1
|
Capela AM, Cunha A, Fortuna AM, Falcão Reis C. Pre-implantation Genetic Testing in Inherited Metabolic Diseases? Stateof- the-art and current challenges. Endocr Metab Immune Disord Drug Targets 2023; 24:EMIDDT-EPUB-136732. [PMID: 38111111 DOI: 10.2174/0118715303279986231211090830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 12/05/2023] [Indexed: 12/20/2023]
Abstract
INTRODUCTION Inborn errors of metabolism (IEM) are genetic diseases involving congenital disorders of enzyme activities. Most follow Mendelian autosomal recessive inheritance and few follow mitochondrial inheritance. In many cases, after the birth of an affected child parents discover that have been the carriers for the condition and worry about the risk of recurrence in future offspring. Preimplantation genetic testing (PGT) can analyze embryos before their transfer to the uterus and prevent the transmission of hereditary conditions to descendants, however this procedure is of limited value in mtDNA conditions. METHODS The list of diseases currently approved for PGT were reviewed. The process for eligibility, was as for the Comissão Nacional Procriação Medicamente Assistida (CNPMA), of Portugal (PT). Review of international practices for Assisted Reproductive Techniques (ART) in IEM was carried out. RESULTS As of 07.2022, 23 IEM diseases associated with deleterious variants in nDNA were approved for PGT in PT. Couples at risk for conditions not included in the list can solicit an evaluation from an expert committee, after a medical genetics consultation. To qualify for approval, diseases must cause significant suffering and/or premature death. Due to a greater number of solicitations many more IEM conditions have been approved for PGT across the world. ART for mtDNA is not available in PT. International expert centers include PGT for specific well documented variants and mitochondrial donation. CONCLUSION PGT is a reliable approach to reduce the risk of transmission of a genetic condition to the offspring. The list of IEM disorders currently accepted for this technique in Portugal are small, but it is expanding, as many more diseases fit the necessary criteria. While appealing in theory, low success rates coupled with limited availability can be discouraging for patients. Genetic counselling is of paramount importance after the diagnosis of IEM diseases. It is important for both clinicians and patients to be made aware of the available reproductive options and their limitations.
Collapse
Affiliation(s)
- Ana Miguel Capela
- Unidade de Genética Médica, Centro de Genética Médica Jacinto Magalhães - Centro Hospitalar Universitário de Santo António, Portugal
| | - Ana Cunha
- Centro de Medicina Fetal (Medicina Fetal Porto) - Centro Materno Infantil do Norte, Centro Hospitalar Universitário de Santo António, Portugal
| | - Ana Maria Fortuna
- Unidade de Genética Médica, Centro de Genética Médica Jacinto Magalhães - Centro Hospitalar Universitário de Santo António, Portugal
- Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar (UMIB/ICBAS), Universidade do Porto, Porto, Portugal
| | - Cláudia Falcão Reis
- Unidade de Genética Médica, Centro de Genética Médica Jacinto Magalhães - Centro Hospitalar Universitário de Santo António, Portugal
- Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar (UMIB/ICBAS), Universidade do Porto, Porto, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| |
Collapse
|
2
|
Da Silva JD, Pereira Â, Soares AR, Guimas A, Rocha S, Cardoso M, Garrido C, Soares CA, Nunes IS, Fortuna AM, Quelhas D, Figueiroa S, Ribeiro R, Santos M, Martins E, Tkachenko N. Diagnostic accuracy and the first genotype-phenotype correlation in glycogen storage disease type V. Pediatr Res 2023:10.1038/s41390-023-02943-1. [PMID: 38052860 DOI: 10.1038/s41390-023-02943-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 10/20/2023] [Accepted: 11/18/2023] [Indexed: 12/07/2023]
Abstract
BACKGROUND Glycogen storage disease type V (GSDV) is an autosomal recessive metabolic condition caused by pathogenic PYGM variants. This is an underdiagnosed condition as it presents with exercise intolerance in children. We reviewed the GSDV cases of a tertiary hospital center to assess diagnostic timing/accuracy, as well as potential clinical/analytical predictors of such factors. METHODS We retrospectively reviewed all GSDV cases with follow-up in both Pediatric and Adult Metabolic Diseases consultations. We included 28 cases and assessed their hospital record for clinical information. RESULTS Over 90% of our cases had late diagnoses, with more than 50% being diagnosed in adulthood despite symptom onset in preschool (very late diagnosis). Diagnostic age was lower in patients exhibiting myoglobinuria. Interestingly, patients with a positive family history of GSDV had similar rates of very late diagnoses, likely since the index case was already detected very late in life. Finally, we observe that the R50* variant is associated with increased myoglobinuria and CK elevation, in a dosage-dependent manner. CONCLUSION We concluded that GSDV is severely underdiagnosed, and that some clinical and analytical aspects of the condition can be more indicative of this diagnosis. Furthermore, we propose for the first time a genotype-phenotype correlation in GSDV. IMPACT GSDV is a pediatric-onset metabolic disorder that is mostly diagnosed late in the adult age and commonly misdiagnosed. We observed the first genotype-phenotype correlation in GSDV, regarding the common R50* variant. Awareness of GSDV for pediatricians and the overall medical community is vital.
Collapse
Affiliation(s)
- Jorge Diogo Da Silva
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal.
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
- ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal.
| | - Ângela Pereira
- Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Hospital de Braga, Braga, Portugal
| | - Ana Rita Soares
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| | - Arlindo Guimas
- Department of Internal Medicine, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Reference Centre for Inborn Errors of Metabolism, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Sara Rocha
- Department of Internal Medicine, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Reference Centre for Inborn Errors of Metabolism, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Márcio Cardoso
- Unidade Corino de Andrade and Neurophysiology Department, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- European Reference Network-Neuromuscular Diseases ERN-NMD, Paris, France
| | - Cristina Garrido
- Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- European Reference Network-Neuromuscular Diseases ERN-NMD, Paris, France
| | - Célia Azevedo Soares
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
- Departamento de Ciências Médicas, Universidade de Aveiro, Aveiro, Portugal
| | - Isabel Serra Nunes
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Ana Maria Fortuna
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| | - Dulce Quelhas
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
- Reference Centre for Inborn Errors of Metabolism, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Sónia Figueiroa
- Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Rosa Ribeiro
- Department of Internal Medicine, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Reference Centre for Inborn Errors of Metabolism, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Manuela Santos
- Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- European Reference Network-Neuromuscular Diseases ERN-NMD, Paris, France
| | - Esmeralda Martins
- Centro Materno-Infantil do Norte, Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Reference Centre for Inborn Errors of Metabolism, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Nataliya Tkachenko
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| |
Collapse
|
3
|
Pereira Â, Diogo da Silva J, Soares AR, Guimas A, Rocha S, Cardoso M, Garrido C, Azevedo Soares C, Nunes I, Maria Fortuna A, Quelhas D, Figueiroa S, Ribeiro R, Santos M, Martins E, Tkachenko N. Clinical and Laboratory Findings on Glycogen Storage Disease Type V: Results from a Retrospective Observational Study in a Tertiary Hospital. Endocr Metab Immune Disord Drug Targets 2023; 23:EMIDDT-EPUB-134554. [PMID: 37711120 DOI: 10.2174/1871530323666230914122936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023]
Abstract
Introduction - Glycogen storage disease type V (GSDV, MIM #232600) is an autosomal recessive metabolic myopathy caused by pathogenic variants in the PYGM gene. The characteristic symptoms of exercise intolerance, myalgia, and cramps, which improve after a few minutes of rest, are frequently unrecognized in affected children. When there is clinical suspicion, the initial approach with a forearm exercise test has diagnostic value by detecting low post-exercise plasma lactate-to-ammonia ratio values. The diagnostic algorithm is followed by genetic testing if the results suggest myophosphorylase deficiency. Methods - This was a retrospective observational study conducted based on reviewing medical records of patients with GSDV in a tertiary hospital. We assessed demographic variables, including the timing of onset and diagnosis, relevant clinical characteristics, and whether genetic testing was performed, including its results. Results/Case Report - Our goal was to review the GSDV cases in our center to assess our cohort's diagnostic timing and clinical and genetic characteristics. We identified 28 patients from 24 families, three with consanguinity. The mean age at the time of the study was 43 years. While most (26/28; 93%) recalled their first symptoms in childhood/adolescence, only 25% (7/28) were diagnosed then. All patients had exercise intolerance and CK elevation, while about half reported the second wind phenomenon. Genetic testing was performed in 22 patients, revealing biallelic PYGM variants (9 homozygous, 13 compound heterozygous) as the most common (p.R50*). Conclusion - GSDV is rare and presents in the pediatric age, with subtle manifestations often underestimated for decades. A late diagnosis may negatively impact the psychosocial development of affected children. It is essential to recognize some unique features that facilitate diagnosis: history of exercise intolerance, the second wind sign, and high resting serum CK levels. Identifying the disease-causing variants in PYGM is currently the gold standard for diagnosis as it is less invasive than performing a muscle biopsy, and may promptly diagnose the condition and avoid wrongful labelling of patients.
Collapse
Affiliation(s)
- Ângela Pereira
- Centro Hospitalar do Porto Pediatric Neurology Porto Portugal
| | - Jorge Diogo da Silva
- Centro Hospitalar do Porto Centro de Genética Médica Doutor Jacinto Magalhães (CGM) Porto Portugal
| | - Ana Rita Soares
- Centro Hospitalar do Porto Centro de Genética Médica Doutor Jacinto Magalhães (CGM) Porto Portugal
| | - Arlindo Guimas
- Centro Hospitalar do Porto Reference Centre for Inborn Errors of Metabolism Porto Portugal
| | - Sara Rocha
- Centro Hospitalar do Porto Reference Centre for Inborn Errors of Metabolism Porto Portugal
| | - Márcio Cardoso
- Centro Hospitalar do Porto Unidade Corino de Andrade and Neurophysiology Department Porto Portugal
| | | | - Célia Azevedo Soares
- Centro Hospitalar do Porto Centro de Genética Médica Doutor Jacinto Magalhães (CGM) Porto Portugal
| | - Isabel Nunes
- Centro Hospitalar do Porto Centro de Genética Médica Doutor Jacinto Magalhães (CGM) Porto Portugal
| | - Ana Maria Fortuna
- Centro Hospitalar do Porto Centro de Genética Médica Doutor Jacinto Magalhães (CGM) Porto Portugal
| | - Dulce Quelhas
- Centro Hospitalar do Porto Centro de Genética Médica Doutor Jacinto Magalhães (CGM) Porto Portugal
| | - Sónia Figueiroa
- Centro Hospitalar do Porto Centro de Genética Médica Doutor Jacinto Magalhães (CGM) Porto Portugal
| | - Rosa Ribeiro
- Centro Hospitalar do Porto Reference Centre for Inborn Errors of Metabolism Porto Portugal
| | - Manuela Santos
- Centro Hospitalar do Porto Pediatric Neurology Porto Portugal
| | - Esmeralda Martins
- Centro Hospitalar do Porto Reference Centre for Inborn Errors of Metabolism Porto Portugal
| | - Nataliya Tkachenko
- Centro Hospitalar do Porto Centro de Genética Médica Doutor Jacinto Magalhães (CGM) Porto Portugal
| |
Collapse
|
4
|
Pereira Â, Tkachenko N, Fortuna AM, Alonso I, Cardoso M, Da Silva JD. An SPG7 mutation as a novel cause of monogenic progressive muscular atrophy. Neurol Sci 2023; 44:3303-3305. [PMID: 37213040 DOI: 10.1007/s10072-023-06867-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/17/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Progressive muscular atrophy (PMA) is a rare adult-onset neurological disease that is characterized by isolated lower motor neuron degeneration. While it is still disputable whether PMA is a subtype of amyotrophic lateral sclerosis (ALS) or an isolated disorder, it is well-established as a clinically defined entity. About 5% of PMA cases are monogenic, and the implicated genes largely overlap with those causing monogenic ALS. CASE DESCRIPTION Here we describe a 68-year-old female patient with progressive and asymmetric upper-limb weakness throughout an 18-month period, with muscle atrophy, dysphagia and slurring of speech. The lower limbs were unaffected, and there was no sign of upper motor neuron dysfunction. Comprehensive genetic testing for single nucleotide and copy-number variants revealed a pathogenic monoallelic variant c.1529C>T, p.(Ala510Val) in the SPG7 gene. DISCUSSION Pathogenic biallelic SPG7 variants have been originally associated with hereditary spastic paraplegia, but other phenotypes are nowadays known to be linked to these variants, such as ALS. However, there is no report of this (or any) other SPG7 variant in association with PMA, whether it progressed to ALS or not. In conclusion, we present the first known case of PMA associated with a monoallelic SPG7 mutation.
