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Jacob P, Bhavani GS, Udupa P, Wang Z, Hariharan SV, Delampady K, Dalal A, Kamath N, Ikegawa S, Shenoy RD, Handattu K, Shah H, Girisha KM. Exome Sequencing in Monogenic Forms of Rickets. Indian J Pediatr 2023; 90:1182-1190. [PMID: 36692815 PMCID: PMC10627992 DOI: 10.1007/s12098-022-04393-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 09/27/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To understand the phenotypic and genotypic spectrum of genetic forms of rickets in 10 families. METHODS Detailed clinical, radiographic, and biochemical evaluation of 10 families with phenotypes suggestive of a genetic cause of rickets was performed. Molecular testing using exome sequencing aided in the diagnosis of six different forms of known genetic causes. RESULTS Eleven disease-causing variants including five previously reported variants (CYP27B1:c.1319_1325dup, p.(Phe443Profs*24), VDR:c.1171C>T, p.(Arg391Cys), PHEX: c.1586_1586+1del, PHEX: c.1482+5G>C, PHEX: c.58C>T, p.(Arg20*)) and six novel variants (CYP27B1:c.974C>T, p.(Thr325Met), CYP27B1: c.1376G>A, p.(Arg459His), CYP2R1: c.595C>T, p.(Arg199*), CYP2R1:c.1330G>C, p.(Gly444Arg),SLC34A3:c.1336-11_1336-1del, SLC2A2: c.589G>C, p.(Val197Leu)) in the genes known to cause monogenic rickets were identified. CONCLUSION The authors hereby report a case series of individuals from India with a molecular diagnosis of rickets and provide the literature review which would help in enhancing the clinical and molecular profile for rapid and differential diagnosis of rickets.
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Affiliation(s)
- Prince Jacob
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Gandham SriLakshmi Bhavani
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Prajna Udupa
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Zheng Wang
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Sankar V Hariharan
- Department of Pediatrics, Genetics Clinic, SAT Hospital, Government Medical College, Thiruvananthapuram, Kerala, India
| | - Kishan Delampady
- Department of Endocrinology, AJ Hospital & Research Center, Mangalore, Karnataka, India
| | - Ashwin Dalal
- Diagnostics Division, Center for DNA Fingerprinting & Diagnostics, Hyderabad, Telangana, India
| | - Nutan Kamath
- Department of Pediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shiro Ikegawa
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Laboratory for Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Rathika D Shenoy
- Department of Pediatrics, K S Hegde Medical Academy, Nitte University, Mangalore, Karnataka, India
| | - Koushik Handattu
- Department of Pediatrics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Hitesh Shah
- Department of Pediatric Orthopedics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.
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Sharari S, Abou-Alloul M, Hussain K, Ahmad Khan F. Fanconi-Bickel Syndrome: A Review of the Mechanisms That Lead to Dysglycaemia. Int J Mol Sci 2020; 21:E6286. [PMID: 32877990 PMCID: PMC7504390 DOI: 10.3390/ijms21176286] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/30/2020] [Accepted: 08/02/2020] [Indexed: 12/13/2022] Open
Abstract
Accumulation of glycogen in the kidney and liver is the main feature of Fanconi-Bickel Syndrome (FBS), a rare disorder of carbohydrate metabolism inherited in an autosomal recessive manner due to SLC2A2 gene mutations. Missense, nonsense, frame-shift (fs), in-frame indels, splice site, and compound heterozygous variants have all been identified in SLC2A2 gene of FBS cases. Approximately 144 FBS cases with 70 different SLC2A2 gene variants have been reported so far. SLC2A2 encodes for glucose transporter 2 (GLUT2) a low affinity facilitative transporter of glucose mainly expressed in tissues playing important roles in glucose homeostasis, such as renal tubular cells, enterocytes, pancreatic β-cells, hepatocytes and discrete regions of the brain. Dysfunctional mutations and decreased GLUT2 expression leads to dysglycaemia (fasting hypoglycemia, postprandial hyperglycemia, glucose intolerance, and rarely diabetes mellitus), hepatomegaly, galactose intolerance, rickets, and poor growth. The molecular mechanisms of dysglycaemia in FBS are still not clearly understood. In this review, we discuss the physiological roles of GLUT2 and the pathophysiology of mutants, highlight all of the previously reported SLC2A2 mutations associated with dysglycaemia, and review the potential molecular mechanisms leading to dysglycaemia and diabetes mellitus in FBS patients.
