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Published in: Orphanet Journal of Rare Diseases 1/2017

Open Access 01-12-2017 | Research

What can the CF registry tell us about rare CFTR-mutations? A Belgian study

Authors: E. De Wachter, M. Thomas, S. S. Wanyama, S. Seneca, A. Malfroot

Published in: Orphanet Journal of Rare Diseases | Issue 1/2017

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Abstract

Background

CFTR2 provides clinical and functional information of the most common CFTR-mutations. Rare mutations (RMs) occur in only a few patients with limited reported clinical data. Their role in CF-disease liability is hardly documented.

Methods

Belgian CF-Registry 2013 data were analyzed to identify CF with at least 1 RM (CF+RM). Clinical data and sweat chloride of CF+RM were compared to CF-controls, carrying 2 class 1 to 3 mutations (CFclassic). Disease severity was compared between both groups. To avoid bias in the comparison, transplanted patients were excluded from each group.

Results

Seventy-seven CF+RM were identified (77/1183 = 6.5%). Sixty-four different RM were detected, of which 21 had not been previously reported. All RMs, corresponding to HGVS (Human Genome Variation Society) nomenclature, were listed in supplementary data.
Seven transplanted CF+RM were excluded for further analysis. CF+RM had higher age at diagnosis [median (IQR)] [3.7 y (0.3–18.3) vs. 0.3y (0.1–2,0) (p < 0.0001)], lower sweat chloride [96 mmol/L (64–107) vs. 104 mmol/L (97–115) (p < 0.0001)], higher FEV1%pred [77%pred (58–96) vs. 68%pred (48–86) (p = 0.017)], were less frequently pancreatic insufficient [56% vs. 98% (p < 0.0001)], Pseudomonas aeruginosa colonized [24% vs. 44% (p = 0.0093)] and needed fewer IV antibiotics [36% vs. 51% (p = 0.041)] than CFclassic. However, a wide spectrum of disease severity was seen amongst CF+RM.

