1
|
Cárdenas JM, Vergara D, Witting S, Balut F, Guerra P, Mesa JT, Silva S, Tello J, Retamales Á, Barrios A, Pinto F, Faundes V, Troncoso M. Genotype and Phenotype Characterization of Patients with Mucopolysaccharidosis IV-A in Chile. Mol Syndromol 2023; 14:416-427. [PMID: 37901859 PMCID: PMC10601820 DOI: 10.1159/000529807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 02/16/2023] [Indexed: 10/31/2023] Open
Abstract
Introduction Morquio syndrome or mucopolysaccharidosis type IV-A (MPS IV-A) is an autosomal recessive disease caused by biallelic variants in the GALNS gene, encoding the lysosomal enzyme GalN6S, responsible for glycosaminoglycan keratan sulfate and chondroitin-6-sulfate degradation. Studies have shown that the degree of evolutionary and chemical divergence of missense variants in GalN6S when compared to ancestral amino acids is associated with the severity of the syndrome, suggesting a genotype-phenotype correlation. There is little information on Latin American patients with MPS IV-A that replicate these findings. This study aimed to characterize the phenotype and genotype from patients with MPS IV-A, who are under Enzyme Replacement Therapy at the Children's Neuropsychiatry Service of the Hospital Clínico San Borja Arriarán, Santiago, Chile, and to determine if there is any association between genotype and phenotype with those findings. Methods Information was collected from medical charts, all patients went through a GalN6S enzymatic activity measurement in leukocytes from peripheral blood, and the GALNS gene was sequenced for all cases. Results 12 patients with MPS IV-A were recruited, all patients presented multisystem involvement, mostly skeletal, and 75% of cases underwent surgical interventions, and cervical arthrodesis was the most frequent procedure. In regards of the genotype, the two most frequent variants were c.319+2T>C (n = 10, 41.66%) and p.(Arg386Cys) (n = 8, 33.33%), the first one was previously described in 2018 in a patient from Chile [Bochernitsan et al., 2018]. Conclusion This is the first time that a genotype-phenotype correlation has been studied by analyzing the variants effect on the molecular structure of human GalN6S and the evolutionary conservation degree of affected residues in a cohort of patients in Chile. Albeit our work could not find statistically significant associations, we may infer that the evolutionary conservations of affected amino acids and the effect of variants on enzyme structure may play a main role. Further analyzes should consider a meta-analysis of published cases with genotype data and larger samples and include other variables that could provide more information. Finally, our data strongly suggest that variant c.319+2T>C could have a founder effect in Chilean patients with MPS IV-A.
Collapse
Affiliation(s)
- José Miguel Cárdenas
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Diane Vergara
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Scarlet Witting
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Fernanda Balut
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Patricio Guerra
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - José Tomás Mesa
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Sebastián Silva
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Javiera Tello
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Álvaro Retamales
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Andrés Barrios
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Fernando Pinto
- Hospital Clínico San Borja Arriarán, Facultad de Medicina, Univesidad de Chile, Santiago, Chile
| | - Víctor Faundes
- Laboratorio de Genética y Enfermedades Metabólicas, Instituto de Nutrición y Tecnología en Alimentos, Universidad de Chile, Santiago, Chile
| | - Mónica Troncoso
- Hospital Clínico San Borja Arriarán, Jefe de Unidad de Neurología Pediátrica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| |
Collapse
|