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Groen K, van der Vis JJ, van Batenburg AA, Kazemier KM, de Bruijn MJ, Stadhouders R, Arp P, Verkerk AJ, Schoemaker AE, de Bie CI, Massink MP, van Beek FT, Grutters JC, Vergouw LJ, van Moorsel CH. A new variant in the ZCCHC8 gene: diverse clinical phenotypes and expression in the lung. ERJ Open Res 2024; 10:00487-2023. [PMID: 38375433 PMCID: PMC10875464 DOI: 10.1183/23120541.00487-2023] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 10/12/2023] [Indexed: 02/21/2024] Open
Abstract
Introduction Pulmonary fibrosis is a severe disease which can be familial. A genetic cause can only be found in ∼40% of families. Searching for shared novel genetic variants may aid the discovery of new genetic causes of disease. Methods Whole-exome sequencing was performed in 152 unrelated patients with a suspected genetic cause of pulmonary fibrosis from the St Antonius interstitial lung disease biobank. Variants of interest were selected by filtering for novel, potentially deleterious variants that were present in at least three unrelated pulmonary fibrosis patients. Results The novel c.586G>A p.(E196K) variant in the ZCCHC8 gene was observed in three unrelated patients: two familial patients and one sporadic patient, who was later genealogically linked to one of the families. The variant was identified in nine additional relatives with pulmonary fibrosis and other telomere-related phenotypes, such as pulmonary arterial venous malformations, emphysema, myelodysplastic syndrome, acute myeloid leukaemia and dyskeratosis congenita. One family showed incomplete segregation, with absence of the variant in one pulmonary fibrosis patient who carried a PARN variant. The majority of ZCCHC8 variant carriers showed short telomeres in blood. ZCCHC8 protein was located in different lung cell types, including alveolar type 2 (AT2) pneumocytes, the culprit cells in pulmonary fibrosis. AT2 cells showed telomere shortening and increased DNA damage, which was comparable to patients with sporadic pulmonary fibrosis and those with pulmonary fibrosis carrying a telomere-related gene variant, respectively. Discussion The ZCCHC8 c.586G>A variant confirms the involvement of ZCCHC8 in pulmonary fibrosis and short-telomere syndromes and underlines the importance of including the ZCCHC8 gene in diagnostic gene panels for these diseases.
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Affiliation(s)
- Karlijn Groen
- Department of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Joanne J. van der Vis
- Department of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands
- Department of Clinical Chemistry, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Aernoud A. van Batenburg
- Department of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Karin M. Kazemier
- Department of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands
- Center of Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Ralph Stadhouders
- Department of Pulmonary Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Pascal Arp
- Department of Internal Medicine, Laboratory of Population Genomics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Annemieke J.M.H. Verkerk
- Department of Internal Medicine, Laboratory of Population Genomics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Angela E. Schoemaker
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Charlotte I. de Bie
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Maarten P.G. Massink
- Department of Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Frouke T. van Beek
- Department of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands
| | - Jan C. Grutters
- Department of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands
- Division of Heart and Lungs, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Leonie J.M. Vergouw
- Department of Internal Medicine, Laboratory of Population Genomics, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Coline H.M. van Moorsel
- Department of Pulmonology, St Antonius ILD Center of Excellence, St Antonius Hospital, Nieuwegein, the Netherlands
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Hoffman TW, van Moorsel CH, van der Vis JJ, Biesma DH, Grutters JC. No effect of danazol treatment in patients with advanced idiopathic pulmonary fibrosis. ERJ Open Res 2023; 9:00131-2023. [PMID: 37753281 PMCID: PMC10518878 DOI: 10.1183/23120541.00131-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/14/2023] [Indexed: 09/28/2023] Open
Abstract
Background Telomere dysfunction can underly the development of idiopathic pulmonary fibrosis (IPF), and recent work suggests that patients with telomere syndromes might benefit from treatment with androgens, such as danazol. Methods This was a prospective observational cohort study. 50 patients with IPF received off-label treatment with danazol after they showed progressive disease under treatment with pirfenidone or nintedanib. The primary outcome was the difference in yearly decline in forced vital capacity (FVC) prior to (pre) and after (post) start of treatment with danazol. Results There was no significant difference in FVC-decline between 1 year pre and 1 year post start of danazol treatment (mean decline pre 395 mL (95% confidence interval (CI) 290-500) compared to post 461 mL (95% CI 259-712); p=0.46; paired t-test). 11 patients (22%) were still on danazol after 1 year, and 39 patients had stopped danazol, mainly because of side-effects (56%) or death (33%). In patients who were still using danazol after 1 year, FVC-decline significantly slowed down under danazol treatment (mean pre 512 mL (95% CI 308-716) versus post 198 mL (95% CI 16-380); p=0.04). Median survival post danazol was 14.9 months (95% CI 11.0-18.8). Conclusion Danazol as a treatment of last resort in patients with IPF did not lead to slowing of lung function decline and was associated with significant side-effects. It remains to be determined if earlier treatment or treatment of specific patient subgroups is beneficial.
