Marcella Devoto

University of Pennsylvania, Filadelfia, Pennsylvania, United States

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Publications (195)1669.37 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: New genomic strategies can now be applied to identify a diagnosis in patients and families with previously undiagnosed rare genetic conditions. The large family evaluated in the present study was described in 1966 and now expands the phenotype of a known neuromuscular gene. To determine the genetic cause of a slowly progressive, autosomal dominant, scapuloperoneal neuromuscular disorder by using linkage and exome sequencing. Fourteen affected individuals in a 6-generation family with a progressive scapuloperoneal disorder were evaluated. Participants were examined at pediatric, neuromuscular, and research clinics from March 1, 2005, to May 31, 2014. Exome and linkage were performed in genetics laboratories of research institutions. Examination and evaluation by magnetic resonance imaging, ultrasonography, electrodiagnostic studies, and muscle biopsies (n = 3). Genetic analysis included linkage analysis (n = 17) with exome sequencing (n = 7). Clinical findings included progressive muscle weakness in an initially scapuloperoneal and distal distribution, including wrist extensor weakness, finger and foot drop, scapular winging, mild facial weakness, Achilles tendon contractures, and diminished or absent deep tendon reflexes. Both age at onset and progression of the disease showed clinical variability within the family. Muscle biopsy specimens demonstrated type I fiber atrophy and trabeculated fibers without nemaline rods. Analysis of exome sequences within the linkage region (4.8 megabases) revealed missense mutation c.591C>A p.Glu197Asp in a highly conserved residue in exon 4 of ACTA1. The mutation cosegregated with disease in all tested individuals and was not present in unaffected individuals. This family defines a new scapuloperoneal phenotype associated with an ACTA1 mutation. A highly conserved protein, ACTA1 is implicated in multiple muscle diseases, including nemaline myopathy, actin aggregate myopathy, fiber-type disproportion, and rod-core myopathy. To our knowledge, mutations in Glu197 have not been reported previously. This residue is highly conserved and located in an exposed position in the protein; the mutation affects the intermolecular and intramolecular electrostatic interactions as shown by structural modeling. The mutation in this residue does not appear to lead to rod formation or actin accumulation in vitro or in vivo, suggesting a different molecular mechanism from that of other ACTA1 diseases.
    05/2015; 72(6). DOI:10.1001/jamaneurol.2015.37
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    ABSTRACT: The 22q11.2 deletion syndrome (22q11DS; velocardiofacial/DiGeorge syndrome; VCFS/DGS) is the most common microdeletion syndrome and the phenotypic presentation is highly variable. Approximately 65% of individuals with 22q11DS have a congenital heart defect (CHD), mostly of the conotruncal type, and/or an aortic arch defect. The etiology of this phenotypic variability is not currently known. We hypothesized that copy-number variants (CNVs) outside the 22q11.2 deleted region might increase the risk of being born with a CHD in this sensitized population. Genotyping with Affymetrix SNP Array 6.0 was performed on two groups of subjects with 22q11DS separated by time of ascertainment and processing. CNV analysis was completed on a total of 949 subjects (cohort 1, n = 562; cohort 2, n = 387), 603 with CHDs (cohort 1, n = 363; cohort 2, n = 240) and 346 with normal cardiac anatomy (cohort 1, n = 199; cohort 2, n = 147). Our analysis revealed that a duplication of SLC2A3 was the most frequent CNV identified in the first cohort. It was present in 18 subjects with CHDs and 1 subject without (p = 3.12 × 10(-3), two-tailed Fisher's exact test). In the second cohort, the SLC2A3 duplication was also significantly enriched in subjects with CHDs (p = 3.30 × 10(-2), two-tailed Fisher's exact test). The SLC2A3 duplication was the most frequent CNV detected and the only significant finding in our combined analysis (p = 2.68 × 10(-4), two-tailed Fisher's exact test), indicating that the SLC2A3 duplication might serve as a genetic modifier of CHDs and/or aortic arch anomalies in individuals with 22q11DS. Copyright © 2015 The American Society of Human Genetics. Published by Elsevier Inc. All rights reserved.
