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Blue EE, Moore KJ, North KE, Desrosiers TA, Carmichael SL, White JJ, Chong JX, Bamshad MJ, Jenkins MM, Almli LM, Brody LC, Freedman SF, Reefhuis J, Romitti PA, Shaw GM, Werler M, Kay DM, Browne ML, Feldkamp ML, Finnell RH, Nembhard WN, Pangilinan F, Olshan AF. Exome sequencing identifies novel genes underlying primary congenital glaucoma in the National Birth Defects Prevention Study. Birth Defects Res 2024; 116:e2384. [PMID: 38990107 PMCID: PMC11245170 DOI: 10.1002/bdr2.2384] [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: 02/16/2024] [Revised: 06/07/2024] [Accepted: 06/25/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND Primary congenital glaucoma (PCG) affects approximately 1 in 10,000 live born infants in the United States (U.S.). PCG has a autosomal recessive inheritance pattern, and variable expressivity and reduced penetrance have been reported. Likely causal variants in the most commonly mutated gene, CYP1B1, are less prevalent in the U.S., suggesting that alternative genes may contribute to the condition. This study utilized exome sequencing to investigate the genetic architecture of PCG in the U.S. and to identify novel genes and variants. METHODS We studied 37 family trios where infants had PCG and were part of the National Birth Defects Prevention Study (births 1997-2011), a U.S. multicenter study of birth defects. Samples underwent exome sequencing and sequence reads were aligned to the human reference sample (NCBI build 37/hg19). Variant filtration was conducted under de novo and Mendelian inheritance models using GEMINI. RESULTS Among candidate variants, CYP1B1 was most represented (five trios, 13.5%). Twelve probands (32%) had potentially pathogenic variants in other genes not previously linked to PCG but important in eye development and/or to underlie Mendelian conditions with potential phenotypic overlap (e.g., CRYBB2, RXRA, GLI2). CONCLUSION Variation in the genes identified in this population-based study may help to further explain the genetics of PCG.
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Affiliation(s)
- Elizabeth E Blue
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, Washington, USA
- Brotman-Baty Institute for Precision Medicine, Seattle, Washington, USA
| | - Kristin J Moore
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Kari E North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Tania A Desrosiers
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Suzan L Carmichael
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Janson J White
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Jessica X Chong
- Brotman-Baty Institute for Precision Medicine, Seattle, Washington, USA
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Michael J Bamshad
- Brotman-Baty Institute for Precision Medicine, Seattle, Washington, USA
- Division of Genetic Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, USA
- Division of Genetic Medicine, Seattle Children's Hospital, Seattle, Washington, USA
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, Washington, USA
| | - Mary M Jenkins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lynn M Almli
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lawrence C Brody
- Division of Genomics and Society, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Sharon F Freedman
- Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA
| | - Jennita Reefhuis
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Paul A Romitti
- Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, Iowa, USA
| | - Gary M Shaw
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California, USA
| | - Martha Werler
- Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA
- Slone Epidemiology Center at Boston University, Boston, Massachusetts, USA
| | - Denise M Kay
- Division of Genetics, Wadsworth Center, New York State Department of Health, Albany, New York, USA
| | - Marilyn L Browne
- New York State Department of Health, Birth Defects Registry, Albany, New York, USA
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health, Rensselaer, New York, USA
| | - Marcia L Feldkamp
- Division of Medical Genetics, Department of Pediatrics, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Richard H Finnell
- Center for Precision Environmental Health, Departments of Molecular and Cellular Biology and Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Wendy N Nembhard
- Department of Epidemiology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Faith Pangilinan
- Division of Genomics and Society, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland, USA
| | - Andrew F Olshan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Pan Y, Iwata T. Exploring the Genetic Landscape of Childhood Glaucoma. CHILDREN (BASEL, SWITZERLAND) 2024; 11:454. [PMID: 38671671 PMCID: PMC11048810 DOI: 10.3390/children11040454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024]
Abstract
Childhood glaucoma, a significant cause of global blindness, represents a heterogeneous group of disorders categorized into primary or secondary forms. Primary childhood glaucoma stands as the most prevalent subtype, comprising primary congenital glaucoma (PCG) and juvenile open-angle glaucoma (JOAG). Presently, multiple genes are implicated in inherited forms of primary childhood glaucoma. This comprehensive review delves into genetic investigations into primary childhood glaucoma, with a focus on identifying causative genes, understanding their inheritance patterns, exploring essential biological pathways in disease pathogenesis, and utilizing animal models to study these mechanisms. Specifically, attention is directed towards genes such as CYP1B1 (cytochrome P450 family 1 subfamily B member 1), LTBP2 (latent transforming growth factor beta binding protein 2), TEK (TEK receptor tyrosine kinase), ANGPT1 (angiopoietin 1), and FOXC1 (forkhead box C1), all associated with PCG; and MYOC (myocilin), associated with JOAG. Through exploring these genetic factors, this review aims to deepen our understanding of the intricate pathogenesis of primary childhood glaucoma, thereby facilitating the development of enhanced diagnostic and therapeutic strategies.
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Affiliation(s)
| | - Takeshi Iwata
- National Institute of Sensory Organs, NHO Tokyo Medical Center, Tokyo 152-8902, Japan;
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3
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Kumar A, Han Y, Oatts JT. Genetic changes and testing associated with childhood glaucoma: A systematic review. PLoS One 2024; 19:e0298883. [PMID: 38386645 PMCID: PMC10883561 DOI: 10.1371/journal.pone.0298883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 01/30/2024] [Indexed: 02/24/2024] Open
Abstract
Many forms of childhood glaucoma have been associated with underlying genetic changes, and variants in many genes have been described. Currently, testing is variable as there are no widely accepted guidelines for testing. This systematic review aimed to summarize the literature describing genetic changes and testing practices in childhood glaucoma. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic review and Meta-Analyses (PRISMA) 2020 guidelines and registered with Prospero (ID CRD42023400467). A comprehensive review of Pubmed, Embase, and Cochrane databases was performed from inception through March 2, 2023 using the search terms: (glaucoma) AND (pediatric OR childhood OR congenital OR child OR infant OR infantile) AND (gene OR genetic OR genotype OR locus OR genomic OR mutation OR variant OR test OR screen OR panel). Information was extracted regarding genetic variants including genotype-phenotype correlation. Risk of bias was assessed using the Newcastle-Ottawa Scale. Of 1,916 records screened, 196 studies met inclusion criteria and 53 genes were discussed. Among study populations, mean age±SD at glaucoma diagnosis was 8.94±9.54 years and 50.4% were male. The most common gene discussed was CYP1B1, evaluated in 109 (55.6%) studies. CYP1B1 variants were associated with region and population-specific prevalence ranging from 5% to 86% among those with primary congenital glaucoma. MYOC variants were discussed in 31 (15.8%) studies with prevalence up to 36% among patients with juvenile open angle glaucoma. FOXC1 variants were discussed in 25 (12.8%) studies, which demonstrated phenotypic severity dependent on degree of gene expression and type of mutation. Overall risk of bias was low; the most common domains of bias were selection and comparability. Numerous genes and genetic changes have been associated with childhood glaucoma. Understanding the most common genes as well as potential genotype-phenotype correlation has the potential to improve diagnostic and prognostic outcomes for children with glaucoma.
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Affiliation(s)
- Anika Kumar
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | - Ying Han
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
| | - Julius T. Oatts
- Department of Ophthalmology, University of California San Francisco, San Francisco, California, United States of America
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Franco E, Gagrani M, Scanga HL, Areaux RG, Chu CT, Nischal KK. Variable Phenotype of Congenital Corneal Opacities in Biallelic CYP1B1 Pathogenic Variants. Cornea 2024; 43:195-200. [PMID: 37788597 PMCID: PMC10840913 DOI: 10.1097/ico.0000000000003395] [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: 01/11/2023] [Accepted: 08/19/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE The aim of this study is to describe the variable phenotype of congenital corneal opacities occurring in patients with biallelic CYP1B1 pathogenic variants. METHODS A retrospective chart review was conducted to identify patients with congenital corneal opacities and CYP1B1 pathogenic variants seen at UPMC Children's Hospital of Pittsburgh. Ophthalmic examination, high-frequency ultrasound, anterior segment optical coherence tomography, histopathologic images, and details of genetic testing were reviewed. RESULTS Three children were identified. All presented with raised intraocular pressure. Two patients showed bilateral limbus-to-limbus avascular corneal opacification that did not resolve with intraocular pressure control; 1 showed unilateral avascular corneal opacity with a crescent of clear cornea, iridocorneal adhesions, iridolenticular adhesions, and classical features of congenital glaucoma in the fellow eye (enlarged corneal diameter, Haab striae, and clearing of the corneal clouding with appropriate intraocular pressure control). The first 2 patients were visually rehabilitated with penetrating keratoplasty. Histopathology revealed distinct features: a variably keratinized epithelium; a thick but discontinuous Bowman-like layer with areas of disruption and abnormal cellularity; Descemet membrane, when observed, showed reduced endothelial cells; and no pathological changes of Haab striae were identified. Two patients had compound heterozygous pathogenic variants in CYP1B1 causing premature stop codons, whereas 1 was homozygous for a pathogenic missense variant. CONCLUSIONS Congenital corneal opacities seen in biallelic CYP1B1 pathogenic variants have a variable phenotype. One is that commonly termed as Peters anomaly type 1 (with iridocorneal adhesions, with or without iridolenticular adhesions) and the other is a limbus-to-limbus opacity, termed CYP1B1 cytopathy. Clinicians should be aware of this phenotypic variability.
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Affiliation(s)
- Elena Franco
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy
| | - Meghal Gagrani
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Hannah L Scanga
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
| | - Raymond G Areaux
- Department of Ophthalmology & Visual Neurosciences, University of Minnesota, Minneapolis, MN, USA
| | - Charleen T Chu
- Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ken K Nischal
- Division of Pediatric Ophthalmology, Strabismus, and Adult Motility, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA, USA
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Kaushik S, Luthra-Guptasarma M, Prasher D, Dhingra D, Singh N, Kumar A, Sharma SP, Kaur H, Snehi S, Thattaruthody F, Pandav SS. CYP1B1 and MYOC variants in neonatal-onset versus infantile-onset primary congenital glaucoma. Br J Ophthalmol 2023; 107:227-233. [PMID: 34526297 DOI: 10.1136/bjophthalmol-2020-318563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 09/01/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To compare CYP1B1 and MYOC variants in a cohort of neonatal-onset (NO) and infantile-onset (IO) primary congenital glaucoma (PCG). METHODS This prospective observational study included 43 infants with PCG (14 NO and 29 IO) presenting between January 2017 and January 2019 with a minimum 1-year follow-up. CYP1B1 and MYOC genes were screened using Sanger sequencing with in-silico analysis of the variants using Polymorphism Phenotyping v.2 and Protein Variation Effect Analyser platforms. Allelic frequency was estimated using Genome Aggregation Database (gnomAd). Disease presentation and outcome were correlated to the genetic variants in both groups. RESULTS Babies with CYP1B1 mutations had more severe disease at presentation and worse outcomes. Six of 14 (42.8%) NO glaucoma and 5 of 29 (17.2%) IO harboured CYP1B1 mutations. Five of six babies in the NO group and three of five in the IO group harboured the variant c.1169G>A, [p.R390H]. They required more surgeries and had a poorer outcome. On in-silico analysis c.1169G>A, [p.R390H] scored very likely pathogenic. Two patients in the IO group who had the c.1294C>G, [p.L432V] variant had a good outcome. Five of 14 NO-PCG and 8 of 29 IO-PCG harboured the variant c.227G>A, [p.R76K] in the MYOC gene, which was scored benign by in-silico analysis, and was also found in 2 of 15 normal controls. CONCLUSIONS Patients with CYP1B1 pathogenic variants had a poorer outcome than those without. We found more NO PCG babies with CYP1B1 mutations compared with IO PCG. This may be one of the reasons for NO PCG having a poorer prognosis compared with IO PCG.
