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Zaccheddu E, Zappu A, Barella S, Clemente MG, Orecchia V, Pilia MP, Piras S, Pitturru C, Scarano M, Origa R. Unplanned pregnancy in women with beta-thalassaemia treated with luspatercept. Br J Haematol 2024. [PMID: 38652468 DOI: 10.1111/bjh.19480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/08/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Affiliation(s)
- Eleonora Zaccheddu
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Antonietta Zappu
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Susanna Barella
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | | | - Valeria Orecchia
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Maria Paola Pilia
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Simona Piras
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | - Carla Pitturru
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
| | | | - Raffaella Origa
- SC Microcitemie e Anemie Rare, Ospedale Pediatrico Microcitemico, Cagliari, Italy
- SSD Neonatologia, ARNAS G. Brotzu, Cagliari, Italy
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
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Ponti ML, Comitini F, Murgia D, Ganga R, Canu R, Dessì C, Foschini ML, Leoni G, Morittu M, Perra M, Pilia MP, Casini MR, Zappu A, Origa R. Impact of the direct-acting antiviral agents (DAAs) on chronic hepatitis C in Sardinian patients with transfusion-dependent Thalassemia major. Dig Liver Dis 2019; 51:561-567. [PMID: 30658940 DOI: 10.1016/j.dld.2018.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 08/10/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Direct antiviral agents (DAAs) have revolutionised the standard of care for the treatment of hepatitis even in patients with hemoglobinopathies. The aim of this study is to show how, thanks to DAAs, HCV infection has been substantially eradicated in one of the biggest Centres for the management of Thalassemia in Europe. METHODS Thalassemia major patients regularly transfused and iron chelated in Cagliari (Italy) who were HCV-RNA positive were evaluated for the potential prescription of antiviral therapy. RESULTS A total of 99 patients, 26 of whom had been diagnosed with cirrhosis, were treated with at least one dose of DAAs, which proved to be safe and well tolerated. Two of the patients died during the treatment after becoming HCV-RNA negative while another voluntarily interrupted the therapy. The final SVR in the patients who completed the treatment was 100%, while measuring 97% (96/99) in the Intention-to-Treat analysis. After DAAs, no new cases of hepatocellular carcinoma have been reported. CONCLUSIONS The use of DAAs in patients suffering from beta-Thalassemia major with chronic hepatitis C or cirrhosis can be considered safe and effective. Close monitoring for hepatocellular carcinoma development is, in any case, recommended indefinitely post-SVR.
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Affiliation(s)
| | | | | | | | - Roberto Canu
- Medicine I, 'G.Brotzu' Hospital, Cagliari, Italy
| | - Carlo Dessì
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | | | | | - Maddalena Morittu
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | - Maria Perra
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | - Maria Paola Pilia
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | | | - Antonietta Zappu
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy
| | - Raffaella Origa
- Thalassemia Unit, 'A. Cao' Hospital, A.O. 'G. Brotzu', Cagliari, Italy.
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Floris F, Comitini F, Leoni G, Moi P, Morittu M, Orecchia V, Perra M, Pilia MP, Zappu A, Casini MR, Origa R. Quality of life in Sardinian patients with transfusion-dependent Thalassemia: a cross-sectional study. Qual Life Res 2018; 27:2533-2539. [PMID: 29922915 DOI: 10.1007/s11136-018-1911-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [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] [Accepted: 06/05/2018] [Indexed: 12/31/2022]
Abstract
PURPOSE The aim of this study has been to evaluate the physical, psychological, and social well-being in a large group of Sardinian adult patients with transfusion-dependent beta-Thalassemia when compared with a group of healthy subjects of the same age and geographical extraction. METHODS Male or female patients ≥ 18 years of age with Thalassemia major on regular transfusion at Thalassemia Center in Cagliari (Italy) were requested to complete the World Health Organization Quality of life-BREF (WHOQOL-BREF) questionnaire. The WHOQOL-BREF was also made available online to age- and sex-matched non-thalassemic adult subjects living in Sardinia. RESULTS Two hundred and seven subjects with Thalassemia were invited to participate in the study. The questionnaire was also completed by 211 age- and sex-matched non-thalassemic subjects living in Sardinia. Scores suggestive of a good quality of life were obtained in all the areas investigated. Thalassemia patients had scores at least as good as those of non-thalassemic subjects in all items and the percentage of those with a score ≥ 60 was higher among patients. The analysis of demographic actually highlights that the disease has a little effect on their personal and social lives. There was a positive association between subjective well-being and effective clinical conditions. Moreover, the association between health perception and adherence to treatment suggests that compliance with treatment contributes to the well-being of the patient, both physically and psychologically. CONCLUSIONS Adult subjects with Thalassemia who live in Western countries have a good quality of life in accordance with the advances in the management of the disease.