    The American Journal of Human Genetics 04/2015; 96(5). DOI:10.1016/j.ajhg.2015.03.007 · 10.99 Impact Factor
  • Gastroenterology 04/2015; 148(4):S-71. DOI:10.1016/S0016-5085(15)30248-1 · 13.93 Impact Factor
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    ABSTRACT: Biliary atresia (BA) is a pediatric cholangiopathy with unknown etiology occurring in isolated and syndromic forms. Laterality defects affecting the cardiovascular and gastrointestinal systems are the most common features present in syndromic BA. Most cases are sporadic, although reports of familial cases have led to the hypothesis of genetic susceptibility in some patients. We identified a child with BA, malrotation, and interrupted inferior vena cava whose father presented with situs inversus, polysplenia, panhypopituitarism, and mildly dysmorphic facial features. Chromosomal microarray analysis demonstrated a 277kb heterozygous deletion on chromosome 20 which included a single gene, FOXA2, in the proband and her father. This deletion was confirmed to be de novo in the father. The proband and her father share a common diagnosis of heterotaxy, but they also each presented with a variety of other issues. Further genetic screening revealed that the proband carried an additional protein-altering polymorphism (rs1904589; p.His165Arg) in the NODAL gene that is not present in the father, and this variant has been shown to decrease expression of the gene. As FOXA2 can be a regulator of NODAL expression, we propose that haploinsufficiency for FOXA2 combined with a decreased expression of NODAL is the likely cause for syndromic BA in this proband. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Human Mutation 03/2015; 36(6). DOI:10.1002/humu.22786 · 5.05 Impact Factor
  • American Journal of Medical Genetics Part A 03/2015; 167(4). DOI:10.1002/ajmg.a.36946 · 2.05 Impact Factor
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    ABSTRACT: Based on a genome-wide association study (GWAS) of testicular dysgenesis syndrome (TDS) reporting possible association with TGFBR3, we analyzed GWAS data from a larger, phenotypically restricted cryptorchidism population for potential replication of this signal.
    The Journal of Urology 10/2014; 193(5). DOI:10.1016/j.juro.2014.10.097 · 3.75 Impact Factor
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    ABSTRACT: The genetic etiology of sporadic neuroblastoma is still largely obscure. In a genome-wide association study, we identified single nucleotide polymorphisms (SNP) associated with neuroblastoma at the LINC00340, BARD1, LMO1, DUSP12, HSD17B12, HACE1 and LIN28B gene loci, but these explain only a small fraction of neuroblastoma heritability. Other neuroblastoma susceptibility genes are likely hidden among signals discarded by the multiple testing corrections. In this study, we evaluated 8 additional genes selected as candidates for further study based on proven involvement in neuroblastoma differentiation. SNP at these candidate genes were tested for association with disease susceptibility in 2101 cases and 4202 controls, with the associations found replicated in an independent cohort of 459 cases and 809 controls. Replicated associations were further studied for cis-effect using gene expression, transient overexpression, silencing and cellular differentiation assays. The neurofilament gene NEFL harbored three SNP associated with neuroblastoma (rs11994014; Pcombined=0.0050; OR=0.88, rs2979704; Pcombined=0.0072; OR=0.87, rs105911; Pcombined=0.0049; OR=0.86). The protective allele of rs1059111 correlated with increased NEFL expression. Biological investigations showed that ectopic overexpression of NEFL inhibited cell growth specifically in neuroblastoma cells carrying the protective allele. NEFL overexpression also enhanced differentiation and impaired the proliferation and anchorage-independent growth of cells with protective allele and basal NEFL expression, while impairing invasiveness and proliferation of cells homozygous for the risk genotype. Clinically, high levels of NEFL expression in primary neuroblastoma specimens was associated with better overall survival (P=0.03; HR=0.68). Our results show that common variants of NEFL influence neuroblastoma susceptibility and they establish that NEFL expression influences disease initiation and progression.
