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Sun Y, Li L, Wang J, Liu H, Wang H. Emerging Landscape of Osteogenesis Imperfecta Pathogenesis and Therapeutic Approaches. ACS Pharmacol Transl Sci 2024; 7:72-96. [PMID: 38230285 PMCID: PMC10789133 DOI: 10.1021/acsptsci.3c00324] [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: 11/12/2023] [Revised: 12/10/2023] [Accepted: 12/12/2023] [Indexed: 01/18/2024]
Abstract
Osteogenesis imperfecta (OI) is an uncommon genetic disorder characterized by shortness of stature, hearing loss, poor bone mass, recurrent fractures, and skeletal abnormalities. Pathogenic variations have been found in over 20 distinct genes that are involved in the pathophysiology of OI, contributing to the disorder's clinical and genetic variability. Although medications, surgical procedures, and other interventions can partially alleviate certain symptoms, there is still no known cure for OI. In this Review, we provide a comprehensive overview of genetic pathogenesis, existing treatment modalities, and new developments in biotechnologies such as gene editing, stem cell reprogramming, functional differentiation, and transplantation for potential future OI therapy.
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Affiliation(s)
- Yu Sun
- PET
Center, Chongqing University Three Gorges
Hospital, Chongqing 404000, China
| | - Lin Li
- PET
Center, Chongqing University Three Gorges
Hospital, Chongqing 404000, China
| | - Jiajun Wang
- Medical
School of Hubei Minzu University, Enshi 445000, China
| | - Huiting Liu
- PET
Center, Chongqing University Three Gorges
Hospital, Chongqing 404000, China
| | - Hu Wang
- Department
of Neurology, Johns Hopkins University School
of Medicine, Baltimore, Maryland 21205, United States
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2
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Sagar RL, Walther-Jallow L, Götherström C, Westgren M, David AL. Maternal and fetal safety outcomes after in utero stem cell injection: A systematic review. Prenat Diagn 2023; 43:1622-1637. [PMID: 37975679 DOI: 10.1002/pd.6459] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 10/14/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVE To investigate the maternal and fetal safety of In utero stem cell transplantation (IUSCT). METHODS Medline®, Embase and Cochrane library (1967-2023) search for publications reporting IUSCT in humans. Two reviewers independently screened abstracts and full-text papers. RESULTS Sixty six transplantation procedures in 52 fetuses were performed for haemoglobinopathies (n = 14), red cell/bleeding disorders (n = 4), immunodeficiencies (n = 15), storage disorders (n = 7), osteogenesis imperfecta (n = 2) and healthy fetuses (n = 10). The average gestational age was 18.9 weeks; of procedures reporting the injection route, cells were delivered by intraperitoneal (n = 37), intravenous (n = 19), or intracardiac (n = 4) injection or a combination (n = 3); most fetuses received one injection (n = 41). Haematopoietic (n = 40) or mesenchymal (n = 12) stem cells were delivered. The cell dose was inconsistently reported (range 1.8-3.3 × 109 cells total (n = 27); 2.7-5.0 × 109 /kg estimated fetal weight (n = 17)). The acute fetal procedural complication rate was 4.5% (3/66); the acute fetal mortality rate was 3.0% (2/66). Neonatal survival was 69.2% (36/52). Immediate maternal and pregnancy outcomes were reported in only 30.8% (16/52) and 44.2% (23/52) of cases respectively. Four fetal/pregnancy outcomes would also classify as ≥ Grade 2 maternal adverse events. CONCLUSIONS Short-, medium-, and long-term maternal and fetal adverse events should be reported in all IUSCT studies.
