• Klíčová slova
• sklerokornea,
• MeSH
• abnormality očí * diagnostické zobrazování   genetika   patologie   MeSH
• dědičné nemoci očí * diagnostické zobrazování   genetika   patologie   MeSH
• dospělí MeSH
• lidé MeSH
• mutace MeSH
• optická koherentní tomografie MeSH
• přední segment oční abnormality   MeSH
• předškolní dítě MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• předškolní dítě MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

• MeSH
• aniridie * diagnostické zobrazování   genetika   patologie   MeSH
• dítě MeSH
• lidé MeSH
• optická koherentní tomografie MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH
• práce podpořená grantem MeSH

BACKGROUND: The oculo-facio-cardio-dental syndrome (OFCD) is an ultra-rare multiple congenital anomaly. This report describes clinical findings emphasising dental phenotype in five, molecularly confirmed, female cases from two Czech families. CASE PRESENTATION: Dental examinations were carried out. An orthopantomogram was taken in three patients, and all patients' intraoral cavities and teeth were photographed. Exome sequencing was performed in both probands. Results were validated by Sanger DNA sequencing which was also used to follow segregation of the variants in first-degree relatives. Dental abnormalities and congenital cataracts were present in all five cases, whilst other signs were variable and included facial dysmorphism, microphthalmia, and cardiac and skeletal abnormalities. Two individuals had cleft lip and/or cleft palate. Radiculomegaly occurred in three patients with permanent teeth and was diagnosed on orthopantomograms. Two patients had agenesis of permanent teeth. Malocclusion was also present in two patients due to crowding and a Class III malocclusion and mandibular overjet. De novo novel pathogenic variants in the BCOR gene were identified; c.2382del p.(Lys795Argfs*12) and c.3914dup p.(Gln1306Alafs*20) and co-segregated with the disease in each family. CONCLUSIONS: The OFCD syndrome has a unique dental phenotype and dentists should be aware of signs of this ultra-rare genetic disorder. All patients with congenital cataracts and dental abnormalities, including those without a family history, should be referred for genetic testing and indicated to specialised dental care.

• MeSH
• abnormality očí genetika   MeSH
• abnormality zubů * genetika   MeSH
• defekty srdečního septa MeSH
• dítě MeSH
• dospělí MeSH
• fenotyp MeSH
• genetické nemoci vázané na chromozom X MeSH
• katarakta genetika   vrozené   MeSH
• lidé MeSH
• mikroftalmie * genetika   MeSH
• mladiství MeSH
• mnohočetné abnormality genetika   MeSH
• protoonkogenní proteiny * genetika   MeSH
• rentgendiagnostika panoramatická MeSH
• represorové proteiny * genetika   MeSH
• rodokmen MeSH
• vrozené srdeční vady genetika   komplikace   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Geografické názvy
• Česká republika MeSH

Inherited retinal disease (IRD) represents in developed countries the second most common cause of legal blindness in children. The recent approval of gene therapy for RPE65-associated IRD paves the way to the treatment. IRD exhibit a vast clinical and genetic heterogeneity and can be either isolated conditions or a sign of a multiorgan disease. In the Czech Republic the spectrum of phenotypes and disease-causing mutations in children with IRD is unknown. The aim of the project is to identify Czech children with IRD and to establish a multidisciplinary care centre for them. This will include deep phenotyping and symptomatic management. In cases unsolved after diagnostic testing genome sequencing and functional studies will be performed to assess the effect of identified variants. We expect to significantly aid to the knowledge on childhood-onset IRD. Our project will directly impact patients and their families via improved counseling, timely management of extraocular disease and most importantly access to targeted therapies when available, which is the ultimate goal of the project.

