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The RSPH4A Gene in Primary Ciliary Dyskinesia. Int J Mol Sci 2023; 24:ijms24031936. [PMID: 36768259 PMCID: PMC9915723 DOI: 10.3390/ijms24031936] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/29/2022] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
The radial spoke head protein 4 homolog A (RSPH4A) gene is one of more than 50 genes that cause Primary ciliary dyskinesia (PCD), a rare genetic ciliopathy. Genetic mutations in the RSPH4A gene alter an important protein structure involved in ciliary pathogenesis. Radial spoke proteins, such as RSPH4A, have been conserved across multiple species. In humans, ciliary function deficiency caused by RSPH4A pathogenic variants results in a clinical phenotype characterized by recurrent oto-sino-pulmonary infections. More than 30 pathogenic RSPH4A genetic variants have been associated with PCD. In Puerto Rican Hispanics, a founder mutation (RSPH4A (c.921+3_921+6delAAGT (intronic)) has been described. The spectrum of the RSPH4A PCD phenotype does not include laterality defects, which results in a challenging diagnosis. PCD diagnostic tools can combine transmission electron microscopy (TEM), nasal nitric oxide (nNO), High-Speed Video microscopy Analysis (HSVA), and immunofluorescence. The purpose of this review article is to provide a comprehensive overview of current knowledge about the RSPH4A gene in PCD, ranging from basic science to human clinical phenotype.
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Olm MAK, Marson FAL, Athanazio RA, Nakagawa NK, Macchione M, Loges NT, Omran H, Rached SZ, Bertuzzo CS, Stelmach R, Saldiva PHN, Ribeiro JD, Jones MH, Mauad T. Severe pulmonary disease in an adult primary ciliary dyskinesia population in Brazil. Sci Rep 2019; 9:8693. [PMID: 31213628 PMCID: PMC6582273 DOI: 10.1038/s41598-019-45017-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Accepted: 05/28/2019] [Indexed: 01/19/2023] Open
Abstract
Primary Ciliary Dyskinesia (PCD) is underdiagnosed in Brazil. We enrolled patients from an adult service of Bronchiectasis over a two-year period in a cross-sectional study. The inclusion criteria were laterality disorders (LD), cough with recurrent infections and the exclusion of other causes of bronchiectasis. Patients underwent at least two of the following tests: nasal nitric oxide, ciliary movement and analysis of ciliary immunofluorescence, and genetic tests (31 PCD genes + CFTR gene). The clinical characterization included the PICADAR and bronchiectasis scores, pulmonary function, chronic Pseudomonas aeruginosa (cPA) colonization, exhaled breath condensate (EBC) and mucus rheology (MR). Forty-nine of the 500 patients were diagnosed with definite (42/49), probable (5/49), and clinical (2/49) PCD. Twenty-four patients (24/47) presented bi-allelic pathogenic variants in a total of 31 screened PCD genes. A PICADAR score > 5 was found in 37/49 patients, consanguinity in 27/49, LD in 28/49, and eight PCD sibling groups. FACED diagnosed 23/49 patients with moderate or severe bronchiectasis; FEV1 ≤ 50% in 25/49 patients, eight patients had undergone lung transplantation, four had been lobectomized and cPA+ was determined in 20/49. The EBC and MR were altered in all patients. This adult PCD population was characterized by consanguinity, severe lung impairment, genetic variability, altered EBC and MR.
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Affiliation(s)
- Mary Anne Kowal Olm
- Department of Pathology, São Paulo University Medical School, São Paulo, SP, 01246-903, Brazil.
| | - Fernando Augusto Lima Marson
- Department of Medical Genetics and Genomic Medicine, Faculty of Medical Science, University of Campinas, Campinas, SP, 13083-887, Brazil
| | - Rodrigo Abensur Athanazio
- Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil
| | - Naomi Kondo Nakagawa
- Department of Pathology, São Paulo University Medical School, São Paulo, SP, 01246-903, Brazil
| | - Mariangela Macchione
- Department of Pathology, São Paulo University Medical School, São Paulo, SP, 01246-903, Brazil
| | - Niki Tomas Loges
- Department of Pediatrics and General Pediatrics, Muenster University Hospital, Muenster, 48149, Germany
| | - Heymut Omran
- Department of Pediatrics and General Pediatrics, Muenster University Hospital, Muenster, 48149, Germany
| | - Samia Zahi Rached
- Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil
| | - Carmen Sílvia Bertuzzo
- Department of Medical Genetics and Genomic Medicine, Faculty of Medical Science, University of Campinas, Campinas, SP, 13083-887, Brazil
| | - Rafael Stelmach
- Pulmonary Division, Heart Institute (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, 05403-000, Brazil
| | | | - José Dirceu Ribeiro
- Department of Medical Genetics and Genomic Medicine, Faculty of Medical Science, University of Campinas, Campinas, SP, 13083-887, Brazil
- Department of Pediatrics, Faculty of Medical Science, University of Campinas, Campinas, SP, 13083-887, Brazil
| | - Marcus Herbert Jones
- Department of Pediatrics, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, 90610-000, Brazil
| | - Thais Mauad
- Department of Pathology, São Paulo University Medical School, São Paulo, SP, 01246-903, Brazil
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