1
|
Lal BB, Alam S, Sibal A, Kumar K, Hosaagrahara Ramakrishna S, Shah V, Dheivamani N, Bavdekar A, Nagral A, Wadhwa N, Maria A, Shah A, Shah I, Nalwalla Z, Snehavardhan P, Srikanth KP, Gupta S, Sivaramakrishnan VM, Waikar Y, Suchismita A, Ashritha A, Sood V, Khanna R. Genotype correlates with clinical course and outcome of children with tight junction protein 2 (TJP2) deficiency-related cholestasis. Hepatology 2024; 80:511-526. [PMID: 38447037 DOI: 10.1097/hep.0000000000000828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 02/09/2024] [Indexed: 03/08/2024]
Abstract
BACKGROUND AND AIMS The study aimed to describe the clinical course and outcomes, and analyze the genotype-phenotype correlation in patients with tight junction protein 2 (TJP2) deficiency. APPROACH AND RESULTS Data from all children with chronic cholestasis and either homozygous or compound heterozygous mutations in TJP2 were extracted and analyzed. The patients were categorized into 3 genotypes: TJP2-A (missense mutations on both alleles), TJP2-B (missense mutation on one allele and a predicted protein-truncating mutation [PPTM] on the other), and TJP2-C (PPTMs on both alleles). A total of 278 cases of genetic intrahepatic cholestasis were studied, with TJP2 deficiency accounting for 44 cases (15.8%). Of these, 29 were homozygous and 15 were compound heterozygous variants of TJP2 . TJP2-A genotype was identified in 21 (47.7%), TJP2-B in 7 cases (15.9%), and TJP2-C in 16 cases (36.4%), respectively. Patients with the TJP2-C genotype were more likely to experience early infantile cholestasis (87.5% vs. 53.5%, p =0.033), less likely to clear jaundice (12.5% vs. 52.2%, p =0.037), more likely to develop ascites, and had higher serum bile acids. Patients with the TJP2-C genotype were more likely to die or require liver transplantation (native liver survival: 12.5% vs. 78.6%, p <0.001), with a median age at death/liver transplantation of 2.5 years. Cox regression analysis revealed that TJP2-C mutations ( p =0.003) and failure to resolve jaundice ( p =0.049) were independent predictors of poor outcomes. CONCLUSIONS Patients with the TJP2-C genotype carrying PPTMs in both alleles had a rapidly progressive course, leading to early decompensation and death if they did not receive timely liver transplantation.
Collapse
Affiliation(s)
- Bikrant Bihari Lal
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Seema Alam
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Anupam Sibal
- Department of Pediatric Gastroenterology & Liver Transplantation, Indraprastha Apollo Hospitals, New Delhi, India
| | - Karunesh Kumar
- Department of Pediatric Gastroenterology & Liver Transplantation, Indraprastha Apollo Hospitals, New Delhi, India
| | | | - Vaibhav Shah
- Department of Pediatric Gastroenterology and Hepatology, Gujarat Superspeciality Clinic, Ahmedabad, Gujarat, India
| | - Nirmala Dheivamani
- Department of Pediatric Gastroenterology, Institute of Child Health and Hospital for Children, Chennai, Tamil Nadu, India
| | - Ashish Bavdekar
- Department of Pediatrics, KEM Hospital and Research Centre, Pune, Maharashtra, India
| | - Aabha Nagral
- Department of Pediatric Hepatology and Liver Transplant, Jaslok Hospital and Research Center, Mumbai, Maharashtra, India
- Department of Pediatric Hepatology and Liver Transplantation, Apollo Hospital, Navi Mumbai, Maharashtra, India
| | - Nishant Wadhwa
- Department of Pediatrics, Sir Gangaram Hospital, New Delhi, India
| | - Arjun Maria
- Department of Pediatrics, Sir Gangaram Hospital, New Delhi, India
| | - Aashay Shah
- Department of Pediatric Gastroenterology, PRISM Pediatric Gastro, Ahmedabad, Gujarat, India
| | - Ira Shah
- Department of Pediatric Infectious Disease, Pediatric Gastroenterology, and Hepatology B.J. Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Zahabiya Nalwalla
- Department of Pediatrics, B.J. Wadia Hospital for Children, Mumbai, Maharashtra, India
