Informing patients about their mutation tests : CDKN2A c.256G>A in melanoma as an example

Background When germline mutations are suspected as causal in cancer, patient DNA may be sequenced to detect variants in relevant genes. If a particular mutation has not been reported in reliable family studies, genetic counselors are facing a dilemma of appropriately informing patients. Many sequencing facilities provide an interpretation of the findings based on the available sequence databases or on prediction tools that are curated from bioinformatics and mechanistic datasets. The counseling dilemma is exacerbated if the pedigree data are not informative but the in silico predictions suggest pathogenicity. Methods We present here a real world example of the c.256G > ACDKN2Avariant, which was detected in one melanoma patient where two siblings were diagnosed with melanoma in situ. We investigated a detailed family history of the affected siblings in order to survey probability of the cancer risks within the context to this mutation. Results This c.256G > ACDKN2Avariant was detected in one of the brothers and in the melanoma-free mother while the other brother in the family tested negative. The variant had been previously described in one patient from a melanoma family. In the family under investigation, the mother's 16 first-and second-degree relatives had survived past the median onset age for melanoma and none presented melanoma. We tested the variant using multiple bioinformatic tools that all predicted deleteriousness of the variant. The genetic counseling report to the melanoma patient stated that theCDKN2Avariant was 'likely pathogenic' and the disease was defined as 'likely hereditary melanoma'. Conclusions The pedigree data showed at the most a low penetrance variant, which, if taken into consideration, might have altered the provided diagnosis. When dealing with 'practically' unknown variants the counselors would be advised to incorporate a detailed family history rather than basing predictions on functionality provided by sequencing facilities.Peer reviewe

TERT promoter mutations and telomere length in adult malignant gliomas and recurrences.

In this report on 303 gliomas we show the highest frequency of TERT promoter mutations in gliobastomas (80%) followed by oligodendrogliomas (70%) and astrocytomas (39%). We observed positive association between TERT promoter and IDH mutations in oligodendroglial tumors (OR = 26.3; 95% CI 2.5-250.2) and inverse association in primary glioblastomas (OR = 0.13; 95% CI 0.03-0.58). Tumors with TERT promoter mutations compared to those without showed increased TERT transcription; we also showed difference in the transcription levels due to the two main mutations. Tumors with TERT promoter mutations had shorter telomeres than those without. The patients with only TERT promoter mutations showed worst survival (median survival 14.6 months) and patients with both IDH and TERT promoter mutations showed best survival (246.5 months). In patients with astrocytoma, the TERT promoter mutations only associated with poor survival (P < 0.0001); IDH mutations and 1p/19q deletions associated with increased survival (P = 0.0004). TERT promoter mutations in low grade gliomas associated with reduced progression free survival (HR 10.2; 95% CI 1.9 - 55.9). While our data affirm the role of TERT promoter mutations in glial tumors, effects on transcription and telomere length emphasise the importance of telomere biology in disease genesis and outcome

Variants at the 9p21 locus and melanoma risk

Background: The influence of variants at the 9p21 locus on melanoma risk has been reported through investigation of CDKN2A variants through candidate gene approach as well as by genome wide association studies (GWAS). Methods: In the present study we genotyped, 25 SNPs that tag 273 variants on chromosome 9p21 in 837 melanoma cases and 1154 controls from Spain. Ten SNPs were selected based on previous associations, reported in GWAS, with either melanocytic nevi or melanoma risk or both. The other 15 SNPs were selected to fine map the CDKN2A gene region. Results: All the 10 variants selected from the GWAS showed statistically significant association with melanoma risk. Statistically significant association with melanoma risk was also observed for the carriers of the variant T-allele of rs3088440 (540 C>T) at the 3' UTR of CDKN2A gene with an OR 1.52 (95% CI 1.14-2.04). Interaction analysis between risk associated polymorphisms and previously genotyped MC1R variants, in the present study, did not show any statistically significant association. Statistical significant association was observed for the interaction between phototypes and the rs10811629 (located in intron 5 of MTAP). The strongest association was observed between the homozygous carrier of the A-allele and phototype II with an OR of 15.93 (95% CI 5.34-47.54). Conclusions: Our data confirmed the association of different variants at chromosome 9p21 with melanoma risk and we also found an association of a variant with skin phototypes

