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Published in: Orphanet Journal of Rare Diseases 1/2016

Open Access 01-12-2016 | Research

Role of molecular testing in the multidisciplinary diagnostic approach of ichthyosis

Authors: Andrea Diociaiuti, May El Hachem, Elisa Pisaneschi, Simona Giancristoforo, Silvia Genovese, Pietro Sirleto, Renata Boldrini, Adriano Angioni

Published in: Orphanet Journal of Rare Diseases | Issue 1/2016

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Abstract

Background

The term ichthyosis describes a generalized disorder of cornification characterized by scaling and/or hyperkeratosis of different skin regions. Mutations in a broad group of genes related to keratinocyte differentiation and epidermal barrier function have been demonstrated to play a causative role in disease development. Ichthyosis may be classified in syndromic or non-syndromic forms based on the occurrence or absence of extracutaneous signs. In this setting, the diagnosis of ichthyosis is an integrated multistep process requiring a multidisciplinary approach in order to formulate the appropriate diagnostic hypothesis and to address the genetic testing.

Methods

Due to the complex features of the different ichthyoses and the high number of genes involved we have investigated a group of 64 patients, affected by syndromic and non-syndromic diseases, using Next Generation Sequencing as a new tool for the molecular diagnosis.

Results

Using this innovative molecular approach we were able to find pathogenic mutations in 53 out of 64 patients resulting in 82.8 % total detection rate. An interesting result from the analysis of the data is the high rate of novel sequence variations found compared to known mutations and the relevant rate of homozygous mutations.