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Affiliation(s)
- Sanaa Sharari
- Division of Biological and Biomedical Sciences, College of Health & Life Sciences, Hamad Bin Khalifa University, Qatar Foundation, Education City, Doha, Qatar;
- Department of Pediatric Medicine, Division of Endocrinology, Sidra Medicine, Doha, Qatar;
| | - Mohamad Abou-Alloul
- Department of Pediatric Medicine, Saida Governmental University Hospital, Beirut Arab University, Beirut 115020, Lebanon;
| | - Khalid Hussain
- Department of Pediatric Medicine, Division of Endocrinology, Sidra Medicine, Doha, Qatar;
| | - Faiyaz Ahmad Khan
- Department of Pediatric Medicine, Division of Endocrinology, Sidra Medicine, Doha, Qatar;
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3
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Enogieru OJ, Ung PMU, Yee SW, Schlessinger A, Giacomini KM. Functional and structural analysis of rare SLC2A2 variants associated with Fanconi-Bickel syndrome and metabolic traits. Hum Mutat 2019; 40:983-995. [PMID: 30950137 DOI: 10.1002/humu.23758] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 03/01/2019] [Accepted: 03/23/2019] [Indexed: 02/06/2023]
Abstract
Deleterious variants in SLC2A2 cause Fanconi-Bickel Syndrome (FBS), a glycogen storage disorder, whereas less common variants in SLC2A2 associate with numerous metabolic diseases. Phenotypic heterogeneity in FBS has been observed, but its causes remain unknown. Our goal was to functionally characterize rare SLC2A2 variants found in FBS and metabolic disease-associated variants to understand the impact of these variants on GLUT2 activity and expression and establish genotype-phenotype correlations. Complementary RNA-injected Xenopus laevis oocytes were used to study mutant transporter activity and membrane expression. GLUT2 homology models were constructed for mutation analysis using GLUT1, GLUT3, and XylE as templates. Seventeen FBS variants were characterized. Only c.457_462delCTTATA (p.Leu153_Ile154del) exhibited residual glucose uptake. Functional characterization revealed that only half of the variants were expressed on the plasma membrane. Most less common variants (except c.593 C>A (p.Thr198Lys) and c.1087 G>T (p.Ala363Ser)) exhibited similar GLUT2 transport activity as the wild type. Structural analysis of GLUT2 revealed that variants affect substrate-binding, steric hindrance, or overall transporter structure. The mutant transporter that is associated with a milder FBS phenotype, p.Leu153_Ile154del, retained transport activity. These results improve our overall understanding of the underlying causes of FBS and impact of GLUT2 function on various clinical phenotypes ranging from rare to common disease.
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Affiliation(s)
- Osatohanmwen J Enogieru
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California
| | - Peter M U Ung
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Sook Wah Yee
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California
| | - Avner Schlessinger
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Kathleen M Giacomini
- Department of Bioengineering and Therapeutic Sciences, University of California, San Francisco, San Francisco, California.,Institute for Human Genetics, University of California, San Francisco, San Francisco, California
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4
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Pogoriler J, O'Neill AF, Voss SD, Shamberger RC, Perez-Atayde AR. Hepatocellular Carcinoma in Fanconi-Bickel Syndrome. Pediatr Dev Pathol 2018; 21:84-90. [PMID: 28382841 DOI: 10.1177/1093526617693540] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Fanconi-Bickel syndrome is a rare autosomal recessive disorder due to mutations in the facilitative glucose transporter 2 ( GLUT2 or SLC2A2) gene resulting in excessive glycogen storage predominantly in the liver and kidney. Previous case reports of this condition have described liver biopsies with glycogen storage and variable steatosis and/or fibrosis. Unlike in other types of glycogen storage disease, hepatocellular adenomas and carcinomas have not been described to date in this syndrome. A 6-year-old boy with consanguineous parents had short stature, poorly controlled rickets, hepatosplenomegaly, and renal tubular dysfunction clinically consistent with Fanconi-Bickel Syndrome. Sequencing of the SLC2A2 gene showed a homozygous variant of unknown significance [c.474A > C (p.Arg158Ser)] causing a missense mutation in an evolutionarily conserved residue. An incidental single hepatic lesion was discovered on imaging, and subsequent resection showed a 2.6 cm well-differentiated hepatocellular carcinoma with moderate atypia, diffuse immunoreactivity for glypican-3, and nuclear b-catenin, and with focal complete loss of the reticulin framework. The non-neoplastic liver showed marked glycogen accumulation with mild periportal fibrosis, rare bridging fibrosis, and no regenerative or adenomatous nodules. By electron microscopy, tumor cells had pleomorphic nuclei, prominent nucleoli, and scant cytoplasm with numerous mitochondria. Well-developed canaliculi were occasionally seen. The non-neoplastic liver showed glycogenosis with abundant cytoplasmic free (non-membrane bound) glycogen. Hepatocellular carcinoma should be considered as a possible complication of Fanconi-Bickel syndrome. This well differentiated carcinoma did not appear to be associated with hepatic adenomatosis as has been described in some hepatocellular carcinomas associated with other hepatic glycogen storage disorders. The nuclear beta-catenin immunoreactivity indicates a role for the Wnt signaling pathway in the pathogenesis of this tumor.