Conclusions

CF-patients with a RM cover 6.5% of the Belgian CF-population. Rare mutations can be found in severely ill patients, but more often in late diagnosed, pancreatic sufficient patients.
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Literature
3.
5.
go back to reference Simmonds NJ, D'Souza LD, Roughton M, Alton EWFW, Davies JC, Hodson ME. Cystic fibrosis and survival to 420 years: a study of cystic fibrosis transmembrane conductance regulator function. Eur Respir J. 2011;37:1076–82. doi:10.1183/09031936.00079010.CrossRefPubMed Simmonds NJ, D'Souza LD, Roughton M, Alton EWFW, Davies JC, Hodson ME. Cystic fibrosis and survival to 420 years: a study of cystic fibrosis transmembrane conductance regulator function. Eur Respir J. 2011;37:1076–82. doi:10.​1183/​09031936.​00079010.CrossRefPubMed
6.
go back to reference Kerem BS, Rommens JM, Buchanan JA, Markiewicz D, Cox TK, Chakravarti A, et al. Identification of the cystic fibrosis gene: genetic analysis. Science. 1989;245:1073–80.CrossRefPubMed Kerem BS, Rommens JM, Buchanan JA, Markiewicz D, Cox TK, Chakravarti A, et al. Identification of the cystic fibrosis gene: genetic analysis. Science. 1989;245:1073–80.CrossRefPubMed
12.
go back to reference Rosenstein BJ, Cutting GR. The diagnosis of cystic fibrosis: a consensus statement. J Pediatr. 1998;132(4):589–95.CrossRefPubMed Rosenstein BJ, Cutting GR. The diagnosis of cystic fibrosis: a consensus statement. J Pediatr. 1998;132(4):589–95.CrossRefPubMed
15.
go back to reference Gobeau C, Wilschanski M, Skalicka V, Lebecque P, Southern KW, Sermet I, et al. Phenotypic characterization of patients with intermediate sweat chloride values: towards validation of the European diagnostic algorithm for cystic fibrosis. Thorax. 2009;64:683–91. doi:10.1136/thx.2008.104752.CrossRef Gobeau C, Wilschanski M, Skalicka V, Lebecque P, Southern KW, Sermet I, et al. Phenotypic characterization of patients with intermediate sweat chloride values: towards validation of the European diagnostic algorithm for cystic fibrosis. Thorax. 2009;64:683–91. doi:10.​1136/​thx.​2008.​104752.CrossRef
17.
go back to reference Bombieri C, Claustres M, De Boeck K, Derichs N, Dodge J, Girodon E, et al. Recommendations for the classification of diseases as CFTR-related disorders. J Cyst Fibros. 2011;10(S2):S86–S102.CrossRefPubMed Bombieri C, Claustres M, De Boeck K, Derichs N, Dodge J, Girodon E, et al. Recommendations for the classification of diseases as CFTR-related disorders. J Cyst Fibros. 2011;10(S2):S86–S102.CrossRefPubMed
18.
go back to reference Beekman JM, Sermet-Gaudelus I, De Boeck K, Gonska T, Derichs N, Mall MA, et al. CFTR functional measurements in human models for diagnosis, prognosis and personalized therapy: report on the pre-conference meeting to the 11th ECFS basic science conference, Malta 26–29 March 2014. J Cyst Fibros. 2014;13(4):363–72. doi:10.1016/j.jcf.2014.05.007.CrossRefPubMed Beekman JM, Sermet-Gaudelus I, De Boeck K, Gonska T, Derichs N, Mall MA, et al. CFTR functional measurements in human models for diagnosis, prognosis and personalized therapy: report on the pre-conference meeting to the 11th ECFS basic science conference, Malta 26–29 March 2014. J Cyst Fibros. 2014;13(4):363–72. doi:10.​1016/​j.​jcf.​2014.​05.​007.CrossRefPubMed
20.
22.
go back to reference Rowe SM, Miller S, Sorscher EJ. Mechanisms of disease: cystic fibrosis. N Engl J Med. 2005;352:1992–2001.CrossRefPubMed Rowe SM, Miller S, Sorscher EJ. Mechanisms of disease: cystic fibrosis. N Engl J Med. 2005;352:1992–2001.CrossRefPubMed
23.
go back to reference WangX DDW, Wypij D, Fay ME, Ferris BG Jr. Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol. 1993;15(2):75–88.CrossRef WangX DDW, Wypij D, Fay ME, Ferris BG Jr. Pulmonary function between 6 and 18 years of age. Pediatr Pulmonol. 1993;15(2):75–88.CrossRef
24.
go back to reference Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999;159(1):179–87.CrossRefPubMed Hankinson JL, Odencrantz JR, Fedan KB. Spirometric reference values from a sample of the general U.S. population. Am J Respir Crit Care Med. 1999;159(1):179–87.CrossRefPubMed
25.
go back to reference Rolland-Cachera MF, Cole TJ, Sempé M, Tichet J, Rossignol C, Charraud A. Body mass index variations: centiles from birth to 87 years. Eur J Clin Nutr. 1991;45:13–21.PubMed Rolland-Cachera MF, Cole TJ, Sempé M, Tichet J, Rossignol C, Charraud A. Body mass index variations: centiles from birth to 87 years. Eur J Clin Nutr. 1991;45:13–21.PubMed