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Affiliation(s)
- Sushmita Kaushik
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manni Luthra-Guptasarma
- Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Dimple Prasher
- Immunopathology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.,Biochemistry & Molecular Biology, University of Calgary, Calgary, Alberta, Canada
| | - Deepika Dhingra
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Nirbhai Singh
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Aman Kumar
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Surya Prakash Sharma
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harpreet Kaur
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sagarika Snehi
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Faisal Thattaruthody
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Surinder Singh Pandav
- Advanced Eye Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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6
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Narsani AK, Waryah AM, Rafiq M, Shaikh H, Naqvi SHA, Kumar R, Kumar P. Mutational analysis of CYP1B1 (rs56010818) variant in primary open angle glaucoma (POAG) affected patients of Pakistan. Saudi J Biol Sci 2022; 29:96-101. [PMID: 35002398 PMCID: PMC8716894 DOI: 10.1016/j.sjbs.2021.08.066] [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: 06/23/2021] [Revised: 08/02/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022] Open
Abstract
Background Primary open angle glaucoma (POAG) occurs due to the discrepancies in the angle of anterior chamber characterized by the alterations in intraocular pressure, optic nerves head changes and central loss of visual field. In molecular research, CYP1B1 mutations modulates an integral role in association with glaucoma. Current study was undertaken to reveal the homozygous and heterozygous patterns of CYP1B1 c.1169 G > A variant (rs56010818) in POAG patients of Pakistan. Methods After consent, total n = 88 POAG patients undergone through standard ophthalmological investigations before their recruitment in this study. The blood samples were utilized for DNA isolation. The genotyping of CYP1B1 c.1169 G > A variant was carried out by Sanger sequencing. The mutational patterns and its association with clinical variables were demonstrated by statistical and bioinformatic tools. Results It was evident that the frequencies of heterozygous G/A and homozygous mutants A/A genotypes were higher in males (36.5%, 7.7%) than females (30.6%, 2.8%) of POAG population. Furthermore, the juvenile patients exhibit high manifestation of carrier genotype (66.6%) in comparison to adult patients (31.7%). The results also indicated the significant relationship of intraocular pressure with homozygous mutant A/A genotype of CYP1B1 variant in POAG patients (p < 0.05). Conclusions Our study provided the mutational data of CYP1B1 R390H variant and the patterns of homozygosity and heterozygosity along with clinical associations. Overall, this study revealed the genetic predisposition of CYP1B1 c.1169 G > A variant in the patients of POAG in Pakistan. The findings could be helpful for genetic screening and in-depth understanding of underlying causes in the pathogenesis of POAG.
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Affiliation(s)
- Ashok Kumar Narsani
- Institute of Biotechnology & Genetic Engineering, University of Sindh, Jamshoro, Pakistan.,Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Ali Muhammad Waryah
- Department Molecular Biology and Genetics, Medical Research Center, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Muhammad Rafiq
- Institute of Biotechnology & Genetic Engineering, University of Sindh, Jamshoro, Pakistan
| | - Hina Shaikh
- Department Molecular Biology and Genetics, Medical Research Center, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Syed Habib Ahmed Naqvi
- Institute of Biotechnology & Genetic Engineering, University of Sindh, Jamshoro, Pakistan
| | - Raveet Kumar
- Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Pawan Kumar
- Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
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First Results from the Prospective German Registry for Childhood Glaucoma: Phenotype-Genotype Association. J Clin Med 2021; 11:jcm11010016. [PMID: 35011756 PMCID: PMC8745723 DOI: 10.3390/jcm11010016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 12/27/2022] Open
Abstract
Childhood glaucoma is a heterogeneous disease and can be associated with various genetic alterations. The aim of this study was to report first results of the phenotype–genotype relationship in a German childhood glaucoma cohort. Forty-nine eyes of 29 children diagnosed with childhood glaucoma were prospectively included in the registry. Besides medical history, non-genetic risk factor anamnesis and examination results, genetic examination report was obtained (23 cases). DNA from peripheral blood or buccal swab was used for molecular genetic analysis using a specific glaucoma gene panel. Primary endpoint was the distribution of causative genetic mutations and associated disorders. Median age was 1.8 (IQR 0.6; 3.8) years, 64% participants were female. Secondary childhood glaucoma (55%) was more common than primary childhood glaucoma (41%). In 14%, parental consanguinity was indicated. A mutation was found in all these cases, which makes consanguinity an important risk factor for genetic causes in childhood glaucoma. CYP1B1 (30%) and TEK (10%) mutations were found in primary childhood glaucoma patients. In secondary childhood glaucoma cases, alterations in CYP1B1 (25%), SOX11 (13%), FOXC1 (13%), GJA8 (13%) and LTBP2 (13%) were detected. Congenital cataract was associated with variants in FYCO1 and CRYBB3 (25% each), and one case of primary megalocornea with a CHRDL1 aberration. Novel variants of causative genetic mutations were found. Distribution of childhood glaucoma types and causative genes was comparable to previous investigated cohorts. This is the first prospective study using standardized forms to determine phenotypes and non-genetic factors in childhood glaucoma with the aim to evaluate their association with genotypes in childhood glaucoma.
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8
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Heshmati A, Taghizadeh P, Ahmadieh H, Yaseri M, Suri F, Alizadeh M, Dadashzadeh M, Khatami H, Navi MM, Zamanparvar P, Behboudi H, Elahi E. Carrier Status for p.Gly61Glu and p.Arg368His CYP1B1 Mutations Causing Primary Congenital Glaucoma in Iran. J Ophthalmic Vis Res 2021; 16:574-581. [PMID: 34840680 PMCID: PMC8593531 DOI: 10.18502/jovr.v16i4.9747] [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: 02/02/2021] [Accepted: 05/24/2021] [Indexed: 12/02/2022] Open
Abstract
Purpose To estimate carrier frequencies of CYP1B1 mutations p.Gly61Glu and p.Arg368His, respectively, in Talesh and the east of Guilan province in Iran with a maximum error of 2%. Previously, it was shown that these CYP1B1 mutations may be relatively prevalent in these regions. Methods Population-based screenings were performed. DNA was extracted from saliva samples of 1036 individuals from Talesh and 3029 individuals from the east of Guilan. P.Gly61Glu and p.Arg368His screenings were performed, respectively, by RFLP and ARMS-based PCR protocols. For confirmation, the DNA of individuals with mutations was sequenced using the Sanger protocol. Results Nine individuals from Talesh (0.86%; 95%CI: 0.45–1.64%) carried the p.Gly61Glu mutation, and 73 from the east of Guilan (2.41%; 95%CI: 1.91–3.04%) carried p.Arg368His. There was no significant difference in frequencies between urban and rural regions of the various cities, nor among four cities within the east of Guilan. Conclusion The frequencies of p.Gly61Glu carriers in Talesh and of p.Arg368His carriers in the east of Guilan were within the 95% confidence interval of a previous study based on screenings of fewer individuals. The reliability of the recent estimates is higher, as the confidence interval for p.Gly61Glu decreased from 6.5% to 1.19% and the interval for p.Arg368His decreased from 4% to 1.13%. Based on the new findings, the maximum expected frequency of p.Gly61Glu carriers in Talesh is 1.64%, and of p.Arg368His carriers in the east of Guilan is 3%. The need for performing premarital screenings in the respective cities can be evaluated.
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Affiliation(s)
- Ali Heshmati
- School of Biology, University College of Science, University of Tehran, Tehran, Iran
| | - Peyman Taghizadeh
- School of Biology, University College of Science, University of Tehran, Tehran, Iran
| | - Hamid Ahmadieh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Suri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | - Hassan Behboudi
- Department of Ophthalmology, Guilan University of Medical Sciences, Rasht, Iran
| | - Elahe Elahi
- School of Biology, University College of Science, University of Tehran, Tehran, Iran
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Rezaei Kanavi M, Yazdani S, Elahi E, Mirrahimi M, Hajizadeh M, Khodaverdi S, Suri F. Prenatal diagnosis of primary congenital glaucoma and histopathological features in a fetal globe with cytochrome p4501B1 mutations. Eur J Ophthalmol 2021; 32:11206721211051235. [PMID: 34730456 DOI: 10.1177/11206721211051235] [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: 11/16/2022]
Abstract
BACKGROUND/OBJECTIVES This study aims to report the developmental and histopathological features of ocular tissues from an electively aborted human fetus with mutations in cytochrome p4501B1, and thus predisposed to primary congenital glaucoma in comparison to an age-matched healthy fetal globe. SUBJECTS/METHODS Both eyes of two 17-week gestational aged fetuses, the first with CYP1B1 mutations and the second as healthy control fetus, were studied. Hematoxylin and eosin, Periodic acid-Schiff, Gomori's trichrome, and Verhoeff-Van Gieson staining protocols in addition to immunohistochemistry staining using anti-cytochrome p4501B1, anti-fibrillin-1, and anti-4-hydroxy-2-nonenal antibodies, as primary antibodies, were performed to assess the effect of the mutations on tissue development, cytochrome p4501B1 protein expression, extracellular matrix structure, and oxidative stress in the developing fetus eye. Quantitative analyses were performed using ImageJ software. Student's t-test was used for statistical analysis and P-values <0.05 were considered as significant. RESULTS Delayed development in ocular tissues, decreased expression of cytochrome p4501B1 protein, irregular extracellular matrix structure, and increased oxidative stress biomarker were evident in the ocular tissues of the fetus with cytochrome p4501B1 mutations as compared to a normal globe from an age-matched fetus. CONCLUSION To the best of our knowledge, this is the first report of prenatal diagnosis of primary congenital glaucoma. We also describe histopathological changes in the primary congenital glaucoma-affected globes revealing the effect of cytochrome p4501B1 deficiency on ocular tissues during early fetal development contributing to the glaucoma phenotype.
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Affiliation(s)
- Mozhgan Rezaei Kanavi
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahin Yazdani
- Ocular Tissue Engineering Research Center, Research Institute for Ophthalmology and Vision Science, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Elahi
- School of Biology, University College of Science, 48425University of Tehran, Tehran, Iran
| | - Mehraban Mirrahimi
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Maryam Hajizadeh
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
- 226735Department of Ophthalmology, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Sepideh Khodaverdi
- Department of Obstetrics and Gynecology, Endometriosis Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Suri
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, 556492Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Emamalizadeh B, Daneshmandpour Y, Kazeminasb S, Aghaei Moghadam E, Bahmanpour Z, Alehabib E, Alinaghi S, Doozandeh A, Atakhorrami M, Darvish H. Mutational analysis of CYP1B1 gene in Iranian pedigrees with glaucoma reveals known and novel mutations. Int Ophthalmol 2021; 41:3269-3276. [PMID: 34019190 DOI: 10.1007/s10792-021-01888-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 05/12/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Primary congenital glaucoma (PCG) (OMIM#231,300) can be caused by pathogenic sequence variations in CYP1B1, LTBP2, MYOC and PXDN genes. The purpose of this study was to investigate mutations in the CYP1B1 gene in families affected with primary congenital glaucoma (PCG) using linkage analysis and Sanger sequencing. METHODS A total number of four families with nine affected PCG patients during six months were included in this study. The mutations were identified by homozygosity mapping to find the linked loci and then direct sequencing of all coding exons, the exon-intron boundaries and the 5' untranslated region of CYP1B1 using genomic DNA obtained from affected family members and their parents. Moreover, bioinformatic tools were applied to study mutation effect on protein structure and function. RESULTS A total of four mutations were identified, and three of these were novel. Two were missense mutations: One was truncating mutation, and the other was an in-frame deletion. Mutations in CYP1B1 could fully explain the PCG phenotype in all of the patients. Also, the bioinformatic study of the mutations showed the structure of the protein is affected, and it is well conserved among similar species. CONCLUSION In this study, we identified 4 CYP1B1 mutations, 3 of which were novel. In silico analysis of identified mutations confirmed their molecular pathogenicity. A similar analysis will help understand the biological role of CYP1B1 and the effect of mutations on the regulatory and enzymatic functions of CYP1B1 that result in PCG. CLINICAL TRIALS REGISTRATION Not relevant.
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Affiliation(s)
- Babak Emamalizadeh
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Yousef Daneshmandpour
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Kazeminasb
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ehsan Aghaei Moghadam
- Department of Pediatrics, School of Medicine, Children's Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Bahmanpour
- Department of Medical Genetics, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.,Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Alehabib
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Somayeh Alinaghi
- Student Research Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Doozandeh
- Department of Ophthalmology, Torfeh Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Minoo Atakhorrami
- Department of Biology, Faculty of Basic Sciences, East Tehran Branch (Ghiamdasht), Islamic Azad University, Tehran, Iran.
| | - Hossein Darvish
- Department of Medical Genetics, School of Medicine, Semnan University of Medical Sciences, Semnan, Iran. .,Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran.
