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Jáñez Pedrayes A, Rymen D, Ghesquière B, Witters P. Glycosphingolipids in congenital disorders of glycosylation (CDG). Mol Genet Metab 2024; 142:108434. [PMID: 38489976 DOI: 10.1016/j.ymgme.2024.108434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/26/2024] [Accepted: 02/27/2024] [Indexed: 03/17/2024]
Abstract
Congenital disorders of glycosylation (CDG) are a large family of rare disorders affecting the different glycosylation pathways. Defective glycosylation can affect any organ, with varying symptoms among the different CDG. Even between individuals with the same CDG there is quite variable severity. Associating specific symptoms to deficiencies of certain glycoproteins or glycolipids is thus a challenging task. In this review, we focus on the glycosphingolipid (GSL) synthesis pathway, which is still rather unexplored in the context of CDG, and outline the functions of the main GSLs, including gangliosides, and their role in the central nervous system. We provide an overview of GSL studies that have been performed in CDG and show that abnormal GSL levels are not only observed in CDG directly affecting GSL synthesis, but also in better known CDG, such as PMM2-CDG. We highlight the importance of studying GSLs in CDG in order to better understand the pathophysiology of these disorders.
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Affiliation(s)
- Andrea Jáñez Pedrayes
- Laboratory of Applied Mass Spectrometry, Department of Cellular and Molecular Medicine, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; Metabolomics Expertise Center, Center for Cancer Biology VIB, 3000 Leuven, Belgium; Department of Development and Regeneration, Katholieke Universiteit Leuven, 3000 Leuven, Belgium.
| | - Daisy Rymen
- Center for Metabolic Diseases, Department of Paediatrics, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Bart Ghesquière
- Laboratory of Applied Mass Spectrometry, Department of Cellular and Molecular Medicine, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; Metabolomics Expertise Center, Center for Cancer Biology VIB, 3000 Leuven, Belgium.
| | - Peter Witters
- Department of Development and Regeneration, Katholieke Universiteit Leuven, 3000 Leuven, Belgium; Center for Metabolic Diseases, Department of Paediatrics, University Hospitals Leuven, 3000 Leuven, Belgium.
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Decru B, Blanckaert H, Naulaers G, Vanhole C, Rymen D, Witters P, Van Wambeke I, Gillard P, Vermeersch P. Pseudohyperglycemia due to glucometer interference in galactosemia. Clin Chem Lab Med 2024; 62:e107-e109. [PMID: 38019925 DOI: 10.1515/cclm-2023-1304] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Bram Decru
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
| | - Hilde Blanckaert
- Department of Laboratory Medicine, Heilig Hart Hospital, Leuven, Belgium
| | - Gunnar Naulaers
- Neonatal Intensive Care, University Hospitals Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Christine Vanhole
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Daisy Rymen
- Department of Development and Regeneration, University of Leuven, Leuven, Belgium
- Department of Pediatrics, Center for Metabolic Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Peter Witters
- Department of Development and Regeneration, University of Leuven, Leuven, Belgium
- Department of Pediatrics, Center for Metabolic Diseases, University Hospitals Leuven, Leuven, Belgium
| | | | - Pieter Gillard
- Department of Endocrinology, University Hospitals Leuven, Leuven, Belgium
| | - Pieter Vermeersch
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, Belgium
- Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium
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Raynor A, Bruneel A, Vermeersch P, Cholet S, Friedrich S, Eckenweiler M, Schumann A, Hengst S, Tuncel AT, Fenaille F, Thiel C, Rymen D. "Hide and seek": Misleading transferrin variants in PMM2-CDG complicate diagnostics. Proteomics Clin Appl 2024; 18:e2300040. [PMID: 37876147 DOI: 10.1002/prca.202300040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/28/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023]
Abstract
PURPOSE Congenital disorders of glycosylation (CDG) are one of the fastest growing groups of inborn errors of metabolism. Despite the availability of next-generation sequencing techniques and advanced methods for evaluation of glycosylation, CDG screening mainly relies on the analysis of serum transferrin (Tf) by isoelectric focusing, HPLC or capillary electrophoresis. The main pitfall of this screening method is the presence of Tf protein variants within the general population. Although reports describe the role of Tf variants leading to falsely abnormal results, their significance in confounding diagnosis in patients with CDG has not been documented so far. Here, we describe two PMM2-CDG cases, in which Tf variants complicated the diagnostic. EXPERIMENTAL DESIGN Glycosylation investigations included classical screening techniques (capillary electrophoresis, isoelectric focusing and HPLC of Tf) and various confirmation techniques (two-dimensional electrophoresis, western blot, N-glycome, UPLC-FLR/QTOF MS with Rapifluor). Tf variants were highlighted following neuraminidase treatment. Sequencing of PMM2 was performed. RESULTS In both patients, Tf screening pointed to CDG-II, while second-line analyses pointed to CDG-I. Tf variants were found in both patients, explaining these discrepancies. PMM2 causative variants were identified in both patients. CONCLUSION AND CLINICAL RELEVANCE We suggest that a neuraminidase treatment should be performed when a typical CDG Tf pattern is found upon initial screening analysis.
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Affiliation(s)
- Alexandre Raynor
- AP-HP, Biochimie Métabolique et Cellulaire, Hôpital Bichat, Paris, France
| | - Arnaud Bruneel
- AP-HP, Biochimie Métabolique et Cellulaire, Hôpital Bichat, Paris, France
- INSERM UMR1193, Faculté de Pharmacie, Université Paris-Saclay, bâtiment Henri Moissan, Orsay, France
| | - Pieter Vermeersch
- Clinical Department of Laboratory Medicine, UZ Leuven, Leuven, Belgium
| | - Sophie Cholet
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), MetaboHUB, Gif sur Yvette, France
| | - Sebastian Friedrich
- Centre for Child and Adolescent Medicine Freiburg, Department of General Paediatrics, Adolescent Medicine and Neonatology, Freiburg, Germany
| | - Matthias Eckenweiler
- Department of Neuropediatrics and Muscle Disorders, Centre for Child and Adolescent Medicine Freiburg, Freiburg, Germany
| | - Anke Schumann
- Centre for Child and Adolescent Medicine Freiburg, Department of General Paediatrics, Adolescent Medicine and Neonatology, Freiburg, Germany
| | - Simone Hengst
- Department 1, Centre for Child and Adolescent Medicine Heidelberg, Heidelberg, Germany
| | - Ali Tunç Tuncel
- Department 1, Centre for Child and Adolescent Medicine Heidelberg, Heidelberg, Germany
| | - François Fenaille
- Université Paris-Saclay, CEA, INRAE, Département Médicaments et Technologies pour la Santé (DMTS), MetaboHUB, Gif sur Yvette, France
| | - Christian Thiel
- Department 1, Centre for Child and Adolescent Medicine Heidelberg, Heidelberg, Germany
| | - Daisy Rymen
- Department of Pediatrics, Center for Metabolic Diseases, University Hospitals Leuven, Leuven, Belgium
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Delafontaine S, Iannuzzo A, Bigley TM, Mylemans B, Rana R, Baatsen P, Poli MC, Rymen D, Jansen K, Mekahli D, Casteels I, Cassiman C, Demaerel P, Lepelley A, Frémond ML, Schrijvers R, Bossuyt X, Vints K, Huybrechts W, Tacine R, Willekens K, Corveleyn A, Boeckx B, Baggio M, Ehlers L, Munck S, Lambrechts D, Voet A, Moens L, Bucciol G, Cooper MA, Davis CM, Delon J, Meyts I. Heterozygous mutations in the C-terminal domain of COPA underlie a complex autoinflammatory syndrome. J Clin Invest 2024; 134:e163604. [PMID: 38175705 PMCID: PMC10866661 DOI: 10.1172/jci163604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/20/2023] [Indexed: 01/05/2024] Open
Abstract
Mutations in the N-terminal WD40 domain of coatomer protein complex subunit α (COPA) cause a type I interferonopathy, typically characterized by alveolar hemorrhage, arthritis, and nephritis. We described 3 heterozygous mutations in the C-terminal domain (CTD) of COPA (p.C1013S, p.R1058C, and p.R1142X) in 6 children from 3 unrelated families with a similar syndrome of autoinflammation and autoimmunity. We showed that these CTD COPA mutations disrupt the integrity and the function of coat protein complex I (COPI). In COPAR1142X and COPAR1058C fibroblasts, we demonstrated that COPI dysfunction causes both an anterograde ER-to-Golgi and a retrograde Golgi-to-ER trafficking defect. The disturbed intracellular trafficking resulted in a cGAS/STING-dependent upregulation of the type I IFN signaling in patients and patient-derived cell lines, albeit through a distinct molecular mechanism in comparison with mutations in the WD40 domain of COPA. We showed that CTD COPA mutations induce an activation of ER stress and NF-κB signaling in patient-derived primary cell lines. These results demonstrate the importance of the integrity of the CTD of COPA for COPI function and homeostatic intracellular trafficking, essential to ER homeostasis. CTD COPA mutations result in disease by increased ER stress, disturbed intracellular transport, and increased proinflammatory signaling.
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Affiliation(s)
- Selket Delafontaine
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Alberto Iannuzzo
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | - Tarin M. Bigley
- Department of Pediatrics, Division of Rheumatology/Immunology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Bram Mylemans
- Laboratory of Biomolecular Modelling and Design, Department of Chemistry, KU Leuven, Leuven, Belgium
| | - Ruchit Rana
- Division of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - Pieter Baatsen
- Electron Microscopy Platform of VIB Bio Imaging Core, KU Leuven, Leuven, Belgium
| | - Maria Cecilia Poli
- Department of Pediatrics, Clínica Alemana de Santiago, Universidad del Desarollo, Santiago, Chile
- Immunology and Rheumatology Unit, Hospital de Niños Dr. Roberto del Rio, Santiago, Chile
| | - Daisy Rymen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Katrien Jansen
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Djalila Mekahli
- PKD Research Group, Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
- Department of Pediatric Nephrology
| | | | | | - Philippe Demaerel
- Department of Radiology, University Hospitals Leuven, Leuven, Belgium
| | - Alice Lepelley
- Université Paris Cité, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, INSERM UMR 1163, Paris, France
| | - Marie-Louise Frémond
- Université Paris Cité, Imagine Institute, Laboratory of Neurogenetics and Neuroinflammation, INSERM UMR 1163, Paris, France
- Paediatric Haematology-Immunology and Rheumatology Unit, Necker Hospital, AP-HP.Centre - Université Paris Cité, Paris, France
| | - Rik Schrijvers
- Allergy and Clinical Immunology Research Group, Department of Microbiology, Immunology and Transplantation, and
| | - Xavier Bossuyt
- Clinical and Diagnostic Immunology, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Katlijn Vints
- Electron Microscopy Platform of VIB Bio Imaging Core, KU Leuven, Leuven, Belgium
| | - Wim Huybrechts
- Center for Human Genetics, Leuven University Hospitals, Leuven, Belgium
| | - Rachida Tacine
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | - Karen Willekens
- Center for Human Genetics, Leuven University Hospitals, Leuven, Belgium
| | - Anniek Corveleyn
- Center for Human Genetics, Leuven University Hospitals, Leuven, Belgium
| | - Bram Boeckx
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, Leuven, Belgium
| | - Marco Baggio
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Lisa Ehlers
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Sebastian Munck
- VIB Bio Imaging Core and VIB–KU Leuven Center for Brain & Disease Research, KU Leuven Department of Neurosciences, Leuven, Belgium
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Human Genetics, KU Leuven, Leuven, Belgium
- VIB Center for Cancer Biology, Leuven, Belgium
| | - Arnout Voet
- Laboratory of Biomolecular Modelling and Design, Department of Chemistry, KU Leuven, Leuven, Belgium
| | - Leen Moens
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
| | - Giorgia Bucciol
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Megan A. Cooper
- Department of Pediatrics, Division of Rheumatology/Immunology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Carla M. Davis
- Division of Immunology, Allergy and Retrovirology, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas, USA
| | - Jérôme Delon
- Université Paris Cité, CNRS, INSERM, Institut Cochin, Paris, France
| | - Isabelle Meyts
- Laboratory for Inborn Errors of Immunity, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
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del Caño-Ochoa F, Ng BG, Rubio-del-Campo A, Mahajan S, Wilson MP, Vilar M, Rymen D, Sánchez-Pintos P, Kenny J, Martos ML, Campos T, Wortmann SB, Freeze HH, Ramón-Maiques S. Beyond genetics: Deciphering the impact of missense variants in CAD deficiency. J Inherit Metab Dis 2023; 46:1170-1185. [PMID: 37540500 PMCID: PMC10838372 DOI: 10.1002/jimd.12667] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/29/2023] [Accepted: 08/01/2023] [Indexed: 08/05/2023]
Abstract
CAD is a large, 2225 amino acid multienzymatic protein required for de novo pyrimidine biosynthesis. Pathological CAD variants cause a developmental and epileptic encephalopathy which is highly responsive to uridine supplements. CAD deficiency is difficult to diagnose because symptoms are nonspecific, there is no biomarker, and the protein has over 1000 known variants. To improve diagnosis, we assessed the pathogenicity of 20 unreported missense CAD variants using a growth complementation assay that identified 11 pathogenic variants in seven affected individuals; they would benefit from uridine treatment. We also tested nine variants previously reported as pathogenic and confirmed the damaging effect of seven. However, we reclassified two variants as likely benign based on our assay, which is consistent with their long-term follow-up with uridine. We found that several computational methods are unreliable predictors of pathogenic CAD variants, so we extended the functional assay results by studying the impact of pathogenic variants at the protein level. We focused on CAD's dihydroorotase (DHO) domain because it accumulates the largest density of damaging missense changes. The atomic-resolution structures of eight DHO pathogenic variants, combined with functional and molecular dynamics analyses, provided a comprehensive structural and functional understanding of the activity, stability, and oligomerization of CAD's DHO domain. Combining our functional and protein structural analysis can help refine clinical diagnostic workflow for CAD variants in the genomics era.