Pancreatic Cancer Susceptibility Loci and Their Role in Survival

Pancreatic cancer has one of the worst mortality rates of all cancers. Little is known about its etiology, particularly regarding inherited risk. The PanScan project, a genome-wide association study, identified several common polymorphisms affecting pancreatic cancer susceptibility. Single nucleotide polymorphisms (SNPs) in ABO, sonic hedgehog (SHH), telomerase reverse transcriptase (TERT), nuclear receptor subfamily 5, group A, member 2 (NR5A2) were found to be associated with pancreatic cancer risk. Moreover the scan identified loci on chromosomes 13q22.1 and 15q14, to which no known genes or other functional elements are mapped. We sought to replicate these observations in two additional, independent populations (from Germany and the UK), and also evaluate the possible impact of these SNPs on patient survival. We genotyped 15 SNPs in 690 cases of pancreatic ductal adenocarcinoma (PDAC) and in 1277 healthy controls. We replicated several associations between SNPs and PDAC risk. Furthermore we found that SNP rs8028529 was weakly associated with a better overall survival (OS) in both populations. We have also found that NR5A2 rs12029406_T allele was associated with a shorter survival in the German population. In conclusion, we found that rs8028529 could be, if these results are replicated, a promising marker for both risk and prognosis for this lethal disease

The evaluation of acoustic characteristic performance on natural sound absorbing materials from cogon grass waste

In the past few decades, synthetic fibers are been used widely in the field of sound absorption due to their superior characteristics such as durable and chemical resistant. However, there are several disadvantages of synthetic fibers such as non-biodegradability and hazards to the health of human. In this research, the natural sound absorber from cogon grass was investigated. The objective of the research was to evaluate the performance of cogon grass physical characteristics on its acoustical behavior, to evaluate the effect of sodium hydroxide (NaOH) treatment times on physical and acoustical characteristics of cogon grass, to investigate the decay effects after it was left over for twelve months and lastly to compare and verify the acoustical results with theoretical models based on (Delany-Bazley and Miki Model). The measurement of acoustical characteristics which are sound absorption coefficient (SAC) and noise reduction coefficient (NRC) were done by using impedance tube method (ITM). The samples of cogon grass were tested in a way of the untreated and treated with NaOH in varied soaked hours which are one, two, three, four and five hours. Scanning electron microscope (SEM) and density kit were used to investigate physical characteristics. The research confirmed that physical characteristics of tortuosity and airflow resistivity values tend to increase with the increment of treatment times, but the density and porosity tend to decrease. Untreated samples were tested with varied thicknesses of 10, 20, 30, 40 and 50mm. The results show SAC value increases when the thickness of the sample was increased. Treated samples results show the least treated sample (1 hour) reached the maximum SAC value and indicated the highest value of NRC which is 0.50. The results also show a reduction in sound absorption value after the samples were left for twelve months. Verification parts demonstrated that Delany-Bazley and Miki Model can predict approximately pattern compared with ITM results because of the theoretical models are developed by a simple empirical model approach. Overall, cogon grass samples have the good characteristics to be an acoustic material component

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Studies on conformational stability of the ectodomain of influenza virus hemagglutinin

