LRRK1

LRRK1
  • 文章类型: Journal Article
    富含亮氨酸重复序列激酶2(LRRK2)的突变是帕金森病(PD)最常见的遗传原因。然而,LRRK2突变是否通过毒性功能获得或功能丧失机制导致多巴胺能(DA)神经元的PD和变性尚未解决,这对基于LRRK2的PD治疗具有重要意义.在这项研究中,我们通过发展DA神经元特异性Lrrk条件性双基因敲除(cDKO)小鼠,研究Lrrk2及其功能同源物Lrrk1是否在DA神经元存活中发挥细胞内在作用。与Lrrk种系DKO小鼠不同,DA神经元限制的LrrkcDKO小鼠表现出正常的死亡率,但发生年龄依赖性的DA神经元损失,如在20和24个月大时黑质致密质(SNpc)中DA神经元的逐渐减少所示。此外,DA神经变性伴随着SNpc中细胞凋亡的增加和小胶质细胞增生的增加以及纹状体中DA末端的减少,在运动协调能力受损之前。一起来看,这些发现为DA神经元中LRRK的细胞内在需求提供了明确的证据,并提高了LRRK2突变可能损害其对DA神经元的保护的可能性,导致PD中的DA神经变性。
    Mutations in leucine-rich repeat kinase 2 (LRRK2) are the most common genetic cause of Parkinson\'s disease (PD). However, whether LRRK2 mutations cause PD and degeneration of dopaminergic (DA) neurons via a toxic gain-of-function or a loss-of-function mechanism is unresolved and has pivotal implications for LRRK2-based PD therapies. In this study, we investigate whether Lrrk2 and its functional homolog Lrrk1 play a cell-intrinsic role in DA neuron survival through the development of DA neuron-specific Lrrk conditional double knockout (cDKO) mice. Unlike Lrrk germline DKO mice, DA neuron-restricted Lrrk cDKO mice exhibit normal mortality but develop age-dependent loss of DA neurons, as shown by the progressive reduction of DA neurons in the substantia nigra pars compacta (SNpc) at the ages of 20 and 24 months. Moreover, DA neurodegeneration is accompanied with increases in apoptosis and elevated microgliosis in the SNpc as well as decreases in DA terminals in the striatum, and is preceded by impaired motor coordination. Taken together, these findings provide the unequivocal evidence for the cell-intrinsic requirement of LRRK in DA neurons and raise the possibility that LRRK2 mutations may impair its protection of DA neurons, leading to DA neurodegeneration in PD.
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  • 文章类型: Case Reports
    骨硬化性干phy端发育不良(OSMD,OMIM615198)是一种极为罕见的常染色体隐性食骨症,导致长管状骨的干phy端边缘骨硬化的独特模式。迄今为止,仅报告了13例(8个分子证实)。已鉴定出富含亮氨酸的重复序列激酶1(LRRK1)基因中的五个纯合序列变体引起OSMD。我们提出了两个具有OSMD的男性兄弟姐妹,它们具有新的LRRK1变体。
    索引案例,现在6岁,在9个月时,肋骨和椎体弥漫性硬化,提示骨质疏松,在胸片上偶然发现疑似下呼吸道感染。父母是近亲,有巴基斯坦血统。进一步评估显示发育迟缓,眼球震颤伴双侧视神经发育不全,视力严重受损。骨骼调查证实了OSMD的典型变化,广泛弥漫性硬化症和锥形瓶畸形的长骨。他的哥哥姐姐,现在12岁,转诊时为7年,临床病程和骨骼检查结果相似.此外,他患有慢性进行性左下颌骨坏死,需要清创,减积和长期抗生素。骨骼调查显示发现与他的兄弟姐妹相似。兄弟姐妹都没有明显的骨骼骨折或癫痫发作。与以前的大多数报告显示保留头骨和缺乏视力障碍不同,我们的患者有颅骨硬化的证据。对石骨病常见常染色体隐性和显性致病变异的遗传筛查为阴性。全外显子组测序(WES),然后进行Sanger测序,鉴定了一种新的纯合LRRK1c.2506C>Tp。(Gln836Ter)无义变体,预测会导致LRRK1转录物的过早截短。
    我们的病例证实了常染色体隐性遗传,并扩大了文献报道的OSMD的基因型和表型谱。在这种表型中,越来越多的LRRK1变体的报道提出了一个问题,即LRRK1是否应包括在靶向的骨硬化组中。先前病例的骨组织学表明,这是一种富含破骨细胞的骨硬化症,这增加了造血干细胞移植可能是一种适当的治疗方式的可能性。
    Osteosclerotic metaphyseal dysplasia (OSMD, OMIM 615198) is an extremely rare autosomal recessive osteopetrosis disorder resulting in a distinctive pattern of osteosclerosis of the metaphyseal margins of long tubular bones. To date, only thirteen cases have been reported (eight molecularly confirmed). Five homozygous sequence variants in the leucine-rich repeat kinase 1 (LRRK1) gene have been identified to cause OSMD. We present two male siblings with OSMD with a novel LRRK1 variant.