Dědičná onemocnění sítnice (inherited retinal disease, IRD) představují v rozvinutých zemích druhou nejčastější příčinu slepoty u dětí. Nedávné schválení genové terapie pro pacienty s mutacemi v genu RPE65 představuje milník v terapii těchto doposud neléčitelných onemocnění. V České republice není spektrum fenotypů a mutací způsobujících IRD u dětí známo, neexistují žádné registry. Cílem projektu je identifikovat dětské pacienty s IRD a vytvořit pro ně program multidisciplinární péče, v jehož rámci bude provedena detailní charakterizace klinických nálezů a symptomatická péče. U případů, kde rutinní vyšetření v diagnostické laboratoři nepovede k odhalení patogenních mutací, provedeme celogenomové sekvenování a funkční studie k posouzení dopadu odhalených variant. Očekáváme, že se nám podaří významně přispět ke znalostem o IRD s manifestací v dětském věku. Projekt bude mít přímý přínos pacienty a jejich rodiny spočívající ve zlepšení genetického poradenství, včasnou léčbu extraokulárních projevů a zvýšení možnosti k přístupu k cíleným terapiím, které jsou v současné době vyvíjeny.

• Klíčová slova
• novel therapies, genomové sekvenování, genome sequencing, genetické testování, Genetic Testing, retinopatie dětského věku, primární ciliopatie, syndromová onemocnění, funkční studie, mechanismus onemocňení, Childhood-onset inherited retinal disease, primary ciliopathy, syndromic disease, functional studies, disease mechanisms, nové terapeutické přístupy,

• NLK Publikační typ
• závěrečné zprávy o řešení grantu AZV MZ ČR

BACKGROUND: Fuchs endothelial corneal dystrophy (FECD) is the most common repeat-mediated disease in humans. It exclusively affects corneal endothelial cells (CECs), with ≤81% of cases associated with an intronic TCF4 triplet repeat (CTG18.1). Here, we utilise optical genome mapping (OGM) to investigate CTG18.1 tissue-specific instability to gain mechanistic insights. METHODS: We applied OGM to a diverse range of genomic DNAs (gDNAs) from patients with FECD and controls (n = 43); CECs, leukocytes and fibroblasts. A bioinformatics pipeline was developed to robustly interrogate CTG18.1-spanning DNA molecules. All results were compared with conventional polymerase chain reaction-based fragment analysis. FINDINGS: Analysis of bio-samples revealed that expanded CTG18.1 alleles behave dynamically, regardless of cell-type origin. However, clusters of CTG18.1 molecules, encompassing ∼1800-11,900 repeats, were exclusively detected in diseased CECs from expansion-positive cases. Additionally, both progenitor allele size and age were found to influence the level of leukocyte-specific CTG18.1 instability. INTERPRETATION: OGM is a powerful tool for analysing somatic instability of repeat loci and reveals here the extreme levels of CTG18.1 instability occurring within diseased CECs underpinning FECD pathophysiology, opening up new therapeutic avenues for FECD. Furthermore, these findings highlight the broader translational utility of FECD as a model for developing therapeutic strategies for rarer diseases similarly attributed to somatically unstable repeats. FUNDING: UK Research and Innovation, Moorfields Eye Charity, Fight for Sight, Medical Research Council, NIHR BRC at Moorfields Eye Hospital and UCL Institute of Ophthalmology, Grantová Agentura České Republiky, Univerzita Karlova v Praze, the National Brain Appeal's Innovation Fund and Rosetrees Trust.

• MeSH
• alely MeSH
• expanze trinukleotidových repetic MeSH
• Fuchsova endoteliální dystrofie * genetika   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mapování chromozomů MeSH
• nestabilita genomu MeSH
• orgánová specificita genetika   MeSH
• senioři MeSH
• transkripční faktor 4 * genetika   metabolismus   MeSH
• trinukleotidové repetice genetika   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Corneal dystrophies are phenotypically and genetically heterogeneous, often resulting in visual impairment caused by corneal opacification. We investigated the genetic cause of an autosomal dominant corneal stromal dystrophy in a pedigree with eight affected individuals in three generations. Affected individuals had diffuse central stromal opacity, with reduced visual acuity in older family members. Histopathology of affected cornea tissue removed during surgery revealed mild stromal textural alterations with alcianophilic deposits. Whole genome sequence data were generated for four affected individuals. No rare variants (MAF < 0.001) were identified in established corneal dystrophy genes. However, a novel heterozygous missense variant in exon 4 of SPARCL1, NM_004684: c.334G > A; p.(Glu112Lys), which is predicted to be damaging, segregated with disease. SPARC-like protein 1 (SPARCL1) is a secreted matricellular protein involved in cell migration, cell adhesion, tissue repair, and remodelling. Interestingly, SPARCL1 has been shown to regulate decorin. Heterozygous variants in DCN, encoding decorin, cause autosomal dominant congenital stromal corneal dystrophy, suggesting a common pathogenic pathway. Therefore, we performed immunohistochemistry to compare SPARCL1 and decorin localisation in corneal tissue from an affected family member and an unaffected control. Strikingly, the level of decorin was significantly decreased in the corneal stroma of the affected tissue, and SPARCL1 appeared to be retained in the epithelium. In summary, we describe a novel autosomal dominant corneal stromal dystrophy associated with a missense variant in SPARCL1, extending the phenotypic and genetic heterogeneity of inherited corneal disease.