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Affiliation(s)
| | | | - GiovanBattista Leoni
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Paolo Moi
- University of Cagliari, Cagliari, Italy
| | - Maddalena Morittu
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Valeria Orecchia
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Maria Perra
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Maria Paola Pilia
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Antonietta Zappu
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Maria Rosaria Casini
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy
| | - Raffaella Origa
- Ospedale Pediatrico Microcitemico "A.Cao" - A.O. "G.Brotzu", Via Jenner s.n., 09121, Cagliari, Italy.
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Origa R, Tatti F, Zappu A, Leoni GB, Dessì C, Moi P, Morittu M, Orecchia V, Denotti AR, Pilia MP, Anni F, Perra M, Casini MR, Barella S. Earlier initiation of transfusional and iron chelation therapies in recently born children with transfusion-dependent thalassemia. Am J Hematol 2017; 92:E627-E628. [PMID: 28741691 DOI: 10.1002/ajh.24869] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 07/19/2017] [Accepted: 07/21/2017] [Indexed: 12/21/2022]
Affiliation(s)
- Raffaella Origa
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Federica Tatti
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Antonietta Zappu
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | | | - Carlo Dessì
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Paolo Moi
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Maddalena Morittu
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Valeria Orecchia
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Anna Rita Denotti
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Maria Paola Pilia
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | - Franco Anni
- Department of Medical Sciences and Public Health; University of Cagliari; Cagliari Italy
| | - Maria Perra
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
| | | | - Susanna Barella
- Ospedale Pediatrico Microcitemico “A.Cao”-A.O. G.Brotzu; Cagliari Italy
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Origa R, Anni F, Mereu L, Follesa I, Campus S, Dessì C, Foschini ML, Leoni G, Moi P, Morittu M, Orecchia V, Perra M, Zappu A, Podda RA. Causes of hospital admission in children and adults with transfusion-dependent thalassemia in Sardinia, 2000–2015. Ann Hematol 2017; 96:1041-1042. [DOI: 10.1007/s00277-017-2963-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 02/20/2017] [Indexed: 12/01/2022]
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Origa R, Zappu A, Foschini ML, Leoni G, Morittu M, Moi P, Corpino M, Dessì C. Deferasirox and children: From clinical trials to the real world. Am J Hematol 2016; 91:E304-5. [PMID: 26950047 DOI: 10.1002/ajh.24353] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 03/03/2016] [Indexed: 11/05/2022]
Affiliation(s)
- Raffaella Origa
- Department of Public Health; Clinical and Molecular Medicine, University of Cagliari; Cagliari Italy
| | - Antonietta Zappu
- Ospedale Pediatrico Microcitemico “a.Cao”- a.O. G.Brotzu; Cagliari Italy
| | | | | | - Maddalena Morittu
- Ospedale Pediatrico Microcitemico “a.Cao”- a.O. G.Brotzu; Cagliari Italy
| | - Paolo Moi
- Department of Public Health; Clinical and Molecular Medicine, University of Cagliari; Cagliari Italy
| | - Mara Corpino
- Ospedale Pediatrico Microcitemico “a.Cao”- a.O. G.Brotzu; Cagliari Italy
| | - Carlo Dessì
- Ospedale Pediatrico Microcitemico “a.Cao”- a.O. G.Brotzu; Cagliari Italy
