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Silao CLT, Latiff ZA, Kountouris P, Zilfalil BA. Editorial: Insights in thalassemia: from genomics to clinical practice. Front Pediatr 2023; 11:1222946. [PMID: 37520048 PMCID: PMC10381938 DOI: 10.3389/fped.2023.1222946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 06/27/2023] [Indexed: 08/01/2023] Open
Affiliation(s)
- Catherine Lynn T. Silao
- Institute of Human Genetics, National Institutes of Health, Manila, Philippines
- Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Zarina Abdul Latiff
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Petros Kountouris
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology and Genetics, Nicosia, Cyprus
| | - Bin Alwi Zilfalil
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kelantan, Malaysia
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Silao CLT. Molecular Insights to Clinical Perspectives. J ASEAN Fed Endocr Soc 2023; 38:3. [PMID: 37234926 PMCID: PMC10207865 DOI: 10.15605/jafes.037.s1] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Affiliation(s)
- Catherine Lynn T Silao
- Institute of Human Genetics, National Institutes of Health Department of Pediatrics, College of Medicine and Philippine General Hospital, University of the Philippines Manila
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Silao CLT. A Child's Nutrition and Epigenetics. Nestle Nutr Inst Workshop Ser 2023; 97:1-10. [PMID: 37023732 DOI: 10.1159/000528991] [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] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 10/05/2022] [Indexed: 04/08/2023]
Abstract
Studies have shown a dramatic increase in the incidence and the prevalence of chronic diseases such as type 2 diabetes mellitus and cardiovascular disorders over the last several decades. Environmental triggers and nutrition are considered major contributors to this increase. The first 1,000 days of life, which is the period between conception and the first 2 years of age, is considered the time for environmental factors, such as nutrition, to exert their positive and most crucial effects on a child's health. Nutrigenomics, the study of how genes and food components interact, looks into diet-altering disease development by modulating processes involved with the onset, progression, and severity of disease. These factors affecting the development of these chronic diseases are thought to be mediated by epigenetic mechanisms, which are heritable and reversible, and carry genetic information without changing the nucleotide sequence of the genome and are also mediated by maternal and postnatal nutrition.
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Affiliation(s)
- Catherine Lynn T Silao
- Institute of Human Genetics, National Institutes of Health, Manila, Philippines
- Department of Pediatrics and Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
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Halim-Fikri BH, Lederer CW, Baig AA, Mat-Ghani SNA, Syed-Hassan SNRK, Yusof W, Abdul Rashid D, Azman NF, Fucharoen S, Panigoro R, Silao CLT, Viprakasit V, Jalil N, Mohd Yasin N, Bahar R, Selvaratnam V, Mohamad N, Nik Hassan NN, Esa E, Krause A, Robinson H, Hasler J, Stephanou C, Raja-Sabudin RZA, Elion J, El-Kamah G, Coviello D, Yusoff N, Abdul Latiff Z, Arnold C, Burn J, Kountouris P, Kleanthous M, Ramesar R, Zilfalil BA. Global Globin Network Consensus Paper: Classification and Stratified Roadmaps for Improved Thalassaemia Care and Prevention in 32 Countries. J Pers Med 2022; 12:jpm12040552. [PMID: 35455667 PMCID: PMC9032232 DOI: 10.3390/jpm12040552] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/06/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
The Global Globin Network (GGN) is a project-wide initiative of the Human Variome/Global Variome Project (HVP) focusing on haemoglobinopathies to build the capacity for genomic diagnosis, clinical services, and research in low- and middle-income countries. At present, there is no framework to evaluate the improvement of care, treatment, and prevention of thalassaemia and other haemoglobinopathies globally, despite thalassaemia being one of the most common monogenic diseases worldwide. Here, we propose a universally applicable system for evaluating and grouping countries based on qualitative indicators according to the quality of care, treatment, and prevention of haemoglobinopathies. We also apply this system to GGN countries as proof of principle. To this end, qualitative indicators were extracted from the IthaMaps database of the ITHANET portal, which allowed four groups of countries (A, B, C, and D) to be defined based on major qualitative indicators, supported by minor qualitative indicators for countries with limited resource settings and by the overall haemoglobinopathy carrier frequency for the target countries of immigration. The proposed rubrics and accumulative scores will help analyse the performance and improvement of care, treatment, and prevention of haemoglobinopathies in the GGN and beyond. Our proposed criteria complement future data collection from GGN countries to help monitor the quality of services for haemoglobinopathies, provide ongoing estimates for services and epidemiology in GGN countries, and note the contribution of the GGN to a local and global reduction of disease burden.
