Different Pattern of Gene Mutations in Iranian Patients with Severe Congenital Neutropenia (Including 2 New Mutations)
Abstract
Severe congenital neutropenia (SCN) is a rare primary immunodeficiency disease. Different genes are found to be associated with SCN, including ELA2, HAX1, WAS, GFI1, G-CSFR and G6PC3. The aim of this study was to find different gene mutations responsible for SCN in Iranian patients.
Twenty-seven patients with SCN referred to Immunology, Asthma and Allergy Research Institute during a five year priod 5 years (May 2007 and May 2012), were included in this study. Neutropenia related exons and flanking regions of ELA2, HAX1, WAS, GFI1, G-CSFR and G6PC3 were amplified by PCR and the sequences were analyzed.
The results showed different mutations including 4 ELANE mutations, 11 HAX1 mutations and 2 G6PC3 mutations. None of the patients had GFI1 mutation and also one mutation was found in G-CSFR in a patient with ELANE mutation. Ten patients had unknown genetic diagnosis which was compatible with other studies.
According to these results, most of the patients showed HAX1 mutations and this finding which significantly differed from other reports, might be related to differences in Iranian ethnicity and also in high rate of consanguineous marriages in Iran.
1. Boxer LA, Newburger PE. A molecular classification of congenital neutropenia syndromes. Pediatr Blood Cancer.2007;49(5):609-14. Epub 2007/06/23.
2. Klein C. Molecular basis of congenital neutropenia.Haematologica. 2009;94(10):1333.
3. Ancliff P, Gale R, Liesner R, Hann I, Linch D. Mutations in the ELA2 gene encoding neutrophil elastase are present in most patients with sporadic severe congenital neutropenia but only in some patients with the familial form of the disease. Blood. 2001;98(9):2645.
4. Skokowa J, Fobiwe JP, Dan L, Thakur BK, Welte K.Neutrophil elastase is severely down-regulated in severe congenital neutropenia independent of ELA2 or HAX1 mutations but dependent on LEF-1. Blood.2009;114(14):3044-51. Epub 2009/07/22.
5. Dale D, Person R, Bolyard A, Aprikyan A, Bos C, Bonilla M, et al. Mutations in the gene encoding neutrophil elastase in congenital and cyclic neutropenia. Blood. 2000;96(7):2317.
6. Shiohara M, Shigemura T, Saito S, Tanaka M,Yanagisawa R, Sakashita K, et al. Ela2 mutations and clinical manifestations in familial congenital neutropenia. J Pediatr Hematol Oncol. 2009;31(5):319-24. Epub2009/05/06.
7. Boztug K, Ding XQ, Hartmann H, Ziesenitz L, Schaffer AA, Diestelhorst J, et al. HAX1 mutations causing severe congenital neuropenia and neurological disease lead to cerebral microstructural abnormalities documented by quantitative MRI. Am J Med Genet A.010;152A(12):3157-63. Epub 2010/11/26.
8. Boztug K, Klein C. Novel genetic etiologies of severe congenital neutropenia. Curr Opin Immunol.2009;21(5):472-80. Epub 2009/09/29.
9. Boztug K, Klein C. Genetic etiologies of severe congenital neutropenia. Curr Opin Pediatr.2011;23(1):21-6. Epub 2011/01/06.
10. Boztug K, Appaswamy G, Ashikov A, Schaffer AA, Salzer U, Diestelhorst J, et al. A syndrome with congenital neutropenia and mutations in G6PC3. N Engl J Med. 2009;360(1):32-43. Epub 2009/01/02.
11. Carlsson G, Elinder G, Malmgren H, Trebinska A,Grzybowska E, Dahl N, et al. Compound heterozygous HAX1 mutations in a Swedish patient with severe congenital neutropenia and no neurodevelopmental abnormalities. Pediatr Blood Cancer. 2009;53(6):1143-6. Epub 2009/06/06.
12. Germeshausen M, Zeidler C, Stuhrmann M, Lanciotti M,Ballmaier M, Welte K. Digenic mutations in severe congenital neutropenia. Haematologica. 2010;95(7):1207-10. Epub 2010/03/12.
13. Lanciotti M, Indaco S, Bonanomi S, Coliva T, Mastrodicasa E, Caridi G, et al. Novel HAX1 gene mutations associated to neurodevelopment abnormalities in two Italian patients with severe congenital neutropenia. Haematologica. 2010;95(1):168-9. Epub 2010/01/13.
14. Ishikawa N, Okada S, Miki M, Shirao K, Kihara H, Tsumura M, et al. Neurodevelopmental abnormalities associated with severe congenital neutropenia due to the R86X mutation in the HAX1 gene. J Med Genet.2008;45(12):802-7. Epub 2008/07/10.
15. Arostegui JI, de Toledo JS, Pascal M, Garcia C, Yague J, Diaz de Heredia C. A novel G6PC3 homozygous 1-bp deletion as a cause of severe congenital neutropenia. Blood. 2009;114(8):1718-9. Epub2009/08/22.
16. Banka S, Chervinsky E, Newman WG, Crow YJ, Yeganeh S, Yacobovich J, et al. Further delineation of the phenotype of severe congenital neutropenia type 4 due to mutations in G6PC3. Eur J Hum Genet. 2011;19(1):18-22. Epub 2010/08/19.
17. Person RE, Li FQ, Duan Z, Benson KF, Wechsler J, Papadaki HA, et al. Mutations in proto-oncogene GFI1 cause human neutropenia and target ELA2. Nat Genet.2003;34(3):308-12. Epub 2003/06/05.
18. Xia J, Bolyard AA, Rodger E, Stein S, Aprikyan AA, Dale DC, et al. Prevalence of mutations in ELANE, GFI1, HAX1, SBDS, WAS and G6PC3 in patients with severe congenital neutropenia. Br J Haematol. 2009;147(4):535-42. Epub 2009/09/25.
19. Zeidler C, Germeshausen M, Klein C, Welte K. Clinical implications of ELA2-, HAX1-, and G-CSF-receptor (CSF3R) mutations in severe congenital neutropenia. Br J Haematol. 2009;144(4):459-67. Epub 2009/01/06.
20. Rosenberg PS, Alter BP, Link DC, Stein S, Rodger E,Bolyard AA, et al. Neutrophil elastase mutations and risk of leukaemia in severe congenital neutropenia. Br J Haematol. 2008;140(2):210-3. Epub 2007/11/22.
21. Germeshausen M, Ballmaier M, Welte K. Incidence of CSF3R mutations in severe congenital neutropenia and relevance for leukemogenesis: Results of a long-term survey. Blood. 2007;109(1):93.
22. Rezaei N, Moin M, Pourpak Z, Ramyar A, Izadyar M, Chavoshzadeh Z, et al. The clinical, immunohematological, and molecular study of Iranian patients with severe congenital neutropenia. J Clin Immunol. 2007;27(5):525-33. Epub 2007/06/26.
23. Alizadeh Z, Fazlollahi MR, Eshghi P, Hamidieh AA, Ghadami M, Pourpak Z. Two cases of syndromic neutropenia with a report of novel mutation in G6PC3. Iranian journal of allergy, asthma, and immunology.2011;10(3):227-30. Epub 2011/09/06.
24. Bellanne-Chantelot C, Clauin S, Leblanc T, Cassinat B, Rodrigues-Lima F, Beaufils S, et al. Mutations in the ELA2 gene correlate with more severe expression of neutropenia: a study of 81 patients from the French Neutropenia Register. Blood. 2004;103(11):4119-25. Epub 2004/02/14.
25. Salehi T, Fazlollahi MR, Maddah M, Nayebpour M,Tabatabaei Yazdi M, Alizadeh Z, et al. Prevention and Control of Infections in Patients with Severe Congenital Neutropenia; A Follow up Study. Iranian journal of allergy, asthma, and immunology. 2012;11(1):51-6. Epub2012/03/20.
26. Donadieu J, Fenneteau O, Beaupain B, Mahlaoui N, Chantelot CB. Congenital neutropenia: diagnosis, molecular bases and patient management. Orphanet J Rare Dis. 2011;6:26. Epub 2011/05/21.
27. Kollner I, Sodeik B, Schreek S, Heyn H, von Neuhoff N,Germeshausen M, et al. Mutations in neutrophil elastase causing congenital neutropenia lead to cytoplasmic protein accumulation and induction of the unfolded protein response. Blood. 2006;108(2):493-500. Epub 2006/03/23.
28. Horwitz MS, Duan Z, Korkmaz B, Lee HH, Mealiffe ME, Salipante SJ. Neutrophil elastase in cyclic and severe congenital neutropenia. Blood. 2007;109(5):1817-24. Epub 2006/10/21.
29. Saadat M, Ansari-Lari M, Farhud DD. Consanguineous marriage in Iran. Annals of human biology.2004;31(2):263-9. Epub 2004/06/19.
30. Aytekin C, Germeshausen M, Tuygun N, Tanir G, Dogu F, Ikinciogullari A. Kostmann disease with developmental delay in three patients. Eur J Pediatr.2010;169:759-762
31. Germeshausen M, Ballmaier M, Welte K. Incidence of CSF3R mutations in severe congenital neutropenia and relevance for leukemogenesis: Results of a long-term survey. Blood. 2007;109(1):93-9. Epub 2006/09/21.
Files | ||
Issue | Vol 12, No 1 (2013) | |
Section | Articles | |
Keywords | ||
Neutropenia Gene mutation Severe congenital neutropenia |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |