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Jalali H, Zamanfar D, Amirzadegan M, Ghadami F, Mahdavi M, Mahdavi MR. Mutation Analysis of PAH Gene in Phenylketonuria Patients from the North of Iran: Identification of Three Novel Pathogenic Variants. Int J Prev Med 2024; 15:22. [PMID: 39170926 PMCID: PMC11338363 DOI: 10.4103/ijpvm.ijpvm_50_23] [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: 02/20/2023] [Accepted: 02/20/2024] [Indexed: 08/23/2024] Open
Abstract
Background There are more than 1100 different pathogenic variants in the phenylalanine hydroxylase (PAH) gene that are responsible for phenylketonuria (PKU) diseases, and the spectrum of these mutations varies in different ethnic groups. The aim of the present study was to identify the frequency of pathogenic variants in all 13 exons of the PAH gene among patients with PKU in Mazandaran and Golestan provinces in the north of Iran. Methods Forty unrelated PKU patients from Mazandaran and Golestan provinces were enrolled in the study. Genomic DNA was extracted from leukocytes using a Qiagen DNA extraction kit and polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP), and Sanger sequencing methods were applied to detect the variants. In the case of new variants, the InterVar online tool (PMID: 28132688) was used to classify the variants. Results Twenty-one different pathogenic variants were observed among the 40 investigated patients. The c.106611G>A variant had the highest frequency (27.5%) in the region, and the c.168+5G>C, c.473G>A, and c.782 G>A variants were the other most frequent mutations with allelic frequencies of 7.5, 5, and 5%, respectively. Three novel pathogenic variants including c.773T>G, c.878 T>C, and c. 1245del variants were observed among the investigated patients. Conclusions The introduction of pathogenic variants in the PAH gene in each ethnic group provides valuable data regarding the understanding of the pathogenesis of the disease and can be helpful for prenatal diagnosis programs.
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Affiliation(s)
- Hossein Jalali
- Thalassemia Research Center, Hemoglobinopathies Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Daniel Zamanfar
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | | | - Farshide Ghadami
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahan Mahdavi
- Diabetes Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mohammad Reza Mahdavi
- Thalassemia Research Center, Hemoglobinopathies Institute, Mazandaran University of Medical Sciences, Sari, Iran
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2
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Baynam G, Baker S, Steward C, Summar M, Halley M, Pariser A. Increasing Diversity, Equity, Inclusion, and Accessibility in Rare Disease Clinical Trials. Pharmaceut Med 2024; 38:261-276. [PMID: 38977611 DOI: 10.1007/s40290-024-00529-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2024] [Indexed: 07/10/2024]
Abstract
Diversity, equity, inclusion, and accessibility (DEIA) are foundational principles for clinical trials and medical research. In rare diseases clinical research, where numbers of participants are already challenged by rarity itself, maximizing inclusion is of particular importance to clinical trial success, as well as ensuring the generalizability and relevance of the trial results to the people affected by these diseases. In this article, we review the medical and gray literature and cite case examples to provide insights into how DEIA can be proactively integrated into rare diseases clinical research. Here, we particularly focus on genetic diversity. While the rare diseases DEIA literature is nascent, it is accelerating as many patient advocacy groups, professional societies, training and educational organizations, researcher groups, and funders are setting intentional strategies to attain DEIA goals moving forward, and to establish metrics to ensure continued improvement. Successful examples in underserved and underrepresented populations are available that can serve as case studies upon which rare diseases clinical research programs can be built. Rare diseases have historically been innovation drivers in basic, translational, and clinical research, and ultimately, all populations benefit from data diversity in rare diseases populations that deliver novel insights and approaches to how clinical research can be performed.
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Affiliation(s)
- Gareth Baynam
- Rare Care Centre, Perth Children's Hospital, Perth, WA, Australia
| | - Simeón Baker
- Genomics England, London, UK
- HealthWeb Solutions, London, UK
- School of Health Studies, University of Western Ontario, London, ON, Canada
| | | | | | - Meghan Halley
- Stanford Center for Biomedical Ethics, Stanford University School of Medicine, Stanford, CA, USA
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Tebieva IS, Mishakova PV, Gabisova YV, Khokhova AV, Kaloeva TG, Marakhonov AV, Shchagina OA, Polyakov AV, Ginter EK, Kutsev SI, Zinchenko RA. Genetic Landscape and Clinical Features of Hyperphenylalaninemia in North Ossetia-Alania: High Frequency of P281L and P211T Genetic Variants in the PAH Gene. Int J Mol Sci 2024; 25:4598. [PMID: 38731816 PMCID: PMC11083185 DOI: 10.3390/ijms25094598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Revised: 03/30/2024] [Accepted: 04/05/2024] [Indexed: 05/13/2024] Open
Abstract
This study, conducted in the Republic of North Ossetia-Alania (RNOA), aimed to explore the genetic landscape of hyperphenylalaninemia (HPA) and phenylketonuria (PKU) in the Ossetian population using data from newborn screening (NBS). Through comprehensive molecular genetic analysis of 29 patients with HPA from diverse ethnic backgrounds, two major genetic variants in the PAH gene, P281L and P211T, were identified, constituting 50% of all detected pathogenic alleles in Ossetian patients. Remarkably, these variants exhibited an exceptionally high frequency in the Ossetian population, surpassing global prevalence rates. This study unveiled a notable prevalence of mild forms of HPA (78%), underscoring the importance of genetic counseling for carriers of pathogenic variants in the PAH gene. Moreover, the findings emphasized the necessity for ongoing monitoring of patients with mild forms, as they may lack significant symptoms for diagnosis, potentially impacting offspring. Overall, this research offers valuable insights into the genetic landscape of HPA and PKU in the Ossetian population.
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Affiliation(s)
- Inna S. Tebieva
- North-Ossetian State Medical Academy, 362003 Vladikavkaz, Russia; (I.S.T.); (T.G.K.)