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Affiliation(s)
- Rachel L Sagar
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
| | - Lilian Walther-Jallow
- Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institutet, ANA Futura, Huddinge, Sweden
| | - Cecilia Götherström
- Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institutet, ANA Futura, Huddinge, Sweden
| | - Magnus Westgren
- Department of Clinical Science, Intervention and Technology, Division of Obstetrics and Gynecology, Karolinska Institutet, ANA Futura, Huddinge, Sweden
| | - Anna L David
- Elizabeth Garrett Anderson Institute for Women's Health, University College London, London, UK
- NIHR University College London Hospitals Biomedical Research Centre, London, UK
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Rapoport M, Bober MB, Raggio C, Wekre LL, Rauch F, Westerheim I, Hart T, van Welzenis T, Mistry A, Clancy J, Booth L, Prince S, Semler O. The patient clinical journey and socioeconomic impact of osteogenesis imperfecta: a systematic scoping review. Orphanet J Rare Dis 2023; 18:34. [PMID: 36814274 PMCID: PMC9945474 DOI: 10.1186/s13023-023-02627-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 02/06/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Osteogenesis imperfecta (OI) is a rare heritable connective tissue disorder primarily characterised by skeletal deformity and fragility, and an array of secondary features. The purpose of this review was to capture and quantify the published evidence relating specifically to the clinical, humanistic, and economic impact of OI on individuals, their families, and wider society. METHODS A systematic scoping review of 11 databases (MEDLINE, MEDLINE in-progress, EMBASE, CENTRAL, PsycINFO, NHS EED, CEA Registry, PEDE, ScHARRHUd, Orphanet and Google Scholar), supplemented by hand searches of grey literature, was conducted to identify OI literature published 1st January 1995-18th December 2021. Searches were restricted to English language but without geographical limitations. The quality of included records was assessed using the AGREE II checklist and an adapted version of the JBI cross-sectional study checklist. RESULTS Of the identified 7,850 records, 271 records of 245 unique studies met the inclusion criteria; overall, 168 included records examined clinical aspects of OI, 67 provided humanistic data, 6 reported on the economic impact of OI, and 30 provided data on mixed outcomes. Bone conditions, anthropometric measurements, oral conditions, diagnostic techniques, use of pharmacotherapy, and physical functioning of adults and children with OI were well described. However, few records included current care practice, diagnosis and monitoring, interactions with the healthcare system, or transition of care across life stages. Limited data on wider health concerns beyond bone health, how these concerns may impact health-related quality of life, in particular that of adult men and other family members, were identified. Few records described fatigue in children or adults. Markedly few records provided data on the socioeconomic impact of OI on patients and their caregivers, and associated costs to healthcare systems, and wider society. Most included records had qualitative limitations. CONCLUSION Despite the rarity of OI, the volume of recently published literature highlights the breadth of interest in the OI field from the research community. However, significant data gaps describing the experience of OI for individuals, their families, and wider society warrant further research to capture and quantify the full impact of OI.
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Affiliation(s)
| | | | | | - Lena Lande Wekre
- TRS National Resource Center for Rare Disorders, Sunnaas Rehabilitation Hospital, Bjørnemyr, Nesodden, Norway
| | | | | | - Tracy Hart
- Osteogenesis Imperfecta Foundation, Gaithersburg, MD, USA
| | | | | | | | - Lucy Booth
- Wickenstones Ltd, Abingdon, Oxfordshire, UK
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4
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Chang B, Keating S, Mikhael M, Lim J. Osteogenesis Imperfecta: Multidisciplinary and Goal-Centered Care. AJP Rep 2022; 12:e144-e147. [PMID: 36187198 PMCID: PMC9522483 DOI: 10.1055/s-0042-1757481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/06/2022] [Indexed: 11/30/2022] Open
Abstract
We describe a case of osteogenesis imperfecta (OI) in a late preterm female of 35-week gestation. The mother did have a history of substance abuse, poor prenatal care, and hypertension. On the day of delivery, an ultrasound revealed skeletal dysplasia and breech with nonreassuring fetal tracing, leading to an emergency cesarean. The clinical exam was concerning for OI, and postnatal care was focused on optimizing respiratory status and minimizing pain and discomfort during routine care. Genetics, endocrine, orthopaedics, and palliative care were all involved to diagnose and educate the family. Support and education were needed for bedside staff to minimize angst at performing routine care, given the high risk of fractures. While initially stable on minimal oxygen, once the diagnosis of type III OI was made, a progressively deforming condition with respiratory status decompensation, the family wished to minimize suffering, limited aggressive medical care, and focused on comfort. The infant eventually died from respiratory failure in the neonatal intensive care unit. We present this case to demonstrate the need for an interdisciplinary team approach to support both family and staff in cases of OI.