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Affiliation(s)
- Bin Hashim Halim-Fikri
- Malaysian Node of the Human Variome Project Secretariat, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (B.H.H.-F.); (S.-N.R.-K.S.-H.); (W.Y.)
| | - Carsten W. Lederer
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology & Genetics, 6 Iroon Avenue, Ayios Dometios, Nicosia 2371, Cyprus; (C.W.L.); (C.S.); (P.K.); (M.K.)
| | - Atif Amin Baig
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu 20400, Terengganu, Malaysia;
| | - Siti Nor Assyuhada Mat-Ghani
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.N.A.M.-G.); (N.N.N.H.)
| | - Sharifah-Nany Rahayu-Karmilla Syed-Hassan
- Malaysian Node of the Human Variome Project Secretariat, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (B.H.H.-F.); (S.-N.R.-K.S.-H.); (W.Y.)
| | - Wardah Yusof
- Malaysian Node of the Human Variome Project Secretariat, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (B.H.H.-F.); (S.-N.R.-K.S.-H.); (W.Y.)
| | - Diana Abdul Rashid
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (D.A.R.); (N.F.A.); (N.M.)
| | - Nurul Fatihah Azman
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (D.A.R.); (N.F.A.); (N.M.)
| | - Suthat Fucharoen
- Thalassemia Research Centre, Institute of Molecular Biosciences, Mahidol University, Nakhom Pathom 73170, Thailand;
| | - Ramdan Panigoro
- Department of Biomedical Sciences, Medical Genetics Research Centre, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia;
| | - Catherine Lynn T. Silao
- Institute of Human Genetics, National Institutes of Health, University of the Philippines, Manila 1000, Philippines;
- Department of Pediatrics, College of Medicine, University of the Philippines, Manila 1000, Philippines
| | - Vip Viprakasit
- Department of Paediatrics & Thalassaemia Centre, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Norunaluwar Jalil
- UKM Specialist Children’s Hospital, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia;
| | - Norafiza Mohd Yasin
- Haematology Unit, Cancer Research Centre, Institute for Medical Research, National Institutes of Health, No. 1, Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, Shah Alam 40170, Selangor Darul Ehsan, Malaysia; (N.M.Y.); (E.E.)
| | - Rosnah Bahar
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Veena Selvaratnam
- Hospital Ampang, Jalan Mewah Utara, Taman Pandan Mewah, Ampang Jaya 68000, Selangor, Malaysia;
| | - Norsarwany Mohamad
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (D.A.R.); (N.F.A.); (N.M.)
| | - Nik Norliza Nik Hassan
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.N.A.M.-G.); (N.N.N.H.)
| | - Ezalia Esa
- Haematology Unit, Cancer Research Centre, Institute for Medical Research, National Institutes of Health, No. 1, Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, Shah Alam 40170, Selangor Darul Ehsan, Malaysia; (N.M.Y.); (E.E.)