- Republican Children’s Clinical Hospital, 362003 Vladikavkaz, Russia; (Y.V.G.); (A.V.K.)
| | - Polina V. Mishakova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (P.V.M.); (A.V.M.); (O.A.S.); (A.V.P.); (E.K.G.); (S.I.K.)
| | - Yulia V. Gabisova
- Republican Children’s Clinical Hospital, 362003 Vladikavkaz, Russia; (Y.V.G.); (A.V.K.)
| | - Alana V. Khokhova
- Republican Children’s Clinical Hospital, 362003 Vladikavkaz, Russia; (Y.V.G.); (A.V.K.)
| | - Tamara G. Kaloeva
- North-Ossetian State Medical Academy, 362003 Vladikavkaz, Russia; (I.S.T.); (T.G.K.)
| | - Andrey V. Marakhonov
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (P.V.M.); (A.V.M.); (O.A.S.); (A.V.P.); (E.K.G.); (S.I.K.)
| | - Olga A. Shchagina
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (P.V.M.); (A.V.M.); (O.A.S.); (A.V.P.); (E.K.G.); (S.I.K.)
| | - Alexander V. Polyakov
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (P.V.M.); (A.V.M.); (O.A.S.); (A.V.P.); (E.K.G.); (S.I.K.)
| | - Evgeny K. Ginter
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (P.V.M.); (A.V.M.); (O.A.S.); (A.V.P.); (E.K.G.); (S.I.K.)
| | - Sergey I. Kutsev
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (P.V.M.); (A.V.M.); (O.A.S.); (A.V.P.); (E.K.G.); (S.I.K.)
| | - Rena A. Zinchenko
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (P.V.M.); (A.V.M.); (O.A.S.); (A.V.P.); (E.K.G.); (S.I.K.)
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4
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Shchagina O, Kurilova V, Zinina E, Porubov V, Efishova S, Polyakov A. Step-by-Step Double-Trouble OBAIRH and DMD Diagnosis in a One-Year-Old Boy. Int J Mol Sci 2023; 24:12357. [PMID: 37569734 PMCID: PMC10418305 DOI: 10.3390/ijms241512357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/30/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
We present a case of a combination of two rare hereditary disorders: obesity, adrenal insufficiency and red hair syndrome (OBAIRH) and Duchenne muscular dystrophy (DMD) in a boy. Both diseases were diagnosed during the first year of life. OBAIRH was suggested based on the ethnicity and family history of the patient, while DMD was based on an extreme increase in transaminase and CK (creatine kinase) levels during a biochemical analysis of his blood. The OBAIRH syndrome was caused by a pathogenic homozygous variant in the regulatory region of the POMC gene (NM_001035256.3): c.-71+1G>A, while DMD was caused by the de novo deletion of exons 38-45 of the DMD (NM_004006.3) gene (NC_000023.10:g.(?_32380941)(31950285_?)del).
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Affiliation(s)
- Olga Shchagina
- Research Centre for Medical Genetics, Moscow 115522, Russia; (E.Z.); (A.P.)
| | - Vera Kurilova
- State Budgetary Institution of Health of the Perm Region “Regional Children’s Clinical Hospital”, Perm 614066, Russia; (V.K.); (V.P.); (S.E.)
| | - Elena Zinina
- Research Centre for Medical Genetics, Moscow 115522, Russia; (E.Z.); (A.P.)
| | - Vyacheslav Porubov
- State Budgetary Institution of Health of the Perm Region “Regional Children’s Clinical Hospital”, Perm 614066, Russia; (V.K.); (V.P.); (S.E.)
| | - Svetlana Efishova
- State Budgetary Institution of Health of the Perm Region “Regional Children’s Clinical Hospital”, Perm 614066, Russia; (V.K.); (V.P.); (S.E.)
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Balobaid A, Imtiaz F, Ramzan K, Afzal S, AlSayed M. Identification of Variants Underlying Phenylalanine Hydroxylase Deficiency in Saudi Arabia. Genet Test Mol Biomarkers 2023; 27:142-148. [PMID: 37257178 DOI: 10.1089/gtmb.2022.0218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
Background: Deleterious mutations in the human gene phenylalanine hydroxylase (PAH) encoding the phenylalanine hydroxylase enzyme give rise to classic phenylketonuria and hyperphenylalaninemia. Our study was designed to characterize the spectrum of variants in the PAH gene in Saudi patients. Materials and Methods: We screened a cohort of 72 Saudi patients with clinical and biochemical diagnoses of hyperphenylalaninemia at the largest tertiary care center in Saudi Arabia; the King Faisal Specialist Hospital and Research Center (KFSH&RC), Riyadh. All patient's charts were reviewed under an approved study by Institutional Review Board. Results: Twenty-one different PAH variants were identified among the 144 PAH alleles assessed by targeted gene sequencing. Within the studied cohort, 60 of 72 patients had homozygous mutations with the the remaining 12 being compound heterozygotes. The most prevalent of the disease alleles identified in this study was the p.(Arg252Trp) mutation, which accounted for 38 of 144 alleles (26.4%). With the high incidence of genetic disorders in the population, religiously permissible preventive reproductive measures are a priority in our practice. Prenatal diagnoses carried out on four fetuses revealed two that were homozygous for PAH pathogenic variants. In addition, pre-implantation genetic diagnoses were initiated for 19 families. Eight of these families completed more than one full cycle of treatment, from which one healthy newborn was delivered. Conclusions: This study describes the spectrum of PAH variants in the Saudi population and highlights the molecular heterogeneity underlying phenylketonuria and hyperphenylalaninemia. These results add to the existing knowledge about PAH variants in Middle Eastern Countries. These results can be further translated to provide: informed counseling; cascade carrier testing in extended family members; and pre-marital screening.