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Affiliation(s)
- Bryston Chang
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, California
| | - Sarah Keating
- Department of Palliative Care, Children's Hospital of Orange County, Orange, California
| | - Michel Mikhael
- Department of Neonatal-Perinatal Medicine, Orange, California
| | - Jina Lim
- Department of Neonatology, Children's Hospital of Orange County, Orange, California
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5
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Chang B, Keating S, Mikhael M, Lim J. Osteogenesis Imperfecta: Multidisciplinary and Goal-Centered Care. AJP Rep 2022; 12:e144-e147. [PMID: 36187200 PMCID: PMC9525185 DOI: 10.1055/a-1911-3755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 07/06/2022] [Indexed: 12/04/2022] Open
Abstract
We describe a case of osteogenesis imperfecta (OI) in a late preterm female of 35-week gestation. The mother did have a history of substance abuse, poor prenatal care, and hypertension. On the day of delivery, an ultrasound revealed skeletal dysplasia and breech with nonreassuring fetal tracing, leading to an emergency cesarean. The clinical exam was concerning for OI, and postnatal care was focused on optimizing respiratory status and minimizing pain and discomfort during routine care. Genetics, endocrine, orthopaedics, and palliative care were all involved to diagnose and educate the family. Support and education were needed for bedside staff to minimize angst at performing routine care, given the high risk of fractures. While initially stable on minimal oxygen, once the diagnosis of type III OI was made, a progressively deforming condition with respiratory status decompensation, the family wished to minimize suffering, limited aggressive medical care, and focused on comfort. The infant eventually died from respiratory failure in the neonatal intensive care unit. We present this case to demonstrate the need for an interdisciplinary team approach to support both family and staff in cases of OI.
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Affiliation(s)
- Bryston Chang
- Department of Pediatrics, University of California Irvine School of Medicine, Irvine, California
| | - Sarah Keating
- Department of Palliative Care, Children's Hospital of Orange County, Orange, California
| | - Michel Mikhael
- Department of Neonatal-Perinatal Medicine, Orange, California
| | - Jina Lim
- Department of Neonatology, Children's Hospital of Orange County, Orange, California
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6
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Ahmad N, Aleysae NA, Sobaihi M, Naitah N, Rasol MA, Al-Kouatli AA, Almaghamsi TM, Heaphy ELG, Attiyah MH, Hrays M, Alghamdi B, Alzahrani AS. A single-centre study of genetic mutations, audiology, echocardiogram and pulmonary function in Saudi children with osteogenesis imperfecta. J Pediatr Endocrinol Metab 2022; 35:355-362. [PMID: 34954934 DOI: 10.1515/jpem-2021-0587] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 11/25/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Osteogenesis imperfecta (OI) is a heterogeneous group of inherited connective tissue disorders, characterised by skeletal fragility. Patients with OI may also exhibit extra-skeletal features like blue or grey scleral colour, fragile skin, easy bruising, joint laxity, short stature, deafness, cardiac valve abnormalities and abnormal pulmonary function. The objective of this study is to describe genetic mutations, prevalence of hearing issues, cardiac complications and impaired pulmonary function in children with OI. METHODS This is a cross-sectional study of 23 Saudi children aged 6 months to 18 years who were diagnosed with OI. The revised Sillence classification (2,105) was used to classify the OI type. Whole exome sequencing was performed for genetic mutations. The hearing was assessed by either pure-tone audiometry and/or otoacoustic emission testing. Cardiac defects were screened by echocardiograms. Spirometry was performed to assess pulmonary function. Data were analysed with descriptive statistics. RESULTS Based on the Sillence classification, 16 patients had OI type III, 6 had type IV and 1 had type I. Of the18 patients who had genetic sequencing, 66.6% had autosomal dominant and 33.3% had autosomal recessive mutations. Among children who had screening, hearing loss was diagnosed in 53% (9/17), congenital cardiac malformations in 26% (5/19) and restrictive lung disease in 70% (7/10). CONCLUSIONS We found significant extra-skeletal features and a high yield of genetic mutations associated with OI. We suggest further studies to develop a screening protocol for extra-skeletal features in children with OI.