| | - Amanda Krause
- Division of Human Genetics, National Health Laboratory Service (NHLS) and School of Pathology, Faculty of Health Sciences, The University of the Witwatersrand, Watkins Pitchford Building, NHLS Braamfontein, Cnr Hospital and De Korte St, Hillbrow, P.O. Box 1038, Johannesburg 2000, South Africa;
| | - Helen Robinson
- Nossal Institute for Global Health, MDDHS, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Julia Hasler
- Global Variome, Institute of Genetic Medicine, International Centre for Life, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK;
| | - Coralea Stephanou
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology & Genetics, 6 Iroon Avenue, Ayios Dometios, Nicosia 2371, Cyprus; (C.W.L.); (C.S.); (P.K.); (M.K.)
| | - Raja-Zahratul-Azma Raja-Sabudin
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia;
| | - Jacques Elion
- Medical School, Université Paris Diderot, 75018 Paris, France;
| | - Ghada El-Kamah
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo 12622, Egypt;
| | - Domenico Coviello
- Laboratorio di Genetica Umana, IRCCS Istituto Giannina Gaslini, Largo Gerolamo Gaslini 5, 16147 Genova, Italy;
| | - Narazah Yusoff
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Kepala Batas 13200, Pulau Pinang, Malaysia;
| | - Zarina Abdul Latiff
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Kuala Lumpur, Malaysia;
| | - Chris Arnold
- BioGrid Australia, Hodgson Associates, 4 Hodgson St., Kew, Melbourne, VIC 3101, Australia;
| | - John Burn
- Translational and Clinical Research Institute, International Centre for Life Times Square, Newcastle upon Tyne NE1 3BZ, UK;
| | - Petros Kountouris
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology & Genetics, 6 Iroon Avenue, Ayios Dometios, Nicosia 2371, Cyprus; (C.W.L.); (C.S.); (P.K.); (M.K.)
| | - Marina Kleanthous
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology & Genetics, 6 Iroon Avenue, Ayios Dometios, Nicosia 2371, Cyprus; (C.W.L.); (C.S.); (P.K.); (M.K.)
| | - Raj Ramesar
- Department of Pathology, University of Cape Town City of Cape Town, Cape Town 7925, South Africa;
| | - Bin Alwi Zilfalil
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Correspondence: or ; Tel.: +60-9767-6531
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Silao CLT, Fabella TDF, Naranjo MLT, Yuson EDJ. Challenges in the Management of Thalassemias in the Philippines. Hemoglobin 2019. [DOI: 10.1080/03630269.2020.1717761] [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] [Indexed: 10/24/2022]
Affiliation(s)
- Catherine Lynn T. Silao
- Institute of Human Genetics, National Institutes of Health, University of the Philippines College of Medicine, Manila, Philippines
- Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Terence Diane F. Fabella
- Institute of Human Genetics, National Institutes of Health, University of the Philippines College of Medicine, Manila, Philippines
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Canson DM, Silao CLT, Caoili SEC. Functional analysis of GALT variants found in classic galactosemia patients using a novel cell-free translation method. JIMD Rep 2019; 48:60-66. [PMID: 31392114 PMCID: PMC6606980 DOI: 10.1002/jmd2.12037] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 04/04/2019] [Accepted: 04/18/2019] [Indexed: 11/15/2022] Open
Abstract
Classic galactosemia is an autosomal recessive disorder caused by deleterious variants in the galactose-1-phosphate uridylyltransferase (GALT) gene. GALT enzyme deficiency leads to an increase in the levels of galactose and its metabolites in the blood causing neurodevelopmental and other clinical complications in affected individuals. Two GALT variants NM_000155.3:c.347T>C (p.Leu116Pro) and NM_000155.3:c.533T>G (p.Met178Arg) were previously detected in Filipino patients. Here, we determine their functional effects on the GALT enzyme through in silico analysis and a novel experimental approach using a HeLa-based cell-free protein expression system. Enzyme activity was not detected for the p.Leu116Pro protein variant, while only 4.5% of wild-type activity was detected for the p.Met178Arg protein variant. Computational analysis of the variants revealed destabilizing structural effects and suggested protein misfolding as the potential mechanism of enzymological impairment. Biochemical and computational data support the classification of p.Leu116Pro and p.Met178Arg variants as pathogenic. Moreover, the protein expression method developed has utility for future studies of GALT variants.