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Affiliation(s)
- Francisco del Caño-Ochoa
- Structure of Macromolecular Targets Unit. Instituto de Biomedicina de Valencia (IBV), CSIC. Valencia, Spain
| | - Bobby G. Ng
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Antonio Rubio-del-Campo
- Structure of Macromolecular Targets Unit. Instituto de Biomedicina de Valencia (IBV), CSIC. Valencia, Spain
| | - Sonal Mahajan
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Matthew P. Wilson
- Laboratory for Molecular Diagnosis, Center for Human Genetics, KU Leuven, 3000 Leuven, Belgium
| | - Marçal Vilar
- Molecular Basis of Neurodegeneration Unit. Instituto de Biomedicina de Valencia (IBV), CSIC. Valencia, Spain
| | - Daisy Rymen
- Department of Pediatrics - Center for Metabolic Diseases, University Hospitals of Leuven, Belgium
| | - Paula Sánchez-Pintos
- Unidad de Diagnóstico y Tratamiento de Enfermedades Metabólicas Congénitas. C.S.U.R. de Enfermedades Metabólicas. MetabERN. Hospital Clínico Universitario de Santiago de Compostela, La Coruña, Spain
- Instituto de Investigación Sanitaria Santiago de Compostela (IDIS), La Coruña, Spain
| | - Janna Kenny
- Children's Health Ireland at Crumlin, Ireland
| | - Myriam Ley Martos
- Pediatric Neurology Unit. Hospital Universitario Puerta del Mar, Cádiz, Spain
| | - Teresa Campos
- Reference Center of Inherited Metabolic Diseases of Hospital de São João, Porto, Portugal
| | - Saskia B. Wortmann
- University Children’s Hospital, Paracelsus Medical University (PMU), Salzburg, Austria
- Amalia Children’s Hospital, Radboudumc, Nijmegen, The Netherlands
| | - Hudson H. Freeze
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, CA, USA
| | - Santiago Ramón-Maiques
- Structure of Macromolecular Targets Unit. Instituto de Biomedicina de Valencia (IBV), CSIC. Valencia, Spain
- Group 739, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER)–Instituto de Salud Carlos III, Valencia, Spain
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Adant I, Bird M, Decru B, Windmolders P, Wallays M, de Witte P, Rymen D, Witters P, Vermeersch P, Cassiman D, Ghesquière B. Pyruvate and uridine rescue the metabolic profile of OXPHOS dysfunction. Mol Metab 2022; 63:101537. [PMID: 35772644 PMCID: PMC9287363 DOI: 10.1016/j.molmet.2022.101537] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/31/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction Primary mitochondrial diseases (PMD) are a large, heterogeneous group of genetic disorders affecting mitochondrial function, mostly by disrupting the oxidative phosphorylation (OXPHOS) system. Understanding the cellular metabolic re-wiring occurring in PMD is crucial for the development of novel diagnostic tools and treatments, as PMD are often complex to diagnose and most of them currently have no effective therapy. Objectives To characterize the cellular metabolic consequences of OXPHOS dysfunction and based on the metabolic signature, to design new diagnostic and therapeutic strategies. Methods In vitro assays were performed in skin-derived fibroblasts obtained from patients with diverse PMD and validated in pharmacological models of OXPHOS dysfunction. Proliferation was assessed using the Incucyte technology. Steady-state glucose and glutamine tracing studies were performed with LC-MS quantification of cellular metabolites. The therapeutic potential of nutritional supplements was evaluated by assessing their effect on proliferation and on the metabolomics profile. Successful therapies were then tested in a in vivo lethal rotenone model in zebrafish. Results OXPHOS dysfunction has a unique metabolic signature linked to an NAD+/NADH imbalance including depletion of TCA intermediates and aspartate, and increased levels of glycerol-3-phosphate. Supplementation with pyruvate and uridine fully rescues this altered metabolic profile and the subsequent proliferation deficit. Additionally, in zebrafish, the same nutritional treatment increases the survival after rotenone exposure. Conclusions Our findings reinforce the importance of the NAD+/NADH imbalance following OXPHOS dysfunction in PMD and open the door to new diagnostic and therapeutic tools for PMD. OXPHOS deficiency causes a distinct metabolic profile linked to a NAD+/NADH imbalance. Depleted intracellular aspartic acid is a potential biomarker for OXPHOS dysfunction. Therapy with pyruvate and uridine corrects the metabolic profile of OXPHOS deficiency. Pyruvate and uridine treatment increases survival in a lethal rotenone zebrafish model.
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Affiliation(s)
- Isabelle Adant
- Laboratory of Hepatology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, 3000, Belgium; Metabolomics Expertise Center, Center for Cancer Biology, CCB-VIB, VIB, Leuven, 3000, Belgium
| | - Matthew Bird
- Laboratory of Hepatology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, 3000, Belgium; Metabolomics Expertise Center, Center for Cancer Biology, CCB-VIB, VIB, Leuven, 3000, Belgium; Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, 3000, Belgium
| | - Bram Decru
- Laboratory of Hepatology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, 3000, Belgium; Metabolomics Expertise Center, Center for Cancer Biology, CCB-VIB, VIB, Leuven, 3000, Belgium
| | - Petra Windmolders
- Laboratory of Hepatology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, 3000, Belgium
| | - Marie Wallays
- Laboratory of Hepatology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, 3000, Belgium
| | - Peter de Witte
- Laboratory for Molecular Biodiscovery, Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Leuven, 3000, Belgium
| | - Daisy Rymen
- Metabolic Centre, University Hospitals Leuven, Leuven, 3000, Belgium
| | - Peter Witters
- Metabolic Centre, University Hospitals Leuven, Leuven, 3000, Belgium
| | - Pieter Vermeersch
- Clinical Department of Laboratory Medicine, University Hospitals Leuven, Leuven, 3000, Belgium; Department of Cardiovascular Sciences, KU Leuven, Leuven, 3000, Belgium
| | - David Cassiman
- Laboratory of Hepatology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, Leuven, 3000, Belgium; Metabolic Centre, University Hospitals Leuven, Leuven, 3000, Belgium.
| | - Bart Ghesquière
- Metabolomics Expertise Center, Center for Cancer Biology, CCB-VIB, VIB, Leuven, 3000, Belgium; Metabolomics Expertise Center, Department of Oncology, KU Leuven, Leuven, 3000, Belgium.
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7
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Wilson MP, Durin Z, Unal Ö, Ng BG, Marrecau T, Keldermans L, Souche E, Rymen D, Gündüz M, Köse G, Sturiale L, Garozzo D, Freeze HH, Jaeken J, Foulquier F, Matthijs G. CAMLG-CDG: a novel congenital disorder of glycosylation linked to defective membrane trafficking. Hum Mol Genet 2022; 31:2571-2581. [PMID: 35262690 PMCID: PMC9396942 DOI: 10.1093/hmg/ddac055] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 09/13/2021] [Revised: 02/15/2022] [Accepted: 03/07/2022] [Indexed: 12/03/2022] Open
Abstract
The transmembrane domain recognition complex (TRC) pathway is required for the insertion of C-terminal tail-anchored (TA) proteins into the lipid bilayer of specific intracellular organelles such as the endoplasmic reticulum (ER) membrane. In order to facilitate correct insertion, the recognition complex (consisting of BAG6, GET4 and UBL4A) must first bind to TA proteins and then to GET3 (TRC40, ASNA1), which chaperones the protein to the ER membrane. Subsequently, GET1 (WRB) and CAML form a receptor that enables integration of the TA protein within the lipid bilayer. We report an individual with the homozygous c.633 + 4A>G splice variant in CAMLG, encoding CAML. This variant leads to aberrant splicing and lack of functional protein in patient-derived fibroblasts. The patient displays a predominantly neurological phenotype with psychomotor disability, hypotonia, epilepsy and structural brain abnormalities. Biochemically, a combined O-linked and type II N-linked glycosylation defect was found. Mislocalization of syntaxin-5 in patient fibroblasts and in siCAMLG deleted Hela cells confirms this as a consistent cellular marker of TRC dysfunction. Interestingly, the level of the v-SNARE Bet1L is also drastically reduced in both of these models, indicating a fundamental role of the TRC complex in the assembly of Golgi SNARE complexes. It also points towards a possible mechanism behind the hyposialylation of N and O-glycans. This is the first reported patient with pathogenic variants in CAMLG. CAMLG-CDG is the third disorder, after GET4 and GET3 deficiencies, caused by pathogenic variants in a member of the TRC pathway, further expanding this novel group of disorders.