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Affiliation(s)
- Noman Ahmad
- King Faisal Specialist Hospital & Research Centre (Gen. Org.), Jeddah, Saudi Arabia
| | | | | | | | - Mohammed Amin Rasol
- King Faisal Specialist Hospital & Research Centre (Gen. Org.), Jeddah, Saudi Arabia
| | | | | | | | | | | | - Balgees Alghamdi
- Molecular Oncology Department, King Faisal Specialist Hospital & Research Centre (Gen. Org.), Riyadh, Saudi Arabia
| | - Ali Saeed Alzahrani
- Research Centre, King Faisal Specialist Hospital & Research Centre (Gen. Org.), Jeddah, Saudi Arabia
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7
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Koumakis E, Cormier-Daire V, Dellal A, Debernardi M, Cortet B, Debiais F, Javier RM, Thomas T, Mehsen-Cetre N, Cohen-Solal M, Fontanges E, Laroche M, Porquet-Bordes V, Marcelli C, Benachi A, Briot K, Roux C, Cormier C. Osteogenesis Imperfecta: characterization of fractures during pregnancy and post-partum. Orphanet J Rare Dis 2022; 17:22. [PMID: 35090500 PMCID: PMC8796450 DOI: 10.1186/s13023-021-02148-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 12/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background Pregnancy and breastfeeding are associated with bone density loss. Fracture occurrence during pregnancy and post-partum, and its determinants, remain poorly known in Osteogenesis Imperfecta (OI). The aim of this study was to characterize fractures that occurred during pregnancy and post-partum in OI patients. Results We conducted a retrospective multicentric study including a total of 50 previously pregnant OI women from 10 Bone Centers in France. Among these patients, 12 (24%) patients experienced fractures during pregnancy or in the 6 months following delivery, and 38 (76%) did not experience any fracture. The most frequent localizations were: proximal femur (25%), spine (25%), distal femur (12.5%), and pelvis (12.5%). Fractures during pregnancy occurred during the third trimester and post-partum fractures occurred with a mean delay of 2 months following delivery. No fractures occurred during childbirth. We next compared the 12 patients with pregnancy or post-partum fractures with the 38 patients without fractures. Mean age at pregnancy was 32.7 ± 3.1 years-old in the fractured group, vs 29.3 ± 5.0 years-old in the non-fractured group (p = 0.002). Breastfeeding was reported in 85.7% of patients in the fractured group, vs 47.1% in the non-fractured group (p = 0.03). All patients with post-partum fractures were breastfeeding. Bone mineral density was significantly lower in patients with pregnancy-related fractures compared with other patients: spine Z-score − 2.9 ± 1.6DS vs − 1.5 ± 1.7DS (p = 0.03), and total hip Z-score − 2.0 ± 0.7DS vs − 0.5 ± 1.4DS (p = 0.04). At least one osteoporosis-inducing risk factor or disease other than OI was identified in 81.8% vs 58.6% of fractured vs non-fractured patients (not significant). Fracture during pregnancy or post-partum was not associated with the severity of OI. Bisphosphonates before pregnancy were reported in 16.7% and 21.1% of patients with pregnancy-related fractures and non-fractured patients, respectively (not significant). Conclusions OI management during pregnancy and post-partum should aim for optimal control of modifiable osteoporosis risk factors, particularly in patients with low BMD. Breastfeeding should be avoided.
