Samrah
- Department of Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | | | - Sukiana Rawashdeh
- Department of Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Basheer Khassawneh
- Department of Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
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Jönsson ÅLM, Bendstrup E, Mogensen S, Kopras EJ, McCormack FX, Campo I, Mariani F, Escribano-Montaner A, Holm AM, Martinez-Colls MDM, Pintos-Morell G, Taillé C, Crestani B, Hilberg O, Hvarregaard Christensen J, Simonsen U. Eight novel variants in the SLC34A2 gene in pulmonary alveolar microlithiasis. Eur Respir J 2020; 55:13993003.00806-2019. [PMID: 31831582 DOI: 10.1183/13993003.00806-2019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 11/15/2019] [Indexed: 01/13/2023]
Abstract
BACKGROUND Pulmonary alveolar microlithiasis (PAM) is caused by genetic variants in the SLC34A2 gene, which encodes the sodium-dependent phosphate transport protein 2B (NaPi-2b). PAM is characterised by deposition of calcium phosphate concretions (microliths) in the alveoli leading to pulmonary dysfunction. The variant spectrum of SLC34A2 has not been well investigated and it is not yet known whether a genotype-phenotype correlation exists. METHODS We collected DNA from 14 patients with PAM and four relatives, and analysed the coding regions of SLC34A2 by direct DNA sequencing. To determine the phenotype characteristics, clinical data were collected and a severity score was created for each variant, based on type and localisation within the protein. RESULTS We identified eight novel allelic variants of SLC34A2 in 14 patients with PAM. Four of these were nonsense variants, three were missense and one was a splice site variant. One patient was heterozygous for two different variants and all other patients were homozygous. Four patients were asymptomatic and 10 patients were symptomatic. The severity of the disease was associated with the variant severity. CONCLUSIONS Our findings support a significant role for SLC34A2 in PAM and expand the variant spectrum of the disease. Thus, SLC34A2 variants were detected in all patients and eight novel allelic variants were discovered. An association between disease severity and the severity of the variants was found; however, this needs to be investigated in larger patient populations.
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Affiliation(s)
| | - Elisabeth Bendstrup
- Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark
| | | | - Elizabeth J Kopras
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Francis X McCormack
- Division of Pulmonary, Critical Care and Sleep Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Ilaria Campo
- Pneumology unit, IRCCS San Matteo Hospital Foundation, Pavia, Italy
| | | | - Amparo Escribano-Montaner
- Pediatric Pneumology Unit, Clinic University Hospital, Dept of Pediatrics, Obstetrics and Gynecology, University of Valencia, Valencia, Spain
| | - Are M Holm
- Dept of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Guillem Pintos-Morell
- Dept of Pediatrics, University Hospital Germans Trias i Pujol, Badalona, Spain.,Centre for Rare Diseases, University Hospital Vall d'Hebron, Barcelona, Spain.,Research Institute IGTP, CIBERER-GCV08, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Camille Taillé
- APHP, Hopital Bichat, DHU FIRE, Pulmonology Dept, Reference Center for Rare Pulmonary Diseases, Unité Inserm 1152, Université Paris Diderot, Paris, France
| | - Bruno Crestani
- APHP, Hopital Bichat, DHU FIRE, Pulmonology Dept, Reference Center for Rare Pulmonary Diseases, Unité Inserm 1152, Université Paris Diderot, Paris, France
| | - Ole Hilberg
- Dept of Respiratory Diseases and Allergy, Aarhus University Hospital, Aarhus, Denmark.,Medical Dept, Vejle Hospital, Vejle, Denmark
| | | | - Ulf Simonsen
- Dept of Biomedicine, Aarhus University, Aarhus, Denmark.,Shared senior authorship
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Zhang XD, Gao JM, Luo JM, Zhao Y. Pulmonary alveolar microlithiasis: A case report and review of the literature. Exp Ther Med 2017; 15:831-837. [PMID: 29434686 PMCID: PMC5772952 DOI: 10.3892/etm.2017.5457] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 08/01/2017] [Indexed: 12/29/2022] Open
Abstract
Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease characterized by the formation of calcium phosphate microliths in the alveoli. Mutations in the gene encoding the solute carrier family 34 member 2 gene are considered to be involved in the pathogenesis of PAM. Although PAM can develop in children, the majority of patients with PAM are diagnosed in adulthood due to the slow progressive nature of the disease within the lungs. In childhood, the majority of patients with PAM are asymptomatic and changes in the lung parenchyma are usually identified incidentally. Symptoms of PAM typically appear in the third or fourth decade of life and there is often a notable dissociation between the advanced radiological findings and the mild clinical presentation. A positive diagnosis of PAM is reached by the combination of a positive chest radiograph and histological examination. Genetic testing may help to identify other latent patients in the family of the patient with PAM. In the present study, the cases of 3 patients diagnosed with PAM have been reported, including their clinical presentation, radio imaging, pathological symptoms, genetic test results and treatment plans, as well as the associated literature.