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Affiliation(s)
- Ameera Balobaid
- Department of Medical Genomics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Faiqa Imtiaz
- Department of Clinical Genomics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Khushnooda Ramzan
- Department of Clinical Genomics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
| | - Sibtain Afzal
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Moeenaldeen AlSayed
- Department of Medical Genomics, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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6
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Zhang C, Zhang P, Yan Y, Zhou B, Wang Y, Tian X, Hao S, Ma P, Zheng L, Zhang Q, Hui L, Wang Y, Cao Z, Ma X. The spectrum of phenylalanine hydroxylase variants and genotype-phenotype correlation in phenylketonuria patients in Gansu, China. Hum Genomics 2023; 17:36. [PMID: 37098607 PMCID: PMC10127316 DOI: 10.1186/s40246-023-00475-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/15/2023] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND Phenylketonuria (PKU) is a common, congenital, autosomal recessive, metabolic disorder caused by Phenylalanine hydroxylase (PAH) variants. METHODS 967 PKU patients from Gansu, China were genotyped by Sanger sequencing, multiplex ligation-dependent probe amplification, and whole exome sequencing. We analyzed the variants of PAH exons, their flanking sequences, and introns. RESULTS The detection of deep intronic variants in PAH gene can significantly improve the genetic diagnostic rate of PKU. The distribution of PAH variants among PKU subtypes may be related to the unique genetic background in Gansu, China. CONCLUSION The identification of PAH hotspot variants will aid the development of large-scale neonatal genetic screening for PKU. The five new PAH variants found in this study further expand the spectrum of PAH variants. Genotype-phenotype correlation analysis may help predict the prognosis of PKU patients and enable precise treatment regimens to be developed.
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Affiliation(s)
- Chuan Zhang
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
- National Research Institute for Family Planning , National Human Genetic Resources Center, Beijing, China
| | - Pei Zhang
- Department of Nosocomial Infection Management, Lanzhou University Second Hospital, Lanzhou, China
| | - Yousheng Yan
- Prenatal Diagnostic Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Bingbo Zhou
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Yupei Wang
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Xinyuan Tian
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Shengju Hao
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Panpan Ma
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Lei Zheng
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Qinghua Zhang
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Ling Hui
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Yan Wang
- Gansu Province Medical Genetics Center,Gansu Provincial Clinical Research Center for Birth Defects and Rare Diseases, Gansu Provincial Maternity and Child-Care Hospital, Lanzhou, China
| | - Zongfu Cao
- National Research Institute for Family Planning , National Human Genetic Resources Center, Beijing, China.
| | - Xu Ma
- National Research Institute for Family Planning , National Human Genetic Resources Center, Beijing, China.
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7
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Zinchenko RA, Ginter EK, Marakhonov AV, Petrova NV, Kadyshev VV, Vasilyeva TP, Alexandrova OU, Polyakov AV, Kutsev SI. Epidemiology of Rare Hereditary Diseases in the European Part of Russia: Point and Cumulative Prevalence. Front Genet 2021; 12:678957. [PMID: 34527017 PMCID: PMC8435741 DOI: 10.3389/fgene.2021.678957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 07/15/2021] [Indexed: 11/20/2022] Open
Abstract
The issue of point prevalence, cumulative prevalence (CP), and burden of rare hereditary diseases (RHD), comprising 72–80% of the group of rare diseases, is discussed in many reports and is an urgent problem, which is associated with the rapid progress of genetic technology, the identification of thousands of genes, and the resulting problems in society. This work provides an epidemiological analysis of the groups of the most common RHDs (autosomal dominant, autosomal recessive, and X-linked) and their point prevalence (PP) and describes the structure of RHD diversity by medical areas in 14 spatially remote populations of the European part of Russia. The total size of the examined population is about 4 million. A total of 554 clinical forms of RHDs in 10,265 patients were diagnosed. The CP for all RHDs per sample examined was 277.21/100,000 (1:361 people). It is worth noting that now is the time for characterizing the accumulated data on the point prevalence of RHDs, which will help to systematize our knowledge and allow us to develop a strategy of care for patients with RHDs. However, it is necessary to address the issues of changing current medical classifications and coding systems for nosological forms of RHDs, which have not kept pace with genetic advances.
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Affiliation(s)
- Rena A Zinchenko
- Research Centre for Medical Genetics, Moscow, Russia.,Department of Public Health Research, N.A. Semashko National Research Institute of Public Health, Moscow, Russia
| | | | | | | | | | - Tatyana P Vasilyeva
- Department of Public Health Research, N.A. Semashko National Research Institute of Public Health, Moscow, Russia
| | - Oksana U Alexandrova
- Department of Public Health Research, N.A. Semashko National Research Institute of Public Health, Moscow, Russia
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8
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Posukh OL. Genetic etiology of hearing loss in Russia. Hum Genet 2021; 141:649-663. [PMID: 34363095 DOI: 10.1007/s00439-021-02327-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 07/28/2021] [Indexed: 10/20/2022]
Abstract
Prevalence and locus/allelic heterogeneity of the hereditary hearing loss (HL) vary significantly in different human populations. Investigation of the hereditary HL diversity and the evaluation of the factors determining the region-specific landscapes of genetic HL are important for local healthcare and medical genetic services. This review presents the summarized data from the published studies concerning the genetic etiology of HL in different populations of Russia. Multiethnic population of Russia (in total, about 146 million on 2021) includes over 180 different ethnic groups, the number of which varies from millions to just several thousand people. Among them, Russians are the largest group (about 111 million). The contribution of GJB2 gene in the HL etiology in patients of different ethnicities and ethnic-specific prevalence of the GJB2 pathogenic variants were studied in many local populations of Russia. However, the investigation of other "deafness" genes is still limited to a relatively small number of studies on patients with HL of unsolved etiology.
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Affiliation(s)
- Olga L Posukh
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia, 630090. .,Novosibirsk State University, Novosibirsk, Russia, 630090.
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9
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Abstract
Phenylketonuria (PKU; also known as phenylalanine hydroxylase (PAH) deficiency) is an autosomal recessive disorder of phenylalanine metabolism, in which especially high phenylalanine concentrations cause brain dysfunction. If untreated, this brain dysfunction results in severe intellectual disability, epilepsy and behavioural problems. The prevalence varies worldwide, with an average of about 1:10,000 newborns. Early diagnosis is based on newborn screening, and if treatment is started early and continued, intelligence is within normal limits with, on average, some suboptimal neurocognitive function. Dietary restriction of phenylalanine has been the mainstay of treatment for over 60 years and has been highly successful, although outcomes are still suboptimal and patients can find the treatment difficult to adhere to. Pharmacological treatments are available, such as tetrahydrobiopterin, which is effective in only a minority of patients (usually those with milder PKU), and pegylated phenylalanine ammonia lyase, which requires daily subcutaneous injections and causes adverse immune responses. Given the drawbacks of these approaches, other treatments are in development, such as mRNA and gene therapy. Even though PAH deficiency is the most common defect of amino acid metabolism in humans, brain dysfunction in individuals with PKU is still not well understood and further research is needed to facilitate development of pathophysiology-driven treatments.
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Affiliation(s)
- Francjan J van Spronsen
- Beatrix Children's Hospital, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands.
| | - Nenad Blau
- University Children's Hospital in Zurich, Zurich, Switzerland
| | - Cary Harding
- Department of Molecular and Medical Genetics and Department of Pediatrics, Oregon Health & Science University, Oregon, USA
| | | | - Nicola Longo
- Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA
| | - Annet M Bosch
- University of Amsterdam, Department of Pediatrics, Division of Metabolic Disorders, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
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10
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Hozyasz KK, Żółkowska J, Chyż K. Comparison of phenylalanine tolerance in singleton and twin pregnancies in patients with phenylketonuria. J Int Med Res 2021; 48:300060520934623. [PMID: 32962492 PMCID: PMC7520934 DOI: 10.1177/0300060520934623] [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] [Indexed: 11/25/2022] Open
Abstract
Objectives Empirical determination of phenylalanine (Phe) tolerance in patients with
phenylketonuria (PKU) relies on frequent assessment of blood Phe
concentrations in relation to Phe intake from detailed meal records. This
study aimed to determine Phe tolerance in twin pregnancies. Methods The reviewed cases included three women with PKU who each had a singleton and
twin pregnancy (i.e., they were pregnant twice). All patients were under
regular supervision to maintain Phe concentrations in a steady state and
determine safe Phe intake. Restriction of Phe in the patient’s diet was
determined depending on the amount of Phe intake, which allowed for stable
blood Phe concentrations within the target range. Results In all three patients with PKU, the ratio of Phe tolerance during the course
of the twin and singleton pregnancies was <1 for most of the pregnancy.
The ratio of the increase in Phe tolerance between 29 and 34 weeks of
gestation and that between 15 and 28 weeks of gestation was 0.66 and 1.17,
0.51 and 0.14, and 0.76 and 1.42 in the twin and singleton pairs of
pregnancies, respectively. Conclusions Our study shows that Phe tolerance in a twin pregnancy is not greater than
that in a singleton pregnancy.
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Affiliation(s)
- Kamil Konrad Hozyasz
- Institute of Health Sciences, State School of Higher Education, Biała Podlaska, Poland
| | | | - Katarzyna Chyż
- PKU Polyclinic, Institute of Mother and Child, Warsaw, Poland
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11
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Romanov GP, Pshennikova VG, Lashin SA, Solovyev AV, Teryutin FM, Cherdonova AM, Borisova TV, Sazonov NN, Khusnutdinova EK, Posukh OL, Fedorova SA, Barashkov NA. A new approach to estimating the prevalence of hereditary hearing loss: An analysis of the distribution of sign language users based on census data in Russia. PLoS One 2020; 15:e0242219. [PMID: 33253245 PMCID: PMC7703874 DOI: 10.1371/journal.pone.0242219] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/28/2020] [Indexed: 11/19/2022] Open
Abstract
The absence of comparable epidemiological data challenges the correct estimation of the prevalence of congenital hearing loss (HL) around the world. Sign language (SL) is known as the main type of communication of deaf people. We suggest that the distribution of SL can be interpreted as an indirect indicator of the prevalence of congenital HL. Since a significant part of congenital HL is due to genetic causes, an assessment of the distribution of SL users can reveal regions with an extensive accumulation of hereditary HL. For the first time, we analyzed the data on the distribution of SL users that became available for the total population of Russia by the 2010 census. Seventy-three out of 85 federal regions of Russia were ranked into three groups by the 25th and 75th percentiles of the proportion of SL users: 14 regions-"low proportion"; 48 regions-"average proportion"; and 11 regions-"high proportion". We consider that the observed uneven prevalence of SL users can reflect underlying hereditary forms of congenital HL accumulated in certain populations by specific genetic background and population structure. At least, the data from this study indicate that the highest proportions of SL users detected in some Siberian regions are consistent with the reported accumulation of specific hereditary HL forms in indigenous Yakut, Tuvinian and Altaian populations.
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Affiliation(s)
- Georgii P. Romanov
- Laboratory of Molecular Biology, MK Ammosov North-Eastern Federal University, Yakutsk, Russia
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russia
| | - Vera G. Pshennikova
- Laboratory of Molecular Biology, MK Ammosov North-Eastern Federal University, Yakutsk, Russia
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russia
| | - Sergey A. Lashin
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
- Novosibirsk State University, Novosibirsk, Russia
| | - Aisen V. Solovyev
- Laboratory of Molecular Biology, MK Ammosov North-Eastern Federal University, Yakutsk, Russia
- Laboratory of the Human in the Arctic, Institute for Humanitarian Research and North Indigenous Peoples Problems, Federal Research Centre “The Yakut Scientific Centre of the Siberian Branch of the Russian Academy of Sciences”, Yakutsk, Russia
| | - Fedor M. Teryutin
- Laboratory of Molecular Biology, MK Ammosov North-Eastern Federal University, Yakutsk, Russia
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russia
| | | | - Tuyara V. Borisova
- Laboratory of Molecular Biology, MK Ammosov North-Eastern Federal University, Yakutsk, Russia
| | - Nikolay N. Sazonov
- Laboratory of Molecular Biology, MK Ammosov North-Eastern Federal University, Yakutsk, Russia
| | - Elza K. Khusnutdinova
- Laboratory of Human Molecular Genetics, Institute of Biochemistry and Genetics, Ufa Federal Research Centre of the Russian Academy of Sciences, Ufa, Russia
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russia
| | - Olga L. Posukh
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russia
- Novosibirsk State University, Novosibirsk, Russia
| | - Sardana A. Fedorova
- Laboratory of Molecular Biology, MK Ammosov North-Eastern Federal University, Yakutsk, Russia
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russia
| | - Nikolay A. Barashkov
- Laboratory of Molecular Biology, MK Ammosov North-Eastern Federal University, Yakutsk, Russia
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russia
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12
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Zhao Z, Liu X, Huang C, Xu H, Fu C. Variants of the phenylalanine hydroxylase gene in neonates with phenylketonuria in Hainan, China. Scandinavian Journal of Clinical and Laboratory Investigation 2020; 80:619-622. [PMID: 33161754 DOI: 10.1080/00365513.2020.1827287] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the incidence of phenylalanine hydroxylase (PAH) deficiency and PAH genotypes in neonates in Hainan, China. Methods: We performed heal stick to collect blood and obtain dry blood spot specimens from newborns in Hainan from January 2007 to December 2016. Phenylalanine (Phe) concentration in these dry blood spots was measured by the fluorescence method to screen phenylketonuria (PKU). For suspicious samples, the genotypes of the PAH gene were amplified by biotin labeled oligonucleotide primers. Polymerase chain reaction (PCR) products were then analyzed by flow-through hybridization to detect genotypes. At the same time, peripheral blood samples of children suspicious of PKU and their parents were used to perform gene sequencing. Results: Of the 914,520 newborns screened, 29 of them had PAH deficiency. The incidence of PAH deficiency in Hainan was 3.17/100,000. A total of 58 mutant alleles belonging to 15 different types were identified in the 29 patients. In terms of genotypes frequency, the top 4 were: c.611A > G 20.7% (12/58) , c.728G > A 17.2%, c.158G > A 15.2% (9/58) and c.721C > T 13.8% (8/58). The frequencies of other genotypes were all below 10%. Conclusion: The incidence of PAH deficiency in Hainan is relatively high among all provinces in southern China. With a total frequency of 67.2%, c.611A > G, c.728G > A, c.158G > A and c.721C > T, and are the most common PAH gene genotypes.
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Affiliation(s)
- Zhendong Zhao
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
| | - Xiulian Liu
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
| | - Cidan Huang
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
| | - Haizhu Xu
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
| | - Chaohui Fu
- Hainan Women and Children's Medical Center, Hainan Newborn Screening Center, Haikou, China
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13
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Carducci C, Amayreh W, Ababneh H, Mahasneh A, Al Rababah B, Al Qaqa K, Al Aqeel M, Artiola C, Tolve M, D'Amici S, Shen N, Yu Y, Hillert A, Himmelreich N, Okun JG, Hoffmann GF, Blau N. Molecular genetics of phenylketonuria and tetrahydrobiopterin deficiency in Jordan. JIMD Rep 2020; 55:59-67. [PMID: 32905092 PMCID: PMC7463056 DOI: 10.1002/jmd2.12130] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/27/2020] [Accepted: 05/04/2020] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Information regarding the prevalence of PKU in the Middle East in comparison to other world regions is scarce, which might be explained by difficulties in the implementation of national newborn screening programs. OBJECTIVE This study seeks for the first time to genotype and biochemically characterize patients diagnosed with hyperphenylalaninemia (HPA) at the Pediatric Metabolic Genetics Clinic at the King Hussein Medical Center, Amman, Jordan. METHODS A total of 33 patients with HPA and 55 family members were investigated for pterins (neopterin and biopterin) and dihydropteridine reductase (DHPR) activity in dried blood spots. Patients with HPA were genotyped for phenylketonuria (PKU) and the genes involved in tetrahydrobiopterin (BH4) metabolism. RESULTS In total 20 patients were diagnosed with PKU due to phenylalanine hydroxylase (PAH) deficiency, 2 with GTP cyclohydrolase I (GTPCH) deficiency, 6 with DHPR deficiency, and 3 with the 6-pyruvoyl-tetrahydropterin synthase (PTPS) deficiency. Diagnosis was not possible in 2 patients. This study documents a high percentage of BH4 deficiencies within HPA patients. With one exception, all patients were homozygous for particular gene variants. CONCLUSIONS This approach enables differentiation between PKU and BH4 deficiencies and, thus, allows for critical selection of a specific treatment strategies.