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Affiliation(s)
- Eugénie Koumakis
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France. .,Clinical Genetics, Reference Center for bone disorders, INSERM UMR 1163, Imagine Institute, Necker Enfants-Malades Hospital, AP-HP, Paris University, Paris, France.
| | - Valérie Cormier-Daire
- Clinical Genetics, Reference Center for bone disorders, INSERM UMR 1163, Imagine Institute, Necker Enfants-Malades Hospital, AP-HP, Paris University, Paris, France
| | - Azeddine Dellal
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Marc Debernardi
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Bernard Cortet
- Department of Rheumatology and ULR 4490 (MABLAB), Competence Center for Rare Genetic Bone Disorders, University-Hospital of Lille, 59000, Lille, France
| | - Françoise Debiais
- Department of Rheumatology, CHU Poitiers; CNRS ERL7003, University of Poitiers, Poitiers, France
| | - Rose-Marie Javier
- Rheumatology Department, Competence Center for Rare Genetic Bone Disorders, University-Hospital of Strasbourg, 67098, Strasbourg, France
| | - Thierry Thomas
- Department of Rheumatology, CHU Saint-Etienne, INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - Nadia Mehsen-Cetre
- Service de Rhumatologie, Centre de Compétence MOC et Dysplasie Fibreuse, CHU Bordeaux-Tripode, Bordeaux, France
| | - Martine Cohen-Solal
- Biocar Inserm U1132 and Université de Paris, Hôpital Lariboisière, 75010, Paris, France
| | - Elisabeth Fontanges
- Department of Rheumatology, Hôpital Edouard Herriot, CHU de Lyon, Lyon, France
| | - Michel Laroche
- Centre de Rhumatologie, CHU Purpan, 1 place du Dr Baylac, 31059, Toulouse Cedex, France
| | - Valérie Porquet-Bordes
- Endocrine, Bone Diseases, and Genetics Unit, Reference Centre for Rare Diseases of the Calcium and Phosphate Metabolism, ERN BOND, OSCAR Network, Children's Hospital, Toulouse University Hospital, Toulouse, France
| | | | - Alexandra Benachi
- Departement of Obstetrics, Gynecology and Reproductive Medicine, Hôpital Antoine-Béclère - Hôpitaux Universitaires Paris-Sud, Le Kremlin-Bicêtre, France
| | - Karine Briot
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.,INSERM UMR 1153, INSERM, PRESS Sorbonne Paris-Cité, Paris, France
| | - Christian Roux
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France.,INSERM UMR 1153, INSERM, PRESS Sorbonne Paris-Cité, Paris, France
| | - Catherine Cormier
- Rheumatology Department, Cochin Hospital, Paris, AP-HP Centre-Paris University, Reference Center for Rare Genetic Bone Disorders-Cochin-constitutive site, Cochin Hospital, 27 Rue du Faubourg Saint-Jacques, 75014, Paris, France
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8
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Anabusi S, Berndl A. Osteogenesis Imperfecta Type V in a Mother and Baby Pair: First Case Report of Pregnancy and Delivery. JOURNAL OF OBSTETRICS AND GYNAECOLOGY CANADA 2020; 43:S1701-2163(20)30684-8. [PMID: 34756406 DOI: 10.1016/j.jogc.2020.08.017] [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: 04/20/2020] [Revised: 08/07/2020] [Accepted: 08/10/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Osteogenesis imperfecta (OI) is a rare condition with limited data on fetal and maternal impact for almost all subtypes. OI type V is a very rare, autosomal dominant, inherited subtype of OI. The care of pregnant women with OI is managed by an interdisciplinary team, and fetal diagnosis is possible through amniocentesis, which may assist in delivery planning. CASE This report is the first to describe a case of maternal and fetal OI type V. We detail maternal and fetal management during pregnancy and delivery planning. While no major complications occurred during pregnancy or delivery, the neonate developed multiple fractures in the first few months of life. CONCLUSION Our case shows favourable maternal and pregnancy outcomes with OI type V and emphasizes the importance of fetal diagnosis.