    Cancer Research 10/2014; 74(23). DOI:10.1158/0008-5472.CAN-14-0431 · 9.28 Impact Factor
  • Gastroenterology 05/2014; 146(5):S-27. DOI:10.1016/S0016-5085(14)60095-0 · 13.93 Impact Factor
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    ABSTRACT: TP53 is the most frequently mutated gene in human malignancies; however, de novo somatic mutations in childhood embryonal cancers such as neuroblastoma are rare. We report on the analysis of three independent case-control cohorts comprising 10290 individuals and demonstrate that rs78378222 and rs35850753, rare germline variants in linkage disequilibrium that map to the 3' untranslated region (UTR) of TP53 and 5' UTR of the Δ133 isoform of TP53, respectively, are robustly associated with neuroblastoma (rs35850753: odds ratio [OR] = 2.7, 95% confidence interval [CI] = 2.0 to 3.6, P combined = 3.43×10(-12); rs78378222: OR = 2.3, 95% CI = 1.8 to 2.9, P combined = 2.03×10(-11)). All statistical tests were two-sided. These findings add neuroblastoma to the complex repertoire of human cancers influenced by the rs78378222 hypomorphic allele, which impairs proper termination and polyadenylation of TP53 transcripts. Future studies using whole-genome sequencing data are likely to reveal additional rare variants with large effect sizes contributing to neuroblastoma tumorigenesis.
    CancerSpectrum Knowledge Environment 03/2014; 106(4). DOI:10.1093/jnci/dju047 · 15.16 Impact Factor
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    ABSTRACT: Collagen VI related myopathies are disorders of connective tissue presenting with an overlap phenotype combining clinical involvement from the muscle and from the connective tissue. Not all patients displaying related overlap phenotypes between muscle and connective tissue have mutations in collagen VI. Here we report a homozygous recessive loss of function mutation and a de-novo dominant mutation in collagen XII (COL12A1) as underlying a novel overlap syndrome involving muscle and connective tissue. Two siblings homozygous for a loss of function mutation showed widespread joint hyperlaxity combined with weakness precluding independent ambulation, while the patient with the de novo missense mutation was more mildly affected, showing improvement including the acquisition of walking. A mouse model with inactivation of the Col12a1 gene showed decreased grip strength, a delay in fiber type transition and a deficiency in passive force generation while the muscle seems more resistant to eccentric contraction induced force drop, indicating a role for a matrix based passive force-transducing elastic element in the generation of the weakness. This new muscle connective tissue overlap syndrome expands on the emerging importance of the muscle extracellular matrix in the pathogenesis of muscle disease.
    Human Molecular Genetics 12/2013; DOI:10.1093/hmg/ddt627 · 6.68 Impact Factor
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    ABSTRACT: Developmental Dysplasia of the Hip (DDH) is a debilitating condition characterized by incomplete formation of the acetabulum leading to dislocation of the femur, suboptimal joint function, and accelerated wear of the articular cartilage resulting in arthritis. DDH affects 1 in 1000 newborns in the United States with well defined "pockets" of high prevalence in Japan, Italy and other Mediterranean countries. Although reasonably accurate for detecting gross forms of hip dysplasia, existing techniques fail to find milder forms of dysplasia. Undetected hip dysplasia is the leading cause of osteoarthritis of the hip in young individuals causing over 40% of cases in this age group. A sensitive and specific test for DDH has remained a desirable yet elusive goal in orthopaedics for a long time. A 72 member, four generation affected family has been recruited, and DNA from its members retrieved. Genome-wide linkage analysis revealed a 2.61 Mb candidate region (38.7-41.31 Mb from the p term of chromosome 3) co-inherited by all affected members with a maximum LOD score of 3.31. Whole exome sequencing and analysis of this candidate region in four severely affected family members revealed one shared variant, rs3732378, that causes a threonine (polar) to methionine (non-polar) alteration at position 280 in the trans-membrane domain of CX3CR1. This mutation is predicted to have a deleterious effect on its encoded protein which functions as a receptor for the ligand fractalkine. By Sanger sequencing this variant was found to be present in the DNA of all affected individuals and obligate heterozygotes. CX3CR1 mediates cellular adhesive and migratory functions and is known to be expressed in mesenchymal stem cells destined to become chondrocytes. A genetic risk factor that might to be among the etiologic factors for the family in this study has been identified, along with other possible aggravating mutations shared by 4 severely affected family members. These findings might illuminate the molecular pathways affecting chondrocyte maturation and bone formation.