• MeSH
• dědičné dystrofie rohovky * genetika   patologie   MeSH
• dekorin genetika   metabolismus   MeSH
• dospělí MeSH
• extracelulární matrix - proteiny * genetika   MeSH
• heterozygot MeSH
• lidé středního věku MeSH
• lidé MeSH
• missense mutace * MeSH
• proteiny vázající vápník * genetika   MeSH
• rodokmen * MeSH
• senioři MeSH
• stroma rohovky patologie   metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Dědičná onemocnění sítnice představují jednu z nejčastějších příčin ztráty zraku ve vyspělých zemích u dětí a mladších dospělých. Donedávna byla všechna tato onemocnění neléčitelná, pacientům byla poskytována jen symptomatická péče. Přelomový okamžik nastal v roce 2018, kdy byla Evropskou lékovou agenturou schválena první oční genová terapie voretigen neparvovekem u pacientů s dědičným onemocněním sítnice způsobeným bialelickými mutacemi v genu RPE65 kódujícím protein specifický pro retinální pigmentový epitel. Práce podává přehled o tomto léku a způsobu jeho aplikace.

Inherited retinal diseases are one of the most common causes of visual loss in children and young adults in developed countries. Until recently, all these disorders were incurable, patients were only provided with symptomatic care. The breakthrough moment was approval of the first ocular gene therapy by European Medical Agency in 2018 - voretigene neparvovec - for patients with inherited retinal diseases caused by biallelic mutations in the RPE65 gene. Herein we provide an overview of this medicine and its application.

The aim of this study was to describe the clinical and molecular genetic findings in seven individuals from three unrelated families with Blau syndrome. A complex ophthalmic and general health examination including diagnostic imaging was performed. The NOD2 mutational hot spot located in exon 4 was Sanger sequenced in all three probands. Two individuals also underwent autoinflammatory disorder gene panel screening, and in one subject, exome sequencing was performed. Blau syndrome presenting as uveitis, skin rush or arthritis was diagnosed in four cases from three families. In two individuals from one family, only camptodactyly was noted, while another member had camptodactyly in combination with non-active uveitis and angioid streaks. One proband developed two attacks of meningoencephalitis attributed to presumed neurosarcoidosis, which is a rare finding in Blau syndrome. The probands from families 1 and 2 carried pathogenic variants in NOD2 (NM_022162.3): c.1001G>A p.(Arg334Gln) and c.1000C>T p.(Arg334Trp), respectively. In family 3, two variants of unknown significance in a heterozygous state were found: c.1412G>T p.(Arg471Leu) in NOD2 and c.928C>T p.(Arg310*) in NLRC4 (NM_001199139.1). In conclusion, Blau syndrome is a phenotypically highly variable, and there is a need to raise awareness about all clinical manifestations, including neurosarcoidosis. Variants of unknown significance pose a significant challenge regarding their contribution to etiopathogenesis of autoinflammatory diseases.