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11
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Ava S, Demirtaş AA, Karahan M, Erdem S, Oral D, Keklikçi U. Genetic analysis of patients with primary congenital glaucoma. Int Ophthalmol 2021; 41:2565-2574. [PMID: 33745036 DOI: 10.1007/s10792-021-01815-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 03/11/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To determine the common gene mutation in patients with primary congenital glaucoma (PCG) in the Southeast region of Turkey via genetic analysis and to evaluate whether there were other gene mutations in these patients. METHODS A total of 25 patients with PCG were included in this study. We performed sequence analysis including all exons of cytochrome p450 1B1 (CYP1B1), myocilin (MYOC), forkhead box C1 (FOXC1), and paired-like homeodomain 2 (PITX2) genes of the obtained samples. Further, we analyzed the results using the Nextgen analysis program. RESULTS The CYP1B1 gene mutation was detected in 20 (80%) of 25 patients, and FOXC1 gene mutation was detected in one (4%) patient. The mutation site of nine (45%) of the 20 CYP1B1 genes was found in the second exon. The pathogenic variant (p.Gly61Glu) was observed in 12 (60%) patients (in the first and second exons); the mutation type of six (50%) of these patients was homozygous. The mutation site of one patient with FOXC1 gene mutation was found to be in the first exon; its pathogenic variant was p.Met400lle. The mutation type in this gene was observed to be heterozygous. Lastly, there were no mutations in the MYOC, FOXC1, and PITX2 genes in combination with the CYP1B1 gene mutation. CONCLUSION The most common cause of PCG in our region is the CYP1B1 gene mutation, and the most frequent pathogenic variant is c.182G > A (p.Gly61Glu). We also determined that the CYP1B1 gene mutation was alone and did not occur with other gene mutations (MYOC, FOXC1, and PITX2).
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Affiliation(s)
- Sedat Ava
- Department of Ophthalmology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Atılım Armağan Demirtaş
- Department of Ophthalmology, Health Sciences University, Izmir Tepecik Training and Research Hospital, Izmir, Turkey.
| | - Mine Karahan
- Department of Ophthalmology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Seyfettin Erdem
- Department of Ophthalmology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Diclehan Oral
- Department of Medical Genetics, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
| | - Uğur Keklikçi
- Department of Ophthalmology, Faculty of Medicine, Dicle University, Diyarbakır, Turkey
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12
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Lang E, Koller S, Bähr L, Töteberg-Harms M, Atac D, Roulez F, Bahr A, Steindl K, Feil S, Berger W, Gerth-Kahlert C. Exome Sequencing in a Swiss Childhood Glaucoma Cohort Reveals CYP1B1 and FOXC1 Variants as Most Frequent Causes. Transl Vis Sci Technol 2020; 9:47. [PMID: 32832252 PMCID: PMC7414719 DOI: 10.1167/tvst.9.7.47] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 04/15/2020] [Indexed: 12/14/2022] Open
Abstract
Purpose The aim of this study was to investigate the molecular basis of childhood glaucoma in Switzerland to recommend future targeted genetic analysis in the Swiss population. Methods Whole-exome sequencing and copy number variation (CNV) analysis was performed in a Swiss cohort of 18 patients from 14 unrelated families. Identified variants were validated by Sanger sequencing and multiplex ligation-dependent probe amplification. Breakpoints of structural variants were determined by a microarray. A minigene assay was conducted for functional analysis of a splice site variant. Results A diagnosis of primary congenital glaucoma was made in 14 patients, of which six (43%) harbored pathogenic variants in CYP1B1, one (7%) a frameshift variant in FOXC1, and seven (50%) remained without a genetic diagnosis. Three patients were diagnosed with glaucoma associated with nonacquired ocular anomalies, of which two patients with mild ocular features of Axenfeld-Rieger syndrome harbored a FOXC1 duplication plus an additional FOXC1 missense variant, and one patient with a Barkan membrane remained without genetic diagnosis. A diagnosis of juvenile open-angle glaucoma was made in one patient, and genetic analysis revealed a FOXC1 duplication. Conclusions Sequencing of CYP1B1 and FOXC1, as well as analysis of CNVs in FOXC1, should be performed before extended gene panel sequencing. Translational Relevance The identification of the molecular cause of childhood glaucoma is a prerequisite for genetic counseling and personalized care for patients and families.
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Affiliation(s)
- Elena Lang
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.,Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland
| | - Samuel Koller
- Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland
| | - Luzy Bähr
- Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland
| | - Marc Töteberg-Harms
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - David Atac
- Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland
| | - Françoise Roulez
- Department of Ophthalmology, University Hospital Basel, Basel, Switzerland
| | - Angela Bahr
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Katharina Steindl
- Institute of Medical Genetics, University of Zurich, Zurich, Switzerland
| | - Silke Feil
- Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland
| | - Wolfgang Berger
- Institute of Medical Molecular Genetics, University of Zurich, Schlieren, Switzerland.,Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland.,Neuroscience Center Zurich, University and ETH Zurich, Zurich, Switzerland
| | - Christina Gerth-Kahlert
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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13
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Coêlho REA, Sena DR, Santa Cruz F, Moura BCFS, Han CC, Andrade FN, Lira RPC. CYP1B1 Gene and Phenotypic Correlation in Patients From Northeastern Brazil With Primary Congenital Glaucoma. J Glaucoma 2020; 28:161-164. [PMID: 30520782 PMCID: PMC6358192 DOI: 10.1097/ijg.0000000000001132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Purpose: To identify variants in the CYP1B1 gene in northeastern Brazilian patients with primary congenital glaucoma (PCG) and possible genotype-phenotype correlations. Materials and Methods: This is a cross-sectional observational study of 17 nonrelated patients with PCG, performed at the Altino Ventura Foundation, Recife, Brazil, between December 2017 and February 2018. All patients underwent an examination, including gathering information from their medical records, slit-lamp examination, fundoscopy, tonography, and measuring corneal diameter and thickness. Results: The mean age at the time of the examination was 27.7 years; 52.9% (n=9) were male, 29.4% (n=5) had history of parental consanguinity. The mean age when the diagnosis was confirmed was 0.53±2.18 years. Horizontal corneal diameter ranged from 12 to 16 mm (mean: 14.05±1.42 mm) and the IOP mean value was 17.31±9.84 mm Hg. Predicted pathogenic variants of the CYP1B1 gene were identified in 4 patients (23.5%). The differences among all clinical parameters did not reach statistical significance between individuals with and without CYP1B1 variants (P-values >0.05). Conclusions: Two variants which had not been previously related to PCG in Brazil (c.182G>A, c.241T>A) were identified. No statistically significant genotype-phenotype correlations were found.
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Affiliation(s)
- Rodrigo E A Coêlho
- Hospital das Clínicas, Federal University of Pernambuco (HC-UFPE).,Altino Ventura Foundation (FAV)
| | - Dayse R Sena
- Hospital das Clínicas, Federal University of Pernambuco (HC-UFPE).,Laboratory of Immunopathology Keizo Asami (LIKA)
| | - Fernando Santa Cruz
- School of Medicine, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | | | - Cristal C Han
- Hospital das Clínicas, Federal University of Pernambuco (HC-UFPE).,Altino Ventura Foundation (FAV)
| | - Flaviano N Andrade
- School of Medicine, Federal University of Pernambuco, Recife, Pernambuco, Brazil
| | - Rodrigo P C Lira
- Hospital das Clínicas, Federal University of Pernambuco (HC-UFPE)
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14
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Jubair S, N Al-Rubae'i SH, M Al-Sharifi AN, Jabbar Suleiman AA. Investigation of CYP1B1 Gene Involvement in Primary Congenital Glaucoma in Iraqi Children. Middle East Afr J Ophthalmol 2020; 26:203-209. [PMID: 32153331 PMCID: PMC7034157 DOI: 10.4103/meajo.meajo_116_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/24/2019] [Accepted: 12/24/2019] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Primary congenital glaucoma (PCG) is a severe type of glaucoma that occurs early in life. PCG is usually inherited in an autosomal recessive pattern. Cytochrome P450, family 1, subfamily B, polypeptide 1 (CYP1B1) gene is reported to be PCG-related gene. It codes for the CYP1B1 enzyme which is considered as phase I xenobiotic-metabolizing enzyme and its function is related to the eye oxidative homeostasis and correspondingly to the normal development of the eye. This is the first genetic study in Iraq that investigates the CYP1B1 polymorphisms behind the PCG disease. METHODS Genomic DNA was extracted from the whole blood of 100 unrelated Iraqi PCG patients and 100 healthy children, all of them were aged between 1 month and 3 years. All the coding sequence of CYP1B1 gene was amplified using polymerase chain reaction; restriction fragment length polymorphism was used to follow G61E and E229K mutations. Direct sequencing was performed to screen for other mutations. RESULTS CYP1B1 mutations were identified in 78 (78%) of the patients. We detected a total of eight mutations: Four missense mutations (c.182G>A, c.685G>A, g.6813G>A, and g.6705G>A), one silence mutation (D449D) and three insertions (g.10068ins10069, g.10138ins10139, and g.10191ins10192). Five mutations (g.6813G>A, g.6705G>A, g.10068ins10069, g.10138ins10139, and g.10191ins10192) are novel. G61E is the only mutation that was detected in patients merely. CONCLUSIONS CYP1B1 mutation (G61E) is considered as PCG-related allele in the Iraqi population.
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Affiliation(s)
- Suzanne Jubair
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Kerbala, Kerbala, Iraq
| | - Salwa H N Al-Rubae'i
- Department of Chemistry, College of Science, Mustansiriyah University, Baghdad, Iraq
| | - Ali N M Al-Sharifi
- Department of Glaucoma, Ibn Al-Haitham Teaching Eye Hospital, Baghdad, Iraq
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15
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Salehi Chaleshtori AR, Garshasbi M, Salehi A, Noruzinia M. The identification and stereochemistry analysis of a novel mutation p.(D367Tfs*61) in the CYP1B1 gene: A case report. J Curr Ophthalmol 2019; 32:114-118. [PMID: 32510024 PMCID: PMC7265266 DOI: 10.1016/j.joco.2019.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 09/02/2019] [Accepted: 09/18/2019] [Indexed: 11/16/2022] Open
Abstract
Purpose: To investigate the presence of a probable genetic defect(s) that may cause primary congenital glaucoma (PCG) in a seven-year-old female patient. Methods: A seven-year-old female patient and her family received genetic counseling and underwent full clinical examinations by an expert ophthalmologist. The patient's genomic DNA was subjected to the targeted gene capture and next-generation sequencing (NGS) along with Sanger sequencing method. The 3D structure prediction and stereochemistry analysis were performed for both mutant and wild-type forms of the CYP1B1 protein. Results: The clinical examinations indicated that the diagnosis of PCG was correctly made. We identified a novel homozygous deletion in which a “C” nucleotide was deleted from the final exon of the Cytochrome P450 Family 1 Subfamily B Member 1 (CYP1B1) gene. The 3D molecular modeling of the CYP1B1 protein predicted significant structural changes could occur in this protein as a result of the mutation mentioned earlier. The stereochemistry analysis revealed mutant features of the protein, as well as significant misfolding and possible malfunctions in the mutant form of the CYP1B1 protein. Conclusions: This mutation might cause a frameshift in the translation process, leading to the malfunction of the CYP1B1 protein and development of glaucoma. This newly-identified mutation could be regarded as potential deletion mutation in genetic counseling and molecular examination for the detection of PCG disease in Iran.
