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Zhu X, Cheung WW, Zhang A, Ding G. Mutation Characteristics of Primary Hyperoxaluria in the Chinese Population and Current International Diagnosis and Treatment Status. KIDNEY DISEASES (BASEL, SWITZERLAND) 2024; 10:313-326. [PMID: 39131880 PMCID: PMC11309763 DOI: 10.1159/000539516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/16/2024] [Indexed: 08/13/2024]
Abstract
Background Primary hyperoxaluria (PH) is a rare autosomal recessive disorder, mainly due to the increase in endogenous oxalate production, causing a series of clinical features such as kidney stones, nephrocalcinosis, progressive impairment of renal function, and systemic oxalosis. There are three common genetic causes of glycolate metabolism anomalies. Among them, PH type 1 is the most prevalent and severe type, and early end-stage renal failure often occurs. Summary This review summarizes PH through pathophysiology, genotype, clinical manifestation, diagnosis, and treatment options. And explore the characteristics of Chinese PH patients. Key Messages Diagnosis of this rare disease is based on clinical symptoms, urinary or blood oxalate concentrations, liver biopsy, and genetic testing. Currently, the main treatment is massive hydration, citrate inhibition of crystallization, dialysis, liver and kidney transplantation, and pyridoxine. Recently, RNA interference drugs have also been used. In addition, technologies such as gene editing and autologous liver cell transplantation are also being developed. C.815_816insGA and c.33_34insC mutation in the AGXT gene could be a common variant in Chinese PH1 population. Mutations at the end of exon 6 account for approximately 50% of all Chinese HOGA1 mutations. Currently, the treatment of PH in China still relies mainly on symptomatic and high-throughput dialysis, with poor prognosis (especially for PH1 patients).
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Affiliation(s)
- Xingying Zhu
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Wai W. Cheung
- Division of Pediatric Nephrology, Rady Children’s Hospital, University of California, San Diego, CA, USA
| | - Aihua Zhang
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
- State Key Laboratory of Reproductive Medicine, Children’s Hospital of Nanjing Medical University, Nanjing, China
| | - Guixia Ding
- Department of Nephrology, Children’s Hospital of Nanjing Medical University, Nanjing, China
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2
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Chetruengchai W, Phowthongkum P, Shotelersuk V. Carrier frequency estimation of pathogenic variants of autosomal recessive and X-linked recessive mendelian disorders using exome sequencing data in 1,642 Thais. BMC Med Genomics 2024; 17:9. [PMID: 38167091 PMCID: PMC10762924 DOI: 10.1186/s12920-023-01771-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 12/11/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND People with autosomal recessive disorders often were born without awareness of the carrier status of their parents. The American College of Medical Genetics and Genomics (ACMG) recommends screening 113 genes known to cause autosomal recessive and X-linked conditions in couples seeking to learn about their risk of having children with these disorders to have an appropriate reproductive plan. METHODS We analyzed the exome sequencing data of 1,642 unrelated Thai individuals to identify the pathogenic variant (PV) frequencies in genes recommended by ACMG. RESULTS In the 113 ACMG-recommended genes, 165 PV and likely PVs in 60 genes of 559 exomes (34%, 559/1642) were identified. The carrier rate was increased to 39% when glucose-6-phosphate dehydrogenase (G6PD) was added. The carrier rate was still as high as 14.7% when thalassemia and hemoglobinopathies were excluded. In addition to thalassemia, hemoglobinopathies, and G6PD deficiency, carrier frequencies of > 1% were found for Gaucher disease, primary hyperoxaluria, Pendred syndrome, and Wilson disease. Nearly 2% of the couples were at risk of having offsprings with the tested autosomal recessive conditions. CONCLUSIONS Based on the study samples, the expanded carrier screening, which specifically targeted common autosomal recessive conditions in Thai individuals, will benefit clinical outcomes, regarding preconception/prenatal genetic carrier screening.