Conclusions

The possibility to analyze a large number of genes associated with various diseases allows to study cases with phenotypes not well-determined, giving the opportunity to make new genotype-phenotype correlation. In some cases there were discrepancies between clinical features and histology or electron microscopy and only molecular analysis allowed to definitively resolve the diagnostic dilemma. The genetic diagnosis of ichthyosis leads to a more accurate and effective genetic counseling, allowing correct evaluation of the risk of recurrence, particularly in families with consanguineous background.
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Literature
1.
go back to reference Oji V, Tadini G, Akiyama M, Blanchet Bardon C, Bodemer C, Bourrat E, et al. Revised nomenclature and classification of inherited ichthyoses: results of the First Ichthyosis Consensus Conference in Sorèze 2009. J Am Acad Dermatol. 2010;63:607–41.PubMedCrossRef Oji V, Tadini G, Akiyama M, Blanchet Bardon C, Bodemer C, Bourrat E, et al. Revised nomenclature and classification of inherited ichthyoses: results of the First Ichthyosis Consensus Conference in Sorèze 2009. J Am Acad Dermatol. 2010;63:607–41.PubMedCrossRef
2.
3.
go back to reference Farasat S, Wei MH, Herman M, Liewehr DJ, Steinberg SM, Bale SJ, et al. Novel transglutaminase-1 mutations and genotype-phenotype investigations of 104 patients with autosomal recessive congenital ichthyosis in the USA. J Med Genet. 2009;46:103–11.PubMedPubMedCentralCrossRef Farasat S, Wei MH, Herman M, Liewehr DJ, Steinberg SM, Bale SJ, et al. Novel transglutaminase-1 mutations and genotype-phenotype investigations of 104 patients with autosomal recessive congenital ichthyosis in the USA. J Med Genet. 2009;46:103–11.PubMedPubMedCentralCrossRef
4.
go back to reference Liu L, Li Y, Li S, Hu N, He Y, Pong R, et al. Comparison of next-generation sequencing systems. J Biomed Biotechnol. 2012;2012:251364.PubMedPubMedCentral Liu L, Li Y, Li S, Hu N, He Y, Pong R, et al. Comparison of next-generation sequencing systems. J Biomed Biotechnol. 2012;2012:251364.PubMedPubMedCentral
5.
go back to reference Quail MA, Smith M, Coupland P, Otto TD, Harris SR, Connor TR, et al. A tale of three next generation sequencing platforms: comparison of Ion Torrent. Pacific Biosciences and Illumina MiSeq sequencers. BMC Genomics. 2012;13:341.PubMedPubMedCentralCrossRef Quail MA, Smith M, Coupland P, Otto TD, Harris SR, Connor TR, et al. A tale of three next generation sequencing platforms: comparison of Ion Torrent. Pacific Biosciences and Illumina MiSeq sequencers. BMC Genomics. 2012;13:341.PubMedPubMedCentralCrossRef
6.
go back to reference Thorvaldsdóttir H, Robinson JT, Mesirov JP. Integrative Genomics Viewer (IGV): high-performance genomics data visualization and exploration. Brief Bioinform. 2013;14:178–92.PubMedPubMedCentralCrossRef Thorvaldsdóttir H, Robinson JT, Mesirov JP. Integrative Genomics Viewer (IGV): high-performance genomics data visualization and exploration. Brief Bioinform. 2013;14:178–92.PubMedPubMedCentralCrossRef
7.
8.
go back to reference Scott CA, Plagnol V, Nitoiu D, Bland PJ, Blaydon DC, Chronnell CM, et al. Targeted sequence capture and high-throughput sequencing in the molecular diagnosis of ichthyosis and other skin diseases. J Invest Dermatol. 2013;133:573–6.PubMedCrossRef Scott CA, Plagnol V, Nitoiu D, Bland PJ, Blaydon DC, Chronnell CM, et al. Targeted sequence capture and high-throughput sequencing in the molecular diagnosis of ichthyosis and other skin diseases. J Invest Dermatol. 2013;133:573–6.PubMedCrossRef
9.
go back to reference Traupe H, Fischer J, Oji V. Nonsyndromic types of ichthyoses - an update. J Dtsch Dermatol Ges. 2014;12:109–21.PubMed Traupe H, Fischer J, Oji V. Nonsyndromic types of ichthyoses - an update. J Dtsch Dermatol Ges. 2014;12:109–21.PubMed
10.
go back to reference Dahlqvist J, Klar J, Hausser I, Anton-Lamprecht I, Pigg MH, Gedde-Dahl Jr T, et al. Congenital ichthyosis: mutations in ichthyin are associated with specific structural abnormalities in the granular layer of epidermis. J Med Genet. 2007;44:615–20.PubMedPubMedCentralCrossRef Dahlqvist J, Klar J, Hausser I, Anton-Lamprecht I, Pigg MH, Gedde-Dahl Jr T, et al. Congenital ichthyosis: mutations in ichthyin are associated with specific structural abnormalities in the granular layer of epidermis. J Med Genet. 2007;44:615–20.PubMedPubMedCentralCrossRef