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Affiliation(s)
- Daffodil M. Canson
- Institute of Human Genetics, National Institutes of HealthUniversity of the Philippines ManilaManilaPhilippines
- Department of Biochemistry and Molecular Biology, College of MedicineUniversity of the Philippines ManilaManilaPhilippines
| | - Catherine Lynn T. Silao
- Institute of Human Genetics, National Institutes of HealthUniversity of the Philippines ManilaManilaPhilippines
| | - Salvador Eugenio C. Caoili
- Department of Biochemistry and Molecular Biology, College of MedicineUniversity of the Philippines ManilaManilaPhilippines
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Silao CLT, Fabella TDF, Naranjo MLT, Padilla CD, Yuson EDJ. AB089. Prevalence of the most common β-globin gene mutations in Filipino β-thalassemia patients. Ann Transl Med 2017. [DOI: 10.21037/atm.2017.s089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Chiong MAD, Canson DM, Abacan MAR, Baluyot MMP, Cordero CP, Silao CLT. Clinical, biochemical and molecular characteristics of Filipino patients with mucopolysaccharidosis type II - Hunter syndrome. Orphanet J Rare Dis 2017; 12:7. [PMID: 28077157 PMCID: PMC5225557 DOI: 10.1186/s13023-016-0558-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 08/06/2016] [Accepted: 12/21/2016] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Mucopolysaccharidosis type II, an X-linked recessive disorder is the most common lysosomal storage disease detected among Filipinos. This is a case series involving 23 male Filipino patients confirmed to have Hunter syndrome. The clinical and biochemical characteristics were obtained and mutation testing of the IDS gene was done on the probands and their female relatives. RESULTS The mean age of the patients was 11.28 (SD 4.10) years with an average symptom onset at 1.2 (SD 1.4) years. The mean age at biochemical diagnosis was 8 (SD 3.2) years. The early clinical characteristics were developmental delay, joint stiffness, coarse facies, recurrent respiratory tract infections, abdominal distention and hernia. Majority of the patients had joint contractures, severe intellectual disability, error of refraction, hearing loss and valvular regurgitation on subspecialists' evaluation. The mean GAG concentration was 506.5 mg (SD 191.3)/grams creatinine while the mean plasma iduronate-2-sulfatase activity was 0.86 (SD 0.79) nmol/mg plasma/4 h. Fourteen (14) mutations were found: 6 missense (42.9%), 4 nonsense (28.6%), 2 frameshift (14.3%), 1 exon skipping at the cDNA level (7.1%), and 1 gross insertion (7.1%). Six (6) novel mutations were observed (43%): p.C422F, p.P86Rfs*44, p.Q121*, p.L209Wfs*4, p.T409R, and c.1461_1462insN[710]. CONCLUSION The age at diagnosis in this series was much delayed and majority of the patients presented with severe neurologic impairment. The results of the biochemical tests did not contribute to the phenotypic classification of patients. The effects of the mutations were consistent with the severe phenotype seen in the majority of the patients.
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Affiliation(s)
- Mary Anne D Chiong
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, 625 Pedro Gil St., Ermita, Manila, 1000, Philippines. .,Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines. .,Department of Pediatrics, College of Medicine, University of Santo Tomas, Manila, Philippines.