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Affiliation(s)
| | - Masoud Garshasbi
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Ali Salehi
- Department of Ophthalmology, Feiz Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mehrdad Noruzinia
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
- Address for correspondence: Mehrdad Noruzinia, Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, Jalal Al e Ahmad Street, P. O. Box: 14115-331, Tehran, Iran. E-mail:
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16
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Afzal R, Firasat S, Kaul H, Ahmed B, Siddiqui SN, Zafar SN, Shahzadi M, Afshan K. Mutational analysis of the CYP1B1 gene in Pakistani primary congenital glaucoma patients: Identification of four known and a novel causative variant at the 3' splice acceptor site of intron 2. Congenit Anom (Kyoto) 2019; 59:152-161. [PMID: 30270463 DOI: 10.1111/cga.12312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 09/25/2018] [Accepted: 09/25/2018] [Indexed: 01/06/2023]
Abstract
Primary congenital glaucoma (PCG) causes blindness in early age. It has an autosomal recessive pattern of inheritance, hence is more prevalent in populations with frequent consanguineous marriages that occur in the Pakistani population. Mutations in the CYP1B1 gene are commonly associated with PCG. The aim of the present study was to identify genetic mutations in the CYP1B1 gene in PCG cases belonging to 38 Pakistani families. DNA was extracted using blood samples collected from all enrolled patients, their available unaffected family members and controls. Direct sequencing of the CYP1B1 gene revealed a novel 3' splice acceptor site causative variant segregating in an autosomal recessive manner in a large consanguineous family with four PCG-affected individuals. The novel variant was not detected in 93 ethnically matched controls. Furthermore, four already reported mutations, including p.G61E, p.R355X, p.R368H, and p.R390H were also detected in patients belonging to nine different families. All identified causative variants were evaluated by computational programs, that is, SIFT, PolyPhen-2, and MutationTaster. Pathogenicity of the novel splice site variant identified in this study was analyzed by Human Splicing Finder and MaxEntScan. Ten out of 38 families with PCG had the disease due to CYP1B1 mutations, suggesting CYP1B1 was contributing to PCG in these Pakistani patients. Identification of this novel 3' splice acceptor site variant in intron 2 is the first report for the CYP1B1 gene contributing to genetic heterogeneity of disease.
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Affiliation(s)
- Rabia Afzal
- Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sabika Firasat
- Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Haiba Kaul
- Genetics Division, Department of Livestock Production, University of Veterinary and Animal Sciences, Pattoki, Pakistan
| | - Bashir Ahmed
- Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Sorath N Siddiqui
- Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Saemah N Zafar
- Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi, Pakistan
| | - Misbah Shahzadi
- Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Kiran Afshan
- Department of Animal Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
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17
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Khafagy MM, El-Guendy N, Tantawy MA, Eldaly MA, Elhilali HM, Abdel Wahab AHA. Novel CYP1B1 mutations and a possible prognostic use for surgical management of congenital glaucoma. Int J Ophthalmol 2019; 12:607-614. [PMID: 31024815 DOI: 10.18240/ijo.2019.04.14] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Accepted: 11/09/2018] [Indexed: 01/03/2023] Open
Abstract
AIM To identify CYP1B1 gene mutations and evaluate their possible role as a prognostic factor for success rates in the surgical management of Egyptian congenital glaucoma patients. METHODS Totally 42 eyes of 29 primary congenital glaucoma patients were operated on with combined trabeculotomy/trabeculectomy with mitomycin-C and followed up at 1d, 1wk, 1, 6 and 12mo postoperatively. Genomic DNA was extracted from peripheral blood leukocytes. Coding regions of CYP1B1 gene were amplified using 13 pairs of primers, screened for mutations using single-strand conformation polymorphism followed by sequencing of both strands. Efficacy of the operation was graded as either a success [maintaining intraocular pressure (IOP) less than 21 mm Hg with or without anti-glaucoma medication], or a failure (IOP more than 21 mm Hg with topical antiglaucoma medications). RESULTS Seven novel mutations out of a total of 15 different mutations were found in the CYP1B1 genes of 14 patients (48.2%). The presence of CYP1B1 gene mutations did not correlate with the failure of the surgery (P=0.156, odds ratio=3.611, 95%CI, 0.56 to 22.89); while the positive consanguinity strongly correlated with failure of the initial procedure (P=0.016, odds ratio=11.25, 95%CI, 1.57 to 80.30). However, the Kaplan-Meier survival analysis revealed a significantly lower time of IOP control in the subgroup with mutations in CYP1B1 versus the congenital primary glaucoma group without mutations (log rank test, P=0.015). CONCLUSION Seven new CYP1B1 mutations are identified in Egyptian patients. Patients harboring confirmed mutations suffered from early failure of the initial surgery. CYP1B1 mutations could be considered as a prognostic factor for surgery in primary congenital glaucoma.
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Affiliation(s)
- Mohamed M Khafagy
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Nadia El-Guendy
- Cancer Biology Department, National Cancer Institute, Cairo University, Cairo 11796, Egypt
| | - Marwa A Tantawy
- Research Department, Children's Cancer Hospital, Cairo 11617, Egypt
| | - Mohamed A Eldaly
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Hala M Elhilali
- Ophthalmology Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt
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18
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Waryah YM, Iqbal M, Sheikh SA, Baig MA, Narsani AK, Atif M, Bhinder MA, Ur Rahman A, Memon AI, Pirzado MS, Waryah AM. Two novel variants in CYP1B1 gene: a major contributor of autosomal recessive primary congenital glaucoma with allelic heterogeneity in Pakistani patients. Int J Ophthalmol 2019; 12:8-15. [PMID: 30662834 DOI: 10.18240/ijo.2019.01.02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Accepted: 09/10/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To find the CYP1B1 mutations associated with primary congenital glaucoma (PCG) in Pakistani consanguineous pedigrees. METHODS After getting informed consent, 11 consanguineous pedigrees belonging to different ethnic groups were enrolled. Detailed medical history was recorded and pedigrees were drawn. The standard ophthalmological examination was done to characterize the phenotype. Genomic DNA was extracted from 10 mL whole blood and coding exons and exon intron boundaries of CYP1B1 gene were directly sequenced. Bioinformatics tools were used to model the mutant protein and predict the effect of novel variants on protein structure and function. RESULTS Sequencing analysis revealed 5 different CYP1B1 variants in 7 families (7/11; 64%), including two novel variants. A common mutation, p.R390H was found in four families, whereas p.P437L was found once in a family. Two novel variants, a homozygous non sense variant p.L13* and a compound heterozygous variant, p.P350T along with p.V364M were segregating with PCG in two families. All the patients had the variable onset and severity of the disease. The success rate of early clinical interventions was observed dependent on mutation types and position. Two different haplotypes were associated with frequently found mutation, p.R390H. CONCLUSION Identification of novel CYP1B1 variants reassert the genetic heterogeneity of Pakistani PCG patients. The patients with missense mutations show severe phenotypic presentations and poor vision after surgical interventions as compare to patients with null variants. This may help to better understand the role of CYP1B1 mutations in the development of PCG and its course of pathogenicity.
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Affiliation(s)
- Yar Muhammad Waryah
- Molecular Biology and Genetics Department, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh 76090, Pakistan
| | - Muhammad Iqbal
- Department of Biochemistry, Islamia University, Bahawalpur, Punjab 63100, Pakistan
| | - Shakeel Ahmed Sheikh
- Molecular Biology and Genetics Department, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh 76090, Pakistan
| | - Muhammad Azhar Baig
- Department of Biochemistry, Islamia University, Bahawalpur, Punjab 63100, Pakistan
| | - Ashok Kumar Narsani
- Institute of Ophthalmology, Liaquat University of Medical and Health Sciences Jamshoro, Sindh 76090, Pakistan
| | - Muhammad Atif
- Department of Biochemistry, Islamia University, Bahawalpur, Punjab 63100, Pakistan
| | - Munir Ahmad Bhinder
- Department of Human Genetics, University of Health Sciences, Lahore, Punjab 54000, Pakistan
| | - Attiq Ur Rahman
- Center of Excellence in Marine Biology, University of Karachi, Karachi District 75270, Pakistan
| | - Azam Iqbal Memon
- Molecular Biology and Genetics Department, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh 76090, Pakistan
| | - Muhammad Suleman Pirzado
- Molecular Biology and Genetics Department, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh 76090, Pakistan
| | - Ali Muhammad Waryah
- Molecular Biology and Genetics Department, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh 76090, Pakistan
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Sarfarazi M. Targeted Screening for Predominant CYP1B1 Mutations in Primary Congenital Glaucoma. J Ophthalmic Vis Res 2018; 13:373-375. [PMID: 30479704 PMCID: PMC6210886 DOI: 10.4103/jovr.jovr_232_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Mansoor Sarfarazi
- Department of Surgery, Molecular Ophthalmic Genetics Laboratory, UConn Health, Farmington, CT, USA
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20
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Qashqai M, Suri F, Yaseri M, Elahi E. P.Gly61Glu and P.Arg368His Mutations in CYP1B1 that Cause Congenital Glaucoma may be Relatively Frequent in Certain Regions of Gilan Province, Iran. J Ophthalmic Vis Res 2018; 13:403-410. [PMID: 30479709 PMCID: PMC6210879 DOI: 10.4103/jovr.jovr_147_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2017] [Accepted: 05/03/2018] [Indexed: 11/13/2022] Open
Abstract
PURPOSE To perform a population-based screening of four CYP1B1 mutations-p.Gly61Glu, p.Arg368His, p.Arg390His, and p.Arg469Trp-in the province of Gilan, Iran. Previous studies have shown that CYP1B1 is a cause of disease in approximately 70% of Iranian patients with primary congenital glaucoma (PCG), and that these four mutations constitute the majority of CYP1B1 mutated alleles. The carrier frequencies may even justify premarital screenings. METHODS DNA was extracted from the blood samples of 700 individuals recruited in a population-based epidemiology study in Gilan. Screenings were performed using polymerase chain reaction protocols based on restriction fragment length polymorphism or the amplification-refractory mutation system. For confirmation, the DNA of individuals with mutations was sequenced using the Sanger protocol. RESULTS Five individuals carried the p.Gly61Glu mutation, and seven carried the p.Arg368His mutation. The p.Arg390His and p.Arg469Trp mutations were not observed in any of the 700 individuals screened. The mutations were not geographically randomly distributed in Gilan; four of the p.Gly61Glu-harboring individuals were from Talesh, and six of the p.Arg368His-harboring individuals were from the eastern regions of Gilan. CONCLUSION The frequency of individuals who carry either p.Gly61Glu or p.Arg368His is relatively high in Gilan, and notably high in certain localities within Gilan. We suggest further screenings be performed to definitively assess the need for implementing measures to encourage screening for p.Gly61Glu and p.Arg368His before marriage in Talesh and the eastern regions of Gilan, respectively. Finally, our assessment showed that regional frequencies of CYP1B1 mutations do not necessarily mirror national frequencies.
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Affiliation(s)
- Mansoure Qashqai
- School of Biology, University College of Science, University of Tehran, Tehran, Iran
| | - Fatemeh Suri
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Elahi
- Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran
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Gupta V, Somarajan BI, Walia GK, Kaur J, Kumar S, Gupta S, Chaurasia AK, Gupta D, Kaushik A, Mehta A, Gupta V, Sharma A. Role of CYP1B1, p.E229K and p.R368H mutations among 120 families with sporadic juvenile onset open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2017; 256:355-362. [PMID: 29168043 DOI: 10.1007/s00417-017-3853-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 11/06/2017] [Accepted: 11/13/2017] [Indexed: 12/01/2022] Open
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Lewis CJ, Hedberg-Buenz A, DeLuca AP, Stone EM, Alward WL, Fingert JH. Primary congenital and developmental glaucomas. Hum Mol Genet 2017; 26:R28-R36. [PMID: 28549150 PMCID: PMC5886473 DOI: 10.1093/hmg/ddx205] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 05/24/2017] [Accepted: 05/24/2017] [Indexed: 11/13/2022] Open
Abstract
Glaucoma is the leading cause of irreversible blindness worldwide. Although most glaucoma patients are elderly, congenital glaucoma and glaucomas of childhood are also important causes of visual disability. Primary congenital glaucoma (PCG) is isolated, non-syndromic glaucoma that occurs in the first three years of life and is a major cause of childhood blindness. Other early-onset glaucomas may arise secondary to developmental abnormalities, such as glaucomas that occur with aniridia or as part of Axenfeld-Rieger syndrome. Congenital and childhood glaucomas have strong genetic bases and disease-causing mutations have been discovered in several genes. Mutations in three genes (CYP1B1, LTBP2, TEK) have been reported in PCG patients. Axenfeld-Rieger syndrome is caused by mutations in PITX2 or FOXC1 and aniridia is caused by PAX6 mutations. This review discusses the roles of these genes in primary congenital glaucoma and glaucomas of childhood.