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Affiliation(s)
- Xu-Dong Zhang
- Department of Respiratory Disease, Peking Union Medical College Hospital, Beijing 100730, P.R. China
| | - Jin-Ming Gao
- Department of Respiratory Disease, Peking Union Medical College Hospital, Beijing 100730, P.R. China
| | - Jin-Mei Luo
- Department of Respiratory Disease, Peking Union Medical College Hospital, Beijing 100730, P.R. China
| | - Yu Zhao
- Department of Pathology, Peking Union Medical College Hospital, Beijing 100730, P.R. China
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7
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Izumi H, Kurai J, Kodani M, Watanabe M, Yamamoto A, Nanba E, Adachi K, Igishi T, Shimizu E. A novel SLC34A2 mutation in a patient with pulmonary alveolar microlithiasis. Hum Genome Var 2017; 4:16047. [PMID: 28144448 PMCID: PMC5267164 DOI: 10.1038/hgv.2016.47] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 11/07/2016] [Accepted: 11/22/2016] [Indexed: 12/19/2022] Open
Abstract
Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disease caused by mutations in SLC34A2 and characterized by intra-alveolar accumulation of microliths. We diagnosed a case of PAM in a 27-year-old Japanese female and identified a novel mutation in SLC34A2 (c.1390 G>C [G464R] in exon 12).
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Affiliation(s)
- Hiroki Izumi
- Faculty of Medicine, Division of Medical Oncology and Molecular Respirology, Tottori University , Yonago, Japan
| | - Jun Kurai
- Faculty of Medicine, Division of Medical Oncology and Molecular Respirology, Tottori University , Yonago, Japan
| | - Masahiro Kodani
- Faculty of Medicine, Division of Medical Oncology and Molecular Respirology, Tottori University , Yonago, Japan
| | - Masanari Watanabe
- Faculty of Medicine, Division of Medical Oncology and Molecular Respirology, Tottori University , Yonago, Japan
| | - Akihiro Yamamoto
- Faculty of Medicine, Division of Medical Oncology and Molecular Respirology, Tottori University , Yonago, Japan
| | - Eiji Nanba
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University , Yonago, Japan
| | - Kaori Adachi
- Division of Functional Genomics, Research Center for Bioscience and Technology, Tottori University , Yonago, Japan
| | - Tadashi Igishi
- Faculty of Medicine, Division of Medical Oncology and Molecular Respirology, Tottori University , Yonago, Japan
| | - Eiji Shimizu
- Faculty of Medicine, Division of Medical Oncology and Molecular Respirology, Tottori University , Yonago, Japan
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Emiralioglu N, Beken B, Ozcan HN, Yalcin E, Dogru D, Ozcelik U, Haliloglu M, Kiper N. Diagnosis and treatment of pulmonary alveolar microlithiasis. Pediatr Int 2016; 58:805-7. [PMID: 27553891 DOI: 10.1111/ped.13032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Revised: 04/17/2016] [Accepted: 04/25/2016] [Indexed: 11/28/2022]
Abstract
Pulmonary alveolar microlithiasis (PAM) is a rare genetic disease caused by mutations in sodium-phosphate co-transporter (SLC34A2), which encodes a type 2b sodium phosphate co-transporter. Disease is characterized by intra-alveolar microlith formation of phosphate. Turkey has a high prevalence of PAM. Herein, we report the clinical and radiological findings of three patients diagnosed with PAM and treated with disodium etidronate.