| | - Pandey Snehavardhan
- Department of Pediatric Hepatology and Liver Transplantation, Sahyadri Superspeciality Hospital Pvt Ltd, Pune, Maharashtra, India
| | - K P Srikanth
- Department of Pediatric Gastroenterology and Hepatology, Pediatric Gastroenterology & Hepatology, Manipal Hospitals, Bengaluru, Karnataka, India
| | - Subhash Gupta
- Department of Liver Transplantation, Centre for Liver and Biliary Sciences, Max Superspeciality Hospital, Saket, New Delhi, India
| | | | - Yogesh Waikar
- Department of Pediatric Gastroenterology, Superspeciality GI Kids Clinics, Nagpur, Maharashtra, India
| | - Arya Suchismita
- Department of Gastroenterology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
| | - A Ashritha
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Vikrant Sood
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajeev Khanna
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| |
Collapse
|
2
|
Halabi H, Kalantan K, Abdulhaq W, Alshaibi H, Almatrafi MA. A Rare Case of Progressive Familial Intrahepatic Cholestasis Type 4: A Case Report and Literature Review. Cureus 2023; 15:e47276. [PMID: 38021987 PMCID: PMC10656038 DOI: 10.7759/cureus.47276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Abstract
Progressive familial intrahepatic cholestasis (PFIC) is a group of genetic disorders characterized by progressive intrahepatic cholestasis. Different mutations in hepatocellular transport genes result in distinct PFIC subtypes with unique clinical manifestations, laboratory findings, and histopathological characteristics. Three PFIC genotypes have been commonly described (PFIC 1, 2, and 3), but in recent years, PFIC 4, 5, and 6 genetic mutations have been identified. Here, we report the first PFIC 4 case in the Middle East in a 46-day-old male infant who was successfully treated with a liver transplant. A 46-day-old, male, full-term infant presented with persistent jaundice and obstructive liver pathology suggested by liver profile and biopsy. Whole exome sequencing confirmed the diagnosis of PFIC 4. Medical treatment failed to improve the patient's symptoms. Therefore, the patient underwent hepatectomy and an unrelated liver transplant. He is currently exhibiting significant clinical improvements and is free of active complaints. PFIC is a rare disease that poses diagnostic and therapeutic challenges for clinicians. Infants presenting with unexplained cholestasis should have PFIC 4 as a differential diagnosis. Early recognition and treatment of PFIC 4 with liver transplantation may result in a more favorable prognosis.
Collapse
Affiliation(s)
- Hana Halabi
- Department of Pediatrics, Maternity and Children Hospital, Makkah, SAU
| | - Khawla Kalantan
- Department of Pediatrics, Maternity and Children Hospital, Makkah, SAU
| | - Warif Abdulhaq
- Department of Medicine and Surgery, Medical College of Umm Al-Qura University, Makkah, SAU
| | - Habeib Alshaibi
- Department of Anatomic Pathology, Maternity and Children Hospital, Makkah, SAU
| | | |
Collapse
|
3
|
Xie S, Wei S, Ma X, Wang R, He T, Zhang Z, Yang J, Wang J, Chang L, Jing M, Li H, Zhou X, Zhao Y. Genetic alterations and molecular mechanisms underlying hereditary intrahepatic cholestasis. Front Pharmacol 2023; 14:1173542. [PMID: 37324459 PMCID: PMC10264785 DOI: 10.3389/fphar.2023.1173542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
Hereditary cholestatic liver disease caused by a class of autosomal gene mutations results in jaundice, which involves the abnormality of the synthesis, secretion, and other disorders of bile acids metabolism. Due to the existence of a variety of gene mutations, the clinical manifestations of children are also diverse. There is no unified standard for diagnosis and single detection method, which seriously hinders the development of clinical treatment. Therefore, the mutated genes of hereditary intrahepatic cholestasis were systematically described in this review.