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Affiliation(s)
- Thijs W. Hoffman
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Coline H.M. van Moorsel
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Joanne J. van der Vis
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
- Department of Clinical Chemistry, St Antonius Hospital, Nieuwegein, The Netherlands
| | - Douwe H. Biesma
- Department of Internal Medicine, St Antonius Hospital, Nieuwegein, The Netherlands
- Department of Internal Medicine, Leiden University Medical Centre, Leiden, The Netherlands
| | - Jan C. Grutters
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology, St Antonius Hospital, Nieuwegein, The Netherlands
- Division of Heart and Lungs, University Medical Center, Utrecht, The Netherlands
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Gudmundsson E, Zhao A, Mogulkoc N, van Beek F, Goos T, Brereton CJ, Veltkamp M, Chapman R, van Es HW, Garthwaite H, Gholipour B, Heightman M, Nair A, Pontoppidan K, Savas R, Ahmed A, Vermant M, Unat O, Procter A, De Sadeleer L, Denneny E, Wallis T, Duncan M, Taylor M, Verleden S, Janes SM, Alexander DC, Wells AU, Porter J, Jones MG, Stewart I, van Moorsel CH, Wuyts W, Jacob J. Delineating associations of progressive pleuroparenchymal fibroelastosis in patients with pulmonary fibrosis. ERJ Open Res 2023; 9:00637-2022. [PMID: 37009018 PMCID: PMC10052711 DOI: 10.1183/23120541.00637-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 12/01/2022] [Indexed: 01/27/2023] Open
Abstract
BackgroundComputer quantification of baseline computed tomography (CT) radiologic pleuroparenchymal fibroelastosis (PPFE) associates with mortality in idiopathic pulmonary fibrosis (IPF). We examined mortality associations of longitudinal change in computer quantified PPFE-like lesions in IPF and fibrotic hypersensitivity pneumonitis (FHP).MethodsTwo CT scans 6–36 months apart were retrospectively examined in one IPF (n=414) and one FHP population (n=98). Annualised change in computerised upper-zone pleural surface area comprising radiologic PPFE-like lesions (Δ-PPFE) was calculated. Δ-PPFE >1.25% defined progressive PPFE above scan noise. Mixed-effects models evaluated Δ-PPFE against change in visual CT interstitial lung disease (ILD) extent and annualised forced vital capacity (FVC) decline. Multivariable models were adjusted for age, gender, smoking history, baseline emphysema presence, antifibrotic use and diffusion capacity for carbon monoxide. Mortality analyses further adjusted for baseline presence of clinically important PPFE-like lesions and ILD change.FindingsΔ-PPFE associated weakly with ILD and FVC change. 22–26% of IPF and FHP cohorts demonstrated progressive PPFE-like lesions which independently associated with mortality in the IPF cohort (HR=1.25, 95% CI 1.16–1.34, p<0.0001) and the FHP cohort (HR=1.16, 95% CI 1.00–1.35, p=0.045).InterpretationProgression of PPFE-like lesions independently associates with mortality in IPF and FHP but does not associate strongly with measures of fibrosis progression.