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Dessì C, Leoni G, Moi P, Danjou F, Follesa I, Foschini ML, Morittu M, Zappu A, Defraia E, Bina P, Cunico A, Civolani A, Podda RA, Origa R. Thalassemia major between liver and heart: Where we are now. Blood Cells Mol Dis 2015; 55:82-8. [DOI: 10.1016/j.bcmd.2015.03.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2015] [Accepted: 03/29/2015] [Indexed: 02/08/2023]
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Pinna F, Carta R, Morittu M, Dessì C, Moi P, Leoni G, Foschini ML, Defraia E, Zappu A, Origa R. Thalassemia Major: Who Is Afraid of Serum Ferritin below 500 μg/l? Acta Haematol 2015; 134:183-4. [PMID: 26022742 DOI: 10.1159/000371866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 01/01/2015] [Indexed: 11/19/2022]
Affiliation(s)
- Francesca Pinna
- Ospedale Regionale per le Microcitemie, ASL8, Cagliari, Italy
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Piga A, Longo F, Origa R, Roggero S, Pinna F, Zappu A, Castiglioni C, Cappellini MD. Deferasirox for cardiac siderosis in β-thalassaemia major: a multicentre, open label, prospective study. Br J Haematol 2014; 167:423-6. [DOI: 10.1111/bjh.12987] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Antonio Piga
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Filomena Longo
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Raffaella Origa
- Department of Biomedical Science and Biotechnology; University of Cagliari; Ospedale Regionale Microcitemie; Cagliari Italy
| | - Simona Roggero
- Department of Clinical and Biological Sciences; University of Turin; Turin Italy
| | - Francesca Pinna
- Department of Biomedical Science and Biotechnology; University of Cagliari; Ospedale Regionale Microcitemie; Cagliari Italy
| | - Antonietta Zappu
- Department of Biomedical Science and Biotechnology; University of Cagliari; Ospedale Regionale Microcitemie; Cagliari Italy
| | | | - Maria Domenica Cappellini
- Department of Internal Medicine; IRCCS Ca' Granda Foundation Maggiore Policlinico Hospital; University of Milan; Milan Italy
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Loudianos G, Lepori MB, Mameli E, Dessì V, Zappu A. Wilson's disease. Pril (Makedon Akad Nauk Umet Odd Med Nauki) 2014; 35:93-98. [PMID: 24798599] [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: 06/03/2023]
Abstract
Wilson's disease (WD) is a disorder of copper transport resulting from the defective function of a copper transporting P-type ATPase, ATP7B. The WD incidence is approximately 1/50-10,000 live births worldwide. Clinical manifestations of WD may be of any kind, but usually the symptoms of presentation are hepatic or neuropsychiatric, with a vast range of disturbances for both groups of symptoms. In children, however, clinical symptoms may be absent, making the diagnosis of the disease more difficult than in adults. Hepatic manifestations may range from asymptomatic minor biochemical disturbances, to acute, but mostly chronic, hepatitis, cirrhosis or severe fulminant hepatic failure. The spectrum of neurological manifestations is wide, including tremor, hypersalivation, Dysarthria, coordination defects, dystonia, ataxia. The spectrum of psychiatric manifestations is considerable and may include different disturbances such as altered working performance, anxiety, depression and antisocial behaviour. Kayser-Fleischer rings (KF) are present in 95% of patients with neurological symptoms and somewhat over half of those without neurological symptoms. In children presenting with liver disease, KF rings are usually absent. To obtain a more reliable diagnosis of WD, the Leipzig scoring system was proposed by an international consensus of experts. Wilson's disease copper overload is treated with chelating agents such as penicillamine, trientine and tetrathiomolybdate. Zinc is used mostly for mantainance therapy or the treatment of asymptomatic WD patients.