| | - Daffodil M Canson
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, 625 Pedro Gil St., Ermita, Manila, 1000, Philippines
| | - Mary Ann R Abacan
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, 625 Pedro Gil St., Ermita, Manila, 1000, Philippines.,Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Melissa Mae P Baluyot
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, 625 Pedro Gil St., Ermita, Manila, 1000, Philippines.,Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Cynthia P Cordero
- Department of Clinical Epidemiology, College of Medicine, University of the Philippines, Manila, Philippines
| | - Catherine Lynn T Silao
- Institute of Human Genetics, National Institutes of Health, University of the Philippines Manila, 625 Pedro Gil St., Ermita, Manila, 1000, Philippines.,Department of Pediatrics, University of the Philippines-Philippine General Hospital, Manila, Philippines
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Silao CLT, Fabella TDF, Rama KID, Estrada SC. Novel cystathionine β-synthase gene mutations in a Filipino patient with classic homocystinuria. Pediatr Int 2015; 57:884-7. [PMID: 25939784 DOI: 10.1111/ped.12666] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [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: 01/21/2014] [Revised: 02/10/2015] [Accepted: 03/06/2015] [Indexed: 11/28/2022]
Abstract
BACKGROUND Classic homocystinuria due to cystathionine β-synthase (CBS) deficiency is an autosomal recessive disorder of sulfur metabolism. Clinical manifestations include mental retardation, dislocation of the optic lens (ectopia lentis), skeletal abnormalities and a tendency to thromboembolic episodes. We present the first mutational analysis of CBS in a Filipino patient with classic homocystinuria. METHODS Genomic DNA was extracted from peripheral blood collected from a diagnosed Filipino patient with classic homocystinuria. The entire coding region of CBS (17 exons) was amplified using polymerase chain reaction and bidirectionally sequenced using standard protocols. RESULTS The patient was found to be compound heterozygous for two novel mutations, g.13995G>A [c.982G>A; p.D328K] and g.15860-15868dupGCAGGAGCT [c.1083-1091dupGCAGGAGCT; p. Q362-L364dupQEL]. Four known single-nucleotide polymorphisms (rs234706, rs1801181, rs706208 and rs706209) were also detected in the present patient's CBS. The patient was heterozygous for all the identified alleles. CONCLUSIONS This is the first mutational analysis of CBS done in a Filipino patient with classic homocystinuria who presented with a novel duplication mutation and a novel missense mutation. Homocystinuria due to CBS deficiency is a heterogeneous disorder at the molecular level.
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Affiliation(s)
- Catherine Lynn T Silao
- Institute of Human Genetics, National Institutes of Health Philippines.,Department of Pediatrics, University of the Philippines College of Medicine-Philippine General Hospital, Manila, Philippines
| | | | | | - Sylvia C Estrada
- Institute of Human Genetics, National Institutes of Health Philippines.,Department of Pediatrics, University of the Philippines College of Medicine-Philippine General Hospital, Manila, Philippines
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Estrada SC, Canson DM, Silao CLT. Mutational analysis of the GALT gene in Filipino patients. Kobe J Med Sci 2013; 59:E106-E111. [PMID: 24045215] [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: 06/02/2023]
Abstract
Classic galactosemia is an inherited metabolic disorder due to mutations in the galactose-1-phosphate uridyltransferase (GALT) gene. This study describes the results of the GALT gene analysis of four unrelated Filipino patients with Classic Galactosemia. DNA extracted from dried blood spots and peripheral blood of the patients, age one month to two and a half years, underwent PCR-amplification with subsequent bidirectional sequencing of all eleven exons with their flanking intronic regions following standard protocols. Clinical data of these patients were reviewed. The patients presented with jaundice, hepatomegaly, diarrhea, vomiting, poor feeding and seizures during their neonatal period. They were diagnosed with elevated blood galactose and galactose-1-phosphate and absent GALT activity. Four missense mutations were found wherein two were previously reported (p.V168L and p.A345D) and two were novel (p.L116P and p.M178R). The most frequent mutation in our cohort is p.V168L. This study suggests that GALT mutations are ethnic-specific and that galactosemia is a heterogeneous disorder at the molecular level. The importance of early detection, immediate and proper medical management and genetic counseling of the patients and their families cannot be overemphasized.