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Affiliation(s)
- Matthew P Wilson
- Laboratory for Molecular Diagnosis, Center for Human Genetics, KU Leuven, 3000 Leuven, Belgium
| | - Zoé Durin
- Univ. Lille, CNRS, UMR 8576, UGSF, Unité de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - Özlem Unal
- Division of Pediatric Metabolism and Nutrition, Ankara Children's Training and Research Hospital, Ankara, Turkey
| | - Bobby G Ng
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, CA 92037, USA
| | - Thomas Marrecau
- Laboratory for Molecular Diagnosis, Center for Human Genetics, KU Leuven, 3000 Leuven, Belgium
| | - Liesbeth Keldermans
- Laboratory for Molecular Diagnosis, Center for Human Genetics, KU Leuven, 3000 Leuven, Belgium
| | - Erika Souche
- Laboratory for Molecular Diagnosis, Center for Human Genetics, KU Leuven, 3000 Leuven, Belgium
| | - Daisy Rymen
- Department of Pediatrics, Center for Metabolic Diseases, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Mehmet Gündüz
- Division of Pediatric Metabolism and Nutrition, Ankara Children's Training and Research Hospital, Ankara, Turkey
| | - Gülşen Köse
- Department of Pediatric Neurology, Şişli Etfal Education and Research Hospital, Istanbul, Turkey
| | - Luisa Sturiale
- CNR, Institute for Polymers, Composites and Biomaterials, IPCB, Catania, Italy
| | - Domenico Garozzo
- CNR, Institute for Polymers, Composites and Biomaterials, IPCB, Catania, Italy
| | - Hudson H Freeze
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California, CA 92037, USA
| | - Jaak Jaeken
- Department of Pediatrics, Center for Metabolic Diseases, University Hospitals Leuven, 3000 Leuven, Belgium
| | - François Foulquier
- Univ. Lille, CNRS, UMR 8576, UGSF, Unité de Glycobiologie Structurale et Fonctionnelle, 59000 Lille, France
| | - Gert Matthijs
- Laboratory for Molecular Diagnosis, Center for Human Genetics, KU Leuven, 3000 Leuven, Belgium
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8
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Wilson MP, Garanto A, Pinto e Vairo F, Ng BG, Ranatunga WK, Ventouratou M, Baerenfaenger M, Huijben K, Thiel C, Ashikov A, Keldermans L, Souche E, Vuillaumier-Barrot S, Dupré T, Michelakakis H, Fiumara A, Pitt J, White SM, Lim SC, Gallacher L, Peters H, Rymen D, Witters P, Ribes A, Morales-Romero B, Rodríguez-Palmero A, Ballhausen D, de Lonlay P, Barone R, Janssen MC, Jaeken J, Freeze HH, Matthijs G, Morava E, Lefeber DJ. Active site variants in STT3A cause a dominant type I congenital disorder of glycosylation with neuromusculoskeletal findings. Am J Hum Genet 2021; 108:2130-2144. [PMID: 34653363 DOI: 10.1016/j.ajhg.2021.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 09/21/2021] [Indexed: 12/27/2022] Open
Abstract
Congenital disorders of glycosylation (CDGs) form a group of rare diseases characterized by hypoglycosylation. We here report the identification of 16 individuals from nine families who have either inherited or de novo heterozygous missense variants in STT3A, leading to an autosomal-dominant CDG. STT3A encodes the catalytic subunit of the STT3A-containing oligosaccharyltransferase (OST) complex, essential for protein N-glycosylation. Affected individuals presented with variable skeletal anomalies, short stature, macrocephaly, and dysmorphic features; half had intellectual disability. Additional features included increased muscle tone and muscle cramps. Modeling of the variants in the 3D structure of the OST complex indicated that all variants are located in the catalytic site of STT3A, suggesting a direct mechanistic link to the transfer of oligosaccharides onto nascent glycoproteins. Indeed, expression of STT3A at mRNA and steady-state protein level in fibroblasts was normal, while glycosylation was abnormal. In S. cerevisiae, expression of STT3 containing variants homologous to those in affected individuals induced defective glycosylation of carboxypeptidase Y in a wild-type yeast strain and expression of the same mutants in the STT3 hypomorphic stt3-7 yeast strain worsened the already observed glycosylation defect. These data support a dominant pathomechanism underlying the glycosylation defect. Recessive mutations in STT3A have previously been described to lead to a CDG. We present here a dominant form of STT3A-CDG that, because of the presence of abnormal transferrin glycoforms, is unusual among dominant type I CDGs.
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9
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Rapp CK, Van Dijck I, Laugwitz L, Boon M, Briassoulis G, Ilia S, Kammer B, Reu S, Hornung S, Buchert R, Sofan L, Froukh T, Witters P, Rymen D, Haack TB, Proesmans M, Griese M. Expanding the phenotypic spectrum of FINCA (fibrosis, neurodegeneration, and cerebral angiomatosis) syndrome beyond infancy. Clin Genet 2021; 100:453-461. [PMID: 34165204 DOI: 10.1111/cge.14016] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 06/11/2021] [Accepted: 06/21/2021] [Indexed: 11/28/2022]
Abstract
Fibrosis, neurodegeneration, and cerebral angiomatosis (FINCA, MIM#618278) is a rare clinical condition caused by bi-allelic variants in NHL repeat containing protein 2 (NHLRC2, MIM*618277). Pulmonary disease may be the presenting sign and the few patients reported so far, all deceased in early infancy. Exome sequencing was performed on patients with childhood interstitial lung disease (chILD) and additional neurological features. The chILD-EU register database and an in-house database were searched for patients with NHLRC2 variants and clinical features overlapping FINCA syndrome. Six patients from three families were identified with bi-allelic variants in NHLRC2. Two of these children died before the age of two while four others survived until childhood. Interstitial lung disease was pronounced in almost all patients during infancy and stabilized over the course of the disease with neurodevelopmental delay (NDD) evolving as the key clinical finding. We expand the phenotype of FINCA syndrome to a multisystem disorder with variable severity. FINCA syndrome should also be considered in patients beyond infancy with NDD and a history of distinct interstitial lung disease. Managing patients in registers for rare diseases helps identifying new diagnostic entities and advancing care for these patients.
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Affiliation(s)
- Christina K Rapp
- Dr. von Haunersches Kinderspital, University of Munich, German Center for Lung Research, Munich, Germany
| | - Ine Van Dijck
- Department of Pediatric Pulmonology, University Hospitals Leuven campus Gasthuisberg, Leuven, Belgium
| | - Lucia Laugwitz
- Institute of Medical Genetics and Applied Genomics, University Hospital of Tuebingen, Tübingen, Germany.,Department of Neuropediatrics, Developmental Neurology and Social Pediatrics, University of Tübingen, Tübingen, Germany
| | - Mieke Boon
- Department of Pediatric Pulmonology, University Hospitals Leuven campus Gasthuisberg, Leuven, Belgium
| | - George Briassoulis
- Pediatric Intensive Care Unit, Medical School, University of Crete, Crete, Greece
| | - Stavroula Ilia
- Pediatric Intensive Care Unit, Medical School, University of Crete, Crete, Greece
| | - Birgit Kammer
- Department of Radiology, Pediatric Radiology, University of Munich, Munich, Germany
| | - Simone Reu
- Institute of Pathology, University of Würzburg, Würzburg, Germany
| | - Stefanie Hornung
- Consulting & Training, SH Mgt. Consulting & Training, Siegmund-Schacky-Straße 27, Munich, Germany
| | - Rebecca Buchert
- Institute of Medical Genetics and Applied Genomics, University Hospital of Tuebingen, Tübingen, Germany
| | - Linda Sofan
- Institute of Medical Genetics and Applied Genomics, University Hospital of Tuebingen, Tübingen, Germany
| | - Tawfiq Froukh
- Department of Biotechnology and Genetic Engineering, Philadelphia University, Amman, Jordan
| | - Peter Witters
- Department of Pediatric Metabolic disease, University Hospitals Leuven campus Gasthuisberg, Leuven, Belgium
| | - Daisy Rymen
- Department of Pediatric Metabolic disease, University Hospitals Leuven campus Gasthuisberg, Leuven, Belgium
| | - Tobias B Haack
- Institute of Pathology, University of Würzburg, Würzburg, Germany.,Centre for Rare Diseases, University of Tübingen, Tübingen, Germany
| | - Marijke Proesmans
- Department of Pediatric Pulmonology, University Hospitals Leuven campus Gasthuisberg, Leuven, Belgium
| | - Matthias Griese
- Dr. von Haunersches Kinderspital, University of Munich, German Center for Lung Research, Munich, Germany
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10
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Wilson MP, Quelhas D, Leão‐Teles E, Sturiale L, Rymen D, Keldermans L, Race V, Souche E, Rodrigues E, Campos T, Van Schaftingen E, Foulquier F, Garozzo D, Matthijs G, Jaeken J. SLC37A4-CDG: Second patient. JIMD Rep 2021; 58:122-128. [PMID: 33728255 PMCID: PMC7932867 DOI: 10.1002/jmd2.12195] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/01/2020] [Accepted: 12/16/2020] [Indexed: 12/19/2022] Open
Abstract
Recently, a disorder caused by the heterozygous de novo c.1267C>T (p.R423*) substitution in SLC37A4 has been described. This causes mislocalization of the glucose-6-phosphate transporter to the Golgi leading to a congenital disorder of glycosylation type II (SLC37A4-CDG). Only one patient has been reported showing liver disease that improved with age and mild dysmorphism. Here we report the second patient with a type II CDG caused by the same heterozygous de novo c.1267C>T (p.R423*) mutation thereby confirming the pathogenicity of this variant and expanding the clinical picture with type 1 diabetes, severe scoliosis, and membranoproliferative glomerulonephritis. Additional clinical and biochemical data provide further insight into the mechanism and prognosis of SLC37A4-CDG.
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Affiliation(s)
- Matthew P. Wilson
- Laboratory for Molecular DiagnosisCenter for Human Genetics, KU LeuvenLeuvenBelgium
| | - Dulce Quelhas
- Centro de Genetica Medica Jacinto de Magalhaes, Centro Hospitalar Universitário de São JoãoPortoPortugal
| | - Elisa Leão‐Teles
- Centro de Referência de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de São JoãoPortoPortugal
| | - Luisa Sturiale
- CNR, Institute for Polymers, Composites and Biomaterials (IPCB)CataniaItaly
| | - Daisy Rymen
- Department of PediatricsCenter for Metabolic Diseases, University Hospitals LeuvenLeuvenBelgium
| | - Liesbeth Keldermans
- Laboratory for Molecular DiagnosisCenter for Human Genetics, KU LeuvenLeuvenBelgium
| | - Valérie Race
- Laboratory for Molecular DiagnosisCenter for Human Genetics, KU LeuvenLeuvenBelgium
| | - Erika Souche
- Laboratory for Molecular DiagnosisCenter for Human Genetics, KU LeuvenLeuvenBelgium
| | - Esmeralda Rodrigues
- Centro de Referência de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de São JoãoPortoPortugal
| | - Teresa Campos
- Centro de Referência de Doenças Hereditárias do Metabolismo, Centro Hospitalar Universitário de São JoãoPortoPortugal
| | | | - François Foulquier
- Univ. Lille, CNRS, UMR 8576, UGSF, Unité de Glycobiologie Structurale et FonctionnelleLilleFrance
| | - Domenico Garozzo
- CNR, Institute for Polymers, Composites and Biomaterials (IPCB)CataniaItaly
| | - Gert Matthijs
- Laboratory for Molecular DiagnosisCenter for Human Genetics, KU LeuvenLeuvenBelgium
| | - Jaak Jaeken
- Department of PediatricsCenter for Metabolic Diseases, University Hospitals LeuvenLeuvenBelgium
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11
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Altassan R, Radenkovic S, Edmondson AC, Barone R, Brasil S, Cechova A, Coman D, Donoghue S, Falkenstein K, Ferreira V, Ferreira C, Fiumara A, Francisco R, Freeze H, Grunewald S, Honzik T, Jaeken J, Krasnewich D, Lam C, Lee J, Lefeber D, Marques-da-Silva D, Pascoal C, Quelhas D, Raymond KM, Rymen D, Seroczynska M, Serrano M, Sykut-Cegielska J, Thiel C, Tort F, Vals MA, Videira P, Voermans N, Witters P, Morava E. International consensus guidelines for phosphoglucomutase 1 deficiency (PGM1-CDG): Diagnosis, follow-up, and management. J Inherit Metab Dis 2021; 44:148-163. [PMID: 32681750 PMCID: PMC7855268 DOI: 10.1002/jimd.12286] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/07/2020] [Accepted: 07/14/2020] [Indexed: 12/13/2022]
Abstract
Phosphoglucomutase 1 (PGM1) deficiency is a rare genetic disorder that affects glycogen metabolism, glycolysis, and protein glycosylation. Previously known as GSD XIV, it was recently reclassified as a congenital disorder of glycosylation, PGM1-CDG. PGM1-CDG usually manifests as a multisystem disease. Most patients present as infants with cleft palate, liver function abnormalities and hypoglycemia, but some patients present in adulthood with isolated muscle involvement. Some patients develop life-threatening cardiomyopathy. Unlike most other CDG, PGM1-CDG has an effective treatment option, d-galactose, which has been shown to improve many of the patients' symptoms. Therefore, early diagnosis and initiation of treatment for PGM1-CDG patients are crucial decisions. In this article, our group of international experts suggests diagnostic, follow-up, and management guidelines for PGM1-CDG. These guidelines are based on the best available evidence-based data and experts' opinions aiming to provide a practical resource for health care providers to facilitate successful diagnosis and optimal management of PGM1-CDG patients.