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Affiliation(s)
- Wanna Chetruengchai
- Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand
- Center of Excellence for Medical Genomics, Medical Genomics Cluster, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Prasit Phowthongkum
- Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand.
- Division of Medical Genetics and Genomics, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Vorasuk Shotelersuk
- Excellence Center for Genomics and Precision Medicine, King Chulalongkorn Memorial Hospital, the Thai Red Cross Society, Bangkok, 10330, Thailand
- Center of Excellence for Medical Genomics, Medical Genomics Cluster, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
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Wu J, Song J, He Y, Zhong C, Yang Q, Li Q, Wang M. Case series and literature review of primary hyperoxaluria type 1 in Chinese patients. Urolithiasis 2023; 51:123. [PMID: 37874369 PMCID: PMC10598140 DOI: 10.1007/s00240-023-01494-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023]
Abstract
Based on the single-center case reports and all reported patients with primary hyperoxaluria type 1 (PH1) in China, this study discussed the clinical and genetic characteristics of this disease retrospectively. We reported and validated a novel genetic variation c.302 T > G: the clinical phenotypes of the two siblings were similar, in which both had onset in infancy, mainly manifested as renal insufficiency, and died within 6 months out of end-stage renal disease. The literature review is the first to summarize the Chinese patients with PH1 up to now. Forty-eight Chinese patients were included, containing 7 adults and 41 children. The median onset age was 51 months, and the ratio of male to female was 2.69:1. It showed a poor prognosis: 51.1% of Chinese primary hyperoxaluria type 1 patients suffered from end-stage renal disease, and 38.9% of patients died. Urolithiasis was the most common clinical manifestation both in adults and children, while infant-onset patients generally presented with renal insufficiency and had a higher mortality of 75.0%. One hundred and forty-nine AGXT mutant alleles are currently known in the Chinese population, c.33dupC and c.815_816insGA were the most common AGXT genes, accounting for 12.0% and 10.1% of allele frequencies, respectively. The exons 1, 2, 6, and 8 were the most common locations of gene variants, accounting for 78% of all variants, which will be promising targets of DNA sequencing for primary hyperoxaluria type 1.
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Affiliation(s)
- Jiayu Wu
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Jing Song
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Yanzhao He
- University of Leeds, Woodhouse, Leeds, LS2 9JT, UK
| | - Cheng Zhong
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Qin Yang
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Qiu Li
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China
| | - Mo Wang
- Department of Nephrology, Ministry of Education Key Laboratory of Child Development and Disorders, National Clinical Research Center for Child Health and Disorders, China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Children's Hospital of Chongqing Medical University, Chongqing, 400014, China.
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Xin Q, Dong Y, Guo W, Zhao X, Liu Z, Shi X, Lang Y, Shao L. Four novel variants identified in primary hyperoxaluria and genotypic and phenotypic analysis in 21 Chinese patients. Front Genet 2023; 14:1124745. [PMID: 37139236 PMCID: PMC10150119 DOI: 10.3389/fgene.2023.1124745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 04/04/2023] [Indexed: 05/05/2023] Open
Abstract
Background: Primary hyperoxaluria (PH) is a rare genetic disorder characterized by excessive accumulation of oxalate in plasma and urine, resulting in various phenotypes due to allelic and clinical heterogeneity. This study aimed to analyze the genotype of 21 Chinese patients with primary hyperoxaluria (PH) and explore their correlations between genotype and phenotype. Methods: Combined with clinical phenotypic and genetic analysis, we identified 21 PH patients from highly suspected Chinese patients. The clinical, biochemical, and genetic data of the 21 patients were subsequently reviewed. Results: We reported 21 cases of PH in China, including 12 cases of PH1, 3 cases of PH2 and 6 cases of PH3, and identified 2 novel variants (c.632T > G and c.823_824del) in AGXT gene and 2 novel variants (c.258_272del and c.866-34_866-8del) in GRHPR gene, respectively. A possible PH3 hotspot variant c.769T > G was identified for the first time. In addition, patients with PH1 showed higher levels of creatinine and lower eGFR than those with PH2 and PH3. In PH1, patients with severe variants in both alleles had significantly higher creatinine and lower eGFR than other patients. Delayed diagnosis still existed in some late-onset patients. Of all cases, 6 had reached to end-stage kidney disease (ESKD) at diagnosis with systemic oxalosis. Five patients were on dialysis and three had undergone kidney or liver transplants. Notably, four patients showed a favorable therapeutic response to vitamin B6, and c.823_824dup and c.145A > C may be identified as potentially vitamin B6-sensitive genotypes. Conclusion: In brief, our study identified 4 novel variants and extended the variant spectrum of PH in the Chinese population. The clinical phenotype was characterized by large heterogeneity, which may be determined by genotype and a variety of other factors. We first reported two variants that may be sensitive to vitamin B6 therapy in Chinese population, providing valuable references for clinical treatment. In addition, early screening and prognosis of PH should be given more attention. We propose to establish a large-scale registration system for rare genetic diseases in China and call for more attention on rare kidney genetic diseases.