27.
go back to reference Berwouts S, Morris M, Girodon E, Schwarz M, Stuhrmann M, Dequeker E. Mutation nomenclature in practice: findings and recommendations from the cystic fibrosis external quality assessment scheme. Hum Mutat. 2011;00:1–7. doi:10.1002/humu.21569. Berwouts S, Morris M, Girodon E, Schwarz M, Stuhrmann M, Dequeker E. Mutation nomenclature in practice: findings and recommendations from the cystic fibrosis external quality assessment scheme. Hum Mutat. 2011;00:1–7. doi:10.​1002/​humu.​21569.
28.
go back to reference den Dunnen DR, Maglott DR, Hart RK, Greenblatt MS, McGowan-Jordan J, et al. HGVS recommendations for the description of sequence variants: 2016 update. Hum Mutat. 2016;37:564–9. doi:10.1002/humu.22981.CrossRef den Dunnen DR, Maglott DR, Hart RK, Greenblatt MS, McGowan-Jordan J, et al. HGVS recommendations for the description of sequence variants: 2016 update. Hum Mutat. 2016;37:564–9. doi:10.​1002/​humu.​22981.CrossRef
29.
go back to reference Ooi CY, Dupuis A, Ellis L, Jarvi K, Martin S, Ray PN, et al. Does extensive genotyping and nasal potential difference testing clarify the diagnosis of cystic fibrosis among patients with single-organ manifestations of cystic fibrosis? Thorax. 2014;69:254–60. doi:10.1136/thoraxjnl-2013-203832.CrossRefPubMed Ooi CY, Dupuis A, Ellis L, Jarvi K, Martin S, Ray PN, et al. Does extensive genotyping and nasal potential difference testing clarify the diagnosis of cystic fibrosis among patients with single-organ manifestations of cystic fibrosis? Thorax. 2014;69:254–60. doi:10.​1136/​thoraxjnl-2013-203832.CrossRefPubMed
30.
go back to reference Ooi CY, Dupuis A, Gonska T, Ellis L, Ni A, Jarvi K, et al. Does integration of various ion channel measurements improve diagnostic performance in cystic fibrosis? Annals ATS. 2014;11(4):562–70.CrossRef Ooi CY, Dupuis A, Gonska T, Ellis L, Ni A, Jarvi K, et al. Does integration of various ion channel measurements improve diagnostic performance in cystic fibrosis? Annals ATS. 2014;11(4):562–70.CrossRef
31.
32.
go back to reference Burgel PR, Bellis G, Olesen HV, Viviani L, Zolin A, Blasi F, Elborn JS. On behalf of the ERS/ECFS task force on provision of care for adults with cystic fibrosis in Europe. Future trends in cystic fibrosis demography in 34 European countries. Eur Respir J. 2015;46:133–41. doi:10.1183/09031936.00196314.CrossRefPubMed Burgel PR, Bellis G, Olesen HV, Viviani L, Zolin A, Blasi F, Elborn JS. On behalf of the ERS/ECFS task force on provision of care for adults with cystic fibrosis in Europe. Future trends in cystic fibrosis demography in 34 European countries. Eur Respir J. 2015;46:133–41. doi:10.​1183/​09031936.​00196314.CrossRefPubMed
33.
go back to reference Kerem E, Viviani L, Zolin A, MacNiell S, Hatziagorou E, Ellemunter H, et al. On behalf of the ECFS patient registry steering group. Factors associated with FEV1 decline in cystic fibrosis: analysis of the ECFS patient registry. Eur Respir J. 2014;43:125–33. doi:10.1183/09031936.00166412.CrossRefPubMed Kerem E, Viviani L, Zolin A, MacNiell S, Hatziagorou E, Ellemunter H, et al. On behalf of the ECFS patient registry steering group. Factors associated with FEV1 decline in cystic fibrosis: analysis of the ECFS patient registry. Eur Respir J. 2014;43:125–33. doi:10.​1183/​09031936.​00166412.CrossRefPubMed
35.
go back to reference Chillon M, Dörk T, Casals T, Giménez J, FonknechtenN WK, et al. A novel donor splice site in intron 11 of the CFTR gene, created by mutation 1811+1.6kbA>G, produces a new exon: high frequency in Spanish cystic fibrosis chromosomes and association with severe phenotype. Am J Hum Genet. 1995;56:623–9.PubMedPubMedCentral Chillon M, Dörk T, Casals T, Giménez J, FonknechtenN WK, et al. A novel donor splice site in intron 11 of the CFTR gene, created by mutation 1811+1.6kbA>G, produces a new exon: high frequency in Spanish cystic fibrosis chromosomes and association with severe phenotype. Am J Hum Genet. 1995;56:623–9.PubMedPubMedCentral
36.
Metadata
Title
What can the CF registry tell us about rare CFTR-mutations? A Belgian study
Authors
E. De Wachter
M. Thomas
S. S. Wanyama
S. Seneca
A. Malfroot
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Orphanet Journal of Rare Diseases / Issue 1/2017
Electronic ISSN: 1750-1172
DOI
https://doi.org/10.1186/s13023-017-0694-1

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