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Affiliation(s)
- Ruqaiah Altassan
- Department of Medical Genetics, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Silvia Radenkovic
- Metabolomics Expertise Center, Center for Cancer Biology, VIB, Leuven, Belgium
- Metabolomics Expertise Center, Department of Oncology, KU Leuven, Leuven, Belgium
- Laboratory of Hepatology, Department CHROMETA, KU Leuven, Leuven, Belgium
- Department of Clinical Genomics and Laboratory of Medical Pathology, Mayo Clinic, Rochester, Minnesota
| | - Andrew C. Edmondson
- Department of Pediatrics, Division of Human Genetics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Rita Barone
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Sandra Brasil
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Anna Cechova
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - David Coman
- Metabolic Medicine, Queensland Children’s Hospital, Brisbane, Australia
| | - Sarah Donoghue
- Department of Metabolic Medicine, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Kristina Falkenstein
- Center for Child and Adolescent Medicine, Department, University of Heidelberg, Heidelberg, Germany
| | - Vanessa Ferreira
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
| | - Carlos Ferreira
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Agata Fiumara
- Child Neurology and Psychiatry Unit, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Rita Francisco
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Hudson Freeze
- Sanford Children’s Health Research Center, Sanford-Burnham-Prebys Medical Discovery Institute, La Jolla, California
| | - Stephanie Grunewald
- Metabolic Department, Great Ormond Street Hospital NHS Foundation Trust and Institute for Child Health, NIHR Biomedical Research Center (BRC), University College London, London, UK
| | - Tomas Honzik
- Department of Paediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - Jaak Jaeken
- Center for Metabolic Diseases, KU Leuven, Leuven, Belgium
| | - Donna Krasnewich
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Christina Lam
- Division of Genetic Medicine, Department of Pediatrics, University of Washington School of Medicine, Seattle, Washington
- Center for Integrative Brain Research, Seattle Children’s Research Institute, Seattle, Washington
| | - Joy Lee
- Department of Metabolic Medicine, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Dirk Lefeber
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, Netherlands
| | - Dorinda Marques-da-Silva
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Carlota Pascoal
- Portuguese Association for Congenital Disorders of Glycosylation (CDG), Lisbon, Portugal
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Dulce Quelhas
- Centro de Genética Médica Doutor Jacinto Magalhães, Unidade de Bioquímica Genética, Porto, Portugal
| | - Kimiyo M. Raymond
- Biochemical Genetics Laboratory, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Daisy Rymen
- Department of Paediatrics and Metabolic Center, University Hospitals Leuven, Leuven, Belgium
| | - Malgorzata Seroczynska
- Department of Inborn Errors of Metabolism and Paediatrics, the Institute of Mother and Child, Warsaw, Poland
| | - Mercedes Serrano
- Neurology Department, Hospital Sant Joan de Déu, U-703 Centre for Biomedical Research on Rare Diseases (CIBER-ER), Instituto de Salud Carlos III, Barcelona, Spain
| | - Jolanta Sykut-Cegielska
- Department of Inborn Errors of Metabolism and Paediatrics, the Institute of Mother and Child, Warsaw, Poland
| | - Christian Thiel
- Center for Child and Adolescent Medicine, Department, University of Heidelberg, Heidelberg, Germany
| | - Frederic Tort
- Section of Inborn Errors of Metabolism, Department of Biochemistry and Molecular Genetics, Hospital Clínic, IDIBAPS, CIBERER, Barcelona, Spain
| | - Mari-Anne Vals
- Department of Clinical Genetics, Institute of Clinical Medicine, University of Tartu, Tartu, Estonia
| | - Paula Videira
- UCIBIO, Departamento Ciências da Vida, Faculdade de Ciências e Tecnologia, Universidade NOVA de Lisboa, Caparica, Lisbon, Portugal
- Professionals and Patient Associations International Network (CDG & Allies-PPAIN), Lisbon, Portugal
| | - Nicol Voermans
- Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Peter Witters
- Department of Paediatrics and Metabolic Center, University Hospitals Leuven, Leuven, Belgium
- Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Eva Morava
- Department of Clinical Genomics and Laboratory of Medical Pathology, Mayo Clinic, Rochester, Minnesota
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12
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Rymen D, Lindhout M, Spanou M, Ashrafzadeh F, Benkel I, Betzler C, Coubes C, Hartmann H, Kaplan JD, Ballhausen D, Koch J, Lotte J, Mohammadi MH, Rohrbach M, Dinopoulos A, Wermuth M, Willis D, Brugger K, Wevers RA, Boltshauser E, Bierau J, Mayr JA, Wortmann SB. Expanding the clinical and genetic spectrum of CAD deficiency: an epileptic encephalopathy treatable with uridine supplementation. Genet Med 2020; 22:1589-1597. [PMID: 32820246 DOI: 10.1038/s41436-020-0933-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 04/01/2020] [Revised: 07/02/2020] [Accepted: 07/28/2020] [Indexed: 01/05/2023] Open
Abstract
PURPOSE Biallelic CAD variants underlie CAD deficiency (or early infantile epileptic encephalopathy-50, [EIEE-50]), an error of pyrimidine de novo biosynthesis amenable to treatment via the uridine salvage pathway. We further define the genotype and phenotype with a focus on treatment. METHODS Retrospective case series of 20 patients. RESULTS Our study confirms CAD deficiency as a progressive EIEE with recurrent status epilepticus, loss of skills, and dyserythropoietic anemia. We further refine the phenotype by reporting a movement disorder as a frequent feature, and add that milder courses with isolated developmental delay/intellectual disability can occur as well as onset with neonatal seizures. With no biomarker available, the diagnosis relies on genetic testing and functional validation in patient-derived fibroblasts. Underlying pathogenic variants are often rated as variants of unknown significance, which could lead to underrecognition of this treatable disorder. Supplementation with uridine, uridine monophosphate, or uridine triacetate in ten patients was safe and led to significant clinical improvement in most patients. CONCLUSION We advise a trial with uridine (monophosphate) in all patients with developmental delay/intellectual disability, epilepsy, and anemia; all patients with status epilepticus; and all patients with neonatal seizures until (genetically) proven otherwise or proven unsuccessful after 6 months. CAD deficiency might represent a condition for genetic newborn screening.
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Affiliation(s)
- Daisy Rymen
- Metabolic Center, University Hospitals Leuven, Leuven, Belgium
| | - Martijn Lindhout
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Maria Spanou
- 3rd Paediatric Department, Attikon University Hospital, Athens, Greece
| | - Farah Ashrafzadeh
- Department of Pediatric Neurology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ira Benkel
- Klinik für Kinderneurologie und Kinderneurologisches Zentrum, EEG, Sana Kliniken Düsseldorf GmbH, Düsseldorf, Germany
| | - Cornelia Betzler
- Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany.,Institute for Transition, Rehabilitation and Palliation, Paracelsus Private Medical University of Salzburg, Salzburg, Austria
| | - Christine Coubes
- Département de Génétique Médicale, Maladies Rares et Médecine Personnalisée, CHU, Montpellier, France
| | - Hans Hartmann
- Clinic for Pediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Julie D Kaplan
- Nemours A.I. DuPont Hospital for Children, Department of Pediatrics, Division of Medical Genetics, Wilmington, Delaware, DE, USA.,Department of Pediatrics, Division of Medical Genetics, University of Mississippi Medical Center, Jackson, MS, USA
| | - Diana Ballhausen
- Pediatric unit for metabolic diseases, Woman-Mother-Child Department, University Hospital Lausanne, Lausanne, Switzerland
| | - Johannes Koch
- University Children's Hospital, Paracelsus Medical University (PMU), Salzburg, Austria
| | - Jan Lotte
- Clinic for Neuropediatrics and Neurological Rehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik Vogtareuth, Vogtareuth, Germany
| | | | - Marianne Rohrbach
- Division of Metabolism and Children's Research Centre, University Children's Hospital, 8032, Zürich, Switzerland
| | | | - Marieke Wermuth
- Department of Pediatrics, Klinikum Links der Weser, Bremen, Germany
| | - Daniel Willis
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Karin Brugger
- University Children's Hospital, Paracelsus Medical University (PMU), Salzburg, Austria
| | - Ron A Wevers
- Department Laboratory Medicine, Translational Metabolic Laboratory, Radboudumc, Nijmegen, The Netherlands
| | - Eugen Boltshauser
- Department of Pediatric Neurology, Children's University Hospital, Zürich, Switzerland
| | - Jörgen Bierau
- Department of Clinical Genetics, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Johannes A Mayr
- University Children's Hospital, Paracelsus Medical University (PMU), Salzburg, Austria
| | - Saskia B Wortmann
- University Children's Hospital, Paracelsus Medical University (PMU), Salzburg, Austria. .,Radboud Center for Mitochondrial Medicine, Department of Pediatrics, Amalia Children's Hospital, Radboudumc, Nijmegen, The Netherlands.
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13
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Rymen D, Ritelli M, Zoppi N, Cinquina V, Giunta C, Rohrbach M, Colombi M. Clinical and Molecular Characterization of Classical-Like Ehlers-Danlos Syndrome Due to a Novel TNXB Variant. Genes (Basel) 2019; 10:genes10110843. [PMID: 31731524 PMCID: PMC6895888 DOI: 10.3390/genes10110843] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 10/20/2019] [Accepted: 10/23/2019] [Indexed: 12/21/2022] Open
Abstract
The Ehlers-Danlos syndromes (EDS) constitute a clinically and genetically heterogeneous group of connective tissue disorders. Tenascin X (TNX) deficiency is a rare type of EDS, defined as classical-like EDS (clEDS), since it phenotypically resembles the classical form of EDS, though lacking atrophic scarring. Although most patients display a well-defined phenotype, the diagnosis of TNX-deficiency is often delayed or overlooked. Here, we described an additional patient with clEDS due to a homozygous null-mutation in the TNXB gene. A review of the literature was performed, summarizing the most important and distinctive clinical signs of this disorder. Characterization of the cellular phenotype demonstrated a distinct organization of the extracellular matrix (ECM), whereby clEDS distinguishes itself from most other EDS subtypes by normal deposition of fibronectin in the ECM and a normal organization of the α5β1 integrin.
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Affiliation(s)
- Daisy Rymen
- Connective Tissue Unit, Division of Metabolism and Children’s Research Centre, University Children’s Hospital, 8032 Zürich, Switzerland; (C.G.); (M.R.)
