OBJECTIVE: Hereditary spastic paraplegia (HSP) is a highly heterogeneous neurologic disorder characterized by lower-extremity spasticity. Here, we set out to determine the genetic basis of an autosomal dominant, pure, and infantile-onset form of HSP in a cohort of 8 patients with a uniform clinical presentation. METHODS: Trio whole-exome sequencing was used in 5 index patients with infantile-onset pure HSP to determine the genetic cause of disease. The functional impact of identified genetic variants was verified using bioinformatics and complementary cellular and biochemical assays. RESULTS: Distinct heterozygous KPNA3 missense variants were found to segregate with the clinical phenotype in 8 patients; in 4 of them KPNA3 variants had occurred de novo. Mutant karyopherin-α3 proteins exhibited a variable pattern of altered expression level, subcellular distribution, and protein interaction. INTERPRETATION: Our genetic findings implicate heterozygous variants in KPNA3 as a novel cause for autosomal dominant, early-onset, and pure HSP. Mutant karyopherin-α3 proteins display varying deficits in molecular and cellular functions, thus, for the first time, implicating dysfunctional nucleocytoplasmic shuttling as a novel pathomechanism causing HSP. ANN NEUROL 2021;90:738-750.
- MeSH
- alfa karyoferiny genetika MeSH
- dospělí MeSH
- fenotyp MeSH
- heterozygot MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mutace genetika MeSH
- předškolní dítě MeSH
- rodokmen MeSH
- sekvenování exomu metody MeSH
- spastická paraplegie dědičná genetika MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
Human 4-hydroxyphenylpyruvate dioxygenase-like (HPDL) is a putative iron-containing non-heme oxygenase of unknown specificity and biological significance. We report 25 families containing 34 individuals with neurological disease associated with biallelic HPDL variants. Phenotypes ranged from juvenile-onset pure hereditary spastic paraplegia to infantile-onset spasticity and global developmental delays, sometimes complicated by episodes of neurological and respiratory decompensation. Variants included bona fide pathogenic truncating changes, although most were missense substitutions. Functionality of variants could not be determined directly as the enzymatic specificity of HPDL is unknown; however, when HPDL missense substitutions were introduced into 4-hydroxyphenylpyruvate dioxygenase (HPPD, an HPDL orthologue), they impaired the ability of HPPD to convert 4-hydroxyphenylpyruvate into homogentisate. Moreover, three additional sets of experiments provided evidence for a role of HPDL in the nervous system and further supported its link to neurological disease: (i) HPDL was expressed in the nervous system and expression increased during neural differentiation; (ii) knockdown of zebrafish hpdl led to abnormal motor behaviour, replicating aspects of the human disease; and (iii) HPDL localized to mitochondria, consistent with mitochondrial disease that is often associated with neurological manifestations. Our findings suggest that biallelic HPDL variants cause a syndrome varying from juvenile-onset pure hereditary spastic paraplegia to infantile-onset spastic tetraplegia associated with global developmental delays.
- MeSH
- dánio pruhované MeSH
- krysa rodu rattus MeSH
- lidé MeSH
- mutace MeSH
- myši MeSH
- oxygenasy genetika MeSH
- rodokmen MeSH
- spastická paraplegie dědičná genetika MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- lidé MeSH
- mužské pohlaví MeSH
- myši MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
Hearing loss is a genetically heterogeneous sensory defect, and the frequent causes are biallelic pathogenic variants in the GJB2 gene. However, patients carrying only one heterozygous pathogenic (monoallelic) GJB2 variant represent a long-lasting diagnostic problem. Interestingly, previous results showed that individuals with a heterozygous pathogenic GJB2 variant are two times more prevalent among those with hearing loss compared to normal-hearing individuals. This excess among patients led us to hypothesize that there could be another pathogenic variant in the GJB2 region/DFNB1 locus. A hitherto undiscovered variant could, in part, explain the cause of hearing loss in patients and would mean reclassifying them as patients with GJB2 biallelic pathogenic variants. In order to detect an unknown causal variant, we examined 28 patients using NGS with probes that continuously cover the 0.4 Mb in the DFNB1 region. An additional 49 patients were examined by WES to uncover only carriers. We did not reveal a second pathogenic variant in the DFNB1 region. However, in 19% of the WES-examined patients, the cause of hearing loss was found to be in genes other than the GJB2. We present evidence to show that a substantial number of patients are carriers of the GJB2 pathogenic variant, albeit only by chance.