Collapse
Affiliation(s)
- Ângela Pereira
- Centro Materno-Infantil do Norte, Centro Hospital Universitário de Santo António, Porto, Portugal
- Hospital de Braga, Braga, Portugal
| | - Nataliya Tkachenko
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| | - Ana Maria Fortuna
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| | | | - Márcio Cardoso
- Corino de Andrade Unit, Centro Hospitalar Universitário de Santo António, Porto, Portugal
| | - Jorge Diogo Da Silva
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário de Santo António, Porto, Portugal.
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal.
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.
- ICVS/3B's-PT Government Associate Laboratory, Braga/Guimarães, Portugal.
| |
Collapse
|
5
|
Azevedo Soares C, Ferreira Almeida M, Soares G, Tkachenko N, Fortuna AM, Carmona C. Predicting factors of neurodevelopmental performance in children with phenylketonuria. Am J Med Genet A 2023; 191:1525-1529. [PMID: 36872876 DOI: 10.1002/ajmg.a.63174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/07/2023]
Abstract
In phenylketonuria (PKU), high phenylalanine (Phe) levels hamper neurodevelopment impairing executive function later in life. While the second has been more studied, fewer data exist on predictors of PKU patients' development in specific populations. To contribute to the field, we performed a retrospective analysis of predictors of neurodevelopment in PKU patients in a Portuguese cohort. We analyzed the retrospective data on the metabolic control of 89 patients, as their health and familial features. Griffith's Mental Development Scale performance at age 6 (GMDS6) was used to assess neurodevelopment. Our cohort included 14 GMDS6low and 75 GMDS6high patients. In a multivariate analysis, the better predictors of neurodevelopment were the metabolic control at age 3 and year of birth (n = 87, β0 = -121, β1 = -1.77, β2 = 0.06, LRchi2(2) = 13.61, Prob > chi2 = 0.001, Pseudo R2 = 0.1773). With this model, it was possible to define a safety cut-off of 7.8 mg/dL for the Phe level at age 3 (sensitivity = 72.6%, specificity = 78.6%), confirming the safety of the cut-off of 6 mg/dL already used in the clinical practice. Our study supports the relevance of metabolic control to predict the neurodevelopment of PKU patients, in the historical context of the disease management.
Collapse
Affiliation(s)
- Célia Azevedo Soares
- Centro de Genética Médica Dr. Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar (UMIB/ICBAS) and Laboratory for Integrative and Translational Research in Population Health (ITR), Universidade do Porto, Porto, Portugal.,Departamento de Ciências Médicas, Universidade de Aveiro, Aveiro, Portugal.,i3S - Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Porto, Portugal
| | - Manuela Ferreira Almeida
- Centro de Genética Médica Dr. Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar (UMIB/ICBAS) and Laboratory for Integrative and Translational Research in Population Health (ITR), Universidade do Porto, Porto, Portugal.,Centro de Referência de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Gabriela Soares
- Centro de Genética Médica Dr. Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Consulta de Genética Médica, Centro Hospitalar de Trás-os-Montes e Alto Douro, Unidade de Vila Real, Portugal
| | - Natália Tkachenko
- Centro de Genética Médica Dr. Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar (UMIB/ICBAS) and Laboratory for Integrative and Translational Research in Population Health (ITR), Universidade do Porto, Porto, Portugal
| | - Ana Maria Fortuna
- Centro de Genética Médica Dr. Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar (UMIB/ICBAS) and Laboratory for Integrative and Translational Research in Population Health (ITR), Universidade do Porto, Porto, Portugal.,Centro de Referência de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Carla Carmona
- Centro de Genética Médica Dr. Jacinto Magalhães, Centro Hospitalar Universitário do Porto, Porto, Portugal.,Unidade Multidisciplinar de Investigação Biomédica, Instituto de Ciências Biomédicas Abel Salazar (UMIB/ICBAS) and Laboratory for Integrative and Translational Research in Population Health (ITR), Universidade do Porto, Porto, Portugal.,Centro de Referência de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário do Porto, Porto, Portugal
| |
Collapse
|
6
|
Da Silva JD, Gonzaga D, Barreta A, Correia H, Fortuna AM, Soares AR, Tkachenko N. Refining the Clinical Spectrum of the 17p13.3 Microduplication Syndrome: Case-Report of a Familial Small Microduplication. Biomedicines 2022; 10:biomedicines10123078. [PMID: 36551834 PMCID: PMC9775100 DOI: 10.3390/biomedicines10123078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 11/18/2022] [Accepted: 11/26/2022] [Indexed: 12/02/2022] Open
Abstract
The chromosomal region 17p13.3 contains extensive repetitive sequences and is a well-recognized region of genomic instability. The 17p13.3 microduplication syndrome has been associated with a clinical spectrum of moderately non-specific phenotypes, including global developmental delay/intellectual disability, behavioral disorders, autism spectrum disorder and variable dysmorphic features. Depending on the genes involved in the microduplication, it can be categorized in two subtypes with different phenotypes. Here, we report a case of a 7-year-old boy with global developmental delay, speech impairment, hypotonia, behavioral conditions (ADHD and ODD), non-specific dysmorphic features and overgrowth. Genetic testing revealed a small 17p13.3 chromosomal duplication, which included the BHLHA9, CRK and YWHAE genes. Additionally, we observed that this was maternally inherited, and that the mother presented with a milder phenotype including mild learning disabilities, speech impairment and non-specific dysmorphic features, which did not significantly affect her. In conclusion, we present a clinical case of a 17p13.3 duplication that further delineates the clinical spectrum of this syndrome, including its intrafamilial/intergenerational variability.
Collapse
Affiliation(s)
- Jorge Diogo Da Silva
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário do Porto, 4050-106 Porto, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057 Braga, Portugal
- ICVS/3B’s—PT Government Associate Laboratory, 4806-909 Braga, Portugal
- Correspondence:
| | - Diana Gonzaga
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário do Porto, 4050-106 Porto, Portugal
- Centro Materno-Infantil do Norte, Centro Hospital Universitário do Porto, 4099-001 Porto, Portugal
| | - Ana Barreta
- Medical Genetics Service, Joaquim Chaves Saúde, 2685-145 Oeiras, Portugal
| | - Hildeberto Correia
- Medical Genetics Service, Joaquim Chaves Saúde, 2685-145 Oeiras, Portugal
| | - Ana Maria Fortuna
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário do Porto, 4050-106 Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, 4050-345 Porto, Portugal
| | - Ana Rita Soares
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário do Porto, 4050-106 Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, 4050-345 Porto, Portugal
| | - Nataliya Tkachenko
- Centro de Genética Médica Doutor Jacinto Magalhães (CGM), Centro Hospitalar Universitário do Porto, 4050-106 Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, 4050-345 Porto, Portugal
| |
Collapse
|
7
|
Maia N, Potelle S, Yildirim H, Duvet S, Akula SK, Schulz C, Wiame E, Gheldof A, O'Kane K, Lai A, Sermon K, Proisy M, Loget P, Attié-Bitach T, Quelin C, Fortuna AM, Soares AR, de Brouwer APM, Van Schaftingen E, Nassogne MC, Walsh CA, Stouffs K, Jorge P, Jansen AC, Foulquier F. Impaired catabolism of free oligosaccharides due to MAN2C1 variants causes a neurodevelopmental disorder. Am J Hum Genet 2022; 109:345-360. [PMID: 35045343 PMCID: PMC8874227 DOI: 10.1016/j.ajhg.2021.12.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/10/2021] [Indexed: 01/16/2023] Open
Abstract
Free oligosaccharides (fOSs) are soluble oligosaccharide species generated during N-glycosylation of proteins. Although little is known about fOS metabolism, the recent identification of NGLY1 deficiency, a congenital disorder of deglycosylation (CDDG) caused by loss of function of an enzyme involved in fOS metabolism, has elicited increased interest in fOS processing. The catabolism of fOSs has been linked to the activity of a specific cytosolic mannosidase, MAN2C1, which cleaves α1,2-, α1,3-, and α1,6-mannose residues. In this study, we report the clinical, biochemical, and molecular features of six individuals, including two fetuses, with bi-allelic pathogenic variants in MAN2C1; the individuals are from four different families. These individuals exhibit dysmorphic facial features, congenital anomalies such as tongue hamartoma, variable degrees of intellectual disability, and brain anomalies including polymicrogyria, interhemispheric cysts, hypothalamic hamartoma, callosal anomalies, and hypoplasia of brainstem and cerebellar vermis. Complementation experiments with isogenic MAN2C1-KO HAP1 cells confirm the pathogenicity of three of the identified MAN2C1 variants. We further demonstrate that MAN2C1 variants lead to accumulation and delay in the processing of fOSs in proband-derived cells. These results emphasize the involvement of MAN2C1 in human neurodevelopmental disease and the importance of fOS catabolism.