    The index case, now aged 6 years, was referred aged 9 months when diffuse sclerosis of the ribs and vertebral bodies, suggestive of osteopetrosis, was incidentally identified on a chest radiograph for suspected lower respiratory tract infection. Parents were consanguineous and of Pakistani origin. Further evaluation revealed developmental delay, nystagmus with bilateral optic nerve hypoplasia and severe visual impairment. Skeletal survey confirmed typical changes of OSMD, with widespread diffuse sclerosis and Erlenmeyer flask deformity of long bones. His older sibling, now aged 12 years, was 7 years at the time of referral and had similar clinical course and skeletal findings. Additionally, he had a chronic progressive osteonecrosis of the left mandible that required debridement, debulking and long-term antibiotics. Skeletal survey revealed findings similar to his sibling. Neither sibling had significant skeletal fractures or seizures. Unlike most previous reports suggesting sparing of the skull and lack of visual impairment, our patients had evidence of osteosclerosis of the cranium. Genetic screening for the common autosomal recessive and dominant pathogenic variants of osteopetrosis was negative. Whole Exome Sequencing (WES) followed by Sanger sequencing, identified a novel homozygous LRRK1 c.2506C>T p. (Gln836Ter) nonsense variant predicted to result in premature truncation of LRRK1 transcript.
    Our cases confirm the autosomal recessive inheritance and expand the spectrum of genotype and phenotype of OSMD reported in the literature. Increasing reports of LRRK1 variants in this phenotype raise the question of whether LRRK1 should be included in targeted osteopetrosis panels. Bone histology in previous cases has shown this to be an osteoclast rich form of osteopetrosis raising the possibility that haematopoietic stem cell transplantation may be an appropriate treatment modality.