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Kelich J, Aramburu T, van der Vis JJ, Showe L, Kossenkov A, van der Smagt J, Massink M, Schoemaker A, Hennekam E, Veltkamp M, van Moorsel CH, Skordalakes E. Telomere dysfunction implicates POT1 in patients with idiopathic pulmonary fibrosis. J Exp Med 2022; 219:e20211681. [PMID: 35420632 PMCID: PMC9014792 DOI: 10.1084/jem.20211681] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/28/2022] [Accepted: 03/09/2022] [Indexed: 12/17/2022] Open
Abstract
Exonic sequencing identified a family with idiopathic pulmonary fibrosis (IPF) containing a previously unreported heterozygous mutation in POT1 p.(L259S). The family displays short telomeres and genetic anticipation. We found that POT1(L259S) is defective in binding the telomeric overhang, nuclear accumulation, negative regulation of telomerase, and lagging strand maintenance. Patient cells containing the mutation display telomere loss, lagging strand defects, telomere-induced DNA damage, and premature senescence with G1 arrest. Our data suggest POT1(L259S) is a pathogenic driver of IPF and provide insights into gene therapy options.
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Affiliation(s)
| | | | - Joanne J. van der Vis
- Department of Pulmonology, Interstitial Lung Disease Center of Excellence, St Antonius Hospital, Nieuwegein, Netherlands
| | | | | | - Jasper van der Smagt
- Department of Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Maarten Massink
- Department of Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Angela Schoemaker
- Department of Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Eric Hennekam
- Department of Pharmacy and Biomedical Genetics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marcel Veltkamp
- Department of Pulmonology, Interstitial Lung Disease Center of Excellence, St Antonius Hospital, Nieuwegein, Netherlands
| | - Coline H.M. van Moorsel
- Department of Pulmonology, Interstitial Lung Disease Center of Excellence, St Antonius Hospital, Nieuwegein, Netherlands
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Farré X, Espín R, Baiges A, Blommaert E, Kim W, Giannikou K, Herranz C, Román A, Sáez B, Casanova Á, Ancochea J, Valenzuela C, Ussetti P, Laporta R, Rodríguez-Portal JA, van Moorsel CH, van der Vis JJ, Quanjel MJ, Tena-Garitaonaindia M, Sánchez de Medina F, Mateo F, Molina-Molina M, Won S, Kwiatkowski DJ, de Cid R, Pujana MA. Evidence for shared genetic risk factors between lymphangioleiomyomatosis and pulmonary function. ERJ Open Res 2021; 8:00375-2021. [PMID: 35083324 PMCID: PMC8784893 DOI: 10.1183/23120541.00375-2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 09/17/2021] [Indexed: 11/05/2022] Open
Abstract
IntroductionLymphangioleiomyomatosis (LAM) is a rare low-grade metastasising disease characterised by cystic lung destruction. The genetic basis of LAM remains incompletely determined, and the disease cell-of-origin is uncertain. We analysed the possibility of a shared genetic basis between LAM and cancer, and LAM and pulmonary function.MethodsThe results of genome-wide association studies of LAM, 17 cancer types and spirometry measures (forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), FEV1/FVC ratio and peak expiratory flow (PEF)) were analysed for genetic correlations, shared genetic variants and causality. Genomic and transcriptomic data were examined, and immunodetection assays were performed to evaluate pleiotropic genes.ResultsThere were no significant overall genetic correlations between LAM and cancer, but LAM correlated negatively with FVC and PEF, and a trend in the same direction was observed for FEV1. 22 shared genetic variants were uncovered between LAM and pulmonary function, while seven shared variants were identified between LAM and cancer. The LAM-pulmonary function shared genetics identified four pleiotropic genes previously recognised in LAM single-cell transcriptomes: ADAM12, BNC2, NR2F2 and SP5. We had previously associated NR2F2 variants with LAM, and we identified its functional partner NR3C1 as another pleotropic factor. NR3C1 expression was confirmed in LAM lung lesions. Another candidate pleiotropic factor, CNTN2, was found more abundant in plasma of LAM patients than that of healthy women.ConclusionsThis study suggests the existence of a common genetic aetiology between LAM and pulmonary function.