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Affiliation(s)
- Carly J. Lewis
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Stephen A. Wynn Institute for Vision Research, 3111B Medical Education and Research Facility, University of Iowa, Iowa City, IA 52242, USA
| | - Adam Hedberg-Buenz
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Stephen A. Wynn Institute for Vision Research, 3111B Medical Education and Research Facility, University of Iowa, Iowa City, IA 52242, USA
| | - Adam P. DeLuca
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Stephen A. Wynn Institute for Vision Research, 3111B Medical Education and Research Facility, University of Iowa, Iowa City, IA 52242, USA
| | - Edwin M. Stone
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Stephen A. Wynn Institute for Vision Research, 3111B Medical Education and Research Facility, University of Iowa, Iowa City, IA 52242, USA
| | - Wallace L.M. Alward
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Stephen A. Wynn Institute for Vision Research, 3111B Medical Education and Research Facility, University of Iowa, Iowa City, IA 52242, USA
| | - John H. Fingert
- Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA
- Stephen A. Wynn Institute for Vision Research, 3111B Medical Education and Research Facility, University of Iowa, Iowa City, IA 52242, USA
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Fassad MR, Amin AK, Morsy HA, Issa NM, Bayoumi NH, El Shafei SA, Kholeif SF. CYP1B1 and myocilin gene mutations in Egyptian patients with primary congenital glaucoma. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2017. [DOI: 10.1016/j.ejmhg.2016.07.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Chouiter L, Nadifi S. Analysis of CYP1B1 Gene Mutations in Patients with Primary Congenital Glaucoma. J Pediatr Genet 2017; 6:205-214. [PMID: 29142762 DOI: 10.1055/s-0037-1602695] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
Primary congenital glaucoma (PCG) is the most common type of infantile glaucoma, yet it remains a relatively rare disease, because the disease is often transmitted in an autosomal recessive pattern. However, PCG occurs up to 10 times more frequently in certain ethnic and geographical groups where consanguineous relationships are common. The aim of this study was to investigate the distribution of mutations in the cytochrome P450 1B1 gene ( CYP1B1 ) in patients with PCG among different populations around the world from 2011 until May 2016. We referred to the electronic databases, such as Medline, Clinicalkey, Scopus, and ScienceDirect, to search for articles that were published in this area. Nineteen records were included in this qualitative synthesis. CYP1B1 mutations were assessed in 1,220 patients with PCG and identified in 41.6% of them. According to these studies, 99 mutations including 60 novel mutations were found. Nonsignificant difference in the sex ratio has been reported. This current review shows that consanguinity plays an important role in the PCG pathogenesis and transmission; however, sporadic mutations have been found in some cases. A difference in penetrance was highlighted by some mutations. The CYP1B1 mutations were mostly found in the Middle East and the Maghreb with a rate of 64.8 and 54.4%, respectively, followed by Europe (34.7%), Asia (21.3%), and finally the United States (14.9%). Founder mutations in different geographical areas have been discovered. For instance, the p.Gly61Glu, p.Arg390His, p.Gly61Glu, c.4,339delG, p.E387Lys, and p.Val320Leu were considered founder mutations for Iran/Saudi Arabia, Pakistan, Lebanon, Morocco, Europe, and Vietnam/South Korea, respectively. Many common mutations in different countries were found, such as in Morocco, where its mutations were similar to seven other countries. These findings suggest that the ethnic differences and the geographical distribution of PCG give us a large CYP1B1 mutation pattern. Genetic tests looking for founder and common mutations should be the first step in genetic screening for patients with PCG.
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Affiliation(s)
- Leila Chouiter
- Department of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
| | - Sellama Nadifi
- Laboratory of Medical Genetics and Molecular Pathology, Department of Medicine and Pharmacy, Hassan II University of Casablanca, Casablanca, Morocco
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Moazzeni H, Akbari MT, Yazdani S, Elahi E. Expression of CXCL6 and BBS5 that may be glaucoma relevant genes is regulated by PITX2. Gene 2016; 593:76-83. [PMID: 27520585 DOI: 10.1016/j.gene.2016.08.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 07/31/2016] [Accepted: 08/08/2016] [Indexed: 12/26/2022]
Abstract
The transcription factor PITX2 is implicated in glaucoma pathology. In an earlier study we had used microarray analysis to identify genes in the trabecular meshwork (TM) that are affected by knock down of PITX2. Here, those studies were pursued to identify genes that are direct targets of PITX2 and that may be relevant to glaucoma. Initially, bioinformatics tools were used to select among the genes that had been affected by PITX2 knock down those that have PITX2 binding sites and that may be involved in glaucoma related functions. Subsequently, the effect of PITX2 was tested using the dual luciferase assay in four cell cultures including two primary TM cultures co-transfected with vectors containing promoter fragments of six candidate genes upstream of a luciferase gene and a vector that expressed PITX2. Finally, the effect of PITX2 on endogenous expression of two genes was assessed by over expression and knock down of PITX2 in TM cells. Thirty four genes were found to contain PITX2 binding sites in their putative promoter regions, and 16 were found to be associated with TM-specific and/or glaucoma associated functions. Results of dual luciferase assays confirmed that two of six genes tested were directly targeted by PITX2. The two genes were CXCL6 (chemokine (C-X-C motif) ligand 6) and BBS5 (Bardet-Biedl syndrome 5). Over expression and knock down of PITX2 showed that this transcription factor affects endogenous expression of these two genes in TM cells. CXCL6 encodes a pro-inflammatory cytokine, and many studies have suggested that cytokines and other immune system functions are involved in glaucoma pathogenesis. BBS5 is a member of the BBS family of genes that affect ciliary functions, and ciliary bodies in the anterior chamber of the eye produce the aqueous fluid that affects intraocular pressure. Immune related functions and intraocular pressure are both important components of glaucoma pathology. The role of PITX2 in glaucoma may be mediated partly by regulating the expression of CXCL6 and BBS5 and thus affecting immune functions and intraocular pressure.
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Affiliation(s)
- Hamidreza Moazzeni
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14115-331, Tehran, Iran
| | - Mohammad Taghi Akbari
- Department of Medical Genetics, Faculty of Medical Sciences, Tarbiat Modares University, P.O. Box. 14115-331, Tehran, Iran.
| | - Shahin Yazdani
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Elahi
- School of Biology, College of Science, University of Tehran, Tehran, Iran; Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran.
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A spectrum of CYP1B1 mutations associated with primary congenital glaucoma in families of Pakistani descent. Hum Genome Var 2016; 3:16021. [PMID: 27508083 PMCID: PMC4972894 DOI: 10.1038/hgv.2016.21] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 01/31/2016] [Accepted: 03/27/2016] [Indexed: 11/25/2022] Open
Abstract
Glaucoma is the second leading cause of blindness, affecting ~65 million people worldwide. We identified and ascertained a large cohort of inbred families with multiple individuals manifesting cardinal symptoms of primary congenital glaucoma (PCG) to investigate the etiology of the disease at a molecular level. Ophthalmic examinations, including slit-lamp microscopy and applanation tonometry, were performed to characterize the causal phenotype and confirm that affected individuals fulfilled the diagnostic criteria for PCG. Subsequently, exclusion analysis was completed with fluorescently labeled short tandem repeat markers, followed by Sanger sequencing to identify pathogenic variants. Exclusion analysis suggested linkage to the CYP1B1 locus, with positive two-point logarithm of odds scores in 23 families, while Sanger sequencing identified a total of 11 variants, including two novel mutations, in 23 families. All mutations segregated with the disease phenotype in their respective families. These included the following seven missense mutations: p.Y81N, p.E229K, p.R368H, p.R390H, p.W434R, p.R444Q and p.R469W, as well as one nonsense mutation, p.Q37*, and three frameshift mutations, p.W246Lfs81*, p.T404Sfs30* and p.P442Qfs15*. In conclusion, we identified a total of 11 mutations, reconfirming the genetic heterogeneity of CYP1B1 in the pathogenesis of PCG. To the best of our knowledge, this is the largest study investigating the contribution of CYP1B1 to the pathogenesis of PCG in the Pakistani population.
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Functional and Structural Analyses of CYP1B1 Variants Linked to Congenital and Adult-Onset Glaucoma to Investigate the Molecular Basis of These Diseases. PLoS One 2016; 11:e0156252. [PMID: 27243976 PMCID: PMC4887111 DOI: 10.1371/journal.pone.0156252] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 05/11/2016] [Indexed: 02/08/2023] Open
Abstract
Glaucoma, the leading cause of irreversible blindness, appears in various forms. Mutations in CYP1B1 result in primary congenital glaucoma (PCG) by an autosomal recessive mode of inheritance while it acts as a modifier locus for primary open angle glaucoma (POAG). We investigated the molecular basis of the variable phenotypes resulting from the defects in CYP1B1 by using subclones of 23 CYP1B1 mutants reported in glaucoma patients, in a cell based system by measuring the dual activity of the enzyme to metabolize both retinol and 17β-estradiol. Most variants linked to POAG showed low steroid metabolism while null or very high retinol metabolism was observed in variants identified in PCG. We examined the translational turnover rates of mutant proteins after the addition of cycloheximide and observed that the levels of enzyme activity mostly corroborated the translational turnover rate. We performed extensive normal mode analysis and molecular-dynamics-simulations-based structural analyses and observed significant variation of fluctuation in certain segmental parts of the mutant proteins, especially at the B-C and F-G loops, which were previously shown to affect the dynamic behavior and ligand entry/exit properties of the cytochrome P450 family of proteins. Our molecular study corroborates the structural analysis, and suggests that the pathologic state of the carrier of CYP1B1 mutations is determined by the allelic state of the gene. To our knowledge, this is the first attempt to dissect biological activities of CYP1B1 for correlation with congenital and adult onset glaucomas.
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Safari I, Suri F, Haji-Seyed-Javadi R, Yazdani S, Elahi E. The p.Gly61Glu Mutation in CYP1B1 Affects the Extracellular Matrix in Glaucoma Patients. Ophthalmic Res 2016; 56:98-103. [PMID: 26982174 DOI: 10.1159/000443508] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 12/17/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE The aim of this work was to assess the possible effects of CYP1B1 mutations on the extracellular matrix (ECM) in glaucoma patients. CYP1B1 mutations are the cause of disease in a notable fraction of primary congenital glaucoma (PCG) patients and in a smaller fraction of primary open angle glaucoma (POAG) patients. METHODS The study was performed on a glaucoma family with the common homozygous p.Gly61Glu CYP1B1 mutation. The father was affected with POAG and three siblings had PCG. Microscopy was performed on the skin of the father and one son, as well as controls. Immunohistochemical studies were done using anti-CYP1B1 and anti-fibrillin-1 antibodies. Fibrillin-1 served as a marker for the ECM, and electron microscopy was also performed. RESULTS CYP1B1 expression patterns were the same in the patients and controls. However, microfibrils that are associated with fibrillin-1 were less abundant and more fragmented in both patients. Electron microscopy showed disturbed collagen fibers only in the PCG patient. CONCLUSIONS The p.Gly61Glu mutation in CYP1B1 affects the ECM structure. This implies that the ECM of the trabecular meshwork may also be disrupted in a manner that affects aqueous humor flow resulting in increased intraocular pressure and contributing to the glaucoma phenotype.
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Affiliation(s)
- Iman Safari
- School of Biology, University College of Science, University of Tehran, Tehran, Iran
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Chen L, Huang L, Zeng A, He J. CYP1B1 gene mutations with incomplete penetrance in a Chinese pedigree with primary congenital glaucoma: a case report and review of literatures. Int J Clin Exp Med 2015; 8:14538-14541. [PMID: 26550445 PMCID: PMC4613130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 08/02/2015] [Indexed: 06/05/2023]
Abstract
To investigate the cytochrome P4501B1 (CYP1B1) mutations in a three-generation Chinese Han family with PCG, the 2 and 3 coding exons of CYP1B1 gene were amplified by PCR, and were directly sequenced using Sanger bidirectional sequencing reactions. The mutation c.517 G>A p.E173K was detected in all the affected individuals (which showed homozygous AA genotype) and not in all the unaffected ones except one individual. The mutation c.517 G>A p.E173K is associated with disease causing in this pedigree. And the possible genetic model is recessive inheritance. One apparently unaffected individual had mutations and haplotypes identical to her affected sibs suggested incomplete penetrance in this pedigree.