Collapse
Affiliation(s)
- Nuno Maia
- Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário do Porto, 4050-466 Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine and Laboratory for Integrative and Translational Research in Population Health, Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
| | - Sven Potelle
- Laboratory of Physiological Chemistry, de Duve Institute, 1200 Brussels, Belgium; WELBIO, 1200 Brussels, Belgium
| | - Hamide Yildirim
- Neurogenetics Research Group, Reproduction Genetics and Regenerative Medicine Research Cluster, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Sandrine Duvet
- Univ. Lille, CNRS, UMR 8576-UGSF-Unit. de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - Shyam K Akula
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA 02115, USA; Howard Hughes Medical Institute, Boston, MA 02115, USA; Broad Institute of MIT and Harvard, Boston, MA 02115, USA; Manton Center for Orphan Disease Research, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Celine Schulz
- Univ. Lille, CNRS, UMR 8576-UGSF-Unit. de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - Elsa Wiame
- Laboratory of Physiological Chemistry, de Duve Institute, 1200 Brussels, Belgium; WELBIO, 1200 Brussels, Belgium
| | - Alexander Gheldof
- Centre for Medical Genetics, UZ Brussel, 1090 Brussels, Belgium; Reproduction and Genetics Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Katherine O'Kane
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA 02115, USA; Howard Hughes Medical Institute, Boston, MA 02115, USA; Broad Institute of MIT and Harvard, Boston, MA 02115, USA; Manton Center for Orphan Disease Research, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Abbe Lai
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA 02115, USA; Howard Hughes Medical Institute, Boston, MA 02115, USA; Broad Institute of MIT and Harvard, Boston, MA 02115, USA; Manton Center for Orphan Disease Research, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Karen Sermon
- Reproduction and Genetics Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Maïa Proisy
- CHU Brest, Radiology Department, Brest University, 29609 Brest Cedex, France
| | - Philippe Loget
- Department of Pathology, Rennes University Hospital, 35000 Rennes, France
| | - Tania Attié-Bitach
- APHP, Embryofœtopathologie, Service d'Histologie-Embryologie-Cytogénétique, Hôpital Universitaire Necker-Enfants Malades, 75015 Paris, France; Université de Paris, Imagine Institute, INSERM UMR 1163, 75015 Paris, France
| | - Chloé Quelin
- Clinical Genetics Department, Rennes University Hospital, 35000 Rennes, France
| | - Ana Maria Fortuna
- Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário do Porto, 4050-466 Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine and Laboratory for Integrative and Translational Research in Population Health, Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
| | - Ana Rita Soares
- Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário do Porto, 4050-466 Porto, Portugal
| | - Arjan P M de Brouwer
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Center, 6500 Nijmegen, the Netherlands
| | - Emile Van Schaftingen
- Laboratory of Physiological Chemistry, de Duve Institute, 1200 Brussels, Belgium; WELBIO, 1200 Brussels, Belgium
| | - Marie-Cécile Nassogne
- Department of Pediatric Neurology, Cliniques Universitaires Saint-Luc, UCLouvain, 1200 Brussels, Belgium; Institute Of NeuroScience, Clinical Neuroscience, UCLouvain, 1200 Brussels, Belgium
| | - Christopher A Walsh
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA 02115, USA; Howard Hughes Medical Institute, Boston, MA 02115, USA; Broad Institute of MIT and Harvard, Boston, MA 02115, USA; Manton Center for Orphan Disease Research, Boston, MA 02115, USA; Harvard Medical School, Boston, MA 02115, USA
| | - Katrien Stouffs
- Centre for Medical Genetics, UZ Brussel, 1090 Brussels, Belgium; Reproduction and Genetics Research Group, Vrije Universiteit Brussel, 1090 Brussels, Belgium
| | - Paula Jorge
- Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar Universitário do Porto, 4050-466 Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine and Laboratory for Integrative and Translational Research in Population Health, Institute of Biomedical Sciences Abel Salazar, University of Porto, 4050-313 Porto, Portugal
| | - Anna C Jansen
- Neurogenetics Research Group, Reproduction Genetics and Regenerative Medicine Research Cluster, Vrije Universiteit Brussel, 1090 Brussels, Belgium; Pediatric Neurology Unit, Department of Pediatrics, UZ Brussel, 1090 Brussels, Belgium.
| | - François Foulquier
- Univ. Lille, CNRS, UMR 8576-UGSF-Unit. de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France.
| |
Collapse
|
8
|
Soares CA, Tkachenko N, Fernandes EV, Barreiro M, Abreu M, Reis CF, Soares G, Fortuna AM, Soares AR. Genetic counseling and carrier screening in candidates for gamete donation at a Portuguese center. JBRA Assist Reprod 2022. [DOI: 10.5935/1518-0557.20220012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
9
|
Quelhas D, Martins E, Azevedo L, Bandeira A, Diogo L, Garcia P, Sequeira S, Ferreira AC, Teles EL, Rodrigues E, Fortuna AM, Mendonça C, Fernandes HC, Medeira A, Gaspar A, Janeiro P, Oliveira A, Laranjeira F, Ribeiro I, Souche E, Race V, Keldermans L, Matthijs G, Jaeken J. Congenital Disorders of Glycosylation in Portugal-Two Decades of Experience. J Pediatr 2021; 231:148-156. [PMID: 33340551 DOI: 10.1016/j.jpeds.2020.12.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/09/2020] [Accepted: 12/10/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To describe the clinical, biochemical, and genetic features of both new and previously reported patients with congenital disorders of glycosylation (CDGs) diagnosed in Portugal over the last 20 years. STUDY DESIGN The cohort includes patients with an unexplained multisystem or single organ involvement, with or without psychomotor disability. Serum sialotransferrin isoforms and, whenever necessary, apolipoprotein CIII isoforms and glycan structures were analyzed. Additional studies included measurement of phosphomannomutase (PMM) activity and analysis of lipid-linked oligosaccharides in fibroblasts. Sanger sequencing and massive parallel sequencing were used to identify causal variants or the affected gene, respectively. RESULTS Sixty-three individuals were diagnosed covering 14 distinct CDGs; 43 patients diagnosed postnatally revealed a type 1, 14 a type 2, and 2 a normal pattern on serum transferrin isoelectrofocusing. The latter patients were identified by whole exome sequencing. Nine of them presented also a hypoglycosylation pattern on apolipoprotein CIII isoelectrofocusing, pointing to an associated O-glycosylation defect. Most of the patients (62%) are PMM2-CDG and the remaining carry pathogenic variants in ALG1, ATP6AP1, ATP6AP2, ATP6V0A2, CCDC115, COG1, COG4, DPAGT1, MAN1B1, SLC35A2, SRD5A3, RFT1, or PGM1. CONCLUSIONS Portuguese patients with CDGs are presented in this report, some of them showing unique clinical phenotypes. Among the 14 genes mutated in Portuguese individuals, 8 are shared with a previously reported Spanish cohort. However, regarding the mutational spectrum of PMM2-CDG, the most frequent CDG, a striking similarity between the 2 populations was found, as only 1 mutated allele found in the Portuguese group has not been reported in Spain.
Collapse
Affiliation(s)
- Dulce Quelhas
- Unidade de Bioquímica Genética, Centro de Genética Médica, Centro Hospitalar Universitário do Porto, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, ICBAS, UP, Porto, Portugal; Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário do Porto, Porto, Portugal.
| | - Esmeralda Martins
- Unit for Multidisciplinary Research in Biomedicine, ICBAS, UP, Porto, Portugal; Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luísa Azevedo
- i3S- Instituto de Investigação e Inovação em Saúde, Universidade do Porto, Population Genetics and Evolution Group, Porto, Portugal; IPATIMUP-Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal; FCUP-Department of Biology, Faculty of Sciences, University of Porto, Porto, Portugal
| | - Anabela Bandeira
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luísa Diogo
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Paula Garcia
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
| | - Sílvia Sequeira
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Ana Cristina Ferreira
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal
| | - Elisa Leão Teles
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de S João, Porto, Portugal
| | - Esmeralda Rodrigues
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de S João, Porto, Portugal
| | - Ana Maria Fortuna
- Unidade de Genética Médica, Centro Genética Médica, Centro Hospitalar do Porto, Porto, Portugal
| | - Carla Mendonça
- Centro de Neuropediatria e Desenvolvimento, Centro Hospitalar Universitário do Algarve, Faro, Portugal
| | | | | | - Ana Gaspar
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de Sta Maria, CHLN, Lisboa, Portugal
| | - Patrícia Janeiro
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de Sta Maria, CHLN, Lisboa, Portugal
| | - Anabela Oliveira
- Centro Referência Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de Sta Maria, CHLN, Lisboa, Portugal
| | - Francisco Laranjeira
- Unidade de Bioquímica Genética, Centro de Genética Médica, Centro Hospitalar Universitário do Porto, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, ICBAS, UP, Porto, Portugal
| | - Isaura Ribeiro
- Unidade de Bioquímica Genética, Centro de Genética Médica, Centro Hospitalar Universitário do Porto, Porto, Portugal; Unit for Multidisciplinary Research in Biomedicine, ICBAS, UP, Porto, Portugal
| | - Erica Souche
- Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Valérie Race
- Department of Human Genetics, KU Leuven, Leuven, Belgium
| | | | - Gert Matthijs
- Department of Human Genetics, KU Leuven, Leuven, Belgium
| | - Jaak Jaeken
- Center for Metabolic Diseases, KU Leuven, Leuven, Belgium
| |
Collapse
|
10
|
Maia N, Soares AR, Fortuna AM, Marques I, Gonçalves A, Santos R, Melo Pires M, de Brouwer APM, Jorge P. Usher syndrome and Nebulin-associated myopathy in a single patient due to variants in MYO7A and NEB. Clin Case Rep 2020; 8:2476-2482. [PMID: 33363762 PMCID: PMC7752365 DOI: 10.1002/ccr3.3146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/08/2020] [Accepted: 06/14/2020] [Indexed: 12/02/2022] Open
Abstract
In a patient with Usher syndrome and atypical muscle complaints, we have identified two separate variants in MYO7A andNEB genes by exome sequencing. The homozygous variants in these two recessive genes could explain the full phenotype of our patient.
Collapse
Affiliation(s)
- Nuno Maia
- Unidade de Genética MolecularCentro de Genética Médica Jacinto de Magalhães (CGM)Centro Hospitalar Universitário do Porto (CHUP)PortoPortugal
- Unidade Multidisciplinar de Investigação Biomédica (UMIB)Instituto de Ciências Biomédicas Abel Salazar (ICBAS)Universidade do PortoPortoPortugal
| | - Ana Rita Soares
- Unidade de Genética MédicaCentro de Genética Médica Jacinto de Magalhães (CGM)Centro Hospitalar Universitário do Porto (CHUP)PortoPortugal
| | - Ana Maria Fortuna
- Unidade Multidisciplinar de Investigação Biomédica (UMIB)Instituto de Ciências Biomédicas Abel Salazar (ICBAS)Universidade do PortoPortoPortugal
- Unidade de Genética MédicaCentro de Genética Médica Jacinto de Magalhães (CGM)Centro Hospitalar Universitário do Porto (CHUP)PortoPortugal
| | - Isabel Marques
- Unidade de Genética MolecularCentro de Genética Médica Jacinto de Magalhães (CGM)Centro Hospitalar Universitário do Porto (CHUP)PortoPortugal
- Unidade Multidisciplinar de Investigação Biomédica (UMIB)Instituto de Ciências Biomédicas Abel Salazar (ICBAS)Universidade do PortoPortoPortugal
| | - Ana Gonçalves
- Unidade de Genética MolecularCentro de Genética Médica Jacinto de Magalhães (CGM)Centro Hospitalar Universitário do Porto (CHUP)PortoPortugal
- Unidade Multidisciplinar de Investigação Biomédica (UMIB)Instituto de Ciências Biomédicas Abel Salazar (ICBAS)Universidade do PortoPortoPortugal
| | - Rosário Santos
- Unidade de Genética MolecularCentro de Genética Médica Jacinto de Magalhães (CGM)Centro Hospitalar Universitário do Porto (CHUP)PortoPortugal
- Unidade Multidisciplinar de Investigação Biomédica (UMIB)Instituto de Ciências Biomédicas Abel Salazar (ICBAS)Universidade do PortoPortoPortugal
| | - Manuel Melo Pires
- Serviço de NeuropatologiaCentro Hospitalar e Universitário do Porto (CHUP)PortoPortugal
| | - Arjan P. M. de Brouwer
- Department of Human GeneticsDonders Institute for Brain, Cognition and BehaviourRadboud University NijmegenNijmegenThe Netherlands
| | - Paula Jorge
- Unidade de Genética MolecularCentro de Genética Médica Jacinto de Magalhães (CGM)Centro Hospitalar Universitário do Porto (CHUP)PortoPortugal
- Unidade Multidisciplinar de Investigação Biomédica (UMIB)Instituto de Ciências Biomédicas Abel Salazar (ICBAS)Universidade do PortoPortoPortugal
| |
Collapse
|
11
|
Soares AR, Figueiredo CM, Quelhas D, Silva ES, Freitas J, Oliveira MJ, Faria S, Fortuna AM, Borges T. Hyperinsulinaemic Hypoglycaemia and Polycystic Kidney Disease - A Rare Case Concerning PMM2 Gene Pleiotropy. Eur Endocrinol 2020; 16:66-68. [PMID: 32595772 DOI: 10.17925/ee.2020.16.1.66] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Accepted: 11/08/2019] [Indexed: 12/21/2022]
Abstract
Co-occurrence of hyperinsulinaemic hypoglycaemia and polycystic kidney disease (HIPKD) has been recently described. It is caused by a non-coding variant in the promoter region for phosphomannomutase 2 (PMM2), c.-167G>T, both in homozygous or compound heterozygous variants with deleterious coding. Although PMM2 has been associated with congenital disorder of glycosylation, patients do not present with this phenotype and have normal carbohydrate-deficient transferring testing. The authors present a rare case where specific PMM2 study was performed as a result of clinical suspicions. The patient was a 6-year-old female followed at our clinic due to congenital hyperinsulinism since she was 1 month old. She also presented with bilateral polycystic kidneys, detected in prenatal set, and simple hepatic cysts, for which she was treated with diazoxide and captopril. Initial metabolic and genetic studies were normal. PMM2 gene sequence study revealed the promotor variant c.-167G>T in compound heterozygosity with the previously described pathogenic variant c.422G>A (p.Arg141His), confirming the diagnosis of HIPKD. This is a notable case as it highlights the importance of keeping this diagnostic hypothesis in mind and serves as a reminder to perform proper clinical and genetic investigation. A correct, and early, diagnosis will avoid unnecessary additional investigations and will allow appropriate genetic counselling for this autosomal recessive disorder.