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  • 文章类型: Case Reports
    骨硬化性干phy端发育不良(OSMD)是一种非常罕见的常染色体隐性遗传疾病,由富亮氨酸重复序列激酶1(LRRK1)基因突变引起。它是一种硬化性骨骼发育不良,其特征是长骨的骨硬化,主要发生在干phy端和椎骨。表型特征可以是身材矮小,病理性骨折,延迟发展,和低张力,但是它们并不统一存在,从文献中知道的病例相对较少。由于青春期以来的非自发性多发性外周低能量创伤骨折,在我们的骨中心看到了一名40岁的男子。他没有其他抱怨,他的家族史是负面的。除身材矮小(167厘米;-1.5SD)外,检查没有异常,包括实验室测试。最初,怀疑成骨不全症,但是骨密度高,整个骨骼的X射线显示长骨和椎骨的干is端骨硬化。全外显子组测序显示纯合,可能致病,LRRK1基因的变体(美国医学遗传学和基因组学学院标准第4类),拟合OSMD的诊断。总之,我们描述了一名40岁的患者,患有由LRRK1基因纯合变体引起的骨硬化性干phy端发育不良,导致长骨多处骨折,没有其他疾病特征,增加了OSMD的表型变异。©2023作者。JBMRPlus由WileyPeriodicalsLLC代表美国骨骼和矿物研究学会出版。
    Osteosclerotic metaphyseal dysplasia (OSMD) is a very rare autosomal-recessive disease caused by mutations in the leucine-rich repeat kinase 1 (LRRK1) gene. It is a sclerosing skeletal dysplasia characterized by osteosclerosis of the long bones, predominantly at the metaphyses and vertebrae. Phenotypic features can be short stature, pathological fractures, delayed development, and hypotonia, but they are not uniformly present, and relatively few cases are known from the literature. A 40-year-old man was seen at our bone center because of nonspontaneous multiple peripheral low-energy trauma fractures since puberty. He had no other complaints and his family history was negative. Except for a relatively short stature (167 cm; -1.5 SD), there were no abnormalities on examination, including laboratory tests. Initially, a suspicion was raised of osteogenesis imperfecta, but bone mineral density was high and X-rays of the whole skeleton showed osteosclerosis of the metaphyses of long bones and vertebrae. Whole-exome sequencing showed a homozygous, likely pathogenic, variant (American College of Medical Genetics and Genomics criteria class 4) in the LRRK1 gene, fitting the diagnosis of OSMD. In conclusion, we described a 40-year-old patient with osteosclerotic metaphyseal dysplasia caused by a homozygous variant in the LRRK1 gene, resulting in multiple fractures of the long bones without other features of the disease, adding to the phenotypic variation of OSMD. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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  • 文章类型: Journal Article
    我们先前证明,由于破骨细胞无法再吸收骨,因此靶向缺失富含亮氨酸重复序列的激酶1(Lrrk1)基因的小鼠是骨质疏松的。为了确定LRRK1如何调节破骨细胞活性,我们检查了细胞内和细胞外酸化与酸化探针,吖啶橙,在骨片上的活破骨细胞中。我们通过LAMP-2,组织蛋白酶K的定位检查了破骨细胞中的溶酶体分布,和v-ATP酶用特异性抗体免疫荧光染色。我们发现,野生型(WT)破骨细胞的垂直和水平横截面图像均显示分散到褶皱边界的细胞内酸性液泡/溶酶体的橙色染色。相比之下,由于酸性液泡/溶酶体的分布改变,缺乏LRRK1的破骨细胞在远离细胞外腔的细胞质中显示出荧光橙色染色。此外,WT破骨细胞显示LAMP-2阳性溶酶体的外周分布,具有典型的肌动蛋白环。簇状的F-肌动蛋白构成外围密封区和皱褶的边界,该边界伸展到吸收凹坑中。LAMP-2阳性溶酶体也分布到密封区,细胞与吸收坑有关。相比之下,缺乏LRRK1的破骨细胞在整个细胞质中显示出扩散的F-肌动蛋白。密封区很弱,与吸收坑无关。LAMP-2阳性溶酶体也在细胞质中扩散,未分布到褶皱边界。尽管LRRK1缺陷型破骨细胞表达正常水平的组织蛋白酶K和v-ATPase,溶酶体相关的组织蛋白酶K和v-ATPase在Lrrk1KO破骨细胞的褶皱边界没有积累。我们的数据表明,LRRK1通过调节溶酶体分布来控制破骨细胞活性,酸分泌,和蛋白酶胞吐作用.