Das Hüllglykoprotein Hämagglutinin (HA) von Influenzavirus ist verantwortlich sowohl für die Bindung als auch für die nachfolgende Fusion der viralen Hülle mit der endosomalen Membran. Eine Analyse der 3D Struktur der HA-Ektodomaine zeigt, dass die Stabilität des Proteins sowohl durch kovalente als auch durch nicht-kovalente Wechselwirkungen bedingt ist. Die Konformationsänderung von HA bei saurem pH-Wert weißt auf eine mögliche Rolle von Protonierungseffekten auf ionisierbare Aminosäuren hin. Untersuchungen zur Bedeutung geladener Aminosäuren und Salzbrücken für die Struktur des HA wurden auf der Grundlage von ‚site directed mutagenesis’ durchgeführt. Der Einfluss der Mutationen auf die Konformationsänderung und die Fusionsaktivität von HA wurden durch einen Proteinase K-Assay bzw. Fluoreszenzmikroskopie erfasst. Die Ergebnisse beider Methoden wurden miteinander korreliert. Abgesehen von der Mutante R109E zeigten Wildtyp-HA und alle anderen Mutanten eine vergleichbare Oberflächenexpression. Die beobachteten Unterschiede in der pH-Abhängigkeit der Konformationumwandlung zwischen Wildtyp-HA und HA-Mutanten zeigen, daß eine Zerstörung von Salzbrücken und ggf. eine Erhöhung der elektrostatischen Abstoßung an den betrachteten Kontakstellen sehr wahrscheinlich eine Herabsetzung der energetischen Barriere der Konformationsumwandlung verursacht. Dieser Ergebnisse erklären die molekularen Grundlagen des erhöhten pH-Schwellwertes der HA-Konformationsumwandlung von Amantadin-resistenten Influenzaviren. Im Gegensatz wurde für Mutanten, die die Stabilität von HA erhöhten, keine Konformationsumwandlung bei einem pH-Wert beobachtet, der typisch für die Konformationumwandlung von Wildtyp-HA war. Aminosäuren, die denen dieser stabiliserenden Mutationen entsprachen, wurden in einer natürlichen Influenzavirusvariante – A/JPN/305/57 – gefunden. Die Bedeutung von Ladungen für die Stabilität der HA-Ektodomaine wird dadurch unterstrichen, dass eine Konservierung einer positiven Ladung und insbesondere eines Argininrestes in der Position 109 (Nummerierung auf der Basis von HA X31) für alle Influenzaviren A und B gefunden wurde. Die Ergebnisse der Arbeit zeigen, dass sehr wahrscheinlich eine komplexe Salzbrücke an der Kontaktfläche zwischen HA1 und HA2 für alle Influenzaviren A evolutionär konserviert ist.Hemagglutinin (HA), a major envelope glycoprotein is responsible for fusing viral and endosomal membranes during influenza virus entry. The analysis of 3D crystal structure of the HA ectodomain shows that the stability of protein is maintained by both non-covalent and covalent interactions. The conformational change of HA at low pH indicates a role for protonation effects of the ionisable amino acids. Structural investigations were done using “site directed mutagenesis” in order to conceive the importance of charged amino acids and more emphatically the involvement of salt bridges. The effect of mutations on the conformational change and fusion activity was probed by proteinase K assay and fluorescence microscopy respectively. It was observed that HA-wt and all the mutants except R109E showed comparable surface expression. The difference in pH threshold between the HA-wt and the mutants showed that breakage of salt bridge and further incorporation of repulsion at the considered interfaces would lower the energy barrier requirements for the conformational change. The results explain the molecular basis of the higher pH threshold for naturally occurring amantadine resistant mutants. On the other hand, mutants designed to stabilise the HA were resistant to conformational changes at those pH values which typically trigger the conformational change of HA-wt. Coincidentally these mutations were found to be existing in the natural variant of H2 Japan subtype (A/JPN/305/57). Interestingly, the study shows that a positive charge and, more specifically, an Arg residue at position 109 (numbering based on X-31 strain) is conserved in all of the influenza A and B viruses underlining the relevance of electrostatic interactions for the HA stability. Aptly a complex salt bridge at the interface of HA1 and HA2 is probably conserved evolutionarily in all the members of influenza A virus

Telomeres and Telomere Length: A General Overview

Telomeres are highly conserved tandem nucleotide repeats that include proximal double-stranded and distal single-stranded regions that in complex with shelterin proteins afford protection at chromosomal ends to maintain genomic integrity. Due to the inherent limitations of DNA replication and telomerase suppression in most somatic cells, telomeres undergo age-dependent incremental attrition. Short or dysfunctional telomeres are recognized as DNA double-stranded breaks, triggering cells to undergo replicative senescence. Telomere shortening, therefore, acts as a counting mechanism that drives replicative senescence by limiting the mitotic potential of cells. Telomere length, a complex hereditary trait, is associated with aging and age-related diseases. Epidemiological data, in general, support an association with varying magnitudes between constitutive telomere length and several disorders, including cancers. Telomere attrition is also influenced by oxidative damage and replicative stress caused by genetic, epigenetic, and environmental factors. Several single nucleotide polymorphisms at different loci, identified through genome-wide association studies, influence inter-individual variation in telomere length. In addition to genetic factors, environmental factors also influence telomere length during growth and development. Telomeres hold potential as biomarkers that reflect the genetic predisposition together with the impact of environmental conditions and as targets for anti-cancer therapies

TERT promoter mutations in cancer development.

Human telomerase reverse transcriptase (TERT) encodes a rate-limiting catalytic subunit of telomerase that maintains genomic integrity. TERT expression is mostly repressed in somatic cells with exception of proliferative cells in self-renewing tissues and cancer. Immortality associated with cancer cells has been attributed to telomerase over-expression. The precise mechanism behind the TERT activation in cancers has mostly remained unknown. The newly described germline and recurrent somatic mutations in melanoma and other cancers in the TERT promoter that create de novo E-twenty six/ternary complex factors (Ets/TCF) binding sites, provide an insight into the possible cause of tumor-specific increased TERT expression. In this review we discuss the discovery and possible implications of the TERT promoter mutations in melanoma and other cancers