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Affiliation(s)
| | - Maria Barbara Lepori
- Dipartimento di Sanità publica, medicina clinica e molecolare, Università di Cagliari, Italy
| | - Eva Mameli
- Dipartimento di Sanità publica, medicina clinica e molecolare, Università di Cagliari, Italy
| | - Valentina Dessì
- Dipartimento di Sanità publica, medicina clinica e molecolare, Università di Cagliari, Italy
| | - Antonietta Zappu
- Dipartimento di Sanità publica, medicina clinica e molecolare, Università di Cagliari, Italy
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Gialluisi A, Incollu S, Pippucci T, Lepori MB, Zappu A, Loudianos G, Romeo G. The homozygosity index (HI) approach reveals high allele frequency for Wilson disease in the Sardinian population. Eur J Hum Genet 2013; 21:1308-11. [PMID: 23486543 PMCID: PMC3798848 DOI: 10.1038/ejhg.2013.43] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [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: 09/26/2012] [Revised: 01/13/2013] [Accepted: 02/07/2013] [Indexed: 12/28/2022] Open
Abstract
Wilson disease (WD) is an autosomal recessive disorder resulting in pathological progressive copper accumulation in liver and other tissues. The worldwide prevalence (P) is about 30/million, while in Sardinia it is in the order of 1/10,000. However, all of these estimates are likely to suffer from an underdiagnosis bias. Indeed, a recent molecular neonatal screening in Sardinia reported a WD prevalence of 1:2707. In this study, we used a new approach that makes it possible to estimate the allelic frequency (q) of an autosomal recessive disorder if one knows the proportion between homozygous and compound heterozygous patients (the homozygosity index or HI) and the inbreeding coefficient (F) in a sample of affected individuals. We applied the method to a set of 178 Sardinian individuals (3 of whom born to consanguineous parents), each with a clinical and molecular diagnosis of WD. Taking into account the geographical provenance of the parents of every patient within Sardinia (to make F computation more precise), we obtained a q=0.0191 (F=7.8 × 10(-4), HI=0.476) and a corresponding prevalence P=1:2732. This result confirms that the prevalence of WD is largely underestimated in Sardinia. On the other hand, the general reliability and applicability of the HI approach to other autosomal recessive disorders is confirmed, especially if one is interested in the genetic epidemiology of populations with high frequency of consanguineous marriages.
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Affiliation(s)
- Alessandro Gialluisi
- Unità Operativa di Genetica Medica, Dipartimento di Scienze Mediche e Chirurgiche Policlinico Sant'Orsola-Malpighi, Bologna, Italy
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Simona Incollu
- Dipartimento delle Scienze Biomediche e Biotecnologie, Università di Cagliari, Cagliari, Italy
| | - Tommaso Pippucci
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
| | - Maria Barbara Lepori
- Dipartimento delle Scienze Biomediche e Biotecnologie, Università di Cagliari, Cagliari, Italy
| | - Antonietta Zappu
- Dipartimento delle Scienze Biomediche e Biotecnologie, Università di Cagliari, Cagliari, Italy
| | | | - Giovanni Romeo
- Language and Genetics Department, Max Planck Institute for Psycholinguistics, Nijmegen, The Netherlands
- European Genetics Foundation, Bologna, Italy
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Loudianos G, Zappu A, Lepori MB, Incollu S, Dessì V, Mameli E, Garrucciu G, De Virgiliis S, Cao A. Wilson's disease in two consecutive generations: the detection of three mutated alleles in the ATP7B gene in two Sardinian families. Dig Liver Dis 2013; 45:342-5. [PMID: 23219664 DOI: 10.1016/j.dld.2012.10.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2012] [Revised: 09/28/2012] [Accepted: 10/02/2012] [Indexed: 12/11/2022]
Abstract
BACKGROUND Wilson's disease diagnosis is still a challenge for clinicians. AIM To underline the importance of genetic testing in carrier detection and diagnosis of atypical Wilson's disease cases. METHODS Two families with Wilson's disease in two consecutive generations were analysed with clinical, biochemical and genetic testing. RESULTS In one family with triplet siblings, two of whom monozygotic, molecular screening of ATP7B, the gene responsible for Wilson's disease phenotype, allowed detection of 3 disease alleles, the discrimination between carrier and disease state and the postmortem diagnosis of Wilson's disease in the siblings' father. In the second family, molecular analysis detected 3 disease alleles and confirmed the diagnosis of Wilson's disease in two asymptomatic monozygotic twins. CONCLUSION These results demonstrate that mutational analysis is determinant for carrier identification and diagnosis of atypical Wilson's disease patients.