Collapse
Affiliation(s)
- Ana Rita Soares
- Medical Genetics Department, Centre of Medical Genetics Doutor Jacinto Magalhães, Porto University Hospital Centre, Porto, Portugal
| | - Catarina Matos Figueiredo
- Paediatric Endocrinology Unit, Northern Maternal and Child Centre, Porto University Hospital Centre, Porto, Portugal
| | - Dulce Quelhas
- Biochemical Genetics Unit, Centre of Medical Genetics Doutor Jacinto Magalhães, Porto University Hospital Centre, Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| | - Ermelinda Santos Silva
- Paediatric Gastroenterology Unit, Northern Maternal and Child Centre, Porto University Hospital Centre, Porto, Portugal
| | - Joana Freitas
- Paediatric Endocrinology Unit, Northern Maternal and Child Centre, Porto University Hospital Centre, Porto, Portugal
| | - Maria João Oliveira
- Paediatric Endocrinology Unit, Northern Maternal and Child Centre, Porto University Hospital Centre, Porto, Portugal
| | - Sameiro Faria
- Paediatric Nephrology Unit, Northern Maternal and Child Centre, Porto University Hospital Centre, Porto, Portugal
| | - Ana Maria Fortuna
- Medical Genetics Department, Centre of Medical Genetics Doutor Jacinto Magalhães, Porto University Hospital Centre, Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Abel Salazar Biomedical Sciences Institute, Porto University, Porto, Portugal
| | - Teresa Borges
- Paediatric Endocrinology Unit, Northern Maternal and Child Centre, Porto University Hospital Centre, Porto, Portugal
| |
Collapse
|
12
|
Soares AR, Soares G, Mota-Freitas M, Oliva-Teles N, Fortuna AM. Subtelomeric Rearrangements: Presentation of 21 Probands with Emphasis on Familial Cases. ACTA MEDICA PORT 2019; 32:529-535. [PMID: 31445533 DOI: 10.20344/amp.11466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/08/2019] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Intellectual disability affects 2% - 3% of the general population, with a chromosomal abnormality being found in 4% - 28% of these patients and a cryptic subtelomeric abnormality in 3% - 16%. In most cases, these subtelomeric rearrangements are submicroscopic, requiring techniques other than conventional karyotype for detection. They may be de novo or inherited from an affected parent or from a healthy carrier of a balanced chromosomal abnormality. The aim of this study was to characterize patients from our medical genetics center, in whom both a deletion and duplication in subtelomeric regions were found. MATERIAL AND METHODS Clinical and cytogenetic characterization of 21 probands followed at our center, from 1998 until 2017, with subtelomeric rearrangements. RESULTS There were 21 probands from 19 families presenting with intellectual disability and facial dysmorphisms. Seven had behavior changes, five had epilepsy and 14 presented with some other sign or symptom. Four had chromosomal abnormalities detected by conventional karyotype and four were diagnosed by array-comparative genomic hybridization. In four cases, parental studies were not possible. The online mendelian inheritance in man classification was provided whenever any of the phenotypes (deletion or duplication syndrome) was dominant. DISCUSSION Patients and relevant family members were clinically and cytogenetically characterized. Although rare, subtelomeric changes are a substantial cause of syndromic intellectual disability with important familial repercussions. It is essential to remember that a normal array-comparative genomic hybridization result does not exclude a balanced rearrangement in the parents. CONCLUSION Parental genetic studies are essential not only for a complete characterization of the rearrangement, but also for accurate genetic counselling and screening of family members at risk for recurrence.
Collapse
Affiliation(s)
- Ana Rita Soares
- Unidade de Genética Médica. Centro de Genética Médica Jacinto Magalhães. Centro Hospitalar Universitário do Porto. Porto. Portugal
| | - Gabriela Soares
- Unidade de Genética Médica. Centro de Genética Médica Jacinto Magalhães. Centro Hospitalar Universitário do Porto. Porto. Portugal
| | - Manuela Mota-Freitas
- Unidade de Citogenética. Centro de Genética Médica Jacinto Magalhães. Centro Hospitalar Universitário do Porto. Porto. Unidade Multidisciplinar de Investigação Biomédica. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto. Portugal
| | - Natália Oliva-Teles
- Unidade de Citogenética. Centro de Genética Médica Jacinto Magalhães. Centro Hospitalar Universitário do Porto. Porto. 3. Unidade Multidisciplinar de Investigação Biomédica. Instituto de Ciências Biomédicas Abel Salazar. Universidade do Porto. Porto. Portugal
| | - Ana Maria Fortuna
- Unidade de Genética Médica. Centro de Genética Médica Jacinto Magalhães. Centro Hospitalar Universitário do Porto. Porto. Unidade de Citogenética. Centro de Genética Médica Jacinto Magalhães. Centro Hospitalar Universitário do Porto. Porto. Portugal
| |
Collapse
|
13
|
Lopes F, Torres F, Soares G, Barbosa M, Silva J, Duque F, Rocha M, Sá J, Oliveira G, Sá MJ, Temudo T, Sousa S, Marques C, Lopes S, Gomes C, Barros G, Jorge A, Rocha F, Martins C, Mesquita S, Loureiro S, Cardoso EM, Cálix MJ, Dias A, Martins C, Mota CR, Antunes D, Dupont J, Figueiredo S, Figueiroa S, Gama-de-Sousa S, Cruz S, Sampaio A, Eijk P, Weiss MM, Ylstra B, Rendeiro P, Tavares P, Reis-Lima M, Pinto-Basto J, Fortuna AM, Maciel P. Genomic imbalances defining novel intellectual disability associated loci. Orphanet J Rare Dis 2019; 14:164. [PMID: 31277718 PMCID: PMC6612161 DOI: 10.1186/s13023-019-1135-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 06/12/2019] [Indexed: 11/29/2022] Open
Abstract
Background High resolution genome-wide copy number analysis, routinely used in clinical diagnosis for several years, retrieves new and extremely rare copy number variations (CNVs) that provide novel candidate genes contributing to disease etiology. The aim of this work was to identify novel genetic causes of neurodevelopmental disease, inferred from CNVs detected by array comparative hybridization (aCGH), in a cohort of 325 Portuguese patients with intellectual disability (ID). Results We have detected CNVs in 30.1% of the patients, of which 5.2% corresponded to novel likely pathogenic CNVs. For these 11 rare CNVs (which encompass novel ID candidate genes), we identified those most likely to be relevant, and established genotype-phenotype correlations based on detailed clinical assessment. In the case of duplications, we performed expression analysis to assess the impact of the rearrangement. Interestingly, these novel candidate genes belong to known ID-related pathways. Within the 8% of patients with CNVs in known pathogenic loci, the majority had a clinical presentation fitting the phenotype(s) described in the literature, with a few interesting exceptions that are discussed. Conclusions Identification of such rare CNVs (some of which reported for the first time in ID patients/families) contributes to our understanding of the etiology of ID and for the ever-improving diagnosis of this group of patients. Electronic supplementary material The online version of this article (10.1186/s13023-019-1135-0) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Fátima Lopes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Fátima Torres
- CGC Genetics, Porto, Portugal.,Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Gabriela Soares
- Center for Medical Genetics Dr. Jacinto Magalhães, Porto Hospital Center, Praça Pedro Nunes, Porto, Portugal
| | - Mafalda Barbosa
- Center for Medical Genetics Dr. Jacinto Magalhães, Porto Hospital Center, Praça Pedro Nunes, Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal.,The Mindich Child Health & Development Institute and the Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,The Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Graduate School of Biomedical Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - João Silva
- Center for Medical Genetics Dr. Jacinto Magalhães, Porto Hospital Center, Praça Pedro Nunes, Porto, Portugal.,Centro de Genética Preditiva e Preventiva - CGPP, Instituto de Biologia Molecular e Celular - IBMC, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde - i3S, Universidade do Porto, Porto, Portugal
| | - Frederico Duque
- Unidade de Neurodesenvolvimento e Autismo do Serviço do Centro de Desenvolvimento da Criança and Centro de Investigação e Formação Clínica, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, 3041-80, Coimbra, Portugal.,University Clinic of Pediatrics and Institute for Biomedical Imaging and Life Science, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Miguel Rocha
- Center for Medical Genetics Dr. Jacinto Magalhães, Porto Hospital Center, Praça Pedro Nunes, Porto, Portugal.,Medical Genetics Unit, Hospital de Braga, Braga, Portugal
| | - Joaquim Sá
- CGC Genetics, Porto, Portugal.,Department of Medical Genetics, Hospital de Faro, Faro, Portugal
| | - Guiomar Oliveira
- Unidade de Neurodesenvolvimento e Autismo do Serviço do Centro de Desenvolvimento da Criança and Centro de Investigação e Formação Clínica, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, 3041-80, Coimbra, Portugal.,University Clinic of Pediatrics and Institute for Biomedical Imaging and Life Science, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Maria João Sá
- Center for Medical Genetics Dr. Jacinto Magalhães, Porto Hospital Center, Praça Pedro Nunes, Porto, Portugal.,Unit for Multidisciplinary Research in Biomedicine, Institute of Biomedical Sciences Abel Salazar (ICBAS), University of Porto, Porto, Portugal
| | - Teresa Temudo
- Pediatric Neurology Department, Centro Materno-Infantil Centro Hospitalar do Porto, Porto, Portugal
| | - Susana Sousa
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.,Centro de Genética Preditiva e Preventiva - CGPP, Instituto de Biologia Molecular e Celular - IBMC, Universidade do Porto, Porto, Portugal.,Instituto de Investigação e Inovação em Saúde - i3S, Universidade do Porto, Porto, Portugal
| | - Carla Marques
- Unidade de Neurodesenvolvimento e Autismo do Serviço do Centro de Desenvolvimento da Criança and Centro de Investigação e Formação Clínica, Pediatric Hospital, Centro Hospitalar e Universitário de Coimbra, 3041-80, Coimbra, Portugal
| | - Sofia Lopes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Catarina Gomes
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Gisela Barros
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal.,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal
| | - Arminda Jorge
- Development Unit, Pediatrics Service, Hospital Centre of Cova da Beira, Covilhã, Portugal.,CICS - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
| | - Felisbela Rocha
- Department of Pediatrics, Médio Ave Hospital Center, Vila Nova de Famalicão, Portugal
| | - Cecília Martins
- Department of Pediatrics, Médio Ave Hospital Center, Vila Nova de Famalicão, Portugal
| | - Sandra Mesquita
- Development Unit, Pediatrics Service, Hospital Centre of Cova da Beira, Covilhã, Portugal
| | - Susana Loureiro
- Department of Pediatrics, Hospital S. Teotónio, Tondela/Viseu Hospital Center, Viseu, Portugal
| | - Elisa Maria Cardoso
- Department of Pediatrics, Hospital S. Teotónio, Tondela/Viseu Hospital Center, Viseu, Portugal
| | - Maria José Cálix
- Department of Pediatrics, Hospital S. Teotónio, Tondela/Viseu Hospital Center, Viseu, Portugal
| | - Andreia Dias
- Department of Pediatrics, Hospital S. Teotónio, Tondela/Viseu Hospital Center, Viseu, Portugal
| | - Cristina Martins
- Neuropaediatric Unit - Garcia de Orta Hospital, Almada, Portugal
| | - Céu R Mota
- Pediatric and Neonatal Intensive Care, Department of Pediatrics, Porto Hospital Center, Porto, Portugal
| | - Diana Antunes
- Department of Genetics, Hospital D. Estefânia, Lisboa-Norte Hospital Center, Lisbon, Portugal
| | - Juliette Dupont
- Genetics Service, Paediatric Department, University Hospital Santa Maria, Lisbon, Portugal
| | - Sara Figueiredo
- Department of Pediatrics, Médio Ave Hospital Center, Santo Tirso, Portugal
| | - Sónia Figueiroa
- Division of Pediatric Neurology, Department of Child and Adolescent, Centro Hospitalar do Porto e Hospital de Santo António, Porto, Portugal
| | - Susana Gama-de-Sousa
- Department of Pediatrics, Médio Ave Hospital Center, Vila Nova de Famalicão, Portugal
| | - Sara Cruz
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Adriana Sampaio
- Neuropsychophysiology Lab, CIPsi, School of Psychology, University of Minho, Braga, Portugal
| | - Paul Eijk
- Department of Pathology, VU University Medical Center, Amsterdam, 1007, MB, The Netherlands
| | - Marjan M Weiss
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, 1007, MB, The Netherlands
| | - Bauke Ylstra
- Department of Pathology, VU University Medical Center, Amsterdam, 1007, MB, The Netherlands
| | | | | | - Margarida Reis-Lima
- Center for Medical Genetics Dr. Jacinto Magalhães, Porto Hospital Center, Praça Pedro Nunes, Porto, Portugal.,GDPN- SYNLAB, Porto, Portugal
| | | | - Ana Maria Fortuna
- Center for Medical Genetics Dr. Jacinto Magalhães, Porto Hospital Center, Praça Pedro Nunes, Porto, Portugal
| | - Patrícia Maciel
- Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, 4710-057, Braga, Portugal. .,ICVS/3B's - PT Government Associate Laboratory, Braga/Guimarães, Portugal.