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Affiliation(s)
- Qing Xin
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Yameng Dong
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Wencong Guo
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Xiangzhong Zhao
- Medical Research Center, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Zhiying Liu
- Renal Division, Peking University First Hospital, Beijing, China
| | - Xiaomeng Shi
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
| | - Yanhua Lang
- Department of Nursing, Qingdao Municipal Hospital, Qingdao, China
- *Correspondence: Yanhua Lang, ; Leping Shao,
| | - Leping Shao
- Department of Nephrology, Qingdao Municipal Hospital, Qingdao, China
- *Correspondence: Yanhua Lang, ; Leping Shao,
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Xu CB, Zhou XD, Xu HE, Zhao YL, Zhao XH, Liu DH, Tian YA, Hu XX, Guan JY, Guo JC, Tang WX, Xue X. A novel nonsense variant of the AGXT identified in a Chinese family: special variant research in the Chinese reference genome. BMC Nephrol 2021; 22:83. [PMID: 33691640 PMCID: PMC7945658 DOI: 10.1186/s12882-021-02276-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 02/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Primary hyperoxaluria(PH)is a rare autosomal recessive genetic disease that contains three subtypes (PH1, PH2 and PH3). Approximately 80% of PH patients has been reported as subtype PH1, this subtype of PH has been related to a higher risk of renal failure at any age. Several genetic studies indicate that the variants in gene AGXT are responsible for the occurrence of PH1. However, the population heterogeneity of the variants in AGXT makes the genetic diagnosis of PH1 more challenging as it is hard to locate each specific variant. It is valuable to have a complete spectrum of AGXT variants from different population for early diagnosis and clinical treatments of PH1. CASE PRESENTATION In this study, We performed high-throughput sequencing and genetic analysis of a 6-year-old male PH1 patient from a Chinese family. Two variants (c.346G > A: p.Gly116Arg; c.864G > A: p.Trp288X) of the gene AGXT were identified. We found a nonsense variant (c.864G > A: p.Trp288X) that comes from the proband's mother and has never been reported previously. The other missense variant (c.346G > A: p.Gly116Arg) was inherited from his father and has been found previously in a domain of aminotransferase, which plays an important role in the function of AGT protein. Furthermore, we searched 110 pathogenic variants of AGXT that have been reported worldwide in healthy local Chinese population, none of these pathogenic variants was detected in the local genomes. CONCLUSIONS Our research provides an important diagnosis basis for PH1 on the genetic level by updating the genotype of PH1 and also develops a better understanding of the variants in AGXT by broadening the variation database of AGXT according to the Chinese reference genome.