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Zappu A, Lepori MB, Incollu S, Dessì V, Noli MC, Mameli E, Bonafé L, Garcia Dépraz N, De Virgiliis S, Cao A, Loudianos G. Feasibility of RNA studies on illegitimate transcription for molecular characterization of splicing mutations in the ATP7B gene: A case report. Mol Cell Probes 2012; 26:63-5. [DOI: 10.1016/j.mcp.2011.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 10/06/2011] [Accepted: 10/06/2011] [Indexed: 11/29/2022]
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Lepori MB, Zappu A, Incollu S, Dessì V, Mameli E, Demelia L, Nurchi AM, Gheorghe L, Maggiore G, Sciveres M, Leuzzi V, Indolfi G, Bonafé L, Casali C, Angeli P, Barone P, Cao A, Loudianos G. Mutation analysis of the ATP7B gene in a new group of Wilson's disease patients: contribution to diagnosis. Mol Cell Probes 2012; 26:147-50. [PMID: 22484412 DOI: 10.1016/j.mcp.2012.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Revised: 03/05/2012] [Accepted: 03/14/2012] [Indexed: 01/23/2023]
Abstract
Wilson's disease (WD), an autosomal recessive disorder of copper transport with a broad range of genotypic and phenotypic characteristics, results from mutations in the ATP7B gene. Herein we report the results of mutation analysis of the ATP7B gene in a group of 118 Wilson disease families (236 chromosomes) prevalently of Italian origin. Using DNA sequencing we identified 83 disease-causing mutations. Eleven were novel, while twenty one already described mutations were identified in new populations in this study. In particular, mutation analysis of 13 families of Romanian origin showed a high prevalence of the p.H1069Q mutation (50%). Detection of new mutations in the ATP7B gene in new populations increases our capability of molecular analysis that is essential for early diagnosis and treatment of WD.
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Incollu S, Lepori MB, Zappu A, Dessì V, Noli MC, Mameli E, Iorio R, Ranucci G, Cao A, Loudianos G. DNA and RNA studies for molecular characterization of a gross deletion detected in homozygosity in the NH2-terminal region of the ATP7B gene in a Wilson disease patient. Mol Cell Probes 2011; 25:195-8. [PMID: 21925265 DOI: 10.1016/j.mcp.2011.07.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Revised: 07/08/2011] [Accepted: 07/27/2011] [Indexed: 01/19/2023]
Abstract
Wilson disease is an autosomal recessive disorder caused by defective function of the copper transporting protein ATP7B. Approximately 520 Wilson disease-causing mutations have been described to date. In this study we report the use of DNA and RNA analysis for molecular characterization of a gross deletion of the ATP7B gene detected in homozygosity in a Wilson disease patient. The c.51+384_1708-953del mutation spans an 8798 bp region of the ATP7B gene from exon 2 to intron 4. The results obtained suggest that the combination of DNA and RNA analyses can be used for molecular characterization of gross ATP7B deletions, thus improving genetic counselling and diagnosis of Wilson disease. Moreover these studies, help to better establish the molecular mechanisms producing Wilson disease.
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Affiliation(s)
- Simona Incollu
- Dipartimento di Scienze Biomediche e Biotecnologie, USC, Cagliari, Italy
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Zappu A, Lilliu F, Podda RA, Loudianos G. Molecular analysis of glycogen storage disease type Ib in Sardinian population: evidence for a founder effect. Genet Test Mol Biomarkers 2010; 14:399-403. [PMID: 20578944 DOI: 10.1089/gtmb.2010.0024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We describe epidemiological, genetic, and clinical data of the 1124-2del mutation in the G6PT gene, detected in homozygosity in three glycogen storage disease type Ib patients of Sardinian origin. This mutation was found to be associated with four sequence variations: c.593 A>T (p.N198I), c.625+19 C>T, c.1062 C>T (N354N), and c.1224 G>A (p.T408T) in the G6PT gene. RNA studies were performed for c.1124-2del and c.625+19 C>T. The c.1124-1del2 acceptor splicing mutation showed skipping of 31 nucleotides of exon 9 due to the activation of a downstream cryptic acceptor splice site in 1154-1155 nucleotide positions, resulting in a downstream stop codon at aa position 402. RNA analysis of c.625+19 C>T variation showed a small amount of alternative splicing with skipping of exon 4, resulting in a stop codon at aa position 211. Our cases present most of features of the severe form of disease, including early onset with chronic neutropenia, frequent infections, and inflammatory bowel disease. Our results suggest a founder effect for glycogen storage disease type Ib that facilitates diagnosis using mutation analysis, sparing patients from liver biopsy. DNA-based diagnosis will enable us to make accurate determination of carrier status and prenatal diagnosis, thus improving genetic counseling.