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Affiliation(s)
- Ling Chen
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Shenzhen Eye Hospital of Jinan UniversityShenzhen, P. R. China
| | - Lina Huang
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Shenzhen Eye Hospital of Jinan UniversityShenzhen, P. R. China
- Huaxia Shenzhen Eye Hospital Affiliated Medical College of Xiamen UniversityShenzhen, P. R. China
| | - Aineng Zeng
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Shenzhen Eye Hospital of Jinan UniversityShenzhen, P. R. China
| | - Jing He
- Shenzhen Eye Hospital, Shenzhen Key Laboratory of Ophthalmology, Affiliated Shenzhen Eye Hospital of Jinan UniversityShenzhen, P. R. China
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Suri F, Yazdani S, Elahi E. Glaucoma in iran and contributions of studies in iran to the understanding of the etiology of glaucoma. J Ophthalmic Vis Res 2015; 10:68-76. [PMID: 26005556 PMCID: PMC4424722 DOI: 10.4103/2008-322x.156120] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2014] [Accepted: 03/17/2014] [Indexed: 12/14/2022] Open
Abstract
Epidemiologic and genetic/molecular research on glaucoma in Iran started within the past decade. A population-based study on the epidemiology of glaucoma in Yazd, a city in central Iran, revealed that 4.4% of studied individuals were affected with glaucoma: 1.6% with high tension primary open angle glaucoma (POAG), 1.6% with normal tension POAG, and 0.4% each with primary angle closure glaucoma (PACG) and pseudoexfoliation glaucoma (PEXG), and other types of secondary glaucoma. Two notable observations were the relatively high frequency of normal tension glaucoma cases (1.6%) and the large fraction of glaucoma affected individuals (nearly 90%) who were unaware of their condition. The first and most subsequent genetic studies on glaucoma in Iran were focused on primary congenital glaucoma (PCG) showing that cytochrome P450 1B1 (CYP1B1) is the cause of PCG in the majority of Iranian patients, many different CYP1B1 mutations are present among Iranian patients but only four mutations constitute the vast majority, and the origins of most mutations in the Iranians are identical by descent (IBD) with the same mutations in other populations. Furthermore, most of the PCG patients are from the northern and northwestern provinces of Iran. A statistically significant male predominance of PCG was observed only among patients without CYP1B1 mutations. Clinical investigations on family members of PCG patients revealed that CYP1B1 mutations exhibit variable expressivity, but almost complete penetrance. A great number of individuals harboring CYP1B1 mutations become affected with juvenile onset POAG. Screening of JOAG patients showed that an approximately equal fraction of the patients harbor CYP1B1 and (myocilin) MYOC mutations; MYOC is a well-known adult onset glaucoma causing gene. Presence of CYP1B1 mutations in JOAG patients suggests that in some cases, the two conditions may share a common etiology. Further genetic analysis of Iranian PCG patients led to identification of Latent-transforming growth factor beta-binding protein 2 (LTBP2) as a causative gene for both PCG and several diseases which are often accompanied by glaucomatous presentations, such as Weill-Marchesani syndrome 3 (WMS3). The findings on LTBP2 have contributed to recognize the importance of the extracellular matrix in pathways leading to glaucoma.
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Affiliation(s)
- Fatemeh Suri
- Department of Cell and Molecular Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Shahin Yazdani
- Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran ; Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Elahe Elahi
- Department of Cell and Molecular Biology, School of Biology, College of Science, University of Tehran, Tehran, Iran ; Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran
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de Melo MB, Mandal AK, Tavares IM, Ali MH, Kabra M, de Vasconcellos JPC, Senthil S, Sallum JMF, Kaur I, Betinjane AJ, Moura CR, Paula JS, Costa KA, Sarfarazi M, Paolera MD, Finzi S, Ferraz VEF, Costa VP, Belfort R, Chakrabarti S. Genotype-Phenotype Correlations in CYP1B1-Associated Primary Congenital Glaucoma Patients Representing Two Large Cohorts from India and Brazil. PLoS One 2015; 10:e0127147. [PMID: 25978063 PMCID: PMC4433271 DOI: 10.1371/journal.pone.0127147] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 04/13/2015] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Primary congenital glaucoma (PCG), occurs due to the developmental defects in the trabecular meshwork and anterior chamber angle in children. PCG exhibits genetic heterogeneity and the CYP1B1 gene has been widely implicated worldwide. Despite the diverse mutation spectra, the clinical implications of these mutations are yet unclear. The present study attempted to delineate the clinical profile of PCG in the background of CYP1B1 mutations from a large cohort of 901 subjects from India (n=601) and Brazil (n=300). METHODS Genotype-phenotype correlations was undertaken on clinically well characterized PCG cases from India (n=301) and Brazil (n=150) to assess the contributions of CYP1B1 mutation on a set of demographic and clinical parameters. The demographic (gender, and history of consanguinity) and quantitative clinical (presenting intraocular pressure [IOP] and corneal diameter [CD]) parameters were considered as binary and continuous variables, respectively, for PCG patients in the background of the overall mutation spectra and also with respect to the prevalent mutations in India (R368H) and Brazil (4340delG). All these variables were fitted in a multivariate logistic regression model using the Akaike Information Criterion (AIC) to estimate the adjusted odds ratio (OR) using the R software (version 2.14.1). RESULTS The overall mutation spectrum were similar across the Indian and Brazilian PCG cases, despite significantly higher number of homozygous mutations in the former (p=0.024) and compound heterozygous mutations in the later (p=0.012). A wide allelic heterogeneity was observed and only 6 mutations were infrequently shared between these two populations. The adjusted ORs for the binary (demographic) and continuous (clinical) variables did not indicate any susceptibility to the observed mutations (p>0.05). CONCLUSIONS The present study demonstrated a lack of genotype-phenotype correlation of the demographic and clinical traits to CYP1B1 mutations in PCG at presentation. However, the susceptibility of these mutations to the long-term progression of these traits are yet to be deciphered.
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Affiliation(s)
- Mônica Barbosa de Melo
- Center of Molecular Biology and Genetic Engineering, University of Campinas, Campinas, SP, Brazil
| | - Anil K. Mandal
- Jasti V Ramanamma Childrens Eye Care Centre, L.V. Prasad Eye Institute, Hyderabad, India
| | - Ivan M. Tavares
- Department of Ophthalmology, Federal University of São Paulo, SP, Brazil
| | - Mohammed Hasnat Ali
- Centre for Clinical Epidemiology and Biostatistics, L.V. Prasad Eye Institute, Hyderabad, India
| | - Meha Kabra
- Kallam Anji Reddy Molecular Genetics Laboratory, L.V. Prasad Eye Institute, Hyderabad, India
| | | | - Sirisha Senthil
- Jasti V Ramanamma Childrens Eye Care Centre, L.V. Prasad Eye Institute, Hyderabad, India
| | | | - Inderjeet Kaur
- Kallam Anji Reddy Molecular Genetics Laboratory, L.V. Prasad Eye Institute, Hyderabad, India
| | - Alberto J. Betinjane
- Department of Ophthalmology, University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | | | - Jayter S. Paula
- Department of Ophthalmology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Karita A. Costa
- Department of Ophthalmology, Federal University of São Paulo, SP, Brazil
| | - Mansoor Sarfarazi
- Molecular Ophthalmic Genetics Laboratory, Surgical Research Center, Department of Surgery, University of Connecticut Health Center, Farmington, Connecticut, United States of America
| | - Mauricio Della Paolera
- Department of Ophthalmology, Irmandade da Santa Casa de Misericordia de São Paulo, School of Medical Sciences, São Paulo, SP, Brazil
| | - Simone Finzi
- Department of Ophthalmology, University of São Paulo School of Medicine, São Paulo, SP, Brazil
| | - Victor E. F. Ferraz
- Genetics Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Vital P. Costa
- Department of Ophthalmology, Faculty of Medical Sciences, University of Campinas, Campinas, SP, Brazil
| | - Rubens Belfort
- Department of Ophthalmology, Federal University of São Paulo, SP, Brazil
| | - Subhabrata Chakrabarti
- Kallam Anji Reddy Molecular Genetics Laboratory, L.V. Prasad Eye Institute, Hyderabad, India
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Badeeb OM, Micheal S, Koenekoop RK, den Hollander AI, Hedrawi MT. CYP1B1 mutations in patients with primary congenital glaucoma from Saudi Arabia. BMC MEDICAL GENETICS 2014; 15:109. [PMID: 25261878 PMCID: PMC4258803 DOI: 10.1186/s12881-014-0109-2] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2014] [Accepted: 09/24/2014] [Indexed: 12/02/2022]
Abstract
Background CYP1B1 is the most commonly mutated gene in primary congenital glaucoma (PCG). This study was undertaken to identify mutations in CYP1B1 in the Western region of Saudi Arabia. Methods Blood of patients who had typical findings of PCG, were screened by direct sequencing of all coding exons and splice junctions of the CYP1B1 gene. Results 34 patients were studied; 18 patients belonged to 8 families, and 16 patients were non-familial, isolated PCG. Consanguinity was found in 27/34 (79.4%) of cases. All patients were diagnosed to have bilateral PCG at birth except one child, who had glaucoma in the right eye. More males (61.8%) were affected than females (38.2%). 79.4% (27/34) of patients were solved with pathogenic mutations and 20.6% (7/34) remained unsolved. Of the solved ones, 22.2% (6/27) of patients carry a pathogenic allele on one allele while the other allele remained yet to be determined. Direct sequencing of exon 2 revealed two pathogenic variants (p.Gly61Glu, p.Glu229Lys). P.Gly61Glu substitution was found both homozygously in 63% (17/27) of cases, and heterozygously in one patient. P.Glu229Lys variant was found heterozygous in 3.7% (1/27) of cases. One pathogenic variant (p.Arg469Trp) was found in exon 3, and is present homozygously in 14.8% (4/27) of cases while four patients have this variant heterozygously. All mutations were reported previously in the Saudi population, except p.Glu229Lys. Severe cases were associated with p.Gly61Glu, and p.Arg469Trp in 50% and 30% of ten patients respectively. Conclusions This study confirms that CYP1B1 mutations are the most frequent cause of PCG in the Saudi population, with p.Gly61Glu being the major disease-associated mutation. P.Glu229Lys is a newly discovered mutation in our PCG patients. Patient lacking mutation in CYP1B1 gene seems likely, to have another genetic loci involved in the pathogenesis of the disease, and need further study. Genetic studies of recessive diseases such as PCG is important in consanguineous populations, since it will increase awareness and allows genetic counseling to be offered to patients and their relatives. This will not only reduce the disease to be inherited to future generations, but will also reduce the disease burden in the community.
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Affiliation(s)
- Osama M Badeeb
- Glaucoma unit, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
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Sheikh SA, Waryah AM, Narsani AK, Shaikh H, Gilal IA, Shah K, Qasim M, Memon AI, Kewalramani P, Shaikh N. Mutational spectrum of the CYP1B1 gene in Pakistani patients with primary congenital glaucoma: novel variants and genotype-phenotype correlations. Mol Vis 2014; 20:991-1001. [PMID: 25018621 PMCID: PMC4087121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 07/03/2014] [Indexed: 11/23/2022] Open
Abstract
PURPOSE This study aimed to investigate the role of CYP1B1 mutations in primary congenital glaucoma (PCG) in Pakistani patients. METHODS After consent was received, 20 families with at least more than one member affected with primary congenital glaucoma were enrolled in the study. The disease was confirmed with standard ophthalmological investigations. Genomic DNA was extracted from whole blood for localization of linkage and sequencing. Bioinformatics tools were used to assess the predicted pathological role of novel variants. RESULTS Ten out of 20 families (50%, 10/20) showed homozygosity with CYP1B1-linked short tandem repeat (STR) markers. On direct sequencing of the CYP1B1 gene in the linked families, six mutations, including two novel pathogenic variants, were identified. p. R390H was the most frequently found mutation in five families (50%, 5/10), whereas c.868_869insC, p.E229K, and p.A115P were found once in three families. Two novel mutations, a missense mutation (p.G36D) and an in-frame deletion mutation (p.G67-A70del), were segregated with disease phenotype in two families. Age of disease onset was congenital in all mutations; however, disease severity and response to clinical interventions varied among the mutations and families. Haplotype analysis using five polymorphisms revealed a distinct haplotype for a common mutation. CONCLUSIONS This is the largest cohort of Pakistani patients with PCG to be genetically screened for CYP1B1 mutations. Identifying common mutation and genotype-phenotype correlations may help in genetic testing and better prognosis for the disease. Novel mutations identified in the study may help in better understanding the pathophysiology of CYP1B1-associated glaucoma.