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Affiliation(s)
- Saja Anabusi
- Department of Obstetrics and Gynaecology, Division of Maternal-Fetal Medicine, Sunnybrook Health Sciences Centre, Toronto, ON; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON
| | - Anne Berndl
- Department of Obstetrics and Gynaecology, Division of Maternal-Fetal Medicine, Sunnybrook Health Sciences Centre, Toronto, ON; Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON.
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9
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Chamunyonga F, Masendeke KL, Mateveke B. Osteogenesis imperfecta and pregnancy: a case report. J Med Case Rep 2019; 13:363. [PMID: 31822291 PMCID: PMC6905103 DOI: 10.1186/s13256-019-2296-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 10/16/2019] [Indexed: 11/18/2022] Open
Abstract
Background Osteogenesis imperfecta is a rare connective tissue disorder of varying phenotypic presentations. In pregnancies complicated by osteogenesis imperfecta, there is an increased risk to both the mother and fetus. Case presentation We present a case of a 34-year-old, wheelchair-bound, primigravid African (Zimbabwean) patient with short stature and skeletal deformities. Her care, requiring a multidisciplinary team approach, resulted in the delivery of a live baby girl with a birth weight of 2100 g, also with osteogenesis imperfecta. Conclusion Good outcomes are reported when a multidisciplinary team is involved in the care of patients with osteogenesis imperfecta. Pregnancies can be carried to term but require close antenatal surveillance. Prenatal diagnosis is possible with ultrasound and genetic testing. Delivery should be carefully planned by a multidisciplinary team. Decisions on delivery mode should be made on a case-by-case basis.
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Affiliation(s)
- Felix Chamunyonga
- Department of Obstetrics and Gynecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe.
| | - Kudzaishe Lloyd Masendeke
- Department of Obstetrics and Gynecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe
| | - Bismark Mateveke
- Department of Obstetrics and Gynecology, University of Zimbabwe, College of Health Sciences, Harare, Zimbabwe
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10
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Tosi LL, Floor MK, Dollar CM, Gillies AP, Hart TS, Cuthbertson DD, Sutton VR, Krischer JP. Assessing disease experience across the life span for individuals with osteogenesis imperfecta: challenges and opportunities for patient-reported outcomes (PROs) measurement: a pilot study. Orphanet J Rare Dis 2019; 14:23. [PMID: 30696467 PMCID: PMC6350324 DOI: 10.1186/s13023-019-1004-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 01/21/2019] [Indexed: 01/07/2023] Open
Abstract
Background Patient reported outcome (PRO) information is crucial for establishing better patient-provider communication, improving shared decision-making between clinicians and patients, assessing patient responses to therapeutic interventions, and increasing satisfaction with care. We used the Brittle Bones Disease Consortium (BBDC) Contact Registry for People with OI, managed by the Rare Disease Clinical Research Network (RDCRN) to (1) to evaluate the construct validity of the Patient-Reported Outcome Measurement Information System® (PROMIS®) to record important components of the disease experience among individuals with OI; and (2) explore the feasibility of using a registry to recruit individuals with OI to report on health status. Our long-term goal is to enhance communication of health and disease management findings back to the OI community, especially those who do not have access to major OI clinical centers. Results We demonstrated the construct validity of PROMIS instruments in OI. Our results confirm that the scores from most domains differ significantly from the general US population: individuals with OI have worse symptom burden and functioning. We found no excessive floor or ceiling effects. Our study demonstrates that the BBDC Contact Registry can be used to recruit participants for online health status surveys. However, there are numerous challenges that must be addressed: lack of self-knowledge of OI type, under-representation of men, limited ethnic diversity, and imperfect questionnaire completion rates. Conclusion Our pilot study demonstrated the feasibility of using a contact registry to recruit respondents from the OI community and to obtain analyzable PROMIS data regarding disease experience. Because the results differ from the general population and avoid excessive floor and ceiling effects, PROMIS instruments can be used to assess response to therapeutic interventions in individuals with OI. Future directions will include (1) development and validation of an OI-specific patient-based classification system that aggregates persons with similar clinical characteristics and risks for complications to identify treatment needs; and (2) integrating these PRO tools into routine patient care and research studies. Electronic supplementary material The online version of this article (10.1186/s13023-019-1004-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Laura L Tosi
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA.