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Affiliation(s)
- Antonietta Zappu
- Dipartimento di Scienze Biomediche e Biotecnologie, USC, Cagliari, Italy
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Zappu A, Lepori MB, Incollu S, Noli MC, De Virgiliis S, Cao A, Loudianos G. Development of TaqMan allelic specific discrimination assay for detection of the most common Sardinian Wilson's disease mutations. Implications for genetic screening. Mol Cell Probes 2010; 24:233-5. [DOI: 10.1016/j.mcp.2010.01.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 01/08/2010] [Accepted: 01/27/2010] [Indexed: 10/19/2022]
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Lovicu M, Lepori MB, Incollu S, Dessì V, Zappu A, Iorio R, D'Ambrosi M, Pellecchia MT, Barone P, Maggiore G, De Virgiliis S, Cao A, Loudianos G. RNA Analysis of Consensus Sequence Splicing Mutations: Implications for the Diagnosis of Wilson Disease. Genet Test Mol Biomarkers 2009; 13:185-91. [DOI: 10.1089/gtmb.2008.0089] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Affiliation(s)
- Mario Lovicu
- Istituto di Neurogenetica e Neurofarmacologia, CNR, Cagliari, Italy
| | | | - Simona Incollu
- Dipartimento di Scienze Biomediche e Biotecnologie, USC, Cagliari, Italy
| | - Valentina Dessì
- Dipartimento di Scienze Biomediche e Biotecnologie, USC, Cagliari, Italy
| | - Antonietta Zappu
- Dipartimento di Scienze Biomediche e Biotecnologie, USC, Cagliari, Italy
| | - Raffaele Iorio
- Dipartimento di Pediatria, Università Federico II, Naples, Italy
| | | | | | - Paolo Barone
- Dipartimento di Scienze Neurologiche, Università Federico II, Naples, Italy
| | - Giuseppe Maggiore
- Dipartimento di Medicina della Procreazione e dell'Età Evolutiva, Pisa, Italy
| | | | - Antonio Cao
- Istituto di Neurogenetica e Neurofarmacologia, CNR, Cagliari, Italy
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Lepori MB, Lovicu M, Dessi V, Zappu A, Incollu S, Zancan L, Giacchino R, Iorio R, Vajro P, Maggiore G, Marcellini M, Barbera C, Pellecchia MT, Simonetti R, Kostic V, Farci AMG, Solinas A, De Virgiliis S, Cao A, Loudianos G. Twenty-Four Novel Mutations in Wilson Disease Patients of Predominantly Italian Origin. ACTA ACUST UNITED AC 2007; 11:328-32. [DOI: 10.1089/gte.2007.0015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | - Mario Lovicu
- Istituto di Neurogenetica e Neurofarmacologia, CNR-Cagliari, Italy
| | - Valentina Dessi
- Dipartimento di Scienze Biomediche e Biotecnologie, USC, Cagliari, Italy
| | - Antonietta Zappu
- Dipartimento di Scienze Biomediche e Biotecnologie, USC, Cagliari, Italy
| | - Simona Incollu
- Dipartimento di Scienze Biomediche e Biotecnologie, USC, Cagliari, Italy
| | - Lucia Zancan
- Dipartimento di Pediatria, University di Padova, Padua, Italy
| | | | - Raffaele Iorio
- Dipartimento di Pediatria, Università Federico II, Naples, Italy
| | - Pietro Vajro
- Dipartimento di Pediatria, Università Federico II, Naples, Italy
| | - Giuseppe Maggiore
- Dipartimento di Medicina della Procreazione e dell' Età Evolutiva, Pisa, Italy
| | | | | | | | - Rosanna Simonetti
- Divisione di Medicina Generale, Azienda Ospedaliera V. Cervello, Palermo, Italy
| | - Vladimir Kostic
- Institute of Neurology-Clinical Center of Serbia, Belgrade, Yugoslavia
| | | | | | | | - Antonio Cao
- Istituto di Neurogenetica e Neurofarmacologia, CNR-Cagliari, Italy
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Galanello R, Piga A, Forni GL, Bertrand Y, Foschini ML, Bordone E, Leoni G, Lavagetto A, Zappu A, Longo F, Maseruka H, Hewson N, Sechaud R, Belleli R, Alberti D. Phase II clinical evaluation of deferasirox, a once-daily oral chelating agent, in pediatric patients with beta-thalassemia major. Haematologica 2006; 91:1343-51. [PMID: 17018383] [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: 05/12/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Deferasirox (ICL670) is a novel once-daily oral iron chelator developed for the treatment of chronic iron overload from blood transfusions. This study evaluated the safety and tolerability