11.
go back to reference Lesueur F, Bouadjar B, Lefèvre C, Jobard F, Audebert S, Lakhdar H, et al. Novel mutations in ALOX12B in patients with autosomal recessive congenital ichthyosis and evidence for genetic heterogeneity on chromosome 17p13. J Invest Dermatol. 2007;127:829–34.PubMedCrossRef Lesueur F, Bouadjar B, Lefèvre C, Jobard F, Audebert S, Lakhdar H, et al. Novel mutations in ALOX12B in patients with autosomal recessive congenital ichthyosis and evidence for genetic heterogeneity on chromosome 17p13. J Invest Dermatol. 2007;127:829–34.PubMedCrossRef
12.
go back to reference Eckl KM, Krieg P, Küster W, Traupe H, André F, Wittstruck N, et al. Mutation spectrum and functional analysis of epidermis-type lipoxygenases in patients with autosomal recessive congenital ichthyosis. Hum Mutat. 2005;26:351–61.PubMedCrossRef Eckl KM, Krieg P, Küster W, Traupe H, André F, Wittstruck N, et al. Mutation spectrum and functional analysis of epidermis-type lipoxygenases in patients with autosomal recessive congenital ichthyosis. Hum Mutat. 2005;26:351–61.PubMedCrossRef
13.
go back to reference Lefèvre C, Bouadjar B, Ferrand V, Tadini G, Mégarbané A, Lathrop M, et al. Mutations in a new cytochrome P450 gene in lamellar ichthyosis type 3. Hum Mol Genet. 2006;15:767–76.PubMedCrossRef Lefèvre C, Bouadjar B, Ferrand V, Tadini G, Mégarbané A, Lathrop M, et al. Mutations in a new cytochrome P450 gene in lamellar ichthyosis type 3. Hum Mol Genet. 2006;15:767–76.PubMedCrossRef
14.
go back to reference Esposito G, Auricchio L, Rescigno G, Paparo F, Rinaldi M, Salvatore F. Transglutaminase 1 gene mutations in Italian patients with autosomal recessive lamellar ichthyosis. J Invest Dermatol. 2001;116:809–12.PubMedCrossRef Esposito G, Auricchio L, Rescigno G, Paparo F, Rinaldi M, Salvatore F. Transglutaminase 1 gene mutations in Italian patients with autosomal recessive lamellar ichthyosis. J Invest Dermatol. 2001;116:809–12.PubMedCrossRef
15.
go back to reference Herman ML, Farasat S, Steinbach PJ, Wei MH, Toure O, Fleckman P, et al. Transglutaminase-1 gene mutations in autosomal recessive congenital ichthyosis: summary of mutations (including 23 novel) and modeling of TGase-1. Hum Mutat. 2009;30:537–47.PubMedPubMedCentralCrossRef Herman ML, Farasat S, Steinbach PJ, Wei MH, Toure O, Fleckman P, et al. Transglutaminase-1 gene mutations in autosomal recessive congenital ichthyosis: summary of mutations (including 23 novel) and modeling of TGase-1. Hum Mutat. 2009;30:537–47.PubMedPubMedCentralCrossRef
16.
go back to reference Oji V, Hautier JM, Ahvazi B, Hausser I, Aufenvenne K, Walker T, et al. Bathing suit ichthyosis is caused by transglutaminase-1 deficiency: evidence for a temperature-sensitive phenotype. Hum Mol Genet. 2006;15:3083–97.PubMedCrossRef Oji V, Hautier JM, Ahvazi B, Hausser I, Aufenvenne K, Walker T, et al. Bathing suit ichthyosis is caused by transglutaminase-1 deficiency: evidence for a temperature-sensitive phenotype. Hum Mol Genet. 2006;15:3083–97.PubMedCrossRef
17.
go back to reference Hennies HC, Raghunath M, Wiebe V, Vogel M, Velten F, Traupe H, et al. Genetic and immunohistochemical detection of mutations inactivating the keratinocyte transglutaminase in patients with lamellar ichthyosis. Hum Genet. 1998;102:314–8.PubMedCrossRef Hennies HC, Raghunath M, Wiebe V, Vogel M, Velten F, Traupe H, et al. Genetic and immunohistochemical detection of mutations inactivating the keratinocyte transglutaminase in patients with lamellar ichthyosis. Hum Genet. 1998;102:314–8.PubMedCrossRef
18.
go back to reference Lefévre C, Audebert S, Jobard F, Bouadjar B, Lakhdar H, Boughdene-Stambouli O, et al. Mutations in the transporter ABCA12 are associated with lamellar ichthyosis type 2. Hum Mol Genet. 2003;12:2369–78.PubMedCrossRef Lefévre C, Audebert S, Jobard F, Bouadjar B, Lakhdar H, Boughdene-Stambouli O, et al. Mutations in the transporter ABCA12 are associated with lamellar ichthyosis type 2. Hum Mol Genet. 2003;12:2369–78.PubMedCrossRef
19.
go back to reference Richardson ES, Lee JB, Hyde PH, Richard G. A novel mutation and large size polymorphism affecting the V2 domain of keratin 1 in an African-American family with severe, diffuse palmoplantar keratoderma of the ichthyosis hystrix Curth-Macklin type. J Invest Dermatol. 2006;126:79–84.PubMedCrossRef Richardson ES, Lee JB, Hyde PH, Richard G. A novel mutation and large size polymorphism affecting the V2 domain of keratin 1 in an African-American family with severe, diffuse palmoplantar keratoderma of the ichthyosis hystrix Curth-Macklin type. J Invest Dermatol. 2006;126:79–84.PubMedCrossRef