| |
Collapse
|
14
|
Barceló A, Morell-Garcia D, Salord N, Esquinas C, Pérez G, Pérez A, Monasterio C, Gasa M, Fortuna AM, Montserrat JM, Mayos M. A randomized controlled trial: branched-chain amino acid levels and glucose metabolism in patients with obesity and sleep apnea. J Sleep Res 2017; 26:773-781. [PMID: 28513068 DOI: 10.1111/jsr.12551] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Accepted: 03/28/2017] [Indexed: 12/11/2022]
Abstract
There is evidence that changes in branched-chain amino acid (BCAA) levels may correlate with the efficacy of therapeutic interventions for affecting improvement in metabolic control. The objective of this study was to evaluate whether serum concentrations of BCAAs (leucine, isoleucine, valine) could mediate in insulin sensitivity and glucose tolerance after continuous positive airway pressure (CPAP) treatment in patients with obstructive sleep apnea (OSA). A prospective randomized controlled trial of OSA patients with morbid obesity was conducted. Eighty patients were randomized into two groups: 38 received conservative treatment and 42 received CPAP treatment for 12 weeks. Plasma levels of BCAA, glucose tolerance and insulin resistance were evaluated at baseline and after treatment. After treatment, significant decreases of leucine levels were observed in both groups when compared with baseline levels (P < 0.005). With respect to patients with normal glucose tolerance (NGT), patients with impaired glucose tolerance (IGT) had higher baseline levels of isoleucine (78 ± 16 versus 70 ± 13 μmol L-1 , P = 0.014) and valine (286 ± 36 versus 268 ± 41 μmol L-1 , P = 0.049), respectively. Changes in levels of leucine and isoleucine after treatment were related negatively to changes in fasting plasma glucose and glycosylated haemoglobin values only in the conservative group (P < 0.05). In summary, we found that the treatment with CPAP for 12 weeks caused similar changes in circulating BCAAs concentrations to conservative treatment and a differential metabolic response of CPAP and conservative treatment was observed between the relationship of BCAAs and glucose homeostasis. Additional studies are needed to determine the interplay between branched-chain amino acids and glucose metabolism in patients with sleep apnea.
Collapse
Affiliation(s)
- Antonia Barceló
- Servei Análisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain
| | - Daniel Morell-Garcia
- Servei Análisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain.,Institut d'Investigació Sanitària de Palma (IdISPa), Palma de Mallorca, Spain
| | - Neus Salord
- CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Sleep Unit. Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), Respiratory Medicine Section, Hospitalet de Llobregat, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Esquinas
- Department of Respiratory Medicine, Hospital Universitari Vall d'Hebrón, Barcelona, Spain
| | - Gerardo Pérez
- Servei Análisis Clíniques, Hospital Universitari Son Espases, Palma de Mallorca, Spain
| | - Antonio Pérez
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.,CIBER de Diabetes y Enfermedades Metabólicas (CIBERDEM), Spain
| | - Carmen Monasterio
- CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Sleep Unit. Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), Respiratory Medicine Section, Hospitalet de Llobregat, Spain
| | - Merce Gasa
- Sleep Unit. Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.,Bellvitge Biomedical Research Institute (IDIBELL), Respiratory Medicine Section, Hospitalet de Llobregat, Spain
| | - Ana Maria Fortuna
- CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sleep Unit, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Josep Maria Montserrat
- CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Sleep Unit, Department of Respiratory Medicine, Hospital Clínic de Barcelona, Barcelona, Spain
| | - Mercedes Mayos
- CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sleep Unit, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| |
Collapse
|
15
|
Fijalkowski I, Geets E, Steenackers E, Van Hoof V, Ramos FJ, Mortier G, Fortuna AM, Van Hul W, Boudin E. A Novel Domain-Specific Mutation in a Sclerosteosis Patient Suggests a Role of LRP4 as an Anchor for Sclerostin in Human Bone. J Bone Miner Res 2016; 31:874-81. [PMID: 26751728 DOI: 10.1002/jbmr.2782] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 01/04/2016] [Accepted: 01/07/2016] [Indexed: 12/22/2022]
Abstract
Mutations in the LRP4 gene, coding for a Wnt signaling coreceptor, have been found to cause several allelic conditions. Among these, two are characterized by a strong skeletal involvement, namely sclerosteosis and Cenani-Lenz syndrome. In this work, we evaluated the role of LRP4 in the pathophysiology of these diseases. First, we report a novel LRP4 mutation, leading to the substitution of arginine at position 1170 in glutamine, identified in a patient with sclerosteosis. This mutation is located in the central cavity of the third β-propeller domain, which is in line with two other sclerosteosis mutations we previously described. Reporter assays demonstrate that this mutation leads to impaired sclerostin inhibition of Wnt signaling. Moreover, we compared the effect of this novel variant to mutations causing Cenani-Lenz syndrome and show that impaired membrane trafficking of the LRP4 protein is the likely mechanism underlying Cenani-Lenz syndrome. This is in contrast to sclerosteosis mutations, previously shown to impair the binding between LRP4 and sclerostin. In addition, to better understand the biology of LRP4, we investigated the circulating sclerostin levels in the serum of a patient suffering from sclerosteosis owing to a LRP4 mutation. We demonstrate that impaired sclerostin binding to the mutated LRP4 protein leads to dramatic increase in circulating sclerostin in this patient. With this study, we provide the first evidence suggesting that LRP4 is responsible for the retention of sclerostin in the bone environment in humans. These findings raise potential concerns about the utility of determining circulating sclerostin levels as a marker for other bone-related parameters. Although more studies are needed to fully understand the mechanism whereby LRP4 facilitates sclerostin action, it is clear that this protein represents a potent target for future osteoporosis therapies and an interesting alternative for the antisclerostin treatment currently under study.
Collapse
Affiliation(s)
- Igor Fijalkowski
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Ellen Geets
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Ellen Steenackers
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Viviane Van Hoof
- Department of Clinical Chemistry, Antwerp University Hospital, Antwerp, Belgium
| | - Feliciano J Ramos
- Unidad de Genética, Servicio de Pediatria, Hospital Clinico Universitario "Lozano Blesa", GCV-CIBERER, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain
| | - Geert Mortier
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Ana Maria Fortuna
- Centro de Genética Médica, Centro Hospitalar do Porto, and Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP,, Porto, Portugal
| | - Wim Van Hul
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | - Eveline Boudin
- Department of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| |
Collapse
|
16
|
Salord N, Fortuna AM, Monasterio C, Gasa M, Pérez A, Bonsignore MR, Vilarrasa N, Montserrat JM, Mayos M. A Randomized Controlled Trial of Continuous Positive Airway Pressure on Glucose Tolerance in Obese Patients with Obstructive Sleep Apnea. Sleep 2016; 39:35-41. [PMID: 26350474 DOI: 10.5665/sleep.5312] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 07/18/2015] [Indexed: 12/21/2022] Open
Abstract
STUDY OBJECTIVES Obstructive sleep apnea (OSA) is associated with an increased prevalence of metabolic syndrome (MetS), even in patients with morbid obesity. Our goal was to address whether continuous positive airway pressure (CPAP) treatment improved glucose metabolism in this population. METHODS A prospective randomized controlled trial was performed in severe OSA patients with morbid obesity without diabetes in two university referral hospitals. Patients received conservative (CT) versus CPAP treatment for 12 weeks. MetS components, homeostasis model assessment of insulin resistance (HOMA-IR) and oral glucose tolerance were assessed at baseline and after treatment. RESULTS A total of 80 patients completed the study (42 CPAP and 38 CT patients). After 12 w of CPAP treatment, weight loss was similar in both groups and physical activity, prevalence of MetS, and HOMA-IR did not change in either group. In the CPAP group impaired glucose tolerance (IGT) reversed in nine patients and IGT developed in none, whereas IGT reversed in five patients and IGT developed in five patients in the CT group (P = 0.039 in the Fisher test). Changes in 2-h plasma glucose after glucose load were greater in the CPAP group than in the CT group (CPAP: -0.5 ± 1.5 versus CT: 0.33 ± 1.9, P = 0.007). CONCLUSIONS The improvement of glucose tolerance in morbidly obese patients with severe obstructive sleep apnea, without changes in homeostasis model assessment of insulin resistance, supports an improvement in peripheral insulin resistance after continuous positive airway pressure treatment. CLINICAL TRIALS REGISTRATION NCT 01029561.