of deferasirox in pediatric patients with transfusion-dependent beta-thalassemia major. Efficacy and pharmacokinetic assessments were secondary objectives. DESIGN AND METHODS Forty patients equally stratified into two age groups--children (2 to <12 years) and adolescents (12-17 years)--were treated with deferasirox for 48 weeks. All received once-daily deferasirox 10 mg/kg/day with modifications allowed after 12 weeks' treatment. Safety, liver iron concentration (LIC), serum ferritin and pharmacokinetics were assessed. RESULTS Thirty-nine patients completed the study. One withdrew due to a skin rash. Adverse events were typical of this population, but only four were considered related to the study drug: mild nausea (two adolescents) and moderate skin rash (two children). There were no serious adverse events related to the study drug. Five patients briefly interrupted treatment due to elevated transaminases with no recurrences when treatment resumed. The mean deferasirox dose was 11.3 mg/kg/day. Overall LIC increased gradually from week 12 as mean daily iron intake was higher than excretion. Steady-state plasma levels of deferasirox and its iron complex, Fe-[deferasirox]2, were comparable between children and adolescents. INTERPRETATION AND CONCLUSIONS Deferasirox was well tolerated by this pediatric population. Toxicities known to be associated with other commercially available iron chelators were not observed. The dose employed was too low to induce a net negative iron balance in this regularly transfused population. Pharmacokinetic data support a once-daily dosing regimen based on body weight.
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Affiliation(s)
- Renzo Galanello
- Ospedale Regionale Microcitemie, Dipartimento di Scienze Biomediche e Biotecnologie, Università di Cagliari, Via Jenner s/n, 09121 Cagliari, Italy.
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Piga A, Galanello R, Forni GL, Cappellini MD, Origa R, Zappu A, Donato G, Bordone E, Lavagetto A, Zanaboni L, Sechaud R, Hewson N, Ford JM, Opitz H, Alberti D. Randomized phase II trial of deferasirox (Exjade, ICL670), a once-daily, orally-administered iron chelator, in comparison to deferoxamine in thalassemia patients with transfusional iron overload. Haematologica 2006; 91:873-80. [PMID: 16818273] [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: 05/10/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Iron accumulation is an inevitable consequence of chronic blood transfusions and results in serious complications in the absence of chelation treatment to remove excess iron. Deferoxamine (Desferal, DFO) reduces morbidity and mortality although the administration schedule of slow, parenteral infusions several days each week limits compliance and negatively affects long-term outcome. Deferasirox (Exjade, ICL670) is an oral chelator with high iron-binding potency and selectivity. In a phase II study, the tolerability and efficacy of deferasirox were compared with those of DFO in 71 adults with transfusional hemosiderosis. DESIGN AND METHODS Patients were randomized to receive once-daily deferasirox (10 or 20 mg/kg; n=24 in both groups) or DFO (40 mg/kg, 5 days/week; n=23) for 48 weeks. Results. Both treatments were well tolerated and no patient discontinued deferasirox due to drug-related adverse events. The reported frequency of transient, mild to moderate gastrointestinal disturbances was higher in the deferasirox group than in the DFO group, but these disturbances settled spontaneously without dose interruption in all patients. Decreases in liver iron concentration (LIC) were comparable in the deferasirox 20 mg/kg/day and DFO groups; baseline values of 8.5 and 7.9 mg Fe/g dw fell to 6.6 and 5.9 mg Fe/g dw, respectively, by week 48. Deferasirox showed a plasma elimination half-life of 8-16 hours, supporting its once-daily administration. INTERPRETATION AND CONCLUSIONS Deferasirox at daily doses of 10 or 20 mg/kg was well tolerated and, at 20 mg/kg, showed similar efficacy to DFO 40 mg/kg in terms of decreases in LIC.
