Ferenci, P. Regional distribution of mutations of the ATP7B gene in patients with Wilson disease: impact on genetic testing. Hum. Genet. 120, 151-159
Department of Internal Medicine IV, University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. Human Genetics
(Impact Factor: 4.82).
10/2006; 120(2):151-9. DOI: 10.1007/s00439-006-0202-5
Wilson disease is an autosomal recessive inherited disorder of copper metabolism. The Wilson disease gene codes for a copper transporting P-type ATPase (ATP7B). Molecular genetic analysis reveals at least 300 distinct mutations. While most reported mutations occur in single families, a few are more common. The most common mutation in patients from Central, Eastern, and Northern Europe is the point mutation H1069Q (exon 14). About 50-80% of Wilson disease (WD) patients from these countries carry at least one allele with this mutation with an allele frequency ranging between 30 and 70%. Other common mutations in Central and Eastern Europe are located on exon 8 (2299insC, G710S), exon 15 (3400delC) and exon 13 (R969Q). The allele frequency of these mutations is lower than 10%. In Mediterranean countries there is a wide range of mutations, the frequency of each of them varies considerably from country to country. In Sardinia, a unique deletion in the 5' UTR (-441/-427 del) is very frequent. In mainland Spain the missense mutation M645R in exon 6 is particularly common. Data from non-European countries are scarce. Most data from Asia are from Far Eastern areas (China, South Korea and Japan) where the R778L missense mutation in exon 8 is found with an allele frequency of 14-49%. In summary, given the constant improvement of analytic tools genetic testing will become an integral part for the diagnosis of WD. Knowledge of the differences in the worldwide distribution of particular mutations will help to design shortcuts for genetic diagnosis of WD.
Available from: Eun Joo Chung
- "WD occurs due to mutations in the gene coding for the copper-transporting P-type ATPase (ATP7B) protein , which is located on chromosome 13 (Bull, Thomas, Rommens, Forbes, & Cox, 1993; Tanzi et al., 1993). There are at least 300 known mutations of the ATP7B gene, and these mutations exhibit distinct regional distributions (Ferenci, 2006). The H1069Q mutation in exon 14 of the ATP7B gene is the most frequent mutation found in European and North American patients with WD (Caca et al., 2001), whereas the R778L mutation is most prevalent in Asian patients (Liu et al., 2004). "
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ABSTRACT: Extrapyramidal signs are neurological dysfunction commonly associated with Wilson's disease (WD). In addition, cognitive dysfunction has been reported in the early stages of WD. In this report, we describe a 49-year-old woman presenting with memory impairments and without Parkinsonian or extrapyramidal signs. She was diagnosed with WD based on the presence of Kayser-Fleischer rings around the irises of her eyes and two ATP7B gene mutations, R778L at exon 8 and A874V at exdyon 11. Serial magnetic resonance imaging analysis and neuropsychological tests showed improvements following treatment with trientine.
- "As a result, excess copper accumulates in many organs and tissues, particularly the liver and brain. The disease is characterised by the presence of liver disease, neurological and psychiatric symptoms (Ferenci 2006; Weiss 1999). Osteoporosis is a metabolic bone disease characterised by an imbalance between bone formation and resorption, that leads to a net decrease in bone mass with reduced bone strength and increased susceptibility to fracture (Gielen et al 2011). "
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ABSTRACT: We compared the bone mineral density (BMD) of adult Wilson disease (WD) patients (n = 148), with an age- and gender-matched healthy control population (n = 148). Within the WD cohort, correlations of BMD with WD disease parameters, lab results, type of treatment and known osteoporosis risk factors were analysed.
Hip and lumbar spine absolute BMD and T-score were measured by dual-energy X-ray absorptiometry. Osteoporosis and osteopenia were defined as a T-score ≤ -2.5, and between -1 and -2.5, respectively.
There were significantly more subjects with abnormal T-scores in the WD population (58.8 %) than in the control population (45.3 %) (χ(2) = 6.65, df = 2, p = 0.036), as there were 50.0 % osteopenic and 8.8 % osteoporotic WD patients, vs. 41.2 % and 4.1 %, respectively, in the controls. Especially L2-L4 spine BMD measurements (BMD and T-scores) differed significantly between the WD population and matched controls. L2-L4 spine BMD for WD patients was on average 0.054 g/cm(2) (5.1 %) lower than in matched normal controls (0.995 ± 0.156 vs 1.050 ± 0.135; p = 0.002). We found no significant correlation between BMD values and any of the WD disease parameters (e.g. the severity of liver disease), lab results, type of treatment or known osteoporosis risk factors. Duration of D-penicillamine treatment was negatively correlated with femoral BMD value, but in a clinically irrelevant manner, compared to age and gender. Importantly, BMD remained significantly lower in WD patients (n = 89) vs. controls after excluding WD patients with cirrhosis (p = 0.009).
Our study suggests that WD is intrinsically associated with bone demineralisation.
Available from: Duc-Hung Pham
- "ATP7B plays an essential role in Cu excretion from hepatocytes into bile and for mobilization of ceruloplasmin-bound Cu from hepatocytes into the serum (Huster, 2010). ATP7B mutations in WD patients cause accumulation of Cu in the liver (Ferenci, 2006) that can result in acute liver failure (ALF) or cirrhosis (Ala et al., 2007). Furthermore , elevated intracellular Cu levels cause degeneration of neuronal cells, which is also a WD-characteristic (Loudianos and Gitlin, 2000; Huster, 2010). "
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Wilson disease (WD) is caused by accumulation of excess copper (Cu) due to a mutation in the gene encoding the liver Cu transporter ATP7B, and is characterized by acute liver failure or cirrhosis and neuronal cell death. We investigated the effect of OSIP108, a plant derived decapeptide that prevents Cu-induced apoptosis in yeast and human cells, on Cu-induced toxicity in various mammalian in vitro models relevant for WD and in a Cu-toxicity zebrafish larvae model applicable to WD.
The effect of OSIP108 was evaluated on viability of various cell lines in presence of excess Cu, on liver morphology of a Cu-treated zebrafish larvae strain that expresses a fluorescent reporter in hepatocytes, and on oxidative stress levels in wild type AB zebrafish larvae.
OSIP108 increased viability of Cu-treated CHO cells transgenically expressing ATP7B and the common WD-causing mutant ATP7BH1069Q, but also viability of Cu-treated human glioblastoma U87 cells. Aberrancies in liver morphology of Cu-treated zebrafish larvae were observed, which were further confirmed as Cu-induced hepatotoxicity by liver histology. Injections of OSIP108 into Cu-treated zebrafish larvae significantly increased the amount of larvae with normal liver morphology, and decreased Cu-induced production of reactive oxygen species.
OSIP108 prevents Cu-induced toxicity in in vitro models and in a Cu-toxicity zebrafish larvae model applicable to WD.
All the above data indicate the potential of OSIP108 as a drug lead for further development as a novel WD treatment.
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