    We previously demonstrated that mice with targeted deletion of the leucine repeat rich kinase 1 (Lrrk1) gene were osteopetrotic due to the failure of osteoclasts to resorb bone. To determine how LRRK1 regulates osteoclast activity, we examined the intracellular and extracellular acidification with an acidotropic probe, acridine orange, in live osteoclasts on bone slices. We examined lysosome distribution in osteoclasts by localization of LAMP-2, cathepsin K, and v-ATPase by immunofluorescent staining with specific antibodies. We found that both vertical and horizontal cross-sectional images of the wild-type (WT) osteoclasts showed orange-staining of the intracellular acidic vacuoles/lysosomes dispersed to the ruffled border. By contrast, the LRRK1 deficient osteoclasts exhibited fluorescent orange staining in the cytoplasm away from the extracellular lacunae because of an altered distribution of the acidic vacuoles/lysosomes. In addition, WT osteoclasts displayed a peripheral distribution of LAMP-2 positive lysosomes with a typical actin ring. The clustered F-actin constitutes a peripheral sealing zone and a ruffled border which was stretched out into a resorption pit. The LAMP-2 positive lysosomes were also distributed to the sealing zone, and the cell was associated with a resorption pit. By contrast, LRRK1-deficient osteoclasts showed diffused F-actin throughout the cytoplasm. The sealing zone was weak and not associated with a resorption pit. LAMP-2 positive lysosomes were also diffuse in the cytoplasm and were not distributed to the ruffled border. Although the LRRK1-deficient osteoclast expressed normal levels of cathepsin K and v-ATPase, the lysosomal-associated cathepsin K and v-ATPase were not accumulated at the ruffled border in Lrrk1 KO osteoclasts. Our data indicate that LRRK1 controls osteoclast activity by regulating lysosomal distribution, acid secretion, and protease exocytosis.
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  • 文章类型: Journal Article
    Proper control of epidermal growth factor receptor (EGFR) signaling is important for maintaining cellular homeostasis. Given that EGFR signaling occurs at the plasma membrane and endosomes following internalization, endosomal trafficking of EGFR spatiotemporally regulates EGFR signaling. In this process, leucine-rich repeat kinase 1 (LRRK1) has multiple roles in kinase activity-dependent transport of EGFR-containing endosomes and kinase-independent sorting of EGFR into the intraluminal vesicles (ILVs) of multivesicular bodies. Active, phosphorylated EGFR inactivates the LRRK1 kinase activity by phosphorylating Y944. In this study, we demonstrate that LRRK1 facilitates EGFR dephosphorylation by PTP1B (also known as PTPN1), an endoplasmic reticulum (ER)-localized protein tyrosine phosphatase, at the ER-endosome contact site, after which EGFR is sorted into the ILVs of endosomes. LRRK1 is required for the PTP1B-EGFR interaction in response to EGF stimulation, resulting in the downregulation of EGFR signaling. Furthermore, PTP1B activates LRRK1 by dephosphorylating pY944 on the contact site, which promotes the transport of EGFR-containing endosomes to the perinuclear region. These findings provide evidence that the ER-endosome contact site functions as a hub for LRRK1-dependent signaling that regulates EGFR trafficking.
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  • 文章类型: Journal Article
    线粒体自噬,一种选择性自噬,特别针对受损的线粒体。ULK复合物调节Parkin介导的线粒体自噬,但ULK复合物启动线粒体吞噬体形成的机制尚不清楚。Rab7GTP酶(本文指Rab7a)是形成有丝分裂吞噬体的关键引发剂。Rab7的Ser-72磷酸化对这一过程很重要。我们先前已将LRRK1鉴定为负责Rab7Ser-72磷酸化的蛋白激酶。在这项研究中,我们研究了LRRK1在线粒体自噬中的作用。我们表明LRRK1在Parkin介导的线粒体自噬中起ULK1和ULK2下游的作用。此外,我们证明了活性LRRK1对线粒体的异位靶向足以诱导Rab7的Ser-72磷酸化,从而避免了对ULK复合物成分ATG13的需求。因此,ULK复合物通过与ATG13相互作用来将LRRK1募集到线粒体以启动线粒体吞噬体的形成。这项研究强调了ULK复合物-LRRK1轴在调节Parkin介导的线粒体自噬中的关键作用。
    Mitophagy, a type of selective autophagy, specifically targets damaged mitochondria. The ULK complex regulates Parkin-mediated mitophagy, but the mechanism through which the ULK complex initiates mitophagosome formation remains unknown. The Rab7 GTPase (herein referring to Rab7a) is a key initiator of mitophagosome formation, and Ser-72 phosphorylation of Rab7 is important for this process. We have previously identified LRRK1 as a protein kinase responsible for Rab7 Ser-72 phosphorylation. In this study, we investigated the role of LRRK1 in mitophagy. We showed that LRRK1 functions downstream of ULK1 and ULK2 in Parkin-mediated mitophagy. Furthermore, we demonstrated that ectopic targeting of active LRRK1 to mitochondria is sufficient to induce the Ser-72 phosphorylation of Rab7, circumventing the requirement for ATG13, a component of the ULK complex. Thus, the ULK complex recruits LRRK1 to mitochondria by interacting with ATG13 to initiate mitophagosome formation. This study highlights the crucial role of the ULK complex-LRRK1 axis in the regulation of Parkin-mediated mitophagy.