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Affiliation(s)
- Chang Bao Xu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xu Dong Zhou
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Hong En Xu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Academy of Medical Sciences, ZhengZhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China
| | - Yong Li Zhao
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Xing Hua Zhao
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Dan Hua Liu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China
| | - Yong An Tian
- BGI College, ZhengZhou University, Zhengzhou, China
| | - Xin Xin Hu
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China
| | - Jing Yuan Guan
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China
| | - Jian Cheng Guo
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Academy of Medical Sciences, ZhengZhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China.,Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Wen Xue Tang
- The Second Affiliated Hospital of Zhengzhou University, Zhengzhou University, Zhengzhou, China.,Academy of Medical Sciences, ZhengZhou University, Zhengzhou, China.,Precision Medicine Center of ZhengZhou University, Zhengzhou, China.,Henan Institute of Medical and Pharmaceutical Sciences, Zhengzhou University, Zhengzhou, China
| | - Xia Xue
- Academy of Medical Sciences, ZhengZhou University, Zhengzhou, China. .,Precision Medicine Center of ZhengZhou University, Zhengzhou, China.
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6
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Zhao F, Li J, Tang L, Li C, Wang W, Ning C. Characteristics of the genotype and phenotype in Chinese primary hyperoxaluria type 1 populations. Urolithiasis 2020; 49:17-25. [PMID: 32556641 DOI: 10.1007/s00240-020-01201-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/29/2020] [Indexed: 11/30/2022]
Abstract
The aim of our study is to explore the relationship between genotype and phenotype in Chinese PH1 patients and determine the putative mutation hotspot regions. This was a retrospective study regarding 13 Chinese PH1 patients. And all sporadic published researches of Chinese PH1 populations were searched and enrolled based on the inclusive standard. All patients presented with multiple urolithiasis or nephrolithiasis. Urinary oxalate values demonstrated an obvious and extensive variability, ranging from 1.01 to 3.85 mmol/1.73 m2. Molecular diagnosis showed that 13 mutant types were detected. Infantile form patient (pt.) 10 and five patients (pts. 5, 7, 8, 9, 12) carrying c.815_816insGA or c.33_34insC demonstrated a worse prognosis, of whom pt. 5 progressed into ESRD 4 years later and died of chronic kidney failure. Based on the integrated Chinese mutation data, two variants (c.815_816insGA and c.33_34insC) were determined as the most common mutations. Besides, c.1049G>A was initially identified in a Chinese patient. Conclusions: heterogeneity between genotype and phenotype was observed and described in Chinese PH1 patients. c.815_816insGA and c.33_34insC which were recognized as AGXT mutation hotspot regions in China implied a poor prognosis. And c.1049G>A was not determined as the race-specific mutation of Pakistani.
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Affiliation(s)
- Fangzhou Zhao
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Jun Li
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China.
| | - Lei Tang
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Chunming Li
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Wenying Wang
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
| | - Chen Ning
- Department of Urology, Capital Medical University Affiliated Beijing Friendship Hospital, Beijing, 100050, China
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Lu X, Chen W, Li L, Zhu X, Huang C, Liu S, Yang Y, Zhao Y. Two Novel AGXT Mutations Cause the Infantile Form of Primary Hyperoxaluria Type I in a Chinese Family: Research on Missed Mutation. Front Pharmacol 2019; 10:85. [PMID: 30787879 PMCID: PMC6372570 DOI: 10.3389/fphar.2019.00085] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 01/21/2019] [Indexed: 11/13/2022] Open
Abstract
Primary hyperoxaluria type 1 (PH1) is a rare metabolic disorder characterized by a defect in the liver-specific peroxisomal enzyme alanine-glyoxylate and serine-pyruvate aminotransferase (AGT). This disorder results in hyperoxaluria, recurrent urolithiasis, and nephrocalcinosis. Three forms of PH1 have been reported. Data on the infantile form of PH1 are currently limited in literature. Despite the fact that China is the most populated country in the world, only a few AGXT mutations have been reported in several Chinese PH1 patients. In the present study, we investigated a Chinese family in which two siblings are affected by the infantile form of PH1. Sanger sequencing was carried out on the proband, but the results were misleading. Two novel missense mutations (c.517T > C/p.Cys173Arg and c.667A > C/p.Ser223Arg) of the AGXT gene were successfully detected through whole-exome sequencing. These two mutations occurred in the highly conserved residues of the AGT. Four software programs predicted both mutations as the cause of the disease. A postmortem examination was performed and revealed the occurrence of global nephrocalcinosis on both kidneys. The crystals were collected and analyzed as calcium oxalate monohydrate. This study extends the knowledge on the clinical phenotype-genotype correlation of the AGXT mutation. That is, (i) two novel missense mutations were identified for the infantile form of PH1 and (ii) the same AGXT genotype caused the same infantile form of PH1 within the family.
