Home The diagnosis of cystinosis in patients reveals new CTNS gene mutations in the Chinese population
Article
Licensed
Unlicensed Requires Authentication

The diagnosis of cystinosis in patients reveals new CTNS gene mutations in the Chinese population

  • Xiao-Qiao Li , Di Wu , Xue-Jun Liang , Wen-Jing Li , Min Liu , Bing-Yan Cao , Chang Su , Xi Meng and Chun-Xiu Gong EMAIL logo
Published/Copyright: March 8, 2019

Abstract

Background

Cystinosis is a rare autosomal-recessive disorder caused by a defective transport of cystine across the lysosomal membrane. Previous studies have mapped cystinosis to the CTNS gene which is located on chromosome 17p13, and various CTNS mutations have been identified to correlate them with this disease.

Methods

We analyzed six patients from five unrelated families who were diagnosed with cystinosis in our hospital. We described the diagnostic procedures for all the patients and proposed alternative therapies for cystinosis patients instead of using cysteamine, an orphan drug which was commercially unavailable in China. Moreover, genetic analysis of all patients’ samples was carried out to identify novel CTNS gene mutations.

Results and conclusions

The patients in this study were followed up from 1 to more than 10 years to monitor their growth and development, which indicated that the alternative therapies we used were helpful to ameliorate the complications of the cystinosis patients without cysteamine. Furthermore, by sequencing the patients’ genome, we identified novel mutations in the CTNS gene including: c.477C > G (p.S159R), c.274C > T (p.Q92X) and c.680A > T (p.E227V); these mutations were only observed in cystinosis patients and had never been reported in any other populations, suggesting they might be specific to Chinese cystinosis patients.


Corresponding author: Prof. Chun-Xiu Gong, Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China

Acknowledgments

The authors thank the family members of the patients involved in this study.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This study is supported by the National Key Research and Development Program of China (2016YFC0901505).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. 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.

  6. Conflict of interest: The authors declare that they have no conflict of interest.

References

1. Al-Haggar M. Cystinosis as a lysosomal storage disease with multiple mutant alleles: phenotypic–genotypic correlations. World J Nephrol 2013;2:94–102.Search in Google Scholar

2. Cherqui S, Courtoy PJ. The renal Fanconi syndrome in cystinosis: pathogenic insights and therapeutic perspectives. Nat Rev Nephrol 2017;13:115–31.10.1038/nrneph.2016.182Search in Google Scholar

3. Town M, Jean G, Cherqui S, Attard M, Forestier L, et al. A novel gene encoding an integral membrane protein is mutated in nephropathic cystinosis. Nat Genet 1998;18:319–24.10.1038/ng0498-319Search in Google Scholar

4. Sadeghipour F, Basiratnia M, Derakhshan A, Fardaei M. Mutation analysis of the CTNS gene in Iranian patients with infantile nephropathic cystinosis: identification of two novel mutations. Hum Genome Var 2017;4:17038.10.1038/hgv.2017.38Search in Google Scholar

5. Jaradat S, Al-Rababah B, Hazza I, Akl K, Saca E, et al. Molecular analysis of the CTNS gene in Jordanian families with nephropathic cystinosis. Nefrología 2015;35:547–53.10.1016/j.nefro.2015.09.009Search in Google Scholar

6. Yeetong P, Tongkobpetch S, Kingwatanakul P, Deekajorndech T, Bernardini IM, et al. Two novel CTNS mutations in cystinosis patients in Thailand. Gene 2012;499:323–5.10.1016/j.gene.2012.03.047Search in Google Scholar

7. Yang YJ, Hu Y, Zhao R, He X, Zhao L, et al. First report of CTNS mutations in a Chinese family with infantile cystinosis. Sci World J 2015;2015:309410.10.1155/2015/309410Search in Google Scholar

8. Nesterova G, Gahl WA. Cystinosis: the evolution of a treatable disease. Pediatr Nephrol 2013;28:51–9.10.1007/s00467-012-2242-5Search in Google Scholar

9. Cherqui S. Cysteamine therapy: a treatment for cystinosis, not a cure. Kidney Int 2012;81:127–9.10.1038/ki.2011.301Search in Google Scholar

10. Wilson P, Jelley D, Stratton R, Coldwell JG. Nephropathic cystinosis: improved linear growth after treatment with recombinant human growth hormone. J Pediatr 1989;115:758–61.10.1016/S0022-3476(89)80658-4Search in Google Scholar

11. Andersson HC, Markello T, Schneider JA, Gahl WA. Effect of growth hormone treatment on serum creatinine concentration in patients with cystinosis and chronic renal disease. J Pediatr 1992;120:716–20.10.1016/S0022-3476(05)80233-1Search in Google Scholar