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Affiliation(s)
- Sylvia C Estrada
- Institute of Human Genetics, National Institutes of Health Philippines, Manila, Philippines
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Jumbo-Lucioni PP, Garber K, Kiel J, Baric I, Berry GT, Bosch A, Burlina A, Chiesa A, Pico MLC, Estrada SC, Henderson H, Leslie N, Longo N, Morris AAM, Ramirez-Farias C, Schweitzer-Krantz S, Silao CLT, Vela-Amieva M, Waisbren S, Fridovich-Keil JL. Diversity of approaches to classic galactosemia around the world: a comparison of diagnosis, intervention, and outcomes. J Inherit Metab Dis 2012; 35:1037-49. [PMID: 22450714 PMCID: PMC3774053 DOI: 10.1007/s10545-012-9477-y] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2012] [Revised: 02/29/2012] [Accepted: 03/05/2012] [Indexed: 11/30/2022]
Abstract
Without intervention, classic galactosemia is a potentially fatal disorder in infancy. With the benefit of early diagnosis and dietary restriction of galactose, the acute sequelae of classic galactosemia can be prevented or reversed. However, despite early and lifelong dietary treatment, many galactosemic patients go on to experience serious long-term complications including cognitive disability, speech problems, neurological and/or movement disorders and, in girls and women, ovarian dysfunction. Further, there remains uncertainty surrounding what constitutes a 'best practice' for treating this disorder. To explore the extent and implications of this uncertainty, we conducted a small but global survey of healthcare providers who follow patients with classic galactosemia, seeking to compare established protocols for diagnosis, intervention, and follow-up, as well as the outcomes and outcome frequencies seen in the patient populations cared for by these providers. We received 13 survey responses representing five continents and 11 countries. Respondents underscored disparities in approaches to diagnosis, management and follow-up care. Notably, we saw no clear relationship between differing approaches to care and long-term outcomes in the populations studied. Negative outcomes occurred in the majority of cases regardless of when treatment was initiated, how tightly galactose intake was restricted, or how closely patients were monitored. We document here what is, to our knowledge, the first global comparison of healthcare approaches to classic galactosemia. These data reinforce the idea that there is currently no one best practice for treating patients with classic galactosemia, and underscore the need for more extensive and statistically powerful comparative studies to reveal potential positive or negative impacts of differing approaches.
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Affiliation(s)
- Patricia P Jumbo-Lucioni
- Department of Human Genetics, Emory University School of Medicine, Rm. 325.2 Whitehead Bldg, 615 Michael St, Atlanta, GA 30322, USA
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Ishizaki Y, Yukaya N, Kusuhara K, Kira R, Torisu H, Ihara K, Sakai Y, Sanefuji M, Pipo-Deveza JR, Silao CLT, Sanchez BC, Lukban MB, Salonga AM, Hara T. PD1 as a common candidate susceptibility gene of subacute sclerosing panencephalitis. Hum Genet 2011; 127:411-9. [PMID: 20066438 DOI: 10.1007/s00439-009-0781-z] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Accepted: 12/22/2009] [Indexed: 12/17/2022]
Abstract
Although the exact pathogenesis of subacute sclerosing panencephalitis (SSPE) remains to be determined, our previous data suggested a genetic contribution to the host susceptibility to SSPE. During chronic viral infection, virus-specific cytotoxic T lymphocytes display poor effector functions. Since co-inhibitory molecules are involved in the suppression of T lymphocytes, we investigated whether single nucleotide polymorphisms (SNPs) of genes encoding co-inhibitory molecules contributed to a susceptibility to SSPE. Association studies on a total of 20 SNPs in 8 genes (CTLA4, CD80, CD86, PD1, PDL1, PDL2, BTLA and HVEM) and subsequent haplotype analysis of 4 SNPs in the PD1 genes were performed in Japanese and Filipino SSPE patients and controls. Then, we investigated a functional difference in promoter activity of two haplotypes and compared the expression levels of PD1 between SSPE and controls. The frequency of GCG(C) haplotype of PD1 containing -606G allele was significantly higher in SSPE patients than in controls both in Japanese and in Filipinos. The promoter activity was significantly higher in the construct with -606G allele than in that with -606A allele. The expression levels of PD1 were significantly higher in SSPE patients than in the controls. Our results suggested that the PD1 gene contributed to a genetic susceptibility to SSPE.