Collapse
Affiliation(s)
- Shuying Xie
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Shizhang Wei
- Department of Anatomy, Histology and Embryology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing, China
| | - Xiao Ma
- Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ruilin Wang
- Department of Pharmacy, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Tingting He
- Department of Pharmacy, 5th Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Zhao Zhang
- Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ju Yang
- Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jiawei Wang
- Pharmacy College, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Lei Chang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
| | - Manyi Jing
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | - Haotian Li
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| | - Xuelin Zhou
- Department of Pharmacology, School of Basic Medical Sciences, Capital Medical University, Beijing, China
| | - Yanling Zhao
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China
- Department of Pharmacy, Chinese PLA General Hospital, Beijing, China
| |
Collapse
|
4
|
Ning X, Li Q, Zi J, Mei Z, Liu J, Zhang Y, Bi M, Ren Y, Liu X, Lv C, Yao H, Sun J, Rao F, Li S, Liu S. New Set of Isobaric Labeling Reagents for Quantitative 16Plex Proteomics. Anal Chem 2023; 95:5788-5795. [PMID: 36958307 DOI: 10.1021/acs.analchem.3c00235] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2023]
Abstract
Peptide labeling by isobaric tags is a powerful approach for the relative quantitative analysis of proteomes in multiple groups. There has been a revolution in the innovation of new isobaric reagents; however, great effort is being made to expand simultaneous labeling groups to identify more labeled peptides and reduce reporter ion signal suppression. We redesigned the original chemical structure of the deuterium isobaric amine-reactive tag developed in our laboratory. We optimized the synthetic pathway to create a new set of 16-plex isobaric tags (IBT-16plex). The novel reagent enabled almost complete labeling of peptides within 90 min, with all labeling reporter ions exhibiting comparable MS/MS signals. Compared to a typical 16plex reagent, TMTpro-16plex, the peptides and proteins identified by IBT-16plex in trypsinized HeLa cells were significantly increased by 14.8 and 8.6%, respectively. Moreover, differences in peptide abundance within 10-fold among multiple groups were barely suppressed in IBT-16plex, whereas the dynamic range in TMTpro-16plex-labeled groups was smaller. After quantitative examination of MCF7 cell proteins, IBT-16plex was confirmed as feasible and useful for evaluating protein responses of glucose-starved MCF7 cells to a glucose-rich medium.
Collapse
Affiliation(s)
- Xiaolian Ning
- College of Life Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
- BGI-Shenzhen, Shenzhen, Guangdong 518083, China
| | - Qidan Li
- BGI-Shenzhen, Shenzhen, Guangdong 518083, China
| | - Jin Zi
- BGI-Shenzhen, Shenzhen, Guangdong 518083, China
- Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Zhejiang, Hangzhou 310022, China
| | | | - Jie Liu
- BGI-Shenzhen, Shenzhen, Guangdong 518083, China
| | | | - Mao Bi
- School of Life Sciences, Department of Biology, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Yan Ren
- Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Zhejiang, Hangzhou 310022, China
- Experiment Center for Science and Technology, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China
| | - Xingang Liu
- Nanjing Apollomics Biotech Inc., Nanjing, Jiangsu 210033, China
| | - Chao Lv
- Nanjing Apollomics Biotech Inc., Nanjing, Jiangsu 210033, China
| | - Hequan Yao
- China Pharmaceutical University, Nanjing, Jiangsu 210009, China
| | - Jianguo Sun
- China Pharmaceutical University, Nanjing, Jiangsu 210009, China
| | - Feng Rao
- School of Life Sciences, Department of Biology, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China
| | - Shuwei Li
- Nanjing Apollomics Biotech Inc., Nanjing, Jiangsu 210033, China
- China Pharmaceutical University, Nanjing, Jiangsu 210009, China
| | - Siqi Liu
- BGI-Shenzhen, Shenzhen, Guangdong 518083, China
- Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Zhejiang, Hangzhou 310022, China
| |
Collapse
|
5
|
Abstract
Bile acid transport is a complex physiologic process, of which disruption at any step can lead to progressive intrahepatic cholestasis (PFIC). The first described PFIC disorders were originally named as such before identification of a genetic cause. However, advances in clinical molecular genetics have led to the identification of additional disorders that can cause these monogenic inherited cholestasis syndromes, and they are now increasingly referred to by the affected protein causing disease. The list of PFIC disorders is expected to grow as more causative genes are discovered. Here forth, we present a comprehensive overview of known PFIC disorders.
Collapse
Affiliation(s)
- Sara Hassan
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. https://twitter.com/SaraHassanMD
| | - Paula Hertel
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Baylor College of Medicine, Texas Children's Hospital, 6621 Fannin Street, Houston, TX 77030, USA.
| |
Collapse
|