Collapse
Affiliation(s)
- Neus Salord
- Sleep Unit, Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.,Bellvitge Biomedical Research Institute (IDIBELL). Area: Inflammatory, Chronic and Degenerative Diseases. Section: Respiratory Medicine. Hospitalet de Llobregat, Spain.,Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain
| | - Ana Maria Fortuna
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Sleep Unit, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Carmen Monasterio
- Sleep Unit, Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.,Bellvitge Biomedical Research Institute (IDIBELL). Area: Inflammatory, Chronic and Degenerative Diseases. Section: Respiratory Medicine. Hospitalet de Llobregat, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain
| | - Mercè Gasa
- Sleep Unit, Department of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.,Bellvitge Biomedical Research Institute (IDIBELL). Area: Inflammatory, Chronic and Degenerative Diseases. Section: Respiratory Medicine. Hospitalet de Llobregat, Spain
| | - Antonio Pérez
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Endocrinology and Nutrition, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER de diabetes y Enfermedades Metabólicas (CIBERDEM), Spain
| | - Maria R Bonsignore
- Biomedical Department of Internal and Specialistic Medicine (DIBIMIS), University of Palermo, Italy
| | - Núria Vilarrasa
- CIBER de diabetes y Enfermedades Metabólicas (CIBERDEM), Spain.,Department of Endocrinology and Nutrition, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain
| | - Josep Maria Montserrat
- CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Sleep Unit. Department of Respiratory Medicine, Hospital Clinic de Barcelona, Barcelona, Spain
| | - Mercedes Mayos
- Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,CIBER Enfermedades Respiratorias (CibeRes) (CB06/06), Spain.,Sleep Unit, Department of Respiratory Medicine, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| |
Collapse
|
17
|
Koolen DA, Pfundt R, Linda K, Beunders G, Veenstra-Knol HE, Conta JH, Fortuna AM, Gillessen-Kaesbach G, Dugan S, Halbach S, Abdul-Rahman OA, Winesett HM, Chung WK, Dalton M, Dimova PS, Mattina T, Prescott K, Zhang HZ, Saal HM, Hehir-Kwa JY, Willemsen MH, Ockeloen CW, Jongmans MC, Van der Aa N, Failla P, Barone C, Avola E, Brooks AS, Kant SG, Gerkes EH, Firth HV, Õunap K, Bird LM, Masser-Frye D, Friedman JR, Sokunbi MA, Dixit A, Splitt M, Kukolich MK, McGaughran J, Coe BP, Flórez J, Nadif Kasri N, Brunner HG, Thompson EM, Gecz J, Romano C, Eichler EE, de Vries BBA. The Koolen-de Vries syndrome: a phenotypic comparison of patients with a 17q21.31 microdeletion versus a KANSL1 sequence variant. Eur J Hum Genet 2015; 24:652-9. [PMID: 26306646 DOI: 10.1038/ejhg.2015.178] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/21/2015] [Accepted: 06/24/2015] [Indexed: 12/16/2022] Open
Abstract
The Koolen-de Vries syndrome (KdVS; OMIM #610443), also known as the 17q21.31 microdeletion syndrome, is a clinically heterogeneous disorder characterised by (neonatal) hypotonia, developmental delay, moderate intellectual disability, and characteristic facial dysmorphism. Expressive language development is particularly impaired compared with receptive language or motor skills. Other frequently reported features include social and friendly behaviour, epilepsy, musculoskeletal anomalies, congenital heart defects, urogenital malformations, and ectodermal anomalies. The syndrome is caused by a truncating variant in the KAT8 regulatory NSL complex unit 1 (KANSL1) gene or by a 17q21.31 microdeletion encompassing KANSL1. Herein we describe a novel cohort of 45 individuals with KdVS of whom 33 have a 17q21.31 microdeletion and 12 a single-nucleotide variant (SNV) in KANSL1 (19 males, 26 females; age range 7 months to 50 years). We provide guidance about the potential pitfalls in the laboratory testing and emphasise the challenges of KANSL1 variant calling and DNA copy number analysis in the complex 17q21.31 region. Moreover, we present detailed phenotypic information, including neuropsychological features, that contribute to the broad phenotypic spectrum of the syndrome. Comparison of the phenotype of both the microdeletion and SNV patients does not show differences of clinical importance, stressing that haploinsufficiency of KANSL1 is sufficient to cause the full KdVS phenotype.
Collapse
Affiliation(s)
- David A Koolen
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Rolph Pfundt
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Katrin Linda
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Gea Beunders
- Department of Clinical Genetics, VU University Medical Center, Amsterdam, The Netherlands
| | - Hermine E Veenstra-Knol
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jessie H Conta
- Department of Laboratories, Seattle Children's Hospital, Seattle, WA, USA
| | - Ana Maria Fortuna
- Unidade de Genética Médica, Centro de Genética Médica Dr Jacinto Magalhães, Centro Hospitalar do Porto, Porto, Portugal
| | | | - Sarah Dugan
- Genetics Department, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, USA
| | - Sara Halbach
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Omar A Abdul-Rahman
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, USA
| | | | - Wendy K Chung
- Department of Pediatrics and Medicine, Columbia University, New York, NY, USA
| | | | - Petia S Dimova
- Epilepsy Center, St Ivan Rilski University Hospital, Sofia, Bulgaria
| | - Teresa Mattina
- Department of Pediatrics, Medical Genetics University of Catania, Catania, Italy
| | - Katrina Prescott
- Clinical Genetics, Yorkshire Regional Genetics Service, Leeds, UK
| | - Hui Z Zhang
- Department of genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Howard M Saal
- Division of Human Genetics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jayne Y Hehir-Kwa
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolein H Willemsen
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Charlotte W Ockeloen
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marjolijn C Jongmans
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Pinella Failla
- Pediatrics and Medical Genetics, I.R.C.C.S. Associazione Oasi Maria Santissima, Troina, Italy
| | - Concetta Barone
- Pediatrics and Medical Genetics, I.R.C.C.S. Associazione Oasi Maria Santissima, Troina, Italy
| | - Emanuela Avola
- Pediatrics and Medical Genetics, I.R.C.C.S. Associazione Oasi Maria Santissima, Troina, Italy
| | - Alice S Brooks
- Department of Clinical Genetics, Erasmus MC, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Sarina G Kant
- Department of Clinical Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Erica H Gerkes
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Helen V Firth
- Department of Medical Genetics, Cambridge University Addenbrooke's Hospital, Cambridge, UK
| | - Katrin Õunap
- Department of Genetics, United Laboratories, Tartu University Hospital, Tartu, Estonia
| | - Lynne M Bird
- Departments of Neurosciences and Pediatrics, University of California San Diego, and Divisions of Neurology and Genetics, Rady Children's Hospital San Diego, San Diego, CA, USA
| | - Diane Masser-Frye
- Departments of Neurosciences and Pediatrics, University of California San Diego, and Divisions of Neurology and Genetics, Rady Children's Hospital San Diego, San Diego, CA, USA
| | - Jennifer R Friedman
- Departments of Neurosciences and Pediatrics, University of California San Diego, and Divisions of Neurology and Genetics, Rady Children's Hospital San Diego, San Diego, CA, USA
| | | | - Abhijit Dixit
- Clinical Genetics, Nottingham City Hospital, Nottingham, UK
| | - Miranda Splitt
- Northern Genetic Service, Institute of Genetic Medicine, Newcastle upon Tyne, UK
| | | | - Mary K Kukolich
- Clinical Genetics, Cook Children's Hospital, Fort Worth, TX, USA
| | - Julie McGaughran
- Genetic Health Queensland, Royal Brisbane and Women's Hospital and School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Bradley P Coe
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA
| | - Jesús Flórez
- Department of Physiology and Pharmacology, University of Cantabria, Cantabria, Spain
| | - Nael Nadif Kasri
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Han G Brunner
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of Clinical Genetics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Elizabeth M Thompson
- South Australian Clinical Genetics Service, Women's and Children's Hospital; and Department of Paediatrics, University of Adelaide, Adelaide, South Australia, Australia
| | - Jozef Gecz
- School of Paediatrics and Reproductive Health and Robinson Research Institute, The University of Adelaide at the Women's and Children's Hospital, North Adelaide, South Australia, Australia
| | - Corrado Romano
- Pediatrics and Medical Genetics, I.R.C.C.S. Associazione Oasi Maria Santissima, Troina, Italy
| | - Evan E Eichler
- Department of Genome Sciences, University of Washington School of Medicine, Seattle, WA, USA.,Howard Hughes Medical Institute, University of Washington, Seattle, WA, USA
| | - Bert B A de Vries
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
18
|
Sá MJN, Rocha JC, Almeida MF, Carmona C, Martins E, Miranda V, Coutinho M, Ferreira R, Pacheco S, Laranjeira F, Ribeiro I, Fortuna AM, Lacerda L. Infantile Refsum Disease: Influence of Dietary Treatment on Plasma Phytanic Acid Levels. JIMD Rep 2015; 26:53-60. [PMID: 26303611 DOI: 10.1007/8904_2015_487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Revised: 07/08/2015] [Accepted: 07/22/2015] [Indexed: 04/04/2023] Open
Abstract
Infantile Refsum disease (IRD) is one of the less severe of Zellweger spectrum disorders (ZSDs), a group of peroxisomal biogenesis disorders resulting from a generalized peroxisomal function impairment. Increased plasma levels of very long chain fatty acids (VLCFA) and phytanic acid are biomarkers used in IRD diagnosis. Furthermore, an increased plasma level of phytanic acid is known to be associated with neurologic damage. Treatment of IRD is symptomatic and multidisciplinary.The authors report a 3-year-old child, born from consanguineous parents, who presented with developmental delay, retinitis pigmentosa, sensorineural deafness and craniofacial dysmorphisms. While the relative level of plasma C26:0 was slightly increased, other VLCFA were normal. Thus, a detailed characterization of the phenotype was essential to point to a ZSD. Repeatedly increased levels of plasma VLCFA, along with phytanic acid and pristanic acid, deficient dihydroxyacetone phosphate acyltransferase activity in fibroblasts and identification of the homozygous pathogenic mutation c.2528G>A (p.Gly843Asp) in the PEX1 gene, confirmed this diagnosis. Nutritional advice and follow-up was proposed aiming phytanic acid dietary intake reduction. During dietary treatment, plasma levels of phytanic acid decreased to normal, and the patient's development evaluation showed slow progressive acquisition of new competences.This case report highlights the relevance of considering a ZSD in any child with developmental delay who manifests hearing and visual impairment and of performing a systematic biochemical investigation, when plasma VLCFA are mildly increased. During dietary intervention, a biochemical improvement was observed, and the long-term clinical effect of this approach needs to be evaluated.
Collapse
Affiliation(s)
- Maria João Nabais Sá
- Department of Medical Genetics, Centro de Genética Médica Dr. Jacinto de Magalhães/Centro Hospitalar do Porto, Porto, Portugal.