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  • 文章类型: Journal Article
    肌张力硬化(DSS)是指骨骼发育不良,其影像学特征是局灶性阑尾骨硬化并伴有可变的颈椎病。DSS表型的遗传异质性越来越多,现在涉及SLC29A3,TNFRSF11A,TCIRG1、LRRK1和CSF1R。典型的放射学发现是增宽的射线可透的长骨,皮质薄,但致密的不规则干is端。扁平的椎体,密集的肋骨,和多处骨折.然而,DSS的射线照相特征演变,干phy端和/或阑尾骨硬化随着患者年龄的增加而逐渐消失,可能是由于一些残余的破骨细胞功能。骨折是DSS的主要表现,甚至可能发生在与SLC29A3相关的DSS的婴儿期。颅底硬化会导致视神经萎缩等颅神经麻痹,可能是最初的演示,尽管与SLC29A3关联的DSS没有观察到。基因特异性骨骼外特征可能是某些形式的DSS(例如CSF1R相关DSS)的主要并发症。进一步的遗传异质性是可能的,特别是X连锁隐性DSS和目前具有未知遗传缺陷的病例。由于可变的临床和放射学特征以及不断发展的表型,区分DSS可能具有挑战性。然而,定义DSS表型对于预测并发症很重要,预后,并建立适当的健康监测和治疗。
    Dysosteosclerosis (DSS) refers to skeletal dysplasias that radiographically feature focal appendicular osteosclerosis with variable platyspondyly. Genetic heterogeneity is increasingly reported for the DSS phenotype and now involves mutations of SLC29A3, TNFRSF11A, TCIRG1, LRRK1, and CSF1R. Typical radiological findings are widened radiolucent long bones with thin cortices yet dense irregular metaphyses, flattened vertebral bodies, dense ribs, and multiple fractures. However, the radiographic features of DSS evolve, and the metaphyseal and/or appendicular osteosclerosis variably fades with increasing patient age, likely due to some residual osteoclast function. Fractures are the principal presentation of DSS, and may even occur in infancy with SLC29A3-associated DSS. Cranial base sclerosis can lead to cranial nerve palsies such as optic atrophy, and may be the initial presentation, though not observed with SLC29A3-associated DSS. Gene-specific extra-skeletal features can be the main complication in some forms of DSS such as CSF1R- associated DSS. Further genetic heterogeneity is likely, especially for X-linked recessive DSS and cases currently with an unknown genetic defect. Distinguishing DSS can be challenging due to variable clinical and radiological features and an evolving phenotype. However, defining the DSS phenotype is important for predicting complications, prognosis, and instituting appropriate health surveillance and treatment.