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van der Vis JJ, van der Smagt JJ, Hennekam FA, Grutters JC, van Moorsel CH. Pulmonary Fibrosis and a TERT Founder Mutation With a Latency Period of 300 Years. Chest 2020; 158:612-619. [DOI: 10.1016/j.chest.2020.03.069] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 02/10/2020] [Accepted: 03/04/2020] [Indexed: 10/24/2022] Open
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Platenburg MG, Wiertz IA, van der Vis JJ, Crestani B, Borie R, Dieude P, Kannengiesser C, Burgers JA, Grutters JC, van Moorsel CH. The MUC5B promoter risk allele for idiopathic pulmonary fibrosis predisposes to asbestosis. Eur Respir J 2020; 55:13993003.02361-2019. [DOI: 10.1183/13993003.02361-2019] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 01/05/2020] [Indexed: 11/05/2022]
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Wiertz IA, van Moorsel CH, Vorselaars AD, Quanjel MJ, Grutters JC. Cyclophosphamide in steroid refractory unclassifiable idiopathic interstitial pneumonia and interstitial pneumonia with autoimmune features (IPAF). Eur Respir J 2018; 51:13993003.02519-2017. [DOI: 10.1183/13993003.02519-2017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Accepted: 02/17/2018] [Indexed: 11/05/2022]
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Wiertz IA, Wuyts WA, van Moorsel CH, Vorselaars AD, van Es HW, van Oosterhout MF, Grutters JC. Unfavourable outcome of glucocorticoid treatment in suspected idiopathic pulmonary fibrosis. Respirology 2017; 23:311-317. [DOI: 10.1111/resp.13230] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 05/30/2017] [Accepted: 06/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Ivo A. Wiertz
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology; St Antonius Hospital; Nieuwegein The Netherlands
| | - Wim A. Wuyts
- Department of Respiratory Medicine, Unit for Interstitial Lung Diseases; University Hospitals Leuven; Leuven Belgium
| | - Coline H.M. van Moorsel
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology; St Antonius Hospital; Nieuwegein The Netherlands
- Division of Heart and Lungs; University Medical Centre Utrecht; Utrecht The Netherlands
| | - Adriane D.M. Vorselaars
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology; St Antonius Hospital; Nieuwegein The Netherlands
| | - Hendrik W. van Es
- Department of Radiology; St Antonius Hospital; Nieuwegein The Netherlands
| | | | - Jan C. Grutters
- Interstitial Lung Diseases Center of Excellence, Department of Pulmonology; St Antonius Hospital; Nieuwegein The Netherlands
- Division of Heart and Lungs; University Medical Centre Utrecht; Utrecht The Netherlands
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Verwoerd A, Vorselaars AD, van Moorsel CH, Bos WJW, van Velzen-Blad H, Grutters JC. Discrepant elevation of sIL-2R levels in sarcoidosis patients with renal insufficiency. Eur Respir J 2015; 46:277-80. [DOI: 10.1183/09031936.00005315] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Accepted: 01/25/2015] [Indexed: 11/05/2022]
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Vorselaars AD, Wuyts WA, Vorselaars VM, Zanen P, Deneer VH, Veltkamp M, Thomeer M, van Moorsel CH, Grutters JC. Methotrexate vs Azathioprine in Second-line Therapy of Sarcoidosis. Chest 2013; 144:805-812. [DOI: 10.1378/chest.12-1728] [Citation(s) in RCA: 162] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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