Clinical evaluation and mutational analysis of GALK and GALE genes in patients with galactosemia in Greece: one novel mutation and two rare cases
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Kleopatra H. Schulpis
, Georgia Thodi , Konstantinos Iakovou , Maria Chatzidaki , Yannis Dotsikas , Elina Molou , Olga Triantafylli und Yannis L. Loukas
Abstract
Background:
Deficiencies of galactokinase (GALK) and UDP-epimerase (GALE) are implicated with galactose metabolic disorders. The aim of the study was the identification of mutations in GALK and GALE genes and clinical evaluation of patients.
Methods:
Five patients with GALK and five with GALE deficiency were picked up via the Neonatal Screening Program. Additionally, two females, 4 years old, were referred with late diagnosed galactosemia, as rare cases. Mutational analysis was conducted via Sanger sequencing, while in silico analysis tools were utilized for the novel mutation. Psychomotor and speech development tests were performed, as well.
Results:
The mutation p.Pro28Thr was identified in both alleles in GALK-deficient patients of Roma (gypsy) origin, whereas the novel p.Asn39Ser was detected in two non-Roma patients. In GALE-deficient patients benign and/or likely benign mutations were found. Psychomotor and speech delay were determined in the Roma GALK patients. In each of the late diagnosed females, four mutations were identified in all galactosemia-related genes.
Conclusions:
The mutational spectrums of GALE- and GALK-deficient patients in Greece are presented for the first time along with a clinical evaluation. Mutational analysis in all galactosemia-related genes of symptomatic patients is highly recommended for future cases.
Acknowledgments
The authors are very grateful to the technicians M. Kalogerakou, M. Gounaropoulou and D. Vasilakos for their technical assistance. Also, the authors are highly indebted to Marianthi Vlachou, Biochemist, for her support, in preparing this manuscript.
Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.
Research funding: None declared.
Employment or leadership: None declared.
Honorarium: None declared.
Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.
References
1. Schulpis KH, Kalogerakou M, Monopolis I. Incidence of galactose metabolic disorders in Greece. Minerva Pediatr 2016;68:505–7.Suche in Google Scholar
2. Novelli G, Reichardt JK. Molecular basis of disorders of human galactose metabolism: past, present and future. Mol Genet Metab 2000;71:62–5.10.1006/mgme.2000.3073Suche in Google Scholar PubMed
3. Koliofoti EG, Gkentzi D, Varvarigou A, Trigka M, Schulpis K. Rare case of homozygous epimerase deficiency and heterozygous of Duarte 2 variant. J Pediatr Endocrinol Metab 2014;27:947–9.10.1515/jpem-2013-0431Suche in Google Scholar PubMed
4. Reich S, Hennermann J, Vetter B, Neumann LM, Shin YS, et al. An unexpectedly high frequency of hypergalactosemia in an immigrant Bosnian population revealed by new-born screening. Paediatr Res 2002;51:598–601.10.1203/00006450-200205000-00009Suche in Google Scholar PubMed
5. Sangiuolo F, Magnani M, Stambolian D, Novelli G. Biochemical characterization of two GALK mutations in patients with galactokinase deficiency. Hum Mutat 2004;23:396.10.1002/humu.9223Suche in Google Scholar PubMed
6. Dunn LM, Dunn LM. Peabody picture vocabulary test. Circle Pines, Minnesota: American Guidance Service, 1981.Suche in Google Scholar
7. Deggouj N, Estienne F, Derue L, Vanderlinden F, Ovaert C, et al. Evaluation of the efficiency of ERTL4/6 screening tests for language disorders for children with a 22q11 deletion. Rev Laryngol Otol Rhinol (Bord) 2009;130:41–4.Suche in Google Scholar
8. Woolger C. Wechsler Intelligence Scale for Children-Third Edition (WISC-III) In: Dorfman WI, Hersen M, editors. Understanding Psychological Assessment, Boston: Springer US, 2001:219–33.10.1007/978-1-4615-1185-4_11Suche in Google Scholar
9. Adzhubei I, Jordan DM, Sunyaev SR. Predicting functional effect of human missense mutations using PolyPhen-2. Curr Protoc Hum Genet 2013;Chapter 7:Unit7.20.10.1002/0471142905.hg0720s76Suche in Google Scholar PubMed PubMed Central
10. Ng PC, Henikoff S. SIFT: predicting amino acid changes that affect protein function. Nucleic Acids Res 2003;31:3812–4.10.1093/nar/gkg509Suche in Google Scholar PubMed PubMed Central
11. Choi Y, Sims GE, Murphy S, Miller JR, Chan AP. Predicting the functional effect of amino acid substitutions and indels. PLoS One 2012;7:e46688.10.1371/journal.pone.0046688Suche in Google Scholar PubMed PubMed Central
12. Schwarz JM, Rödelsperger C, Schuelke M, Seelow D. MutationTaster evaluates disease-causing potential of sequence alterations. Nat Methods 2010;7:575–6.10.1038/nmeth0810-575Suche in Google Scholar PubMed