    Journal of bone and mineral research: the official journal of the American Society for Bone and Mineral Research 12/2013; 28(12). DOI:10.1002/jbmr.1999 · 6.59 Impact Factor
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    ABSTRACT: In the United States, biliary atresia (BA) is the most frequent indication for liver transplantation in pediatric patients. BA is a complex disease, with suspected environmental and genetic risk factors. A genome-wide association study in Chinese patients identified association to the 10q24.2 (hg18) genomic region. This signal was upstream of two genes, XPNPEP1 and ADD3, both expressed in intrahepatic bile ducts. We tested association to this region in 171 BA patients and 1,630 controls of European descent and found the strongest signal to be at rs7099604 (p = 2.5 × 10(-3)) in intron 1 of the ADD3 gene. Moreover, expression data suggest that ADD3, but not XPNPEP1, is differentially expressed in BA patients. The role of ADD3 in biliary development is unclear, but our findings suggest that this gene may be functionally relevant for the development of BA.
    Human Genetics 10/2013; 133(2). DOI:10.1007/s00439-013-1368-2 · 4.52 Impact Factor
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    ABSTRACT: In a small proportion of patients with an Ullrich-like clinical phenotype no mutations in the collagen VI genes are detected. Here we report on a novel muscle and tendon collagenopathy caused by mutations in COL12A1. In a consanguineous family with hypotonia, weakness and significant joint hyperlaxity we identified a homozygous frame shifting mutation in COL12A1 in the two affected children, causing complete absence of collagen XII in muscle and fibroblasts. Patients were unable to walk and developed scoliosis and respiratory insufficiency. In the second family the proband presented with milder hypotonia, motor delay, hyperlaxity and incomplete deficiency of collagen XII. We identified a de novo, presumably dominantly acting missense mutation. COL12A1 encodes collagen XII. Collagen XII is a homotrimer found in association with collagen I and acts as a cross-bridge between collagen fibrils while also interacting with tenascin X (TNX), heparin and decorin. We next investigated the muscle phenotype in a Col12a1 KO mouse, which showed age dependent weakness. At 9 months of age there was no significant difference in muscle fiber size, but the overall weight of the muscles was less with an altered slow-to-fast fiber type transition in both soleus and tibilias anterior muscles. Physiological measurements on isolated EDL showed protection from eccentric force drop and a decrease in passive force, suggesting an increased compliance of the matrix as well as decreased lateral and longitudinal force transmission to the matrix and tendon. We hypothesize that the functional abnormalities seen in muscle force measurement in COL12 KO mice originate at least partly from an underlying tendon and matrix pathology caused by the absence of collagen XII.
    Neuromuscular Disorders 10/2013; 23(s 9–10):739–740. DOI:10.1016/j.nmd.2013.06.380 · 3.13 Impact Factor
  • Cancer Research 04/2013; 73(8 Supplement):3811-3811. DOI:10.1158/1538-7445.AM2013-3811 · 9.28 Impact Factor
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    ABSTRACT: This report describes a three generation family with late onset bilateral sensorineural hearing impairment (BLSNHI) and tinnitus in which a novel mutation in the COCH gene was identified after a genome-wide linkage approach. The COCH gene is one of the few genes clinically examined when investigating the etiology of autosomal dominant late onset hearing impairment. Initially mutations in the COCH gene were only reported in exons 4 and 5, coding for the LCCL protein domain. More recently, additional mutations have been identified in exon 12, the only mutations identified outside of the LCCL domain. Currently clinical genetic testing for the COCH gene primarily focuses on identifying mutations in these three exons. In this study, we identify a novel mutation in the COCH gene in exon 11, which, like the exon 12 mutations, falls within the vWFA2 protein domain. This finding reinforces the need for clinical genetic screening of the COCH gene to be expanded beyond the current limited exon screening, as there is now more evidence to support that mutations in other areas of this gene are also causative of a similar form of late onset BLSNHI.