• MeSH
• artritida * genetika   diagnóza   MeSH
• dědičné zánětlivé autoimunitní nemoci MeSH
• lidé MeSH
• lymfedém genetika   diagnóza   MeSH
• mutace * MeSH
• nemoci centrálního nervového systému MeSH
• neuropatická artropatie genetika   diagnóza   MeSH
• rodokmen * MeSH
• sarkoidóza * genetika   diagnóza   MeSH
• sekvenování exomu MeSH
• signální adaptorový protein Nod2 * genetika   MeSH
• synovitida * genetika   diagnóza   MeSH
• uveitida * genetika   diagnóza   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: Leber hereditary optic neuropathy (LHON) is the most frequent mitochondrial disease causing dyschromatopsia and progressive central visual loss that is subacute in progression and painless. Several studies have been published assessing QoL in patients with LHON, but no estimate of the economic burden has been reported to date. This study aims to quantify direct non-medical and indirect costs (productivity loss) incurred by LHON patients and their informal caregivers in Czechia and Slovakia, as well as to assess their quality of life. METHODS: The study was performed in 27 adults and children with LHON. To determine the socioeconomic burden of LHON, separate questionnaires for adults, children, and their parents were developed, including demographic and socioeconomic data. The following data were collected: age, education, family size, severity of LHON, non-medical direct and indirect costs of LHON. RESULTS: The mean age of adult respondents was 36.1 years (SD 13.1; n = 21). The total cost of absenteeism was EUR 1003 per person/year in adult employees, and EUR 2711 per person/year in children's parents. The productivity loss as a consequence of LHON due to combined relative absenteeism and relative presenteeism was estimated at EUR 9840 per an adult patient/year, and EUR 6298 per a parent/year, respectively. The mean cost of informal care was estimated at EUR 4502 (SD 4772; n = 6) per person/year. The mean VFQ-25 score for adult patients with LHON was 43.47 (SD 15.86). CONCLUSION: The results of this study clearly show that patients with LHON and their families face an extensive socioeconomic burden related to this rare disease. Early, timely and appropriate access to diagnosis, treatment, and reimbursement decisions, but also to psychological counselling and services may help the patients and their relatives adapt and cope with the challenging aspects of vision loss and life with the disease.

• Publikační typ
• časopisecké články MeSH

Fuchs endothelial corneal dystrophy (FECD) is an age-related cause of vision loss, and the most common repeat expansion-mediated disease in humans characterised to date. Up to 80% of European FECD cases have been attributed to expansion of a non-coding CTG repeat element (termed CTG18.1) located within the ubiquitously expressed transcription factor encoding gene, TCF4. The non-coding nature of the repeat and the transcriptomic complexity of TCF4 have made it extremely challenging to experimentally decipher the molecular mechanisms underlying this disease. Here we comprehensively describe CTG18.1 expansion-driven molecular components of disease within primary patient-derived corneal endothelial cells (CECs), generated from a large cohort of individuals with CTG18.1-expanded (Exp+) and CTG 18.1-independent (Exp-) FECD. We employ long-read, short-read, and spatial transcriptomic techniques to interrogate expansion-specific transcriptomic biomarkers. Interrogation of long-read sequencing and alternative splicing analysis of short-read transcriptomic data together reveals the global extent of altered splicing occurring within Exp+ FECD, and unique transcripts associated with CTG18.1-expansions. Similarly, differential gene expression analysis highlights the total transcriptomic consequences of Exp+ FECD within CECs. Furthermore, differential exon usage, pathway enrichment and spatial transcriptomics reveal TCF4 isoform ratio skewing solely in Exp+ FECD with potential downstream functional consequences. Lastly, exome data from 134 Exp- FECD cases identified rare (minor allele frequency <0.005) and potentially deleterious (CADD>15) TCF4 variants in 7/134 FECD Exp- cases, suggesting that TCF4 variants independent of CTG18.1 may increase FECD risk. In summary, our study supports the hypothesis that at least two distinct pathogenic mechanisms, RNA toxicity and TCF4 isoform-specific dysregulation, both underpin the pathophysiology of FECD. We anticipate these data will inform and guide the development of translational interventions for this common triplet-repeat mediated disease.

• MeSH
• alternativní sestřih genetika   MeSH
• endoteliální buňky metabolismus   MeSH
• expanze trinukleotidových repetic * genetika   MeSH
• Fuchsova endoteliální dystrofie * genetika   MeSH
• lidé MeSH
• rohovkový endotel metabolismus   patologie   MeSH
• transkripční faktor 4 * genetika   metabolismus   MeSH
• transkriptom genetika   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH