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ADAMTSL2 mutations determine the phenotypic severity in geleophysic dysplasia
Vladimir Camarena, Monique M. Williams, Alejo A. Morales, Mohammad F. Zafeer, Okan V. Kilic, Ali Kamiar, Clemer Abad, Monica A. Rasmussen, Laurence M. Briski, LéShon Peart, Guney Bademci, Deborah S. Barbouth, Sarah Smithson, Gaofeng Wang, Lina A. Shehadeh, Katherina Walz, Mustafa Tekin
Vladimir Camarena, Monique M. Williams, Alejo A. Morales, Mohammad F. Zafeer, Okan V. Kilic, Ali Kamiar, Clemer Abad, Monica A. Rasmussen, Laurence M. Briski, LéShon Peart, Guney Bademci, Deborah S. Barbouth, Sarah Smithson, Gaofeng Wang, Lina A. Shehadeh, Katherina Walz, Mustafa Tekin
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Resource and Technical Advance Genetics

ADAMTSL2 mutations determine the phenotypic severity in geleophysic dysplasia

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Abstract

Geleophysic dysplasia-1 (GD1) is an autosomal recessive disorder caused by ADAMTS-like 2 (ADAMTSL2) variants. It is characterized by distinctive facial features, limited joint mobility, short stature, brachydactyly, and life-threatening cardiorespiratory complications. The clinical spectrum spans from perinatal lethality to milder adult phenotypes. We developed and characterized cellular and mouse models, to replicate the genetic profile of a patient who is compound heterozygous for 2 ADAMTSL2 variants, namely p.R61H and p.A165T. The impairment of ADAMTSL2 secretion was observed in both variants, but p.A165T exhibited a more severe impact. Mice carrying different allelic combinations revealed a spectrum of phenotypic severity, from lethality in knockout homozygotes to mild growth impairment observed in adult p.R61H homozygotes. Homozygous and hemizygous p.A165T mice survived but displayed severe respiratory and cardiac dysfunction. The respiratory dysfunction mainly affected the expiration phase, and some of these animals had microscopic post-obstructive pneumonia. Echocardiograms and MRI studies revealed a significant systolic dysfunction, accompanied by a reduction of the aortic root size. Histology verified the presence of hypertrophic cardiomyopathy with myocyte hypertrophy, chondroid metaplasia, and mild interstitial fibrosis. This study revealed a substantial correlation between the degree of impaired ADAMTSL2 secretion and the severity of the observed phenotype in GD1.

Authors

Vladimir Camarena, Monique M. Williams, Alejo A. Morales, Mohammad F. Zafeer, Okan V. Kilic, Ali Kamiar, Clemer Abad, Monica A. Rasmussen, Laurence M. Briski, LéShon Peart, Guney Bademci, Deborah S. Barbouth, Sarah Smithson, Gaofeng Wang, Lina A. Shehadeh, Katherina Walz, Mustafa Tekin

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Figure 4

Respiratory function and lung structure are abnormal in Adamtsl2 hemizygous and homozygous p.A165T mice.

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Respiratory function and lung structure are abnormal in Adamtsl2 hemizyg...
(A–F) Breathing was analyzed with whole-body plethysmography at 12 and 20 weeks of age in male and female mice. Indicators of expiration are significantly affected in mice with the p.A165T mutation. Data shown as mean ± SD (N = number of animals) (*, P < 0.05, **, P < 0.01, ***, P < 0.001, ****, P < 0.0001 2-way ANOVA). (G) MRI scans show ground glass opacifications and consolidations (arrows) in the lungs of A165T/A165T (mouse 1) and FRTLoxPKo/A165T (mouse 2). These animals had the most severe respiratory abnormalities in the plethysmography. MRI was performed in 4 WT, 4 R61H/R61H, 4 R61H/A165T, 5 A165T/A165T, and 3 FRTLoxPKo/A165T in 6-month male mice. (H and I) Histology from 3 WT, 3 FRTLoxPKo/A165T, 3 A165T/A165T, 3 A165T/R61H, and 3 R61H/R61H in 7-month male mice. (H) Microscopic post-obstructive pneumonia was found in areas of the lungs of FRTLoxPKo/A165T mouse 2 and of the lungs of A165T/A165T mouse 1. (I and J) Staining with CD68 macrophage marker shows large foamy macrophages filling alveolar airspaces, indicating microscopic post-obstructive pneumonia in the mouse whose MRI is shown in G. BPM, breaths per minute.

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