    American journal of otolaryngology 01/2013; 34(3). DOI:10.1016/j.amjoto.2012.11.002 · 1.08 Impact Factor
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    ABSTRACT: BACKGROUND & AIMS: Biliary atresia (BA) is a progressive fibro-inflammatory disorder of infants involving the extra- and intra-hepatic biliary tree. Its etiology is unclear, but is believed to involve exposure of a genetically susceptible individual to certain environmental factors. Biliary atresia occurs exclusively in the neonatal liver, so variants of genes expressed during hepatobiliary development could affect susceptibility. Genome-wide association studies previously identified a potential region of interest at 2q37. We continued these studies to narrow the region and identify BA susceptibility genes. METHODS: We searched for copy number variants that were increased among patients with BA (n=61) compared to healthy individuals (controls; n=5,088). After identifying a candidate gene, we investigated expression patterns of orthologs in zebrafish liver, and the effects of reducing expression, with morpholino antisense oligonucleotides, on biliary development, gene expression, and signal transduction. RESULTS: We observed a statistically significant increase in deletions at 2q37.3 in patients with BA that resulted in deletion of 1 copy of GPC1, which encodes glypican 1-a heparan sulfate proteoglycan that regulates Hedgehog signaling and inflammation. Knockdown of gpc1 in zebrafish led to developmental biliary defects. Exposure of the gpc1 morphants to cyclopamine, a Hedgehog antagonist, partially rescued the gpc1-knockdown phenotype. Injection of zebrafish with recombinant Sonic Hedgehog led to biliary defects similar to those of the gpc1 morphants. Liver samples from patients with BA had reduced levels of apical GPC1 in cholangiocytes, compared with samples from controls. CONCLUSIONS: Based on genetic analysis of patients with BA and zebrafish, GPC1 appears to be a BA susceptibility gene. These findings also support a role for Hedgehog signaling in the pathogenesis of BA.
    Gastroenterology 01/2013; 144(5). DOI:10.1053/j.gastro.2013.01.022 · 13.93 Impact Factor
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    ABSTRACT: Several neuroblastoma (NB) susceptibility loci have been identified within LINC00340, BARD1, LMO1, DUSP12, HSD17B12, DDX4, IL31RA, HACE1, and LIN28B by genome-wide association (GWA) studies including European American (EA) individuals. To validate and comprehensively evaluate the impact of the identified NB variants on disease risk and phenotype, we analyzed 16 single nucleotide polymorphisms (SNPs) in an Italian population (370 cases and 809 controls). We assessed their regulatory activity on gene expression in lymphoblastoid (LCLs) and NB cell lines. We evaluated the cumulative effect of the independent loci on NB risk and high-risk phenotype development in Italian and EAs (1627 cases and 2575 controls) populations. All NB susceptibility genes replicated in the Italian dataset except for DDX4 and IL31RA, and the most significant SNP was rs6435862 in BARD1 (P=8.4x10(-15)). BARD1 showed an additional and independent SNP association (rs7585356). This variant influenced BARD1 mRNA expression in LCLs and NB cell lines. No evidence of epistasis among the NB-associated variants was detected while a cumulative effect of risk variants on NB risk (EAs: P(trend)=6.9x10(-30), Italians: P(trend)=8.55x10(-13)) and development of high-risk phenotype (EAs: P(trend)=6.9x10(-13), Italians: P(trend)=2.2x10(-1)) was observed in a dose-dependent manner. These results provide further evidence that the risk loci identified in GWA studies contribute to NB susceptibility in distinct populations and strengthen the role of BARD1 as major genetic contributor to NB risk. This study shows that even in the absence of interaction the combination of several low-penetrance alleles has potential to distinguish sub-groups of patients at different risks of developing NB.