- MeSH
- frekvence genu MeSH
- heterozygot MeSH
- konexin 26 genetika MeSH
- lidé MeSH
- mutace MeSH
- percepční nedoslýchavost genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: The Roma are a European ethnic minority threatened by several recessive diseases. Variants in MANBA cause a rare lysosomal storage disorder named beta-mannosidosis whose clinical manifestation includes deafness and mental retardation. Since 1986, only 23 patients with beta-mannosidosis and biallelic MANBA variants have been described worldwide. RESULTS: We now report on further 10 beta-mannosidosis patients of Roma origin from eight families in the Czech and Slovak Republics with hearing loss, mental retardation and homozygous pathogenic variants in MANBA. MANBA variant c.2158-2A>G screening among 345 anonymized normal hearing controls from Roma populations revealed a carrier/heterozygote frequency of 3.77%. This is about 925 times higher than the frequency of this variant in the gnomAD public database and classifies the c.2158-2A>G variant as a prevalent, ethnic-specific variant causing hearing loss and mental retardation in a homozygous state. The frequency of heterozygotes/carriers is similar to another pathogenic variant c.71G>A (p.W24*) in GJB2, regarded as the most frequent variant causing deafness in Roma populations. CONLCUSION: Beta-mannosidosis, due to a homozygous c.2158-2A>G MANBA variant, is an important and previously unknown cause of hearing loss and mental retardation among Central European Roma.
- MeSH
- beta-mannosidóza * MeSH
- etnicita MeSH
- hluchota * genetika MeSH
- lidé MeSH
- menšiny MeSH
- nedoslýchavost * genetika MeSH
- Romové * genetika MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Geografické názvy
- Česká republika MeSH
- Slovenská republika MeSH
Biallelic pathogenic variants in FA2H gene have been repeatedly described as a cause of hereditary spastic paraplegia (HSP) type35 (SPG35). Targeted massive parallel sequencing (MPS) of the HSP genes panel revealed a novel homozygous variant c.130C > T (p.P44S) in the FA2H gene in the 30-year-old patient presenting with spastic paraplegia. The patient originated form the Czech minority in Romania. The patient manifests typical clinical signs for SPG35 (youth onset gait impairment, progressive spastic paraparesis on lower limbs, dysarthria, white matter changes in MRI).
Hereditární spastická paraparéza (HSP, též SPG) je klinicky i geneticky vysoce heterogenní závažné onemocnění centrálního motoneuronu, charakterizované progredující spasticitou a slabostí dolních končetin a poruchou chůze. Do dnešní doby bylo popsáno přes 90 genů nebo genových lokusů, jejichž mutace jsou zodpovědné za rozvoj HSP. Podrobnější zmapování genetické podstaty nemoci nebylo až donedávna možné, teprve rozvoj nových sekvenačních metod v posledních letech otevírá možnost postupně doplňovat chybějící genetické i klinické poznatky. U českých pacientů s HSP se vyskytuje nejméně 12 genetických typů nemoci, nejčastěji typ SPG4 a dále SPG31 s autosomálně dominantní dědičností a SPG11 a SPG7 s autosomálně recesivní dědičností, podobně jako v jiných evropských zemích. Naopak rozdílně od řady dřívějších publikací z jiných zemí je v České republice nízký výskyt typu SPG3. Procento geneticky diagnostikovaných a DNA vyšetřením objasněných pacientů je pak výrazně vyšší mezi pacienty s familiárním (tzn. vícečetným) výskytem onemocnění v rodině. Tato fakta je dobré zohlednit při indikaci genetických vyšetření u pacientů se suspektní HSP.
Hereditary spastic parapalegia (HSP or SPG) is clinically and genetically heterogenous serious disease of the central motoneuron. It is characterised by progressive spasticity and weakness of lower libms leading to progressive gait impairement. Pathogenic variants causing HSP in more than 90 genes or gene loci where described to date. Methods of new generation sequencing allow us to map the genetic background of HSP and to bring new knowledges about clinical spectrum of particular types of HSP. There exist at least 12 types of HSP among Czech HSP patients, the most frequent types are SPG4, SPG31 with autosomal dominant and SPG7 and SPG11 with autosomal recessive mode of inheritance, similarly like in other European countries. In spite of previously published data from other populations the occurence of SPG3 is suprisingly low in the Czech Republic. The percentage of genetically and by DNA testing evaluated patients is much higher among familial patients (more affected persons in the family) compared to the sporadic ones. These facts should be taken into account for genetic testing consideration.