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Affiliation(s)
- Carla Carducci
- Department of Experimental MedicineUniversity of Rome “La Sapienza”RomeItaly
| | - Wajdi Amayreh
- Queen Rania Children Hospital, King Hussein Medical CentreAmmanJordan
- Princess Haya Biotechnology CentreJordan University of Science and TechnologyIrbidJordan
| | - Haneen Ababneh
- Princess Haya Biotechnology CentreJordan University of Science and TechnologyIrbidJordan
- Department of Biotechnology and Genetic EngineeringJordan University of Science and TechnologyIrbidJordan
| | - Amjad Mahasneh
- Princess Haya Biotechnology CentreJordan University of Science and TechnologyIrbidJordan
- Department of Biotechnology and Genetic EngineeringJordan University of Science and TechnologyIrbidJordan
| | - Buthaina Al Rababah
- Princess Haya Biotechnology CentreJordan University of Science and TechnologyIrbidJordan
| | - Kefah Al Qaqa
- Queen Rania Children Hospital, King Hussein Medical CentreAmmanJordan
| | - Momen Al Aqeel
- Queen Rania Children Hospital, King Hussein Medical CentreAmmanJordan
| | - Cristiana Artiola
- Department of Experimental MedicineUniversity of Rome “La Sapienza”RomeItaly
| | - Manuela Tolve
- Department of Experimental MedicineUniversity of Rome “La Sapienza”RomeItaly
| | - Sirio D'Amici
- Department of Experimental MedicineUniversity of Rome “La Sapienza”RomeItaly
| | - Nan Shen
- Department of Rehabilitation MedicineXin Hua Hospital affiliated to Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Yongguo Yu
- Department of Pediatric Endocrinology and Genetic MetabolismShanghai Institute for Pediatric Research, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong UniversityShanghaiChina
| | - Alicia Hillert
- Dietmar Hopp Metabolic Center and Centre for Pediatrics and Adolescent MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Nastassja Himmelreich
- Dietmar Hopp Metabolic Center and Centre for Pediatrics and Adolescent MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Jürgen G. Okun
- Dietmar Hopp Metabolic Center and Centre for Pediatrics and Adolescent MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Georg F. Hoffmann
- Dietmar Hopp Metabolic Center and Centre for Pediatrics and Adolescent MedicineUniversity Hospital HeidelbergHeidelbergGermany
| | - Nenad Blau
- Dietmar Hopp Metabolic Center and Centre for Pediatrics and Adolescent MedicineUniversity Hospital HeidelbergHeidelbergGermany
- Division of MetabolismUniversity Children's HospitalZürichSwitzerland
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14
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Hillert A, Anikster Y, Belanger-Quintana A, Burlina A, Burton BK, Carducci C, Chiesa AE, Christodoulou J, Đorđević M, Desviat LR, Eliyahu A, Evers RAF, Fajkusova L, Feillet F, Bonfim-Freitas PE, Giżewska M, Gundorova P, Karall D, Kneller K, Kutsev SI, Leuzzi V, Levy HL, Lichter-Konecki U, Muntau AC, Namour F, Oltarzewski M, Paras A, Perez B, Polak E, Polyakov AV, Porta F, Rohrbach M, Scholl-Bürgi S, Spécola N, Stojiljković M, Shen N, Santana-da Silva LC, Skouma A, van Spronsen F, Stoppioni V, Thöny B, Trefz FK, Vockley J, Yu Y, Zschocke J, Hoffmann GF, Garbade SF, Blau N. The Genetic Landscape and Epidemiology of Phenylketonuria. Am J Hum Genet 2020; 107:234-250. [PMID: 32668217 PMCID: PMC7413859 DOI: 10.1016/j.ajhg.2020.06.006] [Citation(s) in RCA: 145] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 06/05/2020] [Indexed: 11/22/2022] Open
Abstract
Phenylketonuria (PKU), caused by variants in the phenylalanine hydroxylase (PAH) gene, is the most common autosomal-recessive Mendelian phenotype of amino acid metabolism. We estimated that globally 0.45 million individuals have PKU, with global prevalence 1:23,930 live births (range 1:4,500 [Italy]-1:125,000 [Japan]). Comparing genotypes and metabolic phenotypes from 16,092 affected subjects revealed differences in disease severity in 51 countries from 17 world regions, with the global phenotype distribution of 62% classic PKU, 22% mild PKU, and 16% mild hyperphenylalaninemia. A gradient in genotype and phenotype distribution exists across Europe, from classic PKU in the east to mild PKU in the southwest and mild hyperphenylalaninemia in the south. The c.1241A>G (p.Tyr414Cys)-associated genotype can be traced from Northern to Western Europe, from Sweden via Norway, to Denmark, to the Netherlands. The frequency of classic PKU increases from Europe (56%) via Middle East (71%) to Australia (80%). Of 758 PAH variants, c.1222C>T (p.Arg408Trp) (22.2%), c.1066-11G>A (IVS10-11G>A) (6.4%), and c.782G>A (p.Arg261Gln) (5.5%) were most common and responsible for two prevalent genotypes: p.[Arg408Trp];[Arg408Trp] (11.4%) and c.[1066-11G>A];[1066-11G>A] (2.6%). Most genotypes (73%) were compound heterozygous, 27% were homozygous, and 55% of 3,659 different genotypes occurred in only a single individual. PAH variants were scored using an allelic phenotype value and correlated with pre-treatment blood phenylalanine concentrations (n = 6,115) and tetrahydrobiopterin loading test results (n = 4,381), enabling prediction of both a genotype-based phenotype (88%) and tetrahydrobiopterin responsiveness (83%). This study shows that large genotype databases enable accurate phenotype prediction, allowing appropriate targeting of therapies to optimize clinical outcome.
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Affiliation(s)
- Alicia Hillert
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, Clinic I, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Yair Anikster
- Metabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Aviv University, 52621 Tel-Aviv, Israel
| | - Amaya Belanger-Quintana
- Unidad de Enfermedades Metabolicas, Servicio de Pediatria, Hospital Ramon y Cajal, 28034 Madrid, Spain
| | - Alberto Burlina
- Division of Inherited Metabolic Diseases, Department of Woman's and Child's Health, University Hospital, 35129 Padua, Italy
| | - Barbara K Burton
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Carla Carducci
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy
| | - Ana E Chiesa
- Fundación de Endocrinología Infantil (FEI), C1425 Buenos Aires, Argentina
| | - John Christodoulou
- Murdoch Children's Research Institute and Department of Pediatrics, University of Melbourne, Melbourne, VIC 3052, Australia
| | - Maja Đorđević
- Institute of Mother and Child Healthcare "Dr. Vukan Čupić," 11000 Belgrade, Serbia
| | - Lourdes R Desviat
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid. CIBERER, IdiPAz, 28049 Madrid, Spain
| | - Aviva Eliyahu
- Metabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Aviv University, 52621 Tel-Aviv, Israel
| | - Roeland A F Evers
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Section of Metabolic Diseases, 9712 CP Groningen, the Netherlands
| | - Lena Fajkusova
- Centre of Molecular Biology and Gene Therapy, University Hospital Brno, 62500 Brno, Czech Republic
| | - François Feillet
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 54511 Vandoeuvre-lès-Nancy, France
| | - Pedro E Bonfim-Freitas
- Laboratory of Inborn Errors of Metabolism, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, Brazil
| | - Maria Giżewska
- Department of Pediatrics, Endocrinology, Diabetology, Metabolic Diseases and Cardiology, Pomeranian Medical University, 71-252 Szczecin, Poland
| | | | - Daniela Karall
- Clinic of Pediatrics, Division of Inherited Metabolic Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Katya Kneller
- Metabolic Disease Unit, Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Aviv University, 52621 Tel-Aviv, Israel
| | | | - Vincenzo Leuzzi
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
| | - Harvey L Levy
- Division of Genetics and Genomics, Boston Children's Hospital, Harvard Medical School, Boston, MA 02115, USA
| | | | - Ania C Muntau
- University Children's Hospital, University Medical Center Hamburg Eppendorf, 20246 Hamburg, Germany
| | - Fares Namour
- Reference Center for Inherited Metabolic Diseases, University Hospital of Nancy, 54511 Vandoeuvre-lès-Nancy, France
| | - Mariusz Oltarzewski
- Department of Screening and Metabolic Diagnostics, Institute of Mother and Child, 01-211 Warsaw, Poland
| | - Andrea Paras
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
| | - Belen Perez
- Centro de Diagnóstico de Enfermedades Moleculares, Centro de Biología Molecular CSIC-UAM, Universidad Autónoma de Madrid. CIBERER, IdiPAz, 28049 Madrid, Spain
| | - Emil Polak
- Comenius University, Faculty of Natural Sciences, Department of Molecular Biology, 84215 Bratislava 4, Slovak Republic
| | | | - Francesco Porta
- Department of Pediatrics, AOU Citta' della Salute e della Scienza di Torino, 10126 Torino, Italy
| | - Marianne Rohrbach
- Division of Metabolism, University Children's Hospital, 8032 Zürich, Switzerland
| | - Sabine Scholl-Bürgi
- Clinic of Pediatrics, Division of Inherited Metabolic Disorders, Medical University of Innsbruck, 6020 Innsbruck, Austria
| | - Norma Spécola
- Unidad de Metabolismo. Hospital de Niños "Sor Ludovica" de La Plata, 1904 Buenos Aires, Argentina
| | - Maja Stojiljković
- Institute of Molecular Genetics and Genetic Engineering, University of Belgrade, 11000 Belgrade, Serbia
| | - Nan Shen
- Department of Infectious Diseases, Shanghai Children's Medical Center, Shanghai Jiao Tong University School of Medicine, 2000025 Shanghai, China
| | - Luiz C Santana-da Silva
- Laboratory of Inborn Errors of Metabolism, Institute of Biological Sciences, Federal University of Pará, Belém 66075-110, Brazil
| | | | - Francjan van Spronsen
- University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Section of Metabolic Diseases, 9712 CP Groningen, the Netherlands
| | - Vera Stoppioni
- Centro Screening Neonatale Regione Marche, Azienda Ospedaliera Ospedali Riuniti Marche Nord, 61032 Fano, Italy
| | - Beat Thöny
- Division of Metabolism, University Children's Hospital, 8032 Zürich, Switzerland
| | - Friedrich K Trefz
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, Clinic I, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Jerry Vockley
- UPMC, Children's Hospital of Pittsburgh, Pittsburgh, PA 15224, USA
| | - Youngguo Yu
- Department of Pediatric Endocrinology/Genetics, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Institute for Pediatric Research, 2000025 Shanghai, China
| | - Johannes Zschocke
- Institute of Human Genetics, Medical University Innsbruck, 6020 Innsbruck, Austria
| | - Georg F Hoffmann
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, Clinic I, University Hospital Heidelberg, 69120 Heidelberg, Germany
| | - Sven F Garbade
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, Clinic I, University Hospital Heidelberg, 69120 Heidelberg, Germany.
| | - Nenad Blau
- Division of Child Neurology and Metabolic Medicine, Centre for Child and Adolescent Medicine, Clinic I, University Hospital Heidelberg, 69120 Heidelberg, Germany; Division of Metabolism, University Children's Hospital, 8032 Zürich, Switzerland.
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15
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Zinchenko RA, Makaov AK, Marakhonov AV, Galkina VA, Kadyshev VV, El’chinova GI, Dadali EL, Mikhailova LK, Petrova NV, Petrina NE, Vasilyeva TA, Gundorova P, Polyakov AV, Alexandrova OY, Kutsev SI, Ginter EK. Epidemiology of Hereditary Diseases in the Karachay-Cherkess Republic. Int J Mol Sci 2020; 21:E325. [PMID: 31947737 PMCID: PMC6981994 DOI: 10.3390/ijms21010325] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Revised: 12/22/2019] [Accepted: 12/27/2019] [Indexed: 11/16/2022] Open
Abstract
Prevalence and allelic heterogeneity of hereditary diseases (HDs) could vary significantly in different human populations. Current knowledge of HDs distribution in populations is generally limited to either European data or analyses of isolated populations which were performed several decades ago. Thus, an acknowledgement of the HDs prevalence in different modern open populations is important. The study presents the results of a genetic epidemiological study of hereditary diseases (HDs) in the population of the Karachay-Cherkess Republic (KChR). Clinical screening of a population of 410,367 people for the identification of HDs was conducted. The population surveyed is represented by five major ethnic groups-Karachays, Russians, Circassians, Abazins, Nogais. The study of the populations was carried out in accordance with the proprietary protocol of genetic epidemiological examination designed to identify >3500 HDs easily diagnosed during clinical examination by qualified specialists specializing in the HDs. The protocol consists of the population genetic and medical genetic sections and is intended for comprehensive population analysis based on the data on different genetic systems, including the genes of HDs, DNA polymorphisms, demographic data collected during hospital-based survey. 8950 families (with 10,125 patients) with presumably the HDs were initially identified as a result of the survey and data collection through various sources of registration (from 1156 medical workers from 163 medical institutions). A diagnosis of hereditary pathology was established in 1849 patients (from 1295 families). Two hundred and thirty nosological forms were revealed (in 1857 patients from 1295 families). The total prevalence of HDs was 1:221. Differences between populations and ethnic groups were identified: 1:350 in Russians, 1:195 in Karachays, 1:199 in Circassians, 1:218 in Abazins, 1:135 in Nogais. Frequent diseases were determined, the presence of marked genetic heterogeneity was identified during the confirmatory DNA diagnosis. To explain the reasons for the differentiation of populations by load of HD, a correlation analysis was carried out between the FST (random inbreeding) in populations and HDs load values. This analysis showed genetic drift is probably one of the leading factors determining the differentiation of KChR populations by HDs load. For the first time, the size of the load and spectrum of HDs in the populations of the KChR are determined. We have demonstrated genetic drift to be one of the main factors of the population dynamics in studied population. A significant genetic heterogeneity of HDs, both allelic and locus, was revealed in KChR.