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Affiliation(s)
- Xiulan Lu
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
- Pediatric Intensive Care Unit, Hunan Children’s Hospital, University of South China, Changsha, China
| | - Weijian Chen
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
- Department of Pathology, Hunan Children’s Hospital, University of South China, Changsha, China
| | - Liping Li
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
| | - Xinyuan Zhu
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
| | - Caizhi Huang
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
| | | | - Yongjia Yang
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
| | - Yaowang Zhao
- The Laboratory of Genetics and Metabolism, Hunan Children’s Research Institute (HCRI), Hunan Children’s Hospital, University of South China, Changsha, China
- Department of Urinary Surgery, Hunan Children’s Hospital, University of South China, Changsha, China
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Li X, Gu J, Yang Y, Li J, Li Y. A Putative Mutation Hotspot of the AGXT Gene Associated with Primary Hyperoxaluria Type 1 in the Chinese Population. TOHOKU J EXP MED 2018; 246:233-241. [DOI: 10.1620/tjem.246.233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Xiyuan Li
- Precision Medicine Center, General Hospital of Tianjin Medical University
| | - Jie Gu
- Department of Laboratory Animal Center, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
| | - Yanling Yang
- Department of Pediatrics, Peking University First Hospital
| | - Jun Li
- Department of Urology, Beijing Friendship Hospital, Capital Medical University
| | - Yanhan Li
- Department of Laboratory Animal Center, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College
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Kanoun H, Jarraya F, Maalej B, Lahiani A, Mahfoudh H, Makni F, Hachicha J, Fakhfakh F. Identification of compound heterozygous patients with primary hyperoxaluria type 1: clinical evaluations and in silico investigations. BMC Nephrol 2017; 18:303. [PMID: 28969594 PMCID: PMC5625645 DOI: 10.1186/s12882-017-0719-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Accepted: 09/20/2017] [Indexed: 01/04/2023] Open
Abstract
Background Primary hyperoxaluria type 1 (PH1) is an autosomal recessive inherited disorder of glyoxylate metabolism in which excessive oxalates are formed by the liver and excreted by the kidneys. Calcium oxalate crystallizes in the urine, leading to urolithiasis, nephrocalcinosis, and consequent renal failure if treatment is not initiated promptly. Mutations in the AGXT gene which encodes the hepatic peroxisomal enzyme alanine:glyoxylate aminotransferase are responsible of PH1. In the present work, we aimed to analyze AGXT gene and in silico investigations performed in four patients with PH1 among two non consanguineous families. Methods Exhaustive gene sequencing was performed after PCR amplification of coding exons and introns boundaries. Bioinformatic tools were used to predict the impact of AGXT variants on gene expression as well as on the protein structure and function. Results Direct sequencing of all exons of AGXT gene revealed the emergence of multiple mutations in compound heterozygous state in the two studied families. Two patients were compound heterozygous for the c.731 T > C, c.32C > T, c.1020A > G and c.33_34insC and presented clinically with recurrent urinary tract infection, multiple urolithiasis and nephrocalcinosis under the age of 1 year and a persistent hyperoxaluria at the age of diagnosis. The two other patients presenting a less severe phenotypes were heterozygous for c.731 T > C and homozygous for the c.32C > T and c.1020A > G or compound heterozygous for c.26C > A and c.65A > G variants. Conclusion In Summary, we provided relevance regarding the compound heterozygous mutations in non consanguineous PH1 families with variable severity.
