Genetic aspects of adolescent idiopathic scoliosis in a family with multiple affected members: a research article

<p>Abstract</p> <p>Background</p> <p>The etiology of idiopathic scoliosis remains unknown and different factors have been suggested as causal. Hereditary factors can also determine the etiology of the disease; however, the pattern of inheritance remains unknown. Autosomal dominant, X-linked and multifactorial patterns of inheritances have been reported. Other studies have suggested possible chromosome regions related to the etiology of idiopathic scoliosis. We report the genetic aspects of and investigate chromosome regions for adolescent idiopathic scoliosis in a Brazilian family.</p> <p>Methods</p> <p>Evaluation of 57 family members, distributed over 4 generations of a Brazilian family, with 9 carriers of adolescent idiopathic scoliosis. The proband presented a scoliotic curve of 75 degrees, as determined by the Cobb method. Genomic DNA from family members was genotyped.</p> <p>Results</p> <p>Locating a chromosome region linked to adolescent idiopathic scoliosis was not possible in the family studied.</p> <p>Conclusion</p> <p>While it was not possible to determine a chromosome region responsible for adolescent idiopathic scoliosis by investigation of genetic linkage using microsatellites markers during analysis of four generations of a Brazilian family with multiple affected members, analysis including other types of genomic variations, like single nucleotide polymorphisms (SNPs) could contribute to the continuity of this study.</p

Nemaline Myopathy in Brazilian Patients: Molecular and Clinical Characterization

Nemaline myopathy (NM), a structural congenital myopathy, presents a significant clinical and genetic heterogeneity. Here, we compiled molecular and clinical data of 30 Brazilian patients from 25 unrelated families. Next-generation sequencing was able to genetically classify all patients: sixteen families (64%) with mutation in NEB, five (20%) in ACTA1, two (8%) in KLHL40, and one in TPM2 (4%) and TPM3 (4%). In the NEB-related families, 25 different variants, 11 of them novel, were identified; splice site (10/25) and frame shift (9/25) mutations were the most common. Mutation c.24579 G>C was recurrent in three unrelated patients from the same region, suggesting a common ancestor. Clinically, the “typical” form was the more frequent and caused by mutations in the different NM genes. Phenotypic heterogeneity was observed among patients with mutations in the same gene. Respiratory involvement was very common and often out of proportion with limb weakness. Muscle MRI patterns showed variability within the forms and genes, which was related to the severity of the weakness. Considering the high frequency of NEB mutations and the complexity of this gene, NGS tools should be combined with CNV identification, especially in patients with a likely non-identified second mutation

Nemaline Myopathy in Brazilian Patients: Molecular and Clinical Characterization

Nemaline myopathy (NM), a structural congenital myopathy, presents a significant clinical and genetic heterogeneity. Here, we compiled molecular and clinical data of 30 Brazilian patients from 25 unrelated families. Next-generation sequencing was able to genetically classify all patients: sixteen families (64%) with mutation in NEB, five (20%) in ACTA1, two (8%) in KLHL40, and one in TPM2 (4%) and TPM3 (4%). In the NEB-related families, 25 different variants, 11 of them novel, were identified; splice site (10/25) and frame shift (9/25) mutations were the most common. Mutation c.24579 G>C was recurrent in three unrelated patients from the same region, suggesting a common ancestor. Clinically, the “typical” form was the more frequent and caused by mutations in the different NM genes. Phenotypic heterogeneity was observed among patients with mutations in the same gene. Respiratory involvement was very common and often out of proportion with limb weakness. Muscle MRI patterns showed variability within the forms and genes, which was related to the severity of the weakness. Considering the high frequency of NEB mutations and the complexity of this gene, NGS tools should be combined with CNV identification, especially in patients with a likely non-identified second mutation

Segregation distortion in humans

O desvio de segregação, processo biológico definido pela formação de progênie cujas proporções genotípicas diferem das predições mendelianas, pode apresentar diferentes causas: a segregação não aleatória dos cromossomos durante a meiose, a seleção gamética e a viabilidade pós-zigótica diferencial. A fim de investigar a distorção de segregação em humanos, estudamos uma família com transmissão preferencial paterna de uma alteração patogênica no gene CAPN3(CAPN3 c.759_761del), previamente associada à distrofia muscular de cinturas do tipo 2A (LGMD2A). Inicialmente, definimos uma região com 2,1 Mb de extensão, presente na maior parte dos indivíduos da família. O sequenciamento direto de 14 genes contidos nesse intervalo não revelou variantes raras que pudessem estar diretamente associadas à vantagem da subpopulação de gametas portadores da alteração em CAPN3. Entretanto, a presença de variantes comuns distribuídas em cinco genes da região pode indicar que a distorção de segregação observada é consequência da interação, em nível proteico, de pequenas alterações genômicas, resultando no desempenho diferencial de tais células gaméticas. Além disso, utilizamos outra abordagem: espermatozoides de indivíduos saudáveis foram selecionados segundo sua motilidade e as frequências alélicas de cada loco em heterozigose foram comparadas entre células lentas e rápidas, a fim de identificarmos regiões suscetíveis ao desvio de segregação. Alguns resultados estatisticamente significantes foram obtidos para regiões que contêm genes envolvidos na reação acrossômica e na motilidade espermática, como PDE1C e PDE4D. Isso nos sugere que tais processos constituem alvos da seleção, o que pode culminar em formação de progênie com proporções que fogem às predições mendelianas. Esses achados são importantes porque possibilitam a ampliação de nossos conhecimentos acerca do desvio de segregação e seu impacto na espécie humana, considerando ainda possíveis efeitos na fertilidade masculinaThe transmission ratio distortion (TRD), a biological process defined as a deviation from Mendelian predictions, is caused by different mechanisms: nonrandom segregation of chromosomes during meiosis or gametic and postzygotic viability selection. In order to investigate TRD in humans, we have studied a family with an overtransmitted pathogenic deletion in the CAPN3 gene (CAPN3 c.759_761del), previously associated to limb-girdle muscular dystrophy type 2A (LGMD2A). Initially, it was possible to define a 2.1 Mb region which was present in most of the individuals. The direct sequencing of 14 genes contained in this interval did not reveal rare variants that could be responsible for the advantage of gametes carrying the CAPN3 mutation. Nevertheless, common variants identified in five genes could indicate that the observed transmission distortion is caused by the interaction among proteins with small dissimilarities, resulting in differential performance of these gametic cells. Subsequently we developed another approach: spermatozoa from healthy individuals were sorted according to their motility and allelic frequencies at each locus in heterozygous state were compared in order to identify genomic regions susceptible to TRD. Surprisingly, some statistically significant results were achieved for regions containing genes involved with acrosome reaction and sperm motility, as PDE1 and PDE4, suggesting these processes are targets of the selection that ends in offspring with proportions skewed away from the Mendelian predictions. These results are important for enlarge our knowledge about TRD and its impact in humans, considering possible effects in male fertilit