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar/Universidade do Porto, Porto, Portugal.
| | - Júlio C Rocha
- Centro de Genética Médica Doutor Jacinto de Magalhães, CHP EPE, Porto, Portugal
- Faculdade de Ciências da Saúde, Universidade Fernando Pessoa, Porto, Portugal
- Center for Health Technology and Services Research (CINTESIS), Porto, Portugal
| | - Manuela F Almeida
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar/Universidade do Porto, Porto, Portugal
- Centro de Genética Médica Doutor Jacinto de Magalhães, CHP EPE, Porto, Portugal
| | - Carla Carmona
- Department of Medical Genetics, Centro de Genética Médica Dr. Jacinto de Magalhães/Centro Hospitalar do Porto, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar/Universidade do Porto, Porto, Portugal
| | - Esmeralda Martins
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar/Universidade do Porto, Porto, Portugal
- Metabolic Disorders Consultation/Department of Pediatrics, Hospital de Santo António/Centro Hospitalar do Porto, Porto, Portugal
| | - Vasco Miranda
- Department of Ophthalmology, Hospital de Santo António/Centro Hospitalar do Porto, Porto, Portugal
| | - Miguel Coutinho
- Department of ENT, Hospital de Santo António/Centro Hospitalar do Porto, Porto, Portugal
| | - Rita Ferreira
- Unit of Biochemical Genetics, Centro de Genética Médica Dr. Jacinto de Magalhães/Centro Hospitalar do Porto, Porto, Portugal
| | - Sara Pacheco
- Unit of Biochemical Genetics, Centro de Genética Médica Dr. Jacinto de Magalhães/Centro Hospitalar do Porto, Porto, Portugal
| | - Francisco Laranjeira
- Unit of Biochemical Genetics, Centro de Genética Médica Dr. Jacinto de Magalhães/Centro Hospitalar do Porto, Porto, Portugal
| | - Isaura Ribeiro
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar/Universidade do Porto, Porto, Portugal
- Unit of Biochemical Genetics, Centro de Genética Médica Dr. Jacinto de Magalhães/Centro Hospitalar do Porto, Porto, Portugal
| | - Ana Maria Fortuna
- Department of Medical Genetics, Centro de Genética Médica Dr. Jacinto de Magalhães/Centro Hospitalar do Porto, Porto, Portugal
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar/Universidade do Porto, Porto, Portugal
| | - Lúcia Lacerda
- Unit for Multidisciplinary Research in Biomedicine, Instituto de Ciências Biomédicas Abel Salazar/Universidade do Porto, Porto, Portugal
- Unit of Biochemical Genetics, Centro de Genética Médica Dr. Jacinto de Magalhães/Centro Hospitalar do Porto, Porto, Portugal
| |
Collapse
|
19
|
Marques I, Sá MJ, Soares G, Mota MDC, Pinheiro C, Aguiar L, Amado M, Soares C, Calado A, Dias P, Sousa AB, Fortuna AM, Santos R, Howell KB, Ryan MM, Leventer RJ, Sachdev R, Catford R, Friend K, Mattiske TR, Shoubridge C, Jorge P. Unraveling the pathogenesis of ARX polyalanine tract variants using a clinical and molecular interfacing approach. Mol Genet Genomic Med 2015; 3:203-14. [PMID: 26029707 PMCID: PMC4444162 DOI: 10.1002/mgg3.133] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Revised: 01/13/2015] [Accepted: 01/15/2015] [Indexed: 12/22/2022] Open
Abstract
The Aristaless-related homeobox (ARX) gene is implicated in intellectual disability with the most frequent pathogenic mutations leading to expansions of the first two polyalanine tracts. Here, we describe analysis of the ARX gene outlining the approaches in the Australian and Portuguese setting, using an integrated clinical and molecular strategy. We report variants in the ARX gene detected in 19 patients belonging to 17 families. Seven pathogenic variants, being expansion mutations in both polyalanine tract 1 and tract 2, were identifyed, including a novel mutation in polyalanine tract 1 that expands the first tract to 20 alanines. This precise number of alanines is sufficient to cause pathogenicity when expanded in polyalanine tract 2. Five cases presented a probably non-pathogenic variant, including the novel HGVS: c.441_455del, classified as unlikely disease causing, consistent with reports that suggest that in frame deletions in polyalanine stretches of ARX rarely cause intellectual disability. In addition, we identified five cases with a variant of unclear pathogenic significance. Owing to the inconsistent ARX variants description, publications were reviewed and ARX variant classifications were standardized and detailed unambiguously according to recommendations of the Human Genome Variation Society. In the absence of a pathognomonic clinical feature, we propose that molecular analysis of the ARX gene should be included in routine diagnostic practice in individuals with either nonsyndromic or syndromic intellectual disability. A definitive diagnosis of ARX-related disorders is crucial for an adequate clinical follow-up and accurate genetic counseling of at-risk family members.
Collapse
Affiliation(s)
- Isabel Marques
- Unidade de Genética Molecular, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| | - Maria João Sá
- Unidade de Genética Médica, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| | - Gabriela Soares
- Unidade de Genética Médica, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal
| | - Maria do Céu Mota
- Department of Pediatrics, Centro Hospitalar do Porto, EPE Porto, Portugal
| | - Carla Pinheiro
- Department of Pediatrics, Hospital Santa Maria Maior, EPE Barcelos, Portugal
| | - Lisa Aguiar
- Department of Pediatrics, Hospital Distrital de Santarém, EPE Santarém, Portugal
| | - Marta Amado
- Department of Pediatrics, Unidade Hospitalar de Portimão, Centro Hospitalar do Algarve Portimão, Portugal
| | - Christina Soares
- Department of Pediatrics, Unidade Hospitalar de Portimão, Centro Hospitalar do Algarve Portimão, Portugal
| | - Angelina Calado
- Department of Pediatrics, Unidade Hospitalar de Portimão, Centro Hospitalar do Algarve Portimão, Portugal
| | - Patrícia Dias
- Department of Genetics, Hospital de Santa Maria Lisboa, Portugal
| | - Ana Berta Sousa
- Department of Genetics, Hospital de Santa Maria Lisboa, Portugal
| | - Ana Maria Fortuna
- Unidade de Genética Médica, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| | - Rosário Santos
- Unidade de Genética Molecular, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| | - Katherine B Howell
- Department of Neurology, Royal Children's Hospital Melbourne, Victoria, Australia ; Murdoch Childrens Research Institute Melbourne, Victoria, Australia, 3052 ; University of Melbourne Department of Paediatrics Melbourne, Victoria, Australia, 3052
| | - Monique M Ryan
- Department of Neurology, Royal Children's Hospital Melbourne, Victoria, Australia ; Murdoch Childrens Research Institute Melbourne, Victoria, Australia, 3052 ; University of Melbourne Department of Paediatrics Melbourne, Victoria, Australia, 3052
| | - Richard J Leventer
- Department of Neurology, Royal Children's Hospital Melbourne, Victoria, Australia ; Murdoch Childrens Research Institute Melbourne, Victoria, Australia, 3052 ; University of Melbourne Department of Paediatrics Melbourne, Victoria, Australia, 3052
| | - Rani Sachdev
- Department of Medical Genetics, Sydney Children's Hospital High St., Randwick, New South Wales, 2031, Australia
| | - Rachael Catford
- SA Pathology at the Women's and Children's Hospital North Adelaide, South Australia, Australia
| | - Kathryn Friend
- SA Pathology at the Women's and Children's Hospital North Adelaide, South Australia, Australia
| | - Tessa R Mattiske
- Department of Paediatrics, University of Adelaide Adelaide, South Australia, 5006, Australia ; Robinson Research Institute, University of Adelaide Adelaide, South Australia, 5006, Australia
| | - Cheryl Shoubridge
- Department of Paediatrics, University of Adelaide Adelaide, South Australia, 5006, Australia ; Robinson Research Institute, University of Adelaide Adelaide, South Australia, 5006, Australia
| | - Paula Jorge
- Unidade de Genética Molecular, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, EPE Porto, Portugal ; Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP Porto, Portugal
| |
Collapse
|
20
|
Jorge P, Mota-Freitas MM, Santos R, Silva ML, Soares G, Fortuna AM. A 26-Year Experience in Chorionic Villus Sampling Prenatal Genetic Diagnosis. J Clin Med 2014; 3:838-48. [PMID: 26237480 PMCID: PMC4449647 DOI: 10.3390/jcm3030838] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2014] [Revised: 06/20/2014] [Accepted: 06/23/2014] [Indexed: 12/04/2022] Open
Abstract
This report describes the trends of chorionic villus sampling (CVS) referred for prenatal genetic diagnosis in the past two and a half decades in a Portuguese Center. Our cohort of 491 CVS was mostly performed by the transcervical method at the 12th gestational week. Data collected within the framework of this study relate to the following: sampling method, referral reason versus abnormality and incidence of procedure-related pregnancy loss, that declined to about 0.5% over the last 15 years. The year 2000 represented a change in referral reasons for chorionic tissue collection, shifting from almost exclusively for cytogenetic testing to an increasing number of molecular tests for monogenic disorders. Herein, success rates as well as cytogenetic and/or molecular DNA results are presented. These latter include not only tests for several monogenic disorders, but also aneuploidy and maternal cell contamination screening. This retrospective analysis reiterates that CVS is a safe and reliable first trimester technique for prenatal diagnosis in high genetic risk pregnancies.
Collapse
Affiliation(s)
- Paula Jorge
- Center of Medical Genetics Doutor Jacinto Magalhães, Oporto Hospital Center, C.H.P., EPE, Praça Pedro Nunes, 88, 4099-028 Porto, Portugal.
- Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - Maria Manuela Mota-Freitas
- Center of Medical Genetics Doutor Jacinto Magalhães, Oporto Hospital Center, C.H.P., EPE, Praça Pedro Nunes, 88, 4099-028 Porto, Portugal.
- Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - Rosário Santos
- Center of Medical Genetics Doutor Jacinto Magalhães, Oporto Hospital Center, C.H.P., EPE, Praça Pedro Nunes, 88, 4099-028 Porto, Portugal.
- Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| | - Maria Luz Silva
- Center of Medical Genetics Doutor Jacinto Magalhães, Oporto Hospital Center, C.H.P., EPE, Praça Pedro Nunes, 88, 4099-028 Porto, Portugal.
| | - Gabriela Soares
- Center of Medical Genetics Doutor Jacinto Magalhães, Oporto Hospital Center, C.H.P., EPE, Praça Pedro Nunes, 88, 4099-028 Porto, Portugal.
| | - Ana Maria Fortuna
- Center of Medical Genetics Doutor Jacinto Magalhães, Oporto Hospital Center, C.H.P., EPE, Praça Pedro Nunes, 88, 4099-028 Porto, Portugal.
- Unit for Multidisciplinary Research in Biomedicine, UMIB, ICBAS-UP, Rua Jorge Viterbo Ferreira 228, 4050-313 Porto, Portugal.
| |
Collapse
|
21
|
Gasa M, Salord N, Fortuna AM, Mayos M, Vilarrasa N, Dorca J, Montserrat JM, Bonsignore MR, Monasterio C. Obstructive sleep apnoea and metabolic impairment in severe obesity. Eur Respir J 2011; 38:1089-97. [PMID: 21622590 DOI: 10.1183/09031936.00198810] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Obstructive sleep apnoea (OSA) seems to worsen metabolism. This effect has not been evaluated in morbid obesity (MO). We hypothesised that the metabolic profile is more impaired in MO patients with OSA than in those without, and investigated whether any specific metabolic dysfunction is related to OSA in MO. A prospective multicentre cross-sectional study was conducted in consecutive subjects before bariatric surgery. OSA was defined as apnoea/hypopnoea index (AHI) ≥15 by overnight polysomnography. Anthropometrical, blood pressure (BP) and fasting blood measurements were obtained the morning after. Metabolic syndrome (MetS) was defined according to National Cholesterol Education Program Adult Treatment Panel III modified criteria. 159 patients were studied: 72% were female and 72% had OSA. MetS prevalence was 70% in OSA versus 36% in non-OSA (p<0.001). As AHI severity increased, metabolic parameters progressively worsened, even in those without type 2 diabetes (DM2). AHI was independently associated with systolic and diastolic BP, triglycerides and the percentage of glycosylated haemoglobin (HbA1c) in the total sample, and with systolic BP, high-density lipoprotein cholesterol and HbA1c in those samples without DM2. OSA increased the adjusted odds ratio of having MetS by 2.8 (95% CI 1.3-6.2; p=0.009). In MO, OSA is associated with major metabolic impairment caused by higher BP and poorer lipid and glucose control, independent of central obesity or DM2.