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Affiliation(s)
- Yoshito Ishizaki
- Department of Pediatrics, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
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Lee JY, Chiong MA, Estrada SC, Cutiongco-De la Paz EM, Silao CLT, Padilla CD. Maple syrup urine disease (MSUD)--clinical profile of 47 Filipino patients. J Inherit Metab Dis 2008; 31 Suppl 2:S281-5. [PMID: 18989748 DOI: 10.1007/s10545-008-0859-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [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: 12/28/2007] [Revised: 08/20/2008] [Accepted: 09/11/2008] [Indexed: 10/21/2022]
Abstract
Maple syrup urine disease (MSUD) is a very rare disorder of branched-chain amino acid metabolism. However, it is the most common inborn error of metabolism in the Philippines. We present a retrospective review of 21 patients diagnosed with MSUD between 1999 and 2004. The patients presented clinically between 2 and 14 days of life (mean 5 days) and the diagnosis of MSUD was established between 6 days and 11 months of age (mean 39 days). The classical burnt sugar odour was noted in the majority of patients (81%). The diagnosis of MSUD was initially based on clinical suspicion and confirmed biochemically by measurement of leucine/isoleucine levels by thin-layer chromatography. The acute management included removal of accumulated branched-chain amino acids by peritoneal dialysis in 62% of the patients. Mortality rate of this group of patients was 24% and follow-up rate was 87%. We compared this series with a previously reported series of 26 patients to determine whether diagnosis and the management of MSUD improved over the two periods. Four cases have been diagnosed early since 1992, the majority of whom had the classic form of MSUD with the onset of symptoms in the first two weeks of life. A small subset of patients with early nonspecific symptoms was diagnosed much later owing to a low-level clinical suspicion among clinicians. Overall, however, there appears to be a small but general trend towards earlier diagnosis, reduced mortality and long-term follow up in the later series. Although we are able to diagnose and manage MSUD in the Philippines, we recognize that the clinical outcome remains poor and is due mainly to late referral of cases and inadequate long-term management. In the Philippines, we recommend that all newborns who are considered to be septic, have feeding difficulties, fail to regain their birth weight or present with any other symptoms suggestive of MSUD be evaluated in the first instance by analysis of urine for ketones and if they are positive have blood collected and sent to our laboratory for leucine/isoleucine measurement.
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Affiliation(s)
- J Y Lee
- Metabolic Services, Genetic Health Services Victoria, Royal Children's Hospital, Melbourne, Australia
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Abstract
BACKGROUND Maple syrup urine disease (MSUD) is an autosomal recessive disorder caused by defective activity of the branched-chain alpha-ketoacid dehydrogenase enzyme complex. Early diagnosis and management of MSUD are imperative for preventing permanent neurological impairments. In the Philippines, a 4.7 kb deletion in the dihydrolipoamide branched-chain transacylase E2 (DBT) gene has been commonly identified in MSUD patients. Polymerase chain reaction (PCR) amplification of a junction fragment between intron 10 and exon 11 has been used to detect this deletion. The purpose of the present paper was to use PCR-based mutation detection of the deletion mutation to diagnose MSUD in neonates in order to provide proper diagnosis and effective treatment. METHODS A region encompassing exon 11 and the junction fragment of the E2 (DBT) gene was PCR amplified from genomic DNA prepared from two neonates at risk for MSUD. RESULTS PCR amplification of both exon 11 and the junction fragment from one of the neonates demonstrated that this case was a heterozygous carrier of the deletion. Thus, normal feeding was started. For the other neonate, PCR amplification of the junction fragment was successful, whereas the region encompassing exon 11 was not amplified. This neonate was genotyped as homozygous for the deletion, and treatment for MSUD was provided immediately. CONCLUSION Examination of the deletion mutation in the E2 (DBT) gene facilitated early MSUD diagnosis and was beneficial for the determination of the proper course of treatment.
