Predicting the impact of PHEX, FGF23 and DMP1 gene variants found in Malaysian Malay patients with Hypophosphataemic Rickets through in silico analysis of protein function and mRNA secondary structure

Hypophosphataemic Rickets (HR) is a rare bone disorder characterised by chronic hypophosphataemia caused by defective phosphate reabsorption in the renal tubules. Variants in phosphate-regulating endopeptidase homolog, X-linked (PHEX), fibroblast growth factor-23 (FGF23) and dentin matrix protein-1 (DMP1) genes contribute to X-linked dominant, autosomal dominant and autosomal recessive forms of HR, respectively. In this study, four Malaysian patients’ DNA samples were subjected to polymerase chain reaction and Sanger sequencing to identify the types and locations of the variants. Then, in silico study was conducted based on the variants found to predict the effects of amino acid substitution on protein functions using SIFT and PolyPhen-2 software and RNAfold was used to construct the mRNA secondary structure. Mutational analyses had revealed two variants in PHEX; c.10G>C (E4Q), c.1970A>G (Y657C), one mutation in FGF23; c.716C>T (T239M) and three variants on DMP1; c.309A>T (S69C), c.1322C>T (S406S), c.1334G>A (E410E). The variants in these Malay patients were previously reported in different ethnic HR patients. Protein prediction programs suggested that the PHEX Y657C and DMP1 S69C variants may affect protein function. All variants were predicted to alter the secondary mRNA structure. These findings suggest that these missense and silent variants may lead to changes in protein function and mRNA secondary structure that are associated with the manifestation of HR phenotype

Effect of Poly(Vinyl Alcohol) addition on the properties of hydrothermal derived calcium phosphate cement for bone filling materials

The effect of addition of poly(vinyl alcohol) on hydrothermal derived calcium phosphate cement has been studied. The precursors used to prepare the cement were calcium oxide (CaO) and ammonium dihydrogen phosphate (NH4H2PO4); the reaction was conducted in water at 80-100°C. To improve properties of CPC, poly(vinyl alcohol) (PVA) of 1wt% and 2wt% was added to the liquid phase of CPC and the results were compared to CPC without PVA addition. The addition of PVA was proved to bring remarkable effects on cohesion, setting time and mechanical strength of CPC which make it suitable physically for injectable bone filler applications

Phosphate homeostasis and genetic mutations of familial hypophosphatemic rickets

Hypophosphatemic rickets (HR) is a syndrome of hypophosphatemia and rickets that resembles vitamin D deficiency, which is caused by malfunction of renal tubules in phosphate reabsorption. Phosphate is an essential mineral, which is important for bone and tooth structure. It is regulated by parathyroid hormone, 1,25-dihydroxyvitamin D and fibroblast-growth-factor 23 (FGF23). X-linked hypophosphatemia (XLH), autosomal dominant HR (ADHR), and autosomal recessive HR (ARHR) are examples of hereditary forms of HR, which are mainly caused by mutations in the phosphate regulating endopeptidase homolog, X-linked (PHEX), FGF23, and, dentin matrix protein-1 (DMP1) and ecto-nucleotide pyro phosphatase/phosphodiesterase 1 (ENPP1) genes, respectively. Mutations in these genes are believed to cause elevation of circulating FGF23 protein. Increase in FGF23 disrupts phosphate homeostasis, leading to HR. This review aims to summarize phosphate homeostasis and focuses on the genes and mutations related to XLH, ADHR, and ARHR. A compilation of XLH mutation hotspots based on the PHEX gene database and mutations found in the FGF23, DMP1, and ENPP1 genes are also made available in this review

Recent developments on injectable calcium phosphate bone cement

New emerging micro-invasive bone grafting techniques have recently risen the interest towards injectable calcium phosphate cement (CPC) as bone filling material that is able to set itself within the body temperature. There are various formulations of injectable CPC that have been developed in recent years. The development of injectable CPC mainly focuses on getting optimum setting times, mechanical properties, injection capabilities and in vivo properties so that the cement is clinically applicable for orthopedic, dental, craniofacial and maxillofacial, vertebroplasty and kyphoplasty, and drug delivery applications. The existing studies on injectable CPCs have investigated the effects of some factors, such as liquid to powder (P/L) ratio, types solid and liquid phase used, concentration of the liquid phase, density and porosity of the cement, particle size of the cement powder and its crystallinity, needle size, and use of setting retardants, setting accelerators and cohesion promoters on the handling, mechanical and biological properties of the cement. The aim of this paper is to review the recent developments of injectable CPC for bone filling materials. Some prominent patents related to the developments of injectable CPC are also reviewe

The effects of excess calcium on the handling and mechanical properties of hydrothermal derived calcium phosphate bone cement

The objective of this study is to determine the effects of excess calcium on the handling and mechanical properties of hydrothermal derived calcium phosphate cement (CPC) for bone filling applications. Hydroxyapatite powder was synthesized via hydrothermal method using calcium oxide, CaO and ammonium dihydrogen phosphate, NH4H2PO4 as the calcium and phosphorus precursors respectively. The effects of calcium excess were evaluated by varying the CaO content at 0, 5 and 15 mole %. The precursors were then refluxed in distilled water at 90-100˚C and dried overnight until the calcium phosphate powder was formed. CPC was then produced by mixing the synthesized powder with distilled water at the powder-toliquid (P/L) ratio of 1.5. The result from the morphological properties of CPC shows the increase in agglomeration and particles size with 5 mole % of calcium excess but decreased with 15 mole % of calcium excess in CPC. This result was in agreement with the compressive strength result where the CPC increased its strength with 5 mole % of calcium excess but reduced with 15 mole % of calcium excess. The excess in calcium precursor also significantly improved the setting time but reduced the injectability of CPC

Targeted Sequencing of Cytokine-Induced PI3K-Related Genes in Ulcerative Colitis, Colorectal Cancer and Colitis-Associated Cancer

Chronic relapsing inflammatory bowel disease is strongly linked to an increased risk of colitis-associated cancer (CAC). One of the well-known inflammatory carcinogenesis pathways, phosphatidylinositol 3-kinase (PI3K), was identified to be a crucial mechanism in long-standing ulcerative colitis (UC). The goal of this study was to identify somatic variants in the cytokine-induced PI3K-related genes in UC, colorectal cancer (CRC) and CAC. Thirty biopsies (n = 8 long-standing UC, n = 11 CRC, n = 8 paired normal colorectal mucosa and n = 3 CAC) were subjected to targeted sequencing on 13 PI3K-related genes using Illumina sequencing and the SureSelectXT Target Enrichment System. The Genome Analysis Toolkit was used to analyze variants, while ANNOVAR was employed to detect annotations. There were 5116 intronic, 355 exonic, 172 untranslated region (UTR) and 59 noncoding intronic variations detected across all samples. Apart from a very small number of frameshifts, the distribution of missense and synonymous variants was almost equal. We discovered changed levels of IL23R, IL12Rß1, IL12Rß2, TYK2, JAK2 and OSMR in more than 50% of the samples. The IL23R variant in the UTR region, rs10889677, was identified to be a possible variant that might potentially connect CAC with UC and CRC. Additional secondary structure prediction using RNAfold revealed that mutant structures were more unstable than wildtype structures. Further functional research on the potential variants is, therefore, highly recommended since it may provide insight on the relationship between inflammation and cancer risk in the cytokine-induced PI3K pathway