| | - Marianne K Floor
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | - Christina M Dollar
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | - Austin P Gillies
- Bone Health Program, Children's National Health System, 111 Michigan Avenue, NW, Washington, DC, 20010, USA
| | | | - Tracy S Hart
- Osteogenesis Imperfecta Foundation, Gaithersburg, MD, USA
| | | | - V Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA.,Texas Children's Hospital, Houston, TX, USA
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11
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Wang D, Zhang M, Guan H, Wang X. Osteogenesis Imperfecta Due to Combined Heterozygous Mutations in Both COL1A1 and COL1A2, Coexisting With Pituitary Stalk Interruption Syndrome. Front Endocrinol (Lausanne) 2019; 10:193. [PMID: 30984112 PMCID: PMC6447649 DOI: 10.3389/fendo.2019.00193] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 03/07/2019] [Indexed: 12/30/2022] Open
Abstract
Osteogenesis imperfecta (OI) is a hereditary connective tissue disorder, characterized by reduced bone content, fractures and skeletal malformation due to abnormal synthesis or dysfunction of type I collagen protein. Pituitary stalk interruption syndrome (PSIS) is usually associated with environmental and hereditary factors. Here, we report a rare case of OI and PSIS co-occurrence. A 19-year-old male patient sought treatment for growth delay and absent secondary sexual characteristics. Hormone measurements indicated the presence of hypopituitarism (secondary hypothyroidism, growth hormone deficiency, ACTH-cortisol hormone deficiency, hypogonadotropic hypogonadism). Pituitary magnetic resonance imaging indicated reduced morphology of the anterior lobe, absence of the pituitary stalk, and ectopic displacement of the posterior lobe to the infundibulum, supporting a diagnosis of PSIS. In addition, the patient, his monozygotic twin brother (no evidence of PSIS), and their mother all presented blue sclera and susceptibility to bone fractures before adulthood. Next-generation sequencing demonstrated that the family had compound heterozygous mutations in COL1A1 and COL1A2, with no known mutations related to PSIS, pituitary hormone deficiency (PHD), or holoprosencephaly (HPE). The mother experienced breech and natural delivery of the patient and his brother, respectively. Thus, we deduced that the patient's PSIS might have resulted from breech delivery. Although we cannot exclude the possibility that the proband might have an undetected genetic abnormality causing PSIS or increasing his susceptibility to damage to the hypothalamic-pituitary region due to the limitation of exome sequencing, this rare case suggests that breech delivery in the newborn with OI might be related to PSIS.
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Affiliation(s)
- Dongdong Wang
- Obstetrics and Gynecology Department of Shengjing Hospital, China Medical University, Shenyang, China
| | - Mengmeng Zhang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haixia Guan
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
- Haixia Guan
| | - Xiaoli Wang
- Department of Endocrinology and Metabolism, Institute of Endocrinology, Liaoning Provincial Key Laboratory of Endocrine Diseases, The First Affiliated Hospital of China Medical University, Shenyang, China
- *Correspondence: Xiaoli Wang
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Tam A, Chen S, Schauer E, Grafe I, Bandi V, Shapiro JR, Steiner RD, Smith PA, Bober MB, Hart T, Cuthbertson D, Krischer J, Mullins M, Byers PH, Sandhaus RA, Durigova M, Glorieux FH, Rauch F, Sutton VR, Lee B, Rush ET, Nagamani SCS. A multicenter study to evaluate pulmonary function in osteogenesis imperfecta. Clin Genet 2018; 94:502-511. [PMID: 30152014 PMCID: PMC6235719 DOI: 10.1111/cge.13440] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 01/04/2023]
Abstract
Pulmonary complications are a significant cause for morbidity and mortality in osteogenesis imperfecta (OI). However, to date, there have been few studies that have systematically evaluated pulmonary function in individuals with OI. We analyzed spirometry measurements, including forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1 ), in a large cohort of individuals with OI (n = 217) enrolled in a multicenter, observational study. We show that individuals with the more severe form of the disease, OI type III, have significantly reduced FVC and FEV1 which do not follow the expected trends of the normal population. We also show that "normalization" of FVC and FEV1 using general population data to generate percent predicted values underestimates the pulmonary involvement in OI. Within each subtype of OI, we used linear mixed models to find potential correlations between FEV1 and FVC with the clinical variables including mobility, bisphosphonate use, and scoliosis. Our results are an important step in understanding the extent of pulmonary involvement in individuals with OI and for developing pulmonary endpoints for use in the routine patient care as well as in the investigation of new therapies.