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Affiliation(s)
- Jennifer Pogoriler
- 1 Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Allison F O'Neill
- 2 Division of Pediatric Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts, USA
| | - Stephan D Voss
- 3 Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Robert C Shamberger
- 4 Department of Surgery, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Antonio R Perez-Atayde
- 1 Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
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Caparros-Martin JA, Aglan MS, Temtamy S, Otaify GA, Valencia M, Nevado J, Vallespin E, Del Pozo A, Prior de Castro C, Calatrava-Ferreras L, Gutierrez P, Bueno AM, Sagastizabal B, Guillen-Navarro E, Ballesta-Martinez M, Gonzalez V, Basaran SY, Buyukoglan R, Sarikepe B, Espinoza-Valdez C, Cammarata-Scalisi F, Martinez-Glez V, Heath KE, Lapunzina P, Ruiz-Perez VL. Molecular spectrum and differential diagnosis in patients referred with sporadic or autosomal recessive osteogenesis imperfecta. Mol Genet Genomic Med 2016; 5:28-39. [PMID: 28116328 PMCID: PMC5241205 DOI: 10.1002/mgg3.257] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2016] [Revised: 10/12/2016] [Accepted: 10/19/2016] [Indexed: 11/08/2022] Open
Abstract
Background Osteogenesis imperfecta (OI) is a heterogeneous bone disorder characterized by recurrent fractures. Although most cases of OI have heterozygous mutations in COL1A1 or COL1A2 and show autosomal dominant inheritance, during the last years there has been an explosion in the number of genes responsible for both recessive and dominant forms of this condition. Herein, we have analyzed a cohort of patients with OI, all offspring of unaffected parents, to determine the spectrum of variants accounting for these cases. Twenty patients had nonrelated parents and were sporadic, and 21 were born to consanguineous relationships. Methods Mutation analysis was performed using a next‐generation sequencing gene panel, homozygosity mapping, and whole exome sequencing (WES). Results Patients offspring of nonconsanguineous parents were mostly identified with COL1A1 or COL1A2 heterozygous changes, although there were also a few cases with IFITM5 and WNT1 heterozygous mutations. Only one sporadic patient was a compound heterozygote for two recessive mutations. Patients offspring of consanguineous parents showed homozygous changes in a variety of genes including CRTAP,FKBP10,LEPRE1,PLOD2,PPIB,SERPINF1,TMEM38B, and WNT1. In addition, two patients born to consanguineous parents were found to have de novo COL1A1 heterozygous mutations demonstrating that causative variants in the collagen I structural genes cannot be overlooked in affected children from consanguineous couples. Further to this, WES analysis in probands lacking mutations in OI genes revealed deleterious variants in SCN9A,NTRK1, and SLC2A2, which are associated with congenital indifference to pain (CIP) and Fanconi–Bickel syndrome (FBS). Conclusion This work provides useful information for clinical and genetic diagnosis of OI patients with no positive family history of this disease. Our data also indicate that CIP and FBS are conditions to be considered in the differential diagnosis of OI and suggest a positive role of SCN9A and NTRK1 in bone development.
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Affiliation(s)
- Jose A Caparros-Martin
- Instituto de Investigaciones BiomédicasConsejo Superior de Investigaciones Científicas-Universidad Autónoma de MadridMadridSpain; CIBER de enfermedades Raras (CIBERER)MadridSpain
| | - Mona S Aglan
- Human Genetics and Genome Research Division Centre of Excellence of Human Genetics National Research Centre Cairo Egypt
| | - Samia Temtamy
- Human Genetics and Genome Research Division Centre of Excellence of Human Genetics National Research Centre Cairo Egypt
| | - Ghada A Otaify
- Human Genetics and Genome Research Division Centre of Excellence of Human Genetics National Research Centre Cairo Egypt
| | | | - Julián Nevado
- Instituto de Genética Médica y Molecular (INGEMM) Hospital Universitario La Paz-IdiPaz Universidad Autónoma de Madrid Madrid Spain
| | - Elena Vallespin
- Instituto de Genética Médica y Molecular (INGEMM) Hospital Universitario La Paz-IdiPaz Universidad Autónoma de Madrid Madrid Spain
| | - Angela Del Pozo
- Instituto de Genética Médica y Molecular (INGEMM) Hospital Universitario La Paz-IdiPaz Universidad Autónoma de Madrid Madrid Spain
| | - Carmen Prior de Castro