Collapse
Affiliation(s)
- M Gasa
- Sleep Unit, Dept of Respiratory Medicine, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain.
| | | | | | | | | | | | | | | | | |
Collapse
|
22
|
Barbosa M, Lopes A, Mota C, Martins E, Oliveira J, Alves S, De Bonis P, do Céu Mota M, Dias C, Rodrigues-Santos P, Fortuna AM, Quelhas D, Lacerda L, Bisceglia L, Cardoso ML. Clinical, biochemical and molecular characterization of Cystinuria in a cohort of 12 patients. Clin Genet 2011; 81:47-55. [DOI: 10.1111/j.1399-0004.2011.01638.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
23
|
Barbosa M, Sousa AB, Medeira A, Lourenço T, Saraiva J, Pinto-Basto J, Soares G, Fortuna AM, Superti-Furga A, Mittaz L, Reis-Lima M, Bonafé L. Clinical and molecular characterization of Diastrophic Dysplasia in the Portuguese population. Clin Genet 2010; 80:550-7. [PMID: 21155763 DOI: 10.1111/j.1399-0004.2010.01595.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
SLC26A2-related dysplasias encompass a spectrum of diseases: from lethal achondrogenesis type 1B (ACG1B; MIM #600972) and atelosteogenesis type 2 (AO2; MIM #256050) to classical diastrophic dysplasia (cDTD; MIM #222600) and recessive multiple epiphyseal dysplasia (rMED; MIM #226900). This study aimed at characterizing clinically, radiologically and molecularly 14 patients affected by non-lethal SLC26A2-related dysplasias and at evaluating genotype-phenotype correlation. Phenotypically, eight patients were classified as cDTD, four patients as rMED and two patients had an intermediate phenotype (mild DTD - mDTD, previously 'DTD variant'). The Arg279Trp mutation was present in all patients, either in homozygosity (resulting in rMED) or in compound heterozygosity with the known severe alleles Arg178Ter or Asn425Asp (resulting in DTD) or with the mutation c.727-1G>C (causing mDTD). The 'Finnish mutation', c.-26+2T>C, and the p.Cys653Ser, both frequent mutations in non-Portuguese populations, were not identified in any of the patients of our cohort and are probably very rare in the Portuguese population. A targeted mutation analysis for p.Arg279Trp and p.Arg178Ter in the Portuguese population allows the identification of approximately 90% of the pathogenic alleles.
Collapse
Affiliation(s)
- M Barbosa
- Unidade de Genética Médica, Centro de Genética Médica Dr. Jacinto Magalhães, Instituto Nacional de Saúde Dr. Ricardo Jorge, Porto, Portugal.
| | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Vos YJ, de Walle HEK, Bos KK, Stegeman JA, Ten Berge AM, Bruining M, van Maarle MC, Elting MW, den Hollander NS, Hamel B, Fortuna AM, Sunde LEM, Stolte-Dijkstra I, Schrander-Stumpel CTRM, Hofstra RMW. Genotype-phenotype correlations in L1 syndrome: a guide for genetic counselling and mutation analysis. J Med Genet 2009; 47:169-75. [PMID: 19846429 DOI: 10.1136/jmg.2009.071688] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To develop a comprehensive mutation analysis system with a high rate of detection, to develop a tool to predict the chance of detecting a mutation in the L1CAM gene, and to look for genotype-phenotype correlations in the X-linked recessive disorder, L1 syndrome. METHODS DNA from 367 referred patients was analysed for mutations in the coding sequences of the gene. A subgroup of 100 patients was also investigated for mutations in regulatory sequences and for large duplications. Clinical data for 106 patients were collected and used for statistical analysis. RESULTS 68 different mutations were detected in 73 patients. In patients with three or more clinical characteristics of L1 syndrome, the mutation detection rate was 66% compared with 16% in patients with fewer characteristics. The detection rate was 51% in families with more than one affected relative, and 18% in families with one affected male. A combination of these two factors resulted in an 85% detection rate (OR 10.4, 95% CI 3.6 to 30.1). The type of mutation affects the severity of L1 syndrome. Children with a truncating mutation were more likely to die before the age of 3 than those with a missense mutation (52% vs 8%; p=0.02). CONCLUSIONS We developed a comprehensive mutation detection system with a detection rate of almost 20% in unselected patients and up to 85% in a selected group. Using the patients' clinical characteristics and family history, clinicians can accurately predict the chance of finding a mutation. A genotype-phenotype correlation was confirmed. The occurrence of (maternal) germline mosaicism was proven.
Collapse
Affiliation(s)
- Yvonne J Vos
- Department of Genetics, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ Groningen, The Netherlands.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Fortuna AM, Feixas T, González M, Casan P. Diagnostic utility of inflammatory biomarkers in asthma: exhaled nitric oxide and induced sputum eosinophil count. Respir Med 2007; 101:2416-21. [PMID: 17714927 DOI: 10.1016/j.rmed.2007.05.019] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2007] [Revised: 05/23/2007] [Accepted: 05/29/2007] [Indexed: 10/22/2022]
Abstract
BACKGROUND Even though an inflammatory process is known to be the underlying cause of asthma, diagnosis is based on clinical history, reversible airway obstruction and bronchial hyperresponsiveness according to international guidelines. The fraction of exhaled nitric oxide (FE(NO)) and induced sputum eosinophil count (Eos%) have been used as non-invasive inflammatory biomarkers. OBJECTIVES The aim of this study was to compare the sensitivity and specificity of FE(NO), Eos% and spirometry and to assess whether their combined use in clinical practice would improve diagnostic yield. METHODS In 50 patients with asthma symptoms we performed spirometry, a methacholine challenge test, FE(NO) measurement and assessment of Eos% in induced sputum. The standard diagnosis of asthma followed the guidelines of the Global Initiative for Asthma. RESULTS Twenty-two of the 50 patients were diagnosed with asthma. The sensitivity and diagnostic accuracy were higher for FE(NO) measurement (77%; area under the receiver operating curve [AUC], 0.8) than for spirometry (22%; AUC, 0.63). The sensitivity and specificity of Eos% in induced sputum were 40% and 82%, respectively, and the diagnostic accuracy of Eos% was lower (AUC, 0.58). When both inflammatory biomarkers were used together specificity increased to 76%. CONCLUSIONS The diagnostic accuracy of FE(NO) measurement was superior to that of the standard diagnostic spirometry in patients with symptoms suggestive of asthma. The use of FE(NO) measurement and induced sputum Eos% together to diagnose asthma in clinical practice is more accurate than spirometry or FE(NO) assessment alone and easier to perform.
Collapse
Affiliation(s)
- Ana Maria Fortuna
- Department of Pulmonary Function, Hospital de la Santa Creu i Sant Pau, Sant Antoni Maria Claret, 167, Barcelona 08025, Spain.
| | | | | | | |
Collapse
|
26
|
Oldridge M, Fortuna AM, Maringa M, Propping P, Mansour S, Pollitt C, DeChiara TM, Kimble RB, Valenzuela DM, Yancopoulos GD, Wilkie AO. Dominant mutations in ROR2, encoding an orphan receptor tyrosine kinase, cause brachydactyly type B. Nat Genet 2000; 24:275-8. [PMID: 10700182 DOI: 10.1038/73495] [Citation(s) in RCA: 169] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Inherited limb malformations provide a valuable resource for the identification of genes involved in limb development. Brachydactyly type B (BDB), an autosomal dominant disorder, is the most severe of the brachydactylies and characterized by terminal deficiency of the fingers and toes. In the typical form of BDB, the thumbs and big toes are spared, sometimes with broadening or partial duplication. The BDB1 locus was previously mapped to chromosome 9q22 within an interval of 7.5 cM (refs 9,10). Here we describe mutations in ROR2, which encodes the orphan receptor tyrosine kinase ROR2 (ref. 11), in three unrelated families with BDB1. We identified distinct heterozygous mutations (2 nonsense, 1 frameshift) within a 7-amino-acid segment of the 943-amino-acid protein, all of which predict truncation of the intracellular portion of the protein immediately after the tyrosine kinase domain. The localized nature of these mutations suggests that they confer a specific gain of function. We obtained further evidence for this by demonstrating that two patients heterozygous for 9q22 deletions including ROR2 do not exhibit BDB. Expression of the mouse mouse orthologue, Ror2, early in limb development indicates that BDB arises as a primary defect of skeletal patterning.
Collapse
Affiliation(s)
- M Oldridge
- Institute of Molecular Medicine, John Radcliffe Hospital, Oxford, UK
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Sequeiros J, Maciel P, Taborda F, Lêdo S, Rocha JC, Lopes A, Reto F, Fortuna AM, Rousseau M, Fleming M, Coutinho P, Rouleau GA, Jorge CS. Prenatal diagnosis of Machado–Joseph disease by direct mutation analysis. Prenat Diagn 1998. [DOI: 10.1002/(sici)1097-0223(199806)18:6<611::aid-pd289>3.0.co;2-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
|
28
|
Sequeiros J, Maciel P, Taborda F, Lêdo S, Rocha JC, Lopes A, Reto F, Fortuna AM, Rousseau M, Fleming M, Coutinho P, Rouleau GA, Jorge CS. Prenatal diagnosis of Machado-Joseph disease by direct mutation analysis. Prenat Diagn 1998; 18:611-7. [PMID: 9664608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
MJD is the most frequent dominant ataxia and an incapacitating disorder. Onset is most frequently during the reproductive years, and genetic counseling is its only means of prevention. The causative mutation--an expansion of a (CAG)n on chromosome 14q32.1--can now be directly detected. We now report the first two cases of prenatal diagnosis (PND). The first presented as a simultaneous request for predictive testing and PND at 14 weeks of pregnancy. Owing to time constraints, we performed a full protocol of counseling with shorter inter between sessions, while psycho-social evaluation of the other parent obstetric consults were also begun. We ensured that the couple wished termination if the fetus was a carrier, to avoid a presymptomatic test for the unborn child. We were thus able to deliver test results two weeks before PND. As the fetus carried an expanded allele (77 CAGs) inherited from his father, termination was performed and the couple received counselling, psychological and social support. The second case was the fetus of a carrier-mother that was diagnosed as non-carrier, also after amniocentesis.
Collapse
|
29
|
Fortuna AM, Pinheiro D, Príncipe F. [Thrombocytopenia with absence of the radius in a 24-year-old woman]. Sangre (Barc) 1995; 40:223-225. [PMID: 7570276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Thrombocytopenia with absent radius syndrome (TAR) is a rare disorder appearing at birth or soon after. The heredity pattern is autosomal recessive, although some patients in successive generations have been reported. A 24 year-old woman is presented who had moderate thrombocytopenia and shortened forearms due to lack of radius, with preserved thumbs. Her peripheral blood was normal but for a decreased platelet count. The bone marrow megakaryocytes were decreased as well. No other relatives were affected. The association of thrombocytopenia and bilateral radius aplasia, along with the differential diagnosis, are commented, stress being laid on the fact that the patient was diagnosed in adulthood.
Collapse
Affiliation(s)
- A M Fortuna
- Instituto de Genética Médica, Porto, Portugal
| | | | | |
Collapse
|
30
|
Amaral O, Fortuna AM, Lacerda L, Pinto R, Sa Miranda MC. Molecular characterisation of type 1 Gaucher disease families and patients: intrafamilial heterogeneity at the clinical level. J Med Genet 1994; 31:401-4. [PMID: 8064820 PMCID: PMC1049874 DOI: 10.1136/jmg.31.5.401] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Type 1 Gaucher disease families were studied in an attempt to establish a phenotype/genotype correlation in affected persons and also to identify carriers accurately. In the Portuguese type 1 Gaucher patients, screening for mutations N370S, L444P, R463C, and 1066 + 1 G-->A allowed the identification of 85% of the alleles among unrelated patients. A subclinical case with genotype N370S/1066 + 1 G-->A was identified in one family in which there were three other symptomatic sibs. To our knowledge this is the first subclinical case with a genotype other than N370S/N370S. No genotype-phenotype correlation could be established and considerable clinical heterogeneity was found even among sibs with the same genotype. The data collected on the origins of the Gaucher families indicated two areas in northern Portugal where a higher frequency of the disease may be expected to exist.
Collapse
Affiliation(s)
- O Amaral
- Unidade de Enzimologia, Instituto de Genetica Medica Jacinto de Magalhaes, Porto, Portugal
| | | | | | | | | |
Collapse
|