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Affiliation(s)
- Allison Tam
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Shan Chen
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Evan Schauer
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Ingo Grafe
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Venkata Bandi
- Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Jay R Shapiro
- Department of Bone and Osteogenesis Imperfecta, Kennedy Krieger Institute, Baltimore, MD, USA
- Department of Medicine at Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Robert D Steiner
- University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Oregon Health & Science University, and Shriners Hospital for Children, Portland, OR USA
| | | | - Michael B Bober
- Division of Medical Genetics, Alfred I du Pont Hospital for Children, Wilmington, DE, USA
| | - Tracy Hart
- Osteogenesis Imperfecta Foundation, Gaithersburg, MD, USA
| | | | - Jeff Krischer
- College of Medicine, University of South Florida, Tampa, FL, USA
| | - Mary Mullins
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Peter H Byers
- Departments of Medicine and Pathology, Division of Medical Genetics, University of Washington, Seattle, WA, USA
| | | | | | | | - Frank Rauch
- Shriner’s Hospital for Children and McGill University, Montreal
| | - V Reid Sutton
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | - Brendan Lee
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
| | | | - Eric T Rush
- Children’s Mercy Hospital, University of Missouri - Kansas City, Kansas City, MO, USA
| | - Sandesh CS Nagamani
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
- Texas Children’s Hospital, Houston, TX, USA
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Trejo P, Rauch F. Osteogenesis imperfecta in children and adolescents-new developments in diagnosis and treatment. Osteoporos Int 2016; 27:3427-3437. [PMID: 27492436 DOI: 10.1007/s00198-016-3723-3] [Citation(s) in RCA: 108] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 07/25/2016] [Indexed: 12/13/2022]
Abstract
Osteogenesis imperfecta (OI) is the most prevalent heritable bone fragility disorder in children. It has been known for three decades that the majority of individuals with OI have mutations in COL1A1 or COL1A2, the two genes coding for collagen type I alpha chains, but in the past 10 years defects in at least 17 other genes have been linked to OI. Almost all individuals with a typical OI phenotype have a mutation in one of the currently known genes. Regarding medical treatment, intravenous bisphosphonate therapy is the most widely used medical approach. This has a marked effect on vertebra in growing children and can lead to vertebral reshaping after compression fractures, but there is little effect of bisphosphonate therapy on the development of scoliosis. Bisphosphonate treatment decreases long-bone fracture rates, but such fractures are still frequent. Newer medications with anti-resorptive and bone anabolic action are being investigated in an attempt to improve on the efficacy of bisphosphonates but the safety and efficacy of these new approaches in children with OI is not yet established.
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Affiliation(s)
- P Trejo
- Shriners Hospital for Children, 1003 Decarie, Montreal, Quebec, Canada, H4A 0A9
- McGill University, Montreal, Quebec, Canada
| | - F Rauch
- Shriners Hospital for Children, 1003 Decarie, Montreal, Quebec, Canada, H4A 0A9.
- McGill University, Montreal, Quebec, Canada.
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Hosokawa T, Yamada Y, Sato Y, Tanami Y, Oguma E. Subperiosteal new bone and callus formations in neonates with femoral shaft fracture at birth. Emerg Radiol 2016; 24:143-148. [DOI: 10.1007/s10140-016-1462-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Accepted: 10/31/2016] [Indexed: 11/28/2022]
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