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Affiliation(s)
- Antonio Piga
- Centro Microcitemie, Divisione di Ematologia Pediatrica, Dipartimento di Scienze Pediatriche, Università di Torino, Italy.
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Lovicu M, Dessì V, Lepori MB, Zappu A, Zancan L, Giacchino R, Marazzi MG, Iorio R, Vegnente A, Vajro P, Maggiore G, Marcellini M, Barbera C, Kostic V, Farci AMG, Solinas A, Altuntas B, Yuce A, Kocak N, Tsezou A, De Virgiliis S, Cao A, Loudianos G. The canine copper toxicosis gene MURR1 is not implicated in the pathogenesis of Wilson disease. J Gastroenterol 2006; 41:582-7. [PMID: 16868807 DOI: 10.1007/s00535-006-1807-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2005] [Accepted: 02/22/2006] [Indexed: 02/04/2023]
Abstract
BACKGROUND It has recently been demonstrated that the Wilson disease (WD) protein directly interacts with the human homolog of the MURR1 protein in vitro and in vivo, and that this interaction is specific for the copper transporter. The aim of the present study was to clarify the role of MURR1 in the pathogenesis of WD as well as in other WD-like disorders of hepatic copper metabolism of unknown origin. METHODS Using the single-strand conformation polymorphism (SSCP) method followed by sequencing, we analyzed the 5' untranslated region (UTR) and three exons of the MURR1 gene in three groups of patients: 19 WD: patients in whom no mutations were detected in the ATP7B gene, 53 WD: patients in whom only one mutation in the ATP7B gene was found, and 34 patients in whom clinical and laboratory data suggested a WD-like disorder of hepatic copper metabolism of unknown origin. RESULTS We detected in these patients six rare nucleotide substitutions, namely one splice-site consensus sequence and one missense and four silent nucleotide substitutions. All substitutions except one were found in the heterozygous state. No difference in the frequencies of the various substitutions was observed between patients and controls. CONCLUSIONS These data suggest that the MURR1 gene and its protein product are unlikely to play a primary role in the pathogenesis of Wilson disease. More extensive studies with larger numbers of clinically homogeneous patients should be carried out to establish whether nucleotide alterations in the MURR1 gene may have a role in causing WD or WD-like disorders or act as modifying factors in the phenotype variability in WD.
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Affiliation(s)
- Mario Lovicu
- Institute of Neurogenetics and Neuropharmacology, CNR-Cagliari, Cagliari, Italy
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Boccone L, Dessì V, Zappu A, Piga S, Piludu MB, Rais M, Massidda C, De Virgiliis S, Cao A, Loudianos G. Bannayan–Riley–Ruvalcaba syndrome with reactive nodular lymphoid hyperplasia and autism and a PTEN mutation. Am J Med Genet A 2006; 140:1965-9. [PMID: 16894538 DOI: 10.1002/ajmg.a.31396] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Lovicu M, Dessi V, Zappu A, De Virgiliis S, Cao A, Loudianos G. Efficient strategy for molecular diagnosis of Wilson disease in the sardinian population. Clin Chem 2003; 49:496-8. [PMID: 12600964 DOI: 10.1373/49.3.496] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Mario Lovicu
- Instituto di Neurogenetica e Neurofarmacologia, Consiglio Nazionale Richerche, Cagliari, via Boccaccio 8, 0947 Selagius, Italy
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