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Affiliation(s)
- Shakeel Ahmed Sheikh
- Molecular Biology and Genetics Department, Medical Research Center, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Ali Muhammad Waryah
- Molecular Biology and Genetics Department, Medical Research Center, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan,Department of Pathology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Ashok Kumar Narsani
- Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan
| | - Hina Shaikh
- Molecular Biology and Genetics Department, Medical Research Center, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Imtiaz Ahmed Gilal
- Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan
| | - Khairuddin Shah
- Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan
| | - Muhammad Qasim
- Departments of Bioinformatics & Biotechnology, Government College University Faisalabad, Pakistan
| | - Azam Iqbal Memon
- Molecular Biology and Genetics Department, Medical Research Center, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
| | - Pitambar Kewalramani
- Department of Ophthalmology, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan
| | - Naila Shaikh
- Molecular Biology and Genetics Department, Medical Research Center, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan,Department of Pathology, Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan
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Wiggs JL, Langgurth AM, Allen KF. Carrier frequency of CYP1B1 mutations in the United States (an American Ophthalmological Society thesis). TRANSACTIONS OF THE AMERICAN OPHTHALMOLOGICAL SOCIETY 2014; 112:94-102. [PMID: 25646030 PMCID: PMC4311669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE CYP1B1 mutations cause autosomal recessive congenital glaucoma. Disease risk assessment for families with CYP1B1 mutations requires knowledge of the population mutation carrier frequency. The purpose of this study is to determine the CYP1B1 mutation carrier frequency in clinically normal individuals residing in the United States. Because CYP1B1 mutations can exhibit variable expressivity, we hypothesize that the mutation carrier frequency is higher than expected. METHODS Two hundred fifty individuals without glaucoma or a family history of glaucoma were enrolled. CYP1B1 mutations were identified by DNA sequencing, and pathogenicity was estimated by PolyPhen-2 or a previous report of disease causality. RESULTS Based on the disease frequency (1 in 10,000) and prevalence of CYP1B1-related congenital glaucoma (15% to 20%), the frequency of CYP1B1-related congenital glaucoma in the United States is approximately 1 in 50,000. Assuming Hardy-Weinberg equilibrium, the expected CYP1B1 mutation carrier frequency would be 1 in 112, or 0.89%. Among the 250 study participants, 11 (4.4%) are carriers of a single pathogenic mutation, representing a carrier frequency of 1 in 22, which is 5.1 times the expected frequency. A higher-than-expected carrier frequency (1 in 33, 3.0%) was also observed in 4300 white individuals sequenced by the National Heart Lung and Blood Institute Exome Sequencing Project. CONCLUSIONS Our results show that the CYP1B1 mutation carrier frequency in the US population is between 1 in 22 and 1 in 33, which is 5.1 to 3.4 times the expected frequency. These results suggest that more individuals than expected are carriers of a deleterious CYP1B1 mutation, and that the prevalence of CYP1B1-related disease may be higher than expected.
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Affiliation(s)
- Janey L Wiggs
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston Massachusetts
| | - Anne M Langgurth
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston Massachusetts
| | - Keri F Allen
- Department of Ophthalmology, Harvard Medical School, Massachusetts Eye and Ear Infirmary, Boston Massachusetts
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Al-Haddad C, Abdulaal M, Badra R, Barikian A, Noureddine B, Farra C. Genotype/Phenotype Correlation in Primary Congenital Glaucoma Patients in the Lebanese Population: A Pilot Study. Ophthalmic Genet 2014; 37:31-6. [PMID: 24940937 DOI: 10.3109/13816810.2014.924015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The incidence of primary congenital glaucoma (PCG) varies among geographic regions and ethnic groups. The frequency of PCG in Lebanon and identification of disease-causing mutations have not been studied previously. PURPOSE To investigate the role of Cytochrome P1B1 (CYP1B1) gene and Myocillin (MYOC) gene mutations in PCG in the Lebanese population and study possible genotype/phenotype correlations. METHODS Patients with unilateral or bilateral PCG diagnosed at the American University of Beirut Medical Center and their first-degree relatives (parents and siblings) were screened for CYP1B1 and MYOC mutations. Demographic and phenotypic characteristics were recorded. Phenotypic characteristics pertaining to disease severity and outcomes were compared. RESULTS Eighteen Lebanese families (66 subjects) with at least one member affected with PCG were included in this study. Mutations in the CYP1B1 gene were detected in 6 families (33%). Five previously described mutations (p.R444Q; p.E229K; p.R469W; p.G61E; p.M1T) and one new single nucleotide deletion were identified (1793delC). Patients in whom CYP1B1 mutations were detected tended to have a more severe phenotype as evidenced by earlier age at diagnosis, higher rate of bilateral disease, and higher number of glaucoma surgeries than those in whom no CYP1B1 mutations were present. MYOC gene mutations were not detected in any patients. CONCLUSION The rate of CYP1B1 mutations in Lebanese patients with PCG is lower than that reported in other Arab and Middle Eastern populations and suggests other genes are responsible for PCG in the remainder.
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Affiliation(s)
- Christiane Al-Haddad
- a Department of Ophthalmology , American University of Beirut Medical Center , Beirut , Lebanon , and
| | - Marwan Abdulaal
- a Department of Ophthalmology , American University of Beirut Medical Center , Beirut , Lebanon , and
| | - Rebecca Badra
- b Department of Pathology and Laboratory Medicine , Medical Genetics, American University of Beirut Medical Center , Beirut , Lebanon
| | - Anita Barikian
- a Department of Ophthalmology , American University of Beirut Medical Center , Beirut , Lebanon , and
| | - Bahaa Noureddine
- a Department of Ophthalmology , American University of Beirut Medical Center , Beirut , Lebanon , and
| | - Chantal Farra
- b Department of Pathology and Laboratory Medicine , Medical Genetics, American University of Beirut Medical Center , Beirut , Lebanon
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Bouyacoub Y, Ben Yahia S, Abroug N, Kahloun R, Kefi R, Khairallah M, Abdelhak S. CYP1B1Gene Mutations Causing Primary Congenital Glaucoma in Tunisia. Ann Hum Genet 2014; 78:255-63. [DOI: 10.1111/ahg.12069] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 04/15/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Yosra Bouyacoub
- Université Tunis El Manar; Institut Pasteur de Tunis, LR11IPT05; Biomedical Genomics and Oncogenetics Laboratory; 1002 Tunis Tunisia
- Université de Monastir; Institut Supérieur de Biotechnologie; Monastir 5000 Tunisia
| | - Salim Ben Yahia
- Université de Monastir; Faculty of Medicine; Fattouma Bourguiba University Hospital; Department of Ophthalmology; 5000 Monastir Tunisia
| | - Nesrine Abroug
- Université de Monastir; Faculty of Medicine; Fattouma Bourguiba University Hospital; Department of Ophthalmology; 5000 Monastir Tunisia
| | - Rim Kahloun
- Université de Monastir; Faculty of Medicine; Fattouma Bourguiba University Hospital; Department of Ophthalmology; 5000 Monastir Tunisia
| | - Rym Kefi
- Université Tunis El Manar; Institut Pasteur de Tunis, LR11IPT05; Biomedical Genomics and Oncogenetics Laboratory; 1002 Tunis Tunisia
| | - Moncef Khairallah
- Université de Monastir; Faculty of Medicine; Fattouma Bourguiba University Hospital; Department of Ophthalmology; 5000 Monastir Tunisia
| | - Sonia Abdelhak
- Université Tunis El Manar; Institut Pasteur de Tunis, LR11IPT05; Biomedical Genomics and Oncogenetics Laboratory; 1002 Tunis Tunisia
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Moore DB, Tomkins O, Ben-Zion I. A Review of Primary Congenital Glaucoma in the Developing World. Surv Ophthalmol 2013; 58:278-85. [DOI: 10.1016/j.survophthal.2012.11.003] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2012] [Revised: 10/26/2012] [Accepted: 11/01/2012] [Indexed: 11/30/2022]
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Faiq M, Sharma R, Dada R, Mohanty K, Saluja D, Dada T. Genetic, Biochemical and Clinical Insights into Primary Congenital Glaucoma. J Curr Glaucoma Pract 2013; 7:66-84. [PMID: 26997785 PMCID: PMC4741182 DOI: 10.5005/jp-journals-10008-1140] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2013] [Accepted: 04/09/2013] [Indexed: 12/21/2022] Open
Abstract
Glaucoma is an irreversible form of optic neuropathy in which the optic nerve suffers damage in a characteristic manner with optic nerve cupping and retinal ganglion cell death. Primary congenital glaucoma (PCG) is an idiopathic irreversible childhood blinding disorder which manifests at birth or within the first year of life. PCG presents with a classical triad of symptoms (viz epiphora, photophobia and blepharospasm) though there are many additional symptoms, including large eye ball and hazy cornea. The only anatomical anomaly found in PCG is trabecular meshwork (TM) dysgenesis. PCG is an inheritable disease with established genetic etiology. It transmits through autosomal recessive mode. A number of cases are sporadic also. Mutations in many genes have been found to be causative in PCG and many are yet to be found. Mutations in cytochrome P4501B1 (CYP1B1) gene have been found to be the predominant cause of PCG. Other genes that have been implicated in PCG etiology are myocilin, Forkhead-related transcription factor C1 (FOXC1) and latent transforming growth factor beta-binding protein 2 (LTBP2). Mutations in these genes have been reported from many parts of the world. In addition to this, mitochondrial genome mutations are also thought to be involved in its pathogenesis. There appears to be some mechanism involving more than one genetic factor. In this review, we will discuss the various clinical, biochemical and genetic aspects of PCG. We emphasize that etiology of PCG does not lie in a single gene or genetic factor. Research needs to be oriented into a direction where gene-gene interactions, ocular embryology, ophthalmic metabolism and systemic oxidative status need to be studied in order to understand this disorder. We also accentuate the need for ophthalmic genetic facilities in all ophthalmology setups. How to cite this article: Faiq M, Sharma R, Dada R, Mohanty K, Saluja D, Dada T. Genetic, Biochemical and Clinical Insights into Primary Congenital Glaucoma. J Current Glau Prac 2013;7(2):66-84.
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Affiliation(s)
- Muneeb Faiq
- Pursuing Doctorate, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Reetika Sharma
- Resident, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Rima Dada
- Additional Professor, Department of Anatomy, Laboratory for Molecular Reproduction and Genetics, All India Institute of Medical Sciences, New Delhi, India
| | - Kuldeep Mohanty
- Pursuing Doctorate, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Daman Saluja
- Professor, Medical Biotechnology Laboratory, Dr BR Ambedkar Centre for Biomedical Research, University of Delhi, New Delhi, India
| | - Tanuj Dada
- Additional Professor, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Abu-Amero KK, Osman EA, Mousa A, Wheeler J, Whigham B, Allingham RR, Hauser MA, Al-Obeidan SA. Screening of CYP1B1 and LTBP2 genes in Saudi families with primary congenital glaucoma: genotype-phenotype correlation. Mol Vis 2011; 17:2911-9. [PMID: 22128238 PMCID: PMC3224840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2011] [Accepted: 11/07/2011] [Indexed: 10/26/2022] Open
Abstract
PURPOSE Primary congenital glaucoma (PCG) is a severe form of glaucoma that presents early in life. PCG is a clinical and genetic entity that is distinct from juvenile forms of glaucoma. Inheritance is usually autosomal recessive and therefore the disease might be more common in societies where consanguinity is high. We studied the prevalence of cytochrome P450, family 1, subfamily B, polypeptide 1 (CYP1B1) and latent-transforming growth factor beta-binding protein 2 (LTBP2) mutations in a group of Saudi PCG patients and attempted to correlate the mutation status with the disease severity. METHODS Genomic DNA was collected from 54 unrelated Saudi PCG families (74 patients) who were diagnosed as having PCG by standard ophthalmological examinations and screened for mutations in CYP1B1 and LTBP2 by sequencing. We also examined the effect of mutations on the phenotype of patients with PCG (phenotype-genotype correlation). RESULTS Mutations in CYP1B1 were identified in 41 (75.9%) of affected patients. No mutation in CYP1B1 was found in 13 (24.1%) affected persons. We detected a total of 13 mutations: 9 missense mutations (G61E, A119S, R390H, P437L, D441G, A443G, G466S, G466D, and R469W), 2 deletions (g.4238_4247del and g.7901_7913del), and 2 nonsense mutations (R355X and R444X). Two mutations, G466S and D441G, were novel. The G61E mutation was by far the most common mutation detected. PCG cases with CYP1B1 mutation(s) presented with a high degree of haze and greater cup/disc ratio than those with no mutation(s). Also, PCG cases with a mutation had higher post operative indices in terms of post operative haze and the need for anti-glaucoma medications. Additionally, the surgical success rate was higher 13/14 (92.9%) among cases without mutation than those with mutation 42/60 (70%). No mutation(s) were found in LTBP2 in any of the tested patients. CONCLUSIONS CYP1B1 mutations are the predominant cause of PCG in the Saudi Arabian population with G61E as the dominant disease-associated allele. PCG cases with a mutation had higher last postoperative visit indices in terms of postoperative haze and the need for anti-glaucoma medications. This will be a valuable parameter in predicting disease severity earlier on and might help in predicting the surgical outcome.