Altered in vitro muscle differentiation in X-linked myopathy with excessive autophagy

International audienceX-linked myopathy with excessive autophagy (XMEA) is a genetic disease associated with weakness of the proximal muscles. It is caused by mutations in the VMA21 gene, coding for a chaperone that functions in the vacuolar ATPase (v-ATPase) assembly. Mutations associated with lower content of assembled v-ATPases lead to an increase in lysosomal pH, culminating in partial blockage of macroautophagy, with accumulation of vacuoles of undigested content. Here, we studied a 5-year-old boy affected by XMEA, caused by a small indel in the VMA21 gene. Detection of sarcoplasmic Lc3 (also known as MAP1LC3B)-positive vacuoles in his muscle biopsy confirmed an autophagy defect. To understand how autophagy is regulated in XMEA myogenesis, we used patient-derived muscle cells to evaluate autophagy during in vitro muscle differentiation. An increase in lysosomal pH was observed in the patient's cells, compatible with predicted functional defect of his mutation. Additionally, there was an increase in autophagic flux in XMEA myotubes. Interestingly, we observed that differentiation of XMEA myoblasts was altered, with increased myotube formation observed through a higher fusion index, which was not dependent on lysosomal acidification. Moreover, no variation in the expression of myogenic factors nor the presence of regenerating fibers in the patient's muscle were observed. Myoblast fusion is a tightly regulated process; therefore, the uncontrolled fusion of XMEA myoblasts might generate cells that are not as functional as normal muscle cells. Our data provide new evidence on the reason for predominant muscle involvement in the context of the XMEA phenotype.This article has an associated First Person interview with the first author of the paper

Childhood Hypophosphatasia Associated with a Novel Biallelic ALPL Variant at the TNSALP Dimer Interface

The goal of this study was to perform a clinical and molecular investigation in an eight-year-old female child diagnosed with hypophosphatasia (HPP). The proband and her family were evaluated by medical and dental histories, biochemical analyses, radiographic imaging, and genetic analysis of the tissue-nonspecific alkaline phosphatase (ALPL) gene. A bioinformatic analysis was performed to predict the structural and functional impact of the point mutations in the tissue-nonspecific alkaline phosphatase (TNSALP) molecule and to define their potential contribution to the phenotype. We identified a novel combination of heterozygous ALPL missense variants in the proband, p.Ala33Val and p.Asn47His, compatible with an autosomal recessive mode of inheritance and resulting in skeletal and dental phenotypes. Computational modeling showed that the affected Asn47 residue is located in the coil structure close to the N-terminal &alpha;-helix, whereas the affected Ala33 residue is localized in the N-terminal &alpha;-helix. Both affected residues are located close to the homodimer interface, suggesting they may impair TNSALP dimer formation and stability. Clinical and biochemical follow-up revealed improvements after six years of ERT. Reporting this novel combination of ALPL variants in childhood HPP provides new insights into genotype&ndash;phenotype associations for HPP and specific sites within the TNSALP molecule potentially related to a childhood-onset HPP and skeletal and dental manifestations. Beneficial effects of ERT are implicated in skeletal and dental tissues

Nemaline Myopathy in Brazilian Patients: Molecular and Clinical Characterization

Nemaline myopathy (NM), a structural congenital myopathy, presents a significant clinical and genetic heterogeneity. Here, we compiled molecular and clinical data of 30 Brazilian patients from 25 unrelated families. Next-generation sequencing was able to genetically classify all patients: sixteen families (64%) with mutation in NEB, five (20%) in ACTA1, two (8%) in KLHL40, and one in TPM2 (4%) and TPM3 (4%). In the NEB-related families, 25 different variants, 11 of them novel, were identified; splice site (10/25) and frame shift (9/25) mutations were the most common. Mutation c.24579 G&gt;C was recurrent in three unrelated patients from the same region, suggesting a common ancestor. Clinically, the "typical" form was the more frequent and caused by mutations in the different NM genes. Phenotypic heterogeneity was observed among patients with mutations in the same gene. Respiratory involvement was very common and often out of proportion with limb weakness. Muscle MRI patterns showed variability within the forms and genes, which was related to the severity of the weakness. Considering the high frequency of NEB mutations and the complexity of this gene, NGS tools should be combined with CNV identification, especially in patients with a likely non-identified second mutation