20.
go back to reference Haruna K, Suga Y, Mizuno Y, Hasegawa T, Kourou K, Matsuba S, et al. R156C mutation of keratin 10 causes mild form of epidermolytic hyperkeratosis. J Dermatol. 2007;34:545–8.PubMedCrossRef Haruna K, Suga Y, Mizuno Y, Hasegawa T, Kourou K, Matsuba S, et al. R156C mutation of keratin 10 causes mild form of epidermolytic hyperkeratosis. J Dermatol. 2007;34:545–8.PubMedCrossRef
21.
go back to reference Mayuzumi N, Shigihara T, Ikeda S, Ogawa H. Recurrent R156H mutation of KRT10 in a Japanese family with bullous congenital ichthyosiform erythroderma. J Eur Acad Dermatol Venereol. 2000;14:304–6.PubMedCrossRef Mayuzumi N, Shigihara T, Ikeda S, Ogawa H. Recurrent R156H mutation of KRT10 in a Japanese family with bullous congenital ichthyosiform erythroderma. J Eur Acad Dermatol Venereol. 2000;14:304–6.PubMedCrossRef
22.
go back to reference Rizzo WB, Carney G, Lin Z. The molecular basis of Sjögren-Larsson syndrome: mutation analysis of the fatty aldehyde dehydrogenase gene. Am J Hum Genet. 1999;65:1547–60.PubMedPubMedCentralCrossRef Rizzo WB, Carney G, Lin Z. The molecular basis of Sjögren-Larsson syndrome: mutation analysis of the fatty aldehyde dehydrogenase gene. Am J Hum Genet. 1999;65:1547–60.PubMedPubMedCentralCrossRef
23.
go back to reference Oeffner F, Fischer G, Happle R, König A, Betz RC, Bornholdt D, et al. IFAP syndrome is caused by deficiency in MBTPS2, an intramembrane zinc metalloprotease essential for cholesterol homeostasis and ER stress response. Am J Hum Genet. 2009;84:459–67.PubMedPubMedCentralCrossRef Oeffner F, Fischer G, Happle R, König A, Betz RC, Bornholdt D, et al. IFAP syndrome is caused by deficiency in MBTPS2, an intramembrane zinc metalloprotease essential for cholesterol homeostasis and ER stress response. Am J Hum Genet. 2009;84:459–67.PubMedPubMedCentralCrossRef
24.
go back to reference Jansen GA, Waterham HR, Wanders RJ. Molecular basis of Refsum disease: sequence variations in phytanoyl-CoA hydroxylase (PHYH) and the PTS2 receptor (PEX7). Hum Mutat. 2004;23:209–18.PubMedCrossRef Jansen GA, Waterham HR, Wanders RJ. Molecular basis of Refsum disease: sequence variations in phytanoyl-CoA hydroxylase (PHYH) and the PTS2 receptor (PEX7). Hum Mutat. 2004;23:209–18.PubMedCrossRef
25.
go back to reference Sprecher E, Chavanas S, DiGiovanna JJ, Amin S, Nielsen K, Prendiville JS, et al. The spectrum of pathogenic mutations in SPINK5 in 19 families with Netherton syndrome: implications for mutation detection and first case of prenatal diagnosis. J Invest Dermatol. 2001;117:179–87.PubMedCrossRef Sprecher E, Chavanas S, DiGiovanna JJ, Amin S, Nielsen K, Prendiville JS, et al. The spectrum of pathogenic mutations in SPINK5 in 19 families with Netherton syndrome: implications for mutation detection and first case of prenatal diagnosis. J Invest Dermatol. 2001;117:179–87.PubMedCrossRef
26.
go back to reference Capri Y, Vanlieferinghen P, Boeuf B, Dechelotte P, Hovnanian A, Lecomte B. A lethal variant of Netherton syndrome in a large inbred family. Arch Pediatr. 2011;18:294–8.PubMedCrossRef Capri Y, Vanlieferinghen P, Boeuf B, Dechelotte P, Hovnanian A, Lecomte B. A lethal variant of Netherton syndrome in a large inbred family. Arch Pediatr. 2011;18:294–8.PubMedCrossRef
27.
go back to reference Ml A, Sawamura D, Nomura Y, Sugawara M, Shimizu H. Truncation of CGI-58 protein causes malformation of lamellar granules resulting in ichthyosis in Dorfman-Chanarin syndrome. J Invest Dermatol. 2003;121:1029–34.CrossRef Ml A, Sawamura D, Nomura Y, Sugawara M, Shimizu H. Truncation of CGI-58 protein causes malformation of lamellar granules resulting in ichthyosis in Dorfman-Chanarin syndrome. J Invest Dermatol. 2003;121:1029–34.CrossRef
Metadata
Title
Role of molecular testing in the multidisciplinary diagnostic approach of ichthyosis
Authors
Andrea Diociaiuti
May El Hachem
Elisa Pisaneschi
Simona Giancristoforo
Silvia Genovese
Pietro Sirleto
Renata Boldrini
Adriano Angioni
Publication date
01-12-2016
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2016
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-016-0384-4

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