    Carcinogenesis 12/2012; DOI:10.1093/carcin/bgs380 · 5.27 Impact Factor
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    ABSTRACT: OBJECTIVE: Palatal anomalies are one of the identifying features of 22q11.2 deletion syndrome (22q11.2DS) affecting about one third of patients. To identify genetic variants that increase the risk of cleft or palatal anomalies in 22q11.2DS patients, we performed a candidate gene association study in 101 patients with 22q11.2DS genotyped with the Affymetrix genome-wide human SNP array 6.0. METHODS: Patients from Children's Hospital of Philadelphia, USA and Wilhelmina Children's Hospital Utrecht, The Netherlands were stratified based on palatal phenotype (overt cleft, submucosal cleft, bifid uvula). SNPs in 21 candidate genes for cleft palate were analyzed for genotype-phenotype association. In addition, TBX1 sequencing was carried out. Quality control and association analyses were conducted using the software package PLINK. RESULTS: Genotype and phenotype data of 101 unrelated patients (63 non-cleft subjects (62.4%), 38 cleft subjects (37.6%)) were analyzed. A Total of 39 SNPs on 10 genes demonstrated a p-value ≤0.05 prior to correction. The most significant SNPs were found on FGF10. However none of the SNPs remained significant after correcting for multiple testing. CONCLUSIONS: Although these results are promising, analysis of additional samples will be required to confirm that variants in these regions influence risk for cleft palate or palatal anomalies in 22q11.2DS patients.
    International journal of pediatric otorhinolaryngology 10/2012; 77(1). DOI:10.1016/j.ijporl.2012.10.009 · 1.32 Impact Factor

Publication Stats

8k Citations
1,669.37 Total Impact Points


  • 2013–2015
    • University of Pennsylvania
      • Department of Biostatistics and Epidemiology
      Filadelfia, Pennsylvania, United States
  • 2006–2015
    • The Children's Hospital of Philadelphia
      • • Center for Applied Genomics
      • • Department of Pediatrics
      • • Department of Ophthalmology
      Filadelfia, Pennsylvania, United States
  • 2005–2014
    • Sapienza University of Rome
      • • Department of Molecular Medicine
      • • Department of Experimental Medicine
      Roma, Latium, Italy
  • 2008–2011
    • William Penn University
      Filadelfia, Pennsylvania, United States
  • 1999–2005
    • Università degli Studi di Genova
      • Dipartimento di Medicina sperimentale (DIMES)
      Genova, Liguria, Italy
  • 2001
    • Johns Hopkins University
      Baltimore, Maryland, United States
    • Drexel University
      Filadelfia, Pennsylvania, United States
  • 2000
    • Polo d'Innovazione di Genomica Genetica e Biologia
      Perugia, Umbria, Italy
  • 1997–1999
    • The Rockefeller University
      New York, New York, United States
  • 1996
    • Columbia University
      • Department of Psychiatry
      New York City, NY, United States
  • 1995
    • Universität Heidelberg
      • Department of Nephrology
      Heidelberg, Baden-Wuerttemberg, Germany
  • 1988–1995
    • National Institute of Molecular Genetics (INGM)
      Milano, Lombardy, Italy
    • University of London
      Londinium, England, United Kingdom
    • Imperial College Healthcare NHS Trust
      Londinium, England, United Kingdom
  • 1994
    • New York State Psychiatric Institute
      New York City, New York, United States
  • 1989–1994
    • IRCCS Istituto G. Gaslini
      Genova, Liguria, Italy
  • 1992
    • Institute of Molecular Biology, SAS
      Presburg, Bratislavský, Slovakia
  • 1991
    • Istituti Clinici di Perfezionamento
      Milano, Lombardy, Italy
  • 1986
    • University of Bologna
      Bolonia, Emilia-Romagna, Italy