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  • 文章类型: Journal Article
    初级纤毛是通过细胞外信号调节生长和发育的天线样细胞器。然而,纤毛动力学的分子机制,特别是那些规范它们拆卸的人,不是很了解。这里,我们表明富含亮氨酸的重复激酶1(LRRK1)在调节纤毛分解中起作用。LRRK1的消耗会损害培养细胞中血清刺激后的初级纤毛吸收。Polo样激酶1(PLK1)在此过程中起着重要作用。在纤毛吸收期间,PLK1在初级纤毛碱基处磷酸化LRRK1,导致其激活。我们鉴定了核分布蛋白nudE样1(NDEL1),众所周知,它能积极调节纤毛的分解,作为LRRK1磷酸化的靶标。尽管Ser-155上NDEL1的LRRK1磷酸化促进NDEL1与细胞质动力蛋白2的中间链相互作用,但它对于通过动力蛋白2驱动的逆行步行内运输触发纤毛吸收也至关重要。这些发现提供了新的PLK1-LRRK1-NDEL1通路调节纤毛分解的证据。
    Primary cilia are antenna-like organelles that regulate growth and development via extracellular signals. However, the molecular mechanisms underlying cilia dynamics, particularly those regulating their disassembly, are not well understood. Here, we show that leucine-rich repeat kinase 1 (LRRK1) plays a role in regulating cilia disassembly. The depletion of LRRK1 impairs primary cilia resorption following serum stimulation in cultured cells. Polo-like kinase 1 (PLK1) plays an important role in this process. During ciliary resorption, PLK1 phosphorylates LRRK1 at the primary cilia base, resulting in its activation. We identified nuclear distribution protein nudE-like 1 (NDEL1), which is known to positively regulate cilia disassembly, as a target of LRRK1 phosphorylation. Whereas LRRK1 phosphorylation of NDEL1 on Ser-155 promotes NDEL1 interaction with the intermediate chains of cytoplasmic dynein-2, it is also crucial for triggering ciliary resorption through dynein-2-driven retrograde intraflagellar transport. These findings provide evidence that a novel PLK1-LRRK1-NDEL1 pathway regulates cilia disassembly.
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  • 文章类型: Journal Article
    强肌硬化(DSS),该术语于1968年创造,用于描述骨骼的异常发育不良,其特征是伴有局灶性阑尾骨硬化,通过涵盖最近报道的这种表型的遗传异质性,已经变得普遍。我们研究了四名与DSS无关的土耳其患者,以增进对新疾病的了解。患者1在1岁时开始遭受股骨骨折。怀疑DSS在儿童早期因明显的干phy端骨硬化而出现,随后伴有附肢骨骼的斑片状骨硬化。2012年,她在SLC29A3中拥有第一个与DSS相关的基因,一个独特的纯合重复(c.303_320dup,p.102_107dupYFESYL)。患者2在2个月大时表现为类似的骨折和干phy端骨质硬化,但没有颅骨畸形。她是SLC29A3中一种新的无义突变的纯合子(c.128C>G,p.Tyr428*)。患者3在2岁时患有眼部疾病,在11岁时因身材矮小而被提出,直到16岁才开始骨折。X线照片显示轻度颈椎病和局灶性干phy端和股骨骨硬化。她对于TNFRSF11A中的独特剪接位点突变是纯合的(c.616+3A>G)。患者4在2岁时表现出发育延迟和频繁感染,但没有骨折。他有独特的骨折后骨折和骨硬化,椎体终板骨硬化,和长骨皮质变薄,但未检测到SLC29A3,TNFRSF11A的突变,与DSS关联的TCIRG1、LRRK1或CSF1R。我们发现来自有缺陷的SLC29A3的DSS出现最早且具有骨折。作为早期发现,来自受损TNFRSF11A的DSS可导致视神经萎缩。4例患者的阴性突变分析提示DSS骨骼表型的进一步遗传异质性。©2022作者JBMRPlus由WileyPeriodicalsLLC代表美国骨骼和矿物研究学会出版。
    Dysosteosclerosis (DSS), the term coined in 1968 for ultrarare dysplasia of the skeleton featuring platyspondyly with focal appendicular osteosclerosis, has become generic by encompassing the genetic heterogeneity recently reported for this phenotype. We studied four unrelated Turkish patients with DSS to advance understanding of the new nosology. Patient 1 suffered femur fractures beginning at age 1 year. DSS was suspected from marked metaphyseal osteosclerosis in early childhood and subsequently platyspondyly accompanying patchy osteosclerosis of her appendicular skeleton. She harbored in SLC29A3, in 2012 the first gene associated with DSS, a unique homozygous duplication (c.303_320dup, p.102_107dupYFESYL). Patient 2 presented similarly with fractures and metaphyseal osteosclerosis but with no platyspondyly at age 2 months. She was homozygous for a novel