- Instituto de Genética Médica y Molecular (INGEMM) Hospital Universitario La Paz-IdiPaz Universidad Autónoma de Madrid Madrid Spain
| | - Lucia Calatrava-Ferreras
- Instituto de Investigaciones BiomédicasConsejo Superior de Investigaciones Científicas-Universidad Autónoma de MadridMadridSpain; CIBER de enfermedades Raras (CIBERER)MadridSpain
| | - Pilar Gutierrez
- Orthopedic Surgery Department and Endocrinology Department Hospital Universitario de Getafe Madrid Spain
| | - Ana M Bueno
- Orthopedic Surgery Department and Endocrinology Department Hospital Universitario de Getafe Madrid Spain
| | - Belen Sagastizabal
- Orthopedic Surgery Department and Endocrinology Department Hospital Universitario de Getafe Madrid Spain
| | - Encarna Guillen-Navarro
- CIBER de enfermedades Raras (CIBERER)MadridSpain; Unidad de Genética MédicaServicio de PediatríaHospital Universitario Virgen de la ArrixacaMurciaSpain
| | - Maria Ballesta-Martinez
- Unidad de Genética Médica Servicio de Pediatría Hospital Universitario Virgen de la Arrixaca Murcia Spain
| | - Vanesa Gonzalez
- Unidad de Genética Médica Servicio de Pediatría Hospital Universitario Virgen de la Arrixaca Murcia Spain
| | - Sarenur Y Basaran
- Department of Medical Genetics Faculty of Medicine Istanbul Medeniyet University Istanbul Turkey
| | - Ruksan Buyukoglan
- Department of Genetics Faculty of Medicine Erciyes University Kayseri Turkey
| | - Bilge Sarikepe
- Department of Genetics School of Medicine Pamukkale University Denizli Turkey
| | | | | | - Victor Martinez-Glez
- CIBER de enfermedades Raras (CIBERER)MadridSpain; Instituto de Genética Médica y Molecular (INGEMM)Hospital Universitario La Paz-IdiPazUniversidad Autónoma de MadridMadridSpain
| | - Karen E Heath
- CIBER de enfermedades Raras (CIBERER)MadridSpain; Instituto de Genética Médica y Molecular (INGEMM)Hospital Universitario La Paz-IdiPazUniversidad Autónoma de MadridMadridSpain; Skeletal Dysplasia Multidisciplinary Unit (UMDE)Hospital Universitario La PazMadridSpain
| | - Pablo Lapunzina
- CIBER de enfermedades Raras (CIBERER)MadridSpain; Instituto de Genética Médica y Molecular (INGEMM)Hospital Universitario La Paz-IdiPazUniversidad Autónoma de MadridMadridSpain; Skeletal Dysplasia Multidisciplinary Unit (UMDE)Hospital Universitario La PazMadridSpain
| | - Victor L Ruiz-Perez
- Instituto de Investigaciones BiomédicasConsejo Superior de Investigaciones Científicas-Universidad Autónoma de MadridMadridSpain; CIBER de enfermedades Raras (CIBERER)MadridSpain; Skeletal Dysplasia Multidisciplinary Unit (UMDE)Hospital Universitario La PazMadridSpain
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6
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Abbasi F, Azizi F, Javaheri M, Mosallanejad A, Ebrahim-Habibi A, Ghafouri-Fard S. Segregation of a novel homozygous 6 nucleotide deletion in GLUT2 gene in a Fanconi-Bickel syndrome family. Gene 2014; 557:103-5. [PMID: 25523092 DOI: 10.1016/j.gene.2014.12.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Revised: 12/10/2014] [Accepted: 12/12/2014] [Indexed: 12/29/2022]
Abstract
Fanconi-Bickel syndrome (FBS) is a rare autosomal recessive disorder characterized by hepatorenal glycogen accumulation, proximal renal tubular dysfunction, impaired utilization of glucose and galactose, rickets, and severe short stature. It has been shown to be caused by mutations in GLUT2 gene, a member of the facilitative glucose transporter family. Here, we report an Iranian family with 2 affected siblings. The clinical findings in the patients include developmental delay, failure to thrive, hepatomegaly, enlarged kidneys and rickets. A novel 6 nucleotide deletion (c.1061_1066del6, p.V355_S356del2) is shown to be segregated with the disease in this family.
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Affiliation(s)
- Farzaneh Abbasi
- Growth and Development Research Center, Children Medical Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Azizi
- Department of Medical Genetics, Shahid Beheshti University of Medical sciences, Tehran, Iran
| | - Mona Javaheri
- Department of Medical Genetics, Shahid Beheshti University of Medical sciences, Tehran, Iran
| | - Asieh Mosallanejad
- Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Azadeh Ebrahim-Habibi
- Biosensor Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Soudeh Ghafouri-Fard
- Department of Medical Genetics, Shahid Beheshti University of Medical sciences, Tehran, Iran.
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