- MeSH
- diagnostické techniky molekulární metody MeSH
- diferenciální diagnóza MeSH
- genetické nemoci vrozené MeSH
- genetické testování * metody MeSH
- genotyp MeSH
- genotypizační techniky MeSH
- lidé MeSH
- paraplegie diagnóza genetika terapie MeSH
- spastická paraparéza diagnóza genetika terapie MeSH
- spastická paraplegie dědičná * diagnostické zobrazování genetika klasifikace terapie MeSH
- Check Tag
- lidé MeSH
Hereditární spastické paraparézy (HSP) jsou heterogenní skupinou onemocnění centrálního motoneuronu charakterizované bilaterální progredující spasticitou a slabostí dolních končetin. Klinické příznaky nemoci jsou způsobeny postupnou degenerací axonů kortikospinální dráhy a zadních provazců míšních. HSP se manifestuje poruchou chůze, kterou zaznamená buď sám pacient nebo si zhoršené chůze povšimne jeho okolí. Subjektivně může pacient pociťovat ztuhlost dolních končetin nebo také udává křeče svalů. Nástup onemocnění bývá pozvolný a nenápadný, symptomy se mohou začít projevovat v kterémkoli věku od předškolního dětství až do pozdních dekád života. Příčinou onemocnění je vrozená genová porucha/mutace některého z více než 50 genů popsaných u HSP. U největšího procenta pacientů jsou příčinou mutace genu SPAST (SPG4). V současnosti dostupná léčba je pouze symptomatická. Onemocnění je uváděno též pod názvem spastická paraplegie nebo onemocnění Strümpell-Lorrain.
Hereditary spastic paraplegias (HSPs) are a heterogeneous group of central motor neuron disorders characterized by bilateral progressive spasticity and weakness of the lower limbs. The clinical features are caused by progressive axonal degeneration of the corticospinal tract and dorsal columns. Typical clinical symptoms are progressive gait impairment and spasticity of the lower limbs. Clinical symptoms can manifest at any age (from preschool to the elderly), symptoms onset can be very slow. HSP is caused by a pathogenic genetic variant/ mutation in one of more than 50 genes described with HSP. For the majority of patients, the causal mutation is localised in the SPAST gene (SPG4). The available treatment is only symptomatological. The disease is also known as Strümpell-Lorrain disease.
- Klíčová slova
- Synonyma nemoci: onemocnění Strümpell-Lorrain, hereditárn í paraparézy spastické (HSP),
- MeSH
- abnormální reflex * fyziologie genetika imunologie MeSH
- baklofen aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- botulotoxiny typ A aplikace a dávkování škodlivé účinky terapeutické užití MeSH
- diferenciální diagnóza MeSH
- financování organizované MeSH
- genetické poradenství metody trendy využití MeSH
- klinický obraz nemoci MeSH
- lidé MeSH
- management farmakoterapie trendy využití MeSH
- poradenství metody trendy využití MeSH
- spastická paraparéza * diagnóza etiologie patologie MeSH
- statistika jako téma MeSH
- svalová spasticita * diagnóza etiologie patologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
BACKGROUND: DNA methylation is one of major factors in cancer progression. We observed multiple genes involved in cancer-related signaling and focused on patients with advanced non-small cell lung cancer (NSCLC) and evaluated methylation in relation to various clinical parameters. PATIENTS AND METHODS: Thirty genes were examined in 121 NSCLC patients using the methylation-specific multiplex ligation-dependent probe amplification (MS-MLPA) method. Correlations to gender, smoking status, tumor subtype, disease stage and EGFR/KRAS mutation status were performed by chi-square test. RESULTS: 90% of tumors exhibited methylation of at least one gene. Most frequently methylated were cadherin-13 (CDH13), Ras associated domain-containing protein (RASSF1A), Wilms' tumor protein (WT1), adenomatous polyposis coli protein (APC), paired box protein Pax-5 (PAX5), estrogen receptor (ESR1), an inhibitor of cyclin-dependent kinase p15 (CDKN2B), paired box protein Pax-6 (PAX6), transcription factor GATA-5 (GATA5) and cell adhesion molecule 4 (IGSF4). Overall methylation (any gene) was increased in adenocarcinomas (p=0.0329), unrelated to gender or disease stage. Several genes exhibited variable methylation with gender (CDH13, p<0.001; GATA5, p=0.02; PAX6, p=0.01 and ESR1, p=0.03), smoking (CDH13, p=0.002), or epidermal growth factor receptor (EGFR) mutation status [Von Hippel-Lindau disease tumor supresor (VHL), p=0.001; CDKN2B, p=0.02; CDH13, p=0.02; APC, p=0.04 and ESR1, p=0.04]. CONCLUSION: Differences in gene methylation associated with gender, smoking and EGFR mutation suggest potential for prediction in relation to management of tyrosine kinase inhibitor therapy.
- MeSH
- dospělí MeSH
- epigeneze genetická MeSH
- erbB receptory genetika MeSH
- lidé středního věku MeSH
- lidé MeSH
- metylace DNA MeSH
- mutace MeSH
- mutační analýza DNA MeSH
- nádory plic genetika MeSH
- nemalobuněčný karcinom plic genetika MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