nonsense mutation in SLC29A3 (c.1284C>G, p.Tyr428*). Patient 3 had ocular disease at age 2 years, presented for short stature at age 11 years, and did not begin to fracture until age 16 years. Radiographs showed mild platyspondyly and focal metaphyseal and femoral osteosclerosis. She was homozygous for a unique splice site mutation in TNFRSF11A (c.616+3A>G). Patient 4 at age 2 years manifested developmental delay and frequent infections but did not fracture. He had unique metadiaphyseal splaying and osteosclerosis, vertebral end-plate osteosclerosis, and cortical thinning of long bones but no mutation was detected of SLC29A3, TNFRSF11A, TCIRG1, LRRK1, or CSF1R associated with DSS. We find that DSS from defective SLC29A3 presents earliest and with fractures. DSS from compromised TNFRSF11A can lead to optic atrophy as an early finding. Negative mutation analysis in patient 4 suggests further genetic heterogeneity underlying the skeletal phenotype of DSS. © 2022 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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  • 文章类型: Journal Article
    骨硬化性干phy端发育不良是一种罕见的疾病,其特征是涉及长骨的骨硬化,椎骨,肋骨,锁骨和髂峰.已报道的其他特征包括发育迟缓,身材矮小,张力减退和癫痫发作。该疾病是由LRRK1基因的致病变异引起的,以常染色体隐性方式遗传。我们报告了三个兄弟姐妹(14岁,11.5年和0.9年),生于阿拉伯穆斯林血统的近亲,在LRRK1基因中具有纯合致病性变异(Chr15:101068759AGGGGCT>A,c.5965_5970delTGGGGC,P.Trp1989Gly1990del)。患者表现出不同程度的骨骼发育不良,最年长的兄弟姐妹受影响最严重,和骨骼轻微受累的最小婴儿。两个兄弟姐妹表现出正常的神经发育,而最年轻的兄弟姐妹表现出全球发育迟缓。兄弟姐妹都没有癫痫发作;然而,其中两个表现出眼球震颤。先前尚未报道视神经受累是该疾病临床谱的一部分。视神经受累程度与骨骼受累程度无关。这表明家族内可变表达以及LRRK1相关疾病谱的扩大。这些发现需要重新考虑治疗策略,包括造血干细胞移植(HSCT)的可能性,如在恶性和中间形式的骨硬化病例中进行的。
    Osteosclerotic metaphyseal dysplasia is a rare disorder which features osteosclerosis involving long bones, vertebrae, ribs, clavicles and the iliac crests. Additional features which have variably been reported include developmental delay, short stature, hypotonia and seizures. The disease is caused by pathogenic variants in the LRRK1 gene, and inherited in an autosomal recessive manner. We report three siblings (ages 14 years, 11.5 years and 0.9 years), born to consanguineous parents of Arab-Muslim descent, harboring a homozygous pathogenic variant in the LRRK1 gene (Chr15:101068759 AGGGGCT>A, c.5965_5970del TGGGGC, p.Trp1989Gly1990del). The patients displayed variable degrees of skeletal dysplasia, with the oldest sibling most severely affected, and the youngest infant with minor skeletal involvement. Two of the siblings exhibited normal neurological development, while the youngest sibling exhibited global developmental delay. None of the siblings had seizures; however, two of them exhibited nystagmus. Optic nerve involvement has not previously been reported to be part of the clinical spectrum of this disease. The degree of optic nerve involvement did not correlate with the degree of skeletal involvement. This indicates both intra-familial variable expressivity along with a broadening of the spectrum of LRRK1-associated disease. These findings warrant reconsideration of therapeutic strategies, including the possibility of hematopoietic stem cell transplantation (HSCT) as is performed in cases of malignant and intermediate forms of osteopetrosis.
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