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Affiliation(s)
- Khaled K. Abu-Amero
- Ophthalmic Genetics Laboratory, Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia,Department of Ophthalmology, College of Medicine, University of Florida, Jacksonville, FL
| | - Essam A. Osman
- Glaucoma Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Ahmed Mousa
- Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Joshua Wheeler
- Center for Human Genetics, Duke University Medical Center, Durham, NC
| | - Benjamin Whigham
- Center for Human Genetics, Duke University Medical Center, Durham, NC
| | - R. Rand Allingham
- Center for Human Genetics, Duke University Medical Center, Durham, NC,Department of Ophthalmology, Duke University Eye Center, Durham, NC
| | - Michael A. Hauser
- Center for Human Genetics, Duke University Medical Center, Durham, NC,Department of Ophthalmology, Duke University Eye Center, Durham, NC
| | - Saleh A. Al-Obeidan
- Glaucoma Unit, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Overview of Cytochrome P450 1B1 gene mutations in patients with primary congenital glaucoma. Exp Eye Res 2011; 93:572-9. [DOI: 10.1016/j.exer.2011.07.009] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2011] [Revised: 07/10/2011] [Accepted: 07/21/2011] [Indexed: 11/19/2022]
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Kaur K, Mandal AK, Chakrabarti S. Primary Congenital Glaucoma and the Involvement of CYP1B1. Middle East Afr J Ophthalmol 2011; 18:7-16. [PMID: 21572728 PMCID: PMC3085158 DOI: 10.4103/0974-9233.75878] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Primary congenital glaucoma (PCG) is an autosomal recessive disorder in children due to the abnormal development of the trabecular meshwork and the anterior chamber angle. With an onset at birth to early infancy, PCG is highly prevalent in inbred populations and consanguinity is strongly associated with the disease. Gene mapping of PCG-affected families has identified three chromosomal loci, GLC3A, GLC3B and GLC3C, of which, the CYP1B1 gene on GLC3A harbors mutations in PCG. The mutation spectra of CYP1B1 vary widely across different populations but are well structured based on geographic and haplotype backgrounds. Structural and functional studies on CYP1B1 have suggested its potential role in the development and onset of glaucomatous symptoms. A new locus (GLC3D) harboring the LTBP2 gene has been characterized in developmental glaucoma but its role in classical cases of PCG is yet to be understood. In this review, we provide insight into PCG pathogenesis and the potential role of CYP1B1 in the disease phenotype.
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Affiliation(s)
- Kiranpreet Kaur
- Kallam Anji Reddy Molecular Genetics Laboratory, Prof. Brien Holden Eye Research Centre, L.V. Prasad Eye Institute, Hyderabad, India
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Geyer O, Wolf A, Levinger E, Harari-Shacham A, Walton DS, Shochat C, Korem S, Bercovich D. Genotype/phenotype correlation in primary congenital glaucoma patients from different ethnic groups of the Israeli population. Am J Ophthalmol 2011; 151:263-71.e1. [PMID: 21168818 DOI: 10.1016/j.ajo.2010.08.038] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2009] [Revised: 08/23/2010] [Accepted: 08/25/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To investigate the roles of CYP1B1 and MYOC mutations and characterize the phenotype of primary congenital glaucoma in Israeli patients from 3 different ethnic backgrounds. DESIGN Interventional case series. METHODS This institutional study included 34 Israeli primary congenital glaucoma patients (26 families) comprising 9 Jews (9 families), 17 non-Bedouin Muslim Arabs (10 families), and 8 Druze (7 families). The patients and their relatives (n = 99) were screened for CYP1B1 and MYOC mutations. RESULTS Mutations in the CYP1B1 gene were detected in 12 of 26 families (46%) with primary congenital glaucoma (5 Muslim Arab, 5 Druze, and 2 Jewish). The Jewish families had compound heterozygous mutations and digenic mutations (ie, an Ashkenazi family had mutations in the CYP1B1 gene [Arg368His, R48G, A119S, and L432V haplotypes] and an Ashkenazi-Sephardic family had a mutation on the CYP1B1 gene [1908delA, Sephardic] with a second missense mutation on the MYOC gene [R76K, Ashkenazi]). The Muslim Arabs and Druze tended to have a more severe phenotype than that of the Jews. CONCLUSION The phenotype and spectrum of the CYP1B1 and MYOC mutation roles in the clinical characteristics of primary congenital glaucoma varied according to ethnicity. The rarity of mutations in the CYP1B1 gene among Ashkenazi primary congenital glaucoma patients indicates that a different locus may be involved in the phenotype.
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Hilal L, Boutayeb S, Serrou A, Refass-Buret L, Shisseh H, Bencherifa F, El Mzibri M, Benazzouz B, Berraho A. Screening of CYP1B1 and MYOC in Moroccan families with primary congenital glaucoma: three novel mutations in CYP1B1. Mol Vis 2010; 16:1215-26. [PMID: 20664688 PMCID: PMC2901188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 06/24/2010] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To investigate the contribution of cytochrome P4501B1 (CYP1B1) and myocillin (MYOC) mutations to primary congenital glaucoma (PCG) in Moroccan families. METHODS This study included 90 unrelated families with PCG and 100 normal control individuals. Two previously reported CYP1B1 mutations (g.4339delG and p.G61E) were first screened by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The coding exons of CYP1B1 were sequenced in g.4339delG- and p.G61E-negative or heterozygous probands. Then the coding exons of MYOC were sequenced in patients who had no mutation in CYP1B1 or carried heterozygous CYP1B1 mutation. RESULTS Twelve CYP1B1 mutations were identified in 43 PCG pedigrees. Three of them were novel (p.R163C, p.C470Y, and g.4330-4331delTG) and associated with moderate to severe phenotypes. Two novel intronic polymorphisms in CYP1B1 were identified in addition to those previously described. The g.4339delG was the most frequent mutation detected in 31 families (34.44%), followed by the p.G61E in seven families (7.77%). The remaining mutations (p.R163C, p.E173K, g.4330-4331delTG, p.E229K, p.R390S, p.R368H, p.R469W, p.C470Y, and g.7901-7913del13bp) were infrequent. One family with the p.R390S mutation showed both PCG and primary open angle glaucoma (POAG) phenotypes. One proband was heterozygous for p.T193K mutation in MYOC. This mutation has been initially associated with POAG, but never with PCG. CONCLUSIONS Our results support that mutations in CYP1B1 are a major cause for PCG in the Moroccan population with a predominance of the g.4339delG mutation. Furthermore, these results demonstrate the diversity of CYP1B1 mutations, while suggesting a modest role of MYOC in Moroccan PCG.
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Affiliation(s)
- Latifa Hilal
- Laboratoire de Génétique et de Physiologie Neuroendocrinienne, Equipe des Bases Moléculaires de Maladies Génétiques, Université Ibn Tofaïl, Faculté des Sciences, Kénitra, Morocco
| | - Soraya Boutayeb
- Laboratoire de Génétique et de Physiologie Neuroendocrinienne, Equipe des Bases Moléculaires de Maladies Génétiques, Université Ibn Tofaïl, Faculté des Sciences, Kénitra, Morocco
| | - Aziza Serrou
- Service d’Ophtalmologie B, Hôpital des Spécialités, CHU Ibn Sina, Equipe de Recherche sur les maladies oculaires, Faculté des Médecine et de Pharmacie, Rabat, Morocco
| | - Loubna Refass-Buret
- Service d’Ophtalmologie B, Hôpital des Spécialités, CHU Ibn Sina, Equipe de Recherche sur les maladies oculaires, Faculté des Médecine et de Pharmacie, Rabat, Morocco
| | - Hafsa Shisseh
- Laboratoire de Génétique et de Physiologie Neuroendocrinienne, Equipe des Bases Moléculaires de Maladies Génétiques, Université Ibn Tofaïl, Faculté des Sciences, Kénitra, Morocco
| | - Fatiha Bencherifa
- Service d’Ophtalmologie B, Hôpital des Spécialités, CHU Ibn Sina, Equipe de Recherche sur les maladies oculaires, Faculté des Médecine et de Pharmacie, Rabat, Morocco
| | | | - Bouchra Benazzouz
- Laboratoire de Génétique et de Physiologie Neuroendocrinienne, Equipe des Bases Moléculaires de Maladies Génétiques, Université Ibn Tofaïl, Faculté des Sciences, Kénitra, Morocco
| | - Amina Berraho
- Service d’Ophtalmologie B, Hôpital des Spécialités, CHU Ibn Sina, Equipe de Recherche sur les maladies oculaires, Faculté des Médecine et de Pharmacie, Rabat, Morocco
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Feizi S. Novel gene mutations causing primary congenital glaucoma. J Ophthalmic Vis Res 2010; 5:142. [PMID: 22737346 PMCID: PMC3380687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Elahi E, Narooie-Nejhad M, Suri F, yazdani S. Myocilin mutations are not a major cause of primary congenital glaucoma in Iranian patients. J Ophthalmic Vis Res 2010; 5:101-4. [PMID: 22737338 PMCID: PMC3380681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2009] [Accepted: 02/15/2010] [Indexed: 10/27/2022] Open
Abstract
PURPOSE To assess the frequency of mutations in the Myocilin (MYOC) gene in Iranian patients affected with primary congenital glaucoma (PCG). METHODS The individuals evaluated herein are among a larger cohort of 100 patients who had previously been screened for CYP1B1 mutations. Eighty subjects carried mutations in CYP1B1, but the remaining 20 patients who did not, underwent screening for MYOC mutations for the purpose of the study. MYOC exons in the DNA were polymerase chain reaction (PCR) amplified and sequenced. Sequencing was performed using PCR primers, the ABI big dye chemistry and an ABI3730XL instrument. Sequences were analyzed by comparing them to reference MYOC sequences using the Sequencher software. RESULTS Four MYOC sequence variations were observed among the patients, but none of them were considered to be associated with disease status. Three of these variations were single nucleotide polymorphisms already reported not to be disease causing, the fourth variation created a synonymous codon and did not affect any amino acid change. CONCLUSION In this cohort, MYOC mutations were not observed in any Iranian subject with PCG. It is possible that in a larger sample, a few subjects carrying disease causing MYOC mutations could have been observed. But our results show that the contribution of MYOC to PCG status in Iran is small if any.
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Affiliation(s)
- Elahe Elahi
- School of Biology, College of Science, University of Tehran, Tehran, Iran,Department of Biotechnology, College of Science, University of Tehran, Tehran, Iran,Center of Excellence in Biomathematics, Statistics and Computer Science, University of Tehran, Tehran, Iran
| | | | - Fatemeh Suri
- School of Biology, College of Science, University of Tehran, Tehran, Iran
| | - Shahin yazdani
- Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran,Correspondence to: Shahin Yazdani, MD. Associate Professor of Ophthalmology; Ophthalmic Research Center, No. 23, Boostan 9 St., Amir Ebrahimi St., Pasdaran Ave., Tehran 16666, Iran; Tel: +98 21 22585952, Fax: +98 21 22590607; e-mail:
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Shojaee S, Fazlali Z, Ghazavi F, Banihosseini SS, Kazemi MH, Parsa K, Sadeghi H, Sina F, Shahidi GA, Ronaghi M, Elahi E. Identification of four novel potentially Parkinson's disease associated LRRK2 variations among Iranian patients. Neurosci Lett 2009; 467:53-7. [DOI: 10.1016/j.neulet.2009.09.058] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2009] [Revised: 09/17/2009] [Accepted: 09/27/2009] [Indexed: 10/20/2022]
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