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Affiliation(s)
- Rena A. Zinchenko
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
- N.A. Semashko National Research Institute of Public Health, 105064 Moscow, Russia
| | - Amin Kh. Makaov
- Municipal Budgetary Health Care Setting “Khabez Central District Hospital”, 369400 Khabez, Russia;
| | - Andrey V. Marakhonov
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Varvara A. Galkina
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Vitaly V. Kadyshev
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Galina I. El’chinova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Elena L. Dadali
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Lyudmila K. Mikhailova
- N.N. Priorov Central Research Institute of Traumatology and Orthopedics, 117997 Moscow, Russia;
| | - Nika V. Petrova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Nina E. Petrina
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Tatyana A. Vasilyeva
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Polina Gundorova
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Alexander V. Polyakov
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | | | - Sergey I. Kutsev
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
| | - Eugeny K. Ginter
- Research Centre for Medical Genetics, 115522 Moscow, Russia; (R.A.Z.); (V.A.G.); (V.V.K.); (G.I.E.); (E.L.D.); (N.V.P.); (N.E.P.); (T.A.V.); (P.G.); (A.V.P.); (S.I.K.); (E.K.G.)
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16
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Wang T, Ma J, Zhang Q, Gao A, Wang Q, Li H, Xiang J, Wang B. Expanded Newborn Screening for Inborn Errors of Metabolism by Tandem Mass Spectrometry in Suzhou, China: Disease Spectrum, Prevalence, Genetic Characteristics in a Chinese Population. Front Genet 2019; 10:1052. [PMID: 31737040 PMCID: PMC6828960 DOI: 10.3389/fgene.2019.01052] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Accepted: 10/01/2019] [Indexed: 12/30/2022] Open
Abstract
Expanded newborn screening for inborn errors of metabolism (IEMs) by tandem mass spectrometry (MS/MS) could simultaneously analyze more than 40 metabolites and identify about 50 kinds of IEMs. Next generation sequencing (NGS) targeting hundreds of IMEs-associated genes as a follow-up test in expanded newborn screening has been used for genetic analysis of patients. The spectrum, prevalence, and genetic characteristic of IEMs vary dramatically in different populations. To determine the spectrum, prevalence, and gene mutations of IEMs in newborns in Suzhou, China, 401,660 newborns were screened by MS/MS and 138 patients were referred to genetic analysis by NGS. The spectrum of 22 IEMs were observed in Suzhou population of newborns, and the overall incidence (excluding short chain acyl-CoA dehydrogenase deficiency (SCADD) and 3-Methylcrotonyl-CoA carboxylase deficiency (3-MCCD)) was 1/3,163. The prevalence of each IEM ranged from 1/401,660 to 1/19,128, while phenylketonuria (PKU) (1/19,128) and Mild hyperphenylalaninemia (M-HPA) (1/19,128) were the most common IEMs, followed by primary carnitine uptake defect (PCUD) (1/26,777), SCADD (1/28,690), hypermethioninemia (H-MET) (1/30,893), 3-MCCD (1/33,412) and methylmalonic acidemia (MMA) (1/40,166). Moreover, 89 reported mutations and 51 novel mutations in 25 IMEs-associated genes were detected in 138 patients with one of 22 IEMs. Some hotspot mutations were observed for ten IEMs, including PAH gene c.728G > A, c.611A > G, and c.721C > T for Phenylketonuria, PAH gene c.158G > A, c.1238G > C, c.728G > A, and c.1315+6T > A for M-HPA, SLC22A5 gene c.1400C > G, c.51C > G, and c.760C > T for PCUD, ACADS gene c.1031A > G, c.164C > T, and c.1130C > T for SCAD deficiency, MAT1A gene c.791G > A for H-MET, MCCC1 gene c.639+2T > A and c.863A > G for 3-MCCD, MMUT gene c.1663G > A for MMA, SLC25A13 gene c.IVS16ins3Kb and c.852_855delTATG for cittrullinemia II, PTS gene c.259C > T and c.166G > A for Tetrahydrobiopterin deficiency, and ACAD8 gene c.1000C > T and c.286C > A for Isobutyryl coa dehydrogenase deficiency. All these hotspot mutations were reported to be pathogenic or likely pathogenic, except a novel mutation of ACAD8 gene c.286C > A. These mutational hotspots could be potential candidates for gene screening and these novel mutations expanded the mutational spectrum of IEMs. Therefore, our findings could be of value for genetic counseling and genetic diagnosis of IEMs.
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Affiliation(s)
- Ting Wang
- Newborn Screening Laboratory, Center for Reproduction and Genetics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jun Ma
- Newborn Screening Laboratory, Center for Reproduction and Genetics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Qin Zhang
- Genetic Clinic, Center for Reproduction and Genetics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Ang Gao
- Genetic Clinic, Center for Reproduction and Genetics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Qi Wang
- Newborn Screening Laboratory, Center for Reproduction and Genetics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Hong Li
- Infertility Clinic, Center for Reproduction and Genetics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Jingjing Xiang
- Genetic Laboratory, Center for Reproduction and Genetics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Benjing Wang
- Newborn Screening Laboratory, Center for Reproduction and Genetics, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
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Zinchenko RA, Kadyshev VV, Galkina VA, Dadali EL, Mikhailova LK, Marakhonov AV, Petrova NV, Petrina NE, El’chinova GI, Alexandrova OY, Kutsev SI, Ginter EK. Clinical Population Genetics of Hereditary Diseases among Children of the Karachay-Cherkess Republic. RUSS J GENET+ 2019. [DOI: 10.1134/s1022795419080180] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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