- Correspondence:
| | - Marco Ritelli
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy; (M.R.); (N.Z.); (V.C.); (M.C.)
| | - Nicoletta Zoppi
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy; (M.R.); (N.Z.); (V.C.); (M.C.)
| | - Valeria Cinquina
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy; (M.R.); (N.Z.); (V.C.); (M.C.)
| | - Cecilia Giunta
- Connective Tissue Unit, Division of Metabolism and Children’s Research Centre, University Children’s Hospital, 8032 Zürich, Switzerland; (C.G.); (M.R.)
| | - Marianne Rohrbach
- Connective Tissue Unit, Division of Metabolism and Children’s Research Centre, University Children’s Hospital, 8032 Zürich, Switzerland; (C.G.); (M.R.)
| | - Marina Colombi
- Division of Biology and Genetics, Department of Molecular and Translational Medicine, University of Brescia, 25123 Brescia, Italy; (M.R.); (N.Z.); (V.C.); (M.C.)
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14
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Cousin MA, Conboy E, Wang JS, Lenz D, Schwab TL, Williams M, Abraham RS, Barnett S, El-Youssef M, Graham RP, Gutierrez Sanchez LH, Hasadsri L, Hoffmann GF, Hull NC, Kopajtich R, Kovacs-Nagy R, Li JQ, Marx-Berger D, McLin V, McNiven MA, Mounajjed T, Prokisch H, Rymen D, Schulze RJ, Staufner C, Yang Y, Clark KJ, Lanpher BC, Klee EW. RINT1 Bi-allelic Variations Cause Infantile-Onset Recurrent Acute Liver Failure and Skeletal Abnormalities. Am J Hum Genet 2019; 105:108-121. [PMID: 31204009 DOI: 10.1016/j.ajhg.2019.05.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Accepted: 05/13/2019] [Indexed: 01/12/2023] Open
Abstract
Pediatric acute liver failure (ALF) is life threatening with genetic, immunologic, and environmental etiologies. Approximately half of all cases remain unexplained. Recurrent ALF (RALF) in infants describes repeated episodes of severe liver injury with recovery of hepatic function between crises. We describe bi-allelic RINT1 alterations as the cause of a multisystem disorder including RALF and skeletal abnormalities. Three unrelated individuals with RALF onset ≤3 years of age have splice alterations at the same position (c.1333+1G>A or G>T) in trans with a missense (p.Ala368Thr or p.Leu370Pro) or in-frame deletion (p.Val618_Lys619del) in RINT1. ALF episodes are concomitant with fever/infection and not all individuals have complete normalization of liver function testing between episodes. Liver biopsies revealed nonspecific liver damage including fibrosis, steatosis, or mild increases in Kupffer cells. Skeletal imaging revealed abnormalities affecting the vertebrae and pelvis. Dermal fibroblasts showed splice-variant mediated skipping of exon 9 leading to an out-of-frame product and nonsense-mediated transcript decay. Fibroblasts also revealed decreased RINT1 protein, abnormal Golgi morphology, and impaired autophagic flux compared to control. RINT1 interacts with NBAS, recently implicated in RALF, and UVRAG, to facilitate Golgi-to-ER retrograde vesicle transport. During nutrient depletion or infection, Golgi-to-ER transport is suppressed and autophagy is promoted through UVRAG regulation by mTOR. Aberrant autophagy has been associated with the development of similar skeletal abnormalities and also with liver disease, suggesting that disruption of these RINT1 functions may explain the liver and skeletal findings. Clarifying the pathomechanism underlying this gene-disease relationship may inform therapeutic opportunities.
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15
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Rujano MA, Cannata Serio M, Panasyuk G, Péanne R, Reunert J, Rymen D, Hauser V, Park JH, Freisinger P, Souche E, Guida MC, Maier EM, Wada Y, Jäger S, Krogan NJ, Kretz O, Nobre S, Garcia P, Quelhas D, Bird TD, Raskind WH, Schwake M, Duvet S, Foulquier F, Matthijs G, Marquardt T, Simons M. Mutations in the X-linked ATP6AP2 cause a glycosylation disorder with autophagic defects. J Exp Med 2017; 214:3707-3729. [PMID: 29127204 PMCID: PMC5716037 DOI: 10.1084/jem.20170453] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [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: 03/10/2017] [Revised: 08/01/2017] [Accepted: 09/22/2017] [Indexed: 12/25/2022] Open
Abstract
Rujano et al. report mutations in ATP6AP2 leading to liver disease, immunodeficiency, and psychomotor impairment. ATP6AP2 deficiency impairs the assembly and function of the V-ATPase proton pump, causing defects in protein glycosylation and autophagy. The biogenesis of the multi-subunit vacuolar-type H+-ATPase (V-ATPase) is initiated in the endoplasmic reticulum with the assembly of the proton pore V0, which is controlled by a group of assembly factors. Here, we identify two hemizygous missense mutations in the extracellular domain of the accessory V-ATPase subunit ATP6AP2 (also known as the [pro]renin receptor) responsible for a glycosylation disorder with liver disease, immunodeficiency, cutis laxa, and psychomotor impairment. We show that ATP6AP2 deficiency in the mouse liver caused hypoglycosylation of serum proteins and autophagy defects. The introduction of one of the missense mutations into Drosophila led to reduced survival and altered lipid metabolism. We further demonstrate that in the liver-like fat body, the autophagic dysregulation was associated with defects in lysosomal acidification and mammalian target of rapamycin (mTOR) signaling. Finally, both ATP6AP2 mutations impaired protein stability and the interaction with ATP6AP1, a member of the V0 assembly complex. Collectively, our data suggest that the missense mutations in ATP6AP2 lead to impaired V-ATPase assembly and subsequent defects in glycosylation and autophagy.
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Affiliation(s)
- Maria A Rujano
- Laboratory of Epithelial Biology and Disease, Imagine Institute, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Imagine Institute, Paris, France
| | - Magda Cannata Serio
- Laboratory of Epithelial Biology and Disease, Imagine Institute, Paris, France.,Université Paris Descartes-Sorbonne Paris Cité, Imagine Institute, Paris, France
| | - Ganna Panasyuk
- Institut Necker-Enfants Malades, Paris, France.,Institut National de la Santé et de la Recherche Medicale U1151/Centre National de la Recherche Scientifique UMR 8253, Paris, France
| | - Romain Péanne
- University of Leuven (KU Leuven), Center for Human Genetics, Leuven, Belgium
| | - Janine Reunert
- Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin, Münster, Germany
| | - Daisy Rymen
- University of Leuven (KU Leuven), Center for Human Genetics, Leuven, Belgium
| | - Virginie Hauser
- Laboratory of Epithelial Biology and Disease, Imagine Institute, Paris, France.,Institut National de la Santé et de la Recherche Medicale U1151/Centre National de la Recherche Scientifique UMR 8253, Paris, France
| | - Julien H Park
- Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin, Münster, Germany
| | - Peter Freisinger
- Kreiskliniken Reutlingen, Klinik für Kinder- und Jugendmedizin, Klinikum am Steinenberg, Reutlingen, Germany
| | - Erika Souche
- University of Leuven (KU Leuven), Center for Human Genetics, Leuven, Belgium
| | - Maria Clara Guida
- Laboratory of Epithelial Biology and Disease, Imagine Institute, Paris, France.,Institut National de la Santé et de la Recherche Medicale U1151/Centre National de la Recherche Scientifique UMR 8253, Paris, France
| | - Esther M Maier
- Dr. von Haunersches Kinderspital der Universität München, München, Germany
| | - Yoshinao Wada
- Osaka Medical Center and Research Institute for Maternal and Child Health, Osaka, Japan
| | - Stefanie Jäger
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA
| | - Nevan J Krogan
- Department of Cellular and Molecular Pharmacology, University of California, San Francisco, San Francisco, CA
| | - Oliver Kretz
- Centre for Biological Signaling Studies BIOSS, University of Freiburg, Freiburg, Germany
| | - Susana Nobre
- Metabolic Reference Center, Coimbra University Hospital Center, Coimbra, Portugal
| | - Paula Garcia
- Metabolic Reference Center, Coimbra University Hospital Center, Coimbra, Portugal
| | - Dulce Quelhas
- Biochemical Genetics Unit, Centro de Genética Médica Doutor Jacinto Magalhães, Centro Hospitalar do Porto, Abel Salazar Institute of Biomedical Sciences, University of Porto, Porto, Portugal
| | - Thomas D Bird
- Department of Neurology, University of Washington, Seattle, WA.,Geriatric Research Center, Veterans Administration Medical Center, Seattle, WA
| | - Wendy H Raskind
- Department of Medicine, University of Washington, Seattle, WA
| | - Michael Schwake
- Faculty of Chemistry/Biochemistry III, University Bielefeld, Bielefeld, Germany
| | - Sandrine Duvet
- Université Lille, Centre National de la Recherche Scientifique UMR 8576, Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France
| | - Francois Foulquier
- Université Lille, Centre National de la Recherche Scientifique UMR 8576, Unité de Glycobiologie Structurale et Fonctionnelle, Lille, France
| | - Gert Matthijs
- University of Leuven (KU Leuven), Center for Human Genetics, Leuven, Belgium
| | - Thorsten Marquardt
- Universitätsklinikum Münster, Klinik für Kinder- und Jugendmedizin, Münster, Germany
| | - Matias Simons
- Laboratory of Epithelial Biology and Disease, Imagine Institute, Paris, France .,Université Paris Descartes-Sorbonne Paris Cité, Imagine Institute, Paris, France
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16
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Palmigiano A, Bua RO, Barone R, Rymen D, Régal L, Deconinck N, Dionisi-Vici C, Fung CW, Garozzo D, Jaeken J, Sturiale L. MALDI-MS profiling of serum O-glycosylation and N-glycosylation in COG5-CDG. J Mass Spectrom 2017; 52:372-377. [PMID: 28444691 DOI: 10.1002/jms.3936] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/21/2017] [Indexed: 06/07/2023]
Abstract
Congenital disorders of glycosylation (CDG) are due to defective glycosylation of glycoconjugates. Conserved oligomeric Golgi (COG)-CDG are genetic diseases due to defects of the COG complex subunits 1-8 causing N-glycan and O-glycan processing abnormalities. In COG-CDG, isoelectric focusing separation of undersialylated glycoforms of serum transferrin and apolipoprotein C-III (apoC-III) allows to detect N-glycosylation and O-glycosylation defects, respectively. COG5-CDG (COG5 subunit deficiency) is a multisystem disease with dysmorphic features, intellectual disability of variable degree, seizures, acquired microcephaly, sensory defects and autistic behavior. We applied matrix-assisted laser desorption/ionization-MS for a high-throughput screening of differential serum O-glycoform and N-glycoform in five patients with COG5-CDG. When compared with age-matched controls, COG5-CDG showed a significant increase of apoC-III0a (aglycosylated glycoform), whereas apoC-III1 (mono-sialylated glycoform) decreased significantly. Serum N-glycome of COG5-CDG patients was characterized by the relative abundance of undersialylated and undergalactosylated biantennary and triantennary glycans as well as slight increase of high-mannose structures and hybrid glycans. Using advanced and well-established MS-based approaches, the present findings reveal novel aspects on O-glycan and N-glycan profiling in COG5-CDG patients, thus providing an increase of current knowledge on glycosylation defects caused by impairment of COG subunits, in support of clinical diagnosis. Copyright © 2017 John Wiley & Sons, Ltd.