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Affiliation(s)
- Catherine Lynn T Silao
- Institute of Human Genetics, National Institutes of Health Philippines, Manila, Philippines
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Pipo-Deveza JR, Kusuhara K, Silao CLT, Lukban MB, Salonga AM, Sanchez BC, Kira R, Takemoto M, Torisu H, Hara T. Analysis of MxA, IL-4, and IRF-1 genes in Filipino patients with subacute sclerosing panencephalitis. Neuropediatrics 2006; 37:222-8. [PMID: 17177148 DOI: 10.1055/s-2006-924724] [Citation(s) in RCA: 9] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Subacute sclerosing panencephalitis (SSPE) is a chronic and debilitating disease of the central nervous system caused by a latent measles virus infection. Three candidate genes, MxA, IL-4, and IRF-1 genes were shown to be associated with SSPE in Japanese patients. These genes have been suggested to play a role in the establishment of persistent viral infection in the central nervous system. SUBJECTS AND METHODS Sixty Filipino SSPE patients and 120 healthy control subjects were included in the study. Single nucleotide polymorphisms at promoter regions ( IL-4-590C/T and MXA-88G/T) were screened using PCR-RFLP method. Genotyping was done for GT repeat polymorphism within intron 7 of IRF-1. RESULTS The TT genotype of MXA, as well as the CT genotype of IL-4, were seen a little more frequently among the SSPE patients as compared to the control subjects. The values though, did not reach statistical significance. IRF-1 analysis did not differ between the two groups. CONCLUSION Our study failed to demonstrate a significant association between IL-4, MXA, or IRF-1, and SSPE in the Filipino population. Our results might be explained by a greater contribution of environmental factors such as the socio-economic and nutritional factors in the susceptibility of Filipinos to SSPE other than genetic factors.
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Affiliation(s)
- J R Pipo-Deveza
- Section of Pediatric Neurology, Department of Pediatrics and Neurosciences, University of the Philippines, Philippine General Hospital, Taft Avenue, Manila, Philippines.
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Silao CLT, Padilla CD, Matsuo M. A novel deletion creating a new terminal exon of the dihydrolipoyl transacylase gene is a founder mutation of Filipino maple syrup urine disease. Mol Genet Metab 2004; 81:100-4. [PMID: 14741190 DOI: 10.1016/j.ymgme.2003.10.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [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] [Indexed: 11/25/2022]
Abstract
Maple syrup urine disease (MSUD) is a rare, autosomal-recessive disorder of branched-chain amino-acid metabolism. In the Philippines, many MSUD cases have been diagnosed clinically. Here, molecular analysis of the dihydrolipoyl transacylase (E2) gene was done in 13 unrelated families from the Philippines. A novel deletion spanning 4.1 kb of intron 10 and 601 bp of exon 11, caused by non-homologous recombination between an L1 repeat in intron 10 and an Alu repeat in exon 11, was found in 8 out of 13 families, with 5 of them being homozygous for the mutation, implicating it as a founder mutation of Filipino MSUD. The resulting mutant E2 mRNA contains a 239-bp insertion after exon 10, thereby producing a new terminal exon. Large-scale population screening of the deletion revealed that one carrier of the mutation was identified in 100 normal Filipinos. These findings suggest that a limited number of mutations might underlie MSUD in the Filipino population, potentially facilitating prenatal diagnosis and carrier detection of MSUD in this group.
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Affiliation(s)
- Catherine Lynn T Silao
- Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1 Kusunokicho, Chuo-ku, Kobe 650-0017, Japan
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