13. Janzen N, Illsinger S, Meyer U, Shin YS, Sander J, et al. Early cataract formation due to galactokinase deficiency: impact of new-born screening. Arch Med Res 2011;42:608–12.10.1016/j.arcmed.2011.11.004Suche in Google Scholar PubMed
14. Bergsma DJ, Ai Y, Skach WR, Nesburn K, Anoia E, et al. Fine structure of the human galactokinase GALK1 gene. Genome Res 1996;6:980–5.10.1101/gr.6.10.980Suche in Google Scholar
15. Zaffanello M, Zamboni G, Schadewaldt P, Borgiani P, Novelli G. Neonatal screening, clinical features and genetic testing for galactosemia. Genet Med 2005;7:211–2.10.1097/01.GIM.0000157127.14267.DBSuche in Google Scholar
16. Barišić K, Rumora L, Grdić M, Juretić D. Frequency of galactose-1-phosphate uridyl transferase gene mutations in healthy population of Croatia. Croat Chem Acta 2008;81:125–30.Suche in Google Scholar
17. Fridovich-Keil J, Bean L, He M, Schroer R. Epimerase Deficiency Galactosemia. In: Pagon RA, Adam MP, Ardinger HH, et al. editors, GeneReviews, Seattle, WA: University of Washington, Seattle, 1993–2015.Suche in Google Scholar
18. Tyfield L, Reichardt J, Fridovich-Keil J, Croke DT, Elsas LJ 2nd, et al. Classical galactosemia and mutations at the galactose-1-phosphate uridyl transferase (GALT) gene. Hum Mutat 1999;13:417–30.10.1002/(SICI)1098-1004(1999)13:6<417::AID-HUMU1>3.0.CO;2-0Suche in Google Scholar
Supplemental Material:
The online version of this article (DOI: https://doi.org/10.1515/jpem-2017-0065) offers supplementary material, available to authorized users.
©2017 Walter de Gruyter GmbH, Berlin/Boston
Artikel in diesem Heft
- Frontmatter
- Original Articles
- High prevalence of organ specific autoantibodies in Indian type 1 diabetic patients
- Improved metabolic control in tetrahydrobiopterin (BH4), responsive phenylketonuria with sapropterin administered in two divided doses vs. a single daily dose
- Excessive weight gain in exclusively breast-fed infants
- Comparison of Tanner staging of HIV-infected and uninfected girls at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
- Joint association of screen time and physical activity with anthropometric measures in Iranian children and adolescents: the weight disorders survey of the CASPIAN-IV study
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- Impact of discontinuation of growth hormone treatment on lipids and weight status in adolescents
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- A combined approach to generate laboratory reference intervals using unbalanced longitudinal data
- Clinical evaluation and mutational analysis of GALK and GALE genes in patients with galactosemia in Greece: one novel mutation and two rare cases
- Case Reports
- Pediatric toxic polycystic thyroid
- In utero virilization secondary to a maternal Krukenberg tumor: case report and review of literature
- Postprandial hyperinsulinemic hypoglycemia in a child as a late complication of esophageal reconstruction
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Artikel in diesem Heft
- Frontmatter
- Original Articles
- High prevalence of organ specific autoantibodies in Indian type 1 diabetic patients
- Improved metabolic control in tetrahydrobiopterin (BH4), responsive phenylketonuria with sapropterin administered in two divided doses vs. a single daily dose
- Excessive weight gain in exclusively breast-fed infants
- Comparison of Tanner staging of HIV-infected and uninfected girls at the University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria
- Joint association of screen time and physical activity with anthropometric measures in Iranian children and adolescents: the weight disorders survey of the CASPIAN-IV study
- Assessment of insulin like growth factor-1 and IGF binding protein-3 in healthy Indian girls from Delhi and their correlation with age, pubertal status, obesity and thyroid hormonal status
- Impact of discontinuation of growth hormone treatment on lipids and weight status in adolescents
- Clinical, biochemical and genetic features with nonclassical 21-hydroxylase deficiency and final height
- A combined approach to generate laboratory reference intervals using unbalanced longitudinal data
- Clinical evaluation and mutational analysis of GALK and GALE genes in patients with galactosemia in Greece: one novel mutation and two rare cases
- Case Reports
- Pediatric toxic polycystic thyroid
- In utero virilization secondary to a maternal Krukenberg tumor: case report and review of literature
- Postprandial hyperinsulinemic hypoglycemia in a child as a late complication of esophageal reconstruction
- Long-term follow-up of a child with Klinefelter syndrome and achondroplasia from infancy to 16 years