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Affiliation(s)
- A Palmigiano
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
| | - R O Bua
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
| | - R Barone
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
- Child Neurology and Psychiatry, Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia, 78 - 95123, Catania, Italy
| | - D Rymen
- Center for Human Genetics, University of Leuven, Herestraat 49, B-3000, Leuven, Belgium
- Center for Metabolic Diseases, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
| | - L Régal
- Department of Pediatric Neurology and Metabolic Disorders, UZ Brussel - University Hospital Brussels, Campus Jette Laarbeeklaan 101, 1000, Brussels, Belgium
| | - N Deconinck
- Department of Neurology, Hôpital Universitaire des Enfants Reine Fabiola, Université Libre de Bruxelles, Avenue Jean Joseph Crocq 15, 1020, Brussels, Belgium
| | - C Dionisi-Vici
- Division of Metabolism, Bambino Gesù Children's Research Hospital, piazza S. Onofrio 4, 00165, Rome, Italy
| | - C-W Fung
- Department of Pediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Pokfulam, Hong Kong
| | - D Garozzo
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
| | - J Jaeken
- Center for Metabolic Diseases, University Hospital Gasthuisberg, Herestraat 49, 3000, Leuven, Belgium
| | - L Sturiale
- CNR - Institute for Polymers, Composites and Biomaterials, via P. Gaifami, 18 - 95126, Catania, Italy
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17
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Wong SYW, Beamer LJ, Gadomski T, Honzik T, Mohamed M, Wortmann SB, Brocke Holmefjord KS, Mork M, Bowling F, Sykut-Cegielska J, Koch D, Ackermann A, Stanley CA, Rymen D, Zeharia A, Al-Sayed M, Marquardt T, Jaeken J, Lefeber D, Conrad DF, Kozicz T, Morava E. Defining the Phenotype and Assessing Severity in Phosphoglucomutase-1 Deficiency. J Pediatr 2016; 175:130-136.e8. [PMID: 27206562 DOI: 10.1016/j.jpeds.2016.04.021] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 01/22/2016] [Accepted: 04/07/2016] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To define phenotypic groups and identify predictors of disease severity in patients with phosphoglucomutase-1 deficiency (PGM1-CDG). STUDY DESIGN We evaluated 27 patients with PGM1-CDG who were divided into 3 phenotypic groups, and group assignment was validated by a scoring system, the Tulane PGM1-CDG Rating Scale (TPCRS). This scale evaluates measurable clinical features of PGM1-CDG. We examined the relationship between genotype, enzyme activity, and TPCRS score by using regression analysis. Associations between the most common clinical features and disease severity were evaluated by principal component analysis. RESULTS We found a statistically significant stratification of the TPCRS scores among the phenotypic groups (P < .001). Regression analysis showed that there is no significant correlation between genotype, enzyme activity, and TPCRS score. Principal component analysis identified 5 variables that contributed to 54% variance in the cohort and are predictive of disease severity: congenital malformation, cardiac involvement, endocrine deficiency, myopathy, and growth. CONCLUSIONS We established a scoring algorithm to reliably evaluate disease severity in patients with PGM1-CDG on the basis of their clinical history and presentation. We also identified 5 clinical features that are predictors of disease severity; 2 of these features can be evaluated by physical examination, without the need for specific diagnostic testing and thus allow for rapid assessment and initiation of therapy.
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Affiliation(s)
- Sunnie Yan-Wai Wong
- Hayward Genetics Center, Tulane University School of Medicine, New Orleans, LA.
| | - Lesa J Beamer
- Biochemistry and Chemistry Departments, University of Missouri, Columbia, MO
| | - Therese Gadomski
- Hayward Genetics Center, Tulane University School of Medicine, New Orleans, LA
| | - Tomas Honzik
- Department of Pediatrics and Adolescent Medicine, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic
| | - Miski Mohamed
- Department of Pediatrics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Saskia B Wortmann
- Salzburger Landeskliniken, Department of Pediatrics, Paracelsus Medical University, Salzburg, Austria
| | | | - Marit Mork
- Department of Pediatric Habilitation, Stavanger University Hospital, Stavanger, Norway
| | - Francis Bowling
- Biochemical Diseases, Mater Children's Hospital, South Brisbane, Queensland, Australia
| | - Jolanta Sykut-Cegielska
- National Consultant in Paediatric Metabolic Medicine, Screening Department, The Institute of Mother and Child, Warsaw, Poland
| | - Dieter Koch
- Pediatric Cardiology, Bergisch Gladbacher Köln, Germany
| | - Amanda Ackermann
- Pediatric Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Charles A Stanley
- Pediatric Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Daisy Rymen
- Department of Pediatrics, Universitair Ziekenhuis Leuven, Leuven, Belgium
| | - Avraham Zeharia
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - Moeen Al-Sayed
- Department of Medical Genetics, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia
| | - Thomas Marquardt
- Department of Pediatrics, University of Münster, Münster, Germany
| | - Jaak Jaeken
- Centre for Metabolic Diseases, University Hospital Gasthuisberg, Herestraat, Leuven, Belgium
| | - Dirk Lefeber
- Department of Neurology, Radboudumc, Nijmegen, The Netherlands
| | - Donald F Conrad
- Department of Genetics, Washington University School of Medicine, Saint Louis, MO
| | - Tamas Kozicz
- Hayward Genetics Center, Tulane University School of Medicine, New Orleans, LA
| | - Eva Morava
- Hayward Genetics Center, Tulane University School of Medicine, New Orleans, LA; Department of Pediatrics, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
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18
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Ng BG, Shiryaev SA, Rymen D, Eklund EA, Raymond K, Kircher M, Abdenur JE, Alehan F, Midro AT, Bamshad MJ, Barone R, Berry GT, Brumbaugh JE, Buckingham KJ, Clarkson K, Cole FS, O'Connor S, Cooper GM, Van Coster R, Demmer LA, Diogo L, Fay AJ, Ficicioglu C, Fiumara A, Gahl WA, Ganetzky R, Goel H, Harshman LA, He M, Jaeken J, James PM, Katz D, Keldermans L, Kibaek M, Kornberg AJ, Lachlan K, Lam C, Yaplito-Lee J, Nickerson DA, Peters HL, Race V, Régal L, Rush JS, Rutledge SL, Shendure J, Souche E, Sparks SE, Trapane P, Sanchez-Valle A, Vilain E, Vøllo A, Waechter CJ, Wang RY, Wolfe LA, Wong DA, Wood T, Yang AC, Matthijs G, Freeze HH. ALG1-CDG: Clinical and Molecular Characterization of 39 Unreported Patients. Hum Mutat 2016; 37:653-60. [PMID: 26931382 DOI: 10.1002/humu.22983] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 12/17/2015] [Accepted: 02/17/2016] [Indexed: 12/16/2022]
Abstract
Congenital disorders of glycosylation (CDG) arise from pathogenic mutations in over 100 genes leading to impaired protein or lipid glycosylation. ALG1 encodes a β1,4 mannosyltransferase that catalyzes the addition of the first of nine mannose moieties to form a dolichol-lipid linked oligosaccharide intermediate required for proper N-linked glycosylation. ALG1 mutations cause a rare autosomal recessive disorder termed ALG1-CDG. To date 13 mutations in 18 patients from 14 families have been described with varying degrees of clinical severity. We identified and characterized 39 previously unreported cases of ALG1-CDG from 32 families and add 26 new mutations. Pathogenicity of each mutation was confirmed based on its inability to rescue impaired growth or hypoglycosylation of a standard biomarker in an alg1-deficient yeast strain. Using this approach we could not establish a rank order comparison of biomarker glycosylation and patient phenotype, but we identified mutations with a lethal outcome in the first two years of life. The recently identified protein-linked xeno-tetrasaccharide biomarker, NeuAc-Gal-GlcNAc2 , was seen in all 27 patients tested. Our study triples the number of known patients and expands the molecular and clinical correlates of this disorder.
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Affiliation(s)
- Bobby G Ng
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California
| | - Sergey A Shiryaev
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California
| | - Daisy Rymen
- Center for Human Genetics, University of Leuven, Leuven, Belgium.,Center for Metabolic Diseases, University Hospital of Leuven, Leuven, Belgium
| | - Erik A Eklund
- Section of Experimental Pediatrics, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Kimiyo Raymond
- Biochemical Genetics Laboratory, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - Martin Kircher
- Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Jose E Abdenur
- Division of Metabolic Disorders, Children's Hospital of Orange County, Orange, California.,Department of Pediatrics, University of California-Irvine School of Medicine, Orange, California
| | - Fusun Alehan
- Division of Pediatric Neurology, Baskent University School of Medicine, Ankara, Turkey
| | - Alina T Midro
- Department of Clinical Genetics, Medical University, Bialystok, Poland
| | - Michael J Bamshad
- Department of Genome Sciences, University of Washington, Seattle, Washington.,Department of Pediatrics, University of Washington, Seattle, Washington
| | - Rita Barone
- Pediatric Neurology Policlinico, University of Catania, Catania, Italy
| | - Gerard T Berry
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Jane E Brumbaugh
- Stead Family Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
| | - Kati J Buckingham
- Department of Pediatrics, University of Washington, Seattle, Washington
| | | | - F Sessions Cole
- Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | - Shawn O'Connor
- Division of Newborn Medicine, Department of Pediatrics, Washington University School of Medicine, St. Louis, Missouri
| | | | - Rudy Van Coster
- Department of Pediatrics, Division of Pediatric Neurology and Metabolism, University Hospital Gent, Gent, Belgium
| | - Laurie A Demmer
- Clinical Genetics Program, Carolinas Health Care, Levine Childrens Hospital, Charlotte, North Carolina
| | - Luisa Diogo
- Centro de Desenvolvimento da Criança- Pediatric Hospital - CHUC, Coimbra, Portugal
| | - Alexander J Fay
- Division of Pediatric Neurology, Washington University, St. Louis, Missouri
| | - Can Ficicioglu
- Department of Pediatrics, Section of Metabolic Disease, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania Philadelphia, Pennsylvania
| | - Agata Fiumara
- Centre for Inherited Metabolic Diseases, Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - William A Gahl
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, NIH and National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Rebecca Ganetzky
- Department of Pediatrics, Section of Metabolic Disease, The Children's Hospital of Philadelphia, Perelman School of Medicine at the University of Pennsylvania Philadelphia, Pennsylvania
| | - Himanshu Goel
- Hunter Genetics, Waratah, New South Wales, School of Medicine and Public Health, University of Newcastle, Callaghan, New South Wales, Australia
| | - Lyndsay A Harshman
- Stead Family Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
| | - Miao He
- Department of Pathology and Laboratory Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Jaak Jaeken
- Center for Metabolic Diseases, University Hospital of Leuven, Leuven, Belgium
| | - Philip M James
- Division of Genetics & Metabolism, Phoenix Children's Hospital, Phoenix, Arizona
| | - Daniel Katz
- Pediatric Neurology, Stormont-Vail Health Care, Topeka, Kansas
| | | | - Maria Kibaek
- Department of Pediatrics, Odense University Hospital, Odense, Denmark
| | - Andrew J Kornberg
- Department of Neurology, Royal Children's Hospital, Parkville, Victoria, Australia
| | - Katherine Lachlan
- Human Genetics and Genomic Medicine, University of Southampton and Wessex Clinical Genetics Service, Southampton, United Kingdom
| | - Christina Lam
- National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Joy Yaplito-Lee
- Department of Metabolic Medicine, Royal Children's Hospital, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Deborah A Nickerson
- Department of Genome Sciences, University of Washington, Seattle, Washington
| | - Heidi L Peters
- Department of Metabolic Medicine, Royal Children's Hospital, Murdoch Childrens Research Institute, Parkville, Victoria, Australia
| | - Valerie Race
- Center for Human Genetics, University of Leuven, Leuven, Belgium
| | - Luc Régal
- Department of Pediatric Neurology and Metabolism, University Hospital of Brussels, Brussels, Belgium
| | - Jeffrey S Rush
- Department of Molecular and Cellular Biochemistry, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - S Lane Rutledge