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Affiliation(s)
- Nagehan Emiralioglu
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Burcin Beken
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Hatice Nursun Ozcan
- Department of Pediatric Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ebru Yalcin
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Deniz Dogru
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Ugur Ozcelik
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Mithat Haliloglu
- Department of Pediatric Radiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Nural Kiper
- Department of Pediatric Pulmonology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
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Castellana G, Castellana G, Gentile M, Castellana R, Resta O. Pulmonary alveolar microlithiasis: review of the 1022 cases reported worldwide. Eur Respir Rev 2015; 24:607-20. [PMID: 26621975 PMCID: PMC9487614 DOI: 10.1183/16000617.0036-2015] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 05/18/2015] [Indexed: 12/16/2022] Open
Abstract
Pulmonary alveolar microlithiasis (PAM) is a rare disease characterised by the widespread intra-alveolar accumulation of minute calculi called microliths. It is caused by mutation of the SLC34A2 gene encoding the type IIb sodium phosphate cotransporter in alveolar type II cells. The present study explores the epidemiological, familial, genetic, clinical, diagnostic, radiological and therapeutic aspects with the aim of contributing to a better understanding of this uncommon disease.We searched articles on PAM published up to December 2014 and 544 papers were found, accounting for 1022 cases.PAM is present in all continents and in many nations, in particular in Turkey, China, Japan, India, Italy and the USA. Familiality is frequent. The clinical course is not uniform and the causes of this clinical variability seem to be largely nongenetic. The optimal diagnostic procedure is the association of chest high-resolution computed tomography (HRCT) with bronchoalveolar lavage, but a chest radiograph may suffice in families in which a case has already been diagnosed. Moreover, chest radiography and HRCT allow the classification of the evolutionary phase of the disease and its severity. At present lung transplantation is the only effective therapy. However, better knowledge of the gene responsible offers hope for new therapies.
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Affiliation(s)
| | - Giorgio Castellana
- Institute of Respiratory Disease, Aldo Moro University of Bari, Bari, Italy
| | - Mattia Gentile
- Medical Genetics Unit, Azienda Sanitaria Locale Bari, Bari, Italy
| | | | - Onofrio Resta
- Institute of Respiratory Disease, Aldo Moro University of Bari, Bari, Italy
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Wang HY, Zhou NY, Yang XY. Update on diagnosis and treatment of pulmonary alveolar microlithiasis. World J Respirol 2014; 4:26-30. [DOI: 10.5320/wjr.v4.i3.26] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Revised: 09/15/2014] [Accepted: 09/17/2014] [Indexed: 02/06/2023] Open
Abstract
Pulmonary alveolar microlithiasis (PAM) (MIM265100) is a rare disease characterized by the diffuse deposit of microlithiasis in alveolar spaces. PAM could occur worldwide with high prevalence in Asia and Europe. Familial occurrence indicates its autosomal recessive trait and the SLC34A2 gene was identified as the responsible gene for the disease. In spite of the versatile mutation sites in patients from other countries, exon 7 and exon 8 might be the most liable gene in Chinese and Japanese patients. Most mutations caused the premature termination of proteins and produced truncated proteins, leading to the blocking of the recycling and degrading of outdated surfactant which is full of phospholipids. The most outstanding clinical feature of PAM is the discrepancy between the paucity of symptoms and the degree of pulmonary involvement. Diagnosis is easy to establish based on typical chest radiograph image and nuclear medicine improves its early diagnosis and active evaluation. Pathology of the unique intra-alveolar lamellar microliths gives strong support for diagnosis. No effective treatment is considered valid currently. However, lung transplantation is effective for advanced-stage patients, and long term treatment of disodium etidronate seems promising.