12. Antoniazzi F, Mengarda F, Lauriola S, Serra A, Zamboni G, et al. Growth and renal function. Pediatr Med Chir 1997;19:341–7.Search in Google Scholar

13. Besouw MT, Van Dyck M, Francois I, Van Hoyweghen E, Levtchenko EN. Detailed studies of growth hormone secretion in cystinosis patients. Pediatr Nephrol 2012;27:2123–7.10.1007/s00467-012-2213-xSearch in Google Scholar

14. Gahl WA, Thoene JG, Schneider JA. Cystinosis. N Engl J Med 2002;347:111–21.10.1007/978-3-540-76341-3_41Search in Google Scholar

15. Wuhl E, Haffner D, Offner G, Broyer M, van’t Hoff W, et al. Long-term treatment with growth hormone in short children with nephropathic cystinosis. J Pediatr 2001;138:880–7.10.1067/mpd.2001.113263Search in Google Scholar

16. Chan AM, Lynch MJ, Bailey JD, Ezrin C, Fraser D. Hypothyroidism in cystinosis. Am J Med 1970;48:678–92.10.1016/S0002-9343(70)80002-XSearch in Google Scholar

17. Kalatzis V, Antignac C. Cystinosis: from gene to disease. Nephrol Dial Transplant 2002;17:1883–6.10.1093/ndt/17.11.1883Search in Google Scholar PubMed

18. Kalatzis V, Antignac C. New aspects of the pathogenesis of cystinosis. Pediatr Nephrol 2003;18:207–15.10.1007/s00467-003-1077-5Search in Google Scholar PubMed

19. Kiehntopf M, Schickel J, Gonne B, Koch HG, Superti-Furga A, et al. Analysis of the CTNS gene in patients of German and Swiss origin with nephropathic cystinosis. Hum Mutat 2002;20:237.10.1002/humu.9063Search in Google Scholar PubMed

20. Sansanwal P, Li L, Hsieh SC, Sarwal MM. Insights into novel cellular injury mechanisms by gene expression profiling in nephropathic cystinosis. J Inherit Metab Dis 2010;33:775–86.10.1007/s10545-010-9203-6Search in Google Scholar PubMed

21. Freed KA, Blangero J, Howard T, Johnson MP, Curran JE, et al. The 57 kb deletion in cystinosis patients extends into TRPV1 causing dysregulation of transcription in peripheral blood mononuclear cells. J Med Genet 2011;48:563–6.10.1136/jmg.2010.083303Search in Google Scholar PubMed

Received: 2018-06-14
Accepted: 2019-01-30
Published Online: 2019-03-08
Published in Print: 2019-04-24

©2019 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Review
  3. The importance of anthropological methods in the diagnosis of rare diseases
  4. Original Articles
  5. PON1 arylesterase activity, HDL functionality and their correlation in malnourished children
  6. Prevalence of dyslipidemia and factors affecting dyslipidemia in young adults with type 1 diabetes: evaluation of statin prescribing
  7. Myocardial dysfunction in relation to serum thiamine levels in children with diabetic ketoacidosis
  8. Evaluation of long-term follow-up and methimazole therapy outcomes of pediatric Graves’ disease: a single-center experience
  9. Endocrine consequences of neuroblastoma treatment in children: 20 years’ experience of a single center
  10. Analysis of diabetes-associated autoantibodies in children and adolescents with autoimmune thyroid diseases
  11. Adrenal function of extremely premature infants in the first 5 days after birth
  12. Atypical presentation of Leydig cell tumour in three prepubertal patients: diagnosis, treatment and outcomes
  13. The diagnosis of cystinosis in patients reveals new CTNS gene mutations in the Chinese population
  14. Comparing the validity of continuous metabolic syndrome risk scores for predicting pediatric metabolic syndrome: the CASPIAN-V study
  15. Primary pigmented nodular adrenocortical disease (PPNAD): single centre experience
  16. Short Communication
  17. Classical galactosemia patients can achieve high IQ scores
  18. Case Reports
  19. Idiopathic gonadotropin-independent precocious puberty – is regular surveillance required?
  20. MYT1L mutation in a patient causes intellectual disability and early onset of obesity: a case report and review of the literature
  21. A case report and literature review of monoallelic mutation of GHR
  22. Pitfalls in the diagnosis of insulin autoimmune syndrome (Hirata’s disease) in a hypoglycemic child: a case report and review of the literature
Downloaded on 9.11.2025 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2018-0263/html
Scroll to top button