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Fioretti T, Martora F, De Maggio I, Ambrosio A, Piscopo C, Vallone S, Amato F, Passaro D, Acquaviva F, Gaudiello F, Di Girolamo D, Maiolo V, Zarrilli F, Esposito S, Vitiello G, Auricchio L, Sammarco E, Brasi DD, Petillo R, Gambale A, Cattaneo F, Ammendola R, Nappa P, Esposito G. Comprehensive Molecular Analysis of Disease-Related Genes as First-Tier Test for Early Diagnosis, Classification, and Management of Patients Affected by Nonsyndromic Ichthyosis. Biomedicines 2024; 12:1112. [PMID: 38791074 PMCID: PMC11117922 DOI: 10.3390/biomedicines12051112] [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: 04/03/2024] [Revised: 05/07/2024] [Accepted: 05/13/2024] [Indexed: 05/26/2024] Open
Abstract
Inherited ichthyoses are a group of clinically and genetically heterogeneous rare disorders of skin keratinization with overlapping phenotypes. The clinical picture and family history are crucial to formulating the diagnostic hypothesis, but only the identification of the genetic defect allows the correct classification. In the attempt to molecularly classify 17 unrelated Italian patients referred with congenital nonsyndromic ichthyosis, we performed massively parallel sequencing of over 50 ichthyosis-related genes. Genetic data of 300 Italian unaffected subjects were also analyzed to evaluate frequencies of putative disease-causing alleles in our population. For all patients, we identified the molecular cause of the disease. Eight patients were affected by autosomal recessive congenital ichthyosis associated with ALOX12B, NIPAL4, and TGM1 mutations. Three patients had biallelic loss-of-function variants in FLG, whereas 6/11 males were affected by X-linked ichthyosis. Among the 24 different disease-causing alleles we identified, 8 carried novel variants, including a synonymous TGM1 variant that resulted in a splicing defect. Moreover, we generated a priority list of the ichthyosis-related genes that showed a significant number of rare and novel variants in our population. In conclusion, our comprehensive molecular analysis resulted in an effective first-tier test for the early classification of ichthyosis patients. It also expands the genetic, mutational, and phenotypic spectra of inherited ichthyosis and provides new insight into the current understanding of etiologies and epidemiology of this group of rare disorders.
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Affiliation(s)
- Tiziana Fioretti
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (F.M.); (F.G.); (L.A.); (P.N.)
| | - Ilaria De Maggio
- Medical and Laboratory Genetics Unit, AORN A. Cardarelli, 80131 Naples, Italy; (I.D.M.); (C.P.); (R.P.)
| | - Adelaide Ambrosio
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
| | - Carmelo Piscopo
- Medical and Laboratory Genetics Unit, AORN A. Cardarelli, 80131 Naples, Italy; (I.D.M.); (C.P.); (R.P.)
| | - Sabrina Vallone
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Felice Amato
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Diego Passaro
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Fabio Acquaviva
- Medical Genetics Unit, Department of General and Emergency Paediatrics, AORN Santobono-Pausilipon, 80122 Naples, Italy; (F.A.); (D.D.B.)
| | - Francesca Gaudiello
- Section of Dermatology, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (F.M.); (F.G.); (L.A.); (P.N.)
| | - Daniela Di Girolamo
- Department of Biology, University of Naples “Federico II”, 80126 Naples, Italy;
| | - Valeria Maiolo
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Federica Zarrilli
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Speranza Esposito
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Giuseppina Vitiello
- Medical Genetics Unit, Integrated Care Department of Laboratory and Transfusion Medicine, Federico II Hospital, 80131 Naples, Italy; (G.V.); (A.G.)
| | - Luigi Auricchio
- Section of Dermatology, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (F.M.); (F.G.); (L.A.); (P.N.)
| | - Elena Sammarco
- Pediatric Dermatology Unit, Department of Dermo-Immuno-Rheumatology Paediatrics, AORN Santobono-Pausilipon, 80122 Naples, Italy;
| | - Daniele De Brasi
- Medical Genetics Unit, Department of General and Emergency Paediatrics, AORN Santobono-Pausilipon, 80122 Naples, Italy; (F.A.); (D.D.B.)
| | - Roberta Petillo
- Medical and Laboratory Genetics Unit, AORN A. Cardarelli, 80131 Naples, Italy; (I.D.M.); (C.P.); (R.P.)
| | - Antonella Gambale
- Medical Genetics Unit, Integrated Care Department of Laboratory and Transfusion Medicine, Federico II Hospital, 80131 Naples, Italy; (G.V.); (A.G.)
| | - Fabio Cattaneo
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Rosario Ammendola
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
| | - Paola Nappa
- Section of Dermatology, Department of Clinical Medicine and Surgery, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (F.M.); (F.G.); (L.A.); (P.N.)
| | - Gabriella Esposito
- CEINGE Advanced Biotechnologies Franco Salvatore, 80145 Naples, Italy; (T.F.); (A.A.); (S.V.); (F.A.); (F.Z.); (S.E.)
- Department of Molecular Medicine and Medical Biotechnologies, School of Medicine, University of Naples “Federico II”, 80131 Naples, Italy; (D.P.); (V.M.); (F.C.); (R.A.)
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