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Alabama
| | - Jay Shendure
- Department of Genome Sciences, University of Washington, Seattle, Washington.,Howard Hughes Medical Institute, University of Washington, Seattle, Washington
| | - Erika Souche
- Center for Human Genetics, University of Leuven, Leuven, Belgium
| | | | - Pamela Trapane
- Stead Family Department of Pediatrics, University of Iowa Children's Hospital, Iowa City, Iowa
| | | | - Eric Vilain
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California.,Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Arve Vøllo
- Department of Pediatrics, Hospital of Ostfold N-1603 Fredrikstad, Norway
| | - Charles J Waechter
- Department of Molecular and Cellular Biochemistry, College of Medicine, University of Kentucky, Lexington, Kentucky
| | - Raymond Y Wang
- Division of Metabolic Disorders, Children's Hospital of Orange County, Orange, California.,Department of Pediatrics, University of California-Irvine School of Medicine, Orange, California
| | - Lynne A Wolfe
- NIH Undiagnosed Diseases Program, Common Fund, Office of the Director, NIH and National Human Genome Research Institute, NIH, Bethesda, Maryland
| | - Derek A Wong
- Department of Pediatrics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Tim Wood
- Greenwood Genetic Center, Greenwood, South Carolina
| | - Amy C Yang
- Department of Genetics and Genomic Sciences Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Gert Matthijs
- Center for Human Genetics, University of Leuven, Leuven, Belgium
| | - Hudson H Freeze
- Human Genetics Program, Sanford Burnham Prebys Medical Discovery Institute, La Jolla, California
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19
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Jansen J, Cirak S, van Scherpenzeel M, Timal S, Reunert J, Rust S, Pérez B, Vicogne D, Krawitz P, Wada Y, Ashikov A, Pérez-Cerdá C, Medrano C, Arnoldy A, Hoischen A, Huijben K, Steenbergen G, Quelhas D, Diogo L, Rymen D, Jaeken J, Guffon N, Cheillan D, van den Heuvel L, Maeda Y, Kaiser O, Schara U, Gerner P, van den Boogert M, Holleboom A, Nassogne MC, Sokal E, Salomon J, van den Bogaart G, Drenth J, Huynen M, Veltman J, Wevers R, Morava E, Matthijs G, Foulquier F, Marquardt T, Lefeber D. CCDC115 Deficiency Causes a Disorder of Golgi Homeostasis with Abnormal Protein Glycosylation. Am J Hum Genet 2016; 98:310-21. [PMID: 26833332 DOI: 10.1016/j.ajhg.2015.12.010] [Citation(s) in RCA: 77] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Accepted: 12/11/2015] [Indexed: 01/06/2023] Open
Abstract
Disorders of Golgi homeostasis form an emerging group of genetic defects. The highly heterogeneous clinical spectrum is not explained by our current understanding of the underlying cell-biological processes in the Golgi. Therefore, uncovering genetic defects and annotating gene function are challenging. Exome sequencing in a family with three siblings affected by abnormal Golgi glycosylation revealed a homozygous missense mutation, c.92T>C (p.Leu31Ser), in coiled-coil domain containing 115 (CCDC115), the function of which is unknown. The same mutation was identified in three unrelated families, and in one family it was compound heterozygous in combination with a heterozygous deletion of CCDC115. An additional homozygous missense mutation, c.31G>T (p.Asp11Tyr), was found in a family with two affected siblings. All individuals displayed a storage-disease-like phenotype involving hepatosplenomegaly, which regressed with age, highly elevated bone-derived alkaline phosphatase, elevated aminotransferases, and elevated cholesterol, in combination with abnormal copper metabolism and neurological symptoms. Two individuals died of liver failure, and one individual was successfully treated by liver transplantation. Abnormal N- and mucin type O-glycosylation was found on serum proteins, and reduced metabolic labeling of sialic acids was found in fibroblasts, which was restored after complementation with wild-type CCDC115. PSI-BLAST homology detection revealed reciprocal homology with Vma22p, the yeast V-ATPase assembly factor located in the endoplasmic reticulum (ER). Human CCDC115 mainly localized to the ERGIC and to COPI vesicles, but not to the ER. These data, in combination with the phenotypic spectrum, which is distinct from that associated with defects in V-ATPase core subunits, suggest a more general role for CCDC115 in Golgi trafficking. Our study reveals CCDC115 deficiency as a disorder of Golgi homeostasis that can be readily identified via screening for abnormal glycosylation in plasma.
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Rymen D, Winter J, Van Hasselt PM, Jaeken J, Kasapkara C, Gokçay G, Haijes H, Goyens P, Tokatli A, Thiel C, Bartsch O, Hecht J, Krawitz P, Prinsen HCMT, Mildenberger E, Matthijs G, Kornak U. Key features and clinical variability of COG6-CDG. Mol Genet Metab 2015; 116:163-70. [PMID: 26260076 DOI: 10.1016/j.ymgme.2015.07.003] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2015] [Revised: 07/09/2015] [Accepted: 07/09/2015] [Indexed: 11/26/2022]
Abstract
The conserved oligomeric Golgi (COG) complex consists of eight subunits and plays a crucial role in Golgi trafficking and positioning of glycosylation enzymes. Mutations in all COG subunits, except subunit 3, have been detected in patients with congenital disorders of glycosylation (CDG) of variable severity. So far, 3 families with a total of 10 individuals with biallelic COG6 mutations have been described, showing a broad clinical spectrum. Here we present 7 additional patients with 4 novel COG6 mutations. In spite of clinical variability, we delineate the core features of COG6-CDG i.e. liver involvement (9/10), microcephaly (8/10), developmental disability (8/10), recurrent infections (7/10), early lethality (6/10), and hypohidrosis predisposing for hyperthermia (6/10) and hyperkeratosis (4/10) as ectodermal signs. Regarding all COG6-related disorders a genotype-phenotype correlation can be discerned ranging from deep intronic mutations found in Shaheen syndrome as the mildest form to loss-of-function mutations leading to early lethal CDG phenotypes. A comparison with other COG deficiencies suggests ectodermal changes to be a hallmark of COG6-related disorders. Our findings aid clinical differentiation of this complex group of disorders and imply subtle functional differences between the COG complex subunits.
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Affiliation(s)
- Daisy Rymen
- Center for Human Genetics, University of Leuven, Leuven, Belgium; Center for Metabolic Diseases, University Hospital Gasthuisberg, Leuven, Belgium
| | - Julia Winter
- Neonatology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Peter M Van Hasselt
- Department of Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jaak Jaeken
- Center for Metabolic Diseases, University Hospital Gasthuisberg, Leuven, Belgium
| | - Cigdem Kasapkara
- Department of Pediatric Metabolism and Nutrition, Dr. Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Gulden Gokçay
- Department of Pediatric Nutrition and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Hanneke Haijes
- Department of Metabolic Diseases, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Philippe Goyens
- University Children's Hospital Queen Fabiola, Brussels, Belgium
| | - Aysegul Tokatli
- Division of Metabolism and Nutrition, Department of Pediatrics, Hacettepe University, Ankara, Turkey
| | - Christian Thiel
- Center for Child and Adolescent Medicine, Heidelberg, Germany
| | - Oliver Bartsch
- Institute of Human Genetics, University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Jochen Hecht
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Peter Krawitz
- Institute of Medical Genetics and Human Genetics, Charité-Universitaetsmedizin Berlin, Berlin, Germany
| | - Hubertus C M T Prinsen
- Department of Medical Genetics, UMC Utrecht, Section Metabolic Diagnostics, Utrecht, The Netherlands
| | - Eva Mildenberger
- Neonatology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Gert Matthijs
- Center for Human Genetics, University of Leuven, Leuven, Belgium
| | - Uwe Kornak
- Berlin-Brandenburg Center for Regenerative Therapies, Charité-Universitaetsmedizin Berlin, Berlin, Germany; Institute of Medical Genetics and Human Genetics, Charité-Universitaetsmedizin Berlin, Berlin, Germany; Max Planck Institute for Molecular Genetics, Berlin, Germany.
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Küçükçongar A, Tümer L, Ezgü FS, Kasapkara ÇS, Jaeken J, Matthijs G, Rymen D, Dalgiç B, Bıdecı A, Hasanoğlu A. A case with rare type of congenital disorder of glycosylation: PGM1-CDG. Genet Couns 2015; 26:87-90. [PMID: 26043514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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Abstract
The group of congenital disorders of glycosylation (CDG) has expanded tremendously since its first description in 1980, with around 70 distinct disorders described to date. A great phenotypic variability exists, ranging from multisystem disease to single organ involvement. Skin manifestations, although inconsistently present, are part of this broad clinical spectrum. Indeed, the presence of inverted nipples, fat pads and orange peel skin in a patient with developmental delay are considered as a hallmark of CDG, particularly seen in PMM2 deficiency. However, over the years many more dermatological findings have been observed (e.g., ichthyosis, cutis laxa, tumoral calcinosis…). In this review we will discuss the variety of skin manifestations reported in CDG. Moreover, we will explore the possible mechanisms that link a certain glycosylation deficiency to its skin phenotype.
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Affiliation(s)
- D Rymen
- Center for Human Genetics, University of Leuven, Leuven, Belgium,
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Van Scherpenzeel M, Timal S, Rymen D, Hoischen A, Wuhrer M, Hipgrave-Ederveen A, Grunewald S, Peanne R, Saada A, Edvardson S, Grønborg S, Ruijter G, Kattentidt-Mouravieva A, Brum JM, Freckmann ML, Tomkins S, Jalan A, Prochazkova D, Ondruskova N, Hansikova H, Willemsen MA, Hensbergen PJ, Matthijs G, Wevers RA, Veltman JA, Morava E, Lefeber DJ. Diagnostic serum glycosylation profile in patients with intellectual disability as a result of MAN1B1 deficiency. ACTA ACUST UNITED AC 2014; 137:1030-8. [PMID: 24566669 DOI: 10.1093/brain/awu019] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Congenital disorders of glycosylation comprise a group of genetic defects with a high frequency of intellectual disability, caused by deficient glycosylation of proteins and lipids. The molecular basis of the majority of the congenital disorders of glycosylation type I subtypes, localized in the cytosol and endoplasmic reticulum, has been solved. However, elucidation of causative genes for defective Golgi glycosylation (congenital disorders of glycosylation type II) remains challenging because of a lack of sufficiently specific diagnostic serum methods. In a single patient with intellectual disability, whole-exome sequencing revealed MAN1B1 as congenital disorder of glycosylation type II candidate gene. A novel mass spectrometry method was applied for high-resolution glycoprofiling of intact plasma transferrin. A highly characteristic glycosylation signature was observed with hybrid type N-glycans, in agreement with deficient mannosidase activity. The speed and robustness of the method allowed subsequent screening in a cohort of 100 patients with congenital disorder of glycosylation type II, which revealed the characteristic glycosylation profile of MAN1B1-congenital disorder of glycosylation in 11 additional patients. Abnormal hybrid type N-glycans were also observed in the glycoprofiles of total serum proteins, of enriched immunoglobulins and of alpha1-antitrypsin in variable amounts. Sanger sequencing revealed MAN1B1 mutations in all patients, including severe truncating mutations and amino acid substitutions in the alpha-mannosidase catalytic site. Clinically, this group of patients was characterized by intellectual disability and delayed motor and speech development. In addition, variable dysmorphic features were noted, with truncal obesity and macrocephaly in ∼65% of patients. In summary, MAN1B1 deficiency appeared to be a frequent cause in our cohort of patients with unsolved congenital disorder of glycosylation type II. Our method for analysis of intact transferrin provides a rapid test to detect MAN1B1-deficient patients within congenital disorder of glycosylation type II cohorts and can be used as efficient diagnostic method to identify MAN1B1-deficient patients in intellectual disability cohorts. In addition, it provides a functional confirmation of MAN1B1 mutations as identified by next-generation sequencing in individuals with intellectual disability.