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Affiliation(s)
- Houda Kanoun
- Laboratoire de Génétique Moléculaire Humaine, Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie. .,Unité de Recherche Pathologie rénale UR12ES14 et Service de Néphrologie, Hôpital Hédi Chaker Sfax, Sfax, Tunisia.
| | - Faiçal Jarraya
- Unité de Recherche Pathologie rénale UR12ES14 et Service de Néphrologie, Hôpital Hédi Chaker Sfax, Sfax, Tunisia
| | - Bayen Maalej
- Unité de Recherche Pathologie rénale UR12ES14 et Service de Néphrologie, Hôpital Hédi Chaker Sfax, Sfax, Tunisia.,Service de Pédiatrie, Hôpital Hédi Chaker Sfax, Sfax, Tunisia
| | - Amina Lahiani
- Laboratoire de Biochimie, Hôpital Habib Bourguiba Sfax, Sfax, Tunisia
| | - Hichem Mahfoudh
- Unité de Recherche Pathologie rénale UR12ES14 et Service de Néphrologie, Hôpital Hédi Chaker Sfax, Sfax, Tunisia
| | - Fatma Makni
- Laboratoire de Biochimie, Hôpital Habib Bourguiba Sfax, Sfax, Tunisia
| | - Jamil Hachicha
- Unité de Recherche Pathologie rénale UR12ES14 et Service de Néphrologie, Hôpital Hédi Chaker Sfax, Sfax, Tunisia
| | - Faiza Fakhfakh
- Laboratoire de Génétique Moléculaire Humaine, Faculté de Médecine de Sfax, Université de Sfax, Sfax, Tunisie. .,Département des Sciences de la vie, Faculté des Sciences de Sfax, Université des Sfax, Sfax, Tunisia.
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Bazin D, Leroy C, Tielens F, Bonhomme C, Bonhomme-Coury L, Damay F, Le Denmat D, Sadoine J, Rode J, Frochot V, Letavernier E, Haymann JP, Daudon M. Hyperoxaluria is related to whewellite and hypercalciuria to weddellite: What happens when crystalline conversion occurs? CR CHIM 2016. [DOI: 10.1016/j.crci.2015.12.011] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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12
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Dutta AK, Paulose BK, Danda S, Alexander S, Tamilarasi V, Omprakash S. Recurrent truncating mutations in alanine-glyoxylate aminotransferase gene in two South Indian families with primary hyperoxaluria type 1 causing later onset end-stage kidney disease. Indian J Nephrol 2016; 26:288-90. [PMID: 27512303 PMCID: PMC4964691 DOI: 10.4103/0971-4065.171244] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Primary hyperoxaluria type 1 is an autosomal recessive inborn error of metabolism due to liver-specific peroxisomal enzyme alanine-glyoxylate transaminase deficiency. Here, we describe two unrelated patients who were diagnosed to have primary hyperoxaluria. Homozygous c.445_452delGTGCTGCT (p.L151Nfs*14) (Transcript ID: ENST00000307503; human genome assembly GRCh38.p2) (HGMD ID CD073567) mutation was detected in both the patients and the parents were found to be heterozygous carriers. Our patients developed end-stage renal disease at 23 years and 35 years of age. However, in the largest series published from OxalEurope cohort, the median age of end-stage renal disease for null mutations carriers was 9.9 years, which is much earlier than our cases. Our patients had slower progressions as compared to three unrelated patients from North India and Pakistan, who had homozygous c.302T>C (p.L101P) (HGMD ID CM093792) mutation in exon 2. Further, patients need to be studied to find out if c.445_452delGTGCTGCT mutation represents a founder mutation in Southern India.
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Affiliation(s)
- A. K. Dutta
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - B. K. Paulose
- Department of Nephrology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - S. Danda
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - S. Alexander
- Department of Nephrology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - V. Tamilarasi
- Department of Nephrology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
| | - S. Omprakash
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, Tamil Nadu, India
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