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11
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Wang H, Yin X, Wu D, Jiang X. SLC34A2 gene compound heterozygous mutation identification in a patient with pulmonary alveolar microlithiasis and computational 3D protein structure prediction. Meta Gene 2014; 2:557-64. [PMID: 25606438 PMCID: PMC4287860 DOI: 10.1016/j.mgene.2014.07.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Revised: 07/22/2014] [Accepted: 07/24/2014] [Indexed: 12/22/2022] Open
Abstract
We recently diagnosed a patient with pulmonary alveolar microlithiasis (PAM). Because loss-of-function mutations of the SLC34A2 gene are responsible for the development of PAM, we sought to sequence the SLC34A2 gene of the patient and his direct relatives, with a purpose to identify mutations that caused the PAM of the patient as well as the carriers of his family. We found a novel compound heterozygous mutation of the SLC34A2 gene in this patient, which were the mutations of c.1363T > C (p. Y455H) in exon 12 and c.910A > T (p. K304X) in exon 8. Computational prediction of three-dimensional (3D) structures of the mutants revealed that the Y455H mutation resulted in a formation of irregular coils in the trans-membrane domain and the K304X mutation resulted in protein truncation. Our study suggested that sequencing of the SLC34A2 gene together with a computational prediction of the 3D structures of the mutated proteins may be useful in PAM diagnosis and prognosis.
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Affiliation(s)
- Huiying Wang
- Department of Allergy and Clinical Immunology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Xinzhen Yin
- Department of Allergy and Clinical Immunology, the Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, China
| | - Dingwen Wu
- The Children's Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Xinguo Jiang
- Department of Medicine, VA Palo Alto Health Care System, Stanford University School of Medicine, Stanford, CA, 94305, USA
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12
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Pulmonary Alveolar Microlithiasis and Probe-based Confocal Laser Endomicroscopy. J Bronchology Interv Pulmonol 2013; 20:159-63. [DOI: 10.1097/lbr.0b013e31828abc03] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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14
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Yin X, Wang H, Wu D, Zhao G, Shao J, Dai Y. SLC34A2 Gene mutation of pulmonary alveolar microlithiasis: report of four cases and review of literatures. Respir Med 2012; 107:217-22. [PMID: 23164546 DOI: 10.1016/j.rmed.2012.10.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 10/26/2012] [Accepted: 10/28/2012] [Indexed: 12/12/2022]
Abstract
Pulmonary alveolar microlithiasis (PAM) is a rare autosomal recessive disorder characterized by the deposition of calcium phosphate microliths throughout the lungs. Currently the mutation of SLC34A2 gene was considered responsible for PAM. Here we reported the studies on mutation analysis of the SLC34A2 gene in three familial members and one unrelated subject of PAM by DNA direct sequencing. Meanwhile, we also reviewed and analyzed the published studies of the SLC34A2 gene mutation in PAM patients. The three familial patients were siblings of an inbred family whose parents were cousins. All four patients presented recurrent cough and exertional dyspnea. Diagnosis of PAM was made according to the typical manifestation of radiology. One homozygous mutation of the SLC34A2 gene, c.910A > T (p.K304X) was identified. The review of the SLC34A2 gene mutation showed multiple mutation symbols in PAM patients from China, Turkey, and Japan respectively. The present study supports that the clinical features, pathological and radiological characteristics of Chinese PAM patients are similar to those reported in other countries. Our investigation revealed that the c.910A > T mutation in the SCL34A2 gene was responsible for PAM patients in China. The review of literatures suggests that exon7 and exon8 seemed liable to be affected typical Mongoloid of PAM, and exon8 might be the screen target for Chinese patients.
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Affiliation(s)
- Xinzhen Yin
- Department of Neurology, Second Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310009, PR China
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