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Affiliation(s)
- Monique Van Scherpenzeel
- 1 Laboratory of Genetic, Endocrine and Metabolic Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands
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Tegtmeyer LC, Rust S, van Scherpenzeel M, Ng BG, Losfeld ME, Timal S, Raymond K, He P, Ichikawa M, Veltman J, Huijben K, Shin YS, Sharma V, Adamowicz M, Lammens M, Reunert J, Witten A, Schrapers E, Matthijs G, Jaeken J, Rymen D, Stojkovic T, Laforêt P, Petit F, Aumaître O, Czarnowska E, Piraud M, Podskarbi T, Stanley CA, Matalon R, Burda P, Seyyedi S, Debus V, Socha P, Sykut-Cegielska J, van Spronsen F, de Meirleir L, Vajro P, DeClue T, Ficicioglu C, Wada Y, Wevers RA, Vanderschaeghe D, Callewaert N, Fingerhut R, van Schaftingen E, Freeze HH, Morava E, Lefeber DJ, Marquardt T. Multiple phenotypes in phosphoglucomutase 1 deficiency. N Engl J Med 2014; 370:533-42. [PMID: 24499211 PMCID: PMC4373661 DOI: 10.1056/nejmoa1206605] [Citation(s) in RCA: 202] [Impact Index Per Article: 20.2] [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] [Indexed: 01/27/2023]
Abstract
BACKGROUND Congenital disorders of glycosylation are genetic syndromes that result in impaired glycoprotein production. We evaluated patients who had a novel recessive disorder of glycosylation, with a range of clinical manifestations that included hepatopathy, bifid uvula, malignant hyperthermia, hypogonadotropic hypogonadism, growth retardation, hypoglycemia, myopathy, dilated cardiomyopathy, and cardiac arrest. METHODS Homozygosity mapping followed by whole-exome sequencing was used to identify a mutation in the gene for phosphoglucomutase 1 (PGM1) in two siblings. Sequencing identified additional mutations in 15 other families. Phosphoglucomutase 1 enzyme activity was assayed on cell extracts. Analyses of glycosylation efficiency and quantitative studies of sugar metabolites were performed. Galactose supplementation in fibroblast cultures and dietary supplementation in the patients were studied to determine the effect on glycosylation. RESULTS Phosphoglucomutase 1 enzyme activity was markedly diminished in all patients. Mass spectrometry of transferrin showed a loss of complete N-glycans and the presence of truncated glycans lacking galactose. Fibroblasts supplemented with galactose showed restoration of protein glycosylation and no evidence of glycogen accumulation. Dietary supplementation with galactose in six patients resulted in changes suggestive of clinical improvement. A new screening test showed good discrimination between patients and controls. CONCLUSIONS Phosphoglucomutase 1 deficiency, previously identified as a glycogenosis, is also a congenital disorder of glycosylation. Supplementation with galactose leads to biochemical improvement in indexes of glycosylation in cells and patients, and supplementation with complex carbohydrates stabilizes blood glucose. A new screening test has been developed but has not yet been validated. (Funded by the Netherlands Organization for Scientific Research and others.).
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Rymen D, Peanne R, Millón MB, Race V, Sturiale L, Garozzo D, Mills P, Clayton P, Asteggiano CG, Quelhas D, Cansu A, Martins E, Nassogne MC, Gonçalves-Rocha M, Topaloglu H, Jaeken J, Foulquier F, Matthijs G. MAN1B1 deficiency: an unexpected CDG-II. PLoS Genet 2013; 9:e1003989. [PMID: 24348268 PMCID: PMC3861123 DOI: 10.1371/journal.pgen.1003989] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Accepted: 10/09/2013] [Indexed: 11/18/2022] Open
Abstract
Congenital disorders of glycosylation (CDG) are a group of rare metabolic diseases, due to impaired protein and lipid glycosylation. In the present study, exome sequencing was used to identify MAN1B1 as the culprit gene in an unsolved CDG-II patient. Subsequently, 6 additional cases with MAN1B1-CDG were found. All individuals presented slight facial dysmorphism, psychomotor retardation and truncal obesity. Generally, MAN1B1 is believed to be an ER resident alpha-1,2-mannosidase acting as a key factor in glycoprotein quality control by targeting misfolded proteins for ER-associated degradation (ERAD). However, recent studies indicated a Golgi localization of the endogenous MAN1B1, suggesting a more complex role for MAN1B1 in quality control. We were able to confirm that MAN1B1 is indeed localized to the Golgi complex instead of the ER. Furthermore, we observed an altered Golgi morphology in all patients' cells, with marked dilatation and fragmentation. We hypothesize that part of the phenotype is associated to this Golgi disruption. In conclusion, we linked mutations in MAN1B1 to a Golgi glycosylation disorder. Additionally, our results support the recent findings on MAN1B1 localization. However, more work is needed to pinpoint the exact function of MAN1B1 in glycoprotein quality control, and to understand the pathophysiology of its deficiency. Glycosylation concerns the synthesis of sugar chains, their addition onto proteins and/or lipids, and their subsequent modifications. The resulting glycoproteins serve many critical roles in metabolism. The importance of this pathway is illustrated by a group of diseases called Congenital Disorders of Glycosylation (CDG). To date, over 60 distinct disorders have been described. In the present study, we demonstrated that mutations in MAN1B1, a gene formerly linked to non-syndromic intellectual disability, cause CDG. We described 7 patients with similar clinical features (developmental delay, intellectual disability, facial dysmorphism and obesity), defining MAN1B1-CDG as a syndrome. Furthermore, we confirmed that the MAN1B1 protein is localized into the Golgi apparatus instead of the endoplasmic reticulum, where it was assumed to reside for many years. Moreover, we showed that mutations in MAN1B1 lead to alterations of the Golgi structure.
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Affiliation(s)
- Daisy Rymen
- Center for Human Genetics, University of Leuven, Leuven, Belgium
- Center for Metabolic Diseases, University Hospital Gasthuisberg, Leuven, Belgium
| | - Romain Peanne
- Center for Human Genetics, University of Leuven, Leuven, Belgium
| | - María B. Millón
- Centro de Estudio Metabalopatías Congénitas, Faculdad de Ciencias Médicas, Universidad Nacional de Córdoba, Hospital de Niños de la Santísima Trinidad, Córdoba, Argentina
| | - Valérie Race
- Center for Human Genetics, University of Leuven, Leuven, Belgium
| | - Luisa Sturiale
- Institute of Chemistry and Technology of Polymers, CNR, Catania, Italy
| | - Domenico Garozzo
- Institute of Chemistry and Technology of Polymers, CNR, Catania, Italy
| | - Philippa Mills
- Clinical & Molecular Genetics Unit, Institute of Child Health, University College and Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Peter Clayton
- Clinical & Molecular Genetics Unit, Institute of Child Health, University College and Great Ormond Street Hospital for Children NHS Trust, London, United Kingdom
| | - Carla G. Asteggiano
- Centro de Estudio Metabalopatías Congénitas, Faculdad de Ciencias Médicas, Universidad Nacional de Córdoba, Hospital de Niños de la Santísima Trinidad, Córdoba, Argentina
| | - Dulce Quelhas
- Unidade de Genética Médica, Departamento de Genética Humana, Centro de Genética Médica - Dr. Jacinto Magalhães - INSA, IP. Porto, Portugal
| | - Ali Cansu
- Gazi University Faculty of Medicine, Department of Paediatric Neurology, Besevler/Ankara, Turkey
| | - Esmeralda Martins
- Unidade de Doenças Metabólicas, Hospital de Crianças Maria Pia, Porto, Portugal
| | - Marie-Cécile Nassogne
- Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | - Miguel Gonçalves-Rocha
- Unidade de Genética Médica, Departamento de Genética Humana, Centro de Genética Médica - Dr. Jacinto Magalhães - INSA, IP. Porto, Portugal
| | - Haluk Topaloglu
- Department of Child Neurology, Hacettepe University Children's Hospital, Ankara, Turkey
| | - Jaak Jaeken
- Center for Metabolic Diseases, University Hospital Gasthuisberg, Leuven, Belgium
| | - François Foulquier
- Structural and Functional Glycobiology Unit, UMR CNRS/USTL 8576, IFR 147, University of Lille 1, Villeneuve d'Ascq, France
| | - Gert Matthijs
- Center for Human Genetics, University of Leuven, Leuven, Belgium
- * E-mail:
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Rymen D, Keldermans L, Race V, Régal L, Deconinck N, Dionisi-Vici C, Fung CW, Sturiale L, Rosnoblet C, Foulquier F, Matthijs G, Jaeken J. COG5-CDG: expanding the clinical spectrum. Orphanet J Rare Dis 2012; 7:94. [PMID: 23228021 PMCID: PMC3697985 DOI: 10.1186/1750-1172-7-94] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [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: 10/08/2012] [Accepted: 12/05/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Conserved Oligomeric Golgi (COG) complex is involved in the retrograde trafficking of Golgi components, thereby affecting the localization of Golgi glycosyltransferases. Deficiency of a COG-subunit leads to defective protein glycosylation, and thus Congenital Disorders of Glycosylation (CDG). Mutations in subunits 1, 4, 5, 6, 7 and 8 have been associated with CDG-II. The first patient with COG5-CDG was recently described (Paesold-Burda et al. Hum Mol Genet 2009; 18:4350-6). Contrary to most other COG-CDG cases, the patient presented a mild/moderate phenotype, i.e. moderate psychomotor retardation with language delay, truncal ataxia and slight hypotonia. METHODS CDG-IIx patients from our database were screened for mutations in COG5. Clinical data were compared. Brefeldin A treatment of fibroblasts and immunoblotting experiments were performed to support the diagnosis. RESULTS AND CONCLUSION We identified five new patients with proven COG5 deficiency. We conclude that the clinical picture is not always as mild as previously described. It rather comprises a broad spectrum with phenotypes ranging from mild to very severe. Interestingly, on a clinical basis some of the patients present a significant overlap with COG7-CDG, a finding which can probably be explained by subunit interactions at the protein level.
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Affiliation(s)
- Daisy Rymen
- Centre for Metabolic Diseases, University Hospital Gasthuisberg, Leuven, Belgium
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Matthijs G, Rymen D, Millón MBB, Souche E, Race V. Approaches to homozygosity mapping and exome sequencing for the identification of novel types of CDG. Glycoconj J 2012; 30:67-76. [PMID: 22983704 DOI: 10.1007/s10719-012-9445-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2012] [Revised: 08/21/2012] [Accepted: 08/22/2012] [Indexed: 12/18/2022]
Abstract
In the past decade, the identification of most genes involved in Congenital Disorders of Glycosylation (CDG) (type I) was achieved by a combination of biochemical, cell biological and glycobiological investigations. This has been truly successful for CDG-I, because the candidate genes could be selected on the basis of the homology of the synthetic pathway of the dolichol linked oligosaccharide in human and yeast. On the contrary, only a few CDG-II defects were elucidated, be it that some of the discoveries represent wonderful breakthroughs, like e.g, the identification of the COG defects. In general, many rare genetic defects have been identified by positional cloning. However, only a few types of CDG have effectively been elucidated by linkage analysis and so-called reverse genetics. The reason is that the families were relatively small and could-except for CDG-PMM2-not be pooled for analysis. Hence, a large number of CDG cases has long remained unsolved because the search for the culprit gene was very laborious, due to the heterogeneous phenotype and the myriad of candidate defects. This has changed when homozygosity mapping came of age, because it could be applied to small (consanguineous) families. Many novel CDG genes have been discovered in this way. But the best has yet to come: what we are currently witnessing, is an explosion of novel CDG defects, thanks to exome sequencing: seven novel types were published over a period of only two years. It is expected that exome sequencing will soon become a diagnostic tool, that will continuously uncover new facets of this fascinating group of diseases.
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Affiliation(s)
- Gert Matthijs
- Center for Human Genetics, University of Leuven, Herestraat 49, 3000, Leuven, Belgium.
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