TY - JOUR
T1 - Metachromatic leukodystrophy - Mutation analysis provides further evidence of genotype-phenotype correlation
AU - Biffi, Alessandra
AU - Cesani, M.
AU - Fumagalli, F.
AU - Del Carro, U.
AU - Baldoli, C.
AU - Canale, S.
AU - Gerevini, S.
AU - Amadio, S.
AU - Falautano, M.
AU - Rovelli, A.
AU - Comi, G.
AU - Roncarolo, M. G.
AU - Sessa, Maria
PY - 2008
Y1 - 2008
N2 - Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disorder resulting from the inherited deficiency of the arylsulfatase A (ARSA) enzyme. Currently, no valid therapeutic options are available for affected patients. A thorough knowledge of disease progression in its diverse clinical variants, together with the identification of reliable prognostic factors, could be instrumental in accurate patient selection for new upcoming therapeutic opportunities, such as enzyme replacement and gene therapy. The described correlation between genotype and clinical presentation proved helpful in predicting patient's prognosis, only in the minority of MLD patients harboring common mutations. Molecular characterization of a cohort of 26 MLD patients allowed us to identify 18 mutations, excluding the common 0 and R alleles, 10 of which are rare and 8 are novel. By categorizing the rare mutations, we were able to confirm a correlation between ARSA gene mutations, age at onset and patterns of disease progression, not only in those patients bearing common mutations, but also in those carrying rare mutant alleles. Moreover, in the case of absent or delayed molecular diagnosis, or of newly identified mutations, the involvement of peripheral nervous system from disease onset proved to be a sensitive prognostic marker predicting a severe progression.
AB - Metachromatic leukodystrophy (MLD) is a rare lysosomal storage disorder resulting from the inherited deficiency of the arylsulfatase A (ARSA) enzyme. Currently, no valid therapeutic options are available for affected patients. A thorough knowledge of disease progression in its diverse clinical variants, together with the identification of reliable prognostic factors, could be instrumental in accurate patient selection for new upcoming therapeutic opportunities, such as enzyme replacement and gene therapy. The described correlation between genotype and clinical presentation proved helpful in predicting patient's prognosis, only in the minority of MLD patients harboring common mutations. Molecular characterization of a cohort of 26 MLD patients allowed us to identify 18 mutations, excluding the common 0 and R alleles, 10 of which are rare and 8 are novel. By categorizing the rare mutations, we were able to confirm a correlation between ARSA gene mutations, age at onset and patterns of disease progression, not only in those patients bearing common mutations, but also in those carrying rare mutant alleles. Moreover, in the case of absent or delayed molecular diagnosis, or of newly identified mutations, the involvement of peripheral nervous system from disease onset proved to be a sensitive prognostic marker predicting a severe progression.
KW - Genotype
KW - Metachromatic leukodystrophy
KW - Natural history
KW - Peripheral nervous system
KW - Phenotype
KW - Rare mutations
UR - http://www.scopus.com/inward/record.url?scp=52449114747&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=52449114747&partnerID=8YFLogxK
U2 - 10.1111/j.1399-0004.2008.01058.x
DO - 10.1111/j.1399-0004.2008.01058.x
M3 - Article
C2 - 18786133
AN - SCOPUS:52449114747
VL - 74
SP - 349
EP - 357
JO - Clinical Genetics
JF - Clinical Genetics
SN - 0009-9163
IS - 4
ER -